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The lower limb is divided into four regions:
Gluteal region – buttock and hip area.
Thigh – between hip and knee.
Leg – between knee and ankle.
Foot (Pes) – distal part bearing body weight.
Two hip bones (each made of ilium, ischium, and pubis).
They articulate posteriorly with the sacrum and anteriorly at the pubic symphysis.
Ilium (upper two-fifths)
Ischium (posterior two-fifths)
Pubis (anterior one-fifth)
→ All three meet at the Y-shaped cartilage in the acetabulum.
Femur — transmits weight from the hip to the tibia.
About 125°–130° in adults.
Decreased angle (<120°) → Coxa vara
Increased angle (>135°) → Coxa valga
Patella, located within the tendon of quadriceps femoris.
Increases leverage of quadriceps femoris.
Protects anterior surface of knee joint.
Tibia, the medial and weight-bearing bone of the leg.
Fibula, as it is non–weight-bearing and expendable.
Common peroneal (fibular) nerve — injury leads to foot drop.
Calcaneus — forms the heel of the foot.
Intermediate cuneiform — lies between the medial and lateral cuneiforms.
Talus — covered only by articular cartilage and ligaments.
A medial shelf-like projection of calcaneus supporting the head of the talus.
Provides surface for spring ligament and flexor hallucis longus tendon.
Talus, articulating above with the tibia and below with the calcaneus.
Navicular bone, ossifying at about 3–4 years of age.
Cuboid bone, around the 9th month intrauterine or at birth.
A large styloid process on the base of 5th metatarsal for insertion of peroneus brevis.
Small bones embedded in tendons that reduce friction.
Examples in foot:
Two beneath head of 1st metatarsal (in flexor hallucis brevis tendons).
Os peroneum in peroneus longus tendon (near cuboid).
Reduce tendon friction.
Modify pressure on joints.
Improve leverage of muscle pull.
Calcaneus, talus, navicular, three cuneiforms, and first three metatarsals.
→ Keystone: Talus.
Calcaneus, cuboid, 4th and 5th metatarsals.
→ Keystone: Cuboid.
Cuneiforms, cuboid, and bases of metatarsals.
Plantar calcaneonavicular (spring) ligament — main ligament.
Deltoid ligament and long plantar ligament also contribute.
Posteriorly: Calcaneal tuberosity (heel).
Anteriorly: Heads of 1st and 5th metatarsals (ball of foot).
Bimalleolar fracture of ankle due to forced eversion.
Medial malleolus fractures → deltoid ligament tension.
Talus pushes laterally → fracture of fibula.
Painful inflammation of the tibial tuberosity due to traction of patellar ligament in adolescents.
Stress fracture of the 2nd or 3rd metatarsal due to repetitive strain in soldiers or runners.
Avulsion fracture of the base of 5th metatarsal, due to pull of peroneus brevis tendon.
Head of femur (after fracture neck femur) and body of talus (after neck fracture).
20°–40°
→ Decreased in calcaneal compression fracture.
Talus.
Calcaneus.
Posteriorly: Talus
Anteriorly: Three cuneiforms
Laterally: Sometimes cuboid
Calcaneus – ossification starts at the 6th month intrauterine life.
Lower limb → locomotion and weight-bearing.
Upper limb → manipulation and dexterity.
Lower limb bones → thicker, stronger, limited movement but stable joints.
Protects plantar structures.
Maintains longitudinal arches of the foot.
Assists in propulsion during walking.
Blood supply is from small arterial branches entering non-articular surfaces.
Fractures easily disrupt these, leading to ischemic necrosis.
Iliac crest: Site for bone marrow biopsy and bone grafts.
Upper tibia: Site for emergency intraosseous infusion.
Lower end of tibia, medial malleolus, lateral malleolus (fibula), and superior surface of talus.
Tibia, through its lower articular surface to the talus.
Ischial tuberosity — bears body weight while sitting.
Ilium, ischium, and pubis, fusing at the acetabulum.
Tibia.
Fibula.
Ligamentum patellae.
Provide shock absorption, elasticity, and weight distribution during standing and walking.
Cuboid.
Cuneiforms, cuboid, and bases of metatarsals.
Support of body weight
Locomotion
Postural balance
Shock absorption through arches of the foot
A. Ilium, ischium, and pubis
B. Ilium and pubis only
C. Pubis and ischium only
D. Ilium, ischium, and sacrum
✅ Answer: A
→ The acetabulum is formed by all three parts of the hip bone meeting at the Y-shaped cartilage.
A. Tibia
B. Femur
C. Fibula
D. Humerus
✅ Answer: B
→ The femur supports body weight and forms the major lever for locomotion.
