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Structure and Function 1- Exam 2 > Joints and Ligaments of the Lower Limb > Flashcards

Joints and Ligaments of the Lower Limb Flashcards

1
Q

What type of joint is the hip joint? Where is it found? What does it allow for?

A

A multiaxial ball-and-socket- synovial joint between the actebulum of the hip bone and the head of the femur and allowes abduction and adduction, flexion and extension, and circumduction and rotation

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2
Q

What is the blood supply of the hip joint? What about nerve supply?

A

Receives blood from branches of the medial and lateral femoral circumflex, superior and inferior gluteal, and obturator arteries.

It is innervated by branches of the femoral, obturatior, sciatic and superior gluteal nerves, and by the nerve to the quadrats femoris

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3
Q

What are the ligaments of the hip joint?

A

Ilifemoral Ligament

Ischiofemoral Ligament

Pubofemoral ligament

Ligamentum Teres Capitis Femoris

Transverse Acetabular Ligament

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4
Q

What structures articulate with the iliofemoral ligament? What is the fuction of this ligament?

A

It is attached proximally to the anterior-inferior iliac spine and the acetabular rim and distally to the intertrochanteric line and the front of the greater trochanter of the femur.

It resists hyperextension and lateral rotation at the hip joint during standing.

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5
Q

What structures articulate with the ischiofemoral ligament? What is the fuction of this ligament?

A

It reinforces the fibrous capsule posteriorly, extends from the ischial portion of the acetabular rim to the neck of the femur medial to the base of the greater trochanter

It limits extension and medial rotation of the thigh

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6
Q

What structures articulate with the pubofemoral ligament? What is the fuction of this ligament?

A

It reinforces the fibrous capsule inferiorly, extends from the pubic portion of the acetabular rim and the superior pubic ramus to the lower part of the femoral neck

It limits extension and abduction.

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7
Q

What structures articulate with the ligamentum teres capitis femoris ligament? What is the fuction of this ligament?

A

It arises from the floor of the acetabular fossa and attaches to the fovea capitis femoris

It provides a pathway for the artery of the ligamentum capitis femoris from the obturator artery , which is or variable size but represents a significant portion of the blood supply to the femoral head during childhood

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8
Q

What structures articulate with the transverse acetabular ligament? What is the function of this ligament?

A

It is a fibrous band that bridges the acetabular notch and converts it into a foramen, through which the nutrients vessels enter the joint

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9
Q

What type of joint is the knee joint?

A

Although structurally it resembles a hinge joint, it a condylar type of synocial joint between the two condyles of the femur and the tibia

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10
Q

There is an additional joint within the knee joint. What type of joint is it and where is it found?

A

The knee joint inculdes a saddle joint between the femur and the patella

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11
Q

The knee joint permits…

A

Flexion, externsion, and some gliding and rotation in the flexed position of the knee

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12
Q

How is the knee joint stabilizes medially? What about laterally?

A

It is stabilized medially by the sartorius, gracilus, gastrocnemius (medial head), semitendinosus, and semimembranousus muscles and the tibial collateral ligament

It is stabilized laterally by the biceps and gastrocnemius tendons, the iliotibial tract, and the fibular collateral ligaments

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13
Q

What is the innervation and blood supply of the knee joint?

A

Innervation: Branches of the sciatic , femoral, and obturator nerves

Blood supply: Genicular branches of the popliteal artery, a descending branch of the lateral femoral circumflex artert, an articular branch of the descending genicular artery, and the anterior tibial recurrent artery

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14
Q

What are the ligaments of the knee joint?

A

Intracapsular ligaments

  • Anterior Crutiate ligament
  • Posterior Crutiate Ligament
  • Medial meniscus
  • Lateral meniscus
  • Transverse Ligament

Extracapsular Ligaments

  • Medial Collateral Ligament
  • Lateral Collateral Ligament
  • Patellar Ligament
  • Arcuate Poploteal Ligament
  • Oblique Popliteal Ligament
  • Popliteus Tendon
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15
Q

Where does the anterior cruciate ligament insert? What is it’s main function?

