Joints of the Leg Flashcards
synovial joint fo the tibiofibular joint is formed by
head of the fibula and the lateral condyle of the tibia
tibiofibular joint of the leg has — motion
limited
tibiofibular joint is covered by the tendon of
popliteus
tibiofibular joint ligaments are
- tibiofibular capsular ligament (articular capsule)
- anterior ligament
- posterior ligament
interosseous membrane of the leg attaches to
-the lateral (interosseous) border of the shaft of the tibia and the interosseous border of the fibula
interosseous membrane of the leg serves as origin for
some of the leg muscles and separates the anterior compartment of the leg from the deep posterior compartment
interosseous membrane of the leg has an aperture proximally for the
anterior tibial vessels and distally for the perforating vessels
what nerves course through the interosseous membrane
NO NERVES COURSE THROUGH THE INTEROSSEOUS MEMBRANE
tibiofibular syndesmosis is formed by
the fibular notch on the distal extremity of the tibia and the distal aspect of the shaft of the fibula
ligaments of the tibiofibular syndesmosis are
- anterior tibiofibular ligament
- posterior tibiofibular ligament
- interosseous tibiofibular ligaments
interosseous tibiofibular ligament attaches to
- the upper portion of the fibular notch and the shaft of the fibula
- continuos with the interosseous membrane superiorly
inferior transverse ligament attaches to
-the superior aspect of the malleolar fossa and the posterior surface of the distal extremity of the tibia
inferior transverse ligament contains
fibrocartilage where it comes into contact with the trochlea
what kind of joint is the knee joint
complicated hinge type of synovial joint
most hinge joints allow only what type of motion
flexion and extension but there is slight medial and lateral rotation in the knee joint (biaxial joint)
from the anatomical position there is – to – degree of flexion and – to – of hyperextension
130-150
5-10
the knee joint is anatomically formed by the
distal extremity of the femur articulating with the proximal extremity of the tibia, and the patella articulating with distal extremity of the femur
functionally what kind of joint is the knee
bicondylar joint btwn the condyles of the femur and tibia
what is the purpose of the menisci
- distribute the force of the femur over the condyles of the tibia
- increase the concavity of the tibial condyles but there is still a poor fit for the femoral condyles
the strength of the knee joint is derived from
ligaments and muscles that cross the joint
describe the “Screw Home Mechanism”
flexion and extension of the knee joint are accompanied by internal rotation of either the tibia (OKC) or the femur (CKC)
internal and external rotation is due to
- geometry of the articular surfaces
- ligamentous arrangement
- popliteus muscle
in CKC with knee extension there is
internal femoral rotation
in CKC the internal rotation associated with the later stages of extension to put the knee joint in a position of
maximum joint congruency and the ligaments are taught
does the screw home mechanism require a lot of muscle activity
no
in CKC with knee flexion there is
external femoral rotation (popliteus muscle)
fibrous component of the knee joint capsule is called
genu capsular ligament
genu capsular ligament attaches to
the margins of the articular surfaces of the femoral condyles, tibial condyles, and patealla
anteriorly the genu capsular ligament are strengthened by
quadriceps tendons, ligamentum patellae, medial patellar retinacula and lateral patellar retinacula
medially genu capsular ligament attaches to
the medial meniscus and blends with the tibial collateral ligament
laterally the genu capsular ligament attaches to the
lateral meniscus in one area and is separated from the fibular collateral ligament by the tendon of popliteus in antoerh area
laterally the genu capsular ligament extends above
the tendinous attachment of the popliteus muscle to the lateral condyle of the femur makings its tendon of origin/insertion intracapsular
posteriorly the genu capsular ligament is strengthened by
the oblique and arcuate popliteal ligaments
what is the purpose of the synovial membrane of the knee joint
- lines most of the fibrous capsule
- projects around the cruciate ligaments such that they are intracapsular but extrasynovial
superiorly the synovial cavity and the synovial membrane are continuous with
the suprapatellar bursa
inferiorly the synovial cavity of the knee joint is separated from
the ligamentum patella by the infrapatellar fat
synovial membrane of the knee joint project from the sides of the
infrapatellar fat pad as the alar folds
the alar folds joint posteriorly to form
the infrapatellar synovial fold (ligamentum mucosum)
the infrapatellar synovial fold attaches to the
intercondylar eminence of the tibia and the intercondylar notch of the femur
what type of ligament is ligamentum patellae
capsular ligament
ligamentum patellae is a continuation of
the quadriceps femoris tendons
ligamentum patellae attaches proximally to
the apex of the patella and distally to the tibial tuberosity
what type of ligament is the medial patellar retinaculum
capsular ligament
medial patellar retinaculum is an expansion of the tendon of
vastas medialis
medial patellar retinaculum attaches to the
tubercle on the anterior aspect of the medial condyle of the tibia
what type of ligament is the lateral patellar retinaculum
capsular ligament
lateral patellar retinaculum is an expansion of the
tendon of vastus lateralis
lateral patellar retinaculum attaches to
the tubercle on the anterior aspect of the lateral condyle of the tibia (Gerdy’s tubercle)
what type of ligament is the oblique popliteal ligament
capsular ligament
oblique popliteal ligament is an expansion from
the tendon of semimembranosus
oblique popliteal ligament attaches distally to the
posterior aspect of the medial condyle of the tibia
oblique popliteal ligament attaches proximally to the
intercondylar line and posterior aspect of the lateral condyle of the femur
oblique popliteal ligament forms part of the
floor of the popliteal fossa
oblique popliteal ligament has numerous apertures for
vessels and nerves to the knee joint
