MSK - Femur

Question 1

What other bones apart from the femur are present in the thigh?

Answer 1

None other, the femur is the only one!

Question 2

What is the main function of the femur?

Answer 2

Transmit forces from the tibia to the hip joint

Question 3

What end and what view of the femur is being shown here?

Answer 3

Proximal end

Anterior View

Question 4

What end and view of the femur is being shown here?

Answer 4

Proximal End

Posterior View

Question 5

What is the Bony Landmark highlighted in red?

What does it have on it’s medial surface and why?

Answer 5

The Head of the Femur

On it’s medial surface it has a depression for the attachment of the ligament of the head

Question 6

What is the bony landmark highlighted in yellow?

At what angle does it project, and what does this allow?

Answer 6

The Neck of the femur

It projects medially and superiorly, allowing for an increased range of movement at the hip joint

Question 7

What is the bony landmark highlighted in green?

What direction does it project in?

What muscles attach here?

Answer 7

The Greater Trochanter

Angled Superiorly and Posteriorly

Site of attachment for the abductor and lateral rotator muscles of the leg

Question 8

What is the bony landmark highlighted in blue?

What direction does it project in?

What muscles attach here?

Answer 8

The Lesser Trochanter

Projects posteriomedially

The psoas major and iliacus muscles attach here

Question 9

What Bony Landmark is indicated by the line?

What ligament attaches here?

After the ligament passes the lesser trochanter on the posterior surface, what is it known as?

Answer 9

Intertrochanteric Line

Iliofemoral ligament attaches here which is a very strong ligament of the hip joint

Known as the pectineal line

Question 10

What bony landmark is indicated by the line?

What is located on its superior half and what attaches here?

Answer 10

Intertrochanteric crest

Rounded tubercle on its superior half called the quadrate tubercle

Site of attachment for the quadratus femoris

Question 11

Within a year of a hip fracture, what fraction of people will die?

Answer 11

1/3rd

Question 12

What fractures are more common in the elderly?

Answer 12

Intracapsular Fracture

Question 13

What gender are more likely to suffer an intracapsular fracture?

Answer 13

Woman

Question 14

What structure can an intracapsular fracture damage?

What could this lead to?

Answer 14

Medialfemoral circumflex artery

Avascular necrosis of the femoral head.

Question 15

In which direction is the distal fraction pulled and in which direction does it rotate?

How would this manifest clinically?

Answer 15

Pulled Upwards

Rotated Laterally

Manifests as shorter leg with laterally pointing toes

Question 16

What age group do exracapsular fractures occur?

How do they manifest clinically?

Could blood supply be compromised?

Answer 16

Young and middle ages people

Same as intracapsular fractures, shorter leg with laterally pointing toes

No, so avascular necrosis is not possible

Question 17

In what direction does the shaft of the femur descend?

Answer 17

In a slightly medial direction

Question 18

What is the advantage of the slanted descent of the femur shaft?

Answer 18

Brings the knees closer to the body’s center of gravity, increasing stability

Question 19

On the posterior surface there are roughened ridges of bone known as what?

Answer 19

Linea Aspera

Question 20

Proximally, the lateral border of the linea aspera becomes what?

The medial border become what, and what attaches here?

Answer 20

Lateral - Pectineal line

Medial - Gluteal tuberosity - Gluteus maximus attaches

Question 21

Distally, the linea aspera widens and forms the floor of what bony landmark?

The medial and lateral borders form what other bony landmarks?

Answer 21

Forms the floor of the Popliteal fossa

Medial and lateral borders form the supracondylar ridges

(NOTE: The medial supracondyle line stops at the adductor tubercle, where the adductor magnus attaches)

Question 22

How common are fractures of the femur?

Answer 22

Relatively uncommon

Question 23

How do femur fractures occur?

Answer 23

Requires a lot of force such as in a car accident

Question 24

Spiral fractures of the femur present with leg shortening. Why is this?

Answer 24

Because of fragments being pulled by attachments and overriding

Question 25

Due to the method of injury typically being high energy, what may also be damaged?

Answer 25

Surrounding soft tissue

Question 26

When looking at a femur fracture, what other structure should be ensured hasn't been damaged?

Answer 26

**Femoral Artery** as it supplies the rest of the limb

Question 27

What is the distal end of the fibula characterised by?

Answer 27

Presence of the medial and lateral condyles

Question 28

Medial and lateral condyles articulate with what? What join is formed?

Answer 28

**Tibia** and **Patella**, forming the **knee joint**

Question 29

What bony landmark is highlighted in red? What do they articulate with?

Answer 29

**Medial and Lateral condyles** The posterior and inferior surfaces articulate with the tibia and misci of the knee, while the posterior surface articulates with the patella

Question 30

What bony landmarks are highlighted in green? What attaches here?

Answer 30

**Medial and lateral epicondyles** Some muscles and the collateral ligaments of the knee joint

Question 31

What bony landmark is indicated by the line?

Answer 31

The **Adduct**

Question 32

What bony landmark can be found lying on the posterior surface between the two condyles? What attaches here

Answer 32

**Intercondylar Fossa** Contains two facets for attachment of internal knee ligaments

Question 33

Name the two facets for attachment of internal knee ligaments in the intercondylar fossa and which wall they are found on

Answer 33

**Facet for attachment of the posterior cruciate ligament** **Facet for attachment of anterior cruciate ligament**