Download MBBS Femur Lecture PPT

FEMUR

DR. LOVELY MAUSAMI
TUTOR, DEPT OF ANATOMY,

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NMCH, JAMUHAR.
Longest and strongest bone in the body.
Parts:
1.Upper end
2.Shaft

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3.Lower end

At the upper end it articulates with the hip
bone to form the hip joint, and at the lower end
it articulates with the patella and tibia.

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The femur transmits body weight from the hip
bone to the tibia in standing position.

SIDE DETERMINATION

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The side of femur is determined by holding bone

vertically in such a way that:

Its head faces upward, medially, and slightly

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forward.

Long axis of the shaft is directed downward and

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medially with convexity of the shaft facing
anteriorly.

Lower surfaces of both the condyles are in the same

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horizontal plane.
UPPER END:

It possesses:
1. Head

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2. Neck
3. Greater trochanter: 3 surfaces and 1 border
a) anterior surface
b) lateral surface
c) medial surface

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d) superior border
4. Lesser trochanter

UPPER END:

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vHEAD:
? Projects from the medial side of upper end

the shaft.

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? Faces upward forwards and medially.
? It forms about two-third of a sphere and

articulates with the acetabulum of the hip

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bone to form the hip joint.

? It presents a small pit, the fovea, just below

and behind the centre, which provides

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attachment to the ligament of the head of

femur (ligamentum teres femoris).

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? Lies within the capsule of hip joint.

v NECK:

It is 5 cm long and connects the head with the

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shaft.

It is directed upward, medially, and slightly

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forward.

The angle between its lower border and the

medial border of shaft is called neck?shaft

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angle.

The neck presents two borders--upper and

lower, and two surfaces--anterior and

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posterior.
UPPER BORDER:

It is concave and horizontal.

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It meets the shaft near the greater trochanter.
LOWER BORDER:
It is straight and oblique.

It meets the shaft near the lesser trochanter.

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ANTERIOR SURFACE:
It is flat and bears a number of oblique bony ridges.

It meets the shaft at intertrochanteric line.

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It is completely intracapsular.

POSTERIOR SURFACE:

It is convex from above downward and

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concave from side-to-side.

It meets the shaft at intertrochanteric

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crest.

Its medial half is intracapsular.
It presents a faint groove, which lodges

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the tendon of obturator externus.
v GREATER TROCHANTER:

It is a quadrilateral elevation,

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projecting upward from the lateral
aspect of the junction of neck and
shaft.

It presents:

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1. One border (upper)
2. Three surfaces (anterior, medial,

and lateral).

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UPPER BORDER:

Its posterior part presents the apex

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or tip of greater trochanter, which
provides attachment to the piriformis.

ANETERIOR SURFACE:
It provides attachment to the gluteus

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minimus on a ridge in its lateral part.
MEDIAL SURFACE:

It presents two depressions:

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A depression (trochanteric fossa) at its junction with

the neck for insertion of obturator externus.

A shallow depression above and in front of

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trochanteric fossa for insertion of obturator internus

along with the gemellus superior and gemellus inferior.

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LATERAL SURFACE:
It is quadrilateral and divided diagonally by an oblique

ridge into the upper and lower triangular areas.

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The ridge provides attachment to the gluteus medius

muscle.

The triangular areas--anterior and posterior to the

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ridge are related to the trochanteric bursae of the

gluteus medius and gluteus maximus, respectively.

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v LESSER TROCHANTER:

It is a conical projection arising from

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the posteromedial surface of the neck
?shaft angle.

It is directed medially.
Its apex provides attachment to the

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psoas major.

Iliacus is attached to its base on the

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front.

Intertrochanteric line

It continues downward and medially below the

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lesser trochanter on the posterior aspect of femur
as spiral line.

It provides attachment to two ligaments and two

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muscles:

(a) Capsule of the hip joint.

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(b) Iliofemoral ligament (strongest ligament in the

body).

(c) Vastus lateralis to its upper end.

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(d) Vastus medialis to its lower end..

Intertrochanteric crest

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It extends from the posterosuperior angle of

greater trochanter to the tip of lesser trochanter.

It presents a rounded tubercle near the middle

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called quadrate tubercle, which provides
insertion to the quadratus femoris.

SHAFT:

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The shaft of femur presents:
1. Borders: Medial border
Lateral border
Posterior border.

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2. Surfaces: (4 surfaces in upper and lower

thirds but only 3 surfaces in middle third.)
Anterior surface
Medial surface

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Lateral surface.

BORDERS:

Medial border: rounded, ill defined, separates

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anterior from medial surface.

Lateral border: rounded: rounded ill defined.

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Separates anterior from the lateral surface.

Posterior border/ linea aspera:
It is thick roughened crest opposite the middle third

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of the shaft.

Possesses a lateral and a medial lip and an

intermediate area.

