Download MBBS The Tibia Lecture PPT

? Strong bong on the medial side

of the leg.

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? Helps in the formation of knee

joint above and ankle joint

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below.

? Parts: 1. upper end
2. shaft
3. lower end

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SIDE DETERMINATION

1.Upper end is broader.
2.Anterior border of the shaft is

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sharp and prominent.

3.Medial malleolus projects from

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the, medial side of the lower end.
THE UPPER END

? Expanded transversely.
? Consists of: i) medial condyle

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ii) lateral condyle
iii) tuberosity

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A) MEDIAL CONDYLE:
? Larger of the two condyles.
? Possesses 4 surfaces:

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a) Upper articular surface:
? concave, smooth and oval in shape.
? Articulates with medial condyle of femur.
? Anterior, medial and posterior margins of the

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articular surfaces are flattened and related to
medial meniscus(medial semilunar cartilage).

? Lateral margin projects upwards to form medial

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intercondylar tubercle.



b) Posterior surface:

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? Presents a groove.
? Upper lip of the groove gives attachment to:
i. Capsular ligament of knee
ii. Tibial collateral ligament of knee.
? Semimembranosus is inserted into the groove

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and its lower lip.

c) Medial and anterior surfaces:
? Rough

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? Pierced by numerous vascular foramina.
? Gives attachment to: medial patellar retinaculum.

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B) LATERAL CONDYLE:
? Overhangs upper part of posterior surface of shaft.
? It has a small round facet in its posterolateral aspect

called the fibular facet, which articulates with the

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head of fibula. Its margins gives attachment to
capsular ligament of superior tibio-fibular joint.

? Posterior surface is presents a groove which is

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related to popliteus tendon.

? Upper articular surface is concave and circular and

its flattened margins are related to lateral meniscus. It

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articulates with the lateral condyle of femur.

? Medial margin is raised to form lateral intercondylar

tubercle.

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Diagram B

Diagram A

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ATTACHMENTS ON THE LATERAL CONDYLE:

1. A sharp margin separating the anterior and lateral

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surfaces of condyle from the lateral surface of the
shaft; gives attachment to deep fascia of leg.

2. An oval impression on the anterior surface gives

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attachment to ilio tibial tract.

3. Few fibres of biceps femoris are inserted above

and in front of fibular facet.

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4. Extensor digitorum longus. Arise from lateral
surface
5. Peroneus longus. below the fibular
facet.

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6. Lateral patellar retinaculum- above iliotibial tract.

INTERCONDYLAR AREA

? Rough, non articular area between the superior articular surfaces

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of the condyles.

? An elevated area in the middle art is called the intercondylar

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eminence. The lateral and medial part of this prominence projects

upwards and constitutes lateral and medial intercondylar

tubercles, separated by a groove.

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? Intercondylar area gives attachments from before backwards to:
1. Anterior horn of medial meniscus.
2. Anterior cruciate ligament.
3. Anterior horn of lateral meniscus.

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4. Posterior horn of lateral meniscus.
5. Posterior horn of medial meniscus.
6. Posterior cruciate ligament.
? The ridge on the posterior aspect of intercondylar area gives

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attachment to capsular ligament of knee joint.

C) TUBEROSITY OF TIBIA:

? Lies at the upper border of anterior border

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of the shaft and at a place where anterior

surfaces of the condyles becomes

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continuous.

? It is triangular in shape.
? Has two parts:
i. Upper smooth part: gives attachment to

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ligamentum patellae.

ii. Lower rough part: subcutaneous and

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separated from he skin by subcutaneous

infrapatellar bursa.

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THE SHAFT
? Prismoid in shape. Triangular in cross

section.

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? Gradually tapers from above

downwards.

? Possesses:

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1. 3 borders: anterior, interosseous and

medial.

2. 3 surfaces: medial, lateral and

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posterior.


BORDERS

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A) Anterior border
? Begins below the tuberosity of tibia and

ends below the anterior margin of medial
malleolus.

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? Subcutaneous, sharp and prominent in

upper 2/3 and is called the `shin'.

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B) Interosseous (lateral) border
? Begins from antero-inferior part of fibular facet on

the lateral condyle and extends below to reach the
anterior border of fibular notch at the lateral

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aspect of lower end.

? Gives attachment to interosseous membrane

except at its upper and lower ends.

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? Its lower end which forms the anterior boundary

of fibular notch gives attachment to anterior tibio-
fibular ligament.

