Lower Limb Joints and Nerve Injuries

Gross Anatomy


Joints of the Lower Limb; Lower Limb Nerve Injuries



ANNOUNCEMENTS
  1. Review of joint anatomy prior to dissection is an independent learning experience. There will be no lecture on joints. Use your text, your atlas and the following outline to preview the structure and function of the joints of the lower limb prior to atttending lab.



ASSIGNMENTS
Moore's Clinically Oriented Anatomy: 607-645

Grant's Dissector: 177-183; Start at "Joints of the Lower Limb", Continue through the end of the chapter.



WHEN YOU FINISH THIS SECTION, YOU SHOULD BE ABLE TO PERFORM THE FOLLOWING TASKS AND ANSWER THESE QUESTIONS


  1. What feature of the vasculature to the femur is the cause of poor healing in femoral neck fractures?

  2. Why is the flexed hip more prone to posterior dislocation than the extended hip?

  3. Make a chart that lists the direction of force that will result in a tear of each of the following ligaments of the knee: Anterior cruciate ligament, posterior cruciate ligament, medial collateral ligament.

  4. True or false? The ankle is the most frequently injured major joint in the body.

  5. Explain the forces that lead to a "Pott's fracture".

  6. Flat feet are caused by a failure of which ligaments? Which bones are permitted to "fall" by this failure?

  7. Identify the nerve damaged in each of the following disorders:




JOINT REVIEW

Below are listed the main features of the joints of the lower limb that we will dissect. All of them have been covered in previous lectures. Review these features before going to the lab to dissect the joints.

