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Year 2 Medicine > Anatomy of the Knee > Flashcards

Anatomy of the Knee Flashcards

1
Q

The … joint is an articulation between the distal femur and proximal tibia (not the fibula) and an articulation between the femur and patella

A

The knee joint is an articulation between the distal femur and proximal tibia (not the fibula) and an articulation between the femur and patella

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2
Q

The knee joint is an articulation between the distal … and proximal … (not the …) and an articulation between the … and patella

A

The knee joint is an articulation between the distal femur and proximal tibia (not the fibula) and an articulation between the femur and patella

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3
Q

What bone is not part of the knee joint?

A

the fibula (The knee joint is an articulation between the distal femur and proximal tibia)

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4
Q

The knee joint is what type of joint?

A

synovial bicondylar hinge joint

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5
Q

The knee joint is responsible for what movements?

A

extension/flexion of leg at knee joint and some rotation when flexed

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6
Q

The knee joint is a hinge type … joint, which mainly allows for flexion and extension (and a small degree of … and … …). It is formed by articulations between the patella, femur and tibia.

A

The knee joint is a hinge type synovial joint, which mainly allows for flexion and extension (and a small degree of medial and lateral rotation). It is formed by articulations between the patella, femur and tibia.

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7
Q

The knee joint is a hinge type synovial joint, which mainly allows for flexion and extension (and a small degree of medial and lateral rotation). It is formed by articulations between the …, femur and …

A

The knee joint is a hinge type synovial joint, which mainly allows for flexion and extension (and a small degree of medial and lateral rotation). It is formed by articulations between the patella, femur and tibia.

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8
Q

The knee joint consists of two articulations – … and …. The joint surfaces are lined with hyaline cartilage and are enclosed within a single joint cavity.

A

The knee joint consists of two articulations – tibiofemoral and patellofemoral. The joint surfaces are lined with hyaline cartilage and are enclosed within a single joint cavity.

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9
Q

… joint capsule formed by a network of tendons and ligaments around the knee joint

A

Fibrous joint capsule formed by a network of tendons and ligaments around the knee joint

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10
Q

Functions of the knee

  • Functions are unusual, why?
A
  • Unusual:
  • Weight–bearing AND Mobility
    • Frequently injured
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11
Q

What are the 2 functions of the knee?

A

weight-bearing and mobility (incompatible functions) = frequently injured

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12
Q

Why is the knee one of the most frequently injured joints?

A
  • Unusual functions
    • Weight–bearing AND Mobility
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13
Q

Factors strengthening the joint

  • Several factors help improve stability and strength:
    • … factors
      • Bony expansions
      • Locking mechanism
      • Femoral angle
    • … tissue factors
      • Ligaments
      • Menisci
      • Muscles
A
  • Several factors help improve stability and strength:
    • Bony factors
      • Bony expansions
    • Locking mechanism
    • Femoral angle
    • Soft tissue factors
      • Ligaments
      • Menisci
      • Muscles
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14
Q

Factors strengthening the joint

  • Several factors help improve stability and strength:
    • Bony factors
      • Bony …
      • … mechanism
      • Femoral angle
    • Soft tissue factors
      • Ligaments
      • Menisci
      • Muscles
A
  • Several factors help improve stability and strength:
    • Bony factors
      • Bony expansions
      • Locking mechanism
      • Femoral angle
    • Soft tissue factors
      • Ligaments
      • Menisci
      • Muscles
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15
Q

Factors strengthening the joint

  • Several factors help improve stability and strength:
    • Bony factors
      • Bony expansions
      • Locking mechanism
      • … angle
    • Soft tissue factors
      • L…
      • M..
      • Muscles
A
  • Several factors help improve stability and strength:
    • Bony factors
      • Bony expansions
      • Locking mechanism
      • Femoral angle
    • Soft tissue factors
      • Ligaments
      • Menisci
      • Muscles
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16
Q

Bony expansions - Knee

  • Provides stable base for …
A
  • Provides stable base for bipedalism
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17
Q

Bony expansions - Knee

  • Provides stable base for bipedalism
A
  • Provides stable base for bipedalism
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18
Q

Label the bony expansion of the knee

A
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19
Q

What is the tibial plateau?

