Joints

Question 1

What is the coxofemoral joint?
Functionally/Structurally?
What does it do?

Answer 1

hip, iliofemoral, or acetabulofemoral joint.
 diarthrodial joint (functionally)
 synovial, ball and socket joint (structurally) 

multiaxial joint that rotates around all 3 axes and in all three planes of movement

Question 2

Describe the iliofemoral ligament.

Proximal attachments?
Distal attachment?
What does it do?

Answer 2

Y-shaped ligament that covers most of the anterior aspect of the joint.

proximal attachments are the AIIS and the acetabular rim.

distal attachment is the intertrochanteric line of the femur.

Helps prevent hyperextension of the thigh and screws the head of the femur into the acetabulum to help strengthen and stabilize the joint.

Question 3

What is the pubofemoral ligament?
Proximal attachments?
Distally?
What does it do?

Answer 3

Proximally it is attached to the pubic part of the acetabular rim and the iliopubic eminence.

Distally it blends with the medial part of the iliofemoral ligament.

Mainly responsible to check hyperabduction, but also aids in preventing hyperextension of the thigh.

Also helps strengthen the anterior and inferior parts of the capsule.

Question 4

Describe the ischiofemoral ligament.

From where does it arise?
Distally?
What does it do?

Answer 4

Arises proximally from the ischial portion of the acetabular rim.

Distally, it spirals around the posterior neck and attaches to the anterior neck just medial to the greater trochanter.

Prevents hyperextension of the joint and strengthens the posterior capsule.

Question 5

Describe ligamentum teres.

What kind of ligament?
Proximal and distal attachemtns?

What does it do?

Answer 5

Ligament of Head of Femur
-Is an intracapsular ligament.

Weak ligament attached proximally to the acetabular notch and transverse acetabular ligament.

Distally attached to the fovea capitis of the femur.

Does not appear to help stabilize the joint but does have the artery to the head of the femur running through it.

Question 6

Describe the tibiofemoral joint.

Answer 6

(knee)
is the articulation of tibia of femur bones
diarthrodial (functional)
modified synovial, hinge (structural)

(generally hinge joints are uniaxial but there is slight rotation in tibiofemoral so its modified hinge.)

very weak joint so relies heavily on muscles and ligaments for support

Question 7

What are the articulating surfaces of the tibia?

Answer 7

medial and lateral tibial plateaus
mildly concave, mostly flat
covered in hyaline cartilage, separated by intercondylar eminence
medial and lateral menisci attached which help deepen concavity of plateau

Question 8

What are the articulating surfaces of the femur?

Answer 8

medial and lateral femoral condyles

convex structure that are covered in hyaline cartilage

Question 9

Describe the menisci (semilunar cartilages)

Answer 9

(medial and lateral meniscuses)
deepen and widen the tibial plateaus and thus increase stability of the joint

provide proprioception and help lubricate the joint and provide shock absorption by increasing the surface area, and also help with tensional forces on the joint

Question 10

Describe the lateral meniscus.

Answer 10

more O shaped
attached anteriorly and posteriorly to intercondylar area (anteriorly -just posterior to ACL, posterior -just anterior to PCL)
attached posteriorly to popliteus m. and has some coronary ligaments which allow movement of the meniscus more than MM.
(less commonly injured than MM)

Question 11

Describe the medial meniscus.

Answer 11

C-shaped
anterior horn attaches to anterior portion of inter-condylar area anterior to ACL
posterior horn attaches to posterior portion of intercondylar area anterior to PCL

MM is fixed strongly to the medial tibial plateau via coronary ligaments which allow very little displacement
attachment medially with MCL

Question 12

Describe the medial (tibial) collateral ligament.

What are the proximal and distal attachments?

What is attached midpoint?

What does it do?

Answer 12

A strong, wide, flat band of connective tissue.

The proximal attachment is the medial femoral epicondyle and the distal attachment is the medial tibial condyle

At roughly the midpoint, the fibers of the MCL are strongly attached to the medial meniscus.

Primarily checks tibial abduction, secondarily checks hyperextension.

Question 13

Describe the lateral (fibular) collateral ligament.

From where does it extend?
What does it do?

Answer 13

Very strong, cord-like ligament.

Extends from the lateral epicondyle of the femur to the lateral surface of the fibular head.

Primarily checks tibial adduction, and helps secondarily to prevent hyperextension.

Question 14

Describe the anterior cruciate ligament.

From where does it arise? Where does it extend?
What does it do?

Answer 14

Arises from the anterior intercondylar eminence just posterior to the attachment of the anterior horn of medial meniscus.

Extends posteriorly, superiorly, and laterally to attach to the medial side of the lateral femoral condyle.

Will check anterior translation of the tibia on the femur and hyperextension of the leg.

Question 15

Describe the posterior cruciate ligament.

From where does it extend?
What does it do?

Answer 15

Strongest of 2 cruciate ligaments.

Extends from the posterior intercondylar eminence to the anterior part of the lateral surface of the medial femoral condyle.

Will check posterior translation of the tibia on the femur and will also help check hyperflexion of the leg.

Question 16

Describe the patellofemoral joint.
What type?
What do the two articulating surfaces articulate with?

Answer 16

This synovial joint is the articulation of the patella and femur.

The two articulating surfaces of the patella (medial and lateral facets) articulate with the anteromedial borders of the medial and lateral femoral condyles (the patellar surface).

