anatomi - it 10 - the skeletal of lower limb - irh
TRANSCRIPT
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The Lower Limb
Pelvis, Thigh, Leg and Footdr. Irwan
Bagian anatomi
FK Unsri
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Surface Anatomy
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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?
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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.
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Surface Anatomy Gluteal region /
posterior pelvis
Iliac crest
Gluteus maximus Cheeks
Natal/gluteal cleft
Vertical midline;
Crack
Gluteal folds
Bottom of cheek;
prominence
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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.
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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
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Normal alignment Genu varum
(bowleg)
O
Genu valgum
X
1700 >1700
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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
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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
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Surface Anatomy
Anterior leg bones
Tibia
Tibial tuberosity Anterior crest
Medial surface
Medial malleolus
Fibula Lateral malleolus
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Skeletal
Composition
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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)
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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
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Knee
Patella
Triangular sesamoid
bone
Protects knee joint Improves leverage of
thigh muscles acting
across the knee
Contained withinpatellar ligament
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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
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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
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Foot
3 archesMedial
Lateral
Transverse Has tendons that run
inferior to foot bones
Help support archesof foot
Function Recoil after stepping
Longitudinal
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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
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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