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Anatomy 4 > Joints of LE > Flashcards

Joints of LE Flashcards

1
Q

What is the hip joint called?

A

Acetabulo-femoral joint

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2
Q

What is the Acetabulo-femoral joint aka?

A

coxa-femoral joint

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3
Q

What type of joint is the Acetabulo-femoral joint?

A

ball and socket synovial joint

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4
Q

How many DOF does Acetabulo-femoral joint have and what are they?

A

3 DOF:
Flexion/extension
abduction/adduction
IR/ER (circumduction)

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5
Q

What is the size ratio between acetabulum and femoral head?

A

similar in size, about 1:1 ratio there making it very stable

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6
Q

What is the Acetabulo-femoral joint’s angle of inclination?

A

tend to have a normal angle that is medial angle

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7
Q

If the normal medial angle of the Acetabulo-femoral joint straightens out what is that called?

A

coxa valga, valgus

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8
Q

If the normal medial angel of the Acetabulo-femoral joint decreses what is that called?

A

coxa vara, varus

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9
Q

As you begin to weight bear and also in geriatric years of prolonged weight bearing results in what?

A

decreased angle

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10
Q

When looking at the femur from top down, you see a proximal difference to distal what is that curve called?

A

angel of torsion

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11
Q

What angle is the head and neck of the femur angled at?

A

30 degrees

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12
Q

What is angle of torsion increase called?

A

antiversion

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13
Q

What does antiversion of the femur mean?

A

when the distal portion of femur points medially

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14
Q

What does antiversion of the femur result in?

A

knock knee

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15
Q

What is angle of torsion decrease called?

A

retroversion

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16
Q

What does retroversion of the femur mean?

A

when the distal portion of the femur points more laterally

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17
Q

What retroversion of the femur result in?

A

bowlegged

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18
Q

What closes off the acetabular notch of the acetabulum?

A

transverse acetabular ligament

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19
Q

What vessel travels through transverse acetabular ligament of the acetabulum?

A

artery to ligamentum teres

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20
Q

What is the continuation of the joint capsule of the acetabulum?

A

acetabular labrum

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21
Q

What is the function of the acetabular labrum?

A

contributes to congruency and stability of the joint

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22
Q

What causes there to be a higher amount of stability in the acetabulum?

A

vacuum in the joint

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23
Q

What are the 3 major ligaments of the hip?

A

iliofemoral
Pubofemoral
Ischiofemoral

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24
Q

Which two ligaments attach from intertrochanteric line of femur anteriorly?

A

iliofemoral

pubofemoral

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25
Q

Which ligament attaches from the intertrochanteric crest of femur posteriorly?

A

Ischiofemoral ligament

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26
Q

What do all three major ligaments of the hip attach from and to?

A

femur to ilium, pubis, and ischium

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27
Q

The hip ligaments and capsule are most taught and provide most restriction/stability in what motions?

A

Hip extension
abduction
IR

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28
Q

Hip Joint surfaces have maximum articulation in what motions?

A

Hip flexion
abduction
ER

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29
Q

What position is hip dislocation most common?

A

flexed, adducted, and IR causing posterior dislocation

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30
Q

How are the three ligaments of the hip described?

A

as intra-capsular, blending in with the joint capsule

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31
Q

What is the position of the joint where ligaments and joint capsule are most taught and joint surfaces are most congruent called?

A

closed pact position

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32
Q

What does joint congruency mean?

A

most area matches up

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33
Q

Unlike other joints what is the hip joints relationship of congruency and taughtness?

A

they are inverse

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34
Q

When is the hip at high congruency?

A

Hip flexion
abduction
ER
FABER

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35
Q

When is the hip at high taughtness?

A

Extension
Abduction
IR

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36
Q

What is the the hip at closed pact position?

A

just when it’s taught and low congruency

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37
Q

What part of the hip joints are cut when doing a total hip replacement?

A

posterior-lateral joint capsule

iliofemoral ligament

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38
Q

What motion is restricted post total hip replacement?

