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MD2002 Arvin > Elbow and Knee Joints > Flashcards

Elbow and Knee Joints Flashcards

1
Q

Which kind of joint are elbow and knee joints ?

A

Hinge Joints

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2
Q

What are some characteristics of all hinge joints ?

A
  • articular surfaces are reciprocally shaped
  • strong collateral ligaments
  • muscles are grouped at the sides of the joint where they do not interfere with movement
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3
Q

What are the 2 joints making up the elbow joint ?

A

Humero-radial and humero-ulnar joints

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4
Q

What movements does the proximal radio-ulnar joint allow for?

A

Supination and pronation

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5
Q

The knee joint allows for free movement in how many planes ?

A

One plane

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6
Q

Describe the main features of the elbow joint capsule.

A
  • Single fibrous capsule for 3 joints
  • lined by synovial membrane
  • attaches to the articular margins
  • strengthened by radial and ulnar collateral ligaments
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7
Q

What are the weak areas of the elbow joint capsule ?

A

Capsule is weaker anteriorly and posteriorly

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8
Q

Does the radial collateral ligament attach to the radius ?

A

No

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9
Q

What are ligaments surrounding the elbow joint ? What is the role of each ?

A

Anular ligament: holds the radial head in place, but allows its rotatory movement for supination and pronation

Interosseal membrane: holds the radius and ulna together and transmits forces from the radius to the ulna; muscle attachment

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10
Q

What is the possible result of an excessively forceful pull on the hand ?

A

Dislocation of the radial head from the anular ligament

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11
Q

Which joints are in use during pronation and supination ?

A

Proximal and distal radio-ulnar joints

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12
Q

Describe the main features of the knee joint capsule.

A
  • fibrous
  • lined by synovial membrane
  • attaches to the articular margins
  • has collateral ligaments supporting the sides of the joint
  • has intra- articular ligaments and cartilages
  • INCOMPLETE (Anteriorly, replaced by the quadriceps tendon (patellar ligament), the patella and fat pads on either side of patellar ligament)
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13
Q

What are the augmentations of the knee joint capsule ?

A
  • ANTERIORLY, by the iliotibial tract and patellar retinacula from quadriceps
  • POSTERIORLY, by the oblique popliteal ligament (expansion of the semimembranous) and the arcuate popliteal ligament
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14
Q

What bursaes communicate with the articular cavity of the knee joint ?

A
  • Suprapatellar bursa
  • popliteus bursa
  • anserine bursa
  • gastrocnemius bursa
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15
Q

What are the collateral ligaments of the knee joint ? What is their respective role ? Where do they extent from, and where do they extend to ? Are they fused to the joint capsule (if yes, anything else they are fused to ?) ?

A

Lateral (Fibular) ligament:

  • prevents adduction of leg
  • from Lateral femoral epicondyle to Head of fibula
  • Not fused to joint capsule

Medial (Tibial) ligament:

  • prevents abduction of leg
  • from Medial femoral epicondyle to Tibial condyle
  • fused to joint capsule and medial meniscus
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16
Q

Where is the tendon of popliteus found ?

A

Between the lateral fibular ligament and the knee capsule

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17
Q

Allocate each of the following characteristics to either medial, or lateral collateral ligament of the knee: broad, strong, flat

A

Medial collateral ligament: broad, flat

Lateral collateral ligament: strong

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18
Q

How many menisci are there around the knee joint ? What is their names ?

A

2

Medial meniscus and Lateral meniscus

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19
Q

Which connective tissue are menisci usually made of ?

A

Fibrocartillage

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20
Q

What are the functions of the medial and lateral menisci of the knee ?

A
  • Increase the congruence of articular surfaces
  • Dissipate the forces/stress on articular cartilage
  • Absorb shock
  • Decrease friction
  • Participate in locking of knees
  • Proprioception
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21
Q

Where, and how are the medial and lateral menisci of the knee connected ?

