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. 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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25
Q

2. Rotation (locking mechanism)

A
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26
Q

3. Centre of gravity (locking mechanism)

A
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27
Q

Medial rotation of femur on tibia in extension does what to ligaments of the knee?

A

tightens them - locking joint into place

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28
Q

Femoral angle

  • Position of knee joint is critical for … …
  • Adducted femur brings knee joint under pelvis
    • Occurs during …
A
  • Position of knee joint is critical for weight bearing
  • Adducted femur brings knee joint under pelvis
    • Occurs during development
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29
Q

Femoral angle

  • Position of knee joint is critical for weight bearing
  • Adducted femur brings knee joint under …
    • Occurs during development
A
  • Position of knee joint is critical for weight bearing
  • Adducted femur brings knee joint under pelvis
    • Occurs during development
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30
Q

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
A
  • 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
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31
Q

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 …
A
  • 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
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32
Q

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)
A
  • 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
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33
Q

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
A
  • draw a line between Anterior superior iliac spine (ASIS)towards the patella to findanatomical axis
  • draw a line through tibial tuberosity on anterior tibia straight up through the patella to find. mechanical axis
  • approx 15 degrees
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34
Q

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
A
  • 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
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35
Q

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
A
  • 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
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36
Q

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
A
  • 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
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37
Q

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 …
A
  • 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
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38
Q

This shows … deformity (Genu varum)

A

This shows varus deformity (Genu varum)

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39
Q

What is the condition which results in knees pushed apart , a ‘Bow-legged’ appearance (common in children under 2 when learning to walk, rickets)

A

Varus deformity (Genu varum) - medial displacement of the tibia, decrease in Q angle

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40
Q

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 …
A
  • 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
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41
Q

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
A
  • 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
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42
Q

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
A
  • 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
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43
Q

What is the condition which results in knees brought together , ’Knock-kneed’, (common in children aged 2-4, rickets, arthritis)

A

Valgus deformity (Genu valgum) - lateral displacement of the tibia - increase in Q angle

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44
Q

Valgus deformity (Genu valgum) vs Varus deformity (Genu varum) - what is the difference?

A
  • 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
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45
Q
  • … 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
A
  • 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
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46
Q

Ligaments of the knee

  • Provide stability - Two groups of strong ligaments:
    • … – outside …
      • Medial collateral
      • Lateral collateral
    • … – inside …
      • Anterior cruciate
      • Posterior cruciate
A
  • Provide stability - Two groups of strong ligaments:
    • Extracapsular – outside capsule
      • Medial collateral
      • Lateral collateral
    • Intracapsular – inside capsule
      • Anterior cruciate
      • Posterior cruciate
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47
Q

Ligaments of the knee

  • Provide stability - Two groups of strong ligaments:
    • Extracapsular – outside capsule
      • Medial …
      • Lateral …
    • Intracapsular – inside capsule
      • … cruciate
      • … cruciate
A
  • Provide stability - Two groups of strong ligaments:
    • Extracapsular – outside capsule
      • Medial collateral
      • Lateral collateral
    • Intracapsular – inside capsule
      • Anterior cruciate
      • Posterior cruciate
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48
Q

Ligaments of the knee

  • Provide stability - Two groups of strong ligaments:
    • Extracapsular – outside capsule
      • … collateral
      • … collateral
    • Intracapsular – inside capsule
      • Anterior …
      • Posterior …
A
  • Provide stability - Two groups of strong ligaments:
    • Extracapsular – outside capsule
      • Medial collateral
      • Lateral collateral
    • Intracapsular – inside capsule
      • Anterior cruciate
      • Posterior cruciate
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49
Q

Lateral/fibular collateral ligament

  • Strong … cord
    • Prevents … displacement of tibia
A
  • Strong round cord
    • Prevents medial displacement of tibia
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50
Q

Lateral/fibular collateral ligament

  • Strong round …
    • Prevents … displacement of tibia
A
  • Strong round cord
    • Prevents medial displacement of tibia
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51
Q

Tear of Lateral Collateral Ligament = … deformity (medial)

A

Tear of Lateral Collateral Ligament = varus deformity (medial)

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52
Q

What is this ligament?

