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The lateral surface is crossed by an at the upper part of the junction of the neck with the oblique ridge directed downwards and forwards. The medial surface presents a rough impression above. It is convex forwards and is directed obliquely downwards and medially. In the middle one-third. Between the two condyles. The spiral line winds round the shaft below the lesser trochanter to reach the posterior surface of the shaft Fig.
The medial and lateral borders are rounded and ill-defined. The rounded elevation. Lower End The lower end of the femur is widely expanded to form two large condyles. The part over the medial condyle. Intertrochanteric Crest It marks the junction of the posterior surface of the neck with the shaft of the femur. The medial and lateral surfaces are directed more backwards than towards the sides.
Shaft In the upper one-third of the shaft. It is narrowest in the middle. In the lower one-third of the shaft also. The linea aspera has distinct medial and lateral lips.
It is a prominent roughened ridge which begins above. Thus it has four borders. Lesser Trochanter It is a conical eminence directed medially and backwards from the junction of the posteroinferior part of the neck with the shaft.
The patellar surface covers the anterior surfaces of both condyles. The gluteal tuberosity is a broad roughened ridge on the lateral part of the posterior surface. The medial border and medial supracondylar line meet inferiorly to obliterate the medial surface.
The tibial surfaces cover the inferior and posterior surfaces of the two condyles. It is a smooth-rounded ridge. It is separated from the tibial surfaces by two faint grooves. Intertrochanteric Line It marks the junction of the anterior surface of the neck with the shaft of the femur.
The part of the surface over the lateral condyle is short and straight anteroposteriorly. Articular Surface The shaft is more or less cylindrical. The two condyles are partially covered by a large articular surface which is divisible into patellar and tibial parts.
The attachments on the lesser trochanter are as follows. The attachments on the shaft are as follows. The following are attached to the greater trochanter. The most prominent point on it is called the medial epicondyle.
Though it is less prominent than the medial condyle. It has a deeper anterior part and a shallower posterior part. The intertrochanteric line provides: The fovea on the head of the femur provides attachment to the ligament of the head of femur or round ligament. This tubercle is an important landmark.
Lateral Condyle The lateral condyle is flat laterally. Intercondylar Fossa or Intercondylar Notch This notch separates the lower and posterior parts of the two condyles.
The epiphyseal line for the lower end of the femur passes through it. The trochanteric bursa of the gluteus medius lies in front of the ridge. The lateral aspect presents the following. The quadrate tubercle receives the insertion of the quadratus femoris Fig. Posterosuperior to the epicondyle there is a projection.
It is limited anteriorly by the patellar articular surface. They separate the extensor muscles from the adductors medially.
When the knee is flexed the tendon of this muscle lies in the shallow posterior part of the groove. The origin of the medial head of the gastrocnemius extends to the popliteal surface just above the medial condyle.
The attachments on the lateral condyle are as follows. The intercondylar line provides attachment to the capsular ligament and laterally to the oblique popliteal ligament. The upper epiphyses. The lower epiphysis fuses by the twentieth year. The following points are noteworthy. The attachments on the medial condyle are as follows. There are three epiphyses at the upper end and one epiphysis at the lower end.
The femur ossifies from one primary and four secondary centres. The posterior cruciate ligament is attached to the anterior part of the lateral surface of the medial condyle.
The secondary centres appear. The infrapatellar synovial fold is attached to the anterior border of the intercondylar fossa. The attachments on the intercondylar notch are as follows. The nutrient foramen is located on the medial side of the linea aspera. In case it is absent. Nutrient Artery to the Femur This is derived from the second perforating artery. The primary centre for the shaft appears in the seventh week of intrauterine life. The posterioi surface is articular in its upper three-fourths and non-articular in its lower onefourth.
It is covered by an expansion frorr the tendon of the rectus femoris. Ossification of femur. The posterior articular surface is divided by. In addition. Presence of its centre in a newly born child found dead indicates that the child was viable.
The bone laid on a table rests on th broad lateral area. Structure The angles and curvatures of the femur are strengthened on their concave sides by bony buttresses. This strip articulates with a reciprocal strip on the medial side of the intercondylar notch of the femur during full flexion. The apex is non-articula posteriorly. Tripping over minor obstructions or other accidents causing forced medial rotation of the thigh and leg during the fall results in: Features The patella has an apex.
