Transcript 1a Mt SAC Lower Extremity

Urgent Advice
• Around this time, you will be tempted to focus on lab.
However, next month is the hardest test of the year:
muscle lab exam. There are 75 muscle names, origins,
insertions, and actions to learn in 3 weeks. That means
you have to memorize 3 a day, 6 days a week, starting
right after the bone lab exam.
• If you are behind in lecture, you will want to focus on
lecture and you will not memorize 3 muscle OIA’s a day.
As soon as the lecture exam is over, there will only be 2
weeks until the hard lab exam, and you will have to
memorize 6 OIA’s per day. That may seem easy, but 3 a
day is challanging and 6 per day is very difficult.
• The solution is to keep up in lecture, and start
memorizing 3 OIA’s a day right after the lab exam.
Os Coxa:
The fusion of 3 bones during childhood
Ilium
ischium
pubis
OS COXA
Acetabulum
Obturator
foramen
Lateral and Medial Views of the Hip
Bone
Tubercle of
the iliac crest
Anterior gluteal
line
Ilium
Iliac crest
Iliac crest
Anterior
superior
iliac spine
Anterior
superior
iliac spine
Ala
Iliac fossa
Posterior
gluteal line
Posterior
superior
iIiac spine
Posterior inferior
iliac spine
Greater sciatic
notch
Ischial body
Ilium
Inferior
gluteal line
Anterior inferior Anterior inferior
iliac spine
iliac spine
Arcuate
Acetabulum
line
Superior ramus
of pubis
Ischial spine
Pubic tubercle
Lesser sciatic
notch
Ischium
Ilium
Ischium
Pubis
Pubic body
Pubis
Ischial
tuberosity
Ischial ramus
(b) Lateral view, right hip bone
Inferior ramus
of pubis
Articular surface of
pubis (at pubic
symphysis)
Inferior ramus
of pubis
Posterior
superior
iliac spine
Posterior
inferior
iliac spine
Body of
the ilium
Auricular
surface
Ischial spine
Obturator
foramen
Ischium
Ischial ramus
(c) Medial view, right hip bone
Figure 8.8b, c
ILIUM
Iliac crest
Anterior superior
iliac spine
Iliac fossa
Posterior superior
iliac spine
Posterior inferior
iliac spine
Anterior inferior
iliac spine
Greater sciatic notch
ILIUM
Iliac crest
Iliac fossa
Posterior superior
iliac spine
Anterior
superior
iliac spine
Anterior
inferior
iliac spine
Posterior inferior
iliac spine
Greater sciatic notch
Lesser sciatic notch
ISCHIUM
Anterior
Ischial spine
Lesser sciatic
notch
Ischial tuberosity
ISCHIUM
Posterior
Ischial spine
Lesser sciatic notch
Pubic bone
Ischial tuberosity
PUBIS
Pubic crest
Pubic symphysis
Pubic bone
Pubic arch
Female
pelvis
Male
pelvis
Female
pelvis
Male
pelvis
Pubic arch
is broader
in female
Pubic arch
is narrower
in male
Male
pelvis
Female
pelvis
FEMUR
Greater trochanter
Gluteal tuberosity
Neck
Lesser trochanter
Head
Fovea capitis
FEMUR
Head
Neck
Fovea capitus
Greater trochanter
Intertrochanteric
crest
Lesser trochanter
FEMUR
Medial condyle
Gluteal tuberosity
Linea aspera
Popliteal fossa
Lateral condyle
FEMUR
Medial epicondyle
(adductor tubercle)
Medial condyle
Lateral condyle
TIBIA
Medial malleolus
TIBIA
Medial malleolus
Fibular notch
TIBIA
Medial malleolus
Fibular notch
TIBIA
Medial condyle
Lateral condyle
Tibial tuberosity
Anterior crest
TIBIA
Intercondylar eminance
FIBULA
Lateral
malleolus
Lateral
malleolus
Head
Head
TARSALS
NAVICULAR
MEDIAL (or 1st)
CUNEIFORM
TALUS
INTERMEDIATE (or 2nd)
CUNEIFORM
CUBOID
CALCANEUS
LATERAL (or 3rd)
CUNEIFORM
METATARSALS: 1-5
FIRST METATARSAL
Styloid Process
FIFTH METATARSAL
PHALANGES
PROXIMAL PHALANX,
FIRST DIGIT
DISTAL PHALANX,
FIFTH DIGIT
DISTAL PHALANX,
FIRST DIGIT
INTERMEDIATE
PHALANX,
THIRD DIGIT
TIBIA and PATELLA
Patella
Medial articular
facet
Base
Apex
Lateral articular
facet
Patella
Medial articular
facet
The Lateral facet is larger.
If you place the patella on
your desk, it will always fall
onto the lateral articular
facet.
Lateral articular
facet
Turning An Ankle Into A 'Knee'
• Patient was a five-year-old girl with Ewing's
sarcoma, a cancerous tumor, behind her left
knee. Surgeons at The Children's Hospital of
Philadelphia used a limb-sparing technique
called rotationplasty to remove the diseased
portion of bone, turn the shortened portion of the
leg bone in a half-circle and reattach it, with the
ankle joint functioning as a knee.
• With a prosthetic attached to the mobile joint, the
child, now 13, enjoys gymnastics and
cheerleading.
Turning An Ankle Into A 'Knee'
Video of the 13-year-old patient, walking with a normal gait, can be viewed here:
http://content.nejm.org/cgi/content/full/351/8/e7
Rotationplasty
• VIDEO
• MBA Implant