Compartments of the Thigh and Knee Joint Flashcards
What are the three compartments of the thigh?
Anterior, medial, and posterior
The deep fascia of the thigh is called the
Fascia Lata
Acts to facilitate venous return
Fascia Lata
The fascia lata is thickened laterally forming the
Iliotibial tract
Provides support for the knee joint and is a site of attachment for the gluteus maximus and tensor fascia lata muscles
Iliotibial tract/band
The deep fascia extends from the iliotibial tract to the femur creating the
Lateral intermuscular septum
Extends from the deep fascia on the medial aspect of the thigh to the femur
Medial intermuscular septum
The anterior thigh is the hip flexor/knee extensor compartment and is innervated by the
Femoral nerve
What are the 8 anterior thigh muscles?
- ) Psoas major
- ) Illiacus
- ) Tensor Fascia Lata
- ) Sartorius
- ) Rectus femoris
- ) Vastus intermedius
- ) Vastus lateralis
- ) Vastus medialis
Which of the anterior thigh muscles function in HIP FLEXION
Iliopsoas, sartorius, tensor fascia lata, and rectus femoris
Which anterior thigh muscles function in knee extension
Quadriceps femoris
The medial thigh compartment houses the hip adductors and is innervated by the
Obturator nerve
What are the 6 muscles of the medial compartment of the thigh?
Pectineus, adductor longus, adductor brevis, adductor magnus, gracilis, and obturator externus
Which medial thigh muscles function in hip adduction
Pectineaus, adductor longus, adductor brevis, adductor magnus, and Gracilis
Which medial thigh muscles function in hip lateral rotation?
Obturator externus
Which medial thigh muscles function in hip extension?
Hamstring part of the adductor magnus
Which medial thigh muscles function in knee flexion
Gracilis
The posterior compartment is the hip extensor, knee flexor compartment and is innervated by the
Tibial nerve
What are the 5 muscles of the posterior compartment of the thigh?
Semitendinosis, semimembranosis, Biceps femoris (long and short heads), and the hamstring part of the adductor magnus
Which posterior thigh muscles function in hip extension?
Semitendinosus, semimembranosus, aductor magnus, and long head of biceps femoris
Which posterior thigh muscles function in knee flexion?
Semitendinosus, semimembranosus, and the long and short heads of biceps femoris
An invagination of transversalis fascia that is extended into the thigh by the femoral artery, vein, and lymphatics
Femoral sheath
Not contained within the femoral sheath
Femoral nerve
Can occur as loops of bowel that enter the medial most compartment of the femoral sheath, i.e. the femoral canal
Femoral hernias
Femoral hernias are distinguished from inguinal hernias in that they pass posterior to the
Inguinal ligament
A hinge type synovial joint between the femoral condyles and tibial condyles, and the patella and femur
Knee joint
The shape of the articulating surfaces, round femoral condyles, and flat tibial condyles, make the knee joint inherently
Unstable
Two wedges of fibrocartilage that provide a shallow socket for the femoral condyles and divide the joint cavity into two compartments
Menisci
The menisci divide the joint cavity into which two compartments?
Suprameniscal and inframeniscal
Between the femoral condyles and the menisci
Suprameniscal compartment
Between the menisci and tibial condyles
Inframeniscal compartment
What are the five types of EXTRACAPSULAR support for the knee joint?
Patellar, lateral collateral, medial collateral, arcuate popliteal, and oblique popliteal ligaments
Attaches the patella to the tibial tuberosity
Patellar ligament
The patellar tendon functions to
Provide anterior support to joint capsule
Stretched during knee flexion
Patellar ligament
Attaches the lateral femoral epicondyle to the apex of fibula
Lateral collateral ligament (LCL)
The LCL acts to
Provide lateral support to knee
Taught during extension
LCL and MCL
Connects the medial femoral epicondyle to the tibia and medial meniscus
Medial Collateral Ligament (MCL)
The MCL acts to
Provide medial support to the knee
Connects the semimembranosus tendon to the lateral joint capsule
Oblique popliteal ligament
The oblique popliteal ligament acts to
Resist hyperextension of knee
What are the 4 structures functioning in INTRACAPSULAR support?
- ) Medial meniscus
- ) Lateral meniscus
- ) Anterior cruciate ligament (ACL)
- ) Posterior cruciate ligament (PCL)
The medial meniscus attaches to the
Intercondylar area of the tibia, tibial plateau, and MCL
Receives the medial femoral condyle
Medial meniscus
Translates on the tibia and rotates with the femur during knee movements
Medial and Lateral menisci
The lateral meniscus attaches to the
Intercondylar area of the tibia, tibial plateau, and lateral femoral condyle via the meniscofemoral ligament
Receives the lateral femoral condyle
Lateral meniscus
Connects the anterior intercondylar eminence of tibia to medial surface of lateral femoral condyle (up and out)
ACL
During extension, the ACL is
Taut
The ACL acts to
Resist anterior displacement of the tibia on the fixed femur
Attaches the posterior intercondylar eminence of tibia to the lateral surface of medial femoral condyle (up and in)
PCL
Taut during knee flexion
PCL
The PCL acts to
Resist posterior displacement of the tibia on the fixed femur
Movements of the knee with the femur fixed (i.e. sitting in a chair), are described as
Movement of tibia on femur
Movements of the knee with tibia fixed (i.e. standing) are described as
Movement of femur on tibia
The fixed bone is the one that is
Acted on
With the tibia fixed, upon contraction of the quadriceps, extension begins with
Anterior rolling of femur on tibia in suprameniscal compartment
The anterior rolling is checked by the
PCL
Occurs concomitantly with the anterior rolling and prevents the femur from rolling off the tibial surface
Posterior translation (sliding) of femur on the tibia in inframeniscal compartment
This posterior translational movement is checked by the
ACL
Near full extension the lateral femoral condyle reaches the limit of its articular surface (full congruency) and stops rolling while the longer articular surface of the medial femoral condyle continues to roll in the
Suprameniscal compartment
This results in a
-locks the knee in full extension
Medial rotation of the femur
Unlocking of the knee requires muscle action. To unlock the knee, the femur is rotated laterally by
Popliteus muscle contraction
Which muscles function in flexion at the knee?
Hamstrings (ST, SM, BF), Gracilis, sartorius, and popliteus
Which muscles function in extension of the knee?
Quadriceps femoris (RF, VI, VL, and VM)
Which muscles function in medial rotation of the tibia on the femur (lateral rotation of femur on tibia)?
Popliteus, semitendinosus, semimembranosus, sartorius, and gracilis
Which muscles function in lateral rotation of tibia on femur (medial rotation of femur on tibia)?
Biceps femoris
Arterial blood supply is provided to the knee primarily from
Genicular branches of the popliteal artery
Sensory innervation of the knee is via branches of the
Femoral, obturator, tibial, and common fibular nerves
Can occur as a result of bursitis or internal damage leading to knee effusions
Knee swelling
Caused by a lateral blow to the knee
Valgus stress
Valgus stress can result in simultaneous damage to the
ACL, medial menisucs, and MCL (called the unhappy triad)
Caused by a medial blow to the knee
Varus stress
Can occur in excessive knee twisting or hyperextension
Cruciate ligament tears
Analysis of cruciate ligament damage is done by the
Drawer test
How do we test the
- ) ACL
- ) PCL
- ) Anterior drawer test
2. ) Posterior drawer test
How do we test the
- ) MCL
- ) LCL
- ) Applied valgus stress
2. ) Applied varus stress