The anterior surface is rough and non-articulai The upper three-fourths of the posterior surface ar smooth and articular. The articular area is divided by a vertical ridge into a larger lateral and smaller medial portion. The concavity of the neck-shaft angle is strengthened by a thickened buttress of compact bone.
The apex directed downwards. Another vertical ridge separates a medial strip from the medial portion. The patella is triangular in shape with its ape directed downwards. This mechanism helps in resisting stresses including that of body weight.
The rest of the medial portion and the lateral portion of the articular surface are divided by two transverse lines into three pairs of facets. During different phases of movements of the knee. The lateral borderprovides insertion to vastus lateralis in its upper one-third or half. The superior surface of the condyle articulates with the lateral condyle of the femur.
Fusion is complete at puberty. The condition is bilateral and symmetrical Fig. This is prevented by 1 bony factor—the lateral edge of the patellar articular surface of the femur is deeper than the medial edge Fig. The patella probably improves the leverage of the quadriceps femoris by increasing the angulation of the line of pull on the leg. The anterior and medial surfaces are marked by numerous vascular foramina.
It is homologous with the radius of the upper limb. The lower pair of articular facets articulates during extension. Attachments on the Patella The superior border or base provides insertion to the rectus femoris in front and to the vastus intermedius behind.
The medial borderprovides insertion to the vastus medialis in its upper two-thirds or more. The anterior border of the shaft is most prominent and crest-like. The peripheral part is flat and is separated from the femoral condyle by the medial meniscus. Lateral Condyle The lateral condyle overhangs the shaft more than the medial condyle. Fracture of the patella should be differentiated from a bipartite or a tripartite patella Fig.
The articular surface is oval and its long axis is anteroposterior. The upper end is much larger than the lower end. The posterior surface of the medial condyle has a groove. The upper end includes: As in the case of the medial condyle. Features The tibia has an upper end. The articular surface is nearly circular. Medial Condyle Medial condyle is larger than the lateral condyle. Upper End The upper end of the tibia is markedly expanded from side to side.
The lateral margin of the articular surface is raised to cover the medial intercondylar tubercle. One or two centres at the superolateral angle of the patella may form separate pieces of bone. The central part of the surface is slightly concave and comes into direct contact with the femoral condyle.
The patella has a natural tendency to dislocate outwards because of the outward angulation between the long axes of the thigh and leg. It is sinuously curved and terminates below at the anterior border of the medial malleolus. The articular surface has a raised medial margin which covers the 1. The projection is called the medial malleolus.
The medial side of the lower end projects downwards beyond the rest of the bone. The patella ossifies from several centres which appear during 3 to 6 years of age. Its superior surface articulates with the medial condyle of the femur. The non-articular area on the posterior surface provides attachment to the ligamentum patellae below. Such a patella is known as bipartite or tripartite patella.
Surfaces The lateral surface lies between the anterior and interosseous borders. Borders The anterior border is sharp and S-shaped being convex medially in the upper part and convex laterally in the lower part. It is subcutaneous and forms the shin. In its upper three-fourths. The medial surface is subcutaneous and is continuous with the medial surface of the medial malleolus. The medial surface lies between the anterior and medial borders.
The anterior surface of the lower end has an upper smooth part. The inferior surface of the lower end is articular. Shaft The shaft of the tibia is prismoid in shape. It extends from the tibial tuberosity above to the anterior border of the medial malleolus below. It has three borders. The lateral aspect of the lower end presents a triangular fibular notch to which the lower end of the fibula is attached.
It extends from the medial condyle. Medially the articular surface extends on to the medial malleolus. It forms a subcutaneous prominence on the medial side of the ankle.
It articulates with the superior trochlear surface of the talus and thus takes part in forming the ankle joint. The posterior surface lies between the medial ai interosseous borders.
The upper part of the notch is rough. It is divided into medial and laten parts by a vertical ridge. It i directed downwards and transmits the nutrient arter which is a branch of the posterior tibial artery. The medial border is rounded. The lower part is smooth and may be covered with hyaline cartilage.