ANATOMY TABLES FOR TODAY'S TOPIC


Nerves of the Lower Limb - Listed Alphabetically

Nerve Source Branches Motor Sensory Notes
anterior femoral cutaneous n. femoral no named branches sympathetic motor innervation to skin skin of the anterior thigh cutaneous nn. carry postganglionic sympathetic axons to skin
cluneal, inferior posterior femoral cutaneous n. no named branches none skin of the lower part of the buttock "clunis" is a Latin word meaning buttock
cluneal, middle lateral cutaneous branches of the dorsal primary rami of spinal nerves S1-3 no named branches none skin of the intermediate medial portion of the buttock "clunis" is a Latin word meaning buttock
cluneal, superior lateral cutaneous branches of the dorsal primary rami of spinal nerves S1-3 no named branches none skin of the superomedial portion of the buttock "clunis" is a Latin word meaning buttock
coccygeal plexus ventral primary rami of spinal nerves S4, S5, C1 anococcygeal n. none skin of the region overlying the coccyx only part of the S4 ventral primary ramus is contributed to the coccygeal plexus
common fibular n. sciatic n. lateral sural cutaneous n., superficial and deep fibular nn. superficial fibular n.: muscles of the lateral compartment of the leg (fibularis longus and brevis mm.); deep fibular n.: muscles of the anterior compartment of the leg (tibialis anterior m., extensor hallucis longus m., extensor digitorum longus m., fibularis tertius m.) and muscles of the dorsum of the foot (extensor digitorum brevis m.and extensor hallucis brevis m.) superficial fibular n.: distal 1/3 of the anterior surface of the leg, dorsum of the foot excluding the web between the great toe and the 2nd toe and distal interphalangeal segments of all toes; deep fibular n.: skin of the web between the great toe and the 2nd toe "peroneal" is old terminology which has been replaced by "fibular"
common plantar digital nn. medial plantar n. (1st-3rd); superficial br. of the lateral plantar n. (4th) proper plantar digital nn. 1st lumbrical m. skin of the plantar surface of the toes (except the medial side of the great toe and the lateral side of the 5th toe) the dorsal surfaces of the distal tips of the toes (nail bed regions) are supplied by the proper plantar digital brs. of these nn.
deep fibular n. common fibular n. one proper digital br. muscles of the anterior compartment of the leg (tibialis anterior m., extensor hallucis longus m., extensor digitorum longus m., fibularis tertius m.) and muscles of the dorsum of the foot (extensor digitorum brevis m.and extensor hallucis brevis m.) skin of the web between the great toe and the 2nd toe "peroneal" is old terminology which has been replaced by "fibular"; anterior compartment syndrome - trauma to the anterior side of the leg can result in pressure buildup in the anterior compartment (from swelling or bleeding) that can damage the deep fibular n., resulting in "foot drop"
digital, common plantar medial plantar n. (1st-3rd); superficial br. of the lateral plantar n. (4th) proper plantar digital nn. 1st lumbrical m. skin of the plantar surface of the toes (except the medial side of the great toe and the lateral side of the 5th toe) the dorsal surfaces of the distal tips of the toes (nail bed regions) are supplied by the proper plantar digital brs. of these nn.
digital, proper plantar common plantar digital; medial plantar n. (to the medial side of the great toe); superficial br. of the lateral plantar n. (to the lateral side of the 5th toe) no named branches flexor hallucis brevis m. (from the proper plantar digital n. on the medial side of the great toe) skin of the plantar surface of the toes and dorsal surface of the distal interphalangeal segment the nail bed is supplied by the proper plantar digital nn.
femoral cutaneous, anterior femoral no named branches sympathetic motor innervation to skin skin of the anterior thigh cutaneous nn. carry postganglionic sympathetic axons to skin
femoral cutaneous, lateral lumbar plexus (ventral primary rami of spinal nerves L2-L3) anterior & posterior brs. sympathetic motor innervation to skin skin of the lateral thigh cutaneous nn. carry postganglionic sympathetic axons to skin
