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Bones of Lower Limb
Dr. Heba Kalbouneh
Associate Professor of Anatomy and Histology
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Bones of the lower limb
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Hip Bone
• Made up of 3 bones:
1) Ilium (flat), superior in position
2) Ischium (L), postero-inferior in position
3) Pubis (V), antero-inferior in position
Ilium
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The three bones meet at the
Acetabulum:
a socket on the lateral surface of
hip bone where the femur
head articulates to form the
hip joint
The ilium, ischium and pubis meet
one another by means of triradiate
(Y-shaped) cartilage at the
Acetabulum. At puberty the triradiate
cartilage starts to ossify
and near the age of 17 the
triradiate cartilage will be
replaced by bony union
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Ilium
Symphysis pubis
Sacrum
Sacroiliac joint The hip bones articulate with the sacrum at the
sacroiliac joints posteriorly
The hip bones articulate with one another at the
symphysis pubis anteriorly
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Ilium
Lateral surface of hip bone
Outer
Gluteal
Posterolateral
Sacrum
Medial surface of hip bone
Inner
Pelvic
Anteromedial
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Ilium
Consist of:
Two parts:
body & wing (ala)
Four spines:
1: ASIS
2: AIIS
3: PSIS
4: PIIS
Two surfaces:
Gluteal surface (outer)
Sacropelvic surface (inner)
The superior border of
the wing: Iliac crest
(palpable)
Body
Ala
1
2
3
4
Left hip bone
Lateral view
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Iliac tubercle
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The gluteal surface is divided
into 4 parts
by three lines:
1- Posterior gluteal line
2- Anterior gluteal line
(middle)
3- Inferior gluteal line
The gluteal surface
Posterior gluteal line
Anterior gluteal line
Inferior gluteal line
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Left hip bone
Lateral view
Posterior Anterior
Superior
Inferior
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Left hip bone
Medial view
Posterior
Superior
Inferior
Look at the hip
bone from inner
(medial) side
Anterior
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Posterior
The sacropelvic surface
presents:
1- Iliac tuberosity: rough
area that gives attachment to
the interosseous and dorsal
sacroiliac ligaments
2- Auricular surface:
Smooth area articulates with
the sacrum to form the
sacroiliac joint
3- Iliac fossa: Smooth area
Medial border Forms the
Arcuate line which extends
to the
Ilio-pubic eminence
Left hip bone
Medial view
Iliac fossa
Anterior
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Posterior Anterior
Iliac fossa
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Posterior Anterior
Iliac tuberosity
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Posterior Anterior
Auricular surface
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Posterior Anterior
Arcuate line
Look at the hip
bone from inner
(medial) side
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Ilio-pubic eminence
Marks the point of union
between ilium and pubis
Posterior Anterior
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Pubis
(anterior-inferior)
Formed of a body and two rami:
superior and inferior
Pubic crest is the upper border of pubis
Pubic crest ends laterally by the pubic
tubercle
The medial surface of the body
articulates with the opposite pubis to
form the pubic symphysis
The inferior ramus of the pubic bone
joins the ischial ramus to form the
conjoined ramus.
Pectineal line is a ridge on the superior
pubic ramus
Body
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Pectineal line of pubic bone
Pubic tubercles
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Subpubic arch
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Ischium
(posterior-inferior)
Ischial spine
Lesser sciatic notch
Ischial tuberosity
Body
Ischial
ramus
Greater sciatic notch
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Ischial tuberosity
(Sitting bone)
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Acetabulum
It is a C-shaped cavity
located on the lateral
aspect of the hip bone
directed laterally,
downwards and forwards
It is notched inferiorly
by the acetabular notch
which is bridged by the
transverse acetabular
ligament (part of the
acetabular labrum)
The acetabular ligament
converts the acetabular
notch into foramen
Acetabular notch
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Its cavity presents a horse-shoe
shaped articular surface called
Lunate surface
The Lunate surface surrounds a
non articular depression called
acetabular fossa which is
occupied by fat tissue in living
Lunate surface
Acetabular fossa
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The ilium forms the
superior 2/5 of the
lunate surface
The pubis
forms the
anterior 1/5
of the lunate
surface
The ischium
forms the
posterior 2/5
of the lunate
surface
Ilium
Pubis
1/5
2/5
2/5
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Obturator foramen Covered by a membrane
in living subjects
The obturator canals for
the passage of the
obturator vessels and
nerve
Obturator muscles are attached to obturator
membrane
Posterior view
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Posteriorly:
2 notches
(greater & lesser
sciatic notches)
Posterior Anterior
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The sacrospinous ligament is a thin, triangular
ligament. The base of the ligament is attached
to the sacrum and coccyx, and the tip attaches
to the ischial spine
Coccyx
Sacrum
Ischial spine
Posterior view
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Sacrotuberous ligament runs from the sacrum,
coccyx and PSIS to the ischial tuberosity
Ischial tuberosity
PSIS
Coccyx
Sacrum
Posterior view
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This pair of ligaments helps to transition the
greater and lesser sciatic notches (indentations)
into the greater and lesser sciatic foramina
(openings).
