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Week 4 - knee OA and knee replacement > Anatomy > Flashcards

Anatomy Flashcards

1
Q

what makes up the pelvic girdle?

A

innominate bones
ilium
ischium
pubis

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2
Q

which leg bone is much larger tib or fib?

A

tibia

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3
Q

how many tarsal bones are there?

A

7

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4
Q

what are the regions of the lower limb?

A

gluteal region
femoral region
leg - between knee and ankle
foot region

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5
Q

what are the movements of the lower limb?

A

-flexion
-extension
-abduction
-adduction
-rotation (hip)

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6
Q

what do muscles in the anterior compartment of the lower limb do?

A

flex the hip but extend the knee

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7
Q

what do muscles in the posterior compartment of the lower limb do?

A

extend the hip and flex the knee

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8
Q

what region is the pelvic girdle in?

A

gluteal region

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9
Q

what is the pelvic girdle?

A

-connects vertebral column to femurs
-much stronger and less flexible than shoulder girdle
-formed by 3 bones, left and right hip bones and sacrum
-sacroiliac and pubic symphysis joints

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10
Q

what kind of joint is the sacroiliac joint?

A

synovial

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10
Q

what type of joint is the pubic symphysis?

A

secondary cartilaginous joint

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11
Q

what are the 3 parts of the innominate bone?

A

ilium - upper part
ischium - posterior part which we sit on
pubis - anterior which comes together at the front

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12
Q

what is the acetabulum?

A

where all 3 bones join together
joint surface for head of femur

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13
Q

what kind of joint is the hip joint?

A

ball and socket synovial joint
-head of femur
-acetabulum of the innominate bone
-very stable joint, good congruency between articular surfaces
-sacrifices mobility for the sake of stability

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14
Q

what does the acetabular labrum do?

A

cartilage that surrounds the acetabulum
makes joint socket deeper to make it fit

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15
Q

what does the transverse acetabular ligament do?

A

bridges acetabular notch

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16
Q

what provides stability in the hip joints?

A

ligaments
-iliofemoral
-pubofemoral
-ischiofemoral

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17
Q

what is the iliac femoral ligament?

A

covers hip joint superiorly and anteriorly
strongest ligament
prevents hyperextension of the hip during standing

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18
Q

what is the pubofemoral ligament?

A

covers hip joint anteriorly and inferiorly
prevents excessive abduction

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19
Q

what is the ischiofemoral ligament?

A

covers hip joint posteriorly
weakest ligament

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20
Q

where is the sarotuberous ligament?

A

from the sacrum to the ischial tuberosity

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20
Q

where is the sacrospinous ligament?

A

from the sacrum to the ischial spine

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21
Q
A
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22
Q

what do the muscles infront of the hip do?

A

flex it

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23
Q

what do the muscles posterior to the hip do?

A

extend it

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24
Q

what are the plexuses involved in the Lower limb?

A

lumbar plexus
sacral plexus
(lumbosacral plexus)
L1-S4

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25
Q

what are the 3 main nerves involved with the motor and sensory innervation of the lower limb?

A

femoral (L2,3,4)
obturator (L2,3,4)
sciatic (L4-S3)

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26
Q

what nerves supply the gluteal regions for extensors and abductors?

A

superior and inferior gluteal nerves

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26
Q

what is the biggest nerve in the body?

A

sciatic nerve

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27
Q

what are the muscles of the gluteal region?

A

gluteus maximus - extensor
gluteus medius
luteal medius
piriformis

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28
Q

what nerve supplies gluteus maximus?

A

superior and inferior gluteal nerves

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29
Q

what nerve supplies gluteus minimus?

A

superior gluteal nerve

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30
Q

what is the gluteus maximus?

A

largest muscle of the body
origin - iliac bone (outer surface of Ala thoraco lumbal aponeurosis, sacrum (post surface), sacrotuberal ligament
insertions - cranial port - ilio tibial tract
caudal port - femur gluteal tuberosity
used when resisting gravity

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31
Q

gluteus medius?

A

origin
iliac bone : posterior surface of Ala
insertion
greater trochanter (tip)
abductor of hip
important for stabilising hip when standing on one leg

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32
Q

pisiforms?

A

origin
sacrum :pelvic surface
insertion : greater trochanter (medial)
sciatic nerve passes underneath

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33
Q

obturator internus?

A

origin
obturtatory membrane
insertion
trochanteric fossa
rotator of hip
sits above the obturator membrane

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34
Q

what is trendelenburg test?