what type of ligament is the arcuate popliteal ligament
capsular ligament shaped like a Y
the stem of the Y of the arcuate popliteal ligament attaches distally to
the styloid process on the head of the fibula
stem of the arcuate ligament divides into
- a posterior limbe that courses over the tendon of popliteus and attaches to the intercondylar line
- an anterior limb that attaches to the lateral condyle of the femur
what type of ligament is the tibial collateral lig
capsular
tibial collateral ligament attaches proximally to the
- the medial epicondyle of the femur, and distally to the medial condyle and medial surface of the shaft of the tibia
- attaches to the medial meniscus
what type of ligament is the fibuarl collateral lig
cord like extracapsular ligament
fibular collateral ligament attaches proximally to
the lateral epicondyle of the femur
fibular collateral ligament attaches distally to the
lateral side of the head of the fibula
fibular collateral ligament is separated from the lateral meniscus by
the tendon of popliteus
what type of ligament are the cruciate ligaments
very strong intracapsular ligaments
are cruciate ligaments intrasynovial and extrasynovial
extransynovial, the synovial membrane projects around them
anterior cruciate ligament (ACL or external cruciate) attaches distally to
the anterior intercondylar fossa and the anterior horn of the lateral meniscus
the anterior cruciate ligament courses
superiorly, posteriorly and laterally
anterior cruciate ligament attaches proximally to
the medial surface of the lateral condyle of the femur
posterior cruciate ligament (PCL or internal cruciate ligament) is — and — compared to the anterior cruciate ligament
stronger
shorter
PCL attaches distally to
the posterior intercondylar fossa and the posterior horn of the lateral meniscus
PCL attaches proximally to the lateral surface of
the medial condyle of the femur
posterior meniscofemoral ligament is also known as
ligament of Wrisberg
what type of ligament is posterior meniscofemoral ligament
intracapsular ligament by extrasynovial
posterior meniscofemoral ligament attaches distally to the
posterior horn of the lateral meniscus
posterior meniscofemoral ligament attaches proximally to the
lateral surface of the medial condyle of the femur
transverse genicular/intermeniscal ligament connects
the anterior convex borders of the medial and lateral mensici
what type of ligament is the transverse genicular ligament
intracapsular and intrasynovial
coronary ligaments are a portion of the
articular capsule (capsular ligaments) that connects the menisci to the tibial condyles
what shape are menisci
crescent-shaped articular fibrocartilage
what is the function of menisci
serve to help the fit of femoral condyles on the tibial condyles and to distribute the force of the femoral condyles over the tibial plateau
are the peripheral borders of the menisci thick or thin
thick
the peripheral border of the menisci attach to —- by —-
tibial condyles by coronary ligaments
are the inner border of the menisci thick of thin
thin and free
menisci cover —of each condyle
~2/3
what type of ligament are menisci
intracapsular and intrasynovial
what is the shape of the medial meniscus
semicircular in shape
anterior horn of medial meniscus attaches to the
anterior intercondylar fossa in front of the anterior cruciate ligament
posterior horn of the medial meniscus attaches to the
posterior intercondylar fossa btwn the attachments of the lateral meniscus and posterior cruciate lig
medially the medial meniscus is attached to the
capsule and tibial collateral ligament
what is the shape of the lateral meniscus
circular in shape
anterior horn of the lateral meniscus attaches to
the anterior interoncdylar fossa lateral and posterior to the anterior cruciate ligament attachment
posterior horn of the lateral meniscus attaches to
the posterior intercondylar fossa, anterior to the medial meniscus attachment
laterally the lateral meniscus is attached to the capsule but separated from
the fibular collateral ligament
one of the most common knee injuries is a blow to the
lateral side of the knee, or a twisting motion which disrupts the medial side
structures affected on the medial side of the knee would be
- medial aspect of the joint capsule and medial meniscus
- tibial collateral ligament
- anterior cruciate ligament
injury to the medial aspect of the joint capsule and medial mensicus may result in
- synovial fluid (water) on the knee and/or a torn medial meniscus (may be a bucket handle tear)
- tapping the knee to remove fluid, and partial or complete meniscetomy
injury to the tibial collateral ligament may result in
- strained partially torn or completely torn
- surgery may be required to repair or reconstruct the lig
- test knee motion in the flexed position
injury to the anterior cruciate ligament may result in
- strained, partially torn or completely torn
- anterior drawer sign (also positive Lachman Test) if anterior cruciate ligament involved
- surgery may be required to repair or reconstruct the lig
what is an “unhappy triad”
injury involved all 3:
- medial aspect of the joint capsule and medial meniscus
- tibial collateral lig
- anterior cruciate lig
genu varum
the distal end of the tibia is bent inward and the knee joint isbent outward (bowleg)
genu valgum
distal end of the tibia is bent outward and the knee joint is bent inward (knock-knee)
meniscal tears include
- peripheral tear
- bucket-handle tear
- longituinal or flap tear of the anterior horn
- radial tear of the posterior horn
what are the purpose of bursae around the knee joint
-reduce the friction of tendons exerting their action lengthwise across the joint (parallel to the plane of motion)
name the communicating bursa
- Suprapatellar bursa
- Popliteus bursa
- Gastrocnemius bursa
- Semimembranosus bursa
name the separate bursae
- Prepatellar bursa
- Superficial infrapatellar bursa
- Deep infrapatellar bursa
- Anserine bursa
what is popliteal or Baker’s cyst?
a fluid-filled herniation of the synovial membrane of the knee joint, or a distention of the gastrocnemius bursa (or semimembranosus bursa)
what is prepatellar bursitis or housemaids knee?
inflammation of the prepatellar bursa