Bones And Joints Of Lower Limb

Question 1

Where does the head of the femur articulate with the pelvis?

Answer 1

Acetabulum

Question 2

Which 2 parts come together to form the linea aspera?

Answer 2

Pectineal line and gluteal tuberosity

Question 3

Is the linea aspera on the anterior or posterior femur?

Answer 3

Posterior

Question 4

Is the intertrochanteric crest on the anterior or posterior femur?

Answer 4

Posterior

Question 5

Which side of the distal femur is the adductor tubercle on?

Answer 5

Medial side

Question 6

The medial malleolus is formed from which bone?

Answer 6

Tibia

Question 7

The lateral malleolus is formed from which bone?

Answer 7

Fibula

Question 8

Name the proximal tarsals

Answer 8

Talus

Calcaneus

Question 9

Name the intermediate tarsal

Answer 9

Navicular

Question 10

Name the distal tarsals

Answer 10

Cuboid

3 Cuneiforms

Question 11

How many tarsal do we have per foot?

Answer 11

7

Question 12

Where does the greater sciatic foramen run?

Answer 12

Down the lateral aspect of the ilium and round the posterior of the acetabulum

Question 13

What is the Pes Anserinus?

Answer 13

Conjoined tendons of 3 muscles that insert on the anterior, medial, proximal tibia
3 muscles: sartorius, gracilis and semitendinosus

Question 14

What shape is the ligament to the head of the femur?

Answer 14

Triangular

Question 15

What is special about the ligament of the head of the femur?

Answer 15

Contains small arterial blood supply to the head of the femur

Question 16

Which 3 parts of the pelvis come together at the acetabulum?

Answer 16

Ilium
Ischium
Pubis

Question 17

What do we call the part of the acetabulum where it is incomplete inferiorly?

Answer 17

Acetabular notch

Question 18

Which ligament supports the inferior part of the acetabulum?

Answer 18

Transverse acetabular ligament

Question 19

Which 3 ligaments reinforce the joint capsule of the hip?

Answer 19

Iliofemoral
Pubofemoral
Ischiofemoral

Question 20

Describe the iliofemoral ligament

Answer 20

Y shaped 
One of the strongest ligaments in the body
Ilium to intertrochanteric line
Prevents hyperextension 
Reinforces anterior and superior portion

Question 21

Describe the pubofemoral ligament

Answer 21

Attaches to pubic bone and femur
Protects anteriorly
Prevents over abduction

Question 22

Describe the ischiofemoral ligament

Answer 22

Posterior
Weakest of the 3
Ischium to the femur
Limits extension

Question 23

Of the quadriceps, which is the only one that can exert an affect on the hip?

Answer 23

Rectus femoris

Question 24

Name the main hip flexors

Answer 24

Iliopsoas
Rectus femoris
Sartorius

Question 25

Name the adductors of the hip

Answer 25

``` Adductor magnus Adductor longus Adductor brevis Pectineus Gracilis Obturator externus ```

Question 26

Which nerves supply the hip joint and at which faces?

Answer 26

Femoral nerve = anterior Nerve to quadratus femoris = posterior Obturator nerve = inferior Gluteal superior nerve = superior

Question 27

What is the major source of blood supply to the hip?

Answer 27

Medial circumflex femoral artery | Lateral circumflex femoral artery

Question 28

What is the minor blood supply to the hip?

Answer 28

Obturator artery via ligament of head of femur

Question 29

Which type of femoral fractures are more likely to result in avascular necrosis?

Answer 29

Intra capsular

Question 30

Define ankylosis

Answer 30

Stiffness of a joint due to abnormal adhesion

Question 31

What is between the condyles of the femur anteriorly and posteriorly?

Answer 31

``` Anterior = shallow depression for patella articulation Posterior = deep notch: intercondylar fossa ```

Question 32

Which condyle of the femur takes more weight when the knee is locked?

Answer 32

Medial condyle

Question 33

Where is the adductor tubercle of the femur?

Answer 33

At the medial epicondyle

Question 34

Describe the menisci of the knee

Answer 34

Crescenteric plates of fibrocartilage Thicker at the edges Attached to intercondylar areas, attached to joint capsule and anteriorly connected by transverse ligament of the knee

Question 35

Why do we need knee menisci?

Answer 35

Act as shock absorbers | Deepen surface for articulation

Question 36

How does the lateral meniscus of the knee vary from the medial meniscus?

Answer 36

Almost O shaped More mobile than the medial meniscus Attachments to the tibia are closer together Less likely to tear

Question 37

Why is a meniscal tear more likely to heal if it is on the edge?

Answer 37

Menisci have better outer blood supplies so a tear on the periphery is more likely to heal

Question 38

Which ligaments of the knee are intra capsular?

Answer 38

Cruciates (anterior and posterior)

Question 39

Which ligament of the knee strengthens the capsule?

Answer 39

Oblique popliteal ligament

Question 40

How do we remember the course of the cruciates?

Answer 40

PAMs APLs

Question 41

Describe the anterior cruciate ligament

Answer 41

Weaker than posterior Relatively poor blood supply Limits hyperextension

Question 42

Describe the posterior cruciate ligament

Answer 42

Stronger than anterior Limits hyperflexion Main stabiliser in weight bearing when knee is flexed

Question 43

Which muscle unlocks the knee?

Answer 43

Popliteus

Question 44

Describe the 'Unhappy Triad' of damage at the knee

Answer 44

Injury to medial collateral ligament, medial meniscus and anterior cruciate ligament

Question 45

How do we test for cruciate damage?

Answer 45

Anterior and posterior draw sign

Question 46

How does the patella usually dislocate?

Answer 46

Laterally

Question 47

Which are the 3 bursae in which bursitis commonly occurs at the knee?

Answer 47

Supra-patellar Pre-patellar Superficial infra-patellar

Question 48

Which bursa is inflamed in 'housemaid's knee'?

Answer 48

Pre-patellar

Question 49

Which bursa is inflamed in clergyman's knee?

Answer 49

Superficial infra-patellar

Question 50

Define avulsion

Answer 50

Fragment of bone pulled from main body by tendon or ligament

Question 51

When might ischial tuberosity avulsion occur?

Answer 51

In sports needing rapid contration and relaxation of the hamstrings eg. Sprinting

Question 52

Where is the gluteal tuberosity of the femur?

Answer 52

Posterior, lateral

Question 53

Where is the pectineal line of the femur?

Answer 53

Posterior, medial

Question 54

What attaches to the intercondylar fossa of the femur?

Answer 54

Cruciate ligaments

Question 55

What is the main blood supply to the head of the femur?

Answer 55

Medial circumflex artery

Question 56

Where does the patella ligament attach?

Answer 56

Tibial tuberosity

Question 57

What is the innervation of the hip?

Answer 57

Anterior: femoral and obturator nerves Posterior: superior gluteal nerve and nerve to quadratus femoris

Question 58

What are the main medial rotators of the thigh?

Answer 58

Semimembranosus | Semitendinosus

Question 59

What are the main lateral rotators of the thigh?

Answer 59

Gluteus maximus Biceps femoris (The larger muscles laterally rotate the thigh)