A

Anteriorly, by the transverse ligament of the knee

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22
Q

Where do the medial and lateral menisci of the knee move during flexion and extension of the knee?

A

They move antero-posteriorly

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23
Q

Describe the vascularity of the menisci of the knee.

A

Inner 2/3 is avascular, outer 1/3 partially vascular

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24
Q

Where are the horns of the menisci of the knee attached to ?

A

To the intercondylar region of the tibial plateau

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25
What are surrounding structures attached to the medial and lateral menisci of the knee respectively ?
Medial meniscus: to the joint capsule AND to the medial collateral ligament Lateral meniscus: to the joint capsule and to the tendon of the popliteus muscle but NOT to the lateral collateral ligament
26
Where does the Meniscofemoral ligaments extend from and to ?
From the posterior horn of lateral meniscus, to medial condyle of femur
27
What are the two cruciate ligaments of the knee called ?
Anterior and posterior cruciate ligaments
28
What are the functions of the anterior and posterior cruciate ligaments respectively ?
Anterior cruciate ligament: - Prevents anterior movement of tibia and hyperextension - Act as a pivot for rotatory movements between the bones Posterior cruciate ligament: - Prevents posterior movement of tibia (walking downhill) - Act as a pivot for rotatory movements between the bones
29
True or false: Parts of the cruciate ligaments of the knee are taut in all positions of the joint.
True
30
What do the Q-angle and the Carrying angle refer to respectively ?
Q-angle: angle between the anatomical axis of the femur and that of the tibia Carrying angle: angle between the long axes of arm and forearm.
31
Is the carrying angle more pronounced in males or females ? Why ?
More pronounced in the female to account for the wider pelvis
32
What is the carrying angle approximately equal to, in males, and in females ?
10-15 degrees in males | >15 degrees in females
33
Where do flexors of the elbow and knee pass, relative to the elbow and knee joint respectively ?
Anterior to the elbow joint | Posterior to the knee koint
34
What are the flexors of the elbow ?
Main: Brachialis (and control the extension produced by gravity) Also: Brachioradialis (when the forearm is midway between pronation and supination), Biceps brachii (esp. when supinated), Pronator teres and the wrist/digit flexors (Palmaris longus, flexor carpi radialis, flexor digitorum superficialis)
35
What is the major flexor origin ?
Medial epicondyle
36
What is another movement enabled by biceps brachii, besides flexion of the elbow ?
Supination
37
Name the origin and insertion of the main flexors of the elbow.
BRACHIALIS Origin: Distal half of anterior surface of humerus Insertion: Coronoid process and tuberosity of ulna BICEPS BRACHII: Origin: Short head: Coracoid process of scapula Long head: supraglenoid tubercle of scapula Insertion: Tuberosity of radius and fascia of forearm via bicipital aponeurosis (lacertus fibrosus) BRACHIORADIALIS: Origin: Proximal part of lateral supraepicondylar ridge of humerus Insertion: Distal end of the radius just proximal to the radial styloid process PRONATOR TERES
38
How are the flexors of the elbow innervated ?
Supplied by the musculocutaneous nerve except Brachioradialis (radial nerve) and pronator teres
39
True or False: Brachioradialis is the only muscle supplied by the radial nerve that brings about flexion.
True
40
What are the extensors of the elbow ?
Main: Triceps Brachii (but gravity takes over most of the time) Also: Anconeus, Superficial forearm extensors (Extensors carpi radialis longus and brevis, Extensor carpi ulnaris, Extensors digitorum and digiti minimi)
41
What is another function of the long head of the triceps (besides extension of the elbow) ?
Preventing dislocation of the abducted shoulder
42
What is the name of the indentation between lateral and medial heads of triceps ?