A nutrient foramen i situated near the upper end of this ridge. Lower End The lower end of the tibia is slightly expanded. The soleal line begins just behind tl fibular facet. Attachments on the Medial Condyle a The semimembranosus is inserted into the groove on the posterior surface.
The interosseous or lateral border extends from the lateral condyle a little below and in front of the fibular facet. It has five surfaces. It is broad. The area below the sole. The medial malleolus is a short but strong process which projects downwards from the medial surface of the lower end of the tibia. It is widest in its upper pa This part is crossed obliquely by a rough ridge calL the soleal line. Above the soleal line. Mmmmmmmmmmmmmm e The posterior horn of the medial meniscus.
The lower rough area of the tuberosity is subcutaneous. Attachment on Tibial Tuberosity The ligamentum patellae is attached to the upper smooth part of the tibial tuberosity.
The tendinous arch for origin of the soleus is attached to a tubercle at the upper end of the soleal line. Attachment on the Shaft a The tibialis anterior arises from the upper twothirds or less of the lateral surface Fig.
Still further posteriorly this surface gives attachment to the tibial collateral ligament along the media border. It is a branch of the posterior tibial artery which enters the bone on its posterior surface. If the foot gets caught in a hole in the ground there may be forcible abduction and external rotation. Relations of the Tibia Apart from the relations mentioned above. A secondary centre for the upper end appears just before birth.
This may also be caused by tearing of the nutrient artery. The primary centre appears in the shaft during the seventh week of intrauterine life. The upper end of the tibia is one of the commonest sites for acute osteomyelitis. The groove for the tendon of the tibialis posterior continues downwards on the posterior surface of the medial malleolus. The deltoid ligament of the ankle joint is attached to the lower border of the medial malleolus Figs The tibia is commonly fractured at the junction of the upper two-thirds and the lower one-third of the shaft as the shaft is most slender here.
In such an injury. Separate secondary centres may appear for the tibial tuberosity and the medial malleolus Fig. The knee joint remains safe because the capsule is attached near the articular margins of the tibia. Sometimes a surgeon takes a piece of bone from the part of the body and uses it to repair a defect in some other bone called a bone graft. This is the commonest type of the fracture at the ankle. Forward dislocation of the tibia on the talus produces the characteristic prominence of the heel in this injury.
The upper epiphysis usually includes the tibial tuberosity. It is very thin as compared to the tibia. For this purpose pieces of bone are easily obtained from the subcutaneous medM aspect of the tibia. The tibia ossifies from one primary and two secondary centres. It is homologous with the ulna of the upper limb. A secondary centre for the lower end appears during the first year.
These stages are termed 1st. Such fractures may unite slowly. The medial surface of the shaft gives origin to: The posterior surface is the largest of the three surfaces. The posterior border is rounded. The posterior surface is marked by a groove. The part of the posterior surface between the medial crest and the interosseous border.
The upper end. It is twisted backwards in its lower part Fig. It has the following four surfaces. The origins of the extensor digitorum. The head of the fibula receives the insertion of the biceps femoris on the anterolateral slope of the apex.
Shaft The shaft shows considerable variation in its form because it is moulded by the muscles attached to it.
The common peroneal nerve terminates in relation to the neck of fibula Figs 2. The medial side of the lower end bears a triangular articular facet anteriorly. Lower End or Lateral Malleolus The tip of the lateral malleolus is 0. The lateral surface is subcutaneous. The apex of the head or the styloid process projects upwards from its posterolateral aspect. The fibular collateral ligament of the knee joint is attached within the Cshaped area Fig. In its upper two-thirds.
The lateral surface lies between the anterior and posterior borders. The interosseous or medial border lies just medial to the anterior border. Surfaces The medial surface lies between the anterior and interosseous borders. Features The fibula has an upper end. It lies between the interosseous and posterior borders. Its upper end lies in line with the styloid process.
The medial surface bears a triangular articular facet for the talus anteriorly and the malleolar fossa posteriorly. The part of the posterior surface between the medial crest and the posterior border gives origin to: Upper End or Head It is slightly expanded in all directions. The superior surface bears a circular articular facet which articulates with the lateral condyle of the tibia.
