bones and joints Flashcards
Anterior femur palapable structures
adductor tubercle
medial and lateral condyles and epicondyles
lateral buttress wall
patellar surface
posterior femur palpable
linea aspera medial and lateral supracondylar ridges medial and lateral condyles and epicondyles popliteal surface adductor tubercle intercondylar fossa
proximal tibia palpable
medial and lateral tibial condyles tibial plateau intercondylar eminence (med and lat) tibial tuberosity anterior palpable crest
pes anserinus
sartorius
gracilis
semitendinosus
proximal fibula palpable
head and neck of fibula
apex of fibula
interosseous membrane
patella
sesamoid bone within quadriceps tendon patella tendon triangular shaped base superior apex inferior medial and lateral borders
knee joint
largest synovial joint in body
bicondylar modified hinge joint
(between femoral and tibial condyles, menisci attaching to tibial articular surfaces)
2 degrees of movement
patella femoral joint
synovial saddle joint
between patellar and femoral articular surfaces
femoral articular surfaces
convex antero-posteriorly and medio-laterally lateral condyle shorter and wider medial condyle projects more distally lateral condyle projects more anteriorly covered in articular cartilage
tibial articular surfaces
concave centrally
flatter peripherally, covered with semi-lunar cartilages (menisci)
medial tibial condyle projects further anteroom-posteriorly to accommodate the medial femoral condyle
covered in articular cartilage
patellar articular surface
lateral
medial
odd
patellar function
improves mechanical efficiency of the quadriceps muscle group by
- increasing lever arm
- increasing angular torque
Q angle
- angle between the quadriceps muscles (in particular RF) and patellar tendon
- measured as angle between line from ASIS to centre patella and line from centre patella to tibial tuberosity
- represents angle of quadriceps muscle force
patellar stability
q angle
normal angle 13 degrees for men and 18 for females
<13 or >18 considered abnormal
>18 may predispose to patellar lateralisation
patella-femoral joint stability
dependant on
- patella position (alta/baja)
- lateral femoral buttress wall
- ratio between VMO and VL
- tightness of lateral retinaculum
superior tibio fibular joint
synovial plane joint
head of fibula, tibial lateral condyle, capsule attached around joint margins
ant and post lights of fibular head
small rotational movements during ankle DF/PF +/- gliding
menisci
medial 'c' shaped lateral 'o' shaped 2 horns - anterior and posterior medial narrower and thinner medial and less mobile and therefore more easily damaged
medial meniscus attachments
anterior horn
- intercondylar area + ACL
- transverse and coronary ligaments
posterior horn
- PCL + posterior horn of lateral meniscus
- blends with capsule and medial collateral ligt
lateral meniscus attachments
anterior horn
- anterior intercondylar eminence post. to ACL
- transverse and coronary ligaments
posterior horn
-posterior intercondylar area ant. to post. horn of medial meniscus
meniscal function
-enhances tibio-femoral joint stability by deepening tibial articular surface
-act as shock absorbers
-conforms to changing shape of femoral condyles during knee movement
outer stouter
inner thinner
knee joint capsule posteriorly
- post. femoral condyles and intercondylar fossa
- post. tibial condyles
knee joint capsules medially
- blends with gastrocnemius and semimembranosus
- medial articular margins femoral and tibial condyles
- blends with medial collateral ligament
knee joint capsule laterally
- lateral femur above politeus
- lateral tibial condyle
- fibula head
knee joint capsule anteriorly
- patella and retinaculum
- capsule replaced by quadriceps tendon
anterior cruciate ligament attachments
- anterior intercondylar area of tibia
- runs posteriorly, laterally and superiorly
- posterior part of intercondylar area of lateral femoral condyle
posterior cruciate ligament attachments
- posterior part of intercondylar area of tibia
- runs anteriorly, medially and superiorly
- lateral surface of medial femoral condyle
medial (tibial) collateral ligament
- broad flat ligament
- fan shaped
- approx 10cm long
- medial epicondyle of femur
- medial proximal shaft of tibia
- blends with knee joint capsule and medial meniscus
lateral (fibular) collateral ligament
- strong rounded cord
- proximal: lateral femoral epicondyle
- distally: apex of head of fibula
- no connection with the capsule or meniscus
collateral ligament function
- MCL limits valgus movement of the tibia on the femur
- LCL limits various movement of tibia on femur
bursae
suprapatellar bursa prepatellar bursa superficial infrapatellar bursa deep infrapatella bursa pes anserinus bursa semimembranosus bursa
patella femoral accessory movements
longitudinal caudal exursion
med side glide, lat side glide
knee joint accessory movements
AP glide
PA glide
med side glide, lat side glide
superior tibio fibular joint accessory movements
Ap glide
PA glide
