Summer Session II; Anatomy; Lecture 17; Joints of the lower limb

• -Synovial joint
• -Articulation between the sacrum and ilium
• -both surfaces contain iregular shapes that help bones interlock
• -strong joint capsule with the strongest ligaments in the body

• -Interosseous sacroiliac ligament
• -posterior sacroiliac ligament
• -anterior sacroiliac ligament
• -iliolumbar ligament
• -sacrotuberous ligament
• -sacrospinous ligament

• Interosseous Sacroiliac ligaments -massive, strong ligaments that unite the sacral and iliac tuberosities.
• • Posterior Sacroiliac ligaments -composed of short and long fibers that connect the sacrum and ilium posteriorly. It blends with the sacrotuberous ligament.
• • Anterior Sacroiliac ligaments -transverse fibers that support the anterior and inferior portion of the sacroiliac joint. Ligaments
• • Iliolumbar ligament -accessory ligament of the sacroiliac joint. It supports the L5-S 1 joint.
• • Sacrotuberous ligament -helps support the sacroiliac joint by preventing upward movement (nutation) of the sacrum • Sacrospinous ligament --helps support the sacroiliac joint by preventing upward movement (nutation) of the sacrum

acetabulum, femur and capsule

• -synovial joint (ball and socket)
• -articulation of the head of the ffumur and the acetabulum of the os coxae

• acetabular labrum
• 

• -bony rim
• -transverse acetabular ligament (spans the acetabular notch createing the acetabular foramen)

Provide passage of blood vessels and nerves to the joint cavity

attach the femur to the transverse acetabular ligament and the acetabular labrum; fovea capitis

• -Forms a cylindrical sleeve about the head and neck of the femur
• -has 4 thickenings that help to stregthen it;
• -iliofemoral ligament
• -ishiofemoral ligament
• -pubofemoral ligament
• -zona obicularis

• -extends from the AIIS and acetabular rim to the intertrochanteric line;
• it is tight in extension of the thigh;
• prevents hyperextension of the hip in standing
• 

• -extends from the acetabulum posteriorly and spirals superiorlaterally to the neck of femur and greater trochanter.
• -helps prevent hyperextension
• 

• -extends from the pubic part of the acetabulum and superior ramus of the intertrochanteric line;
• tuat in extension;
• -prevents excessive abduction of thigh
• 

• capusular fibers that encircle the neck of the femur
• 

• Anteriorly- bursa under the tendon of the iliopsoas
• Posteriorly- bursa for the tendon of obturator externus muscle (pic showed on posterior side of body)
• 
• 

Medial and lateral cirumflex arteries, and artery to the head of the femur

• Nerve;
• femoral nerve
• obturator nerve
• superior gluteal nerve
• nerve to quadraturs femoris

small rotation. Duh!

• 5
• Patellar ligament
• fibular collateral ligament or lcl
• tibial collateral ligament or mcl
• arcuate ligament
• oblique popliteal ligament

• A continuation of the quadrecipects tendon;
• Strengthens the anterior capsue of the knee
• 

• extends from the lateral epicodyle of the femur to the lateral surface of the head of the fibula.
• -It is partialy fused with the capusle on the superior end. Strengthens lateral capsule

• extends from the medial epicondyle of the femur to the medial surface of the tibia.
• -Strengthens fibrous capusle and is completely intrinsic.

Iliofemoral ligament of the hip joint and the Arcuate ligament of the knee joint

• Arcuate ligament (y-shaped)
• Oblique popliteal ligament ( also is part of the floor of the popliteal fossa *remember PCO- Patellar surface of the femur, Capsule of the knee joint and Oblique popliteal ligament)
• 

• Oblique popliteal ligament!
• 

• (6)
• Suprapatellar- extension of synovial capusule between the femur and quadriceps tendon.
• Popliteus- extension of synovial capusle between the popliteus and lateral condyle of the tibia.
• Gastrocnemius- exstension of synovial capusule between the medial head of gastroc and femur.
• Subcutaneuous prepatellar- b/w skin and patella
• Subcutanuous infrapatellar- b/w skin and tibial tuberosity
• Deep infrapatellar- b/w patellar ligament and tibia.
• 

• Anterior cruciate Ligament-prevents posterior displacement of the femur on the tibia and hyperextension of the knee joint.
• Posterior cruciate ligament- prevents anterior displacement of the femur on the tibia or posterior displacement of the tibia.

Arises from the anterior intercondyler area of the tibia and extends, superiorly/posteriorly/laterally to attach to the posterior part of the medial side of the lateral condyle of the femur.

Posterior Cruciate ligament

• Arises from the posterior aspect of the intercondyler area of the tibia and passes anteriorlly and superiorly on the medial side of the ACL to the anterior part of the lateral side of the medial condyle of the femur.
• -Main stablizer of the flexed knee during gait

• - two fibrocartilaginous discs
• -deepens the shallow articular fossa of the tibia
• -medial meniscus (c shaped) and lateral meniscus (o shaped)
• -transverse meniscal ligament

• -c shaped
• -firmly attached to the tibial collateral ligament (or MCL)
• -attached along the periphery of the tibial condyle by coronary ligaments
• 

• The tendon of the popliteas muscle;
• "O shape";
• coronary ligaments;
• strong tendinous extension of the lateral mensiucs that attaches to the PCL and medial condyle of the femur.
• 

• Ligament of Wrisberg; (this ligament is more common)
• Ligament of humphrey

• -genicular branches
• innervation-
• obturator n
• femoral n.
• tibial n.
• common peroneal n.