A

It inserts into the medial surface of lateral femoral condyle

It prevents forward sliding of the tibia on the femur

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16
Q

Where does the posterior cruciate ligament insert? What is it’s main function?

A

It inserts into the lateral surface of the medial femoral condyle

IT prevents backward sliding of the tibia on the femur and limits hyperflexion of the knee

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17
Q

Where does the medial meniscus insert? What is it’s main function?

A

It is attached to the medial collateral ligament and the interarticular area of the tibia

It acts as a cushion or shock absorber and lubricates the articular surfaces by distibuting synovial fluid

*More commonly torn than the lateral meniscus

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18
Q

Where does the lateral meniscus insert? What is it’s main function?

A

It is separated laterally from the fibular collateral ligament by the tendon of the popliteal muscle

It acts a cushion and facilitates lubrication.

It also aids in forming a more stable base for the articulation of the femoral condyle

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19
Q

Where does the tibial collateral ligament insert? What is it’s main function?

A

It is a broad band that extends from the medial femoral epicondyle to the medial tibial condyle

It prevents medial displacement of the two long bones and thus abduction of the leg at the knee

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20
Q

Where does the fibular collateral ligament insert? What is it’s main function?

A

It extends between the lateral femoral epicondyle and the head of the fibula

It limits extension and adduction of the leg

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21
Q

Where does the patellar ligament insert? What is it’s main function?

A

It extends from the apex of the patella to the tuberosity of the tibia

*It’s portion may be used for repair of the anterior cruciate ligament

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22
Q

Coxa valga

A
  • An alteration of the angle made by the axis of the femoral neck to the axis of the femoral shaft so that the angle exceeds 135 degrees and thus the femoral neck becomes straighter.
  • Lateral
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23
Q

Coxa vara

A
  • An alteration of the angle made by the axis of the femoral neck to the axis of the femoral shaft so that the angle is less than 135 degrees and this the femoral neck becomes more horizontal.
  • Medial
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24
Q

Anterior drawer sign

A

A forward sliding of the tibia on the femur due to arupture of the anterior cruciate ligament

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25
Q

Posterior drawer sign

A

A backward sliding of the tibia on the femur caused by rupture of the posterior cruciate ligament

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26
Q

Unhappy triad

A
  1. Rupture of tibial collateral ligament
    * Results from excessive abduction
  2. Injury to the medial meniscus
    * Results from tibial collateral ligament attachment
  3. Tearing of the anterior cruciate ligament
    * Results from forward displacement of the tibia
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27
Q

Genu valgum

A
  • Also known as knock-knee
  • Deformity in which the tibia is bent or twisted laterally
  • May occur as a result of the collapse of the lateral compartment of the knee and rupture of the medial collateral ligament
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28
Q

Genu varum

A
  • Also known as bowleg
  • Deformity in which the tibia is bent medially
  • May occur as a result of collapse of the medial compartment of the knee and rupture of the lateral collateral ligament
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29
Q

A portion of the _____________ may be used for surgical repair of the anterior cruciate ligament of the knee joint.

A

Patellar tendon

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30
Q

What type of joint is the ankle joint? Where is it found? What movement does it permit?

A

It is a hinge-type synovial joint betwen the tibia and fibular superiorly and the trochlea of the talus inferiorly.

It permits dorsifelxion and plantar flexion

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31
Q

What is the purpose of the thick connective tissue capsule that surrounds the joints?

A

Capsules form the surface of joints and keep joints separate from the rest of the body.

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32
Q

What is the role of ligaments?

A

Help support and maintain the stability of a joint.

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33
Q

What is the normal degree for the mechanical axis of the femur and tibia?

A

87 degrees

34
Q

Why does the femur slant?

A
  • Balance
  • Less energy usage
35
Q

The hip joint is found between which bones?