A

flexion,
adduction,
IR

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39
Q

When an infant is born with a mal-formed femoral head, what motion is done to reshape it into a sphere?

A

FABER
flexion
abduction
ER

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40
Q

What is the knee joint called?

A

Tibio-femoral joint

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41
Q

What type of joint is the tibio-femoral joint?

A

Bi-condyloid joint

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42
Q

How many DOF does the tibio-femoral joint have and what are they?

A

1 DOF primary but there is technically 2
primary- flexion/extension
secondary- when weight bearing abd/add

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43
Q

What do the two condyles of the femur articulate with in the tibio-femoral joint?

A

two condyles of the tibia

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44
Q

What is the screw home mechanism?

A

when the knee is at full extension the tibia ER on the femur for about the last 30 degrees

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45
Q

Why does screw home mechanism occur?

A

This is due to the medial condyle of the femur continuing to move on the medial condyle of the femur, causing the tibia to ER

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46
Q

What is the benefit of screw home mechanism?

A

allows for energy efficiency when you lock the tibia into femur while standing. This is substituting the use of huge muscles of the leg to maintain standing posture

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47
Q

How do you unlock the knee after standing with screw home mechanism?

A

IR the tibia

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48
Q

What surrounds the tibio-femoral joint?

A

joint capsule

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49
Q

Where does the joint capsule’s synovial membrane joint into in the tibio-femoral joint?

A

folds in at the intercondylar fossa

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50
Q

How does the synovium engulf the knee joint?

A

the Synovium doesn’t completely surround the tibio-femoral joint

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51
Q

Since the synovium doesn’t completely surround the knee capsule what occurs?

A

the ACL and PCL are not supplied by synovial fluid

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52
Q

How are ACL and PCL oriented in relations to the synovium and joint capsule?

A

ACP and PCL are extra-synovial

ACP and PCL are intro-capsular

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53
Q

Since ACP and PCL are extra-synovial what can occur?

A

if they are torn they can’t repair themselve and surgery is needed

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54
Q

What does the synovial membrane of the knee have that allows for more freedom?

A

redundancies which are folds

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55
Q

What is it called when the knee’s synovial membrane redundancies become irritated called?

A

Synovial Plica

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56
Q

What causes synovial plica?

A

reduced friction or overuse

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57
Q

What are the two fibrocartilagenous support structures of the knee called?

A

medial and lateral menisci

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58
Q

What are four functions of menisci?

A
  • form concavities for femur to articulate with
  • increase congruency
  • disperse force
  • increases articulation
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59
Q

What does a meniscal tear result in?

A

smaller area to disperse force and increased likelihood of osteoarthritis

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60
Q

Which meniscus is larger and what is it’s shape?

A

medial menisicus is larger with a C shape

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61
Q

Which meniscus is less mobile? and why?

A

medial meniscus is less mobile due to having mulitple attachments

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62
Q

Which meniscus is more likely to tear?

A

medial meniscus

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63
Q

Which meniscus is smaller and what is it’s shape?

A

lateral meniscus is smaller with an almost complete ring shape

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64
Q

What attaches to the posterior aspect of the medial meniscus?

A

semimembranosus

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65
Q

What attaches to the posterior aspect of the lateral meniscus?

A

popliteous

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66
Q

What prevents impingement of the menisci when the two bones come in flexion and pulls them taught?

A

muscular attachement to menisci

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67
Q

Can menisci get stuck?

A

no

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68
Q

What is another function of muscular attachment on menisci besides preventing impingement?

A

ensures menisci are drawn posteriorly and there is always meniscus in contract with tiba and femur throughout the entire ROM

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69
Q

How is menisci bound to the tibial plateau?

A

by coronary ligaments (mensco-tibial)

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70
Q

How is menisci loosely bound to the femur?

A

by menisco-femoral ligament

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71
Q

What are the ligaments of the knee?