A
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20
Q

Locking mechanism

  • Reduces amount of … required when …
  • Three factors contribute to the locking mechanism :
      1. Shape of …
      1. Rotation
      1. Centre of gravity
A
  • Reduces amount of energy required when extended
  • Three factors contribute to the locking mechanism :
      1. Shape of femur
      1. Rotation
      1. Centre of gravity
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21
Q

Locking mechanism

  • Reduces amount of energy required when extended
  • Three factors contribute to the locking mechanism :
      1. Shape of femur
      1. …
      1. Centre of …
A
  • Reduces amount of energy required when extended
  • Three factors contribute to the locking mechanism :
      1. Shape of femur
      1. Rotation
      1. Centre of gravity
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22
Q

Locking mechanism

  • Reduces amount of energy required when extended
  • Three factors contribute to the locking mechanism : what are they?
A
  • Reduces amount of energy required when extended
  • Three factors contribute to the locking mechanism :
    • 1. Shape of femur
    • 2. Rotation
    • 3. Centre of gravity
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23
Q

These 3 factors all contribute to what mechanism?

A

locking mechanism

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24
Q

1. Shape of femur (locking mechanism)

A
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_2. Rotation (locking mechanism)_
26
_3. Centre of gravity (locking mechanism)_
27
Medial rotation of femur on tibia in extension does what to ligaments of the knee?
tightens them - locking joint into place
28
_Femoral angle_ * Position of knee joint is critical for ... ... * Adducted femur brings knee joint under pelvis * Occurs during ...
* Position of knee joint is critical for **weight bearing** * Adducted femur brings knee joint under pelvis * Occurs during **development**
29
_Femoral angle_ * Position of knee joint is critical for weight bearing * Adducted femur brings knee joint under ... * Occurs during development
* Position of knee joint is critical for weight bearing * Adducted femur brings knee joint under **pelvis** * Occurs during development
30
_Femoral angle - Anatomical axis and Mechanical axis_ * Anatomical axis - through the ... * Mechanical axis - passes from hip joint through the patella through the tibial tuberosity right to our foot - line of most ... * Angle between these is the ... angle - clinically important (approx 15 degrees) * To measure: * draw a line between Anterior superior iliac spine (ASIS) towards the patella to find anatomical axis * draw a line through tibial tuberosity on anterior tibia straight up through the patella
* Anatomical axis - through **femur** * Mechanical axis - passes from hip joint through the patella through the tibial tuberosity right to our foot - line of most **force** * Angle between these is the **Q** angle - clinically important (approx 15 degrees) * To measure: * draw a line between Anterior superior iliac spine (ASIS) towards the patella to find anatomical axis * draw a line through tibial tuberosity on anterior tibia straight up through the patella
31
_Femoral angle - Anatomical axis and Mechanical axis_ * Anatomical axis - through femur * Mechanical axis - passes from hip joint through the patella through the tibial tuberosity right to our foot - line of most force * Angle between these is the Q angle - clinically important (approx 15 degrees) * To measure: * draw a line between ... ... iliac spine (ASIS) towards the ... to find anatomical axis * draw a line through ... tuberosity on anterior tibia straight up through the ...
* Anatomical axis - through femur * Mechanical axis - passes from hip joint through the patella through the tibial tuberosity right to our foot - line of most force * Angle between these is the Q angle - clinically important (approx 15 degrees) * To measure: * draw a line between **Anterior superior** iliac spine (ASIS) towards the patella to find anatomical axis * draw a line through **tibial** tuberosity on anterior tibia straight up through the **patella**
32
_Femoral angle - Anatomical axis and Mechanical axis_ * ... axis - through femur * ... axis - passes from hip joint through the patella through the tibial tuberosity right to our foot - line of most force * Angle between these is the Q angle - clinically important (approx ... degrees)
