Hip Knee Ankle Joints

Question 1

Anteriorly the capsule attaches to the

Answer 1

Intertrochanteric line

Question 2

Posteriorly the capsule attaches to the

Answer 2

Femoral neck

Question 3

Most of the hip dislocations happen

Answer 3

Posteriorly and requires a significant amount of trauma because of extreme stability there

Question 4

3 intrinsic ligaments of the hip

Answer 4

Iliofemoral (one of the strongest ligaments in the body)
Ischiofemoral
Pubofemoral

They all get taut with hip extension

Question 5

Osteoarthritis

Answer 5

Happens to older people (usually female), has pain in one joint.
If pain is predominant during weight bearing only and pain is in the groin and they have morning stiffness and pain in ROM specifically to hip flexion and external rotation

Question 6

Rheumatoid arthritis

Answer 6

Usually females in 40s who get diagnosed, have bilateral joint involvement, multiple joints in the body and usually starts in the hands

Question 7

Blood supply to the hip

Answer 7

Fovular artery (branch of obturator artery)
Medial and lateral femoral circumflex arteries (branch of femoral artery)
Profunda femoral artery (largest branch of femoral artery, main artery brining blood to the hip joint)

Question 8

Nerve supply to the hip joint

Answer 8

Femoral nerve
Obturator nerve
Superior gluteal nerve

Question 9

How many degrees of freedom does knee joint have

Answer 9

One, flexion and extension

But not a hinge joint. Can also do minimal external and internal rotation when the knee is flexed 40 degrees

Question 10

Patellofemoral joint

Answer 10

Between patella and trochlear groove

Question 11

Anterior knee pain

Answer 11

Common in teenage girls with growth spurt, muscles not able to keep up, they have shortness of their muscles like rectus or hamstrings or IT band and they disturb length tension relationship, quads get inhibited and want to shut down cause every time it’s used it pulls on patella and irritates it and causes anterior knee pain

Question 12

4 ligaments in knee

Answer 12

ACL
PCL
MCL
LCL

Question 13

Lateral collateral ligament

Answer 13

Extrinsic ligament - does not attach to joint capsule, also does not attach to lateral meniscus
Attaches from lateral femoral condyle to fibula head
Resists varus forces

Question 14

Medial collateral ligament

Answer 14

Intrinsic ligament - attaches to joint capsule and medial meniscus
Attaches from medial femoral condyle to medial tibial condyle
Extra-articulate - outside of joint
Resists valgus forces
Ligament heals on its own! Treated conservatively

Question 15

Anterior cruciate ligament

Answer 15

Attaches from lateral femoral condyle to medial tibial plateau
Intra articular but extrasynovial (not good, hostile environment for healing, cannot heal on its own)
Prevents anterior translation of tibia on femur in open chain, and prevents posterior translation of femur on tibial in closed chain

Question 16

ACL injury

Answer 16

No contact, people hear large pop and it blows up immediately and swells (bleeding in joint because intra articular)
PT next day but won’t operate until at least 6 weeks later
Not really capable of competing sports without reconstruction
Risk of re-injury is common on the other side of original injury

Question 17

Posterior cruciate ligament

Answer 17

Attaches from medial femoral condyle to lateral tibial plateau
Intra articular but extrasynovial
Prevents posterior translation of tibia on femur in open chain, and prevents anterior translation of femur on tibial in closed chain

Question 18

Menisci function

Answer 18

Function is to act as shock absorber to prevent bone on bone rubbing and disperse forces appropriately

Made of fibrocartilage

Question 20

Meniscal tear

Answer 20

Usually happens with loading and rotation (planting and twisting)
If you just plant and twist and no contact is made, then you have a meniscal tear
Means you’re not distributing weight right and you might put excessive force on articular cartilage
90% meniscus is avascular, won’t heal itself
Don’t need surgery, can be treated conservatively

Question 21

Blood supply to the knee joint

Answer 21

Medial and lateral geniculate arteries (from femoral artery)

Question 22

Nerve supply to knee joint

Answer 22

Obturator
Femoral
Tibial
Common fibular nerve

Question 23

Foot divided into 3 regions

Answer 23

Hindfoot: talus and calcaneus
Midfoot: navicular, 3 cuneiforms, cuboid
Forefoot: 5 metatarsals, 14 phalanges

Question 24

True joint of ankle is

Answer 24

Talocrural joint

Dorsi flexion and plantar flexion

Question 25

Subtalar joint

Answer 25

Inversion and eversion

Question 26

Arches of the foot

Answer 26

Transverse arch (medial to lateral)
Longitudinal arch (medial and lateral longitudinal arch, runs distal to proximal) 
Genetically predetermined

Question 27

Lateral collateral ligament complex

Answer 27

Anterior talofibular ligament (most common injured ligament in ankle and body)
Posterior talofibular ligament
Calcaneofibular ligament

Question 28

Medial collateral ligament complex

Answer 28

Also known as deltoid ligament
One of the strongest ligaments in the body
Anterior tibiotalar
Posterior tibiotalar
Tibionavicular
Tibiocalcaneal
More likely to fracture medial malleolus than tear this ligament

Question 29

Medial and lateral meniscus attachments

Answer 29

C-shaped
Attaches to MCL and semimembranosis

Circular shaped
Attaches to popliteus tendon, no LCL