A 
Anterior cruciate ligament
Posterior cruciate ligament
Medial collateral ligament
Lateral collateral ligament
Arcuate ligament
Oblique popliteal ligament
Posterior oblique ligament
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72
Q

Where is the ACL and PCL found?

A

in the intercondylar fossa

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73
Q

What do both ACL and PCL resist?

A

as they cross one another they prevent excessive IR of the Tibia

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74
Q

Which femoral condyle does ACL and PCL attach to?

A

LAMP
lateral ACL
medial PCL

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75
Q

What does ACL resist?

A

anterior translation of the tibia or femur posteriorly

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76
Q

What does PCL resist?

A

posterior translation of the tibia or femur anteirorly

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77
Q

When the femur moves anteriorly/posteriorly what resists excessive movement?

A

excessive femoral anterior: PCL

excessive femoral posterior: ACL

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78
Q

What other structures does the ACL attach to?

A

medial meniscus and MCL

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79
Q

How are the ACL/PCL attached on their respective condyles?

A

ACL is posteriorly on the lateral condyle

PCL is anteriorly on the medial condyle

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80
Q

What does the MCL attach to and from?

A

medial epicondyle of the femur and blends with the medial meniscus

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81
Q

What muscle does the MCL attach with?

A

pes anserenus

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82
Q

What force does the MCL resist on the knee?

A

excessive valgus force

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83
Q

What is happening to the MCL during geno-valgum? and what results?

A

MCL is elongated and knock knee results

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84
Q

Is MCL intra/extra-capsular?

A

intra-capsular blending with the joint capsule

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85
Q

What does the LCL attach to and from?

A

lateral epicondyle of femur

fibular head

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86
Q

is LCL intra/extra-capsular?

A

completely extra-capsular

87
Q

What happening to the LCL during geno-varo? and what results?

A

LCL is elongated and bow legged results

88
Q

What does LCL and MCL both resist together?

A

ER of tibia

89
Q

What is the unhappy triad?

A

ACL
Medial meniscus
MCL
all being torn

90
Q

What three ligaments are located along the posterior of the knee capsule?

A

Posterior oblique ligament
Oblique popliteal ligament
Arcuate ligament

91
Q

What does Posterior oblique ligament, Oblique popliteal ligament, and Arcuate ligament do together?

A

They reinforce joint capsule
and
resist excessive hyperextension of the knee

92
Q

What is hyperextension on the knee called?

A

genu-recurvatul

93
Q

How is the arcuate ligament oriented?

A

more lateral near fibular head

94
Q

How is oblique popliteal and posterior oblique ligaments oriented?

A

more postero-medially

95
Q

Posterior oblique ligament, oblique popliteal ligament, and arcuate ligament resist valgus or varus forces of the knee?

A

both valgus and varus

96
Q

What joint is located in between patella and patella surface of the femur?

A

patello-femoral joint

97
Q

What type of joint is patello-femoral joint?

A

plane synovial joint

98
Q

What are the three posterior facets of the patella?

A

lateral, medial, odd

99
Q

Which patella facet is the most medial in the aspect to the body?

A

odd facet

100
Q

Which patellar facet is the largest?

A

lateral facet

101
Q

Which patellar facet is the smallest?

A

odd facet

102
Q

What does the patellar facets articulate with?

A

femur

103
Q

What type of bone is the patella?

A

sesamoid

104
Q

What tendon is the patella inbedded in?

A

quadriceps femoris

105
Q

What is the function of the patella in aspect to the quadriceps?

A

Patella acts to change the angle of pull of the quadriceps acts as a pulley and angulation of force of quad

106
Q

What is superiorly/inferiorly attached to the patella?

A 
superior= quadriceps tendon
inferior= patellar tendon/ligament
107
Q

What does the patellar tendon connect?

A

patella to tibial tuberosity

108
Q

What is the patellar tendon a continuation of?

A

tendon of quadriceps

109
Q

Why is the patellar tendon also a ligament?

A

bc it connects bone to bone

110
Q

What does the patella help protect?