* **Anatomical** axis - through femur * **Mechanical** axis - passes from hip joint through the patella through the tibial tuberosity right to our foot - line of most force * Angle between these is the Q angle - clinically important (approx **15** degrees) * To measure: * draw a line between Anterior superior iliac spine (ASIS) towards the patella to find anatomical axis * draw a line through tibial tuberosity on anterior tibia straight up through the patella
33
_To measure Q angle:_ * draw a line between ... towards the patella to find ... axis * draw a line through tibial tuberosity on anterior tibia straight up through the patella to find ... axis * approx ... degrees
* draw a line between **Anterior superior iliac spine (ASIS****)**towards the patella to find**anatomical** axis * draw a line through tibial tuberosity on anterior tibia straight up through the patella to find. **mechanical** axis * approx **15 degrees**
34
_To measure Q angle:_ * draw a line between Anterior superior iliac spine (ASIS) towards the patella to find anatomical axis * draw a line through tibial tuberosity on anterior tibia straight up through the patella to find mechanical axis * difference = approx ... degrees
* draw a line between Anterior superior iliac spine (ASIS) towards the patella to find anatomical axis * draw a line through tibial tuberosity on anterior tibia straight up through the patella * approx **15 degrees**
35
_Varus deformity (Genu varum)_ * Deformity in the ... between femur and tibia ... * Medial displacement of the tibia * - Common in children under 2 when learning to walk, rickets * Pushes knees apart - 'Bow-legged; appearance = decrease in ... * Leads to increased stress and eventually results in joint degeneration
* Deformity in the **angle** between femur and tibia (**Q angle**) * Medial displacement of the tibia * - Common in children under 2 when learning to walk, rickets * Pushes knees apart - 'Bow-legged; appearance = decrease in **Q angle** * Leads to increased stress and eventually results in joint degeneration
36
_Varus deformity (Genu varum)_ * Deformity in the angle between femur and tibia (Q angle) * ... displacement of the tibia * - Common in children under ... when learning to walk, rickets * Pushes knees apart - 'Bow-legged; appearance = decrease in Q angle * Leads to increased stress and eventually results in joint degeneration
* Deformity in the angle between femur and tibia (Q angle) * **Medial** displacement of the tibia * - Common in children under **2** when learning to walk, rickets * Pushes knees apart - 'Bow-legged; appearance = decrease in Q angle * Leads to increased stress and eventually results in joint degeneration
37
_Varus deformity (Genu varum)_ * Deformity in the angle between femur and tibia (Q angle) * Medial displacement of the tibia * - Common in children under 2 when learning to walk, rickets * Pushes knees ... - '...-legged; appearance = decrease in Q angle * Leads to increased ... and eventually results in joint ...
* Deformity in the angle between femur and tibia (Q angle) * Medial displacement of the tibia * - Common in children under 2 when learning to walk, rickets * Pushes **knees apart - 'Bow-legged**; appearance = decrease in Q angle * Leads to increased **stress** and eventually results in joint **degeneration**
38
This shows ... deformity (Genu varum)
This shows **varus** deformity (Genu varum)
39
What is the condition which results in knees pushed apart , a ‘Bow-legged’ appearance (common in children under 2 when learning to walk, rickets)
**Varus deformity (Genu varum) - medial displacement of the tibia, decrease in Q angle**
40
_Valgus deformity (Genu valgum)_ * ... displacement of the tibia * Common in children aged 2-4, rickets, arthritis * Brings knees together - ‘Knock-kneed’ * = Increase in Q angle * Increasde stress - eventually results in joint ...
* **Lateral** displacement of the tibia * Common in children aged 2-4, rickets, arthritis * Brings knees together - ‘Knock-kneed’ * = Increase in Q angle * Increasde stress - eventually results in joint **degeneration**
41
_Valgus deformity (Genu valgum)_ * Lateral displacement of the tibia * Common in children aged ..., rickets, arthritis * Brings knees ... - ‘Knock-...’ * = Increase in Q angle * Increasde stress - eventually results in joint degeneration