Greater sciatic foramen
Lessor sciatic foramen
Posterior view
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Anatomical position of the hip bone
It is very important to understand the
anatomical position of the hip bone
In anatomical position:
1-The Anterior superior iliac spine and
the pubic tubercle lie in the same
vertical plane.
2-The ischial spine and the upper
border of the symphysis pubis lie in the
same horizontal plane.
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Ilium
The 2 hip bones
with the sacrum
form the pelvis
Now look! where does
the pelvis look? It is
looking right at you!
Never upwards
During your first practical
session, make sure to have a
look at the anatomical
position of the pelvis
Symphysis pubis
Sacrum
Sacroiliac joint
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Abdominal aorta bifurcates
into the left and right
common iliac arteries
Aortic bifurcation is at the
level of the fourth lumbar
vertebra L4
L4
Right common
iliac artery
Left common
iliac artery
Abdominal aorta
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Inguinal ligament
External iliac artery
Femoral artery
The fact that the pelvis is facing (looking) forward is
important to understand how
structures passing from the pelvis smoothly to join the
thigh
Notice, the external iliac artery as it passes from the
pelvis into thigh to become the femoral artery
What do you think about the femoral nerve and vein?
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External iliac artery
continues as femoral
artery
It enters the thigh
from behind the
inguinal ligament
Femoral vein
continues as
External iliac vein
It leaves the thigh
from behind the
inguinal ligament
External iliac artery
Femoral artery
Femoral vein
Femoral nerve
External iliac
vein
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The inguinal ligament is a band running from
the pubic tubercle to the anterior superior iliac
spine
The inguinal ligament is formed by the external
abdominal oblique aponeurosis
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External abdominal oblique
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Internal abdominal oblique
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Transversus abdominus
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Femur (thigh bone)
• Longest, heaviest, and strongest
bone in the body
• Proximally: articulates with the
acetabulum of the hip bone
forming the hip joint
• Distally: articulate with the tibia
and patella forming the knee
joint
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Proximal end
1. Head: (2/3 sphere)
2. Fovea capitis
3. Neck
4. Greater trochanter: (Lateral)
5. Lesser trochanter: (postero-medial)
6. Trochanteric fossa
7. Intertrochanteric line: (Anterior)
8. Intertrochanteric crest: (Posterior)
9. Quadrate tubercle
10. Gluteal tuberosity
11. Pectineal line of femur
Shaft
1. Linea Aspera: (posterior)
Distal end
1. Femoral Condyles (M & L)
2. Femoral epicondyles (M & L)
3. Intercondylar fossa (Posterior)
4. Patellar surface (Anterior)
5. Popliteal surface
6. Adductor tubercle
Femur (thigh bone)
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Anterior view
Head
Neck
Greater trochanter
Lesser trochanter
Intertrochanteric line
Medial Condyle Lateral Condyle
Lateral epicondyle Medial epicondyle
Patellar surface
Adductor tubercle
Trochanteric fossa
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Posterior view
Linea Aspera
Intercondylar fossa
Intertrochanteric crest
Gluteal tuberosity
Medial Condyle Lateral Condyle
Greater trochanter
Lesser trochanter
Medial supracondylar line Lateral supracondylar line
Adductor tubercle
Pectineal line
Quadrate tubercle
Popliteal surface
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Gluteal tuberosity Pectineal line
Medial supracondylar ridge Lateral supracondylar ridge
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Head of femur
The fovea capitis is an
ovoid depression of the
femoral head, and gives
attachment to the ligament
of head of femur
The ligament of head
of femur
(round ligament of the
femur, ligamentum
teres femoris)
Fovea capitis
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Tibia
Medial malleolus
(articulate with talus)
• Located medially
• Weight-bearing bone of the leg
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Lateral malleolus is
at the distal end of
fibula
Medial
malleolus is at
the distal end of
tibia
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Anterior
Medial Condyle Lateral
Condyle
Tibial tuberosity
Intercondylar area and
eminence
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Cross section in the shaft of tibia
Posterior surface Lateral
border
(Interosseous)
Anterior
border
Medial
border
Cross section in the shaft of fibula
Medial
border
(Interosseous)
Anterior
border
Late
ral
su
rfa
ce
Posterior
border
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Fibular facet
Posterior
surface
Soleal line
Interosseous
border
Anterior border
shin tibia Lateral
surface
Medial
surface
Medial
Condyle Lateral
Condyle
Tibial tuberosity
Medial border
Medial
malleolus
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The shaft of the tibia
is subcutaneous and
unprotected
anteromedially
throughout its course.