A
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53
Q

Medial/tibial collateral ligament​

  • Broad … band
    • … joint capsule
  • Prevents lateral displacement of tibia
A
  • Broad flat band
    • Reinforces joint capsule
  • Prevents lateral displacement of tibia
54
Q

Medial/tibial collateral ligament​

  • Broad flat band
    • Reinforces joint capsule
  • Prevents … displacement of tibia
A
  • Broad flat band
    • Reinforces joint capsule
  • Prevents lateral displacement of tibia
55
Q

Tear of … Collateral Ligament = Valgus deformity (…)

A

Tear of Medial Collateral Ligament = Valgus deformity (lateral)

56
Q

Tear of Medial Collateral Ligament = … deformity (lateral)

A

Tear of Medial Collateral Ligament = Valgus deformity (lateral)

57
Q

Label the ligament

A
58
Q

The medial collateral ligament has a direct attachment with what?

A

medial miniscus

59
Q

Intracapsular ligaments

A
60
Q

Intracapsular ligaments

A
61
Q

Intracapsular ligaments

  • What are they called? (2)
A
62
Q

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
A
  • 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
Q

Function of cruciate ligaments

  • Anterior cruciate
    • Prevents anterior displacement of … on …
  • Posterior cruciate
    • Prevents posterior displacement of … on …
  • Maintain … against ..
  • Always one ligament tense
A
  • 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
Q

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 …
A
  • 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
Q

Cruciate ligaments

A
66
Q

Cruciate ligaments

A
67
Q

With flexed knee:

  • … rotation of leg – tightens cruciate ligaments (limits rotation) (10deg)
  • … rotation of leg – unwinds ligaments (~60deg)
A
  • Medial rotation of leg – tightens cruciate ligaments (limits rotation) (10deg)
  • Lateral rotation of leg – unwinds ligaments (~60deg)
68
Q

With flexed knee:

  • Medial rotation of leg – … cruciate ligaments (limits …) (10deg)
  • Lateral rotation of leg – … ligaments (~60deg)
A
  • Medial rotation of leg – tightens cruciate ligaments (limits rotation) (10deg)
  • Lateral rotation of leg – unwinds ligaments (~60deg)
69
Q

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
A
  • 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
Q

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
A
  • 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
Q

What is the Lachman test for?

A
  • 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
Q

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
A
  • 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
Q

Which cruciate ligament is weaker? (prone to injury)

A

anterior cruciate ligament - caused by sudden twisting of knee

74
Q

Posterior cruciate ligament

  • Stronger - Rarely injured
    • Principle stabilizer when knee … (Especially when walking …)
A
  • Stronger - Rarely injured
    • Principle stabilizer when knee flexed (Especially when walking down hill)
75
Q

Which cruciate ligament is stronger (rarely injured)?

A

Posterior cruciate ligament - Principle stabilizer when knee flexed

76
Q

Menisci of knee joint

  • …-shaped plates of …
    • Deepen the articulating surfaces/stability
    • … absorbers
    • Provides smooth viscous film for joint
A
  • Crescent-shaped plates of fibrocartilage
    • Deepen the articulating surfaces/stability
    • Shock absorbers
    • Provides smooth viscous film for joint
77
Q

Menisci of knee joint

  • Crescent-shaped plates of fibrocartilage
    • … the articulating surfaces/stability
    • Shock absorbers
    • Provides … … film for joint
A
  • Crescent-shaped plates of fibrocartilage
    • Deepen the articulating surfaces/stability
    • Shock absorbers
    • Provides smooth viscous film for joint
78
Q

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)
A
  • 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
Q

Label the menisci

A
80
Q

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
A
  • 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
Q

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
A
  • 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
Q

… of the menisci

A
83
Q

Are the menisci mobile?

