Anatomy lecture 13: Hip and knee joints (pelvic gircle joints & foot muscles)

Question 1

Femoral head:

Answer 1

Forms 2/3 of a sphere of diameter 4-5cm.

Supported by the neck of femur

Axis runs:
-superiorly
-medially
-anteriorly

Question 2

Angle of inclination:

Answer 2

head of the femur in adult:
125

Question 3

Fovea:

Answer 3

impression on the head of the femur for the attachment of the round head.

Question 4

Angle of anteverison:

Answer 4

head of the femur forms an acute angle of 10-30 degrees with femoral plane

Question 5

Femoral anteversion:

Answer 5

determined by measuring the angle formed between the long ais of the femoral neck and line parallel to the dorsal aspect of the femoral condyles.

Question 6

Anteversion:

Answer 6

Increase in angle: causes in-toeing, pigeon toes, as well as genu valgum

Question 7

Retroversion:

Answer 7

Decrease in angle: out-toeing (external rotation) during standing and walking as well as genu valgum during standing

Question 8

Acetabulum:

Answer 8

hemispherical and is bounded at the acetabular rim.

lunate surface of acetabulum: lined by horseshoe-shaped articular cartilage, interrupted inferiorly by the acetabular notch

Directed laterally, inferiorly, and anteriorly

Question 9

Acetabular fossa:

Answer 9

permits movement of the ligamentum teres & importantly serves as a reservoir for synovial fluid when hip is heavily loaded.

When joint surfaces are decreased, synovial fluid returns to the joint space for lubrication and nutrition to the articular cartilages.

Question 10

Acetabular labrum:

Answer 10

fibrocartilaginous ring at the acetabular rim

Question 11

Transverse acetabular ligament (TAL):

Answer 11

attached to either side of the acetabular notch & labrum

Question 12

Ligamentum teres (LT):

Answer 12

flattened fibrous band:
O: acetabular notch
(runs the floor of the acetabular fossa)
I: fovea femoris capitis

-embedded in fibro-adipose tissue
-lined w/ synovial membrane
-Extremely strong

Primary function: carry the vascular supply to the head of the femur

Question 13

Iliofemoral ligament:

Answer 13

Y-shaped ligament w/ two thick borders (superior & inferior bands)

Covers hip anteriorly & superiorly

Question 14

Pubofemoral ligament:

Answer 14

-anterior & inferior to hip
-limiting lateral rotation & abduction

Question 15

Ishiofemoral ligament:

Answer 15

posterior & inferior, limiting rotation

Question 16

Fibrous layer of the joint capsule:

Answer 16

-extension of the hip joint winds (increases the obliquity) pulling the femur tightly into the acetabulum, increasing stability of joint

-Flexion unwinds the fibers of the capsule

Question 17

Active hip flexion w/ knee flexed:

Answer 17

70-120 by hamstrings

Question 18

Active hip flexion w/ knee extended:

Answer 18

70-90 by hamstrings

Question 19

Hyper extension of the hip:

Answer 19

Is limited to 10-20 by iliofemoral ligament .

when knee is flexed it is less because there is a loss of movement at the knee.

Question 20

Hip abduction:

Answer 20

45 degrees and usually accompanied by the elevation of the pelvis

Question 21

Hip adduction:

Answer 21

contact between the two thighs or 0 degrees

legs crossed: 30-40 degrees

Question 22

Medial rotation of hip:

Answer 22

30 degrees

Question 23

Lateral rotation of hip:

Answer 23

60 degrees

Question 24

Flexor muscles of the hip:

Answer 24

1) Psoas major
2) Iliacus
3) Sartorius
4) Rectus femoris
5) Tensor fascia Latae
6) Pectineus
7) Adductor longus
8) Gracilis
9) Anterior fibers of glutei Medius & minimus

First group produces flexion, abduction, and med. rot. (9, 5)

Second group produces flexion, adduction, and lat. rot. (1,2,6,7)

Question 25

First group of extensor muscles of the hip:

Answer 25

1) gluteus maximus 2) posterior fibers of gluteus Medius 3) posterior fibers of gluteus minimus (all inserted into femur)

Question 26

Second group of the extensor muscles of the hip:

Answer 26

4) biceps femoris 5) semitendinosus 6) semimembranosus 7) adductor magnus (inserts at the vicinity of the knee joint)

Question 27

Abductor muscles of the hip:

Answer 27

1) anterior fibers of the gluteus medius 2) Gluteus minimus 3) Tensor fascia Latae 4) Gluteus maximus (upper fibers) 5) piriformis In certain positions other muscles can contribute to the fore of abduction: -Sartorius -Obturators -Gemelli

Question 28

Adductor muscles of the hip:

Answer 28

1) adductor magnus 2) Gracilis 3) Semimembranosus 4) Semitendinosus 5) Biceps femoris 6) gluteus maximus 7) quadratus femoris 8) Pectineus 9) Obturator externus 10) Adductor longus 11) Adductor brevis

Question 29

Lateral Rotator muscles of the hip:

Answer 29

1) piriformis 2) Obturator internus 3) Obturator externus 4) Quadratus femoris 5) Gluteus maximus 6) Gluteus Medius 7) Gemelli

