Joints of Lower Limb

Question 1

What covers opposing bony surfaces in synovial joints?

Answer 1

Hyaline (articular) cartilage

Question 2

What surrounds synovial joints?

Answer 2

A fibrous capsule

Question 3

Give the movements of the hip and the range of motion (in degrees) for each movement

Answer 3

Flexion (120), Extension (15), Abduction (45), Adduction (45), Medial/Internal Rotation (30), Lateral/External Rotation (50), Circumduction

Question 4

What are the intra-articular ligaments of the hip and what does each do?

Answer 4

Ligamentum teres (ligament of femur head, transmits branch of obturator artery), Transverse Acetabular Ligament (bridges acetabular notch)

Question 5

The round ligament of the femur head (ligamentum teres) connects what two structures?

Answer 5

Femur head to acetabular notch

Question 6

What ligament can still support you briefly even with little muscle involvement (e.g. in lower limb paralysis)?

Answer 6

The iliofemoral ligament

Question 7

List the extra-articular ligaments of the hip joint

Answer 7

Iliofemoral (inverted Y) ligament, Pubofemoral ligament, Ischiofemoral ligament

Question 8

What does the iliofemoral ligament do and what shape is it?

Answer 8

Limits hip extension, lateral rotation, and keeps you upright. It is inverted Y shaped

Question 9

What does the pubofemoral ligament do?

Answer 9

Limits extension and abduction

Question 10

What does the ischofemoral ligament do?

Answer 10

Limits hip extension and medial rotation

Question 11

What are the components of the FABER test and what does it test for?

Answer 11

Flexion, ABduction, External Rotation. It tests for a tight hip joint capsule

Question 12

Where are the trochanteric bursae located and what do they do?

Answer 12

Between IT band and greater trochanter. They reduce friction in the hip joint

Question 13

What might cause trochanteric bursitis?

Answer 13

A shortened IT band (increases friction in the hip joint, overworking the trochanteric bursae)

Question 14

What test is done to look for a shortened IT band and briefly describe it

Answer 14

The Ober test. Lying on side with the leg in question behind you, it is attempted to lower the leg below the table. If you cannot lower it below the plane of the table, you have a shortened IT band

Question 15

Where is the knee joint capsule deficient and why?

Answer 15

Posteriorly to allow for passage of the popliteus tendon

Question 16

Give the motions of the knee joint and the range of motion (in degrees) for each

Answer 16

Flexion (130), Extension (0-15), Medial rotation (20-30), Lateral rotation (30-40)

Question 17

Are the cruciate ligaments intra or extra -capsular? Are the intra or extra -synovial?

Answer 17

Intracapsular but extrasynovial

Question 18

What does the ACL do?

Answer 18

Limits extension of the knee, limits anterior tibial translation, limits medial rotation of the knee

Question 19

What test is used to check the integrity of the ACL?

Answer 19

The Lachman test

Question 20

Which is stronger and thicker, the ACL or the PCL?

Answer 20

The PCL is 50 percent stronger and thicker than the ACL

Question 21

If the tibia drops when you sit with your knee up, this is a sign of deficiency in what structure?

Answer 21

The PCL

Question 22

What are the menisci comprised of and what is their function?

Answer 22

They are fibrocartilagenous discs. They 1) Increase contact area and stability, 2) Absorb shock, 3) Aid in joint lubrication

Question 23

Which parts of the menisci have blood supply, what is the blood supply there, and how does the rest get nutritional supply?

Answer 23

Outer third supplied by genicular arteries, inner two thirds gets nutrition from synovial fluid (wont heal if torn, consider menistectomy if torn)

Question 24

What attaches the menisci anteriorly?

Answer 24

The transverse ligament of the knee

Question 25

What attaches the menisci to the capsule?

Answer 25

Coronary ligament and the anterior/posterior horns

Question 26

What test is used to check for injury of the meniscus?

Answer 26

The McMurray test

Question 27

Is the popliteus muscle superficial or deep to the arcuate ligament?

Answer 27

Deep to the arcuate ligament

Question 28

What is the unhappy triad and why are they called this?

Answer 28

The tibial collateral ligament (MCL), the medial meniscus, and the anterior cruciate ligament (ACL). They are commonly injured together

Question 29

What is contained within bursae?

Answer 29

Synovial fluid

Question 30

List the three major bursae within the knee

Answer 30

Suprapatellar bursa (communicates with knee capsule), Pre-patellar bursa (Housemaids syndrome), Infrapatellar bursa (superficial and deep). There are also many others

Question 31

What type of bone is the patella?

Answer 31

A sesamoid bone

Question 32

What is the primary function of the patella?

Answer 32

To increase the mechanical advantage of the quadriceps femoris muscles during knee extension

Question 33

What bones participate in the ankle joint?

Answer 33

Talus, fibula, tibia

Question 34

Which movement of the foot is more stable and why, dorsiflexion or plantarflexion?

Answer 34

Dorsiflexion, because the talus is wider anteriorly

Question 35

Movements of the ankle joint and range of motion (in degrees) of each

Answer 35

Dorsiflexion (12-15), Plantarflexion (55), some rotation when plantarflexed

Question 36

Most injuries of the ankle are the result of what type of movement and injure what structure?

Answer 36

Forced inversion/plantarflexion, cause injury to anterior talofibular ligament

Question 37

Which is stronger, the medial collateral ligament (of the ankle) or the lateral collateral ligament (of the ankle)?

Answer 37

Medial collateral ligament