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Medial lip is continuous above with spiral line and

below with supra condylar ridge while the lateral lip is

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continuous above with gluteal tuberosity and below

with the lateral supra condylar ridge.
SURFACES:

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1. ANTERIOR SURFACE: is smooth and

convex and lies between medial and lateral
borders.

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2. LATERAL SURFACE: faces backwards and

laterally and lies between lateral and posterior
borders.

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3. MEDIAL SURFACE: faces backwards and

medially and lies between posterior and medial
borders. It does not give attachment to any
muscle but is covered by vastus medialis muscle.

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UPPER POSTERIOR:

Lies between spiral line medially and gluteal

tuberosity laterally. spiral line is continuous

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above with lower end of trochanteric line and

below with medial lip of linea aspera.

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Gluteal tuberosity is a bony ridge which is

continuous below with the lateral lip of linea

aspera.

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Attachments:(from lateral to medial side):

gluteus maximus, adductor magnus,

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adductor brevis, pectinius, illiacus and

vastus mediallis.

LOWER POSTERIOR:

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Lies between medial and lateral

supracondylar lines which are continuous
above and medial and lateral lip of linea

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aspera respectively.

It is also called the popliteal surface

because it forms the floor of popliteal

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fossa.

ATTACHMENTS TO THE SHAFT:

Vastus intermedius

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Articularis genu
Vastus lateralis
Vastus medialis
Gluteus maximus
Adductor magnus

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Pectinius
Adductor brevis
Adductor longus
Biceps femoris
Plantaris

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Gastrocenimius
Lateral and medial intermuscular septa are attached to the

linea aspera.

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Arrangement of stuctures on linea aspera:
(medial to lateral)

1. Vastus medialis

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2. Medial intermuscular septum
3. Adductor brevis ( in the upper part)
4. Adductor longus ( in the lower part)
5. Adductor magnus
6. Posterior intermuscular septum

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7. Short head of biceps femoris
8. Lateral intermuscular septum
9. Vastus lateralis
10. Vastus intermedius
Mnemonic: (lateral to medial)

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I- vastus INTERMEDIUS

LOVE- vastus LATERALIS

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B- short head of BICEPS femoris

MR- adductor MAGNUS

B- adductor BREVIS

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LOVES ? adductor LONGUS

ME- vastus MEDIALIS

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LOWER END:

Broadly expanded.
To provide good bearing surface for

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transmitting the body weight to the upper end
of tibia.

Has two articular surfaces: patellar and tibial

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articular surface

Consists of two thick masses of bone called

medial and lateral condyles separated from

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each other by intercondylar fossa.

MEDIAL CONDYLE:

More prominent.

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Adductor tubercle: small projection at the

uppermost part of medial condyle. Adductor
magnus is inserted on the tubercle.

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Medial epicondyle: a low rounded elevation on the

medial aspect and lies below and a little in front of
adductor tubercle. It gives attachment to medial

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collateral ligament of knee.

Its lateral surface forms the medial wall of

intercondylar fossa.

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LATERAL CONDYLE:

Smaller but stronger then medial condyle.

Lateral epicondyle: a low rounded elevation on

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lateral aspect. It gives attachment to lateral
collateral ligament of knee.

There is a groove between the epicondyle and

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articular margin.

Popliteus arises from anterior part of the groove

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while its posterior part lodges the tendon of the
muscle in full flexion of knee.

Its medial surface forms lateral wall of intercondylar

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fossa.
INTERCONDYLAR FOSSA/ NOTCH:

It is a deep notch, which separates two condyles

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posteriorly.

It is limited posteriorly above by intercondylar line.

It presents medial and lateral walls and floor.

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Medial wall of the fossa provides attachments to the

upper end of posterior cruciate ligament in its
anteroinferior part.

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Lateral wall of the fossa provides attachment to the

upper end of anterior cruciate ligament in its
posterosuperior part.

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MNEMONIC:

L ? Lateral condyle provides

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attachment to:

A - Anterior cruciate ligament.
M - Medial condyle provides

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attachment to:

P ? Posterior cruciate ligament.
ARTICULAR SURFACE:

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Articular surface has the shape of

inverted `V'.

It is divided into 2 parts:

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a) Upper patellar surface: for articulation

with patella.

b) Lower tibial surface: for articulation

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with condyles of tibia.

PATELLAR SURFACE:

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Forms the upper part of articular surface

and articulates with patella.

It extends over the anterior surface of

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both condyles but more on the lateral
condyle.

It is separated from the tibial surface by

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two faint grooves, each of which is
related to respective miniscus during full
extension of knee.
TIBIAL SURFACE:

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Forms the posterior and inferior parts of the

articular surface of each condyle.

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It is convex.

Divided into medial and lateral parts by

intercondylar fossa.

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Above and in front the two parts are conyinuous

with the patellar surface.

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The tibial articular surfaces articulate with the

condyles of tibia with semilunar cartilages
intervening