femoral cutaneous, posterior sacral plexus (ventral primary rami of spinal nerves S1-S3) inferior cluneal nn.; perineal br. sympathetic motor innervation to skin skin of the lower buttock & posterior thigh cutaneous nn. carry postganglionic sympathetic axons to skin
femoral n. lumbar plexus (ventral primary rami of spinal nerves L2-L4) anterior femoral cutaneous brs., nn. to: sartorius m., rectus femoris m., vastus lateralis m., vastus intermedius m., vastus medialis m., pectineus m. sartorius, rectus femoris, vastus lateralis, vastus intermedius, vastus medialis, pectineus skin of anterior thigh passes under inguinal ligament lateral to femoral a.
fibular, common sciatic n. lateral sural cutaneous n., superficial and deep fibular nn. superficial fibular n.: muscles of the lateral compartment of the leg (fibularis longus and brevis mm.); deep fibular n.: muscles of the anterior compartment of the leg (tibialis anterior m., extensor hallucis longus m., extensor digitorum longus m., fibularis tertius m.) and muscles of the dorsum of the foot (extensor digitorum brevis m.and extensor hallucis brevis m.) superficial fibular n.: distal 1/3 of the anterior surface of the leg, dorsum of the foot excluding the web between the great toe and the 2nd toe and distal interphalangeal segments of all toes; deep fibular n.: skin of the web between the great toe and the 2nd toe "peroneal" is old terminology which has been replaced by "fibular"
fibular, deep common fibular n. one proper digital br. muscles of the anterior compartment of the leg (tibialis anterior m., extensor hallucis longus m., extensor digitorum longus m., fibularis tertius m.) and muscles of the dorsum of the foot (extensor digitorum brevis m.and extensor hallucis brevis m.) skin of the web between the great toe and the 2nd toe "peroneal" is old terminology which has been replaced by "fibular"; anterior compartment syndrome - trauma to the anterior side of the leg can result in pressure buildup in the anterior compartment (from swelling or bleeding) that can damage the deep fibular n., resulting in "foot drop"
fibular, superficial common fibular n. medial dorsal cutaneous n. to the medial side of the foot; dorsal digital nn. to the lateral 3 toes muscles of the lateral compartment of the leg (fibularis longus and brevis mm.) distal 1/3 of the anterior surface of the leg; dorsum of the foot excluding the skin of the web between the great toe and the 2nd toe and the distal interphalangeal segments of all toes "peroneal" is old terminology which has been replaced by "fibular"; the nail beds are supplied by nerves from the plantar surface of the foot
genitofemoral n. lumbar plexus (ventral primary rami of spinal nerves L1-L2) genital br., femoral br. cremaster m. skin of the anterior scrotum/labia majora & upper medial thigh genitofemoral n. lies on the anterior surface of the psoas major in the abdomen; the genital br. passes through the deep inguinal ring and inguinal canal; brushing the thigh elicits an elevation of the testis via the cremasteric reflex
gluteal, inferior sacral plexus (ventral primary rami of spinal nerves L5, S1-S2) no named branches gluteus maximus m. none inferior gluteal n. passes through the greater sciatic foramen inferior to the piriformis m.
gluteal, superior sacral plexus (ventral primary rami of spinal nerves L4-L5, S1) superior & inferior brs. gluteus medius m., gluteus minimus m., tensor fasciae latae m. none superior gluteal n. passes through the greater sciatic foramen superior to the piriformis m.
lateral femoral cutaneous n. lumbar plexus (ventral primary rami of spinal nerves L2-L3) anterior & posterior brs. sympathetic motor innervation to skin skin of the lateral thigh cutaneous nn. carry postganglionic sympathetic axons to skin
lateral plantar n. tibial n. superficial and deep branches quadratus plantae m., abductor digiti minimi m., flexor digiti minimi brevis m., lateral 3 lumbrical mm., adductor hallucis m., plantar & dorsal interosseous mm. skin of the lateral side of the plantar surface of the foot; skin of the plantar surface of the lateral 1 1/2 toes (and the nail bed of these toes) lateral plantar n. accompanies the lateral plantar a. though the sole of the foot
