Hip and Knee Joint

Question 1

hip joint

Answer 1

synovial ball and socket so 2nd most mobile in body

stable by depth of socket, strong capsule, numerous muscles cross

Question 2

femoral head

Answer 2

covered by articular cartilage except @ fovea capitis for ligament of head of femur attach

Question 3

acetabulum

Answer 3

lunate surface = c shaped rim, covered by articular hyaline cartilage bc direct contact with head femur

acetabular notch = passage for blood vessels and ligament of head femur

Question 4

acetabular labrum

Answer 4

lip of fibrocartilage to inc depth of socket
-cont with transverse acetabular lig across notch

Question 5

acetabular fossa

Answer 5

deeper part of socket, does not articulate with femur but cont with acetabular notch

fat pad covered by synovial membrane

Question 6

synovial joints

general review

Answer 6

most mobile kind of joint
has fibrous CT joint capsule strengthend by extracapsular ligs
-lined by synovial membrane
-synovial cavity
-articular cartilage
-synovial fluid lubricates cartilage
-blood and nerve supply

Question 7

fibrous joint capsule

Answer 7

most fibers spiral from pelvis to femur

reinforced by 3 intrinsic ligaments

lined by synovial membrane as a sleeve around neck of femur

Question 8

annular ligament

Answer 8

aka zona obricularis
intracapsular deep to spiraling fibers
wrap around neck of femur

Question 9

iliofemoral ligament

Answer 9

anterior and superior ligs, Y shape
-from AIIS and rim ilium to intertroch line

strongest ligament in body

limits hip extension by winding to inc stable

Question 10

pubofemoral ligament

Answer 10

anterior and inferior ligs
-from obturator crest/pubis to fibrous layer of joint capsule femur

will limit hip abduction by tightening during extension/abduction

Question 11

ischiofemoral ligament

Answer 11

posterior lig
-from ischial part acetabular rim to superior and lateral femoral neck

limits medial rotation

Question 12

head of femur ligament

Answer 12

intracapsular/ articular
deep to transverse acetabular lig

has foveolar A running with it but can be absent

Question 13

blood supply

hip joint

Answer 13

1. retinacular A from medial circumflex femoral, some from lateral circumflex
   -runs deep to annular lig and synovial mem
2. artery to head of femur from obturator, medial side of head only but insufficient

Question 14

hip fractures

Answer 14

aka femoral neck so danger retinacular A > avascular necrosis bc cut off main supply

hip impact injuries or falls

Question 15

cruciate anastomosis

Answer 15

1. obturator + branches
2. deep femoral branches (medial and lateral circumflex)
3. gluteals (superior and inferior)

descending branch of lateral goes to genicular anastomosis

Question 16

articular innervation

Answer 16

to joint capsule/joint itself aka sensory/proprioception/nociception

-femoral N
-obturator
-sup gluteal
-N to obturator quadratus

Question 17

hilton’s law

Answer 17

nerves supplying muscles that extend directly across/act on given joint will also inn it

Question 18

cutaneous innervation
hip

Answer 18

1. lat femoral cutaneous N ant/lat
2. superior and inferior cluneal post

Question 19

knee joint

general

Answer 19

synovial hinge joint, largest in body
-b/t femoral and tibial condyles + patellofem articulation
-fibula is not part of knee joint

Question 20

knee joint functions

Answer 20

bears more weight than hip

flex/extend + rotate femur vs fixed tibia when locking/unlocking extended knee

knee most stable when fully extended

Question 21

menisci

Answer 21

medial: c shaped, broader, less mobile, attaches to MCL
lateral: more closed circle

fibrocartilage shock absorbers + improve fit of condyles to inc stability

Question 22

menisci ligaments

Answer 22

transverse lig of the knee: b/t anterior margins of both menisci

coronary: short vertical to anchor menisci to margins of tibial condyles

Question 23

tendons that stabilize knee

Answer 23

muscular cage around knee so can strengthen
-quads tendon/patellar (ant)
-pes anserinus (SGT FOT) medial
-biceps femoris insertion (lateral)
-gastrocnemius (posterior)

Question 24

knee joint capsule

Answer 24

fibrous external capsule-thin and gaps, thickened in certain areas aka intrinsic ligs
-anterior gap: quads tendon/patella/pat lig
-posterolat gap: popliteus tendon exits

attach to femur superiorly and tibia inferior

Question 25

synovial membrane knee

Answer 25

lines capsule but not contact with cartilage
-diverts from capsule posteriorly

joint cavity cont with major large knee bursas

where ACL/PCL attach (intercondylar) not intrasynovial

Question 26

capsular ligaments knee

Answer 26

extrinsic: lateral collateral (LCL)

intrinsic: medial collateral (MCL), oblique popliteal, arcuate popliteal

Question 27

lateral collateral ligament

LCL

Answer 27

aka fibular collateral lig
-from lat epicondyle of femur to lateral fibular head
-separated from lateral meniscus by popliteus tendon
-splits tendon of biceps femoris

reinforce lateral side knee + tenses with extension

rounder/thicker than medial

Question 28

medial collateral ligament

MCL

Answer 28

aka tibial collateral lig
-from medial femoral epicondyle to superomedial prox tibia + tibial medial condyle
-deep to pes anserinus
-adhered to medial meniscus

reinforce medial side knee + tense with extension

Question 29

oblique popliteal ligament

Answer 29

continuation of semimembranosus tendon

reinforce posterior side of joint by spanning intercondylar fossa

nike swoosh

Question 30

arcuate popliteal ligament

Answer 30

has two heads
-lateral to femoral lateral epicondly
-medial arches over popliteus tendon, blends with oblique

reinforce joint capsule posterolat

Question 31

intra-articular ligaments of knee

Answer 31

2 cruciate ligs = ACL + PCL
2 menisci-tibia ligs = transverse + coronary

Question 32

anterior cruciate ligament

ACL

Answer 32

medial aspect of lat femoral condyle to anterior intercondylar area of tibia

limits extension + prevent ant displacement

Question 33

posterior cruciate ligament

PCL

Answer 33

from lat medial femoral condyle to post interconylar area tibia

limit flexion + prevent posterior displacement
-main stabilizing factor when weight bearing flexed like walking downhill

Question 34

drawer signs

Answer 34

1. anterior = tibia slides anterior w/o resistance, ACL torn
2. posterior = tibia slide posterior w/o resist, PCL torn

Question 35

blood supply knee joint

Answer 35

5 genicular arteries from popliteal A
1. superior lateral
2. superior medial
3. middle
4. inferior lateral
5. inferior medial

Question 36

genicular anastomosis

Answer 36

1. popliteal A > genicular
2. femoral A > deep fem (>descending lateral circumflex) and descending genicular
3. anterior tibial A > ant tibial recurrent and post tibial recurrent
4. circumflex fibular A

Question 37

nerve supply knee joint

articular

Answer 37

articular branches for motor to muscles crossing
-femoral N + tibial N + common fibular

Question 38

cutaneous innervation knee

Answer 38

-intermediate femoral cutaneous branches
-posterior femoral cutaneous
-saphenous
-lateral sural cutaneous