It is not surprising that
the tibia is the
commonest long bone
to be fractured
Anterior border
(shin tibia) Medial
surface
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Cross section in the shaft of fibula
Late
ral
su
rfa
ce
Provides origin to
The muscles in the lateral
compartment of the leg
Provides origin to some
of the flexor muscles of
the leg (Flexor surface)
Provides origin to
the extensor muscles of the leg
(Extensor surface)
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Fibula The lateral bone of the leg
Slender bone, smaller than
tibia: (No articulation with
femur)
Lateral malleolus
(articulate with talus)
Head
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Articular facet of the head Styloid process
Head
Neck
Lateral malleolus
Subcutaneous
triangular area
Malleolar fossa,
located on the medial
surface of the lateral
malleolus
Inferior
Posterior
medial
Helps to determine
left or right
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Patella
Known as the kneecap
Is triangular
Articulates with the femur
Covers and protects the anterior articular
surface of the knee joint
Is the largest sesamoid bone in the body is
embedded in the quadriceps femoris tendon
Upper part: Serves for the attachment
of the tendon of the quadriceps
muscle
Lower part: Serves as the origin of
the patellar ligament
The patellar ligament inserts into
tibial tuberosity
pat
ella
r li
gam
ent
Tibial
tuberosity
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Tarsal bones
1. Talus
2. Calcaneus
3. Navicular (little boat)
4. Medial Cuneiform (wedge-shape)
5. Intermediate Cuneiform
6. Lateral Cuneiform
7. Cuboid
Bones of the foot Tarsals (7)
Metatarsals (5)
Phalanges (14)
Tarsals Metatarsals Phalanges
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Calcaneus (heel= كعب)
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Talus (ankle= كاحل)
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Subtalar joint
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Calcaneus
Planter surface of the foot
(inferior)
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Talus
Planter surface of the foot
(inferior)
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Head of Talus
Planter surface of the foot
(inferior)
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Navicular bone
Planter surface of the foot
(inferior)
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Medial cuneiform bone
Planter surface of the foot
(inferior)
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Intermediate cuneiform bone
Planter surface of the foot
(inferior)
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Lateral cuneiform bone
Planter surface of the foot
(inferior)
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Cuboid
Planter surface of the foot
(inferior)
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1st 2nd
3rd
4th
5th
Proximal phalanx
Middle phalanx
Distal phalanx
Tuberosity of the
fifth metatarsal
bone
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The knee joint consists of two joints:
1- between the femur and tibia
(tibiofemoral joint)
2- between the femur and patella
(patellofemoral joint).
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The ankle joint is the joint
between the talus and the
distal ends of tibia and fibula
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The femoral triangle
The popliteal fossa
The posteromedial side of the ankle (Tarsal tunnel)
are important areas of transition through which
structures pass between regions
The femoral triangle is a pyramid-shaped depression formed
by muscles in the proximal regions of the thigh and by the
inguinal ligament. The major blood supply and one of the
nerves of the limb (femoral nerve) enter into the thigh from the
abdomen by passing under the inguinal ligament and into the
femoral triangle.
The popliteal fossa is posterior to the knee joint and is a
diamond-shaped region formed by muscles of the thigh and
leg. Major vessels and nerves pass between the thigh and leg
through the popliteal fossa.
The posteromedial side of the ankle: Most nerves, vessels,
and flexor tendons that pass between the leg and foot pass
through a series of canals (tarsal tunnel) on the posteromedial
side of the ankle. The canals are formed by adjacent bones and
a flexor retinaculum, which holds the tendons in position