A. Tibia
B. Femur
C. Fibula
D. Calcaneus
✅ Answer: B
A. Rectus femoris
B. Hamstrings
C. Gluteus medius
D. Tensor fasciae latae
✅ Answer: B
→ The hamstrings—biceps femoris (long head), semitendinosus, semimembranosus—arise from the ischial tuberosity.
A. Ilium
B. Ischium
C. Pubis
D. Sacrum
✅ Answer: B
→ Ischial tuberosity bears body weight in sitting posture.
A. Flat bone
B. Irregular bone
C. Sesamoid bone
D. Short bone
✅ Answer: C
→ It is the largest sesamoid bone, embedded in the quadriceps tendon.
A. Femur
B. Fibula
C. Talus
D. Navicular
✅ Answer: D
→ Tibia articulates with femur (knee), fibula (upper and lower ends), and talus (ankle).
A. Femur
B. Tibia
C. Fibula
D. Talus
✅ Answer: C
→ Fibula serves for muscle attachment and lateral ankle support but does not bear weight.
A. Tibial nerve
B. Common peroneal nerve
C. Sural nerve
D. Saphenous nerve
✅ Answer: B
→ Injury here causes foot drop due to paralysis of dorsiflexors.
A. Talus
B. Navicular
C. Calcaneus
D. Cuboid
✅ Answer: C
→ The calcaneus forms the heel and bears body weight posteriorly.
A. Talus
B. Calcaneus
C. Cuboid
D. Navicular
✅ Answer: A
→ Talus is covered by articular cartilage and ligaments only.
A. Talus
B. Navicular
C. Calcaneus
D. Cuboid
✅ Answer: C
A. Talus
B. Navicular
C. Calcaneus
D. Cuboid
✅ Answer: C
→ It supports the talar head and carries the tendon of flexor hallucis longus below it.
A. Talus
B. Calcaneus
C. Navicular
D. Cuboid
✅ Answer: C
→ Navicular ossifies at 3–4 years, last among tarsals.
A. 4
B. 5
C. 6
D. 7
✅ Answer: B
→ Articulates with calcaneus, lateral cuneiform, navicular, 4th and 5th metatarsals.
A. Tibialis posterior
B. Peroneus brevis
C. Tibialis anterior
D. Peroneus longus
✅ Answer: B
→ Peroneus brevis inserts on the tuberosity of the 5th metatarsal.
A. Talus
B. Calcaneus
C. Cuboid
D. Navicular
✅ Answer: B
→ Calcaneus ossifies in the 6th month IU.
A. Navicular
B. Cuboid
C. Talus
D. Lateral cuneiform
✅ Answer: B
A. Navicular
B. Talus
C. Cuboid
D. Calcaneus
✅ Answer: B
A. Talus
B. Cuboid
C. Navicular
D. Calcaneus
✅ Answer: B
A. Talus
B. Calcaneus
C. Cuboid
D. Navicular
✅ Answer: B
→ Axial compression fractures the calcaneus, reducing Böhler’s angle.
A. Lateral circumflex femoral artery
B. Medial circumflex femoral artery
C. Obturator artery
D. Inferior gluteal artery
✅ Answer: B
→ Provides major blood supply to femoral head via retinacular branches.
A. Talus fracture
B. Femur fracture
C. Calcaneus fracture
D. Fibula fracture
✅ Answer: C
→ Normal 20°–40°, reduced in calcaneal compression.
A. Tibia
B. Femur
C. 2nd metatarsal
D. 5th metatarsal
✅ Answer: C
A. Patella
B. Os peroneum
C. Fabella
D. Sesamoid under great toe
✅ Answer: A
A. Navicular
B. Cuboid
C. Lateral cuneiform
D. Talus
✅ Answer: A
A. Navicular
B. Cuboid
C. Talus
D. 2nd metatarsal
✅ Answer: A
A. Long plantar ligament
B. Spring ligament
C. Short plantar ligament
D. Deltoid ligament
✅ Answer: B
→ The plantar calcaneonavicular (spring) ligament supports the talar head.
A. Long plantar ligament
B. Peroneus longus tendon
C. Tibialis posterior tendon
D. Both B and C
✅ Answer: D
→ Crossing tendons of peroneus longus and tibialis posterior maintain the transverse arch.
