what three bones contribute the acetabulum

ilium, ischium, pubis

what is structural classification of the hip joint

synovial spheroid joint

what is the functional classification of the hip joint

diarthrosis

how many planes does the hip joint have motion in

three planes

triplanar

 what movements are available at the hip joint

flexion

extension

abduction

adduction

circumduction

internal and external rotation

what are the extrinsic ligaments of the hip

iliofemoral ligament

pubofemoral ligament

ischiofemoral ligament

what do the extrinsic ligaments of the hip do

limit extension of the hip

what are the proximal attachments of the iliofemoral ligament

inferior part of the AIIS

and the iliac part of the acetabular rim

what are the two bands of the iliofemoral ligament

upper band

lower band

where do the upper and lower bands of the iliofemoral ligament attach

upper = superior part of the intertrochanteric line

lower = inferior part of the intertrochanteric line

what is the proximal attachment of the pubofemoral ligament

the pubic part of the acetabular rim and lateral part of superior pubic ramus

what is the proximal attachment of the ischiofemoral ligament

ischial part of the acetabular rim

where do the pubofemoral and ischiofemoral ligaments blend with the hip joint capsule

pubofemoral = medially

ischiofemoral = at femoral neck

what are the intrinsic ligaments of the hip joint

Zona obicularis

transverse acetabular ligament

ligamentum capitis femoris

what is the zona orbicularis

thickened constricted area of the capsule around the neck of the femur

a ligament with no bony attachments

zona orbicularis

this converts the acetabular notch into the acetabular foramen

transverse acetabular ligament

what are the attachments of ligamentum capitis femoris

 proximally to the margins of the acetabular notch and the transverse acetabular ligament within the acetabulum

distally to the margins of the fovea capitis femoris

this ligament transmits an artery to the head of the femur and is important in infants under 3

ligamentum capitis femoris

what is the proximal attachment of capsule 

the exterior rim of the acetabulum

what are the distal, anterior, posterior attachements of the hip joint capsule

distal = neck of the femur

anterior = inferior margin of the femoral neck at the intertrochanteric line

posterior = to the mid region of the neck

what is the retinacula

bundles of longitudinal capsular fibers that reflect superiorly along the femoral neck after having reached the inferior margin of the capsular limits

what is the purpose of the retinacula

allows for passage of blood vessels from the capsule and synovial lining to the head of the femur

main area for passage of vessels to nourish head and neck of femur after 3

what is the acetabular labrum

pad of fibrocartilage that lies along and attaches to the acetabular rim

what is the function of the acetabular labrum

to deepen the joint which provides a better fit between the bone ends

what is synovium

lines all the structures contained within the joint capsule except the articular surfaces of the bones

what are the arteries that supply the hip joint

 artery to the ligamentum capitis femoris

medial femoral circumflex artery

lateral femoral circumflex artery

superior gluteal artery

inferior gluteal artery

what is the artery to the ligamentum capitis femoris

branch of acetabular artery which is a branch of the posterior division of the obturator artery

passes into acetabulum via acetabular foramen

supplies head of femur but not primary supply after 3

which branch of the medial femoral circumflex artery supplies the neck and head of the femur

acending branch passes along the intertrochanteric crest

what branch of the lateral femoral circumflex artery supplies the neck and head of the femur

ascending branch passes along the intertrochanteric line

what does the ascending branch of the lateral and medial femoral circumflex arteries pass along to supply the neck and head of the femur

medial = intertrochanteric crest

lateral = intertrochanteric line

this provides the major bloos supply to the head and neck of the femur after 3 yrs of age

trochanteric anastomosis

what arteries are involved in the trochanteric anastomosis

superior gluteal artery

inferior gluteal artery

medial femoral circumfles

lateral femoral circumflex

what arteries are involved in the cruciate anastomosis

medial femoral circumflex

inferior gluteal

lateral femoral circumflex

first perforating of the profunda femoris artery

what branch of the lateral amd medial femoral circumflex arteries are involved in the cruciate anastomosis

 medial = transverse posterior

lateral = transverse anterior

where is the cruciate anastomosis located at

near the lesser trochanter of the femur

the largest sesamoid in the body

patella

what does the patella articulate with

femur

what does the patella do

provides leverage for the quadriceps femoris muscle

what are the longitudinal rigdes on the patella

striae

what are the two facets on the posterior side of the patella

lateral facet = articulates with lateral condyle of femur

medial facet = articulates with the medial condyle of the femur

which parts of the patella are rough and which are smooth

rough = anterior side, medial, lateral, and superior edges of the posterior side

Smooth = posterior side for articulation with condyles

when do patella centers of ossification appear and when do they fuse

appear = between 3 to 6 yrs of age

fuse = by puberty

what do we get when the patella centers do not fuse

bipartite patella

the shin bone

tibia

what are the articulations of the tibia

superior = femur

lateral = fibula

inferior = talus

what are the two large projections at the proximal end of the tibia

medial and lateral condyles

this is located on the inferior surface of the lateral condyle of the tibia

fibular facet

the central superior projection

intercondylar eminence

the patellar tendon attaches here

tibial tuberosity

large projection on the anterior surface of the tibia

tibial tuberosity

this is easily palpated inferior to the patella

tibial tuberosity

what is located along the line that extends from the lateral edge of the tibial tuberosity to the lateral condyle

