Compartments of the Thigh and Knee Joint

Question 1

Anterior Thigh
Innervation:
Function:

Answer 1

Anterior Thigh
Innervation: Femoral
Function: Hip Flexion, knee extension

Question 2

Medial Thigh
Innervation:
Function:

Answer 2

Anterior Thigh
Innervation: Obturator
Function: Hip adduction

Question 3

Posterior Thigh
Innervation:
Function:

Answer 3

Posterior Thigh
Innervation: Tibial
Function: Hip extension, knee flexion

Question 4

gluteus maximus nerve innervation

Answer 4

inferior gluteal nerve innervated it.

Question 5

Describe job of fascia lata

Answer 5

Covers entire leg. Acts as a compression stocking. Meaning that when muscles contract, they expand but are limited by the fascia lata. this increases pressure on deep veins, leading to compartment syndrome. It also helps to facilitate venous return

Question 6

Wat is the illiotibial tract (IT band)?

Answer 6

It’s a tract that runs down the entire lateral side of the tibia and is really secure the entire length of the femor. It works to stabilize the knee and hip. Can be damaged if shifted and accompanied by running (runners suffer IT band tearing, for instance))

Question 7

Anterior thigh
Nerve:
Function:
Muscles: and which are the strongest flexors

Answer 7

Nerve: Femoral
Function: hip flexion, knee extension
Muscles: Iliopsoas (IP) (strong), Pectineus (P) (strong), Sartorius (S), Quadriceps Femoris (QF)

Question 8

Medial thigh
Nerve:
Function:
Muscles:

Answer 8

Medial thigh
Nerve: Obturator
Function: hip adduction
Muscles: Adductor Brevis (AB), Adductor Longus (AL), Gracilis (G), Adductor Magnus (AM) = largest adductor, Obturator Externus (OE)

Question 9

Posterior thigh
Nerve:
Function:
Muscles:

Answer 9

Posterior thigh
Nerve: Tibila, EXCEPT for biceps femoris long head. This is Common fibular!!!!
Function: Hip extension, knee flexion
Muscles: Semitendinosus (ST) (grafted for ACL repairs), Semimembranosus (SM), Biceps Femoris Long Head
(BFL), Biceps Femoris Short Head* (BFS), Adductor Magnus (AM)

Question 10

Arterial supply to the thigh

Answer 10

Profunda femoral, which breaks into medial femoral circumflex, lateral femoral circumflex, and perforating artery (goes through the hamstrings)

Question 11

What passes through the Adductor Hiatus, and what does it change its name to upon doing to?

Answer 11

Femoral artery and vein pass through it, going behind the knee. Upon doing so, their names change to popiteal artery and vein

Question 12

Cubital fossa

Answer 12

Concave area behind elbow

Question 13

What passes through femoral triangle? What does not pass under the femoral sheath?

Answer 13

From lateral to medial, femoral nerve, artery, vein, and lymphatics (NAVL) pass through femoral triangle. Femoral vein does not pass through the femoral sheath.

Question 14

What is the common artery/vein used to access the heart?

Answer 14

Femoral vein (for right heart) and femoral artery (for left heart)

Question 15

Why are femoral hernias dangerous?

Answer 15

Intestine Never seeps back in to where it seeped out of. This closes off blood supply to the bowel. More common in females.

Question 16

What are the three bones of the knee?

Answer 16

Femoral condyles, tibial condyles, and the patella covers them….mainly over the femoral condyles

Question 17

Which side does the fibula sit on? Where does the common fibula nerve run?

Answer 17

Lateral side of the tibula. Most lateral bone of the leg. COmmon fibular nerve runs over the fibular head

Question 18

What is special about the tibiofibular joint?

Answer 18

Prevents tibula and fibula from crossing over like the ulna and radius do.

Question 19

The knee join tot the largest synovial joint. What articulations make it up? What are the knee joint’s actions?

Answer 19

1. Patellofemoral
2. Tibiofemoral.
   ***Patellotibial DNE!!!!
   Actions are flexion, extension, and rotation

Question 20

Goal of patellofemoral joint?

Answer 20

increase mechanical advantage of quads. Note that connective tissue structures control lateral and medial tracking

Question 21

Describe the knee joint. What supports it?

Answer 21

Bears weight, and highly mobile (140 degrees range of motion). problem is that it is round on a flat surface (not stable), making it susceptible to injury. Supported by muscle tendons and ligaments (extracapsular…patellar ligament and patellar retinacula and quads tendon) and menisci and cruciate ligaments (intrsa-articular). Laterally supported by medial patellofemoral ligament (painful if too tight)

Question 22

Valgus vs varus stress….and where are their attachments?

Answer 22

Varus stress = resisted by lateral collateral ligament. Attched to fibula
Valgus stress = resisted by medial collateral ligament. Attached to medial meniscus

Question 23

What triggers LCL tear? MCL tear?

Answer 23

LCL tear caused by varus stress (distal bone being pushed medially). MCL tear caused by valgus stress (distal bone being pushed laterally)

Question 24

What are the popliteal ligaments? What is it’s job

Answer 24

Oblique popliteal ligament (strongest ligament at the joint) and arcuate popliteal ligament both do the job of resisting HYPERextension

Question 25

What is the job of menisci?

Answer 25

They (both medial and lateral) attach to tibia and absorb load-transmitting forces. They also protect articular cartilage (without with, osteoarthritis). Medial meniscus is less mobile and thus more likely to tear.

Question 26

Describe direction of ACL. How do the two bundles react during extension and flexion? What is the overall job?

Answer 26

Moves from anterior at the bottom to posterior and LATERAL (external) at the top. Overall, acl resists anterior displacement of tibia on femur. Anteromedial bundle is tight during flexion. Posterior lateral is tight during extension

Question 27

Describe direction of PCL. How do the two bundles react during extension and flexion? What is the overall job?

Answer 27

Goes from posterior at the bottom to anterior and internal (not going towards the fibula) at the top. Overall, pcl resists posterior displacement of tibia on femur. Anterolateral part is tight during flexion and posteromedial part is tight during extension

Question 28

What kinds of sliding motion are facilitated by the supra and infra meniscas?

Answer 28

Supramenisca facilitates anterior ROLLING of femur on tibia. Inframenisca facilitates posterior sliding (translation) of femur on tibia

Question 29

What is the job of the popliteus muscle?

Answer 29

It unlocks the knee during rotation

Question 30

What causes menisci to tear and which menisci is more likely to tear? Treatment?

Answer 30

Caused by force applied to knee while it is flexed during femoral rotation. Medial menisci is less mobile and more likely to tear. Treat by removing meniscus (meniscectomy), suturing it, or replacing it with an allograft/autograft transplant

Question 31

Taking the suturing approach, which side it more likely to heal? least likely?

Answer 31

Most likely to heal is red-red (most lateral portions) or red-white zones of mensicus. White white is useless because no blood flows there, so it would never heal.

Question 32

What tears acl? How do you repair it?

Answer 32

Hyperextension and rotation forces of knee. Note that repair is requirement in order to comfortably restore athletic ability. Repair with allo/auto graft. Autografts = hamstring tendons, patellar tendons, or quad-patella bone

Question 33

Describe arthritis in the knee. What treatment is available?

Answer 33

You’ll notice pain, swelling, limited range of motion, and loss of joint space + osteophytic growth (radioimage will show the last 2). Treat with total knee arthroplasty (total knee replacement. Bloody procedure)