A

The hip joint is formed between the head of the femur and the acetabulum of the innominate bone

36
Q

What is another name for the pelvic girdle?

A

The innominate bone

37
Q

Which bones fuse to form the acetabular fossa?

A

Ilium, ischium, and pubis

38
Q

The hip joint is made up of _____________ fibers

A

collagen

*There is one section where collagen fibers run in one direction are very thick.

39
Q

The hip joint is surrounded by an ______________

A

Articular capsule

40
Q

The articular capsule that surrounds the hip joint is lined with a ________________ and therefore a __________.

A

Synovial membrane; synovial joint

41
Q

The articular surfaces of the hip joint are covered with _____________.

A

Hyaline cartilage

42
Q

Thickening within the articular form ___________ ligments.

A

Intrinsic

43
Q

Which ligament of the hip is the thickest and strongest?

A

Iliofemoral ligament

*In a standing posture, when the pelvis is tilted posteriorly, the ligament is twisted and tense, which prevents the trunk from falling backwards and the posture is maintained without the need for muscular activity. In this position the ligament also keeps the femoral head pressed into the acetabulum

44
Q

The articular capsule is composed of _____________ fibers.

A

Parallel

45
Q

____________ causes the fibers of the articular capsule to spiral.

A

Extension.

*This draws the acetabulum and femur closer together and increases hip stability

46
Q

__________________ causes the fibers of the articular capsule to unwind.

A

Flexion

47
Q

Which artery runs in the ligament of the head of the femur ?

A

Acetubular artery

  • Supplies the head of the femur
  • Not reliable

*The ligament of the head of the femur is not really necessary and is not always present

48
Q

What does fracture of the neck of the femur result in? Why?

A

Shortening and lateral rotation of the affected limb

  • When there is a fractured bone, the muscles surrounding that fracture go into contraction. This is called protective splinting, where the muscles spasm inorder to stabilize the joint and reduce the pain around the joint.
    • Muscles that attach distal to the fracture go into spasms, pulling the bony segment close to the origin, this shortening the limb
  • At and across the hip joint are a number of muscles and the majority of muscles that are attached to joint are external rotators and muscles tend to travel in the direction with the most strength
49
Q

Spasms can cause what effect?

A

Spasms cause:

  • limb shortening
  • lateral rotation

*Muscles that attach distal to the fracture go into spasms, pulling the bony segment closer to the origin, thus shortening the limb.

50
Q

Hip injuries cause its myotatic unit to _________ whcih provides protective splinting.

A

Spasm

51
Q

Arteries run through the _________ (proximal/ distal) neck of the femur to reach the head of the femur.

A

Proximal

  • Therefore, proximal fractures of the femoral neck are likely to sever the blood supply to the head
52
Q

The more _____________ (proximal/distal) that the neck is fractured, the worst the prognosis is for healing?

A

Proximal

53
Q

Posterior dislocation of the hips results in what? Why?

A

Posterior dislocation of the hips results in:

  1. shortening of the limb
  2. medial rotation of the hip

*The hip does not normally dislocate anteriorally becuase you have a very thick iliofemoral ligament holding the head of the femur in place

54
Q

What type of cells line the synovial membrane?

A

Simple squamous epithelium

55
Q

Is the fibula apart of the knee joint?

A

No!

Knee joint is only formed by the patella, tibia, and femur

56
Q

What causes lateral rotation of one leg after a hip fracture?

A

Lateral rotators are collectively stonger than the medial rotators, which causes lateral rotation of one leg after a hip fracture.

57
Q

What muscles make up the triceps coxae?

A

Obturator internus, superior gemullus, and inferior gemullus

58
Q

What is protective splinting?