lateral sural cutaneous n. common fibular n. fibular communicating br. none skin of the lateral side of the leg contains postganglionic sympathetic axons for supply of sweat glands, arrector pili mm. and blood vessels
lumbar n. ventral primary rami of spinal nerves L1-L5 contributes to the formation of the lumbar and sacral plexuses numerous: see lumbar and sacral plexuses numerous: see lumbar and sacral plexuses lumbar nn. enter into the formation of the lumbar and sacral plexuses and do not give branches directly to muscles or skin
lumbar plexus ventral primary rami of spinal nerves L1-L4 branches of the lumbar plexus: iliohypogastric n., ilioinguinal n., genitofemoral n., lateral femoral cutaneous n., femoral n., obturator n., lumbosacral trunk (considered to be part of sacral plexus), brs. to the psoas major and minor mm., branches to the quadratus lumborum m. muscles of the lower abdominal wall; cremaster m., psoas major and minor mm., quadratus lumborum m., iliacus m.; muscles of the anterior and medial thigh and hip skin of the lower abdominal wall, skin of the anterior scrotum/labium majus, skin of the anterior and medial thigh and lateral hip lumbar plexus is noted for its variable branching pattern of nerves that supply the abdominal wall
lumbosacral plexus ventral primary rami of spinal nerves L4-S4 branches of the lumbosacral plexus: iliohypogastric n., ilioinguinal n., genitofemoral n., lateral femoral cutaneous n., femoral n., obturator n., lumbosacral trunk (considered to be part of sacral plexus), brs. to the psoas major and minor mm., branches to the quadratus lumborum m., superior & inferior gluteal nn., n. to the obturator internus m., n. to the quadratus femoris m., sciatic n., n. to the piriformis m., posterior femoral cutaneous n., pudendal n., n. to the pelvic diaphragm, pelvic splanchnic nn. muscles of the lower abdominal wall; cremaster m., psoas major and minor mm., quadratus lumborum m., iliacus m.; muscles of the anterior and medial thigh and hip, muscles of the pelvic & urogenital diaphragm, posterior hip, posterior thigh, leg and foot skin of the lower abdominal wall, skin of the anterior scrotum/labium majus, skin of the anterior and medial thigh and lateral hip' skin of the perineum, posterior thigh, leg and foot also known as: lumbar & sacral plexuses
lumbosacral trunk part of the ventral primary ramus of L4 united with the ventral primary ramus of L5 no named branches; it contributes to the formation of the sacral plexus muscles of the hip and posterior thigh see sacral plexus the lumbosacral trunk is not considered to be part of the lumbar plexus
medial sural cutaneous n. tibial n. no named branches none skin of the posterior surface of the leg; skin of the lateral side of the foot unites with fibular communicating br. to form the sural n.
obturator internus m., n. to sacral plexus (ventral primary rami of spinal nerves L5-S2 ) n. to the superior gemellus m. obturator internus m., superior gemellus m. none nerve to obturator internus m. crosses the ischial spine and enters the ischioanal fossa by passing through the lesser sciatic foramen
obturator n. lumbar plexus (ventral primary rami of spinal nerves L2-L4) anterior and posterior brs. muscles of the medial thigh: adductor longus m., adductor brevis m. and adductor magnus m., gracilis m., obturator externus m. skin of the lower medial thigh obturator n. passes through the obturator canal
perforating cutaneous n. sacral plexus (ventral primary rami of spinal nerves S2-3) no named branches none skin of the inferomedial buttock perforating cutaneous n. pierces the sacrotuberous ligament
peroneal, common SEE: fibular, common . . . "peroneal" is old terminology which has been replaced by fibular
peroneal, deep SEE: fibular, deep . . . "peroneal" is old terminology which has been replaced by fibular
peroneal, superficial SEE: fibular, superficial . . . "peroneal" is old terminology which has been replaced by fibular
plantar digital, common medial plantar n. (1st-3rd); superficial br. of the lateral plantar n. (4th) proper plantar digital nn. 1st lumbrical m. skin of the plantar surface of the toes (except the medial side of the great toe and the lateral side of the 5th toe) the dorsal surfaces of the distal tips of the toes (nail bed regions) are supplied by the proper plantar digital brs. of these nn.