A

yes - medial is less mobile than lateral miniscus because it is attached to the medial collateral ligament

84
Q

What menisci is attached to medial collateral ligament?

A

the medial miniscus

85
Q
A
86
Q

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
A
  • 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
Q
  • Rupture of
    • Anterior cruciate ligament
    • Medial collateral ligament
    • Medial meniscus (attached to MCL
  • is known as ..
A

unhappy triad

88
Q

Muscles acting on knee joint

  • Knee reinforced by tendons from surrounding muscles and … tract
A
  • Knee reinforced by tendons from surrounding muscles and iliotibial tract
89
Q

Knee

A
90
Q

Which muscles stabilize the extended knee? (2)

A

gluteus maximus, tensor fascia lata

91
Q

Extensors of leg

  • What muscle extend the leg?
A
  • Quadriceps extends leg
    • Also major stabilizing muscle of the knee
    • 4 heads:
      • Rectus femoris
      • Vastus lateralis
      • Vastus intermedius
      • Vastus medialis
92
Q

Extensors of leg

  • Quadriceps extends leg
    • Also major stabilizing muscle of the knee
    • 4 heads:
      • … femoris
      • Vastus …
      • Vastus …
      • Vastus medialis
A
  • Quadriceps extends leg
    • Also major stabilizing muscle of the knee
    • 4 heads:
      • Rectus femoris
      • Vastus lateralis
      • Vastus intermedius
      • Vastus medialis
93
Q

4 parts of the quadriceps are …

A
  • Rectus femoris
  • Vastus lateralis
  • Vastus intermedius
  • Vastus medialis
94
Q

Quadriceps femoris

A
95
Q

Quadriceps femoris

A
96
Q

Quadriceps femoris

  • … fibres of vastus … prevents lateral tracking of patella
A
  • Oblique fibres of vastus medialis prevents lateral tracking of patella
97
Q

Extensor mechanism

A
98
Q

The … mechanism of the knee comprises the quadriceps muscle and tendon, the patella, and the patellar tendon

A

The extensor mechanism of the knee comprises the quadriceps muscle and tendon, the patella, and the patellar tendon

99
Q

The extensor mechanism of the knee comprises the … muscle and tendon, the …, and the … tendon

A
  • The extensor mechanism of the knee comprises the quadriceps muscle and tendon, the patella, and the patellar tendon
100
Q

Patella

  • …-shaped … shaped
  • Protects quadriceps tendon from stresses during locomotion
  • Smooth oval facet on … surface for articulation with femur
A
  • Triangular-shaped sesamoid shaped
  • Protects quadriceps tendon from stresses during locomotion
  • Smooth oval facet on posterior surface for articulation with femur
101
Q

Patella

  • Triangular-shaped sesamoid shaped
  • Protects … tendon from stresses during …
  • Smooth oval facet on posterior surface for articulation with …
A
  • Triangular-shaped sesamoid shaped
  • Protects quadriceps tendon from stresses during locomotion
  • Smooth oval facet on posterior surface for articulation with femur
102
Q

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
A
  • 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
103
Q

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
A
  • 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
104
Q

Dislocation of … common - due to sudden twisting/jumping or ligamentous laxity

A

Dislocation of patella common - due to sudden twisting/jumping or ligamentous laxity

105
Q

Flexors of leg

  • … and … flex leg - … also medially and laterally rotates leg when knee flexed
  • … actually three muscles:
    • Biceps femoris
    • Semimembranosus
    • Semitendinosus
A
  • Hamstrings and gastrocnemius flex leg - Hamstrings also medially and laterally rotates leg when knee flexed
  • Hamstrings actually three muscles:
    • Biceps femoris
    • Semimembranosus
    • Semitendinosus
106
Q

What muscles flex the leg?

