(A Project of National Medical Centre Karachi)

PELVIC GIRDLE & LOWER LIMBS.PELVIC GIRDLE & LOWER LIMBS.BY:

Shahzad Bashir.Lecturer, NMC ION.

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O B J E C T I V ES• Identify the bones of the pelvic girdle and their

principal markings.

• Describe the division of the pelvic girdle into false and true pelvis.

• Compare the principal differences between female • Compare the principal differences between female and male pelvis.

• Identify the bones of the lower limb and their principal markings.

• Describe the joints between the upper limb bones.

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BONES OF THE LOWER LIMBS.

S. NO. REGION NAME NUMBER.

1. PELVIS Innominate Bone. 1

2. THIGH Femur. 1

3. KNEE Patella. 13. KNEE Patella. 1

4. LEG Fibula/ Tibia. 1 Each

5. ANKLE Tarsals 7.

6. FOOT. Metatarsals 5.

7. TOES Phalanges 14.

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PELVIC (HIP) GIRDLE.

• The pelvic (hip) girdle consists of the two hip bones.

• Also called coxal or pelvic bones or coxa (cox= hip).(cox= hip).

• The hip bones unite anteriorly at a joint called the symphysis pubic.

• They unite posteriorly with the sacrum at the SACROILIAC JOINTS, to form Bony Pelvis.

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BONES OF THE PELVIC GIRDLE

• Formed by two coxal (coxae) bones.• Composed of three pairs of fused bones.

– Ilium (Superior)– Ischium (Posterior)– Pubis (Anterior)– Pubis (Anterior)

• All three bones meet at a Cup- Shaped Cavity called ACETABULAM into which fits head of the FEMURto form FEMURO- ACETABULUM JOINT OR HIP JOINT.

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BONES OF THE PELVIC GIRDLE

• The total weight of the upper body rests on the pelvis.

• It protects several organs

– Reproductive organs

– Urinary bladder

– Part of the large intestine– Part of the large intestine

• Functionally, the bony pelvis provides a strong and stable support for the vertebral column and pelvic and lower abdominal organs.

• The pelvic girdle of the bony pelvis also connects the bones of the lower limbs to the axial skeleton.

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The Pelvis

Hip bone

Sacral promontory

Obturator foramen

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THE PELVISPelvic brim landmarks:

Sacral promontory

Sacroiliac joint

Hip bone

Pelvic

(hip)

girdle

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Pubic crest

Symphysis Pubic

Obturator foramenPelvic brim

Acetabulum

Sacrum

Coccyx

ILIUM• It is a Flat Bone.

• Makes the upper part of PELVIC BONE.

• Ileum is the largest part of the three components of the hip bone.

• Ilum contain FOUR major Features.1. ILIAC CREST: (For attachment of abdominal muscles).

2. ILIAC SPINES: (For attachment of muscles).

3. ARTICULAR SURFACE: (For articulation with Sacrum to form SACRO- ILIAC JOINT.

4. GREATER SCIATIC NOTCH: (Through which pass the sciatic nerve, the longest nerve in the body)

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THE PELVIS: RIGHT COXAL BONEAuricular surface

Superior ramus of pubis

Less

er s

ciat

ic n

otch

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ISCHIUM.• Irregular bone.

• The thickest and strongest portion of PELVIC BONE.

• Ischium is comprised of a superior body and an inferior ramus (ram= branch).

• Ischium contain three major Features.• Ischium contain three major Features.

1. ISCHIAL SPINES: (For attachment of Muscle).

2. LESSER SCIATIC NOTCH: (Through which passes lesser sciatic nerve).

3. ISCHIAL TUBEROSITY: (Lies below at the lowest point on which the trunk rests in the sitting position).

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PUBIS• Irregular bone.

• Consists of a body and 2 Rami (Superior & Inferior)

• The Pubis bone meet Anteriorly at SYMPHYSIS PUBIS.• Pubis also contain three major features:

1. OBTURATOR FORAMEN: (Largest foramen in the skeleton). A large whole through which pass the blood skeleton). A large whole through which pass the blood vessels and nerves vessels & is cover by Obturator membrane.

2. SYMPHYSIS PUBIS: Is the joint between the two pubes of the hip bones consists of a disc of fibrocartilage.

3. PUBIC ARCH:

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OBTURATOR FORAMEN.