plantar digital, proper common plantar digital; medial plantar n. (to the medial side of the great toe); superficial br. of the lateral plantar n. (to the lateral side of the 5th toe) no named branches flexor hallucis brevis m. (from the proper plantar digital n. on the medial side of the great toe) skin of the plantar surface of the toes and dorsal surface of the distal interphalangeal segment the nail bed is supplied by the proper plantar digital nn.
plantar, lateral tibial n. superficial and deep branches quadratus plantae m., abductor digiti minimi m., flexor digiti minimi brevis m., lateral 3 lumbrical mm., adductor hallucis m., plantar & dorsal interosseous mm. skin of the lateral side of the plantar surface of the foot; skin of the plantar surface of the lateral 1 1/2 toes (and the nail bed of these toes) lateral plantar n. accompanies the lateral plantar a. though the sole of the foot
plantar, medial tibial n. plantar cutaneous brs.; proper plantar digital n. (medial side of the great toe); common plantar digital nn. (1st-3rd) abductor hallucis m., flexor hallucis brevis m., flexor digitorum brevis m., 1st lumbrical m. skin of the medial side of the plantar surface of the foot; skin of the plantar surface of the medial 3 1/2 toes (and the nail bed of these toes) medial plantar n. accompanies the medial plantar a. though the sole of the foot
plexus, lumbar ventral primary rami of spinal nerves L1-L4 branches of the lumbar plexus: iliohypogastric n., ilioinguinal n., genitofemoral n., lateral femoral cutaneous n., femoral n., obturator n., lumbosacral trunk (considered to be part of sacral plexus), brs. to the psoas major and minor mm., branches to the quadratus lumborum m. muscles of the lower abdominal wall; cremaster m., psoas major and minor mm., quadratus lumborum m., iliacus m.; muscles of the anterior and medial thigh and hip skin of the lower abdominal wall, skin of the anterior scrotum/labium majus, skin of the anterior and medial thigh and lateral hip lumbar plexus is noted for its variable branching pattern of nerves that supply the abdominal wall
plexus, lumbosacral ventral primary rami of spinal nerves L4-S4 branches of the lumbosacral plexus: iliohypogastric n., ilioinguinal n., genitofemoral n., lateral femoral cutaneous n., femoral n., obturator n., lumbosacral trunk (considered to be part of sacral plexus), brs. to the psoas major and minor mm., branches to the quadratus lumborum m., superior & inferior gluteal nn., n. to the obturator internus m., n. to the quadratus femoris m., sciatic n., n. to the piriformis m., posterior femoral cutaneous n., pudendal n., n. to the pelvic diaphragm, pelvic splanchnic nn. muscles of the lower abdominal wall; cremaster m., psoas major and minor mm., quadratus lumborum m., iliacus m.; muscles of the anterior and medial thigh and hip, muscles of the pelvic & urogenital diaphragm, posterior hip, posterior thigh, leg and foot skin of the lower abdominal wall, skin of the anterior scrotum/labium majus, skin of the anterior and medial thigh and lateral hip' skin of the perineum, posterior thigh, leg and foot also known as: lumbar & sacral plexuses
plexus, sacral lumbosacral trunk (ventral primary rami of spinal nerves L4-L5), ventral primary rami of spinal nerves S1-S4 superior & inferior gluteal nn., n. to obturator internus m., n. to quadratus femoris m., sciatic n., n. to piriformis, posterior femoral cutaneous n., pudendal n., n. to pelvic diaphragm, pelvic splanchnic nn. muscles of the pelvic diaphragm; muscles of the urogenital diaphragm; muscles of the posterior hip, posterior thigh, leg and foot skin of the perineum, posterior thigh, leg and foot (excluding the medial side of the leg and foot) the sacral plexus is often grouped with the lumbar plexus as the "lumbosacral plexus"
posterior femoral cutaneous n. sacral plexus (ventral primary rami of spinal nerves S1-S3) inferior cluneal nn.; perineal br. sympathetic motor innervation to skin skin of the lower buttock & posterior thigh cutaneous nn. carry postganglionic sympathetic axons to skin
