02.10.2018 1 SKELETON OF THE LOWER EXTREMITY (ossa membri inferioris) Lower extremity • organ of the locomotion • more robust constitution than the upper extremity • limited range of movements • posture – centroid S2 • pelvis and the vertebral column – functional unit • the most developmental changes - foot Skeleton of the pelvic girdle (Cingulum membri inferioris) Os coxae (hip bone) os ilium os ischii os pubis Skeleton of the free extremity (Ossa membri inferioris liberi) Femur Patella Tibia Fibula Ossa tarsi Ossa metatarsi Ossa digitorum pedis, phalanges (os ilium, os pubis, os ischii) Os coxae (hip bone) acetabulum facies lunata fossa acetabuli incisura acetabuli foramen obturatum Os ilium corpus ossis ilii ala ossis ilii fossa iliaca facies auricularis tuberositas iliaca linea arcuata sulcus praeauricularis 02.10.2018 2 Os ilium crista iliaca labium externum linea intermedia labium internum spinae iliacae spina iliaca anterior superior et inferior spina iliaca posterior superior et inferior linea glutaea posterior, anterior et inferior Os ischii corpus ossis ischii ramus ossis ischii tuber ischiadicum spina ischiadica incisura ischiadica major Incisura ischiadica minor Os pubis corpus ossis pubis ramus superior ossis pubis eminentia iliopubica pecten ossis pubis tuberculum pubicum sulcus obturatorius ramus inferior ossis pubis facies symphysialis crista phallica Pelvis Hip bones + sacral bone + symphysis Femur Proximal end caput femoris fovea capitis femoris Proximal end Body Distal end corpus femoris collum femoris trochanter major et minor linea intertrochanterica crista intertrochanterica fossa trochanterica linea aspera labium mediale (linea pectinea) labium laterale (tuberositas glutaea) Femur 02.10.2018 3 Distal end condylus medialis condylus lateralis epicondylus medialis epicondylus lateralis facies patellaris fossa intercondylaris linea intercondylaris facies poplitea (planum popliteum) Femoral head fracture basis patellae apex patellae facies articularis patellae Patella m. quadriceps femoris Tibia Proximal end, body, distal end Proximal end condylus medialis et lateralis facies articularis superior medialis, lateralis eminentia intercondylaris tuberculum intercondylare mediale tuberculum intercondylare laterale area intercondylaris anterior et posterior facies articularis fibularis 02.10.2018 4 Corpus tuberositas tibiae linea musculi solei margo medialis margo anterior margo interosseus Tibia Tibia Distal end malleolus medialis facies articularis malleoli medialis incisura fibularis tibiae facies articularis inferior tibiae sulcus malleolaris Fibula Proximal end caput fibulae facies articularis capitis fibulae apex capitis fibulae Corpus margo anterior et posterior margo medialis et interosseus Distal end malleolus lateralis facies articularis malleoli lateralis sulcus malleolaris fossa malleoli lateralis Fibula Ossa pedis ossa tarsi 7 ossa metatarsi 5 ossa digitorum pedis, phalanges 14 Talus Calcaneus Os naviculare Os cuboideum Ossa cuneiformia mediale, intermedium et laterale Ossa tarsi 02.10.2018 5 Caput tali (facies articularis navicularis) Collum tali Corpus tali Trochlea tali - facies articularis superior Facies articularis malleolaris lateralis et medialis Facies articularis calcanea posterior, media, anterior Sulcus tali Processus lateralis tali Processus posterior tali (tuberculum laterale, mediale) Sulcus tendinis musculi flexoris hallucis longi Talus Calcaneus tuber calcanei (processus medialis et lateralis) facies articularis talaris posterior, media et anterior sulcus calcanei (sulcus calcanei + sulcus tali = sinus tarsi) sustentaculum tali (sulcus tendinis musculi flexoris hallucis longi) trochlea peronealis facies articularis cuboidea Os naviculare tuberositas ossis navicularis Os cuboideum sulcus tendinis musculi fibularis/peronei longi Ossa cuneiformia mediale, intermedium et laterale basis (tuberositas ossis metatarsi I. et V.) corpus caput Ossa metatarsi I. – V. palec – phalanx proximalis et distalis II. – V. prst – phalanx proximalis, media et distalis basis phalangis corpus phalangis corpus/trochlea tuberositas phalangis distalis Ossa digitorum pedis, phalanges - kosti prstů nohy Metatarsal fractures 02.10.2018 6 X-Ray of the plevis X-ray of the children pelvis X-ray of the knee X-ray of the ankle X-ray of the foot Putz, R. (2008): Atlas of Human Anatomy Sobotta. Elsevier Books. Keith L. Moore, Arthur F. Dalley (2005): Clinically Oriented Anatomy. Williams and Wilkins. Platzer, W., Kahle, W., Leonhardt H. (1992): Locomotor system. Georg Thieme Verlag, Stuttgart, New York, 4th edition. Čihák, R. (1987): Anatomie 1. Avicenum, Zdravotnické nakladatelství. References