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Module 204 Theme 2 > Anatomy of the knee > Flashcards

Anatomy of the knee Flashcards

1
Q

Where is the knee joint?

A

Articulation between distal femur and proximal tibia

Articulation between femur and patella

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2
Q

What type of joint is the knee?

A

Synovial bicondylar hinge joint

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3
Q

List the functions of the knee

A

Unusual

Weight–bearing

Mobility

  • Extension/flexion
  • Some rotation when flexed
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4
Q

List the bony structures which strengthen the knee

A
  • Bony expansions
  • Locking mechanism
  • Femoral angle
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5
Q

List the soft tissue structures which strengthen the knee

A
  • Ligaments
  • Menisci
  • Muscles
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6
Q

List the bony expansions of the knee

A

Epicondyles
Femoral condyles
Tibial condyles
Intercondylar fossa

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7
Q

What is the function of the bony expansions?

A

Provides a strong base

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8
Q

What is the function of the locking mechanism

A

Reduces amount of energy required when extended

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9
Q

Describe the shape of the femoral surfaces in flexion

A

round

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10
Q

Describe the shape of the femoral surfaces in extension

A

Flat

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11
Q

What constitutes the locking mechanism

A

Shape of the femur
Rotation
Centre of gravity

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12
Q

What does medial rotation of the femur on the tibia in extension do?

A

Tightens the ligaments of the knee

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13
Q

Where is the centre of gravity in the knee?

A

In front of the knee

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14
Q

What is the function of the centre of gravity in the knee?

A

Maintains extension

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15
Q

Describe the femoral angle

A

Adducted femur brings knee joint under pelvis

Critical for weight bearing

Occurs during development

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16
Q

What is normal joint alignment in the knee?

A

Vertical line through centre of femoral head,

Centre of knee and centre of ankle

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17
Q

Describe varus deformity (Genu varum)

A

Deformity in the angle tween the femur and tibia
Medial displacement of the tibia - common in children under 2 and rickets
Pushes the knees apart - bow legged - decrease in Q angle

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18
Q

Describe valgus deformity (Genu valgum)

A

Lateral displacement of the tibia
- Common in children aged 2-4, rickets, arthritis
Brings knees together - ‘Knock-kneed’
Increases Q angle

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19
Q

What is the function of the ligaments in the knee?

A

Provide stability

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20
Q

Name the two groups of ligaments in the knee

A

Intracapsular

Extracapsular

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21
Q

Where are the Extracapsular ligaments found?

A

Outside of the capsule

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22
Q

Where are the Intracapsular ligaments found?

A

Inside the capsule

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23
Q

Name the Extracapsular ligaments

A
  • Medial collateral

- Lateral collateral

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24
Q

Name the Intracapsular ligaments

A
  • Anterior cruciate

- Posterior cruciate

25
Q

Describe the lateral/fibular collateral ligament

A

Strong round cord

Prevents medial displacement of the tibia

26
Q

What is a varus deformity?

A

Tear of the LCL

27
Q

Describe the medial/tibial collateral ligament

A

Broad flat band

  • Reinforces joint capsule
  • Prevents lateral displacement of tibia
28
Q

What is a valgus deformity?

A

Tear of the MCL

29
Q

Where is the anterior cruciate ligament?

A

anterior in relation to the tibia

30
Q

Where is the posterior cruciate ligament?

A

Posterior in relation to the tibia

31
Q

What is the function of the anterior cruciate ligament

A

Prevents anterior displacement of tibia on femur

32
Q

What is the function of the posterior cruciate ligament?

A

Prevents posterior displacement of tibia on femur

Stabilizer when knee is flexed

33
Q

What is the function of both cruciate ligaments?

A

Maintain femur against tibia

34
Q

Which is the weaker cruciate ligament?

A

Anterior cruciate

35
Q

Describe injury to the anterior cruciate ligament

A
  • Common sports injury
  • Caused by sharp twisting of knee
  • Immediate decreased range of movement
36
Q

Describe the lachman test

A
  • Patient in supine position with knee bent 20-300 of flexion
  • Move tibia anteriorly and posteriorly while maintaining position of femur
  • Laxity during this manoeuvre indicates anterior cruciate ligament injury
37
Q

What are the menisci of the joints

A

Crescent-shaped plates of fibrocartilage

- Deepen the articulating surfaces/stability
- Shock absorbers
- Provides smooth viscous film for joint
38
Q

Describe the menisci attachments

A

Horns of menisci attached to intercondylar area of tibia
Mobile - Accommodates rolling of femoral condyles
Medial meniscus less mobile- Attached to medial collateral ligament

39
Q

What can be commonly ruptured in the knee?

A
  • Anterior cruciate ligament
  • Medial collateral ligament
  • Medial meniscus (attached to MCL)
40
Q

Describe the iliotibial tract

A
  • Reinforces joint capsule

- Stabilizes extended knee
gluteus maximus, tensor fascia lata

41
Q

List the 4 heads of the quadriceps

A

Rectus femoris
Vastus lateralis
Vastus intermedialis
Vastus medialis

42
Q

What is the function of the quadriceps

A

major stabilizing muscle of the knee

Extends the leg

43
Q

Describe the patellar

A
  • Protects quadriceps tendon from stresses during locomotion

- Smooth oval facet of posterior surface for articulation with femur

44
Q

How can the patella be fractured?

A

due to fall or blow to the knee

45
Q

How can the patella be dislocated?

A

sudden twisting/jumping or ligamentous laxity

46
Q

Name the 3 hamstring muscles

A
  • Biceps femoris
  • Semimembranosus
  • Semitendinosus
47
Q

What is the function of the hamstring muscles

A
  • Also medially and laterally rotates leg when knee flexed

- And extends thigh

48
Q

Which 2 muscles flex the leg?

A

Hamstrings and gastrocnemius

49
Q

Describe how the extended leg can be unlocked

A

Popliteus unlocks knee joint

- Laterally rotates femur on tibia when foot is on ground

50
Q

Describe the synovial membrane

A

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

51
Q

What is the function of the infrapatellar fat pad?

A

separates synovial membrane from patellar ligament

52
Q

What is the function of bursae?

A
  • Protection

- Reduce friction

53
Q

What are bursae?

A

Synovial fluid filled sac lined by synovial membrane

54
Q

What is bursitis?

A

Inflammation of bursae

Due to repetitive movements or direct pressure

55
Q

Describe Prepatellar bursitis

A

Seen in carpet fitters

Leaning forward on the knees brings the prepatellar bursa in contact with floor

56
Q

Describe Infrapatellar bursitis

A
  • After prolonged periods of prayer clergymen sat back on their heels bringing infrapatellar bursa in contact with floor
57
Q

Describe Bakers (popliteal cyst)

A

Abnormal fluid filled sacs in popliteal fossa
- Due to herniation of synovial membrane/bursa
Common in patients with chronic
inflammatory joint disease (e.g. arthritis)
- Presents as swelling in the popliteal fossa
- Can affect joint movement

58
Q

How do you treat bakers cyst?

A

aspiration and cortisone injection

59
Q

Describe the vascular supply to the knee

A

Anastomosis - femoral artery and popliteal artery

Module 204 Theme 2 (31 decks)

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