A

-detects weakness of the gluteus medius and minimus
-ask patient to stand on each leg
-observe pelvis for any tilt
-pelvis will normally remain level
-if pelvis tilts then muscle weakness may be present
-can also be due to hip dislocations or arthritis

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35
Q

tensor fasciale latae?

A

origin - anterior portion of iliac crest
insertion - iliotibial tract
supplied by superior gluteal nerve
stabilise the leg in extension
can become tight
tenses fascia latae of thigh
helps to abduct the leg
can act as a medial rotator

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35
Q

what are the medial rotators?

A

gluteus medius (ant portion)
tensor fascia latae

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36
Q

what are the lateral rotators of the lower limb?

A

gluteus maximus
piriformis
obturator internus
sartorius
iliopsoas

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37
Q

what are the compartments of the thigh?

A

-anterior
-medial
-posterior

38
Q

what is raw anterior compartment of the thigh?

A

hip flexors
-pectineus
-sartoriois
-iliopsoas
-quadricpes
knee extensors
-quadriceps

39
Q

what makes up the medial compartment of the thigh?

A

obturator nerve
pectineus, gracilis, adductors - adductor Magnus (ant part)

40
Q

what makes up the posterior compartment of the thigh?

A

hip extensors and knee flexors
sciatic nerve
hip extensors
-hamstrings
-adductor Magnus (post part)
knee flexors
-hamstrings

41
Q

which muscles are involved in 2 different compartments?

A

pectineus and adductor Magnus

42
Q

what nerve supplies the flexors of the hip?

A

femoral nerve

43
Q

what are the flexor muscles of the hip?

A

rectus femoris
pectineus
sartorius
iliopsoas

44
Q

rectus femoris?

A

origin - anterior inferior iliac spine
insertion - patella, tibial tuberosity + med and lat (patella lig + retinacula)
one of the quadricep muscles that form the bulk of the anterior thigh

45
Q

what is the only quadricep that passes the hip?

A

rectus femoris

46
Q

iliopsoas?

A

origin
illiacus: fossa illiaca, AI iliac spine, anterior
posts major: T12-L4
psoas minor: T12-L1
insertions
iliacus & posts major : femur i.e trochanter minor and medial labium of lines aspera
psoas minor : ilio pectina arch, fascial layers of posts major
crosses into thigh
forms from ilialis and spots major
important postural muscle

47
Q

sartorius?

A

origin
AS iliac spine
insertion
Pes anserinus
allows you to cross your legs

48
Q

pectineus?

A

origin - pecten os pubis
insertion - pectineal line (post aspect of femur)
some supply from femoral nerve
can also adduct the thigh

49
Q

what adductors of the thigh?

A

adductor longus
gracilis
pectineus
adductor portion
obturator ext
quadrates femoris
adductor brevis

50
Q

what supplies the superficial layer of the adductors of the thigh?

A

obturator nerve which passes through obturator frame

51
Q

adductor longus?

A

origin - pubic bone, sup ramus +symphysis
inserion - linea aspera

52
Q

gracilis?

A

origin - pubic bone, inferior ramus
insertion - pes anerinus
most medial

53
Q

pectineus?

A

origin- pecten os pubis
insertion - pectineal line (post aspect of femur)
can also flex

54
Q

adductor Magnus?

A

origin - pubic bone, inf ramus
insertion - linea aspera

55
Q

biceps femoris?

A

long head
origin - ischial tuberosity
insertion - head of fibula
(2 headed muscle attaching to the femur)

56
Q

what are the extensor muscles of the hip?

A

hamstrings
biceps femoris
semintendinous
semimembranous
adductor magnus

57
Q

semitendinosus?

A

origin - ischial tuberosity
insertion - pes anserinus

58
Q

semimembranosus?

A

origin - ischial tuberosity
insertion - medial condyle of tibia

59
Q

adductor Magnus?

A

hamstring portion
origin - ischial tuberosity
insertion - adductor tubercle

60
Q

what nerve supplies the extensors of the hip?

A

sciatic nerve

61
Q

what does the abdominal aorta divide into?

A

common iliac arteries

62
Q

what does the common iliac arteries divide into?

A

internal and external iliac arteries

63
Q

what does the internal iliac artery supply?

A

structures in and around the pelvis

64
Q

what does the external iliac artery go to?

A

pass into lower limb under the inguinal ligaments - changes name into the femoral artery.

65
Q

when does external iliac artery change to the femoral

A

as it runs through the thigh

66
Q

what happens when femoral artery passes adductor hiatus?

