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SF1 - Test 3 > 3 - Zill - Joints of Lower Extremity > Flashcards

3 - Zill - Joints of Lower Extremity Flashcards

61B - 105B

1
Q

Synovial Joints

What do some of these joints have to further reduce friction?

A

Hip / Knee / Ankle

Joints with synovial membrane, that secretes lubricating synovial fluid

  • -

Articular Discs - lay between cartilage heads of joint, further reduces friction

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2
Q

Articular Cartilage

What can be a clinical presentation of issues with these?

A

Cartilage layer on bones at point of contact, serves as shoch absorber and reduces effects of friction on the bones

Osteoarthritis - degeneration of articular cartilage

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3
Q

Intrinsic vs Accessory Ligaments

A

Intrinsic = thickening of capsule (hip ligaments)

Accessory = Separate from capsule (collateral ligaments of knee)

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4
Q

Shape of Acetabulum and Labrum

What is the Y-shaped convergence point of the ilium, ischium, and pubis?

A

Acetabulum = “C” Shaped (Lunate Articular Surface)

Has a gap inferiorly called the acetabular notch

- - -

Acetabular Labrum - deepens cavity with rim of cartilage

Triradial Cartilage

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5
Q

What ligament bridges the acetabular notch?

What covers the surface of the acetabulum and femur head?

A

Transverse Acetabular Ligament

Hyaline Cartilage

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6
Q

What encloses the hip joint?

What is their main role?

A

3 x Intrinsic Ligaments - Limit Extension

  1. Iliofemoral Ligament (limits extension)
  2. Pubofemoral Ligament (limits extension, abdution)
  3. Ischiofemoral Ligament (limits extension)
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7
Q

Strongest ligament in the body? Purpose?

A

Iliofemoral Ligament

O: Ilium

I: Intertrochanteric Line

Action: Prevents over extension

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8
Q

Ligament of Head of Femur

A

Located inside joint capsule, attached to head at fovea capitis and to transverse acetabular ligament

Transmits artery of ligament of head of femur (branch of Obturator artery)

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9
Q

Types of Hip Dislocations:

Congenital

v

Traumatic

v

Fracture

A

Congenital: Superior, Medial Rotation

Traumatic: Posterior

Fracture: Lateral Rotation (risk for avascular necrosis of head of femur)

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10
Q

What is blood source for the head of the femur?

A
  1. Obturator Artery (through ligament head)
  2. Medial and Lateral Femoral Circumflex
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11
Q

Bursae of Knee

A
  1. Suprapatellar Bursa - Outpocketing of synovial cavity of knee joint posterior to quadriceps tendon (largest)
  2. Prepatellar bursa - Between skin and patella (patella)
  3. Superficial Infrapatellar Bursa - Between skin and patellar ligament (low)
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12
Q

Housemaid’s Knee

v

Clergyman’s Knee

A

Housemaid’s - Prepatellar Bursitis (higher)

Clergyman’s - Superficial Infrapatellar Bursitis (lower)

Clergy = Superficial In’friar’patellar

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13
Q

Extracapsular Ligaments:

Lateral Collateral Ligament

Medial Collateral Ligament

A

LCL - Prevents movement of tibia medially

MCL - Prevents movement of tibia laterally

Opposite side restriction!

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14
Q

Intracapsular Ligaments:

Anterior Cruciate Ligament

Posterior Cruciate Ligament

A

ACL - Passes up and back (front view); prevents anterior tibia movement

PCL - Passes up; prevents posterior tibia movement

ACL/PCL prevent same as name!

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15
Q

Test for tears in Cruciate (ACL/PCL) ligaments?

A

ACL - Draw tibia anteriorly (Lachman)

PCL - Push tibia posteriorly

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16
Q

Menisci

A

“C” shaped cartilages that are attached to inner side of joint capsule

  • -

Medial Mediscus

Lateral Meniscus

17
Q

Medial Meniscus

&

Lateral Meniscus

A

Medial: Relatively fixed, attached to medial collateral ligament, between condyles

Lateral: More movable because NOT attached to lateral (fibular) collateral ligament

18
Q

Terrible Triad of Knee Joint Injury

A

Blow to Lateral side of knee

Tear:

MCL (medial [tibial] collateral ligament)

ACL (anterior cruciate ligament)

Medial Meniscus (it’s connected to MCL)

19
Q

Mechanism of Locking and Unlocking the Knee

A

Locking - Femur rotates medially last 30 deg; making ligaments taut ‘locking’ the knee (passive extension locks)

Unlocking - Popliteus muscle rotates femur laterally unlocks (active flextion unlocks)

Lock = passive medial rotation

Unlock = active lateral rotation

20
Q

Joints Between Tibia and Fibula

A

Syndesmosis (sheet of connective tissue between bones)

  1. Interosseus Membrane - broad sheet of connective tissue between tibia/fibula w/gap for Ant. Tibial artery/vein
  2. Anterior and Posterior Inferior Tibio-Fibular Ligaments - join bones above ankle joint (high ankle sprain)
21
Q

High Ankle Sprain cause

A

Tear or stretch of Anterior Inferior Tibio-fibular ligaments

22
Q

What type of joint is the ankle?

A

Uniaxial, hinge-type joint

Only permits dorsiflexion and plantar flexion

Strengthened by collateral ligaments

23
Q

Medial (Deltoid) Ligament

A

Strong, triangular shaped ligament of ankle

O: Medial Malleolus of tibia

I: Medial surface of talus / calcaneus

Action: Limits eversion

This is a strong ligament, and the reason you usually roll your ankle via inversion, NOT eversion

24
Q

Lateral Ligaments of Ankle Joint

A

Generally weaker than medial

O: Lateral malleolus of fibula

I: Anterior / Posterior Talofibular - Talus; Calcaneofibular - Calcaneus

Action: Limit inversion

These are weaker than medial, hence why you usually “roll” or sprain your ankle via inversion (these fail)

25
Q

Joints of Inversion/Eversion of Foot

A
  1. Subtalar Joint (between Talus and Calcaneus)
  2. Transverse Tarsal Joint (between Talus and Navicular medially, and Calcaneus and Cuboid bones laterally)
26
Q

What is damaged in an ankle sprain?

A

Excessive inversion

Anterior Talofibular, Calcaneofibular Ligament stretched or partially torn

27
Q

Pott’s Fracture

A

Excessive eversion of foot/ankle

Deltoid Ligament is strong and doesn’t rupture

Medial Malleolus and Fibula are fractured

- - -

Imagine getting hit low, from the lateral side of the ankle

28
Q

Valgus

v

Varus

A

Genu Valgus = “knock-kneed”

Normal in infants 3-5

Genu Varus = “bow-legged”

Normal in infants 0-3

- - -

In vaLgus, Left Leg forms and “L“

29
Q
A

SF1 - Test 3 (13 decks)

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