* Lateral displacement of the tibia * Common in children aged **2-4**, rickets, arthritis * Brings knees **together** - ‘Knock-**kneed**’ * = Increase in Q angle * Increasde stress - eventually results in joint degeneration
42
_Valgus deformity (Genu valgum)_ * Lateral displacement of the ... * Common in children aged 2-4, rickets, arthritis * Brings knees together - ‘Knock-kneed’ * = ... in Q angle * Increasde stress - eventually results in joint degeneration
* Lateral displacement of the **tibia** * Common in children aged 2-4, rickets, arthritis * Brings knees together - ‘Knock-kneed’ * = **Increase** in Q angle * Increasde stress - eventually results in joint degeneration
43
What is the condition which results in knees brought together , ’Knock-kneed', (common in children aged 2-4, rickets, arthritis)
**Valgus deformity (Genu valgum) - lateral displacement of the tibia - increase in Q angle**
44
Valgus deformity (Genu valgum) vs Varus deformity (Genu varum) - what is the difference?
* Valgus deformity - lateral displacement of the tibia, common in children aged 2-4, rickets, arthritis - brings knees together - knock-kneed therefore increased Q angle * Varus deformity - medial displacement of the tibia, common in children under 2 when learning to walk, rickets - pushes knees apart - 'bow-legged' therefore decreased Q angle
45
* ... deformity - lateral displacement of the tibia, common in children aged 2-4, rickets, arthritis - brings knees together - knock-kneed therefore increased Q angle * ... deformity - medial displacement of the tibia, common in children under 2 when learning to walk, rickets - pushes knees apart - 'bow-legged' therefore decreased Q angle
* **Valgus** deformity - lateral displacement of the tibia, common in children aged 2-4, rickets, arthritis - brings knees together - knock-kneed therefore increased Q angle * **Varus** deformity - medial displacement of the tibia, common in children under 2 when learning to walk, rickets - pushes knees apart - 'bow-legged' therefore decreased Q angle
46
_Ligaments of the knee_ * Provide stability - Two groups of strong ligaments: * ... – outside ... * Medial collateral * Lateral collateral * ... – inside ... * Anterior cruciate * Posterior cruciate
* Provide stability - Two groups of strong ligaments: * **Extracapsular – outside capsule** * Medial collateral * Lateral collateral * **Intracapsular – inside capsule** * Anterior cruciate * Posterior cruciate
47
_Ligaments of the knee_ * Provide stability - Two groups of strong ligaments: * Extracapsular – outside capsule * Medial ... * Lateral ... * Intracapsular – inside capsule * ... cruciate * ... cruciate
* Provide stability - Two groups of strong ligaments: * Extracapsular – outside capsule * Medial **collateral** * Lateral **collateral** * Intracapsular – inside capsule * **Anterior** cruciate * **Posterior** cruciate
48
_Ligaments of the knee_ * Provide stability - Two groups of strong ligaments: * Extracapsular – outside capsule * ... collateral * ... collateral * Intracapsular – inside capsule * Anterior ... * Posterior ...
* Provide stability - Two groups of strong ligaments: * Extracapsular – outside capsule * **Medial** collateral * **Lateral** collateral * Intracapsular – inside capsule * Anterior **cruciate** * Posterior **cruciate**
49
_Lateral/fibular collateral ligament_ * Strong ... cord * Prevents ... displacement of tibia
* Strong **round** cord * Prevents **medial** displacement of tibia
50
_Lateral/fibular collateral ligament_ * Strong round ... * Prevents ... displacement of tibia
* Strong round **cord** * Prevents **medial** displacement of tibia
51
Tear of Lateral Collateral Ligament = ... deformity (medial)
Tear of Lateral Collateral Ligament = **varus** deformity (medial)
52
What is this ligament?
53
_Medial/tibial collateral ligament​_ * Broad ... band * ... joint capsule * Prevents lateral displacement of tibia
* Broad **flat** band * **Reinforces** joint capsule * Prevents lateral displacement of tibia
54
_Medial/tibial collateral ligament​_ * Broad flat band * Reinforces joint capsule * Prevents ... displacement of tibia
* Broad flat band * Reinforces joint capsule * Prevents **lateral** displacement of tibia
55
Tear of ... Collateral Ligament = Valgus deformity (...)
Tear of **Medial** Collateral Ligament = Valgus deformity (**lateral**)
56
Tear of Medial Collateral Ligament = ... deformity (lateral)
Tear of Medial Collateral Ligament = **Valgus** deformity (lateral)
57
Label the ligament
58