A
  • Hamstrings and gastrocnemius flex leg (Hamstrings also medially and laterally rotates leg when knee flexed)
107
Q

Hamstrings actually three muscles: …

A
  • Biceps femoris
  • Semimembranosus
  • Semitendinosus
108
Q

Hamstrings

A
109
Q

Unlocking of extended leg

  • … unlocks knee joint
    • Laterally rotates femur on tibia when foot is on ground
A
  • Popliteus unlocks knee joint
    • Laterally rotates femur on tibia when foot is on ground
110
Q

Unlocking of extended leg

  • Popliteus unlocks knee joint
    • … rotates femur on tibia when foot is on ground
A
  • Popliteus unlocks knee joint
    • Laterally rotates femur on tibia when foot is on ground
111
Q

Popliteus

  • Passes through joint …
  • Passes through space under … collateral ligament
A
  • Passes through joint capsule
  • Passes through space under lateral collateral ligament
112
Q

… unlocks knee joint

A

Popliteus unlocks knee joint

113
Q

Synovial membrane (KNEE)

  • From margins of articular surfaces of femur to tibia
  • Attached to …
  • Extends … behind quadriceps tendon
  • Cuffs anterior surface of cruciate ligaments
A
  • From margins of articular surfaces of femur to tibia
  • Attached to patella
  • Extends superiorly behind quadriceps tendon
  • Cuffs anterior surface of cruciate ligaments
114
Q

Synovial membrane (knee)

  • From margins of articular surfaces of femur to tibia
  • Attached to patella
  • Extends superiorly behind … tendon
  • Cuffs anterior surface of … ligaments
A
  • From margins of articular surfaces of femur to tibia
  • Attached to patella
  • Extends superiorly behind quadriceps tendon
  • Cuffs anterior surface of cruciate ligaments
115
Q

Knee

A
116
Q

Bursae - knee

  • … fluid filled sac lined by … membrane
  • Protect and reduce friction
A
  • Synovial fluid filled sac lined by synovial membrane
  • Protect and reduce friction
117
Q

Bursae

  • … … filled sac lined by synovial membrane
  • Protect and reduce …
A
  • Synovial fluid filled sac lined by synovial membrane
  • Protect and reduce friction
118
Q

Bursae - knee

A
119
Q

Other bursae - knee

A
120
Q

Bursitis is …

A

Inflammation of bursae due to repetitive movements or direct pressure

121
Q

Inflammation of bursae due to repetitive movements or direct pressure is known as …

A

bursitis

122
Q

Prepatellar bursitis (‘housemaid’s knee’)

  • Seen in … fitters
  • Leaning forward on the knees brings the prepatellar bursa in contact with ..
A
  • Seen in carpet fitters
  • Leaning forward on the knees brings the prepatellar bursa in contact with floor
123
Q

What bursitis is seen in carpet fitters?

A

prepatellar bursitis

124
Q

Infrapatellar bursitis (‘clergyman’s knee’)

  • Seen in …
  • After prolonged periods of prayer clergymen sat back on their heels bringing infrapatellar bursa in contact with …
A
  • Seen in roofers
  • After prolonged periods of prayer clergymen sat back on their heels bringing infrapatellar bursa in contact with floor
125
Q

What bursitis is seen in roofers?

A
  • Infrapatellar bursitis (‘clergyman’s knee’)
126
Q

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
A
  • 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
127
Q

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
A
  • 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
Q

How are baker’s (popliteal) cysts treated?

A

Treated by aspiration and cortisone injection

129
Q

What is a baker’s cyst?

A

Abnormal fluid filled sacs in popliteal fossa due to herniation of bursa

130
Q

Vascular supply - Knee

A
131
Q

Complex anastomosis around knee joint - supplied by branches (coming from femoral artery or popliteal artery)

A

Complex anastomosis around knee joint - supplied by genicular branches (coming from femoral artery or popliteal artery)

132
Q

Limited blood supply to … structures of knee - poor repair following injury

A

Limited blood supply to intracapsular structures of knee - poor repair following injury