proper plantar digital nn. common plantar digital; medial plantar n. (to the medial side of the great toe); superficial br. of the lateral plantar n. (to the lateral side of the 5th toe) no named branches flexor hallucis brevis m. (from the proper plantar digital n. on the medial side of the great toe) skin of the plantar surface of the toes and dorsal surface of the distal interphalangeal segment the nail bed is supplied by the proper plantar digital nn.
quadratus femoris m., n. to sacral plexus (ventral primary rami of spinal nerves L4-L5, S1) n. to the inferior gemellus m. quadratus femoris m., inferior gemellus m. none nerve to the quadratus femoris m. passes anterior to the obturator internus tendon
sacral plexus lumbosacral trunk (ventral primary rami of spinal nerves L4-L5), ventral primary rami of spinal nerves S1-S4 superior & inferior gluteal nn., n. to obturator internus m., n. to quadratus femoris m., sciatic n., n. to piriformis, posterior femoral cutaneous n., pudendal n., n. to pelvic diaphragm, pelvic splanchnic nn. muscles of the pelvic diaphragm; muscles of the urogenital diaphragm; muscles of the posterior hip, posterior thigh, leg and foot skin of the perineum, posterior thigh, leg and foot (excluding the medial side of the leg and foot) the sacral plexus is often grouped with the lumbar plexus as the "lumbosacral plexus"
saphenous n. femoral n. infrapatellar br. none skin of the medial side of the leg and medial side of the foot saphenous n. travels with the great saphenous v.; it does not pass through the adductor hiatus at the knee; it passes anterior to the medial malleolus at the ankle
sciatic n. sacral plexus (ventral primary rami of spinal nerves L4-L5 and S1-S3) tibial n., common fibular (peroneal) n. semitendinosus m., semimembranosus m., biceps femoris m., ischioconylar part of the adductor magnus m.; its branches supply all muscles of the leg and foot its branches supply the skin of the leg and foot (excluding the medial side of leg & foot) sciatic n. is composed of tibial and common fibular divisions; branches to muscles come from one of the two divisions, so that the sciatic n. is considered to have no direct muscular brs., only 2 terminal brs.
superficial fibular n. common fibular n. medial dorsal cutaneous n. to the medial side of the foot; dorsal digital nn. to the lateral 3 toes muscles of the lateral compartment of the leg (fibularis longus and brevis mm.) distal 1/3 of the anterior surface of the leg; dorsum of the foot excluding the skin of the web between the great toe and the 2nd toe and the distal interphalangeal segments of all toes "peroneal" is old terminology which has been replaced by "fibular"; the nail beds are supplied by nerves from the plantar surface of the foot
superior gluteal n. sacral plexus (ventral primary rami of spinal nerves L4-L5, S1) superior & inferior brs. gluteus medius m., gluteus minimus m., tensor fasciae latae m. none superior gluteal n. passes through the greater sciatic foramen superior to the piriformis m.
sural cutaneous, lateral common fibular n. fibular communicating br. none skin of the lateral side of the leg contains postganglionic sympathetic axons for supply of sweat glands, arrector pili mm. and blood vessels
sural cutaneous, medial tibial n. no named branches none skin of the posterior surface of the leg; skin of the lateral side of the foot unites with fibular communicating br. to form the sural n.
sural n. formed by the union of the fibular communicating br. of the lateral sural cutaneous n. and the medial sural cutaneous nn. lateral calcaneal brs., lateral dorsal cutaneous n. of the foot none skin of the posterior surface of the lower leg; skin of the lateral side of the foot sural n. courses posterior to the lateral malleolus at the ankle with the lesser saphenous v.
to obturator internus m. sacral plexus (ventral primary rami of spinal nerves L5-S2 ) n. to the superior gemellus m. obturator internus m., superior gemellus m. none nerve to obturator internus m. crosses the ischial spine and enters the ischioanal fossa by passing through the lesser sciatic foramen
to quadratus femoris m. sacral plexus (ventral primary rami of spinal nerves L4-L5, S1) n. to the inferior gemellus m. quadratus femoris m., inferior gemellus m. none nerve to the quadratus femoris m. passes anterior to the obturator internus tendon