A. Navicular
B. Cuboid
C. Calcaneus
D. Lateral cuneiform
✅ Answer: A
A. Semitendinosus tendon
B. Patellar ligament
C. Sartorius tendon
D. Gracilis tendon
✅ Answer: B
A. Fibula
B. Iliac crest
C. Calcaneus
D. Tibia
✅ Answer: B
A. Sacrotuberous ligament
B. Sacrospinous ligament
C. Iliofemoral ligament
D. Pubofemoral ligament
✅ Answer: B
A. Femur
B. Fibula
C. Tibia
D. Talus
✅ Answer: C
A. Flexor digitorum longus
B. Flexor hallucis longus
C. Tibialis posterior
D. Peroneus longus
✅ Answer: B
A. Groove for tibialis posterior tendon
B. Groove for peroneus longus tendon
C. Groove for flexor hallucis longus tendon
D. Groove for flexor digitorum longus tendon
✅ Answer: B
A. Talus
B. Calcaneus
C. Cuboid
D. Navicular
✅ Answer: C
A. 4
B. 5
C. 6
D. 7
✅ Answer: B
→ Talus + 3 cuneiforms + sometimes cuboid.
A. Calcaneus
B. Cuboid
C. Talus
D. Navicular
✅ Answer: B
A. One
B. Two
C. Three
D. None
✅ Answer: B
→ Medial and lateral sesamoids in flexor hallucis brevis tendons.
A. Talus
B. Calcaneus
C. Cuboid
D. Navicular
✅ Answer: C
→ Presence of ossification centre in cuboid indicates full-term fetus.
A. Head of femur
B. Shaft of tibia
C. Base of 5th metatarsal
D. Patella
✅ Answer: A
A. Tibia
B. Fibula
C. Talus
D. Calcaneus
✅ Answer: B
A. Tibia
B. Fibula
C. Talus
D. Navicular
✅ Answer: A
A. Body
B. Ala
C. Arcuate line
D. Iliac crest
✅ Answer: C
A. Tibia
B. Fibula
C. Talus
D. Calcaneus
✅ Answer: A
A. Talus
B. Navicular
C. Cuboid
D. Calcaneus
✅ Answer: C
A. Calcaneus
B. Navicular
C. Cuboid
D. Lateral cuneiform
✅ Answer: B
A. Lateral condyle
B. Medial condyle
C. Anterior intercondylar area
D. Posterior intercondylar area
✅ Answer: C
A. Talus
B. Navicular
C. Cuboid
D. Lateral cuneiform
✅ Answer: B
Q1. How many bones form the lower limb skeleton?
A. Thirty bones — 1 hip bone, 1 femur, 1 patella, 1 tibia, 1 fibula, and 26 bones of the foot.
Q2. Name the bones forming the pelvic girdle.
A. Two hip bones, each formed by fusion of ilium, ischium, and pubis.
Q3. What is the acetabulum?
A. A deep cup-shaped cavity on the lateral side of the hip bone where the head of femur articulates to form the hip joint.
Q4. Which bones take part in forming the acetabulum?
A. Ilium, ischium, and pubis.
Q5. What is the obturator foramen and what passes through it?
A. A large oval opening formed by ischium and pubis; closed by obturator membrane except for the obturator canal through which obturator nerve and vessels pass.
Q6. What is the significance of the ischial spine?
A. Landmark between greater and lesser sciatic foramina; gives attachment to the sacrospinous ligament.
Q7. What is the ischial tuberosity known for?
A. It bears the weight of the body while sitting and gives origin to hamstring muscles.
Q8. What is the function of the pubic symphysis?
A. Joins the two hip bones anteriorly via fibrocartilage, allowing limited movement.
Q9. Which is the longest and strongest bone in the body?
A. Femur.
Q10. Name the parts of the femur.
A. Upper end, shaft, and lower end.
Q11. What is the normal neck-shaft angle of the femur?
A. About 125°–130°.
Q12. What is coxa vara and coxa valga?
A. Coxa vara – decreased neck-shaft angle; Coxa valga – increased angle.
Q13. Name the structures attached to the greater trochanter.
A. Gluteus medius, minimus, piriformis, obturator internus, and gemelli.
Q14. What is the importance of the lesser trochanter?
A. Insertion site for iliopsoas, the chief flexor of the thigh.
Q15. Which artery supplies the head of the femur?
A. Medial circumflex femoral artery (via retinacular branches).
Q16. What happens if these arteries are damaged in neck fracture?
A. Avascular necrosis of the femoral head.
Q17. What type of bone is the patella?
A. Sesamoid bone.
Q18. In which tendon is the patella present?
A. Quadriceps femoris tendon.
Q19. What is the function of the patella?
A. Increases leverage of quadriceps during knee extension.
Q20. What is the clinical importance of patellar fracture?
A. Disrupts the extensor mechanism of the knee.
Q21. Which bone forms the medial malleolus?
A. Tibia.
Q22. What is the function of the tibial tuberosity?
A. Insertion site for the patellar ligament.
Q23. Which surface of tibia is subcutaneous?
