Kin 325 Lecture 1 I Identify all bones of the lower extremity and determine whether they are right or left side bones Identify all bony prominences and structures listed in the lab guide Palpate all bony prominences as indicated in the lab guide Identify all joints of the lower extremity and name each bone and bony prominence that forms each joint II III IV Lecture 1 Lower Extremities Hip Bone innominate bone ILIUM Wing or ala iliac fossa Iliac crest anterior superior iliac spine ASIS posterior superior iliac spine PSIS anterior inferior iliac spine AIIS Greater sciatic notch ISCHIUM greater sciatic notch ischial spine lesser sciatic notch tuberosity of the ischium ischial tuberosity ischial ramus PUBIS Superior ramus medial or symphyseal border surface Inferior ramus Acetabulum Obturator foramen Palpation Ischial tuberosity The bony part of the pelvic girdle upon which the weight rests when an individual is sitting Locate each tuberosity by sitting on your hands and shifting your weight from one side to another Anterior superior iliac spine ASIS This is at the belt line in males Palpate it at the anterior extremity of the iliac crest Iliac crest This is the most lateral and superior part of the hip bone Palpate the crest along its entire extent between the anterior and posterior superior iliac spines Posterior superior iliac spine PSIS Follow the iliac crest posteriorly with your fingers and you will feel a prominence l to 2 inches lateral to the midline of the body posteriorly The site of the posterior spine is often marked by a dimple or skin depression FEMUR head neck greater trochanter lesser trochanter posterior border also called the linea aspera lateral supracondylar line medial supracondylar line popliteal surface lateral condyle lateral epicondyle medial condyle medial epicondyle adductor tubercle patellar surface Palpation Greater trochanter Locate this in an individual who is standing Put the proximal part of your hand on the middle portion of the iliac crest the most superior extent of the hip bone fingers pointing distally The greater trochanter will be felt with the tips of the fingers a little posterior to this mid region of the hip When you think that your fingers are on the trochanter do medial and lateral rotation of the femur in order to bring the greater trochanter into prominence Femoral condyles located at the medial and lateral aspects of the distal extremity of the femur The individual should be seated with the knee joint flexed to 90o The condyles can be palpated indirectly by palpating in the deep groove on either side of the patella Adductor tubercle a prominence on the most superior part of the medial epicondyle about midway between the anterior and posterior limits of the condyle To palpate the adductor tubercle place your fingers on the soft tissue superior to the medial condyle middle of the thigh on the medial aspect Palpate in a progressively distal direction until you feel a bony prominence This is the adductor tubercle PATELLA Apex Base Anterior surface Posterior surface Medial facet Lateral facet TIBIA medial condyle lateral condyle Gerdy s tubercle tubercle of the lateral condyle this is difficult to identify on the plastic bones but is easily felt on your own tibia fibular articular surface facet for fibula intercondylar eminence tibial tuberosity soleal line anterior surface lateral border interosseous border medial malleolus malleolar articular facet for articulation with talus inferior articular surface for articulation with talus fibular notch Palpation Tibial condyles located distal to the condyles of the femur Palpate these in a sitting position with the knee joint flexed to 90o A groove will be felt between each femoral and tibial condyle Move your fingers just distal to the grooves on both sides of the joint and you will feel the condyles You can confirm this by medially and laterally rotating the leg with the knee joint flexed putting your fingers first on the femoral condyles and then on the tibial condyles Tuberosity of the tibia This can be palpated in the midline of the knee joint region just distal to the apex distal end of the patella Tubercle of the lateral condyle Gerdy s tubercle Identify the tibial tuberosity and then move the finger laterally and a bit superiorly The tubercle will be felt as another bony mass Medial malleolus The distal end of the tibia It forms the prominent bulge on the medial aspect of the ankle region Anterior surface palpate this flat surface located just below the skin on the anterior medial aspect of the bone FIBULA Head Interosseous border Lateral malleolus Malleolar articular facet Palpation Head of the fibula at the proximal extremity of the bone Palpate the fibular head on the lateral side of the leg just distal and inferior lateral to the lateral condyle of the tibia Medial and lateral rotation at the knee joint helps to confirm the identity of the fibula Remember that the fibula does not articulate with the femur Lateral malleolus forms the prominent bulge on the lateral aspect of the ankle joint region Palpate the lateral malleolus and the medial malleolus of the tibia simultaneously Notice that the lateral malleolus is located more distally and posteriorly than is the medial malleolus TALUS Head Body CALCANEUS heel Sustentaculum tali This is a knob that extends medially from the bone CUBOID Peroneal sulcus a groove for the tendon of the fibularis longus muscle NAVICULAR Tuberosity of the navicular bone This may occasionally ossify independently of the remainder of the bone in which case it is called an accessory navicular bone MEDIAL INTERMEDIATE AND LATERAL CUNEIFORM BONES These are also called cuneiform bones 1 medial 2 intermediate and 3 lateral METATARSAL BONES base shaft head PHALANGES base shaft head SESAMOID BONES Sesamoid bones are among the smallest bones in the body and develop within tendons or ligaments They occur constantly in some areas the patella is the best example of a constantly occurring sesamoid bone but their frequency varies considerably in other locations Some sesamoid bones such as the patella contribute to the mechanical advantage of their parent muscles Palpation Calcaneus and sustentaculum tali Feel the lateral and medial sides of the calcaneus To palpate the sustentaculum tali identify the medial malleolus and then move your finger about one inch directly inferior to the malleolus and press hard The sustentaculum tali is on the medial side of the bone