Question 30

Medial rotator muscles of the hip:

Answer 30

1) tensor fascia Latae 2) gluteus minimus (anterior fibers) 3) gluteus Medius (anterior fibers)

Question 31

Knee joint:

Answer 31

synovial hinge joint 2 DOF three articular surfaces -Medial tibio-femoral -lateral tibio-femoral -patello-femoral Functions of the knee: -withstanding large forces -providing great stability -enabling a large ROM (many sport injuries are preventable through appropriate conditioning and training)

Question 32

Articular surfaces of the knee joint:

Answer 32

Condyles form the lips of the pully and extend anteriorly by the pully-shaped patellar surfaces. blunt eminance runing through the center if the superior part of the tibia which acts as a pivot when articulating with the intercondylar notch

Question 33

Retinacula & ligaments:

Answer 33

reinforce and become integral parts of the capsule.

Question 34

Proximal tendon of the popliteus:

Answer 34

pierces capsule & attaches to the lateral femoral condyle

Question 35

Oblique popliteal ligament:

Answer 35

semimembranosus reforms part of this ligament and give off fibers to the MCL. reinforces the capsule posteriorly.

Question 36

Arcuate popliteal ligament:

Answer 36

strengthens the joint capsule posterio-laterally. passes over the popliteus tendon spreads over the posterior portion of the knee joint.

Question 37

Collateral ligaments of the knee:

Answer 37

Strengthen the articular capsule on its medial and lateral aspects. Responsible for transverse stability of the knee during extension. stretched during extension & slackened during flexion

Question 38

Medial (tibial) collateral ligament:

Answer 38

O: medial epicondyle of femur I: upper end of tibia posterior to pes anserine (runs inferiorly and laterally)

Question 39

Lateral (fibular) ligament:

Answer 39

O: lateral epicondyle of the femur I: head of the fibula

Question 40

Anterior cruciate ligament:

Answer 40

weaker cruciate ligament: O: anterior intercondylar area of the tibia I: internal aspect of the lateral condyle of femur

Question 41

Posterior cruciate ligament:

Answer 41

O: posterior intercondylar area of tibia I: lateral surface of the medial femoral condyle

Question 42

Cruciate ligaments are intracapsular but ______________

Answer 42

extra synovial

Question 43

Menisci:

Answer 43

(semi-lunar fibrocartilages) corrected the lack of congruency in the articular surfaces. Crescent shaped w/ anterior and posterior horn. Lateral meniscus come closer so its almost a complete circle. Medial meniscus is C-shaped Each horn anchored by the tibial condyle in anterior and posterior intercondylar areas

Question 44

Important ligament attachments of the menisci:

Answer 44

1) two anterior horns: the transverse ligament of the knee 2) medial collateral ligament 3) lateral collateral of the ligament, separated from its corresponding meniscus by the tendon of popliteus

Question 45

Movements of the knee joint:

Answer 45

DOF: flexion-extension, & axial rotation Flexion: 120-150 Hyperextension minimal and will not exceed 15. axial rotation: occurs in transverse plane when knee is flexed to 90.

Question 46

Automatic axial rotation called screw-home mechanism:

Answer 46

inevitably and involuntarily linked to movements of flexion and extension. End of extension or the start of flexion. Extension=external rotation Flexion= internal rotation

Question 48

The patella which is embedded in the tendon of this muscle increases the efficiency of the muscle up to ____.

Answer 48

33%

Question 48

Flexor muscles of the knee are the hamstrings and a few other muscles consisting of:

Answer 48

1) Biceps femoris 2) semitendinosus 3) semimembranosus 4) Gracilis 5) Sartorius 6) Gastrocnemius

Question 48

Quadriceps are the extensor muscles of the knee:

Answer 48

1) Vastus intermedius 2) Vastuc lateralis 3) Vastus medialis 4) Rectus femoris

Question 48

Pelvic region:

Answer 48

Hip joints are the most structurally stable, yet mobile, joints in the body. Transmits large forces between the trunk and the ground. Sustains more than three times the body weight with each step.

Question 48

Rotator muscles of the knee:

Answer 48

Question 49

Sacroiliac joint:

Answer 49

Can be a sight for low back pain often following childbirth due to injuries of ligaments, hyper-and hypo-mobility, or inflammatory conditions Synovial planar (gliding): made between auricular surfaces of the ilium part of the hip bone and sacrum. sacral surfaces are covered in hyaline cartilage and the iliac surface is covered in fibrocartilage.

Question 50

Interosseous ligaments:

Answer 50

fill the space between the sacrum and the inner side of the iliac tuberosity.

Question 51

Posterior sacroiliac ligaments:

Answer 51

cover the interosseous ligaments and the posterior aspect of the sacrum.

Question 52

Anterior sacroiliac ligaments:

Answer 52

anterior aspect of the sacroiliac joint

Question 53

Sacrotuberous and sacrospinous ligaments:

Answer 53

connecting to the SPs and ischial tuberosity, providing them leverage to hold the distal aspect of the sacrum against the anterior weight-bearing forces.