_The medial collateral ligament has a direct attachment with what?_
**medial miniscus**
59
_Intracapsular ligaments_
60
_Intracapsular ligaments_
61
_Intracapsular ligaments_ * What are they called? (2)
62
_Function of cruciate ligaments_ * Anterior cruciate * Prevents ... ... of tibia on femur * Posterior cruciate * Prevents ... ... of tibia on femur * Maintain femur against tibia * Always one ligament tense
* Anterior cruciate * Prevents **anterior displacement** of tibia on femur * Posterior cruciate * Prevents **posterior displacement** of tibia on femur * Maintain femur against tibia * Always one ligament tense
63
_Function of cruciate ligaments_ * Anterior cruciate * Prevents anterior displacement of ... on ... * Posterior cruciate * Prevents posterior displacement of ... on ... * Maintain ... against .. * Always one ligament tense
* Anterior cruciate * Prevents anterior displacement of **tibia** on **femur** * Posterior cruciate * Prevents posterior displacement of **tibia** on **femur** * Maintain **femur** against **tibia** * Always one ligament tense
64
_Function of cruciate ligaments_ * Anterior cruciate * Prevents anterior displacement of tibia on femur * Posterior cruciate * Prevents posterior displacement of tibia on femur * Maintain femur against tibia * Always one ligament ...
* Anterior cruciate * Prevents anterior displacement of tibia on femur * Posterior cruciate * Prevents posterior displacement of tibia on femur * Maintain femur against tibia * Always one ligament **tense**
65
_Cruciate ligaments_
66
_Cruciate ligaments_
67
**With flexed knee:** * ... rotation of leg – tightens cruciate ligaments (limits rotation) (10deg) * ... rotation of leg – unwinds ligaments (~60deg)
* **Medial** rotation of leg – tightens cruciate ligaments (limits rotation) (10deg) * **Lateral** rotation of leg – unwinds ligaments (~60deg)
68
**With flexed knee:** * Medial rotation of leg – ... cruciate ligaments (limits ...) (10deg) * Lateral rotation of leg – ... ligaments (~60deg)
* Medial rotation of leg – **tightens** cruciate ligaments (limits **rotation**) (10deg) * Lateral rotation of leg – **unwinds** ligaments (~60deg)
69
_Anterior cruciate ligament_ * Weaker - can become injured * Common ... injury * Caused by sudden ... of knee * ... test (variation of Drawer test): * Patient in supine position with knee bent 20-30degree of flexion * Move tibia anteriorly and posteriorly while maintaining position of femur * Laxity during this manoeuvre indicates anterior cruciate ligament injury
* Weaker - can become injured * Common **sports** injury (e.g. football) * Caused by sudden **twisting** of knee * **Lachman** test (variation of Drawer test): * Patient in supine position with knee bent 20-30degree of flexion * Move tibia anteriorly and posteriorly while maintaining position of femur * Laxity during this manoeuvre indicates anterior cruciate ligament injury
70
_Anterior cruciate ligament_ * ... - can become injured * Common sports injury (e.g. football) * Caused by sudden twisting of knee * Lachman test (variation of Drawer test): * Patient in ... position with knee bent 20-30degree of ... * Move ... anteriorly and posteriorly while maintaining position of ... * Laxity during this manoeuvre indicates anterior cruciate ligament injury
* **Weaker** - can become injured * Common sports injury (e.g. football) * Caused by sudden twisting of knee * Lachman test (variation of Drawer test): * Patient in **supine** position with knee bent 20-30degree of **flexion** * Move **tibia** anteriorly and posteriorly while maintaining position of **femur** * Laxity during this manoeuvre indicates anterior cruciate ligament injury
71
What is the Lachman test for?
* rupture of anterior cruciate ligament: * Lachman test (variation of Drawer test): * Patient in supine position with knee bent 20-30degree of flexion * Move tibia anteriorly and posteriorly while maintaining position of femur * Laxity during this manoeuvre indicates anterior cruciate ligament injury
72
_Lachman test (variation of Drawer test):_ * Patient in supine position with knee bent 20-30degree of flexion * Move ... anteriorly and posteriorly while maintaining position of ... * Laxity during this manoeuvre indicates ... ... ligament injury
* Patient in supine position with knee bent 20-30degree of flexion * Move **tibia** anteriorly and posteriorly while maintaining position of **femur** * Laxity during this manoeuvre indicates **anterior cruciate** ligament injury