• Largest foramen in the skeleton.

• A large whole below the ACETABULUM

through which pass the blood vessels and through which pass the blood vessels and

nerves vessels & is cover by Obturator

membrane.

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ACETABULAM

• Deep Cup-shaped Cavity formed at the union

of the 3 bones.

• Pubis forms the front part.• Pubis forms the front part.

• Ilium form the upper part.

• Ischium form the back part.

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GENDER DIFFERENCES OF THE PELVIS.

• It is divided into 2 parts by the BRIUM OF THE

PELVIS.

• The GREATER OR FALSE PELVIS is above the

BRIUM.

• The LESSER OR TRUE PELVIS is below the

BRIUM.

• The female pelvis is wider than male for child birth.

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GENDER DIFFERENCES OF THE PELVIS

• The female inlet is larger and more circular.• The female pelvis as a whole is shallower, and

the bones are lighter and thinner.• The female ilia flare more laterally.• The female sacrum is shorter and less curved.• The female ischial spines are shorter and

farther apart; thus the outlet is larger.• The female pubic arch is more rounded

because the angle of the pubic arch is greater.

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GENDER DIFFERENCES OF THE PELVIS

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GENDER DIFFERENCES OF THE PELVIS

• Comparison of Female and Male Pelves.S.No. POINT OF COMPARISON FEMALE MALE

1. General structure Light and thin. Heavy and thick.

2. False (greater) pelvis Shallow. Deep.

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3. Pelvic brim (inlet) Larger and more oval. Smaller and heart-

shaped.

4. Acetabulum Small and faces anteriorly. Large and faces

laterally.

5. Obturator foramen Oval. Round.

6. Pubic arch Greater than 90 angle. Less than 90 angle.

JOINTS OF THE PELVIC GIRDLE.

• Sacro – Iliac Joint

• Symphysis Pubis.

• Femur- Acetabular • Femur- Acetabular

Joint. ( Hip Joint)

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LOWER LIMB (EXTREMITY)

• Each lower limb includes a femur, patella (kneecap), tibia, fibula, tarsals (ankle

Hip bone

SacrumFEMUR

fibula, tarsals (ankle bones), metatarsals, and phalanges (bones of the digits).

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PATELLA

TIBIAFIBULA

TARSALS

ME

TATA

RS

ALS

PHALANGES

LOWER LIMB

�Lower Limb Consists of :

• Femur• Patella• Tibia• Fibula

Patella

Femur

Fibula

Femur

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• Fibula• Tarsals• Metatarsals• Phalanges

Metatarsals

Fibula

Tibia

TTibia

(c) Lateral view

FibulaT Tibia

Lateralcondyle

(d) Posterior view

(b)

Medialcondyle

Femur

TTarsals

Phalanges

Patella

FEMUR.• Long bone, One in number.

• Also known as THIGH BONE.

• It is the longest and Strongest & heaviest bone • It is the longest and Strongest & heaviest bone

of the body.

• Extends from hip to thigh.

• Has a shaft and Two Extremities.

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FEMUR.• UPPER EXTREMITY:• 2/3rd sphere head with small Depression called

FOVEA CAPITIS for attachment of TERES LIAGMENT.

• Long Neck.• Greater Trochanter (Laterally)• Greater Trochanter (Laterally)• Lesser Trochanter ( Medially)• Inter- Trochanter Line ( Anteriorly)• Inter – Trochanteric Crest (Posteriorly)• Gluteal tuberosity (Posteriorly) for attachment of

thigh muscle.

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FEMUR.

• SHAFT:

• Cylindrical and Smooth.

• Curved forwards.

• LINEA ASPERA (Posteriorly), a rough line

posteriorly for the attachment of muscles.

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FEMURNeckHead

Fovea capitis Greatertrochanter

Glutealtuberosity

Lessertrochanter

Head

Greatertrochanter

Lessertrochanter

Intertrochanteric crest

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(a) (b)

LateralcondyleMedial

condyle

Intercondylarfossa

Medialepicondyle

Patellarsurface

Medialepicondyle

Lineaaspera

trochanter

Lateralepicondyle

Lateralepicondyle

FEMUR

Figure 5.25a–b

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FEMUR

HEAD

FOVEA CAPITISGREATER

TROCHANTER

View

Femur

NECKINTERTROCHANTERIC

CREST

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(c) Medial view of proximal end of femur

CREST

LESSER TROCHANTER

FEMUR.• LOWER EXTREMITY:

• Have 2 Condyles (Medial& Lateral) for articulation with TIBIA.