The constriction immediately below the head is known as the neck of the fibula Figs 2. This insertion is C-shaped. At its lower end it divides to enclose an elongated triangular area which is continuous with the lateral surface of the lateral malleolus.
It has three borders—anterior. The anterior surface is rough and rounded. Borders The anterior border begins just below the anterior aspect of the head. It terminates below at the upper end of a roughened area above the talar facet of the lateral malleolus.
The capsular ligament of the superior tibio fibular joint is attached around the articular facet. The lateral surface of the shaft gives origin to: The lower end or lateral malleolus is expanded anteroposteriorly and is flattened from side to side.
The triangular area above the medial surface of the lateral malleolus gives attachment to a the interosseous tibiofibular ligament. The attachment leaves a gap at the upper end for passage of the anterior tibial vessels Fig.
The anterior border of the fibula gives attachment to: The posterior border gives attachment to the posterior intermuscular septum. The interosseous border gives attachment to the interosseous membrane. The attachments on the lateral malleolus are as follows. Right fibula. Posterior aspect. Anterior aspect. Blood Supply The peroneal artery gives off the nutrient artery for the fibula. A secondary centre for the upper end appears during the fourth year.
The fibula violates the law of ossification because the secondary centre which appears first in the lower end does not fuse last. The fibula ossifies from one primary and two secondary centres. The groove on the posterior surface of the malleolus lodges the tendon of the peroneus brevis.
The reasons for this violation are: The primary centre for the shaft appears during the eighth week of intrauterine life. From medial to lateral side these are the medial cuneiform. In the first stage of Pott's fracture. Each tarsal bone is roughly cuboidal in shape. The tarsal bones are much larger and stronger than the carpal bones because they have to support and distribute the body weight.
Another bone. Though it does not bear any weight. The tarsus is made up of seven tarsal bones. In the proximal row. The fibula is an ideal spare bone for a bone graft. The upper and lower ends of the fibula are subcutaneous and palpable. The common peroneal nerve can be rolled against the neck of the fibula. This nerve is commonly injured here. In other words. In the distal row. The body bears a large triangular.
It has a head. R is directed forwards and slightly downwards d medially. The rounded head is directed forwards.
The posterior 2. The downwards. The long axis of this surface is directed downwards and medially. It articulates with the posterior surface of Side Determination the navicular bone. It lies between the tibia above and the calcaneum below.
This surface is also called the trochlear surface. It is wider anteriorly than posteriorly. The sulcus tali lies opposite the sulcus calcanei on the calcaneum. Body The body is cuboidal in shape and has five surfaces. The smaller angle in young children accounts for the inverted position of their feet.
The neck-body angle is to degrees in infants and degrees in adults. It is convex from before backwards and concave from side to side. The medial part of its plantar surface is marked by a deep groove termed the sulcus tali. The medial border of the surface is straight. The superior surface bears an articular surface. In habitual squatters. The facet articulates with the anterior margin of the lower end of the tibia during extreme dorsiflexion of the ankle. Attachments on the Talus The talus is devoid of muscular attachments.
It forms the prominence of the heel. The posterior surface is large and rough. The anterior surface is small and bears a concavoconvex articular facet for the cuboid. The talus ossifies from one centre which appears during the 6th month of intrauterine life. The media tubercle provides attachment to the superficial fibre of the deltoid ligament above and the posterta talocalcanean ligament below Figs. The groove is bounded by medial and lateral tubercles.
The lower. A posterior tubercle is also present. The groove on the posterior surface lodges th tendon of the flexor hallucis longus. It is roughly cuboidal and has six surfaces. The surface is concave from above downwards. The lateral surface bears a triangular articular surface for the lateral malleolus. It is occasionally separate and is then called the os trigonum. Its long axis is directed forwards. The posterior surface is small and is marked by an oblique groove.
The articular surface is comma-shaped and articulates with the medial malleolus. The posterior part of the lateral surface is separated from the trochlea by an ill-defined. The following ligaments are attached to the neck. The lateral surfaceis rough and almost flat. The medial surface is concave from above downwards. Its lower surface is grooved. The plantar surface is rough and triangular Fig.