73
Which cruciate ligament is weaker? (prone to injury)
anterior cruciate ligament - caused by sudden twisting of knee
74
_Posterior cruciate ligament_ * Stronger - Rarely injured * Principle stabilizer when knee ... (Especially when walking ...)
* Stronger - Rarely injured * Principle stabilizer when knee **flexed** (Especially when walking **down hill)**
75
Which cruciate ligament is stronger (rarely injured)?
Posterior cruciate ligament - Principle stabilizer when knee flexed
76
_Menisci of knee joint_ * ...-shaped plates of ... * Deepen the articulating surfaces/stability * ... absorbers * Provides smooth viscous film for joint
* **Crescent**-shaped plates of **fibrocartilage** * Deepen the articulating surfaces/stability * **Shock** absorbers * Provides smooth viscous film for joint
77
_Menisci of knee joint_ * Crescent-shaped plates of fibrocartilage * ... the articulating surfaces/stability * Shock absorbers * Provides ... ... film for joint
* Crescent-shaped plates of fibrocartilage * **Deepen** the articulating surfaces/stability * Shock absorbers * Provides **smooth viscous** film for joint
78
_Menisci of knee joint_ * Crescent-shaped plates of fibrocartilage * Deepen the articulating surfaces/stability * Shock absorbers * Provides smooth viscous film for joint * There are 2: * ... meniscus (smaller and more circular) * ... miniscus (larger)
* Crescent-shaped plates of fibrocartilage * Deepen the articulating surfaces/stability * Shock absorbers * Provides smooth viscous film for joint * There are 2: * **medial** meniscus (smaller and more circular) * **lateral** miniscus (larger)
79
Label the menisci
80
_Menisci attachments (knee)_ * ... of menisci attached to intercondylar area of tibia * Mobile (Accommodates rolling of femoral ...) * Medial meniscus less mobile than lateral meniscus * Attached to ... collateral ligament
* **Horns** of menisci attached to intercondylar area of tibia * Mobile (Accommodates rolling of femoral **condyles**) * Medial meniscus less mobile than lateral meniscus * Attached to **medial** collateral ligament
81
_Menisci attachments (knee)_ * Horns of menisci attached to ... area of tibia * Mobile (Accommodates rolling of femoral condyles) * Medial meniscus ... mobile than lateral meniscus * Attached to medial collateral ligament
* Horns of menisci attached to **intercondylar** area of tibia * Mobile (Accommodates rolling of femoral condyles) * Medial meniscus **less** mobile than lateral meniscus * Attached to medial collateral ligament
82
... of the menisci
83
Are the menisci mobile?
yes - medial is less mobile than lateral miniscus because it is attached to the medial collateral ligament
84
What menisci is attached to medial collateral ligament?
the medial miniscus
85
86
_Unhappy triad_ * Twisting on a flexed knee and blow to lateral side * Contact sports (e.g. rugby tackle) * Rupture: * ... cruciate ligament * ... collateral ligament * ... meniscus (attached to MCL) * Poor blood supply to ... structures * Doesn’t repair easily
* Twisting on a flexed knee and blow to lateral side * Contact sports (e.g. rugby tackle) * Rupture: * **Anterior** cruciate ligament * **Medial** collateral ligament * **Medial** meniscus (attached to MCL * Poor blood supply to **intracapsular** structures * Doesn’t repair easily
87
* Rupture of * Anterior cruciate ligament * Medial collateral ligament * Medial meniscus (attached to MCL * is known as ..
unhappy triad
88
_Muscles acting on knee joint_ * Knee reinforced by tendons from surrounding muscles and ... tract
* Knee reinforced by tendons from surrounding muscles and **iliotibial** tract
89
Knee
90
Which muscles stabilize the extended knee? (2)
**gluteus maximus, tensor fascia lata**
91
_Extensors of leg_ * What muscle extend the leg?
* Quadriceps extends leg * Also major stabilizing muscle of the knee * 4 heads: * Rectus femoris * Vastus lateralis * Vastus intermedius * Vastus medialis
92
_Extensors of leg_ * Quadriceps extends leg * Also major stabilizing muscle of the knee * 4 heads: * ... femoris * Vastus ... * Vastus ... * Vastus medialis
* Quadriceps extends leg * Also major stabilizing muscle of the knee * 4 heads: * **Rectus** femoris * Vastus **lateralis** * Vastus **intermedius** * Vastus medialis
93
4 parts of the quadriceps are ...
* **Rectus femoris** * **Vastus lateralis** * **Vastus intermedius** * **Vastus medialis**
94
_Quadriceps femoris_
95
_Quadriceps femoris_
96
