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MSKI Midterm > Hip and Knee > Flashcards

Hip and Knee Flashcards

1
Q

Hilton’s Law

A

A joint is innervated by the same nerves that innervate the muscles and skin surrounding it

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2
Q

Postganglionic sympathetic adrenergic fibers

A

located around the blood vessels. Responsible for arterial flow

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3
Q

Unmyelinated C fibers

A

Responsible for pain transmission
Fire only when there is trauma (nociceptive)
Prostaglandin E2 can signal nociceptive fibers

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4
Q

Articular surfaces of hip joint

A

Acetabular notch is bridged by the transverse acetabular ligament
Acetabular fossa is not covered with cartilage. Synovial membrane is there. This allows positional changes of femoral head in hip joint.
Fibrocartilaginous acetabular labrum deepens the socket for femoral head.

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5
Q

Hip joint type

A

Diarrhetic ball and socket synovial joint

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6
Q

Hip joint movements

A

flexion-extension
abduction-adduction
circumduction
medial and lateral rotation

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7
Q

Acetabular labrum tears

A

Caused by twisting on a weight bearing knee
Diffuse pain
No visible swelling
Pinching sensation bringing knee to chest if in front of joint
Repaired arthroscopically

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8
Q

Iliofemoral ligament

A

y shaped band that covers anterior aspect of the hip
anterior inferior iliac spine and acetabular rim to intertrochanteric line
Prevents overextension

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9
Q

Pubofemoral ligament

A

Strengthens anterior and inferior parts of fibrous capsule
Arises from obturator crest of pubic bone and passes laterally to blend with joint capsule and iliofemoral ligament
Helps prevent overabduction and overextension

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10
Q

Ischiofemoral ligament

A

Strengthens posterior joint capsule
Arises from ischial part of acetabular rim
Fibers spiral antero-lateral to attach to femoral neck
Helps prevent overextension

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11
Q

Round femoral head ligament (Ligamentum teres)

A

Little importance in strengthening hip
Wide end attaches to acetabular notch. Narrow to fovea
Contains an obturator vessel- assists in spreading synovial fluid
Stretched when flexed thigh is adducted or laterally rotated

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12
Q

Anterior hip dislocation

A

10-15%
Neck of femur or greater trochanter impinges on rim of acetabulum. Levers head of femur out of anterior hip capsule
Happens in abducted hip

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13
Q

Posterior hip dislocation

A

Thigh adducted, medially rotated and flexed
Damages sciatic nerve
-Paralyzes hamstrings and muscles distal to knee
-sensory change may occur in skin over posterolateral aspects of leg and foot

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14
Q

Hip replacement

A

Metal prosthesis anchored in femoral shaft by bone cement

Plastic socket cemented to hip bone to replace acetabulum

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15
Q

First class lever

A

Effort-fulcrum-load Head and neck

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16
Q

Second class lever

A

fulcrum-load-effort Foot and ankle

17
Q

Third class lever

A

load-effort-fulcrum bicep

18
Q

Popliteal Artery

A

Forms genicular anastomosis
Important collateral circulation bypasses popliteal artery (knee fully flexed too long. Narrowed or occluded popliteal vessels)
Supplies articular capsule and ligaments of knee joint

19
Q

Knee joint type

A

diarthrotic, primarily hinge type of synovial joint

permits some gliding and rotation around vertical axis

20
Q

Knee articular surfaces

A

Femur slants medially at knee, where tibia is vertical
Medial and lateral articulation between femoral and tibial condyles
Intermediate articulation between patella and femur (patellofemoral joint)
Fibula is not involved

21
Q

Knee joint stability

A

Dependent on:
strength of surrounding muscles/tendons
Ligaments that bind femur to tibia

22
Q

Five external knee joint ligaments

A
  1. Patellar ligament
  2. Fibular collateral ligament
  3. Tibial collateral ligament
  4. Oblique popliteal ligament
  5. Arcuate popliteal ligament
23
Q

Patellar ligament

A

anterior knee joint ligament

Continuation of the quadriceps/patellar tendon

24
Q

Patellar retinacula

A

Aponeurotic expansions of vastus medialis and lateralis

Support articular capsule laterally and medially

25
Q

Fibular collateral ligamen

A

Strong cordlike ligament that extends inferiorly from lateral femoral epicondyle to fibular head
Popliteus tendon passes deep to fibular collateral ligament
Biceps femoris tendon split by fibular collateral ligament

26
Q

Tibial collateral ligament

A

Flat band that extends from medial femoral epicondyle to medial tibial condyle
Deep fibers attach to medial meniscus (commonly damaged)
Tibial and fibular collateral ligaments
-prevent disruption of the sides of the knee joint
-taut when leg is extended
-lax when leg is in flexion

27
Q

Oblique popliteal ligament

A

Represents and expansion of semi-membranosus tendon

Strengthens capsule posteriorly

28
Q

Arcuate popliteal ligament

A

Y-shaped band
Represents edge of capsule that arches over popliteus muscle
Also strengthens capsule posteriorly

29
Q

Cruciate ligaments

A

Internal ligaments- within capsule, yet separate from joint cavity
Join femur to tibia
Named according to attachment to tibia (Anterior and posterior)

30
Q

Anterior Cruciate Ligament (ACL)

A 
Attachment:
anterior part of intercondylar area of tibia
fibers oriented superiorly, posteriorly and laterally
medial side of lateral condyle of femur
Taut when leg is extended:
prevents posterior displacement of femur
prevents anterior displacement of tibia
Anterior Drawer sign
31
Q

Posterior Cruciate Ligament (PCL)

A

Attachment:
posterior part of intercondylar area of tibia
fibers directed superiorly, anteriorly and medially
lateral surface of medial condyle of femur
Taut when leg is flexed:
prevents anterior displacement of femur
prevents posterior displacement of tibia
Posterior Drawer Sign

32
Q

ACL Bundles

A 
Anteromedial Bundle (AMB)- resists anterior tibial translation especially during flexion
Posterolateral Bundle (PLB)- resists anterior tibial translation and tibial rotation in extension
33
Q

Menisci

A

C-shaped plates of fibrocartilage on medial and lateral articular surfaces of tibia- deepens articular surface and absorb shock
External margins: thick, attached to joint capsule (Coronary ligaments)
Internal margins: thin, not attached to joint capsule
Joined by transverse ligament of knee
-Allows menisci to move together during movements of tibia and femur

34
Q

Medial Meniscus

A

Broad posteriorly
Anterior horn- may attach anteriorly to ACL
Posterior horn- attaches anteriorly to PCL
Adherent to deep surface of tibial collateral ligament

35
Q

Lateral Meniscus

A

Nearly circular- horse shoe shaped
Smaller and more mobile than medial meniscus
Posterior meniscofemoral ligament- joins to PCL
Popliteus tendon passes between it and fibular collateral ligament

36
Q

Unhappy triad of injuries

A

ACL
Tibial Collateral ligament
Medial Meniscus

MSKI Midterm (12 decks)

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