Compartments of the Thigh and Knee Joint Flashcards
Anterior Thigh
Innervation:
Function:
Anterior Thigh
Innervation: Femoral
Function: Hip Flexion, knee extension
Medial Thigh
Innervation:
Function:
Anterior Thigh
Innervation: Obturator
Function: Hip adduction
Posterior Thigh
Innervation:
Function:
Posterior Thigh
Innervation: Tibial
Function: Hip extension, knee flexion
gluteus maximus nerve innervation
inferior gluteal nerve innervated it.
Describe job of fascia lata
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
Wat is the illiotibial tract (IT band)?
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))
Anterior thigh
Nerve:
Function:
Muscles: and which are the strongest flexors
Nerve: Femoral
Function: hip flexion, knee extension
Muscles: Iliopsoas (IP) (strong), Pectineus (P) (strong), Sartorius (S), Quadriceps Femoris (QF)
Medial thigh
Nerve:
Function:
Muscles:
Medial thigh
Nerve: Obturator
Function: hip adduction
Muscles: Adductor Brevis (AB), Adductor Longus (AL), Gracilis (G), Adductor Magnus (AM) = largest adductor, Obturator Externus (OE)
Posterior thigh
Nerve:
Function:
Muscles:
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)
Arterial supply to the thigh
Profunda femoral, which breaks into medial femoral circumflex, lateral femoral circumflex, and perforating artery (goes through the hamstrings)
What passes through the Adductor Hiatus, and what does it change its name to upon doing to?
Femoral artery and vein pass through it, going behind the knee. Upon doing so, their names change to popiteal artery and vein
Cubital fossa
Concave area behind elbow
What passes through femoral triangle? What does not pass under the femoral sheath?
From lateral to medial, femoral nerve, artery, vein, and lymphatics (NAVL) pass through femoral triangle. Femoral vein does not pass through the femoral sheath.
What is the common artery/vein used to access the heart?
Femoral vein (for right heart) and femoral artery (for left heart)
Why are femoral hernias dangerous?
Intestine Never seeps back in to where it seeped out of. This closes off blood supply to the bowel. More common in females.
What are the three bones of the knee?
Femoral condyles, tibial condyles, and the patella covers them….mainly over the femoral condyles
Which side does the fibula sit on? Where does the common fibula nerve run?
Lateral side of the tibula. Most lateral bone of the leg. COmmon fibular nerve runs over the fibular head
What is special about the tibiofibular joint?
Prevents tibula and fibula from crossing over like the ulna and radius do.
The knee join tot the largest synovial joint. What articulations make it up? What are the knee joint’s actions?
- Patellofemoral
- Tibiofemoral.
***Patellotibial DNE!!!!
Actions are flexion, extension, and rotation
Goal of patellofemoral joint?
increase mechanical advantage of quads. Note that connective tissue structures control lateral and medial tracking
Describe the knee joint. What supports it?
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)
Valgus vs varus stress….and where are their attachments?
Varus stress = resisted by lateral collateral ligament. Attched to fibula
Valgus stress = resisted by medial collateral ligament. Attached to medial meniscus
What triggers LCL tear? MCL tear?
LCL tear caused by varus stress (distal bone being pushed medially). MCL tear caused by valgus stress (distal bone being pushed laterally)
What are the popliteal ligaments? What is it’s job
Oblique popliteal ligament (strongest ligament at the joint) and arcuate popliteal ligament both do the job of resisting HYPERextension
What is the job of menisci?
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.
Describe direction of ACL. How do the two bundles react during extension and flexion? What is the overall job?
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
Describe direction of PCL. How do the two bundles react during extension and flexion? What is the overall job?
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
What kinds of sliding motion are facilitated by the supra and infra meniscas?
Supramenisca facilitates anterior ROLLING of femur on tibia. Inframenisca facilitates posterior sliding (translation) of femur on tibia
What is the job of the popliteus muscle?
It unlocks the knee during rotation
What causes menisci to tear and which menisci is more likely to tear? Treatment?
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
Taking the suturing approach, which side it more likely to heal? least likely?
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.
What tears acl? How do you repair it?
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
Describe arthritis in the knee. What treatment is available?
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)