Question 54

Self-locking mechanism:

Answer 54

the fibers of the interosseous and posterior sacro-iliac ligaments run obliquely, the axial wight pulls the sacrum together compressing the sacrum between the ligaments. this locks the irregular but congruent surfaces of the sacroiliac joints together. iliolumbar ligaments are accessory ligaments to this.

Question 55

Sacrococcygeal joint:

Answer 55

synovial planar joint or a symphysis synarthrosis joint depending on the age of the person.

Question 56

Intercoccygeal joints:

Answer 56

synarthrosis joints motion increases between these joints during pregnancy, and ossification of the joints occurs w/ aging.

Question 57

Pubic symphysis:

Answer 57

articulating surfaces of the pubic bones are separated by the fibrocartilaginous interpubic disc. Small motions occur at these joints completes the closure of the ring of the pelvis

Question 58

Extensor digitorum brevis:

Answer 58

O: dorsal surface of calcaneus I: lateral side of the tendon of extensor digitorum longus for toes #2-4 A: Ext. of toes 2-4 @ MTP & PIP Joints N: Deep fibular N. (peroneal)

Question 59

Extensor hallucis brevis:

Answer 59

O: dorsal surface of calcaneus I: proximal phalanx of big toe. A: Extension of big toe @ MTP joint N: Deep fibular N (peroneal)

Question 60

1st layer of the sole of the foot:

Answer 60

1) abductor hallucis 2) flexor digitorum brevis 3) abductor digiti minimi

Question 61

2nd layer of the sole of the foot:

Answer 61

1) Flexor hallucis longus tendon 2) flexor digitorum longus tendon 3) quadratus plantae (flexor accessorius) lumbricals 4) Lumbricals (4 muscles)

Question 62

3rd layer of the sole of the foot:

Answer 62

1) flexor hallucis brevis 2) adductor hallucis 3) flexor digiti minimi brevis pedis

Question 63

4th layer of the sole of the foot:

Answer 63

1) plantar interossei (3muscles) 2) dorsal interossei (4 muscles)

Question 64

Abductor hallucis:

Answer 64

O: -medial process of tuberosity of the calcaneus -Plantar fascia I: Base of the proximal phalanx of the big toe A: Abd. of big toe @ MTP Joint N: Medial plantar N.

Question 65

Flexor digitorum brevis:

Answer 65

O: -medial process of tuberosity of the calcaneus -plantar fascia I: sides of the middle phalanx of toe #2-5 A: Flex. of toes 2-5 @ MTP & PIP joints N: Medial Plantar N.

Question 66

Abductor digiti minimi:

Answer 66

O: -Lateral process of tuberosity of the calcaneus -Plantar fascia I: base of the proximal phalanx of 5th toe A: Abd. of toe 5 @ MTP Joint N: Lateral plantar N.

Question 67

Quadratus plantae:

Answer 67

O: calcaneus I: tendon of the flexor digitorum longus A: Assists flexor digitorum longus to flex toes 2-5 @ MTP and IP Joints N: Lateral plantar nerve

Question 68

Lumbricals

Answer 68

O: Tendon of the flexor digitorum longus I: dorsal digital expansion of toes #2-5 A: 1) Flex of toes 2-5 @ MTP Joints 2) Ext. of toes 2-5 @ PIP & DIP Joints N: Lumbrical 1 => Medial Plantar N. Lumbrical 2-4 => lateral plantar N.

Question 69

Flexor hallucis brevis:

Answer 69

O: -cuboid -3rd lateral cuneiform I: medial and lateral sides of the proximal phalanx of great toe (tendon contains sesamoid bones) A: Flex of big toe @ MTP Joint N: Medial Plantar N.

Question 70

Flexor digiti minimi brevis:

Answer 70

O: -base of 5th metatarsal -tendon of fibularis longus I: proximal phalanx of 5th toe A: Flex. of 5th toe @ MTP Joint N: Lateral plantar N.

Question 71

Adductor hallucis:

Answer 71

O: Oblique head: -The base of metatarsals 2-4 -Tendon of fibularis longus Transverse head: -Plantar metatarsophalangeal ligaments I: base of the proximal phalanx of great toe A: Add. of big toe @ MTP Joint. N: Lateral plantar N.

Question 72

Dorsal interossei:

Answer 72

O: adjacent sides of metatarsal bones I: base of proximal phalanges & dorsal digital expansion 1st inserted to the 2nd the others are inserted to the lateral sides of 2nd, 3rd, and 4th toes A: 1) Abd. toes 2-4 @ MTP 2) Flex. toes 2-4 @ MTP 3) Ext. toes 2-4 @ IP N: Lateral Plantar N.

Question 73

Plantar interossei:

Answer 73

O: metatarsal bones 3-5 I: base of proximal phalanges & dorsal digital expansion 1st inserted to medial side of the 3rd toe, and the other two are inserted into the medial sides of the 4th and 5th toes. A: 1) Add. toes 3-5 @ MTP 2) Flex. toes 3-5 @ MTP 3) Ext. toes 3-5 @ IP N: Lateral Plantar N.