The compounds in the free part of the lower extremity

The compounds in the skeleton of the free part of the lower extremity are hip, knee, shin bone joints, ankle joints and many in the skeleton of the foot - subtalar, talocalcaneal navicular-, cube-shaped heel-and others, and tarsometatarsal, metatarsophalangeal and interphalangeal joints.

The hip joint (articulatio coxae) in the form of orehovidny composed acetabulum with its cartilaginous acetabular lip (labrum acetabulare) and head of the femur. In general, joint deeper than the brachial, which provides greater its strength, but reduces the number of freedom of movement in it. In the joint may be around the three axes of motion: sagittal (allocation and bring the hips), frontal (hip flexion and extension) and the vertical axis (roll inwards and outwards).

In Fig. 52.
The hip joint is a front view
1 - ilio-femoral ligament;
2 - joint capsule;
3 - rib-pubic ligament;
4 - obturator membrane

On the pelvic bone joint capsule (capsula articularis) is attached at the edges of the acetabulum, with the acetabular lip is in the joint cavity. At the femoral neck joint capsule is attached to 3 / 4 length of its upper surface. On the front surface of the neck it is attached to intertrochanteric line and the bottom is fixed at the base of the small trochanter. The back of the neck of the hip joint capsule does not reach the intertrochanteric crest and can be attached at varying distances - from half or less the length of the neck to 2 / 3 of its length.

In Fig. 53.
The hip joint front section
1 - a circular area;
2 - a bunch of the femoral head;
3 - ligament of the acetabulum;
4 - joint capsule
Ligaments that reinforce the hip joint can be divided into intra-and extra-articular. Intra-band is represented by the triangular ligament of the femoral head (lig. capitis femoris), which starts from the edge of the acetabular notch and goes to the bottom of the pit of the femoral head. This ligament, which despite its name is not inside the joint capsule, it is only surrounded with synovial membrane. Bunch is a shock absorber, preventing breaches of the bottom of the acetabulum. Notch above the transverse acetabular ligament is stretched acetabulum (lig. transversum acetabuli).

In Fig. 54.
The knee joint is a front view
1 - patella;
2 - tibial collateral ligament;
3 - patellar ligament;
4 - fibula collateral ligament;
5 - tuberosity of the fibula;
6 - tuberosity of the tibia

In the deep layers of the capsule of the hip joint is a ligament that covers the neck of the femur and is the basis of the fibrous layer of joint capsule - a circular zone (zona orbicularis). Its beams are attached to the lower anterior superior iliac spine. On the adjacent portions of pelvic bones connected to a circular area with sciatic-femoral and femoral-pubic ligament.

Ischio-femoral ligament (lig. ischiofemorale), limiting the rotation of the thigh inwards, connects posterior parts of the joint capsule with the body of the ischium.

Pubic-femoral ligament (lig. pubofemorale), limiting abduction hip, extends from the upper branch of the pubic bone to a small skewer.

The most powerful in the skeleton of ilio-femoral ligament (lig. iliofemorale) is located on the anterior surface of the hip. In conjunction, reaching a thickness of 7-8 mm in width and 7-8 cm, isolated lateral and medial parts. It runs from the front of the lower spine the ilium is attached to the medial and anterior surfaces of the greater trochanter (the intertrochanteric line, before reaching the small trochanter) and limits the possible extension of the joint (to prevent movement of the femur around the front axle back).

The knee joint (articulatio genus) ginglymoidal formed by the proximal tibial epiphysis and the articular surfaces of condyles of the femur. Basic movements are taking place around the frontal axis (flexion-extension). Flexion and extension of the knee are complemented by the ability of a small amplitude rotation around its legs vertical axis.

Malokongruentny joint (articular surface that is it does not quite match up to form): concave condyles of the tibia is not so much compared to the markedly convex condyles of the femur. In addition, since the lateral condyle of the femur is less than the medial, at the junction of the bones forms a small angle, open outwards. Incongruence of the articular surfaces is compensated by the crescent-shaped articular cartilage - lateral and medial menisci (menisci lateralis et medialis). The inner edge of the meniscus is free, front and rear surfaces of fused with tibia (front and rear elevation of intercondyloid). The front ends of the lateral meniscus ligament connects the knee (lig. transversum genus).

