ANATOMI - IT 10 - the Skeletal of Lower Limb - IRH

8/10/2019 ANATOMI - IT 10 - the Skeletal of Lower Limb - IRH

1/20

The Lower Limb

Pelvis, Thigh, Leg and Footdr. Irwan

Bagian anatomi

FK Unsri


2/20

Surface Anatomy


3/20

Vignette Two years ago, Suryani was out-maneuvering a

teammate during soccer practice when she

heard "a pop" coming from her left knee. The

pain was instantaneous. "It felt like glass

breaking," she says, "I fell over, and I knew it

wasn't good.

Her knee develops swelling, which typically lasts

three to four weeks. What is diagnosis and pathofiology of this case?


4/20

Diagnosis: ACL Tears

Suryani had just torn a part of her knee calledthe anterior cruciate ligament, or ACL. All too

common among athletes, an ACL injury is

usually caused by a sudden deceleration or

landing maneuver with the leg in a vulnerable

position. Although ACL injuries are most often

seen in team sports, 70 percent are incurred with

little or no contact with another athlete. As withSuryani, the athlete often reacts to a nearby

player, and the sudden movement causes the

ACL tear.


5/20

Surface Anatomy Gluteal region /

posterior pelvis

Iliac crest

Gluteus maximus Cheeks

Natal/gluteal cleft

Vertical midline;

Crack

Gluteal folds

Bottom of cheek;

prominence


6/20

Nelatons line

a line drawn from the anterior

superior lilac spine to the

ischial tuberosity, passing over

or near the top of the greater

trochanter. The trochanter can

be felt superior to this line in a

person which a dislocated hip

or a fractured femoral neck.


7/20

Coxa vara

(abnormally decreased angle ofinclination, it occurs in fractures

of the neck of the femur and

slipping of the femoral

epiphysis )

Coxa valga

(abnormally increasedangle of inclination, in

cases of congenital

dislocation of the hip)

Normal angle

of inclination1250-1300


8/20

Normal alignment Genu varum

(bowleg)

O

Genu valgum

X

1700 >1700


9/20

Surface Anatomy

Anterior thigh and leg

Palpate

Patella

Condyles of femur

Femoral Triangle

Boundaries:

Sartorius (lateral)

Adductor longus (medial) Inguinal ligament (superior)

Contents:

Femoral artery, vein and

nerve, lymph nodes


10/20

Surface Anatomy

Posterior leg Popliteal fossa

Diamond-shape fossabehind knee

Boundaries

Biceps femoris(superior-lateral)

Semitendinosis andsemimembranosis(superior-medial)

Gastrocnemius heads

(inferior) Contents

Popliteal artery and vein

Calcaneal (Achilles)tendon


11/20

Surface Anatomy

Anterior leg bones

Tibia

Tibial tuberosity Anterior crest

Medial surface

Medial malleolus

Fibula Lateral malleolus


12/20

Skeletal

Composition


13/20

Bones of the Lower Limb

Function: Locomotion Carry weight of entire erect body

Support

Points for muscular attachments

Components: Thigh

Femur

Knee Patella

Leg

Tibia (medial) Fibula (lateral)

Foot Tarsals (7)

Metatarsals (5)

Phalanges (14)


14/20

Thigh

Femur Largest, longest,

strongest bone in thebody!!

Receives a lot ofstress

Courses medially More in women!

Articulates withacetabulum proximally

Articulates with tibia

and patella distally


15/20

Knee

Patella

Triangular sesamoid

bone

Protects knee joint Improves leverage of

thigh muscles acting

across the knee

Contained withinpatellar ligament


16/20

Leg

Tibia

Receives the weight of body

from femur and transmits to foot

Second to femur in size and

weight

Articulates with fibula proximally

and distally

Interosseous membrane

Fibula Does NOT bear weight

Muscle attachment

Not part of knee joint

Stabilize ankle joint


17/20

Foot Function: Supports the weight of the

body

Act as a lever to propel thebody forward

Parts: Tarsals

Talus = ankle

Between tibia and fibula

Articulates with both

Calcaneus = heel

Attachment for Calcanealtendon

Carries talus

Navicular

Cuboid

Medial, lateral andintermediate cuneiforms

Metatarsals

Phalanges


18/20

Foot

3 archesMedial

Lateral

Transverse Has tendons that run

inferior to foot bones

Help support archesof foot

Function Recoil after stepping

Longitudinal


19/20

Joints of Lower Limb

Hip (femur + acetabulum) Ball + socket

Multiaxial

Synovial

Knee (femur + tibia) Hinge (modified)

Biaxial

Synovial

Contains menisci, bursa, manyligaments

Knee (femur + patella)

Plane

Gliding of patella

Synovial


20/20

Joints of Lower Limb

Proximal Tibia + Fibula

Plane, Gliding

Synovial

Distal Tibia + Fibula

Slight give (synarthrosis) Fibrous (syndesmosis)

Ankle (Tibia/Fibula + Talus)

Hinge, Uniaxial

Synovial

Intertarsal & Tarsal-metatarsal Plane, synovial

Metatarsal-phalanges

Condyloid, synovial

Interphalangeal

Hinge, uniaxial

ANATOMI - IT 10 - the Skeletal of Lower Limb - IRH

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