A

goes posteriorly to back of knee
found in popliteal fossa and changes name to popliteal fossa

67
Q

what does the popliteal fossa branch to?

A

posterior tibial artery
anterior tibial artery

68
Q

where does the anterior tibial artery go?

A

down anterior compartments of the leg and continues on to dorsum of foot as dorsalis pedis

69
Q

where does the posterior tibial artery go?

A

down back of leg and gives of branch called fibular artery which runs down lateral side of posterior compartment on fibula side
continues to the plant of the foot where it branches into medial and lateral plantar arteries

70
Q

what is the femoral triangle?

A

a triangular space in anterior thigh where we see important vessels close to the surface
contents are femoral nerve, femoral artery, femoral veins and some lymphatics
-potential for venous access and venous pulse

71
Q

what kind of joint is the knee joint?

A

synovial hinge joint

72
Q

what articulates at the knee joints?

A

femur (femoral condyles)
tibia (tibial plateaus)
patella
3 articulations
2x tibiofemoral (medial and lateral)
1x patella femoral

73
Q

what is the role of the fibula in the knee joint?

A

to involved
little role on weight bearing
important for muscle attachment
biceps femoris attaches here

74
Q

why is knee unstable>

A

rounded epicondyl tries to articulate with flat area
articulating surfaces are incongruent
it is most stable when extended as flattest surfaces are in contact

75
Q

what are menisci?

A

-C shaped wedges of fibrocartilage
-improve the fir (congruency) between articular surfaces
-accomodate the shape changes during movement
-chock absorbers
-contribute to joint nutrition and lubrication
-assist locking mechanism

76
Q

what are meniscal tears?

A

medial one is more often injured
part of the unhappy triad with ACL and MCL
outer 1/3 vascularised
inner 2/3 recieves nourishment from synovial fluid - limited healing ability
generally damaged via direct blow

77
Q

what is the risk of meniscus removal?

A

osteoarthritis

78
Q

what is the ACL?

A

attached to anterior intercondylar region of tibia -> to lateral femoral condyle
prevents hyperextension of knee-prevents anterior displacement of tibia on fixed femur restricted by anterior cruciate ligament

79
Q

what is the PCL?

A

attaches to posterior intercondylar region of tibia -> medial femoral condyle
-prevents hyeprflexion of the knee
main stabiliser of the flexed knee when weight bearing

80
Q

what are the extra articular ligaments of the knee?

A

fibular collateral ligament
tibial collateral ligament
allow flexion and extension

81
Q

what is the fibular collateral ligament?

A

-cord like; extends from lateral epicondyle femur to lateral fibula
-sperate from joint capsule

82
Q

tibial collateral ligament?

A

-broad and flat; extends from medial epicondyle femur to medial tibia
-attached to joint capsule and medial meniscus

83
Q

how do muscles stabilise the knee ?

A

have most important role
many sports injuries are preventable through appropriate training and conditioning particularly of quadriceps

84
Q

what are the main stabilising muscles of the knee?

A

quadriceps, hamstrings, gracilis, sartorius, iliotibial tract, popliteus

85
Q

what is semitendinosus?

A

one of the hamstrings

86
Q

what muscles make up the pes anserinus (gooses foot)?

A

sartorius
gracilis
semitendinosus

87
Q

what do the pes anserinus muscles do?

A

provide support to medial aspect of knee joint, gracilis and sartorius are involved in supporting flexion of knee joint in medial rotation

88
Q

where is the iliotibial tract?

A

laterally from the pelvis to the lateral aspect of the pelvis and provides support

89
Q

what is the angle between the femur and tibia?

A

Q angle - 15degrees

89
Q

which bone in the leg is vertical?

A

femur

90
Q

Which ligament of the hip passes between the sacrum and ischial tuberosity and forms part of the greater sciatic foramen?

A

sacrotuberous

91
Q

The medial border of which muscle forms the medial boundary of the femoral triangle?

A

adductor longus

92
Q

Which muscles form the pes anserinus?

A

sartorius, gracilis and semitendinous

93
Q

Which is the arrangement of the femoral vessels in the femoral triangle from Lateral to Medial?

A

nerve artery vein

94
Q

Trendelenburg gait, or the trendelenburg test, is used to identify a weakness in which muscle group and nerve

A

hip abductors and superior gluteal nerve

95
Q

what nerve supplies the rectus femoris?

A

femoral nerve

Week 4 - knee OA and knee replacement (6 decks)

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