A

ACL and PCL located just posterior to it

111
Q

What are the four ligaments binding the patella?

A

lateral and medial patello-femoral ligaments

lateral and medial patello-tibial ligaments

112
Q

Two lateral ligaments of patello-femoral and patello-tibial ligament, collectively is called what?

A

lateral patellar retinacula

113
Q

Two medial ligaments of patello-femoral and patello-tibial ligament, collectively is called what?

A

medial patellar retinacula

114
Q

What are the attachment sites of the iliotibial band?

A

Iliac tubercle on iliac crest
runs along the lateral aspect of thigh
lateral aspect of patella (lateral retinacula)
Gurdey’s tubercle on tibia

115
Q

The ilitotibial band crosses at the knee to blend in with what?

A

lateral retinaculum

116
Q

What is the ligament that blend the patella with the lateral retinaculum?

A

ilio-patello ligament

117
Q

What occurs when there is tension on the iliotibial band?

A

pulls the patella laterally

118
Q

What is the Q-angle?

A

estimation of line of pull of quadatus femoris muscle. This is not a definitive measurement

119
Q

What are the locations to measure for the Q-angle?

A

Measure from ASIS to Mid patella to tibial tuberosity

120
Q

WIth the Q-angle you can make an assumption that a wider pelvis will what?

A

cause the Quadatus femoris to pull more laterally

121
Q

WIth the Q-angle you can make an assumption that a narrower pelvis will what?

A

cause the quadatus femoris to pull more superiorly

122
Q

Are Q-angle related quad/knee tracking assumptions alwasy true?

A

no

123
Q

What movements should the patella be able to perform?

A

Tilt medially and laterally
Rotate medially and laterally
Glide superiorly/inferiorly/medially/laterally

124
Q

What is the union between the head of fibula and tibia?

A

proximal tibio-fibular joint

125
Q

What type of joint is the proximal tibio-fibular joint?

A

plane synovial joint

126
Q

What two structures make up the proximal tibio-fibular joint?

A

anterior tibio-fibular ligament

posterior tibio-fibular ligament

127
Q

What little movement proximal tibio-fibular joint has, is to do what?

A

accommodate for very distal ankle motion

128
Q

A fusion at the proximal tibio-fibular joint will result in what?

A

limited ROM at the ankle

129
Q

What motions does the proximal tibio-fibular joint have?

A

superior/inferior translation

rotation

130
Q

What type of joint is the distal tibio-fibular joint?

A

syndesmosis

131
Q

What membrane is found in the distal tibio-fibular joint?

A

interosseous membrane

132
Q

What two structures make up the distal tibio-fibular joint?

A

anterior tibio-fibular ligament

posterior tibio-fibular ligament

133
Q

Why is the distal tibio-fibular joint very stable and strong?

A

bc its supported by ligaments and interosseous membrane

134
Q

The distal tibio-fibular joint doesn’t articulate any structure. What separates the distal tibia and fibula?

A

fibro-adipose tissue

135
Q

What is a high ankle sprain?

A

separation of distal tibia and fibula by a tear of interosseous membrane

136
Q

What is the joint found amongst the talus, distal tibia, distal fibula?

A

talocrural joint

137
Q

What does Crural mean?

A

leg

138
Q

The distal tibia and fibula create a mortise, what is it and what is mortise’s function?

A

a bowl shape

that grips the talus

139
Q

What type of joint is the talocrural joint?

A

synovial hinge joint

140
Q

What aspect of the talus is larger in the talocrural joint?

A

the dome of talus bone is larger anterior than posterior

141
Q

How is the lateral and medial malleolus extended in relations to each other?

A

lateral malleolus extend inferior and posteriorly relative to the medial malleolus

142
Q

What is talocrural joint motion?

