Hip/Knee/Popliteal Fossa Flashcards

1
Q

Illiofemoral ligament

A

AIIS –> intertrochanteric line

body’s strongest ligament

prevents hyperextension and anterior displacement

spiral fibers unwind during flexion (and extension limited by wet towel)

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2
Q

pubofemoral ligament

A

pubic bone –> iliofemoral ligament

prevents overabduction

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3
Q

ischiofemoral ligament

A

ischium –> greater trochanter

WEAKEST of 3 ligaments

prevents posterior displacement

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4
Q

zona orbicularis (orbicular zone)

A

surrounds neck of femur

CIRCULAR fibers deep to other ligaments

holds femoral had in place

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5
Q

most common dislocation of hip

A

posterior hip dislocation
(femur is flexed and adducted)

sciatic nerve affected
(pain, paresthesia, weakness of muscles)

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6
Q

Major blood supplier of hip joint

A

medial circumflex femoral a

acetabular branch of obturator a –> imp during devel, occluded in adults

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7
Q

Nerve supply to hip joint

A

anterior –> femoral n
posterior/superior –> superior gluteal n
posterior/inferior –> nerve to quadrates femoris and observator internus, obturator nerve

(follow’s Hilton’s law…nerve supply is same as nerves supplying muscle located across and acting on the joint)

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8
Q

hip joint fractures

A

at femoral neck or intertrochanteric line *not hip itself
individuals 60+ yrs, and in females

if vasculature affected –> need hip replacement to prevent avascular necrosis. Indicated w/ presence of degenerative disease

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9
Q

Knee joint typical movements

A

flexion/extension with some gliding and rotation

Most rotation occurs with knee joint flexed

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10
Q

Popliteus muscle action on knee joint

A

o: femur (lateral condyle), lateral meniscus
I: tibia (medial)

fixed tibia –> laterally rotates femur to UNLOCK knee
unfixed –> medially rotates tibia

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11
Q

Joints of the knee

A

1 tibiofemoral joints (between med and lat femoral condyles and tibial condyles

patellofemoral joint (between patella and femoral condyle, “trochlea”)

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12
Q

Genu varum

A

“bowlegs”

inc lateral tibiofemoral joint space –> smaller Q angle

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13
Q

Genu valgum

A

“knock-knees”

inc medial tibiofemoral joint space –> larger Q angle

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14
Q

Patellofemoral syndrome

A

“runner’s knee”
presents as pain deep to patella, many causes, results from repetetive trauma between patella and trochlea

poor patellar tracking (normally Q angle makes patella want to track laterally, but vastas medalis helps pull patella medially –> if VM weak, then lateral patellar tracking occurs)

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15
Q

Knee joint capsule

A
2 parts
fibrous capsule (external layer)
synovial membrane (internal layer)
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16
Q

articular bursa

A

suprapatellar bursa
prepatellar bursa
subcutaneous and deep infrapatellar bursae

17
Q

suprapatellar bursa

A

extension of joint cavity, lined w/ synovial membrane

18
Q

baker’s cyst

A

fluid within synovial membrane of joint capsule itself

pouches out posteriorly to popliteal fossa

19
Q

5 ligaments supporting the knee joint capsule

A

patellar ligament
tibial (medial) collateral ligament
fibular (lateral) collateral ligament (continuous w/ joint capsule

oblique popliteal ligament
arcuate popliteal ligament

20
Q

the “new” ligament

A

anterolateral ligament (ALL)

related to second fracture (lateral to Gerdy’s tubercle)

21
Q

Medial and lateral meniscus

A

fibrocartilage discs on the tibial plateau

medial–> C shaped
*attached to medial collateral ligament

lateral –> almost circular

*look for fibula to det lateral side

22
Q

Meniscus tears MOI

A

sudden extension or rotation of femur while tibia is fixed

bucket handle or radial tear

23
Q

Cruciate ligaments

A

Within fibrous joint capsule, but outside synovial membrane

Keep articular surfaces of tibia and femur opposed while stabilizing knee joint

24
Q

Anterior cruciate ligament (ACL)

A

runs from interarticular area of tibia to medial surface of lateral femoral condyle

in extension (weight-bearing) ACL prevents posterior movement of femoral condyles on tibial plateau

in flexion (non-weight bearing) ACL prevents anterior movement of tibia

ACL rupture 10x more likely than PCL
Females 2-8x more likely

25
Q

Unhappy triad

A

Lateral blow to knee…

Tear of medial collateral ligament –> bucket handle tear of medial meniscus –> too much pressure on ACL –> ACL tear

26
Q

Anterior drawer test

A

Knee flexed 90 degrees
Lax hamstring tendons
Pull tibia anterior from neutral position (ACL should resist)

27
Q

Posterior cruciate ligament

A

runs from posterior intercondylar area to lateral surface of medial femoral condyle

prevents. ..
- anterior displacement of femur on tibia
- posterior displacement of tibia on femur
- prevents hyperflexion of knee

in weight bearing flexion…
- stabilizes femur over the tibia

28
Q

Dashboard injury

A

Knee in flexion
Body motion forward
Anterior force on tibia drives tibia posteriorally
PCL tear

29
Q

Knee in flexion
Anterior force on tibia
Which injury?

A

PCL tear

fall on flexed knee

30
Q

Posterior sag sign

A

Tibia is posteriorly displaced

If quadriceps compensating, can perform posterior drawer test

31
Q

Boundaries of popliteal fossa

A

semimembranosus
biceps femoris
medial and lateral heads of gastrocnemius

32
Q

Contents of popliteal fossa

A
  • popliteal a. and v.
  • tibial div. of sciatic n.
  • common fibular (peroneal) div. of sciatic n.
  • popliteal lymph nodes
33
Q

Popliteal vein –>

A

Popliteal vein –> small saphenous vein

are more SUPERFICIAL than popliteal a.

34
Q

Origin and function of middle genicular artery

A

middle genicular artery branches off anterior side of popliteal a. shoots into knee joint itself

supplies cruciate ligaments, synovium, peripheral menisci

has branches coming off laterally and medially

35
Q

Nerve supply to anterior knee

A

proximal –> femoral n.

distal –> common (deep) fibular n.

36
Q

Nerve supply to posterior knee

A

tibial n.

37
Q

Nerve supply to lateral knee

A

common (superficial) fibular n.

38
Q

Nerve supply to medial knee

A

obturator n. and saphenous n.

39
Q

Motions at the hip

A

flexion/extension
abduction/adduction
medial rotation/lateral rotation
circumduction=flexion, abduction, extension, and adduction