Gross 2 Knee Flashcards
What are the three facets on the posterior patella?
-Lateral Conyldopatellar
-Medial Condylopatellar
-Odd Facet
(These articulate with femoral condyles)
In regards in movement of the knee, how many facets are there in the patella?
7
- 1, 2, 3 are the superior, middle, and inferior of the Lateral Facets
- 4, 5, 6, 7 are the superior, middle, inferior and vertical (odd facet) of the Medial Facets
When the knee is in Extension, what patellar facets articulate with the femur?
Inferior facets (3, and 6)
When the knee is in slight flexion, what patellar facets articulate with the femur?
Middle facets (2, and 5)
When the knee is in full flexion, what patellar facets articulate with the femur?
Superior (1 and 4) and
Middle (7)
Describe the movement of the patella during knee flexion from neutral, and beyond 90°.
During knee flexion from neutral, there is contact between patella and medial and lateral femoral condyles
Beyond 90° degrees, patella tilts and contact with Odd facet is made to the medial condyle of the femur
What are the Extra-Articular Structures of the Knee?
(8 structures)
-Quadricep Tendon
-Patellar Ligament
-Lateral Patellar Retinaculum
-Medial Patellar Retinaculum
-MCL
-LCL
-Oblique Popliteal Ligament
-Arcuate Popliteal Ligament
(Extra-Articular structure)
What make up the Quadricep tendon and Patellar Ligament? Where do they provide stability?
Quad. Tendon: Tendons from Rectus Femoris, Vastus Lateralis/Medialis, and Intermedius
Patellar Ligament: The attachments are from the patella to the Tibial Tuberosity
Both provide stability ANTERIORLY
(Extra-Articular Structure)
What makes up the Lateral Patellar Retinaculum? What ligaments are within? Where do they provide stability?
Expansion from the tendon of Vastus Lateralis and iliotibial band (IT Band) to patella
-Within the retinaculum there are two ligaments:
–Lateral PatelloFemoral ligament: Transverse band from patella to IT band
–Lateral PatelloTibial Ligament: Longitudinal band from patella to Lateral Tibia
Provides Stability to the Anterolateral Aspect of the knee
(Extra-Articular Structure)
What makes up the Medial Patellar Retinaculum? What are the ligaments within? Where do they provide stability?
Expansion from the tendon of Vastus Medialis to patella
-Within the retinaculum there are two ligaments:
–Medial PatelloFemoral Ligament: Transverse band from VMO tendon to patella
–Medial PatelloTibial Ligament: Longitudinal band from patella to medial tibia
Provides stability to the AnteroMedial aspect of the knee
(Extra-Articular Structure)
Describe the Medial (Tibial) Collateral Ligament.
(Attachment and what it stabilizes)
Attaches from the medial epicondyle of the femur to the medial tibial condyle and the upper tibial shaft, also attaches on the medial meniscus
Provides medial stability to the knee
(Extra-Articular Structure)
Describe the Lateral (Fibular) Collateral Ligament.
(Attachment and what it stabilizes)
Attaches from the lateral femoral epicondyle to the head of the fibula {Does NOT attach to lateral meniscus}
Provides lateral stability to the knees
(Extra-Articular Structure)
Describe the Oblique Popliteal Ligament. Where does it provide stability?
Fibrous extension of Semimembranosus tendon that runs along the posterior capsule from the medial tibial condyle to the upper posterior fibular aspect of the capsule
Provides Posterior Stability to the knee
(Extra-Articular Structure)
Describe the Arcuate Popliteal Ligament.
Y-Shaped band with medial and lateral band
-Medial band: From fibular head medially to join with oblique popliteal ligament
-Lateral band: From fibular head to posterior capsule of lateral epicondyle of femur
Provides Posterior Stability to the knee
What are the Intra-Articular Structures of the knee? (8)
-Medial Meniscus
-Lateral Meniscus
-Anterior Cruciate Ligament (ACL)
-Posterior Cruciate Ligament (PCL)
-Posterior Meniscofemoral Ligament
-Coronary Ligaments
-Transverse Meniscal Ligament
-Oblique Meniscomeniscal Ligament
(Intra-Articular Surface)
Describe the Medial Meniscus.
- C-shaped fibrocartilage plate, runs along the medial condyle.
-Attaches to the MCL and the Anterior and Posterior Tibial intercondylar area
Has body, anterior and posterior horns
Provides stability during flexion and extension of the knee
(Intra-Articular Surface)
Describe the Lateral Meniscus.
- Semi-circular fibrocartilage plate, runs along lateral condyle of tibia
-Attaches anterior and posterior tibial intercondylar
Has body, anterior and posterior horns
Provides stability during flexion and extension of the knee
(Inter-Articular Structure)
Describe the Anterior Cruciate Ligament (ACL).