In Fig. 55.
The knee joint articular capsule with remote
1 - femur;
2 - the posterior cruciate ligament;
3 - anterior cruciate ligament;
4 - fibula collateral ligament;
5 - the medial meniscus;
6 - lateral meniscus;
7 - tibial collateral ligament;
8 - the tibia;
9 - patellar ligament;
10 - patella

On the outer edges of thick meniscus firmly adherent joint capsule (capsula articularis). Thus, the joint cavity (cavitas articulare) is divided into two divisions: femoral-tibial meniscus and meniscal-. On the bones of joint capsule attaches to the front of the femur - 4-5 cm above the articular cartilage, passes laterally between condyles and epicondyles, leaving the latter free, and back up to the articular surface of the condyles, passing directly over the edge of the cartilage. Joint capsule is attached and the edges of the cartilage surface of the patella and the tibial condyles attached below the edge of the articular cartilage.

Fusion of the fibrous and synovial layers of the articular capsule was suspended at the apex of patella, where they are separated by an accumulation of adipose tissue, forming a wing-fold (plisa alaris). In addition, in places of transition synovial joint components with bone formed about 12-13 synovial bags, the majority being under the sinew of the muscles, reduces their friction with the bone, through some of these bags each communicated to the front and rear sections of the joint cavity.

In addition to the transverse ligament inside the joint are anterior (lig. cruciatum anterius) and rear (lig. cru-ciaum posterius) cruciate ligament, the fibrous layer located under the joint capsule, but without of the synovial membrane, which, beginning with the condyles of the femur, Zakho, the CIO at the front surface of a cruciate ligament, covering their front and sides (and thus synovial membrane separates the external and internal divisions knee). Cruciate ligaments connect the femur and tibia. Anterior cruciate ligament, starting from the inner surface of the lateral condyle of the femur is attached to intercondyloid eminence of the tibia. Posterior cruciate ligament begins at the outer surface of the medial condyle of the femur and attaches behind intercondyloid elevation.

In Fig. 56.
The knee joint is a vertical section
1 - femur;
2 - joint capsule;
3 - glenoid cavity;
4 - patella;
5 - the medial meniscus;
6 - fold webbed;
7 - anterior cruciate ligament;
8 - the posterior cruciate ligament;
9 - patellar ligament;
10 - tibia

Tibial collateral ligament (lig. collaterale tibiale) - fan-shaped ligament strengthens the joint with the medial side. It is adherent to the capsule and the medial meniscus of the joint, the medial epicondyle of the beginning of the femur, the ligament is attached to the fan-shaped medial condyle of the tibia.

Fibula collateral ligament (lig. collaterale fibulare), fusiform in shape, strengthens the joint with the lateral side. With the joint capsule is not connected. Connects the lateral epicondyle of the femur with the head of the fibula.

Patellar ligament (lig. patellaes), which is part of the quadriceps tendon, fixing on the tuberosity of the tibia, strengthens the knee in front. Behind the joint capsule strengthen popliteal ligament - oblique and curved.

Tibiofibular joint (articulatio tibiofibularis) connects the proximal epiphysis of the tibia and fibula. The shape of the joint plane, allows small sliding motions. Joint capsule, clip-on the edge of the articular surfaces, reinforced front and back of the head of the fibula ligament (ligg. capitis fibulae anterius et posterius).

The distal epiphyses of the tibia and fibula leg bones connected to the front and rear tibiofibular ligament (ligg. tibiofibularia anterius et posterius).

Ankle (articulatio talocruralis) is formed by the lower articular surface of the tibia and the medial and lateral ankle, covering the lateral surface of the block talus. Ginglymoidal joint, rotate it happens around the front axle. Extensive joint capsule attaches to the edge of the cartilage surface forming the joint bones.

Ankle strengthening strong ligaments and tendons that surround it on all sides.

Deltoid ligament (lig. deltoideum) is the most durable, strengthens joints on the inside. Fan-like ligament passes from the medial malleolus to the navicular, talus and the calcaneus.

In Fig. 57.
Ligaments and joints of the foot surface of the rear
1 - anterior tibiofibular ligament;
2 - front collision-fibula ligament;
3 - the deltoid ligament;
4 - heel-fibula ligament;
5 - interosseous talocalcaneal ligament;
6 - lateral talocalcaneal ligament;
7 - bifurcated ligament;
8 - dorsal tarsometatarsal ligament;
9 - dorsal metatarsal ligament;
10 - metatarsophalangeal joint capsule;
11 - interphalangeal joint capsule;
12 - collateral ligaments

Heel-fibula (lig. calcaneofibulare), the forward collision-fibula (lig. talofibulare anterius) and rear-collision fibula (lig. talofibulare posterius) ligaments reinforce the joint with the outer side. All three ligaments pass from the lateral malleolus, respectively, to the heel bone and the anterior and posterior margins talus.