_Quadriceps femoris_ * ... fibres of vastus ... prevents lateral tracking of patella
* **Oblique** fibres of vastus **medialis** prevents lateral tracking of patella
97
_Extensor mechanism_
98
The ... mechanism of the knee comprises the quadriceps muscle and tendon, the patella, and the patellar tendon
The **extensor** mechanism of the knee comprises the quadriceps muscle and tendon, the patella, and the patellar tendon
99
The extensor mechanism of the knee comprises the ... muscle and tendon, the ..., and the ... tendon
* The extensor mechanism of the knee comprises the **quadriceps** muscle and tendon, the **patella**, and the **patellar** tendon
100
_Patella_ * ...-shaped ... shaped * Protects quadriceps tendon from stresses during locomotion * Smooth oval facet on ... surface for articulation with femur
* **Triangular**-shaped **sesamoid** shaped * Protects quadriceps tendon from stresses during locomotion * Smooth oval facet on **posterior** surface for articulation with femur
101
_Patella_ * Triangular-shaped sesamoid shaped * Protects ... tendon from stresses during ... * Smooth oval facet on posterior surface for articulation with ...
* Triangular-shaped sesamoid shaped * Protects **quadriceps** tendon from stresses during **locomotion** * Smooth oval facet on posterior surface for articulation with **femur**
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_Extensor mechanism injury_ * ... of quadriceps tendon or patellar ligament * ... of the patella - Due to fall or blow to knee * Results in loss of active extension * Dislocation of patella common - due to sudden twisting/jumping or ligamentous laxity
* **Rupture** of quadriceps tendon or patellar ligament * **Fracture** of the patella - Due to fall or blow to knee * Results in loss of active extension * Dislocation of patella common - due to sudden twisting/jumping or ligamentous laxity
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_Extensor mechanism injury_ * Rupture of quadriceps tendon or patellar ligament * Fracture of the patella - Due to fall or blow to knee * Results in loss of ... ... * ... of patella common - due to sudden twisting/jumping or ligamentous laxity
* Rupture of quadriceps tendon or patellar ligament * Fracture of the patella - Due to fall or blow to knee * Results in loss of **active extension** * **Dislocation** of patella common - due to sudden twisting/jumping or ligamentous laxity
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Dislocation of ... common - due to sudden twisting/jumping or ligamentous laxity
Dislocation of **patella** common - due to sudden twisting/jumping or ligamentous laxity
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_Flexors of leg_ * ... and ... flex leg - ... also medially and laterally rotates leg when knee flexed * ... actually three muscles: * Biceps femoris * Semimembranosus * Semitendinosus
* **Hamstrings** and **gastrocnemius** flex leg - **Hamstrings** also medially and laterally rotates leg when knee flexed * **Hamstrings** actually three muscles: * Biceps femoris * Semimembranosus * Semitendinosus
106
What muscles flex the leg?
* Hamstrings and gastrocnemius flex leg (Hamstrings also medially and laterally rotates leg when knee flexed)
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Hamstrings actually three muscles: ...
* Biceps femoris * Semimembranosus * Semitendinosus
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_Hamstrings_
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_Unlocking of extended leg_ * ... unlocks knee joint * Laterally rotates femur on tibia when foot is on ground
* **Popliteus** unlocks knee joint * Laterally rotates femur on tibia when foot is on ground
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_Unlocking of extended leg_ * Popliteus unlocks knee joint * ... rotates femur on tibia when foot is on ground
* Popliteus unlocks knee joint * **Laterally** rotates femur on tibia when foot is on ground
111
_Popliteus_ * Passes through joint ... * Passes through space under ... collateral ligament
* Passes through joint capsule * Passes through space under lateral collateral ligament
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... unlocks knee joint
**Popliteus** unlocks knee joint
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_Synovial membrane (KNEE)_ * From margins of articular surfaces of femur to tibia * Attached to ... * Extends ... behind quadriceps tendon * Cuffs anterior surface of cruciate ligaments
