1 joints Flashcards
Gluteal tuberosity
where lower fibers of gluteus maximus attach to the posterior part of the femur
linea aspera
where adductor muscles attach to
intercondylar fossa
posterior distal femur
ACL PCL insert into it
Tibial tuberosity
anterior of tibia
where patellar ligament insert
Soleal line
proximal posterior tibia, where soleus attach to
iliofemoral ligament
from anterior inferior iliac spine –> bifucates –> insert into the two ends of the intertrochanteric line
limits adduction, lateral rotation and hyperextension
pubofemoral ligament
pubic bone to femoral neck
limits hyperabduction
Ischiofemoral ligament
ischium –> intertrochanteric line
limits medial rotation
Blood supply of femoral neck
medial circumflex femoral artery –> retinacular arteries in synovial fold, lateral circumflex femoral, both from deep femoral artery, obturator artery in ligamentum teres
types of femoral fracture
intertrochanteric fracture: good change of healing
subcapital fracture: just beneath the head and at top of neck, elderly, loss of blood supply –> avascular necrosis –> collapse and flattening of the femoral head, no longer fits the acetabulum, osteoarthritis and arthritis pain
Anterior cruciate ligament
where
state when knee is extended
function
from anterior tibial spine to the lateral aspect of intercondylar fossa
anterior is the weaker and is most taut when the knee is fully extended, slack when flexed, preventing tibia sliding in front of femur (hyperextension). torn in hyperextension with the tibia medially/internally rotated
Meniscus
medial larger, lateral, intercondylar area made of fibrocartilage, avascular, heal poorly (red-red, red-white, white-white), cup-shaped that covers the articular surface of the femur,
1) stabilize the knee joint
2) allow synovial fluid to spread evenly
3) reduce friction and stress on knee joint
4) absorb 1/3 of knee impact load
Structures that stabilize the knee joint
lateral and medial collateral ligament
taut when standing, save energy
medial collateral ligament is attached to the medial meniscus!
Lateral and medial condyles of femur
which one has a larger area for articulation
which one projects more anteriorly
medial condyle has a larger articular surface
but lateral condyle projects further anteriorly to prevent lateral dislocation of patella
What structures prevent lateral and medial patella dislocation?
Lateral: anterior projection of lateral femoral condyle
Medial: vastus medialis insert on medial patella
Lock knee joint (flex –> extension)
Knee move from flexed to extended position, articular surface of lateral femoral condyle stops.
Medial rotation follows as the larger medial condyle continues to articulate with the medial meniscus (30 degrees)
lastly, collateral and anterior cruciate ligaments tighten (posterior CL slack) and stabilize the knee joint in extended positions
Unlocking of knee
Lateral rotation of femoral condyle on tibial condyle by the contraction of the popliteus muscle
posterior cruciate ligament
from posterior intercondylar area of tibia extending anteriorly to medial femoral condyle
Taut when knee is flexed, prevent tibia from sliding backward under femur (hyperflexion)
Unhappy triad
extended knee, sport, receive strong impact on the lateral side
1) Anterior cruciate ligamnet (tau when extended) is torn
2) Medial collateral ligament is torn
3) the connected medial meniscus is broken (red-white, white white zone then can’t heal)
Housemaids knee
- definition
- symptoms
- who is more vulnerable
Prepatellar bursitis (subcutaneous prepatellar bursa, between the skin and the patella)
more common in males surprisingly haha
if in children, more likely to be caused by infection, weak immune system
Symptoms: difficulty in kneeling and walking and knee flexion, pain, swelling of knee, redness of skin, tender kneecap
Clergyman’s knee
Infrapatellar bursitis
ankle joint
deep socket made by inferior ends of tibia and fibula articulate with trochlea of talus
compsoed of tibia, fibula and talus
tibia and fibula are bound together by strong tibiofibular ligaments
movement: dorsiflexion and plantarflexion of the foot
Talus
-anterior and posterior part stability
anterior part is wider than posterior part
Dorsiflexion – the anterior part of the talus is held in the mortise (socket), and the joint is more stable.
Plantarflexion – the posterior part of the talus is held in the mortise, and the joint is less stable.
Transverse tarsal joint + subtalar joint
movement
inversion and eversion (does not happen at the ankle joint)