• Superior to the condyles are the medial and the lateral epicondyle, to which ligaments of the knee joint attach.attach.

• PATELLA SURFACE: Anteriorly for articulation with patella.

• INTER-CONDYLER FOSSA: Posteriorly B/W 2 Condyles.

• POPLITEAL SURFACE: Above the Fossa Posteriorly.

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JOINTS OF FEMUR.

• FEMURO- ACETABULAR JOINT. (Hip Joint)

• FEMURO – TIBIAL JOINT. (Knee Joint)

• ARTICULATES WITH PATELLA.

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HIP JOINT.Hip bone

HEAD

NECK

INTERTROCHANTERICLINE CREST

LESSER TROCHANTER

FEMUR

GLUTEAL

TUBEROSITY

GREATER

TROCHANTERGREATER

TROCHANTER

4/6/2013 30(a) Anterior view (b) Posterior view

FEMUR

BODY

(SHAFT)

MEDIAL EPICONDYLE

MEDIAL CONDYLE

Patella

Tibia FibulaFibula

LATERAL

CONDYLE

INTERCONDYLAR

FOSSA

LINEA ASPERA

LATERAL

EPICONDYLE

LATERAL

CONDYLE

PATELLA.

• Triangular bone one in number.

• Sesamoid bone developed in tendons of QUADRICEPS FEMORIS MUSLE.

• Also know as KNEE CAP.• Also know as KNEE CAP.• Lies in front of knee joint.

• BASE points upward.

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PATELLA.

• APEX points downwards.

• Anterior surface is rough.

• Posterior surface is smooth & contains two articular facets, one for the medial condyle and articular facets, one for the medial condyle and another for the lateral condyle of the femur to form PATELLOFEMORAL JOINT.

• Articulates with lower extremity of femur but does not take part in knee joint.

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(a) Anterior view (b) Posterior view

Base

Articular facetfor medialfemoral condyle

Articularfacetfor lateralfemoralcondyle

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Apex

Patella

TIBIA.• The tibia is larger, weight-bearing bone of the leg.

• The tibia articulates at its proximal end with the femur and fibula, and at its distal end with the fibula and the talus bone of the ankle.

• One in number.• One in number.

• Long bone.

• Also called SHIN BONE.• MEDIAL LEG BONE.

• Two Extremities and 1 Shaft.

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TIBIA

• Shin bone

• Medial to fibulaTibialtuberosity

Anteriorcrest

MedialCondyle

Intercondylareminence

LateralCondyle

Head offibula

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• Condyles

• Tibial tuberosity

• Anterior crest

• Makes the medial

malleolus

Tibia

Fibula

Medialmalleolus

crest

Lateralmalleolus

TIBIA.• UPPER EXTREMITY:

• Wide and flat.

• Medial & Lateral Condyles for articulation with Femur to form TIBIOFEMORAL JOINTS (knee).

• Inferior surface of the lateral Condyle is FACET for articulation with the head of the FIBULA (Laterally) to articulation with the head of the FIBULA (Laterally) to form SUPERIOR TIBIOFIBULAR JOINT.

• CARTILAGES lies on Condyles.

• INTERCONDYLAR EMINENCE: (Slightly concave condyles are separated by an upward projection).

• TIBIAL TUBEROSITY:(On the anterior surface is a point of attachment for the patellar ligament).

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TIBIA & FIBULA.

Femur.

INTERCONDYLAR

EMINENCE.

MEDIAL CONDYLE.

TIBIAL TUBEROSITY.

TIBIA.

Interosseous membrane.FIBULA.

HEAD.HEAD.

LATERAL

CONDYLE.

LATERAL

CONDYLE.

Patella

4/6/2013 37(a) Anterior view (b) Posterior view

Interosseous membrane.

ANTERIOR BORDER (CREST).

MEDIAL MALLEOLUS.