A. The anterior surface and medial border — palpable along the “shin”.
Q24. What is Osgood–Schlatter disease?
A. Painful inflammation at the tibial tuberosity due to traction from quadriceps in adolescents.
Q25. What does the upper articular surface of tibia form?
A. The tibial plateau for articulation with femoral condyles.
Q26. Is the fibula weight-bearing?
A. No, it is non–weight-bearing and mainly for muscle attachment.
Q27. What is the head of the fibula related to clinically?
A. Common peroneal nerve winds around its neck — injury leads to foot drop.
Q28. What does the lower end of the fibula form?
A. The lateral malleolus of the ankle.
Q29. What are the uses of the fibula in surgery?
A. Used as a donor bone for grafting without functional loss.
Q30. Name the tarsal bones.
A. Talus, calcaneus, navicular, cuboid, and three cuneiforms (medial, intermediate, lateral).
Q31. Which is the largest tarsal bone?
A. Calcaneus.
Q32. Which tarsal bone lies between talus and cuneiforms?
A. Navicular.
Q33. Which tarsal bone has no muscular attachment?
A. Talus.
Q34. What is sustentaculum tali?
A. Medial projection from calcaneus supporting talar head and groove for flexor hallucis longus tendon.
Q35. What is the function of the calcaneus?
A. Forms the heel and transmits body weight to the ground.
Q36. Which bone forms the keystone of the medial longitudinal arch?
A. Talus.
Q37. Which bone forms the keystone of the lateral longitudinal arch?
A. Cuboid.
Q38. How many metatarsal bones are there?
A. Five, numbered I to V from medial to lateral side.
Q39. Which is the shortest and thickest metatarsal?
A. First metatarsal.
Q40. What is the special feature of the fifth metatarsal?
A. Tuberosity (styloid process) for insertion of peroneus brevis.
Q41. What are the phalanges of the foot?
A. 14 in total — two in the great toe, three in each of the other toes.
Q42. What is the function of the distal phalanges?
A. Support the nail bed and terminal pad of toes.
Q43. What are sesamoid bones?
A. Small bones embedded in tendons where they pass over joints.
Q44. Name the constant sesamoid bones in the foot.
A. Two under the head of the first metatarsal (medial and lateral).
Q45. What is their function?
A. Reduce friction, protect tendons, and improve leverage of toe flexors.
Q46. What is sesamoiditis?
A. Inflammation of sesamoid bones causing forefoot pain (common in athletes).
Q47. Name the arches of the foot.
A. Medial longitudinal, lateral longitudinal, and transverse arches.
Q48. What are the main ligaments maintaining the arches?
A. Spring ligament, long plantar ligament, and short plantar ligament.
Q49. What is the keystone of the medial arch?
A. Talus.
Q50. What is the clinical importance of the arches?
A. Maintain balance, distribute weight, and act as shock absorbers during locomotion.
Q51. What is Pott’s fracture?
A. Bimalleolar ankle fracture due to forced eversion injury.
Q52. What is March fracture?
A. Stress fracture of 2nd or 3rd metatarsal due to overuse.
Q53. What is Osgood–Schlatter disease?
A. Inflammation of tibial tuberosity in growing children due to repeated strain.
Q54. What is the consequence of a neck of femur fracture in elderly?
A. Shortening and external rotation of the limb due to loss of weight-bearing continuity.
Q55. Why is the talus prone to avascular necrosis?
A. Blood supply enters through small non-articular areas, easily disrupted by fractures.
Q56. What is flatfoot (pes planus)?
A. Collapse of the medial arch due to ligament or muscle weakness.
Q57. What is clubfoot (talipes equinovarus)?
A. Congenital inversion and adduction deformity of the foot.
Q58. What is the importance of the fibular head during injections?
A. Common peroneal nerve passes around it — must be avoided.
Q59. What is the purpose of the calcaneal tuberosity?
A. Insertion site of the tendo calcaneus (Achilles tendon).
Q60. Which bone is commonly fractured in a fall from height?
A. Calcaneus.
Femur → Longest, strongest bone.
Tibia → Weight-bearing bone, subcutaneous.
Fibula → Non–weight-bearing, nerve close to neck.
Patella → Largest sesamoid bone.
Talus → No muscle attachments, keystone of medial arch.
Calcaneus → Heel bone, largest tarsal.
Cuboid → Keystone of lateral arch.
Navicular → Last to ossify, articulates with 3 cuneiforms.
Cuneiforms → Wedge-shaped, maintain arch.
Metatarsals → 1st shortest and thickest; 5th has styloid process.
Sesamoid bones → Beneath head of 1st metatarsal.
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