gerdys tubercle

where does the iliotibial tract attach to

gerdys tubercle

where is gerdys tubercle palpated at

just lateral to the apex of the patella with the knee extended

what are the landmarks for the shaft of the tibia

tibial tuberosity superioly

fibular notch inferiorly

how is the shaft of the tibia divided

into thirds lengthwise

what is the tibial crest

curved sharp anterior line on the shaft

what is the medial surface of the tibia

subcutaneous rounded surface that faces anteromedially

what is the interosseous border/lateral border

the border that provides attachment for the interosseous membrane

intermediate to lateral and posterior surfaces

what is the lateral /extensor surface of the tibia

slightly concave surface that faces laterally and is lateral to the tibial crest

what does the distal extermity of tibia articulate with

talus

what is the pear shaped facet on teh lateral surface of the medial malleolus

talar articular facet

what does the talar articular facet articulate with

talar body

what is the inferior articular surface of the tibia called

tibial plafond

what does the tibial plafond articulate with

talar body

the horizontal groove on the posterior surface near the articular facet of the condyle

groove for insertion of semimembranosus muscle

this extends from the fibular facet to the medial border at the junction of the proximal and middle thirds

popliteal line/soleal line

this begins near the middle of the soleal line and extends inferiorly to the inferior one third

vertical line

this is located inferior to the popliteal line and usually lateral to the vertical line

nutrient foramen

the longitudinal depression on the posterior surface of the medial malleoulus

groove for tibialis posterior and flexor digitorum longus tendon

sometimes called the third malleolus

posterior process

this is the posterior lateral prominence of distal tibial extremity

posterior process

what is the longitudinal depression over the posterior process of the tibia

groove for flexor hallucis longus tendon

 this articulates with the fibula at the tibiofibular syndesmosis

fibular notch

this is a large triangular depression on the lateral surface of the distal extremity of the tibia

fibular notch

this articulates with the medial femoral condyle

articular facet of the medial condyle

this articulates with the lateral femoral condyle

articular facet of the lateral condyle

this lies intermediate to the medial and lateral tibial condyles and runs from the intercondylar eminence to the anterior surface of the tibia

 anterior intercondylar fossa

this lies intermediate to the tibial medial and lateral condyles from the intercondylar eminece to the posterior surface of the tibia

posterior intercondylar fossa

what is the anterior projection at the inferior edge of the medial malleolus

anterior colliculus

what is the posterior projection at the inferior edge of the medial mallelous

posterior colliculus

what is the pear-shaped articular facet on the lateral surface of the medial malleolus

medial malleolar facet

where is the primary center of ossification for the tibia and when does it appear

in the shaft at the 7th fetal week

where are the secondary centers of ossification of the tibia at and when do they appear

one in each extremity

proximal appears at birth

distal appears by age 1

when do the secondary centers of ossification of the tibia fuse

fuse in reverse order between 15 to 18

this bone carries about 15% of the body weight

fibula

what bones does the fibula articulate with

proximally and distally with the tibia

distomedially with the talus

why is the proximal extremity of the fibula a important landmark

because the common fibular nerve passes superfically around the fibular head and neck and can be damaged through physician error

where does the articular facet of the head of the fibular articulate at

articulates at the fibular facet on the lateral condyle of the tibia

this is a small blunt superoposterolateral projection on the fibula

apex of the fibula/styloid process of the fibula

what are the borders and surfaces of the shaft of the fibula

anterior border

interosseous border

medial surface/extensor surface

crista medialis/medial crest

posterior surface/flexor surface

this splits at the distal extremity and forms the smooth lateral surface

anterior border

this extends from the head to the roughened triangular area at the distal extremity

interosseous border

what direction do the interosseous fibers run between the tibia and fibula

inferiorly from tibia to fibula  

 this is the narrow area that runs intermediate to the anterior and interosseous borders extending from the head to the lateral malleolus

medial surface/extensor surface

this is an oblique line on the posterior surface that extends from the head to the shafts distal 1/3

crista medialis/medial crest

this surface is divided by the crista medialis

posterior surface

this surface is located posterior to the interosseous border

posterior surface

the foot plantar flexors attach to which fibular surface

posterior surface

where is the nutrient foramen of the fibula located at

on the posterolateral surface posterior to the medial crest

this is a large triangular surface for articulation the talar body

malleolar articular facet

this is a deep fossa situated posterior to the facet of the lateral malleolus

lateral malleolar fossa/fibular fossa

this is a shallow groove on the posterior border of the lateral malleolus

lateral malleolar sulcus

this allows for passage of tendons, foot everters

lateral malleolar sulcus

this surface is immeadiately posterior to the anterior border

lateral surface/fibular surface/peroneal surface

the foot everters attach here

lateral surface of the fibula

this seperates the lateral and posterior surfaces

posterior border

what is the rounded distal end of the lateral malleolus

summit of the lateral malleolus

where is the primary center of ossification of the fibula and when does it appear

in the shaft appears around 8th fetal week

where are the secondary centers of ossification located at in the fibula and when do they appear

 one in each extremity

distal extremity during the first year

proximal extremity during the third year

when do the secondary centers of ossification fuse in the fibula

fuse between 15 to 19 years in the same order

how is tibiofibular torsion measured

the axis of the malleoli relative to the plane of the tibial condyles

what is the tibiofibular torsion angle at birth and as an adult

at birth 0

adult usualy around 16 to 23 degrees externally rotated

what is the clinical measurement of tibiofibular torsion called

malleolar position