Joints and Ligaments of the Lower Limb - Listed Alphabetically

Joint or ligament Description Notes
acetabular labrum a fibrocartilage rim around the acetabulum the acetabular labrum deepens the acetabulum; it cups around the head of the femur and holds it firmly in the acetabulum
ankle joint the articulation between the distal tibia, the medial malleolus of the tibia, the lateral malleolus of the fibula and the talus a synovial hinge joint; the ankle is reinforced by the deltoid ligament (anterior tibiotalar, tibionavicular, tibiocalcaneal, posterior tibiotalar parts), the anterior talofibular lig., the calcaneofibular lig. and the posterior talofibular lig.; because of the shape of the talus, the ankle is most stable when the foot is dorsiflexed; the ankle is often injured when the foot is plantar flexed
anterior cruciate ligament a ligament connecting the anterior aspect of the intercondylar eminence of the tibia with the medial surface of the lateral femoral condyle an intracapsular ligament located within the fibrous joint capsule of the knee but external to the synovial cavity of the knee; the anterior cruciate ligament limits the anterior movement of the tibia relative to the femur in all positions of joint movement; clipping-type injuries tear the anterior cruciate ligament because the leg is forced anteriorly relative to the femur which places great stress on the anterior cruciate ligament
anterior talofibular ligament a ligament that connects the lateral malleolus of the fibula with the anterolateral surface of the talus it is a ligament that reinforces the ankle joint
anterior tibiofibular ligament the ligament that connects the distal ends of the tibia and the fibula anteriorly this ligament reinforces the tibiofibular syndesmosis (at the distal ends of these bones)
anterior tibiotalar ligament part of the deltoid ligament connecting the medial malleolus of the tibia with the talus it is a ligament that reinforces the ankle joint
calcaneofibular ligament a ligament that connects the lateral malleolus of the fibula with the calcaneus it is a ligament that reinforces the ankle joint
deltoid ligament the ligament that connects the medial malleolus of the tibia with the talus, navicular and calcaneus the deltoid ligament reinforces the ankle joint; it has the shape of the Greek letter delta, hence its name; it has four parts (from anterior to posterior): anterior tibiotalar lig., tibionavicular lig., tibiocalcaneal lig., posterior tibiotalar lig.
fibular collateral ligament the collateral ligament of the knee that connects the lateral epicondyle of the femur with the head of the fibula an extracapsular ligament, not part of the fibrous capsule of the knee; the fibular collateral ligament passes superficial to the tendon of origin of the popliteus m.
hip joint the articulation between the os coxae and the head of the femur a synovial ball and socket joint; it is reinforced by capsular ligaments (iliofemoral, pubofemoral, ischiofemoral, zona orbicularis); the fibers of the articular capsule become taut on hip extension and lax on hip flexion; dislocation injuries of the hip are most common when the hip is flexed (sitting in a car seat during an impact that causes the knees to strike the dash board, for example)
iliofemoral ligament the ligament reinforcing the anterior surface of the articular capsule of the hip joint the iliofemoral ligament is shaped like an inverted "Y"; it connects the anterior inferior iliac spine to the anterior surface of the intertrochanteric line of the femur; also known as: ligament of Bigelow
infrapatellar bursa, deep the bursa lying between the patellar ligament and the tibia synovial membrane, the deep infrapatellar bursa reduces friction between the patellar ligament and the tibia
infrapatellar bursa, superficial a subcutaneous bursa overlying the patellar ligament synovial membrane
interosseous ligaments of the foot ligaments that reinforce intertarsal (gliding) synovial joints they connect adjacent tarsal bones; they are named for the two bones that they connect and whether they are located on the dorsal or plantar surface of those bones
interosseous membrane of the leg the membrane that connects the interosseous borders of the shafts of the tibia and fibula a syndesmosis
interphalangeal joints the articulations between the proximal and middle phalanges (proximal interphalangeal joint, abbreviated PIP) or the middle and distal phalanges (distal interphalangeal joint, abbreviated DIP) a synovial hinge joint; these joints are strengthened by medial and lateral collateral ligaments
ischiofemoral ligament the ligament reinforcing the posterior surface of the articular capsule of the hip joint the ischiofemoral ligament connects the body of the ischium to the posterior portion of the femoral neck
knee joint the articulation between the femoral condyles and the tibial condyles a synovial hinge joint; it is reinforced by intracapsular ligaments (anterior & posterior cruciate ligaments) and two types of collateral ligaments (capsular - tibial collateral ligament, and extracapsular - fibular collateral ligament); the medial and lateral menisci are contained within the joint capsule
lateral meniscus an intra-articular disc within the knee joint located between the lateral femoral condyle and the lateral tibial condyle fibrocartilage; it is attached to the coronary ligament and the intercondylar eminence of the tibia
ligament of the head of the femur an intracapsular ligament that attaches to the fovea of the head of the femur and to the acetabular fossa the ligament of the head of the femur contains a small artery (the a. of the ligament of the head of the femur) which supplies the femoral head; in fractures of the neck of the femur the retinacular aa. that course along the neck may be damaged, so that the artery to the head may be the only blood supply to the head and proximal neck
long plantar ligament a ligament that connects the plantar surface of the calcaneus, cuboid and the bases of the lateral 3 metatarsal bones a ligament that reinforces a complex set of intertarsal (gliding) synovial joints; the long plantar ligament supports the longitudinal arch of the foot