A

dorsiflexion

plantarflexion

143
Q

Which talocrural joint motion is more limited and why? *also how does this relate to proximal tibio-fibial joint

A

dorsiflexion is more limited since the wider portion of talus is inside the distal tibio-fibial joint, not a lot of movement. therefore the proximal tibio-fibila joint needs to move to compensate motion

144
Q

What are the 3 lateral collateral ligaments of the ankle?

A

ATFL anterior talo-fibular ligament
CFL calcaneo-fibular ligament
PTFL posterior talo-fibular ligament

145
Q

Where is the ATFL located?

A

sits on top of sinus tarsi

146
Q

What motion does the ATFL, CFL, PTFL resist?

A

ankle inversion

147
Q

Which lateral collateral ankle ligament is most commonly injured?

A

ATFL

148
Q

When is the ATFL stressed?

A

during plantar flexion

149
Q

What two structures is the ATFL found connecting?

A

Lateral malleolus

anterior aspect of the talus

150
Q

Where is the CFL found?

A

posterior to the ATFL

151
Q

When is the CFL stressed?

A

neurtral inversion

152
Q

What two structures is the CFL found connecting?

A

lateral malleolus

calcaneous

153
Q

Where is the PTFL found?

A

most posterior to all other ligaments

154
Q

When is the PTFL stressed?

A

during dorsiflexion and pushing into inversion

155
Q

What two structures is the PTFL found connecting?

A

lateral malleolus

posterior talus

156
Q

Which lateral collateral ankle ligament is least injured?

A

PTFL

157
Q

What is the function of the medial collateral ankle ligaments?

A

resist evertsion of the ankle

158
Q

What is the medial collateral ankel ligaments commonly called?

A

deltoid ligaments

159
Q

How often do you see medial collateral ankle injures and why?

A

The deltoid ligaments are super strong, rarely seen a injure here. More likely to see the ligament be pulled off the bone before it is torn

160
Q

What are the 4 medial collateral ankle ligaments?

A

Anterior tibio-talar ligament
Tibio-navicular ligament
tibio-calcaneal ligament
Posterior tibio-talar ligament

161
Q

What two structures is the anterior tibio-talar ligament found connecting?

A

medial malleolus

anteiror aspect of talus

162
Q

When is the anterior tibio-talar ligament found stressed?

A

in platar flexion and pushed into eversion

163
Q

What two structrues is the tibio-navicular ligament found connecting?

A

meidal malleolus

navicular tubercle

164
Q

When is the tibio-navicular ligament stressed?

A

plantar flexion and pushed into eversion

165
Q

What two structures is the tibio-calcaneal ligament found connecting?

A

medial malleolus

medial aspect of the calcaneous

166
Q

When is the tibio-calcaneal ligament stressed?

A

when neutral and then eversion

167
Q

What two structures is the posterior tibio-talar ligament found connecting?

A

medial malleolus

posterior aspect of talus

168
Q

When is the posterior tibio-talar ligament stressed?

A

in dorsiflexion and pushed into eversion

169
Q

What is the union of talus and calcaneus?

A

subtalar joint

170
Q

What is subtalar joint’s primary motions?

A

supination

pronation

171
Q

During supination/pronation of subtalar joint, what is the navicular and medial longitudinal arch doing?

A 
supination= elevation of navicular and medial long arch
pronation= depression of navicular and medial long arch
172
Q

Why is the subtalar motion so complex?

A

due to the concavity of posterior facet and

convexity of the anterior and middle facets

173
Q

How is the subtalar joint supported?

A

by MCL and LCL of the ankle

174
Q

What two ligaments support Sinus tarsi?

A

Cervical ligament

interosseous talo-calcaneal ligament

175
Q

Where do the cervical ligament and interosseous talo-calcaneal ligament attach to?

A

talus and calcaneous

176
Q

What shaped opening does the sinus tarsi ? and where?

A

a cone shaped opening/space in between the talus and calcaneus

177
Q

How is the cone shaped sinus tarsi oriented?

A

wider laterally

narrow medially

178
Q

What sits on the sinus tarsi?

A

ATFL

179
Q

Where is it a common site for edema in the LE? and why?

