Lower Extremity Anatomy: Sari Tri Yulianti, S.FT., M.Biomed

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The document discusses the anatomy of the lower extremity including bones, joints, muscles, nerves and blood supply.

The main components are the pelvic girdle formed from hip bones, and the free limb including the thigh, leg and foot.

The main joints are the hip (ball and socket), knee (hinge and gliding), ankle (hinge), and their interconnections between bones like the proximal tibia and fibula (gliding).

Lower

Extremity
Anatomy
Sari Tri Yulianti, S.Ft., M.Biomed
(a)
SCELETON
Anterior superior
iliac spine

Lower Limb Pelvic girdle

• Komponen:
– Pelvic girdle, dibentuk dari Femur

sepasang tulang hip (os coxae)


– Free Limb, terdiri dari: Patella

• Thigh (femur) Tibial plateau

• Leg (tibia dan fibula)


• Foot Lower
leg

Terhubung dengan pelvic girdle


melalui hip joint
Tarsals
Metatarsals Foot

Phalanges
Os. Coxae (Pelvic)
• Dibentuk oleh :
- os.ilium
- os.ischium
- os.pubis
PELVIC
PELVIC
FEMUR
PATELLA
TIBIA
C`

c
FIBULLA

c
c
c
c c

c c
c
c
c

TARSAL c

c
Joints of Lower Limb
 Hip (femur + acetabulum)
 Ball + socket
 Synovial
 Knee (femur + patella)
 Plane
 Synovial
 Knee (femur + tibia)
 Hinge
 Synovial
 Proximal Tibia + Fibula
 Plane
 Synovial
 Distal Tibia + Fibula
 Slight “give”
 Fibrous
 Ankle (Tibia/Fibula + Talus)
 Hinge
Frolich, Human Anatomy,  Synovial
Lower LImb
MUSCLES
Anterior
Thigh

Frolich, Human Anatomy,


Lower LImb
Posterior
Frolich, Human Anatomy,
Thigh
Lower LImb
Medial compartment

Frolich, Human Anatomy,


Lower LImb
Anterior Leg

Frolich, Human Anatomy,


Lower LImb
Lateral Leg

Frolich, Human Anatomy,


Lower LImb
Posterior Leg

Frolich, Human Anatomy,


Lower LImb
Intrinsics of foot
Frolich, Human Anatomy,
Lower LImb
NERVES
Lumbar plexus (L1-L4) Sacral plexus (L4-S4)
Obturator Nerve

12-23
Femoral Nerve

12-24
Sciatic Nerve

12-25
Tibial Nerve

12-26
Peroneal Nerve

12-27
Dermatomes

Frolich, Human Anatomy,


Lower LImb
BLOOD SUPPLY
Blood supply
to lower limb

Frolich, Human Anatomy,


Lower LImb
LOWER EXTREMITY
INJURIES
OUTLINE

• Hip Trauma
• Knee Degeneration
• Ankle Vascular Injury
Sports Injury
AP HIP
FEMORAL HEAD ACETABLUM

FEMORAL NECK

GREATER FOVEA CAPITIS


TROCHANTER

LESSER
TROCHANTER

CORTICAL BONE
MEDULLARY BONE
CORONAL MRI

RT. HIP
INTERTROCHANTERIC
FRACTURE
POST OPERATIVE
REPAIR
ACETABULAR
FRACTURE

CT SCAN PELVIS
AVASCULAR NECROSIS Bo
ne
sc
X-r an
ay

MR
I
BONE DENSITY MEASUREMENT
NUCLEAR MEDICINE
ANGLE OF INCLINATION

Coxa Vara
Coxa Valga
TRANSVERSE MRI OF RIGHT THIGH

http://www.fotosearch.com/bigcomp.asp?path=LIF/LIF137/GA335004.jpg
DISTAL FEMUR

Lateral epicondyle Medial epicondyle

Lateral tibial
Intercondylar eminence
condyle

Medial tibial
Head of fibula
condyle

Tibial tuberosity
FRACTURED FEMUR
AP LAT
DESCRIBE THE FRACTURE

AP

BONE AND WHICH PART


 FRACTURE ORIENTATION AND PARTS
 DISPLACEMENT AND ANGULATION
 JOINT INVOLVEMENT
LAT
EXAMPLE
There is an oblique fracture through the diaphysis of the femur with
approximately 1cm of lateral and anterior displacement of the distil
fragments relative to the proximal fragments. There is no angulation at
the fracture margin. There is some shortening due to unopposed muscle
pull. The fracture does not extend into the joint.
KNEE
AP LATERAL
Tendon Rupture
Which One?
MRI RIGHT KNEE CORONAL

Scan level
MEDIAL

MENISCI PCL

ACL MENISCI PATELLA TENDON

LATERAL
SAGITAL MR KNEE (MID JOINT)
QUADRICEPS TENDON

POSTERIOR CRUCIATE
LIGAMENT Scan level

PATELLA

ANTERIOR CRUCIATE
LIGAMENT
PATELLAR
TENDON
PATELLA FRACTURE

NORMAL
NORMAL
QUADRACEPS
TENDON
INJURY

Patella tendon injury


ANTERIOR CRUCIATE
LIGAMENT INJURY

Normal
POST OPERATIVE
LIGAMENT REPAIR
POSTERIOR CRUCIATE
LIGAMENT INJURY

normal
MENISCUS
NORMAL

TORN
WHAT IS MY AGE?
POST OP TOTAL KNEE

BEFORE

POST -OP
AP TIBIA & FIBULA
(LOWER LEG)
AP ANKLE

Tibial
Fibular shaft
shaft

Medial malleolus
of the tibia

Lateral malleolus
of the fibula
Talus
LATERAL ANKLE

ia
tib
fibula

ar
cul
talus

i
nav
calcaneus cuboid
Fractures through the medial
and lateral malleoli.
fractures through the medial and
lateral maleoli
AP FOOT
LATERAL FOOT
Fibularis brevis
(Peroneal)
Fibularis longus
CALCANEAL
FRACTURE

PATIENT FELL OFF OF A LADDER


DIABETIC
OSTEOMYLITIS
BONE SCAN
OSTEOMYELITIS
GOUT

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