longitudinal arch of the foot the arch that passes from the calcaneus to the talus to the navicular to the cuneiforms to the metatarsal a series of plane synovial joints; the longitudinal arch of the foot is formed by the shapes of the metatarsal bones and is supported by the plantar calcaneonavicular (spring) ligament and many other small interosseous ligaments; the tendons of the tibialis anterior and tibialis posterior mm. also play a supporting role in maintaining the longitudinal arch of the foot
medial meniscus an intra-articular disc within the knee joint located between the medial femoral condyle and the medial tibial condyle fibrocartilage; it is attached to the tibial collateral ligament, coronary ligament and intercondylar eminence of the tibia; its attachment fo the tibial collateral ligament results in injury to the medial meniscus whenever the medial collateral ligament is injured
metatarsophalangeal joint the articulation between the head of a metatarsal and the base of a proximal phalanx a synovial condyloid (or ellipsoid) joint; it is strengthened by medial and lateral collateral ligaments; the joint has two planes of motion: flexion/extension and abduction/adduction which may be combined to yield circumduction
patellar ligament the tendon of insertion of the quadriceps femoris muscle the quadriceps femoris tendon connects the quadriceps femoris muscle group to the patella and the patellar ligament connects the patella to the tibial tuberosity; the patella is a sesamoid bone within the quadriceps femoris tendon
plantar calcaneocuboid ligament a ligament that connects the calcaneus with the cuboid on their plantar surfaces a ligament that reinforces a complex set of intertarsal (gliding) synovial joints; it supports the longitudinal arch of the foot; also known as: short plantar ligament
plantar calcaneonavicular ligament a ligament that connects the sustentaculum tali with the plantar surface of the navicular bone a ligament that reinforces a complex set of intertarsal (gliding) synovial joints; it supports the longitudinal arch of the foot; also known as: spring ligament
posterior cruciate ligament a ligament connecting the posterior aspect of the intercondylar eminence with the lateral surface of the medial femoral condyle an intracapsular ligament located within the fibrous joint capsule of the knee but external to the synovial cavity of the knee; the posterior cruciate ligament limits the posterior movement of the tibia relative to the femur in all positions of joint movement
posterior meniscofemoral ligament an intracapsular ligament that connects the posterior part of the lateral meniscus with the lateral surface of the medial femoral condyle may be absent
posterior talofibular ligament a ligament that connects the lateral malleolus of the fibula with the posterolateral surface of the talus it is a ligament that reinforces the ankle joint
posterior tibiofibular ligament the ligament that connects the distal ends of the tibia and the fibula posteriorly this ligament reinforces the tibiofibular syndesmosis (at the distal ends of these bones)
posterior tibiotalar ligament part of the deltoid ligament connecting the medial malleolus of the tibia with the talus posteriorly it is a ligament that reinforces the ankle joint
prepatellar bursa a subcutaneous bursa overlying the patella synovial membrane; inflammation of this bursa leads to the condition known as "housemaid's knee" (prepatellar bursitis), so named because housemaids at one time traumatized this bursa while scrubbing floors on their hands and knees
pubofemoral ligament the ligament reinforcing the medial surface of the articular capsule of the hip joint the pubofemoral ligament connects the pubic portion of the rim of the bony acetabulum to the medial surface of the femoral neck
suprapatellar bursa the superior extension of the synovial membrane of the knee joint it passes deep to the quadriceps femoris tendon; the suprapatellar bursa reduces friction between the quadriceps femoris tendon and the femur
tarsometatarsal joints the articulations between the distal row of tarsal bones and the proximal ends of the metatarsal bones gliding synovial joints; they are reinforced by dorsal and plantar ligaments which limit the motion between adjacent bones
tibial collateral ligament the collateral ligament of the knee joint connecting the medial epicondyle of the femur with the medial surface of the medial condyle of the tibia the tibial collateral ligament reinforces the medial surface of the articular capsule of the knee; it is attached to the medial meniscus which has clinical relevance - when the tibial collateral ligament tears in a clipping-type injury (knee abduction), the medial meniscus also tears
tibiocalcaneal ligament part of the deltoid ligament connecting the medial malleolus of the tibia with the sustentaculum tali it is a ligament that reinforces the ankle joint
tibionavicular ligament part of the deltoid ligament connecting the medial malleolus of the tibia with the navicular it is a ligament that reinforces the ankle joint
transverse acetabular ligament the ligament that spans the acetabular notch near the rim of the acetabulum the acetabular branch of the obturator artery enters the hip joint by passing beneath the transverse acetabular ligament; the artery of the ligament of the head of the femur is a branch of the acetabular a.
transverse arch of the foot the arch that passes through the distal row of tarsal bones a series of plane synovial joints; the transverse arch of the foot is supported by the shape of the tarsal bones, many small interosseous ligaments and the tendons of the fibularis longus m., tibialis anterior m. and tibialis posterior m.
zona orbicularis circularly oriented ligamentous fibers that reinforce the capsule of the hip joint the zona orbicularis fibers tend to constrict the fibrous joint capsule around the neck of the femur, helping to hold the head of the femur in the acetabulum


Some of the material presented in these tables is contained in the book:
MedCharts Anatomy by Thomas R. Gest and Jaye Schlesinger
Published by ILOC, Inc., New York. Copyright © 1995.

Content of tables edited for use in this course by Patrick W. Tank, Ph.D.
Copyright © 1999, Department of Anatomy, University of Arkansas for Medical Sciences.
Unauthorized use is prohibited.



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