Skeleton of the Lower Limb Olntroduction QHip bone-Hip bone —- Sacrum .... Skeleton of the lower limb \ ¢ s . \ \ ~ symphysis * Pelvic girdle -- 2 hip bones \ pubis sacrum i Femur Thigh * Thigh —-—---— -- femur Patella * Leg tibia (medial) fibula (lateral) Tibia - Leg Fibula -—----—- 7 tarsals 5 metatarsals 14 phalanges * Foot r7/aj2014Hip bone (innominate) - Superior Ais formed of 3 bones, iium, ischium & pubis. They meat Highest point 4 together in a Y-shaped epiphysis at the acetabulum. ‘the broad wing-like above. The pubis is és jot and meatits fellow at the symphysis pubis. & lac tubercle LS is postero-inferior. The pubo-ischial plane is nearly at right angle to that of ium, Un the anatomical position, the pubic tubercle and the anterior superior iliac spine lie in the same vertical plane, with the upper border of symphysis pubis & ischial spine at \ the same horizontal plane. 1 Outer surface- (general features)- s i The acetabulum, is a cup-shaped socket for the hip joint. i I 1 1 FS Itslower margin is deficient forming the acetabular notch. alls Ithas a lunate articular surface, which is widest above over the iliac part of the fossa, weight-bearing area. The lower ae partis non-articular, called acetabular fossa (thin), site of, oa meeting of pubis & iscium till notch. Ilio-pubic anterior margin of acetabulum marks their meeting & another small posterior heeping demarcates the ilio-ischial meeting. Uheiliac erest, the convex upper margin, ends by anterior & posterior superior iliac spines, and similar inferior iliac { spines. The iliac tubercle (15), is cm behind ASIS on the i pubis. *)7 ~ i ' outer lip, forming the most lateral point. The highest point (L4), is behind the tubercle. The anterior 2/3 of the crest has outer & inner lips with intermediate area, and the Postero- posterior 1/3 has outer & inner sloping areas. The PSIS, | inferior makes a skin dimple in the buttock at the level of S2. The greater sciatic notch lies below PIIS. 37/4/2014 ryThe outer surface of the ilium presents posterior, anterior & inferior gluteal ines from behind-forward UTheischium, is an L-shaped bone, it has ramus, body, spine & tuberosity. The ischial ramus, joins the inferior ‘pubic ramus (IPR) to enclose the obturator foramen. The upper part of the body completes the lower part of reater sciatic notch. The ischeal spine, projects medially separating the greater from the lesser sciatic notches. The ischial tuberosity, is a rough area below the lesser notch. It is divided into an upper quadrangular & lower A areas. The Highest point L¢ lac tubercle LS Posterior gluteal Tine upper areais divided by an oblique ridge into upper lateral SIs & lower medial. The lower area is divided by a vertical sz ridge into lateral & medial parts. The ischial tuberosity supports the sitting weight. Pus Othe pubis has body, superior & inferior pubic rami. The body is quadri-ateralin © & Ain 4. Its medial surfaceis oval for symphysis pubis. The pubic crest, ies above the body. The pubic tubercle, is lateral to the crest. The superior pubicramus, has 3 borders & surfaces. An anterior rounded (obturator crest) & superior sharp Ischial spine 1 pubic (pectineal line= pectin pubis) borders, converge at the Lesser 7 1 crest pubic tuberce & enclose the A pectineal surface, and stiatc inferior border, separating an inferior or obturator surface notch & groove from the pelvic surface postero-superior. The inferior pubic ramus, is everted more in males and joins Upper L} the ischial ramus. The obturator foramen, is ange oval in male, or smalla Lover AV infemale, and is bounded by pubis & ischium, and is |schial tuberosity closed by membrane except the obturator canal Acetabularfosse ‘Acetabular notch Ischial ramus. SawwahInner surface- lliac tuberosity Uls divided into abdominal & pelvic by the Abdominal pelvic brim, which is formed by the pubic crest, pectineal line, arcuate line & top of auricular surface. OThe ilium, has 2 surfaces, lateral (gluteal), medial (iliac) & posterior (sacral] separated by 3 borders, anterior, posterior & medial. The medial border separates the fossa from the sacro-iliac joint posteriorly. UThe iliac fossa, is a large smooth depression on the medial surface of ala. Its anterior bone is thin. The inner lip of iliac crest is border present above. The sacral surface iis thick . It presents the auricular surface below, and a rough = Pelvic surface Pelvic obereaity cunen Arcusteline liactuberosity superior for synovial & syndesmotic articulation with reciprocal ectineal ine surfaces of the sacrum. The pre-auricular sulcus lies below the auricular surface & is more evident in female. Pubic erest OThe inner surfaces of both the pubis & ischium are below the pelvic brim, and form the anterior & lateral walls of the pelviccavity, — jyapoia PD Ezzat El-Saywah 5Mo-bial tract Highest point L@ Gluteus ‘maniimas ligament Sarterlus Rectus femoris Rectusfemoris(ref.) AGP *Taieht heed SY eter gsment Piriformis” Inguinal igement ‘um Sacro-spinous lig. Superior gemellus Pubic biceps femoris. ‘tubercle a ' Sate cial Acetabular fossa ReeEpPMrzo16 adductor mages pageter eee POE rors Deetablr notch 6~ Quadratus lumborum — ‘Abdominal lise tuberosity Erector spinge Medial border | K Interosseous - sacrovillac ligament Posterior border Acserl Pre-aurleular Obturator o \. sulcus internus border Pelvic surface Pelvic Arcuate line Pectineal Sacro line tuberous ligement——puiag crest PO Ezrat El-SawwahSecondary centers. at birth the 3 bones are separate The pubic arch fuses by 7 years. 3 Secondary centers for the acetabulum appear at 8 years & fuse at 15-18 years. 4 secondary centers, one for each of iliac crest, Als, ischial tuberosity & symphysis pubis, appear at puberty & fuse by 25 years. Ossification- Primary centers- 3 before birth, ilium (2" Appear a7 month), ischium (3% month) & pubis (4** month). \\ Appear at 8Y Fuse at 15 Y Sexdifferences | Male | female ments lliac fossa Deep Shallow y Greater sciatic notch Narrow Wide 2S Pre-auricular sulcus Absent Present: Ischial spine Inverted Everted { Obturator foramen Large Oval | Triangular TYears ‘Symphysistoacetabulum | Small wide Body of pubis Triangular | quadrangular Pubicarch Everted | Not a7yaj2014 PO Ezzat El-s