A

Sinus tari. bc fluid takes path of least resistance.

180
Q

What does the depression of the subtalar joint/sinus tarsi look like?

A

depression on the lateral side, and runs horizontally across the ankle

181
Q

Where does the transverse tarsal joint articulate (4)?

A

proximal of talus
posterior of calcaneus
distal of navicular
anterior of cuboid

182
Q

Transverse tarsal joint effects what motions of the foot?

A

supination

pronation

183
Q

Which joint is more limited in motion, Transverse tarsal joint or subtalar joint?

A

Transverse tarsal joint is less mobile

184
Q

What does the ray consist of?

A

phalanges, metatarsal, and cuneiforms or cuboid

185
Q

Which ray is least mobile?

A

2nd

186
Q

What is the midline of the feet aka axis of movement?

A

2nd ray

187
Q

What type of joint is MTP?

A

condyloid

188
Q

How many DOF and what are MTP?

A

2 DOF
abd/add
flexion/extension

189
Q

What type of joint is Interphalanges?

A

hinge joints

190
Q

How many DOF and what are IP?

A

1 DOF

flexion/extension

191
Q

What prevents excessive abduction of metatarsals?

A

Deep transverse metatarsal ligament

192
Q

What make up the 1st ray?

A

medial cuneiform
1st metatarsal
2 phalanges (one functional unit)

193
Q

What make up the 2nd ray?

A

middle cuneiform
2nd metatarsal
3 phalanges

194
Q

What make up the 3rd ray?

A

lateral cuneiform
3rd metatarsal
3 phalanges

195
Q

What make up the 4th ray?

A

Cuboid
4th metatarsal
3 phalanges

196
Q

What make up the 5th ray?

A

Cuboid
5th metatarsal
3 phalanges

197
Q

Where is the medial longitudinal arch located?

A

apex of navicular bone on medial aspect of the foot

198
Q

Where is the lateral longitudinal arch located?

A

smaller than medial long arch, on the lateral aspect of the foot

199
Q

What the arch that runs horizontally across the metatarsal heads?

A

transverse arch

200
Q

what ligament supports the medial longitudinal arch?

A

Calcaneo-navicular ligament (spring)

201
Q

What ligament goes from lateral aspect of the calaneous to the metatarsals?

A

long plantar ligament

202
Q

What ligament goes from calcaneous to the cuboid?

A

short plantar ligament

203
Q

What is the short plantar ligament aka?

A

Plantar calcaneo-cuboid ligament

204
Q

What ligaments support the lateral longitudinal arch?

A

short and long plantar ligament

205
Q

What is the thick connective tissue in the bottom of the feet?

A

plantar aponeurosis

206
Q

Where does the plantar aponeurosis attach to?

A

medial calcaneal tubercle of calcaneous
lateral calcaneal tubercle of calcaneous
metatarsal heads
proximal phalanges

207
Q

Which calcaneal tubercle on calcaneous has the most fibers of the plantar apeneurosis bound to it?

A

medial calcaneal tubercle of calcaneous

208
Q

Extending the feet digits will cause the plantar aponeurosis to do what??

A

stretch

209
Q

What ligament holds the plantar apeneurosis to the metatarsal heads?

A

superficial transverse metatarsal ligament

210
Q

What are the 3 groups of retinacula around the ankle?

A

extensor retinaculum
flexor retinaculum
fibular retinaculum

211
Q

What do each group of retinaculum around the ankle have?

A

a superior and inferior band for each retinaculum

212
Q

What is the attachment for extensor retinaculum and it’s function?

A

attached on the anterior aspect of the ankle

to bind the extensor tendons down to prevent bowstringing

213
Q

What is the attachment for flexor retinaculum and its function?

A

bands on the medial aspect of the ankle

to close off the tarsal tunnel

214
Q

What is the attachment for fibular retinaculum and its function?

A

bands on lateral aspect of the ankle

to close off fibular tunnel

Anatomy 4 (8 decks)

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