* From margins of articular surfaces of femur to tibia * Attached to **patella** * Extends **superiorly** behind quadriceps tendon * Cuffs anterior surface of cruciate ligaments
114
_Synovial membrane (knee)_ * From margins of articular surfaces of femur to tibia * Attached to patella * Extends superiorly behind ... tendon * Cuffs anterior surface of ... ligaments
* From margins of articular surfaces of femur to tibia * Attached to patella * Extends superiorly behind **quadriceps** tendon * Cuffs anterior surface of **cruciate** ligaments
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_Knee_
116
_Bursae - knee_ * ... fluid filled sac lined by ... membrane * Protect and reduce friction
* **Synovial** fluid filled sac lined by **synovial** membrane * Protect and reduce friction
117
_Bursae_ * ... ... filled sac lined by synovial membrane * Protect and reduce ...
* **Synovial fluid** filled sac lined by synovial membrane * Protect and reduce **friction**
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_Bursae - knee_
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_Other bursae - knee_
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Bursitis is ...
Inflammation of bursae due to repetitive movements or direct pressure
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Inflammation of bursae due to repetitive movements or direct pressure is known as ...
bursitis
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_Prepatellar bursitis (‘housemaid’s knee’)_ * Seen in ... fitters * Leaning forward on the knees brings the prepatellar bursa in contact with ..
* Seen in **carpet** fitters * Leaning forward on the knees brings the prepatellar bursa in contact with floor
123
What bursitis is seen in carpet fitters?
prepatellar bursitis
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_Infrapatellar bursitis (‘clergyman’s knee’)_ * Seen in ... * After prolonged periods of prayer clergymen sat back on their heels bringing infrapatellar bursa in contact with ...
* Seen in **roofers** * After prolonged periods of prayer clergymen sat back on their heels bringing infrapatellar bursa in contact with **floor**
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What bursitis is seen in roofers?
* **Infrapatellar bursitis (‘clergyman’s knee’)**
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_Baker’s (popliteal) cyst_ * Abnormal fluid filled sacs in popliteal fossa * Due to ... of bursa * Common in patients with ... ... ... disease (e.g. ...) * Presents as swelling in the popliteal fossa * Can affect joint ... * Treated by aspiration and cortisone injection
* Abnormal fluid filled sacs in popliteal fossa * Due to **herniation** of bursa * Common in patients with **chronic inflammatory joint** disease (e.g. **arthritis**) * Presents as swelling in the popliteal fossa * Can affect joint **movement** * Treated by aspiration and cortisone injection
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_Baker’s (popliteal) cyst_ * Abnormal fluid filled sacs in popliteal fossa * Due to herniation of ... * Common in patients with chronic inflammatory joint disease (e.g. arthritis) * Presents as ... in the popliteal fossa * Can affect joint movement * Treated by ... and cortisone injection
* Abnormal fluid filled sacs in popliteal fossa * Due to herniation of **bursa** * Common in patients with chronic inflammatory joint disease (e.g. arthritis) * Presents as **swelling** in the popliteal fossa * Can affect joint movement * Treated by **aspiration** and cortisone injection
128
How are baker's (popliteal) cysts treated?
**Treated by aspiration and cortisone injection**
129
What is a baker's cyst?
Abnormal fluid filled sacs in popliteal fossa due to herniation of bursa
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_Vascular supply - Knee_
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Complex anastomosis around knee joint - supplied by **...** branches (coming from femoral artery or popliteal artery)
Complex anastomosis around knee joint - supplied by **genicular** branches (coming from femoral artery or popliteal artery)
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Limited blood supply to ... structures of knee - poor repair following injury
Limited blood supply to **intracapsular** structures of knee - poor repair following injury

Year 2 Medicine (162 decks)

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