Knee Flashcards
Classify the tibiofemoral joint
Synovial, compound, complex, unmodified ovoid, 3 degrees of motion
What are the medial ligaments of the tibiofemoral joint
MCL - deep and superficial. Posterior oblique ligament (posterolateral support)
What structures provide lateral support to the tibiofemoral joint
LCL, ITB, arcuate ligament, popliteofibular ligament, fabellofibular ligament
How many degrees of motion does the superior tib-fib joint have?
3 DOM
Classify the superior tibiofibular joint
Synovial
Simple
Planar (though some variation)
What movements does the ACL restrain
Ant. tibial translation, external tibial rotation with knee flexion
Osteokinematics of the superior tib-fib joint (with knee flex/extn and ankle DF/PF during WB)
Knee flex - Anterior
Knee extn - Posterior
Ankle DF - anterolateral, superior, IR (variable)
Ankle PF - posteromedial, inferior, ER (variable)
What movements does the PCL restrain
Posterior tibial translation, external tibial rotation
Arthrokinematics
As for osteokinematics
Does the lateral meniscus attach the to LCL
No
Articular surfaces of TIBIA in superior tib-fib joint (location, direction, surface description)
Location: posterior, inferior, lateral from the lateral condyle of the tibia
Direction: posterior, inferior, lateral
Description: small, circular facet
Describe flexion and extension of the tibiofemoral joint osteokinematics
Impure swing around a transverse axis in a sagittal plane. Flex combines with IR, extension combines with ER.
Articular surfaces of FIBULA in superior tib-fib joint (location, direction, surface description)
Location: fibula head
Direction: medial, anterior, superior
Description: circular and planar (styloid process is posterior-lateral)
Describe IR/ER of the tibiofemoral joint osteokinematics
Impure spin in the transverse plane about a vertical axis.
Describe the joint capsule of the superior tib-fib joint (3)
- Hyaline cartilage
- Attaches to rims of fibular facets
- Reinforced by the anterior and posterior superior tib-fib ligaments
Name some of the knee flexor muscles
Semitendinosus, semimembranosus, gracilis, plantaris, gastocnemius, popliteus, TLF
Describe the neurology of the superior tib-fib joint
semental, contributions
Segmental - L4-S3
Contributions
- Common peroneal (passes over neck of fibula)
- Nerve to popliteus
What is the primary nerve innervating the knee flexors
Sciatic nerve
Vascular supply of superior tib-fib joint
Anterior tibial artery
ant/post tibial recurrent rami
Name some of the knee extensors
Rectus femoris, vastus lateralis, vastus intermedius, vastus medialis
Muscles attaching to the superior tib-fib joint (proximal, mid-shaft)
Proximal
- Biceps fem
- Peroneus longus
- Soleus
- EDL
- Tib post
Mid-shaft
- Peroneus brevis
- EHL
- FHL
What is the primary nerve innervating the knee extensors
Femoral nerve
Articular surface of the patella (type of bone, shape, pole)
Type of bone: Largest sesamoid
Shape:
- triangular (distally); curved (proximally)
- posterior articular surface is oval and smooth in proximal 2/3 - 3/4
Poles
- superior pole/base (proximal)
- inferior pole/apex (distal)
Name some of the knee bursae
Suprapatellar bursa, pes anserin bursa, deep infrapatellar bursa, superficial infrapatellar bursa
Describe the area between the apex and articular surface
Roughened
Attaches to infrapatellar fat pad
What is the articular surface for the patella
Trochlea groove
Describe the shape of the intercondylar notch
Shape
- concave medial-lateral
- convex superior-inferior (sagittal plane)
Patellofemoral joint capsule
Capsule extends from the medial and lateral tibial/femoral condyles and blends with vastus lateralis/medialis.
Attaches to patella and patella tendon
Patella tendon (origin/insertion, dimensions)
Inferior pole to tibial tuberosity
5-6cm long, 3cm wide
Where is the infrapatellar fat pad and what is it attached to?
Posterior to the patella tendon
Attached to the menisci and patella
Nerve supply to patellofemoral joint (articular, cutaneous)
Articular (as for tib-fem joint)
- L2-S3
- Obturator
- Femoral
- Tibial
- Common peroneal
Cutaneous
- Saphenous
- Obturator
- Lateral retinacular
- medial/lateral femoral cutaneous
Patellofemoral joint classification
Synovial
Compound
Modified sellar (operates functionally as triplanar arc or TRACKING during knee flex/extn)
Patellofemoral joint degrees of motion
1 DOM
Osteokinematics of patellofemoral joint
Knee flex - inferior glide
Knee extn - superior glide
- sagittal planes
Variable tracking (tilting - transverse/sagittal planes; rotating - frontal plane)
Arthrokinematics of patellofemoral joint (basic)
Inferior movement - inferior glide
Superior movement - superior glide
Describe the articular cartilage in the patellofemoral joint
Cartilage
- thickest in body
- surface is not a mirror image of underlying bone
- more permeable and pliable than other cartilage