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C) Medial border

? It begins below the anterior end of the groove on the medial condyle

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and runs down to the posterior margin of medial malleolus.

? It is sharp and prominent only in its middle part.

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? It is divided into 2 parts by the soleal line joining it.

? Attachments:

1. Above the soleal line:

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a) fascia covering popliteus.

b) tibial collateral ligament of knee joint.

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c) semimembraneous.

2. Below soleal line:

a) soleus.

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b) fascia covering deep muscles of back of leg.


SURFACES

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A) Medial surface

? Lies between anterior and medial borders.

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? It is subcutaneous in nearly the whole of its extent.

? Rough area near its upper end gives attachment to:

1. Tibial collateral ligament of knee joint.

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2. Semimembranosus- inserted behind the ligament

?

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In front of the rough area following muscles are attached from
before backwards:

1. Sartorius

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2. Gracillis

3. Semitendinosus

? The rest of the medial surface is covered only by superficial fascia.

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? (mnemonic: Girl between two Surgeons)


B) Lateral surface

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? Lies between anterior and interosseous borders.
? Tibialis anterior ? arises from its upper 2/3 part.
? Lower third of the surface is related fro medial to

lateral side to:

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1. Tibialis anterior
2. Extensor hallusis longus
3. Anterior tibial artery
4. Deep peroneal nerve

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5. Extensor digitorum longus
6. Peroneal tertius
(mnemonic: The Himalayas Are Not Dry Plateaus.)

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C) Posterior surface

? Lies between the interosseous and medial borders.

? Soleal line- it is an oblique line running from above (in front of fibular

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facet) downwards and medially to the medial border. It is divides the
surface into the upper triangular area and a lower area.

? Attachments:

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1. Fascia covering popliteus

2. soleus.

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? A faint vertical line below soleal line divides the surface into medial

and lateral parts.

1. Flexor digitorum longus arises from the medial part.

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2. Tibialis posterior arises from the lateral part.

? Lower ? of this surface has no muscular attachments but is related

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(medial to lateral) to: Tibialis posterior tendon, flexor digitorum
longus, posterior tibial artery, tibial nerve and flexor halluces longus.

v Mnemonic: The Doctors Are Not Hunters.

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THE LOWER END
? Five surfaces:
1. Anterior

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2. Posterior
3. Medial
4. Lateral
5. Inferior
? Has one process k/a medial

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malleolus.

MEDIAL MALLEOLUS
? Short and stout process which projects down from medial

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part of the lower end.

? It possesses 4 surfaces and one border.
1. Medial surface: convex and subcutaneous.

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2. Lateral surface: has a comma shaped facet for

articulation with the medial side of the body of talus.

3. Anterior surface: gives attachment to anterior part of

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articular capsule of ankle joint.

4. Posterior surface: has a groove which lodges the tendon

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of tibialis posterior.

5. Lower border: has a depression in the middle to which is

attached deltoid ligament of ankle joint.

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SURFACES
1. Anterior surface:
?

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Gently convex and is continuous above with lateral
surface of the shaft. It is separated from its inferior
surface by an arrow transverse groove which gives
attachment to capsular ligament of knee joint.

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?

Relations (medial to lateral):

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a) Tibialis anterior
b) Extensor hallucis longus
c) Anterior tibial vessels
d) Deep peroneal nerve
e) Extensor digitorum longus

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f) Peroneal tertius

2.

Medial surface

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? Convex and subcutaneous.
? Continuous above with medial surface of the shaft and

below with medial surface of medial malleolus.

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3. Posterior surface
? Faces backwards and is continuous with posterior

surface of the shaft. Separated from the inferior surface

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by a sharp margin which gives attachment to capsular
ligament of ankle joint.

? It has a groove at its medial end which lodges the tendon

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of tibialis posterior. Lateral to this groove lies the
posterior tibial vessels and tibial nerves and the tendon of
flexor hallucis longus.

? Presents nutrient foramen which is directed downwards,

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so upper end of the growing end of the bone. Nutrient
artery is derived from posterior tibial artery.

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4. Lateral surface

? Formed by fibular notch which articulates with the lower

end of fibula.

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? Floor of the notch gives attachment to interosseous tibio

-fibular ligament which keeps lower ends of two bones in
strong apposition.

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? Anterior and posterior borders of the notch give

attachment to anterior and posterior tibio-fibular
ligaments.

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5. Inferior border
? Covered by hyaline cartilage and articulates with

superior surface of the body of talus.

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? Medially it is continuous with articular surface of medial

malleolus.

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Thank you.