femer and its attach783428472347328ements.pptx

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1. The Femur

2. The Femur A long bone Divided into thirds

3. Proximal third – closer to the head or cranial end of the body

4. Proximal third – closer to the head or cranial end of the body Middle third

5. Proximal third – closer to the head or cranial end of the body Middle third Distal third – Towards the feet or caudal end of the body

6. Anterior View Posterior View right femur

7. Anterior View Posterior View right femur Side Determination Apex comes inferiorly Rough anterior surface comes anteriorly Large area of posterior surface comes laterally

8. Anterior View Posterior View right femur Ossification- 1 primary centre - 7week 4 secondary centres – At 9 month of IUL for lower end At 6 month of life for head At 4 year age for greater trochanter At 12 year age for lesser trochanter ► Ossification of lower end of femur have medicolegal importance - to differentiate still born and live born baby .

9. Shaft of Femur Upper 1/3 Middle 1/3 Lower 1/3

10. Shaft of Femur Posterior view right femur

11. Pectineal Line Shaft of Femur Posterior view right femur

12. Shaft of Femur Posterior view Gluteal Tuberosity right femur

13. Shaft of Femur Posterior view Linea Aspera right femur

14. Medial Supracondylar Line (ridge) right femur Shaft of Femur Posterior view

15. Lateral Supracondylar Line (ridge) right femur Shaft of Femur Posterior view

16. Muscle Attachments

17. Proximal Femur Anterior View right femur

18. Proximal Femur Anterior View Piriformis right femur

19. Proximal Femur Anterior View Piriformis Arises from the anterior aspect of the sacrum and passes through the greater sciatic foramen before inserting onto the superior and medial aspects of the greater trochanter right femur Right Hip Joint Posterior View

20. Proximal Femur Anterior View Piriformis Arises from the anterior aspect of the sacrum and passes through the greater sciatic foramen before inserting onto the superior and medial aspects of the greater trochanter Externally rotates and stabilises the hip joint Right Hip Joint Posterior View right femur

21. Proximal Femur Anterior View Gluteus Minimus right femur

22. Proximal Femur Anterior View Gluteus Minimus Originates from the outer surface of the ilium and inserts onto the anterior surface of the greater trochanter right femur

23. Proximal Femur Anterior View Gluteus Minimus Originates from the outer surface of the ilium and inserts onto the anterior surface of the greater trochanter It abducts and internally rotates the hip joint right femur

24. Proximal Femur Anterior View Vastus Lateralis right femur

25. Proximal Femur Anterior View Vastus Lateralis This muscle has an extensive attachment from the Upper Intertrochanteric Line Base of the Greater Trochanter Lateral Linea Aspera Lateral Supracondylar Ridge Lateral Intermuscular Septum One of the four Quadriceps muscles right femur

26. Proximal Femur Anterior View Vastus Lateralis It attaches to the patella via the lateral aspect of the quadriceps tendon and then onto the tubercle of the tibia One of the four Quadriceps muscles right femur

27. Proximal Femur Anterior View Vastus Lateralis It attaches to the patella via the lateral aspect of the quadriceps tendon and then onto the tubercle of the tibia One of the four Quadriceps muscles It extends the knee right femur

28. Proximal Femur Anterior View Iliacus & Psoas Both are Flexors of the Hip Joint right femur

29. Proximal Femur Anterior View Iliacus Originates from the inner aspect of the ilium right femur

30. Proximal Femur Anterior View Psoas Originates from the anterior surfaces and lower borders of transverse processes of L1 - L5 and lateral aspect of bodies and discs of T12 - L5 right femur

31. Proximal Femur Anterior View Vastus Medialis One of the four Quadriceps muscles right femur

32. Proximal Femur Anterior View Vastus Medialis One of the four Quadriceps muscles Originates from the Lower aspect of the Intertrochanteric Line Medial Line Aspera Medial Intermuscular Septum right femur

33. Proximal Femur Anterior View Vastus Medialis One of the four Quadriceps muscles It attaches to the patella via the medial aspect of the quadriceps tendon and then onto the tubercle of the tibia It extends the knee right femur

34. Proximal Femur Anterior View Vastus Intermedius One of the four Quadriceps muscles right femur

35. Proximal Femur Anterior View Vastus Intermedius One of the four Quadriceps muscles Originates from the superior 2/3 of anterior and lateral surfaces of femur Inserts with the other quadriceps muscles onto the patella and then onto the tubercle of the tibia right femur

36. Proximal Femur superior view anterior posterior right femur

37. Proximal Femur superior view anterior posterior Obturator Internus right femur

38. Proximal Femur superior view anterior posterior Obturator Internus Originates from Inner surface of obturator membrane and posterior bony margins of obturator foramen right femur

39. Proximal Femur superior view anterior posterior Obturator Internus Originates from Inner surface of obturator membrane and posterior bony margins of obturator foramen Inserts onto medial aspect of Greater Trochanter right femur

40. Proximal Femur superior view anterior posterior Piriformis right femur

41. Proximal Femur superior view anterior posterior Obturator Externus right femur

42. Proximal Femur superior view anterior posterior Obturator Externus Originates from the Outer surface of obturator membrane and posterior bony margins of obturator foramen Inserts onto the Trochanteric Fossa on the medial aspect of the Greater Trochanter right femur