Question 17

How does the patella move with leg flexion and extension? How is it held in place?

Answer 17

The patella moves inferiorly with leg flexion and superiorly with leg extension.

It is held in place by the patellar tendon (quadriceps muscles) and the patellar ligament.

Question 18

Describe the patellar ligament.

Answer 18

Extends from the tibial tuberosity to the apex of the patella.

Serves as the distal attachment for the quadriceps muscles, but also helps stabilize the anterior joint capsule.

Question 19

What is the unhappy triad?

How it is commonly caused?

Answer 19

• rupture of tibial collateral and anterior cruciate ligaments plus tear of medial meniscus

(injury to the ACL, MCL, and medial meniscus)

Commonly caused by trauma to the posterolateral knee (football hit) but can also be caused by a non-traumatic mechanism.

Non-traumatic injuries account for 70%-80% of all ACL injuries

Question 20

What is pivot-shift injury?

Answer 20

a non-contact injury caused by quick deceleration, flexion of the knee, and lateral rotation of the femur (medial rotation of the tibia), and a valgus force (think of “cutting” in football, soccer, or skiing).

Question 21

Describe the superior tibiofibular joint.

From where does the anterior ligament extend? Posterior ligament?

Describe the movement of the joint.

Answer 21

A synovial, planar joint between the fibular head and the lateral tibial condyle.

The ligaments that hold the joint together are intermeshed with the capsule.

The anterior ligament extends from the fibular head to the anterior surface of the lateral tibial condyle.

The posterior ligament extends from the fibular head to the posterior surface of the lateral tibial condyle.

Movement of the joint is minimal, but may help with proper mechanics of the talocrural joint.

Question 22

Describe the inferior tibiofibular joint.

What is between the tibia and fibula?
How is the joint held together inferiorly?
What is on the anterior surface of the joint?
What is on the posterior surface of the joint?

Answer 22

a fibrous syndesmosis joint.

Between the tibia & fibula is the interosseous membrane.

Inferiorly the joint is held together by ligaments.

Anterior tibiofibular ligament is located on the anterior surface of the joint.

Interosseous tibiofibular ligament is a continuation of the interosseous membrane.

This is the strongest of the tibiofibular ligaments and is most responsible for holding the joint together.

Posterior tibiofibular ligament is located on the posterior surface of the joint.

Question 23

Describe a high ankle sprain.
Where does it take place?
What is the most common mechanism of injury?
Why is it difficult to treat?

Answer 23

also known as a syndesmotic ankle sprain
takes place at the distal tibiofibular joint.

Most common mechanism of injury is lateral rotation of the foot, but it can also occur with medial rotation and even forced dorsiflexion.

Very difficult to treat because every step that is taken splays the distal tibiofibular joint thus continually aggravating the damaged tissues.

Question 24

Describe the talocrural (ankle) joint.
How is it formed?
What are the articular surfaces covered with?
What is the joint capsule strengthened by?

Answer 24

This synovial hinge joint is formed by the trochlea of the talus, which articulates with the tibia (including the medial malleolus) and the fibula (lateral malleolus).

All the articular surfaces are covered in hyaline cartilage and there is also a strong capsule surrounding the joint.

The joint capsule is strengthened by two sets of ligaments; the lateral ligaments and the deltoid ligaments.

Question 25

What are the three ligaments that support the lateral talocrural joint?

Answer 25

Anterior Talofibular Ligament

Calcaneofibular Ligament

Posterior Talofibular Ligament

Question 26

Describe the anterior talofibular ligament, calcaneofibular ligament, and posterior talofibular ligament.

Where do they extend from? What do they do?

Answer 26

Anterior Talofibular Ligament:

• Extends from the anterior portion of the lateral malleolus to the talar neck.
• Will help check plantar flexion and inversion.

Calcaneofibular Ligament:

• Extends from the apex of the lateral malleolus to the lateral part of the calcaneous.
• Will help check dorsiflexion and inversion.

Posterior Talofibular Ligament:

• Extends from the posterior portion of the lateral malleolus to the posterior talus.
• Helps check dorsiflexion and inversion.

Question 27

What four ligaments make up the talocrural medial ligament? (deltoid ligament)

Answer 27

anterior tebiotalar ligament
tibionavicular ligament
tibiocalcaneal ligament
posterior tibiotalar ligment

together are very strong and don’t allow much movement.

all check eversion of the talocrural joint.

Question 28

Describe the long plantar ligament.

Where is it found?
What does it do?
What does it form?
Where does it extend?

Answer 28

• Found on the plantar surface of the foot
• helps to maintain the longitudinal arches of the foot
• extends from the plantar surface of the calcaneus to cuboid and the metatarsal bases (2-5)
• Forms a tunnel for the tendon of fibularis longus m.

Question 29

Describe the Short Plantar Ligament.

What does it do?
Where does it extend?

Answer 29

Also known as the plantar calcaneocuboid ligament.

• helps maintain the longitudinal arches of the foot.
• Runs from the anteroinferior calcaneus to the plantar surface of the cuboid.

Question 30

Describe the Plantar Calcaneonavicular (Spring) Ligament:

What does it do?
From where does it extend?

Answer 30

Plays a very important role in the transfer of weight from the talus and helps maintain the medial longitudinal arch.

Extends from the plantar surface of the sustentaculum tali to the posteroinferior surface of the navicular.