The latter is separated from the anterior border by a roughened depressed area. The posterior one-third is rough. It can be compared to the attachment of ligamentum patellae Fig. The upper area is smooth while the others are rough. The lateral surface is flat. The dorsal or superior surface can be divided into three areas.
The posterior surface is divided into three areas. It presents in its anterior part. The upper surface of this process assists in the formation of the talocalcaneonavicular joint.
Features The anterior surface is the smallest surface of the bone. The facet. The middle one-third is covered by the posterior facet for the talus. The plantar surface is rough and marked by three tubercles. The upper area is covered by a bursa. The articular part is in the form of an elongated facet present on the sustentaculum tali. It is covered by a concavoconvex. This facet is oval. The anterior one-third is articular in the anteromedial part. The middle rough area on the posterior surface receives the insertion of the tendocalcaneus and of the plantaris.
The concavity is accentuated by the presence of a shelf-like projection of bone. The medial and lateral tubercles are situated posteriorly. Attachments and Relations of the Calcaneus 1. The lower area is covered by dense fibrofatty tissue and supports the body weight while standing. The lateral part of the non-articular area on the anterior part of the dorsal surface provides: The dorsal or upper surface bears a large convex articular surface in the middle.
Attachments 1. The attachments and relations of the medial surface as follows. The attachments on the plantar surface are: The medial tubercle provides: The peroneal tubercle lies between the tendons of the peroneus brevis above and the peroneus longus below Fig. The primary centre appears during the 3rd month of intrauterine life. The plantar surface is small and slightly concave from side to side.
The lateral tubercle gives origin to the abductor digiti minimi. The anterior tubercle and the rough area in front of it provide attachment to the short plantar ligament. The lateral surface is rough and irregular. The secondary centre appears between years to form a scale-like epiphysis on the posterior surface. The calcaneofibular ligament is attached about 1 cm behind the peroneal trochlea.
The calcaneus ossifies from one primary and one secondary centres. The groove on the lower surface of the sustentaculum tali is occupied by the tendon of the flexor hallucis longus. The medial surface has a blunt and prominent tuberosity. The anterior surface is convex. The posterior surface is concave and oval for articulation with the head of the talus. The attachments and relations of the lateral surface are as follows. Below the groove for the flexor hallucis longus.
The tuberosity of the navicular bone receives the principal insertion of the tibialis posterior. The groove below the tuberosity transmits a part of the tendon of this muscle to other bones Fig. The medial margin of the sustentaculum tali is related to the tendon of the flexor digitorum longus and provides attachment to: The dorsal surface is broad and convex from side to side. The rough strip between the three tubercles affords attachment to the long plantar ligament Fig. The trochlea itself gives attachment to a slip from the inferior peroneal retinaculum.
It is rough for the attachment of ligaments. The medial. The plantar surface provides attachment to the spring ligament or plantar calcaneonavicular ligament. It is situated on the medial side of the foot. It is rough and non-articular. The lateral surface is marked by a vertical facet along its posterior margin. The distal surface is much larger than the proximal. In the medial cuneiform. The dorsal surface is formed by the base of the wedge.
The hilum of this facet is directed laterally.
There are three cuneiform bones. Features 1. The medial surface bears an inverted L-shaped facet along its posterior and superior margins. This forms a deep recess for the base of the second metatarsal bone. These are for the base of the second metatarsal bone. The plantar surface receives a slip from the tibialis posterior. The proximal and distal surfaces are fully articular. The distal surface has a large kidney-shaped facet for the base of the first metatarsal bone.
The proximal surface is rough in its lower onethird. Along the anterior margin of the surface there is a narrow strip often divided into two small facets. The lateral surface is marked by an inverted Lshaped facet along the posterior and superior margins for the intermediate cuneiform bone.
The medial cuneiform is the largest and the intermediate cuneiform. The thin edge forms the dorsal surface. The proximal surface is a pyriform facet for the navicular. The dorsal surface is formed by the rough edge of the wedge. As their name suggests. The anterosuperior part of the facet is separated by a vertical ridge. A part of the peroneus longus is inserted into the rough anteroinferior part of the lateral surface Fig.
The distal surface is completely covered by a triangular articular facet for the third metatarsal bone. In the intermediate and lateral cuneiforms. It is indented in the middle.