Distally: Posterior to the anterior horn of the medial meniscus in the anterior intercondylar fossa of the tibia
Proximally: Intercondylar fossa side of the lateral femoral condyle
Limits Anterior Translation of the tibia
(Inter-Articular Structure)
Describe the Posterior Cruciate Ligament (PCL).
Distally: Posterior intercondylar fossa of the tibia (Medial condyle)
Proximally: Intercondylar fossa side of the lateral femoral condyle
Limits posterior translation of the tibia
(Inter-Articular Ligament)
Describe the Posterior Meniscofemoral Ligament.
Attaches the lateral meniscus to the PCL and Medial Femoral condyle
(Posterior to PCL)
(Inter-Articular Ligament)
Describe the Coronary Ligament.
May be absent
-Secures the medial and lateral meniscus to the tibial condyle
(Inter-Articular Ligament)
Describe the Transverse Meniscal Ligament.
May be absent
-Connects the anterior horns of the medial and lateral menisci
(Internal-Articular Ligament)
Describe the Oblique Meniscomeniscal Ligament.
Connects anterior horn of medial meniscus and posterior horn to lateral meniscus
Where is the Suprapatellar bursae found?
Between the femur and tendon of quadriceps femoris
Where is the Popliteus bursae found?
Between tendon of popliteus and lateral condyle of tibia
Where is the Anserine bursae found?
This bursae separates tendons of sartorius, gracilis and semitendinosus from the tibia and Tibial Collateral Ligament (MCL)
Where is the Gastrocnemius bursae found?
Deep to proximal attachment of tendon of medial head of gastrocnemius
Where is the Semimembranosus bursae found?
Between medial head of gastrocnemius and semimembranosus tendon
Where is the Subcutaneous Prepatellar bursae found?
Between skin and anterior surface of patella
Where is the subcutaneous Infrapatellar bursae found?
Between skin and Tibial Tuberosity
Where is the Deep Infrapatellar bursae found?
Between patellar ligament and anterior surface of tibia
Which nerves supply the knee joint?
Anteriorly: Femoral Nerve
Medially: Saphenous Nerve
Posteriorly: Tibial and Common Fibular Nerve
Which type of nerve fiber innervate the joint?
Afferent-sensory
What is the Primary Artery that supplies the knee?
Popliteal Artery
What branch from the Femoral Artery supplies the knee?
Descending Genicular
What branch of the Profunda Femora supplies the knee?
Descending branch of Lateral circumflex femoral
What artery supplies the Tibiofibular joint?
Inferior Lateral Genicular and Anterior Tibial Recurrent Arteries
What are the boundaries of the Popliteal Fossa?
Superior Lateral: Bicep Femoris
Superior Medial: Semitendinosus & Semimembranosus
Inferior Lateral: Lateral head of Gastroc., & Plantaris
Inferior Medial: Medial head of Gastroc.
What are the contents in the Popliteal Fossa?
N: Tibial and Common Fibular Nerve
A: Popliteal Artery
V: Popliteal Vein
M:Popliteus, Hamstring muscle tendons (all 3), and Medial/Lateral head of Gastrocnemius
What is the definition of “Unlocking of the knee joint”?
The early stage of flexion of the knee joint
What is the mechanism of “Unlocking of the knee joint”?
The leg is medially rotated and the thigh is laterally rotated
What muscle(s) produce “Unlocking of the Knee joint”?
Popliteus muscles
–Semimembranosus and Semitendinosus and Gracilis assist the popliteus
What is Screw Home Mechanism?
-During the last 15-20° of knee extension with the foot free, the tibia rotates externally and “locks” into extension.
-When the knee extends with the foot planted, the femur internally rotates and “locks” into extension
The Popliteus muscle “unlocks” the knee by either externally rotating the femur if the foot is planted (closed chain) or by internally rotating the tibia with the foot is free (Open chain)
What is the direction of Patellar tracking with Genu Valgum?
Laterally
-Also called Knock knee deformity
What is the direction of Patellar tracking with Genu Varum?
Medially
-Bowing of the legs
What is Coxa Vara?
The angle formed by the line through the middle of the femoral head to the shaft being less than 125°
Where is the mechanical stress with Coxa Vara?
On the medial structures, this results in Genu Valgum
What is Coxa Valga?
The Angle formed by the line through the middle of the femoral head to the shaft being more that 140°
Where is the mechanical stress with Coxa Valga?
On the lateral structures, this causes Genu Varum
What is the Unhappy Triad of knee injures?
ACL
Medial Meniscus
MCL