Radial (spiral) groove of humerus | Radial nerve and Profunda brachii artery
43
What is the origin and insertion of the extensors of the elbow ?
TRICEPS Origin: Long head: infraglenoid tubercle of scapula Lateral head: posterior surface of humerus, superior and lateral to the radial groove Medial head: posterior surface of humerus, medial and inferior to the radial groove Insertion: Olecranon ANCONEUS Origin: Lateral epicondyle of humerus Insertion: Lateral surface of olecranon and superior part of posterior surface of ulna
44
How are extensors of the elbow innervated ?
Supplied by the radial nerve (including the superficial forearm extensors)
45
Which structures keep the radius in place ?
Anular ligament, the interosseous membrane and the inferior radio-ulnar joint
46
What are the pronators of the elbow ? Which one initiates pronation ?
Pronator Teres and Pronator Quadratus (initiates it)
47
What are the supinators of the elbow ?
Main: Biceps Brachii Also: Supinator
48
What is the origin and insertion of the pronators of the elbow ?
PRONATOR TERES -Origin: Ulnar head- coronoid process of ulna Humeral head- Medial epicondyle of humerus -Insertion: Middle of convexity of lateral surface of radius PRONATOR QUADRATUS -Origin: Distal quarter of anterior surface of ulna -Insertion: Distal quarter of anterior surface of radius
49
What is the origin and insertion of the supinators of the elbow ?
SUPINATOR: - Origin: Lateral epicondyle of humerus, radial collateral and anular ligaments, supinator fossa, crest of ulna - Insertion: Lateral, posterior, and anterior surfaces of proximal third of radius BICEPS BRACHII: Origin: Short head: Coracoid process of scapula Long head: supraglenoid tubercle of scapula Insertion: Tuberosity of radius and fascia of forearm via bicipital aponeurosis (lacertus fibrosus)
50
How are the pronators of the elbow innervated ?
Median Nerve
51
How are the supinators of the elbow innervated ?
Supinator muscle is supplied by radial nerve | Biceps brachii is innervated by musculocutaneous nerve
52
What is the most powerful supinator when the elbow is flexed ?
Biceps Brachii
53
Which structure passes through supinator muscle ?
Deep branch of the radial nerve
54
List the structures present in the antecubital fossa, lateral to medial.
- biceps brachii tendon - brachial artery and vein - median nerve - superficial veins (median cubital vein)
55
What are the main movements at the knee ?
Flexion and Extension
56
What other movements may take place at the knee when the knee is in a semiflexed position and the foot is off the ground ?
Medial and lateral rotation of the tibia with respect to the femur
57
True or false: Long muscles acting across two joints (e.g. the hamstrings, rectus femoris) can only work efficiently across one joint at a time.
True
58
What are the flexors of the knee ?
``` Biceps femoris Semitendinosus Semimembranosus Gastrocnemius Gracilis Sartorius Plantaris ```
59
What is the origin and insertion of the flexors of the knee ?
BICEPS FEMORIS Long Head- Origin: Ischial tuberosity Insertion: Lateral side of the head of the fibula Short Head- Origin: linea aspera and lateral supracondylar line of femur Insertion: lateral side of the head of the fibula SEMITENDINOUS Origin: ischial tuberosity Insertion: medial surface of tibia SEMIMEMBRANEOUS Origin: ischial tuberosity Insertion: medial tibial condyle GASTROCNEMIUS Origin: Lateral head- lateral aspect of lateral condyle of femur Medial head- popliteal surface of femur, superior to medial condyle Insertion: Posterior surface of calcaneus via calcaneal tendon GRACILIS and SARTORIUS Origin: pelvis Insertion: upper, medial tibia PLANTARIS Origin: Inferior end of lateral supracondylar line of femur and oblique popliteal ligament Insertion: Posterior surface of calcaneus via calcaneal tendon
60
What is the main movement enabled my gastrocnemius, besides knee flexion ? How come it also flexes the knee ?
Plantar flexor of the ankle | Because it is attached to the femur (its origin)
61
What are the hamstring muscles ?
Semimembranous, semitendinous, biceps femoris