Subtalar, talocalcaneal, navicular, heel-and cubiform klinoladevidny joints connecting the corresponding tarsal bones.

Subtalar joint is cylindrical (articulatio subtalaris) is formed by the collision and the heel bone. Joint capsule, which passes along the edge of the articular surfaces, enhanced lateral talocalcaneal ligament (lig. talocalcaneum laterale). In the tarsal sinus lies the interosseous talocalcaneal ligament (lig. talocalcaneum interossum).

Not communicating with each other collision-navicular and calcaneal-cubiform joints combine the transverse tarsal joint (articulatio tarsi transversa), Chopart joint . Taran-navicular joint is strengthened ligaments connecting the scaphoid with the cuboid, calcaneus and talus. Additionally strengthened by the tendons of the joint pouch front and the posterior tibial muscle. Heel-joint cubiform stronger back and plantar ligaments, as well as a strong bifurcated ligament (lig. bifucatum) connecting the heel bone to the navicular and cuboid. This ligament covering the part of the joint capsule is a "key" to the joint Chopart.

Heel-cubiform joint (articulatio calcaneocuboidea), saddle-shaped, formed articular surfaces of the bones. Motion in the joints occur around the longitudinal axis, with the possible sliding (rotational) offset that increase range of motion, provided the other two joints: subtalar and talocalcaneal-scaphoid.

Talocalcaneal navicular joint, (articulatio talocalcaneonavicularis) spherical formed head of the talus, the anterior articular surface of the calcaneus and the navicular bone cavity. Joint works together with the cylindrical subtalar joint. In addition to the interosseous ligament powerful linking the collision and the heel bone, ligaments strengthen the joint capsule, located on the back and sides of the plantar foot.

In Fig. 58.
Ligaments and joints of the foot through the ankle joint sawing
1 - the ankle;
2 - rear collision-fibula ligament;
3 - subtalar joint;
4 - interosseous talocalcaneal ligament;
5 - bifurcated ligament;
6 - talocalcaneal navicular joint-;
7 - heel-cubiform joint;
8 - transverse tarsal joint;
9 - klinoladevidny joint;
10 - tarsometatarsal joints;
11 - the interosseous ligament klinoplyusnevaya;
12 - intercostals metatarsal ligament;
13 - metatarsophalangeal joints;
14 - interphalangeal joints of the foot

Klinoladevidny joint (articulatio cuneonavicularis) is flat, allowing the sliding movement. Form joint front navicular articular surface and posterior articular surface of the sphenoid bone. Joint capsule, clip-on the edge of the articular surfaces, reinforced intercostals, the plantar ligaments and rear.

Tarsometatarsal joints (articulationes tarsometatarsales) are flat, with the possibility of slight sliding motion. Reinforced rear, and the interosseous plantar ligaments. Intercostals metatarsal ligament (ligg. metatarsea interossea) are located between the bases of the metatarsal bones, dorsal (ligg. tarsometatarsea dorsalia) - on the back surface of the joints. By the tarsometatarsal joint are three non-interconnected compounds (cuboid bone with IV and V metatarsal and cuneiform bones with I, II and III of the metatarsal bones). Together they form a transverse joint Lisfranc, strengthened by the interosseous ligament klinoplyusnevoy (lig. cuneometatarseum interosseum) connecting the medial cuneiform bone to the base II metatarsal bone. In addition to the ligaments that connect bones to one named tarsometatarsal joint, joint capsule is strengthened tendons surrounding muscles.

Metatarsophalangeal joint (articulationes metatarsophalangeales) are spherical, formed by connecting the proximal phalanx base with the heads of the metatarsal bones. In the joints may be small amplitude motion around the frontal and vertical axes (flexion-extension and abduction-cast). Supporting ligaments inhibit the possible side bias. Metatarsophalangeal joint deep transverse metatarsal reinforced ligament, as well as collateral and plantar ligaments.

Interphalangeal joints of the foot (articulationes interphalangeales pedis) ginglymoidal, connect the head upstream of the phalanges with bases downstream. Interphalangeal joints provide flexion-extension of fingers, reinforced collateral ligament.





List of Abbreviations

a., aa. — arteria, arteriae (artery, the artery)

lig., ligg. — ligamentum, ligamenta (ligament, the ligaments)

m., mm. — musculus, musculi (muscle, the muscle)

n., nn. — nervus, nervi (nerve, the nerve)

r., rr. — ramus, rami (branch)

s. — seu (or)

v., vv. — vena, venae (vienna)