Talus.

Calcaneus.

LATERAL

MALLEOLUS.LATERAL

MALLEOLUS.

FIBULA.

TIBIA & FIBULA.

TIBIA.• SHAFT:• Triangular

• ANTERIOR BORDER (CREST) OR SHIN: (Anteriorly) (Inferior to the tibial tuberosity is a sharp ridge that can be felt below the skin)

• LOWER EXTREMITY:• MEDIAL MALLEOLUS: (Articulates with the talus of the ankle,

the prominence on the medial surface of the ankle.

• FIBULAR NOTCH: (Articulates with the distal end of the fibula to form the DISTAL/INFERIOR TIBIOFIBULAR JOINT.

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TIBIA.

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FIBULAR

NOTCH

MEDIAL

MALLEOLUS

Tibia

View

JOINTS OF TIBIA.

• FEMURO-TIBIAL JOINT.(With Tibia)

• SUPERIOR- TIBIO -FIBULAR JOINT.(Between Tibia

& Fibula).& Fibula).

• INFERIOR TIBIO -FIBULAR JOINT. (Between Tibia

& Fibula).

• TIBIO -TARSAL-JOINT (Ankle Joint)(With Talus).

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FIBULA.• One in number.• Long bone, Lateral bone of leg.• Fibula does not articulate with the femur, but it does help

stabilize the ankle joint.• Shaft and 2 Extremities.• Head of fibula articulates with the lateral Condyle of Tibia-

Forming PROXIMAL/SUPERIOR TIBIO FIBULAR Forming PROXIMAL/SUPERIOR TIBIO FIBULAR JOINT.

• Lower Extremity of Fibula have LATERAL MALLEOLUS articulates with Talus of Ankle.

• Lower extremity of also articulate with Tibia to form DISTAL/INFERIOR TIBIO-FIBULAR JOINT.

• Lateral Malleolus forms the prominence on the lateral surface of the ankle.

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TIBIA & FIBULA.

FIBULA.

Tibialtuberosity

Anteriorcrest

MedialCondyle

Intercondylareminence

LateralCondyle

Head offibula

• Lateral to tibia

• Long, slender

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Tibia

Fibula

Medialmalleolus

crest

Lateralmalleolus

• Head

• Makes the lateral

malleolus

• Non-weight bearing

JOINTS OF FIBULA.

• PROXIMAL/SUPERIOR –TIBIO-FIBULAR

JOINT.(Between Tibia & Fibula).

• DISTAL/INFERIOR- TIBIO-FIBULAR • DISTAL/INFERIOR- TIBIO-FIBULAR

JOINT.(Between Tibia & Fibula).

• FIBULO- TARSAL JOINT.(Ankle Joint)

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TARSALS• The tarsus (ankle) is the proximal region of the

foot and consists of seven tarsal bones.• They include the talus (ankle bone) and

calcaneus (heel), located in the posterior part of the foot.of the foot.

• The calcaneus is the largest and strongest tarsal bone.

• Joints between tarsal bones are called INTERTARSAL JOINTS.

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TARSALS.

Tibia

Fibula

Tarsals Bone: (7)• Calcaneus• Talus• Navicular

MNEMONIC for tarsal bones:Tall Centers Never Take Shots From Corners.

Talus Calcaneus Navicular Third cuneiform Second cuneiform First cuneiform Cuboid

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(b)

Tibia

TTalus

Navicular

Phalanges Calcaneus

MedialcuneiformMetatarsals

(metatarsus)

Tarsals(tarsus)

Calcanealtuberosity

• Navicular• Cuboid• Lateral (3rd) cuneiform• Intermediate (2nd) cuneiform• Medial (1st) cuneiform

FOOT

TARSALS.

• CALCANEUS OR OSCALIS:

• Largest of the Tarsals.

• Lies Posteriorly forming HEEL.• Lies Posteriorly forming HEEL.

• Articulates with TALUS superiorly.

• Articulates with anteriorly with CUBOID.

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TARSALS.

• TALUS:• The most superior tarsal bone, is the only bone of the foot that

articulates with the fibula and tibia.

• During walking, the talus transmits about half the weight of the body to the calcaneus.

• Central and highest point of foot.• Central and highest point of foot.