The medial surface is marked along its posterior margin by a vertical strip indented in the middle. The distal surface bears a large kidneyshaped facet for the base of the first metatarsal bone. The medial surface is rough and subcutaneous. The anterior parts of the medial and lateral cuneiforms projects further forwards than the intermediate cuneiform.
The plantar surface is formed by the base of the wedge. The greater part of the tibialis anterior is inserted into an impression on the anteroinferior angle of the medial surface Figs 2. The plantar surface is formed by the edge of the wedge.
Additional Features 1. The proximal and distal surfaces bear triangular articular facets. It ossifies from one centre which appears during the third year of life. The anteroinferior part of the lateral surface is roughened.
This part is for the base of the second metatarsal bone. This facet is for the lateral cuneiform bone. An oval facet in the middle articulates with the lateral cuneiform bone. For the differences between the two. The shaft is slightly convex dorsally and concave ventrally. The ridge posterior to the groove gives attachment to the deep fibres of the long plantar ligament Fig. Attachments The plantar surface receives a slip from the tibialis posterior.
The dorsal surface is rough for the attachment of ligaments. The short plantar ligament is attached to the posterior border of the plantar surface. Each cuneiform bone ossifies from one centre. The cuboid bone ossifies from one centre which appears just before birth. The distal surface is also articular. Side Determination Determination of the side of a metatarsal bone is as follows. The nonarticular part of the medial surface provides attachment to ligaments. It is directed upwards and laterally.
The lateral surface is short and notched. The notch on the lateral surface. The groove is bounded posteriorly by a prominent ridge. The proximal surface is concavoconvex for articulation with the calcaneum. Proximal to this a small facet may present for the navicular bone. Each metatarsal is a miniature long bone and has a a shaft.
The head or distal end is flattened from side to side. The lateral surface is marked in its posterosuperior part by a triangular or oval facet for the cuboid. The medial surface is extensive. It is prismoid in form.
The lateral surface is much shorter than the medial. Chapter 2. The bases of the metatarsals are set obliquely so that the deeper edge is directed backwards and laterally. The proximal surface is concavoconvex and articular. The posteromedial part of the plantar surface provides a insertion to a slip from the tibialis posterior. The plantar surface is marked anteriorly by an oblique groove.
It is divided by a vertical ridge into two areas for the fourth and fifth metatarsal bones. The base or proximal end is set obliquely in such a way that it projects backwards and laterally. It has six surfaces. The side of the first metatarsal bone can be found out by examining the kidney-shaped facet on the base.
The plantar surface is crossed anteriorly by an oblique groove. The metatarsus is made up of 5 metatarsal bones. At the anteroinferior angle. Metatarsals versus Metacarpals The metatarsals are quite similar to metacarpals. This is the shortest, thickest and stoutest of all metatarsal bones and is adapted for transmission of the body weight Fig.
The proximal surface of the base has a kidneyshaped facet, which is concave outwards. Second Metatarsal. This is the longest metatarsal. It has a wedgeshaped base Fig. The lateral side of the base has two articular facets, a larger dorsal, and a smaller plantar each of which is subdivided into a proximal part for the lateral cuneiform bone and a distal part for the third metatarsal. The medial, side of the base bears one facet, placed dorsally, for the medial cuneiform.
Third Metatarsal. The peroneus brevis is inserted on the dorsal surface of the tuberosity of the fifth metatarsal bone Fig. The peroneus tertius is inserted on the medial part of the dorsal surface of the base and the medial border of the shaft of the fifth metatarsal bone. The flexor digiti minimi brevis arises from the plantar surface of the base of the fifth metatarsal bone Fig. The shaft of metatarsal bones gives origin to interossei Figs Each metatarsal bone ossifies from one primary and one secondary centre.
The primary centre appears in the shaft during the tenth week of foetal life in the first metatarsal, and during the ninth week of foetal life in the rest of the metatarsals. A secondary centre appears for the base of the first metatarsal during the third year, and for the heads of the other metatarsals between three and four years.
All secondary centres unite with the shaft by 18th year. A separate centre for the tuberosity of the fifth metatarsal bone may be present Fig. The lateral side of the base has one facet, placed dorsally, for the fourth metatarsal bone. The medial side of the base has two facets dorsal and plantar for the second metatarsal bone. Fourth Metatarsal. The proximal surface of the base is quadrangular.