43. Proximal Femur superior view anterior posterior Gluteus Minimus right femur

44. Proximal Femur superior view anterior posterior Gluteus Medius right femur

45. Proximal Femur Posterior View right femur

46. Proximal Femur Posterior View Gluteus Medius right femur

47. Proximal Femur Posterior View Gluteus Medius Originates from the outer surface of ilium between posterior and middle gluteal lines right femur

48. Proximal Femur Posterior View Gluteus Medius Originates from the outer surface of ilium between posterior and middle gluteal lines Inserts onto the lateral and superior surfaces of greater trochanter of femur right femur

49. Proximal Femur Posterior View Gluteus Medius Originates from the outer surface of ilium between posterior and middle gluteal lines Inserts onto the lateral and superior surfaces of greater trochanter of femur It abducts and internally rotates the hip joint right femur

50. Proximal Femur Posterior View Quadratus Femoris right femur

51. Proximal Femur Posterior View Quadratus Femoris Originates from the lateral border Ischial Tuberosity Inserts onto the intertrochanteric crest and adjacent area of proximal posterior femur right femur

52. Proximal Femur Posterior View Quadratus Femoris Originates from the lateral border Ischial Tuberosity Inserts onto the intertrochanteric crest and adjacent area of proximal posterior femur Externally rotates the hip joint right femur

53. Proximal Femur Posterior View Vastus Lateralis right femur

54. Proximal Femur Posterior View Gluteus Maximus right femur

55. Proximal Femur Posterior View Gluteus Maximus Has an extensive origin from; posterior aspect of dorsal ilium posterior surface of sacrum and coccyx sacrotuberous ligament right femur

56. Proximal Femur Posterior View Gluteus Maximus Inserts onto gluteal tuberosity Has an extensive origin from; posterior aspect of dorsal ilium posterior surface of sacrum and coccyx sacrotuberous ligament right femur

57. Proximal Femur Posterior View Gluteus Maximus Inserts onto gluteal tuberosity Extends and laterally rotates the hip joint Has an extensive origin from; posterior aspect of dorsal ilium posterior surface of sacrum and coccyx sacrotuberous ligament right femur

58. Proximal Femur Posterior View Adductor Magnus This muscle has two functional units Hamstring portion Adductor portion right femur

59. Proximal Femur Posterior View Adductor Magnus This muscle has two functional units Hamstring portion Adductor portion The Adductor portion originates from the pubis and ischium It inserts onto the Linea Aspera and Medial Supracondylar Ridge right femur

60. Proximal Femur Posterior View Adductor Brevis right femur

61. Proximal Femur Posterior View Adductor Brevis Originates from the pubis Inserts onto the upper third of the linea aspera Adducts and flexes the hip joint right femur

62. Proximal Femur Posterior View Pectineus right femur

63. Proximal Femur Posterior View Pectineus Originates from the pectineal surface of hip bone Inserts onto Pectineal Line below the Lesser Trochanter Adducts and flexes the hip joint right femur

64. Proximal Femur Posterior View Vastus Medialis right femur

65. medial lateral Posterior Aspect Femoral Shaft right femur

66. medial lateral Vastus Medialis Posterior Aspect Femoral Shaft right femur

67. medial lateral Adductor Longus right femur Posterior Aspect Femoral Shaft Posterior Aspect Femoral Shaft

68. medial lateral Adductor Longus right femur Posterior Aspect Femoral Shaft

69. medial lateral Adductor Longus Originates from the Pubis Inserts onto the middle third of the Linea Aspera right femur Posterior Aspect Femoral Shaft

70. medial lateral Adductor Brevis right femur Posterior Aspect Femoral Shaft

71. medial lateral Adductor Magnus right femur Posterior Aspect Femoral Shaft

72. medial lateral Posterior Aspect Femoral Shaft Short Head of Biceps Posterior Aspect Femoral Shaft

73. medial lateral Short Head of Biceps Originates from the Linea Aspera Lateral Supracondylar Ridge Inserts onto proximal Fibula and Tibia Posterior Aspect Femoral Shaft right femur Short Head

74. medial lateral Vastus Lateralis Posterior Aspect Femoral Shaft right femur

75. Vastus Intermedius One of the four Quadriceps muscles right femur

76. Vastus Intermedius Originates from the anterior and lateral surfaces of the Femur One of the four Quadriceps muscles Inserts with the other Quadriceps muscles onto the patella and then onto the tibia tubercle via the patellar tendon right femur

77. Clinical Aspect

78. Clinical Aspect The appereance of the lower end epiphysis of the femur before birth has a medicolegal significance. It can be used as a proof of viability in cases of newborn deaths The lower epiphyseal line passes through the adductor tubercle. Injury to the epiphysis before fusion will shorten the limb.

79. Clinical Aspect 3. The angle between the neck and shaft of the femur may be less than normal called coxa vara or more than normal called coxa valga .

80. Clinical Aspect Fractures of the femur The femur may be fractured through neck, through trochanteric region, through shaft (at any level), just above the condyles (supracondylar fracture) or through one of the condyles. Fracture of the neck of the femur is common in old persons, especially post- menopausal women. In such persons the neck region has been weakened due to osteoporosis. It can occur as a result of slight injury which is usually a rational force.