• Supports TIBIA , FIBULA and articulates with CALCANEUS inferiorly.

• NAVICULAR:• Boat-Shaped Bone.

• Lies medially, Talus behind and 3 Cuneiform in front.

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TARSALS.• CUNEIFORM:• Three in Number.

• Wedge – Shaped.

• Articulates with Navicular Posteriorly and with Metatarsals anteriorly & with Cuboid laterally.Metatarsals anteriorly & with Cuboid laterally.

• CUBOID:

• One in number.

• Cube-shaped.

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JOINTS OF TARSALS.

• TIBIO – TARSALS JOINT.

• FIBULO – TARSALS JOINT. Ankle Joint.

• INTERTARSAL JOINTS.(Between Tarsals)

• TARSO – META – TARSAL JOINT. (With

Metatarsals)

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METATARSUS.• The metatarsus, the intermediate region of the foot,

consists of five bone called Metatarsals.• The metatarsals articulate proximally with the first,

second, and third cuneiform bones and with the cuboid to form the TARSOMETATARSAL joints.

• Distally, they articulate with the proximal row of phalanges to form the METATARSOPHALANGEAL joints.to form the METATARSOPHALANGEAL joints.

• The first metatarsal is thicker than the others because it bears more weight.

• JOINTS OF META-TARSALS.• TARSO-META-TARSALS.(With Tarsals)

• META-TARSO- PHALANGEAL JOINT.(With Phalanges)4/6/2013 53

FOOT

III III

IVVV

FOOT

Calcaneus

Talus

Navicular

Tarsals(tarsus)

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Navicular

CuboidLateral cuneiformIntermediate cuneiform

Medial cuneiform

Proximal phalanx

Middle phalanx

Distal phalanx Phalanges

Metatarsals (metatarsus)

54

32 1

(a)

PHALANGES.• The phalanges comprise the distal component of the foot.

• Each phalanx (singular) consists of a proximal base, an intermediate shaft, and a distal head.

• The great or big toe is called hallux has two phalanges.

• The other four toes each have three phalanges—proximal, middle, and distal.(Total 14 in numbers in each Side)

• Joints between phalanges of the foot, like those of the hand, are called INTERPHALANGEAL joints.

• Long bone forming Toes.

• JOINTS OF PHALANGES.

• META-TARSO-PHALANGEAL JOINT.(With Metatarsals).

• INTER- PHALANGEAL JOINT.(Between Phalanges).4/6/2013 56

FOOT

ARCHES OF THE FOOT

• Bones of the foot are arranged to form three strong arches

• Arches are fully developed by age 12 or 13.– Two longitudinal (Lateral & Medial).

– One transverse.

�FUNCTION OF ARCHES:

�Arches help the foot support and distribute the weight of the body and provide leverage during walking.

ARCHES OF THE FOOT

JOINTS OF UPPER LIMBS.

• Acromio-Clavicular Joint.• Sterno-Clavicular Joint.• Humero -Scapular Joint. (Shoulder Joint)• Humero- Ulnar Joint. (Elbow Joint)• Humero- Radial Joint. • Humero- Radial Joint. • Superior -Radio Ulnar Joint.• Inferior- Radio Ulnar Joint.• Radio –Carpal Joint. (Wrist Joint)• Carpo –Meta-Carpal Joint.• Meta Carpo –Phalangeal Joint.• Inter- Phalangeal Joint.

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JOINTS OF LOWER LIMBS. • Femuro - Acetabular Joint (Hip Joint)• Femuro – Tibial Joint (Knee Joint)• Superior – Tibial - Fibular Joint.• Inferior – Tibial – Fibular Joint.• Tibio Tarsals Joint. (Ankle Joint)• Tibio Tarsals Joint. (Ankle Joint)• Fibulo - Tarsal Joint. • Tarso - Meta – Tarsal Joint.• Meta – Tarso- Phalangeal Joint.• Inter - Phalangeal Joint.

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REFERENCES

• Tortora, G. J. & Grabowski, S.R. (2000). Principles of anatomy and physiology (12th ed.). New York: John Wiley & sons Inc.

• Eline, N.M, Essential of human anatomy & • Eline, N.M, Essential of human anatomy & physiology (9th ed.). New York: John Wiley & sons Inc.

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