It articulates with the cuboid bone. The lateral side of the base has one facet, placed dorsally, for the fifth metatarsal bone. The medial side of the base has one facet placed dorsally, which is subdivided into a proximal part for the lateral cuneiform and a distal part, for third metatarsal bone. Fifth Metatarsal. There are 14 phalanges in each foot; 2 for the great toe and 3 for each of the other toes.
As compared to the phalanges of the hand, these are much smaller in size, and the shafts particularly of the first row are compressed from side to side. Otherwise their arrangement and features are similar in the two limbs. Attachments A. On Bases of Distal Phalanges. The lateral side of the base has a large tuberosity or styloid process projecting backwards and laterally.
The medial side of the base has one facet for the fourth metatarsal bone. The plantar surface of the base is grooved by the tendon of the abductor digiti minimi. Important Attachments to Metatarsal Bones. On shaft and Bases of Middle Phalanges. A part of the tibialis anterior is inserted on the medial side of the base of the first metatarsal bone Fig. The greater part of the peroneus longus is inserted on a large impression at the inferior angle of the lateral surface of the base of the first metatarsal bone Fig.
Flexor digitorum brevis on each side of the shaft on plantar surface Fig. On Bases of Proximal Phalanges. The fibrous flexor sheath is attached to the margins of the proximal and middle phalanges of the lateral four toes. Phalanx ossifies by one primary centre for the shaft which appears in tenth week of foetal life. The single secondary centre appears in the base. It appears in the proximal phalanx in second year, middle phalanx in third year and in distal phalanx in the sixth year.
These fuse with the respective shafts by eighteenth year. The big toe has two phalanges and their secondary centres appear in second and third years to fuse with shaft in 18th year Fig.
These are located at the following sites. The patella is, by far, the largest sesamoi bone. There is one sesamoid bone in the tendo the peroneus longus. It articulates with th cuboid. Sesamoid bones may be present in the tendor of the tibialis anterior, the tibialis posterior, tr lateral head of the gastrocnemius, the psoas majo and the gluteus maximus.
There are two small sesamoids in the tendon i the flexor hallucis brevis. They articulate with tr head of the first metatarsal bone. The superficial fascia contains one big vein, the great saphenous vein, besides the cutaneous nerves, vessels, lymphatics and lymph nodes. The upper third of thigh medially contains the femoral triangle, middle third carries the femoral vessels through the adductor canal. Front of thigh also contains a vast four-headed muscle, the quadriceps femoris, besides the iliopsoas in the uppermost region and adductor muscles on its medialside.
Femoral hernia if occurs is seen in the upper medial region of front of thigh. Iliac crest is a thick, curved bony margin, forming laterally the lower margin of the waist.
The hands are often supported on the iliac crests in a relaxed standing posture. Anterior superior iliac spine is the anterior end of the iliac crest.
Tubercle of the iliac crest is a low bony prominence situated on the outer lip of the iliac crest about 2. Fold of groin is a shallow curved groove which separates the front of the thigh from the anterior abdominal wall.
It represents the flexion crease of the thigh and overlies the inguinal ligament which extends from the anterior superior iliac spine to the pubic tubercle. The downward convexity of the ligament is due to the pull exerted by the fascia lata of the thigh.
Pubic tubercle is a small bony projection felt at the medial end of the fold of groin. Pubic symphysis is formed in the median plane between the right and left pubic bones. Pubic crest is a short bony ridge between the pubic tubercle and pubic symphysis Fig. The greater trochanter of femur lies a hand'sbreadth about The upper. Midinguinal point lies midway between the anterior superior iliac spine and the pubic symphysis.
The femoral artery and the head of the femur lie beneath the midinguinal point. Patella knee cap is the largest sesamoid bone of the body, developed in the tendon of quadriceps femoris.
It is easily seen and felt in front of the knee. Goodreads helps you keep track of books you want to read. Want to Read saving…. Want to Read Currently Reading Read. Other editions. Enlarge cover. Error rating book. Refresh and try again. Open Preview See a Problem?
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