62
What movements do the hamstring muscles allow for ?
Flexion of the knee | Extension of hip
63
Which type of flexion exactly does the GASTROCNEMIUS muscle function in ?
When the foot is fixed and the person kneels down
64
What muscles is the Pes Anserinus muscle group made of ?
Semiteninosus, Gracilis, Sartorius
65
What is the function of Pes Anserinus as a muscle group ?
Adds significant dynamic stability to the medial | side of the knee
66
Where do the muscles of Pes Anserinus attach, relative to the medial-lateral axis of rotation of the knee ?
Posterior to it
67
What is the structure that Gluteus Maximus and Tensor Fasciae Latae insert into ?
The iliotibaial tract
68
What movements of the knee do the gluteus maximus and tensor fasciae latae facilitate ?
They support the knee in extension, until the hamstrings flex the knee May also augment flexion
69
What are the extensors of the knee ?
Main: Quadriceps femoris Also: Gluteus Maximus, Tensor Fascia Latae
70
What is the origin and insertion of the extensors of the knee ?
QUADRICEPS FEMORIS Origin: Rectus femoris- Anterior inferior iliac spine and ilium superior to acetabulum Vastus lateralis- Greater trochanter and lateral lip of linea aspera Vastus medialis- Intertrochanteric line and medial lip of linea aspera Vastus intermedius- Anterior and lateral surfaces of shaft of femur Insertion: Base of patella Tibial tuberosity via patellar ligament Patella and tibia via Medial and lateral patellar retinacula GLUTEUS MAXIMUS Origin: via iliotibial tract Insertion: via iliotibial tract TENSOR FASCIA LATAE Origin: via iliotibial tract Insertion: via iliotibial tract
71
How is quadriceps femoris innervated ?
Supplied by femoral nerve
72
What does the femur do in the final stage of extension ?
Rotates medially to “screw” the knee into its stable, “close-packed” position
73
What are the roles of the lateral facets of the patella ?
- articulates with prominent lateral femoral condyle - prevent dislocation during knee extension - increase the insertion angle of quadriceps tendon
74
What are the anatomical features of a locked knee ?
- tightened ligaments - flat surface of the femoral condyles are in contact with the tibia plateaus so joint surfaces become larger - amount of muscle work needed to maintain the standing position is reduced - vastus medialis locks the knee, aided by Gluteus maximus, tensor fascia latae
75
During flexion of the knee, what position must popliteus be in ?
Laterally rotated
76
What is the origin and insertion of the popliteus muscle ?
Origin: Posterior surface of tibia, superior to soleal line Insertion: Lateral surface of lateral condyle of femur and lateral meniscus
77
What movements does popliteus participate in ?
Lateral rotation of the femur | Un-locking of the knee
78
Where is the Popliteal Fossa found ? What is its shape ?
Behind the knee joint | Diamond shape
79
What is the Popliteal Fossa bounded by ?
Biceps femoris, semimembranosus and tendon of semitendinosus and Lateral and medial heads of the gastrocnemius
80
Finish the sentence: The adductor canal opens to the popliteal fossa through ?
Adductor hiatus
81
What does the popliteal fossa contain ?
- Popliteal artery and vein, with their branches and tributaries (artery slightly medial to Vein) - Tibial nerve - Common fibular nerve - Posterior cutaneous nerve of the thigh - Terminal part of small saphenous vein - Lymph nodes - Fat
82
Which structure is at risk in knee dislocation and supracondylar fracture of the femur ?
Popliteal artery
83
How is the biceps reflex elicited ?
By tapping the biceps tendon in the antecubital fossa
84
How is the knee reflex elicited ?
By tapping the patellar ligament
85
Which nerve does the biceps reflex test ? Which spinal segments ?
Musculocutaneous nerve | C5 and C6
86
Which nerve does the knee reflex test ? | Which spinal segments ?
Femoral nerve | L3 and L4
87
What are the different levels of a reflex ?
* Absent * Trace (Diminished) * Normal * Brisk * Hyperactive * Clonus

MD2002 Arvin (110 decks)

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