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فصلت
53
الرحيم الرحمن هللا بسم
Joints of the lower limb
By
Dr –Shereen tawfeek
Assistant professor of anatomy
Jouf university
2. The following points must be discussed in any synovial joint:
1. Type of joint and its variety.
2. Articular parts.
3. Fibrous capsule and its attachments.
4. Synovial membrane.
5. Ligaments.
6. Movements.
7. Nerve and blood supply.
3. -Type:
a synovial joint of ball and socket type
-Articulating bones:
the head of the femur and the acetabulum.
The cavity of the acetabulum is deepened
by the presence of a fibrocartilaginous rim
called the acetabular labrum
Hip joint
4. The fibrous capsule
Attachment
• Proximally: the margin of the acetabulum and transverse ligament.
• Distally: intertrochantric line and greater trochanter anteriorly and
neck of femur posteriorly.
The fibrous capsule is lined by the synovial membrane.
5. Ligaments of the joint
1-Iliofemoral ligament is a strongest ligament lie in the
front of the joint. it is inverted Y shaped.
2-Pubofemoral ligament it is triangular ligament lie in the
lower anterior part of the capsule.
3-Ischiofemoral ligament it is spiral in shape lie posteriorly.
4-The transverse acetabular ligament it converts the
notch into a tunnel through which the blood vessels and
nerves enter the joint.
5-Ligaments of the head of the femur it is flat attached to
the pit on the head of the femur and by its base to the
transverse acetabular ligament.
6. ligament of head
of femur
transverse
acetabular
ligament
Ligamentum
teres
Fovea of
head
7. Movements of the joint
Nerve supply: The hip joint is innervated by branches from
the obturator, femoral and sciatic nerves
8. • Type: a synovial joint of the hinge types.
• The articular surfaces
Above: femoral condyles & patella
Below: tibial condyles which is deepen by the mensci
• Fibrous capsule
The capsule of the joint attached to margins of articular
surfaces and surrrounds the sides and posterior aspect of the
joint. On the front of the joint the capsule is absent
The knee joint
9. These are a C shaped plates of
fibrocartilage which deepen the articular
surface of the tibial condyles, they are
medial and lateral and they attached to :
1-intercondylar area by their horns.
2-The margins of the tibial condyles.
The two mensci linked together
anteriorly by transverse ligaments of
the knee.
Mensci
10. 1-The ligamentum patellae which is a continuation
of the quadriceps femoris tendon run on the patella to
reach the tibial tuberosity.
2-Tibial collateral ligament: extends from the medial
epicondyle of the femur to the medial surface of shaft of the
tibia.
3-fibular collateral ligament: it is cord like ligament extends
from the lateral epicondyle of the femur to the head of the
fibula.
4-Oblique popliteal ligament it is the posterior
reinforcement of the capsule of the joint and it is extension
from the tendon of the semimembrenosus m.
Extra capsular Ligaments of the joint
11. Intracapsular ligaments (inside knee joint)
cruciate ligaments
these are two ligaments lie inside the joint cross each
other.
Anterior cruciate ligament extends from anterior
part of the intercondylar area of tibia to the
posterior part of the lateral condyle of the femur it
passes upward and backwards. It prevents
posterior displacement of the femur on the tibia.
Posterior cruciate ligament passes upwards and
forwards from the posterior part of the tibial
intercondylar area to the lateral surface of the
medial condyle of the femur. It prevents anterior
displacement of the femur on the tibia.
13. 1-Flexion: biceps, semitendinosus and
semimembranosus; assisted by the sartorius,
gracilis and popliteus.
2-Extension: quadriceps femoris m.
3-medial rotation: Popliteus, sartorius, gracilis
and semitendinosus (S.G.S).
4-Lateral rotation: biceps femoris m.
Movements of the joint
Nerve supply :The knee joint is innervated
by branches from the obturator, femoral,
tibial, and common fibular nerves.
14. unlocking of
knee joint
At the beginning of
flexion
Lateral rotation of femur on
tibia by Popliteus when the
foot is fixed on the ground
Or medial rotation of tibia on
femur by Popliteus when the foot
is raised from the ground
15. locking of
knee joint
medial rotation of femur on
tibia when the foot is fixed
on the ground
Or lateral rotation of tibia on
femur when the foot is raised
from the ground
At the end of full
extension
4 ligaments of knee are taut which
prevent further extension and
further rotation
16. Ankle joint
Type: a synovial joint of hinge type
Articulating bones:
• Above: distal end of the tibia and medial
malleolus medially and lateral malleolus of
the fibula laterally
• Below: the trochlea of the talus
17. Ligaments of the joint
1-Medial (Deltoid) ligament:
triangular in shape. Its apex is
attached above to the medial
malleolus and its broad base is
attached below to a line that
extends from the tuberosity of
the navicular bone in front to
the medial tubercle of the talus
behind.
18. 2-Lateral ligament : consists of
composed of three separate
ligaments:
A-the anterior talofibular ligamen:
from the lateral malleolus to the
talus
B-the posterior talofibular ligament:
from the malleolar fossa to the talus;
C-the calcaneofibular ligament:
malleolar fossa to calcaneus
19. Movements of the joint
A- Dorsiflexion:
Tibialis anterior,Peroneus tertius, Extensor
digitorum longus and Extensor hallucis longus
B- Plantarflexion:
Gastrocnemius,Flexor digitorum longus
Peroneus longus,Plantaris,Soleus and
Tibialis Posterior
The nerve supply of the ankle
joint is deep peroneal and tibial
nerves.
20. Subtalar joint:
between the inferior surface of the talus
and the superior surface of the calcaneus
Talocalcaneonavicular joint :
head of the talus articulates with the calcaneus
and plantar calcaneonavicular ligament (spring
ligament) below and the navicular in front
Movements
Inversion:Tibialis anterior,Tibialis posterior
Eversion: Peroneus longus,Peroneus
brevis,Peroneus tertius