A
  • The muscles which cross the affected joint come under stress as they begin to attempt to take the strain of the affected joint or area of muscular issue.
  • They are essentially working harder to try and protect the joint from further injury.
    • However, because the pressure builds up over often short periods of time the muscles now instead of proving a flexible surround for the joints begin instead to stiffen up, shorten, tighten , cause pain and then actually lead to the contribution of further wear and tear on the joints.
59
Q

Hip fracture = __________ rotation of the femur

Posterior dilocation= ___________ rotation of the femur

A

Lateral

Medial

60
Q

___________ (Flexion/ Extension) destabilizes the hip joint. Why?

A

Flexion destabilizes the hip joint because flexion increases the space between the head of the femur and actebulum

61
Q

The articulation between the patella and the femur form what type of joint?

A

A synovial joint of the sliding variety

62
Q

The articulations between the condyles of the femur and tibia form what type of joint?

A

A hinge joint with a limited degree of rotation

63
Q

Which ligaments of the the knee are not within or apart of the capsule?

A

Extrinsic

  • Tibial collateral
  • Fibular collateral
64
Q

What are the intra-articular ligaments of the knee and what are their function?

A

Anterior and posterior cruciate ligaments

  • Support and maintain stability of the knee. If ruptured there will be a loss of function.
65
Q

How do you test for a ruptured ACL?

A

Pull tibia forward, if it goes too far out you will have a positive drawer sign

66
Q

The anterior cruciate ligament may be injured when the knee is _____________.

A

Hyperextended

67
Q

The posterior cruciate ligament may be injured when the knee is _____________-

A

Hyperflexed

68
Q

The two menisci of the knee are interposed between the _____________.

A

Condyles

  • The medial ad laterial menisci are half disc made of hyaline cartilage
69
Q

If you damage the tibial collateral ligament, you can end up damaging the _____________, as well.

A

Medial meniscus

*This is becuase the tibial collateral ligament attached to the medial meniscus

70
Q

What does varus stress constitute?

A
  • Rupture of lateral collateral ligament
  • This is rare but can occur when a motorcycle falls on the medial side of the knee
71
Q

What does valgus stress constitute?

A
  • Rupture of the medial collateral ligament
  • This shifts the forces oto the lateral condyles and leads to a torn lateral meniscus and a torn ACL
72
Q

A patellar dislocation usually occurs ____________ (medially/laterally)

A

Laterally

  • The Q angle of the femur can tell you whether a person is predisposed to having a patellar dislocation
73
Q

The most important muscle attached to the patella is the _______________. Why?

A

Rectus femoris

  • The rectus femoris attaches directly below the anterior supperior iliac spine, so when you extend your knee, the rectus femoris is pulling on the patella and pulls at an angle when the Q angle is large.
    *
74
Q

What type of joint is the ankle joint?

A
  • A synovial hinge joint
  • Formed by the articulations of the distal ends of the tibia and fibula (and their malleoli) which forms as deep socket around the talus

NOTE: The ankle joint is a purely hinge synovial joint, with no movement apart from dorsiflexion and plantarflexion.

75
Q

Which bones form the ankle joint?

A

Fibula (lateral malleolus)

Tibia (medial malleolus)

Talus

76
Q

Which ligaments are the most commonly torn when you twist your ankle?

A

Anterior tallofibular ligament

Calcaneofibular ligament

*Torn with forced inversion of ankle

77
Q

The anterior talofibular ligament and calcaneofibular ligament are torn with forced ___________ of the ankle.

The deltoid ligament is torn with forced _____________ of the ankle.

A

Inversion

Eversion

78
Q

What are the lateral ligaments of the ankle?

A

Anterior talofibular ligament

Posterior talofibular ligament

Calcaneofibular Ligament

79
Q

What is the medial ligament of the ankle?

A

Deltoid

80
Q

Pott’s fracture dislocation

A

Results from force eversion of the ankle

81
Q

How is the fibula damaged as result of damage to the deltoid ligament?

A

1) The medial malleolus is avulsed (fractured) by the strong deltoid ligament
2) the ankle becomes unstable and dislocates
3) torque on the fibula results in fracture

Structure and Function 1- Exam 2 (18 decks)

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