Knee Flashcards
Does the proximal part of the tibia have condyles?
Yes! It has medial and lateral condyles
What is the name of the structure between the medial and lateral superior articular surfaces of the tibia?
Intercondylar eminence
What is another word for the intercondylar eminence?
Tibial spine
Name the 2 ligaments that attach to the patella
Quadriceps femoris
Patella ligament
Is the soleal line on the anterior or posterior surface of the tibia?
Posterior surface of tibia
Is the soleal line on the anterior or posterior surface of the tibia?
Posterior surface of tibia
Which is the largest sesamoid bone in the body?
Patella
Are the articular surfaces of the tibia and femur congruent?
No, they are not, they attach better with their respective ligaments
Why type of synovial joint is the knee joint?
Bicondylar synovial joint
What 4 factors of the knee joint affect its stability
Menisci
Membranes
Ligaments
Muscle sand tendons
How many menisci are there?
2
Name the 2 menisci of the knee
Lateral meniscus
Medial meniscus
What is infra patellar fat?
Fat located underneath the patellar ligament
What is infra patellar fat?
Fat located underneath the patellar ligament
What is the function of the menisci?
They improve the fit of the tibia and femur
Which meniscus is more tightly attached to tissues, the lateral or medial?
The medial meniscus is more tightly attached to tissues than the lateral meniscus
How can menisci be torn?
By excessive rotation to a flexed knee
Which meniscus tears more frequently?
The medial meniscus
What indicates a torn meniscus?
Pain on either medial or lateral rotation of the knee, respectively
What indicates a torn meniscus?
Pain on either medial or lateral rotation of the knee, respectively
The cruciate ligaments are ____ articular but _____ synovial
Intra
Extra
Which ligament of the knee is not included within the synovial membrane?
Cruciate ligaments
How many bursae are found in the knee joint?
4
Name the 4 bursae in the knee
Suprapatella bursa
Prepatellar bursa
Infrapatellar bursae
Semimembranosus bursa
Describe the location of the suprapatella bursa
Between the quadriceps femoris tendon and the femur
Describe the location of the prepatella bursa
Between the skin and the top of the patella
Describe the location of the infra patella bursae
Deep - between patella ligament and tibia
Superficial - between skin and patella ligament
Describe the location of the semimembranosus bursa
Posterior between the semimembranosus and the medial head of gastrocnemius
What is the condition called when there is inflammation of the infrapatellar bursa?
Clergyman’s knee (infra patellar bursitis)
What is the condition called when there is inflammation of the prepatellar bursa?
Housemaid’s knee (prepatellar bursitis)
What is the main cause of inflammation of the bursa in the knee?
Too much mechanical stress
Name the 2 main ligaments outside the knee joint
Lateral collateral ligament (fibular)
Medial collateral ligament (tibial)
What are the attachment sites of the lateral collateral ligament (fibular)?
Lateral epicondyle, to the depression on the lateral surface of fibular head
What are the attachment sites of the medial collateral ligament (tibial)?
Medial epicondyle of femur, to the medial surface of tibia
What is the main function of the collateral ligaments?
To stabilise the hinge motion and prevent medial or lateral movement of the knee
What is the attachments of the anterior cruciate ligament?
Anterior intercondylar region of tibia, ascends posteriorly to the femur in the intercondylar fossa
What type of dislocation does the anterior cruciate ligament prevent?
Prevents anterior dislocation of tibia onto femur
What are the attachments of the posterior cruciate ligament?
Posterior intercondylar region of tibia, ascends anteriorly to the femur in the intercondylar fossa
What type of dislocation does the posterior cruciate ligament prevent?
Prevents posterior dislocation of tibia onto femur
The anterior cruciate ligament limits _________
Extension
The posterior cruciate ligament prevents _______
Flexion
Which cruciate ligament is the main stabiliser of a weight bearing knee?
Posterior cruciate ligament
Which cruciate ligament is the main stabiliser of a weight bearing knee?
Posterior cruciate ligament
Which ligament of the knee is not attached to the underlying fibrous membrane?
Lateral (fibular) collateral ligament
Name a test used on patients to check the cruciate ligaments
Drawer tests
Outline the drawer test
Patient lies supine with flexed knees, and pulling and pushing on the leg helps to see if there is displacement of the femur anteriorly or posteriorly.
Movement around knee is greater than normal as the body weight is not directly resisting movement.
Outline the drawer test
Patient lies supine with flexed knees, and pulling and pushing on the leg helps to see if there is displacement of the femur anteriorly or posteriorly.
Movement around knee is greater than normal as the body weight is not directly resisting movement.
Name the tendons that “wraps” around the posterior side of knee joint
Oblique popliteal ligament
Which 3 muscles have tendons that attach to pes anserinus?
Semitendinosus
Gracilis
Sartorius
What is the attachment site of pet anserinus?
Anteromedial aspect of the tibia
What is the origin of the medial part of gastrocnemius?
Medial condyle of femur
What is the origin of the lateral part of gastrocnemius?
Lateral condyle of femur
Where does the tendon of gastrocnemius insert?
Calcaneus
Name the muscles involved in extension of the knee
Quadriceps femoris (inserts on tibial tuberosity)
Name the muscles involved in flexion of the knee
Biceps femoris, semimembranosus, semitendinosus, gracilis, sartorius, popliteus
Name the muscle involved with lateral rotation of the knee
Biceps femoris
Name the muscles involved in medial rotation of the knee
Semimembranosus, semitendinosus, gracilis, sartorius, popliteus
Can lateral and medial rotation at knee joint occur if knee is not flexed?
NO! If the knee is not flexed rotation occurs at the hip joint
What is the origin of popliteus?
Lateral femoral condyle
What is the insertion of popliteus?
Posterior surface of tibia
What innervates popliteus?
Tibial nerve (L4-S1)
What is the action of the popliteus?
Stabilises knee joint by resisting lateral rotation of tibia.
Unlocks the knee joint by laterally rotating femur on a fixed tibia.
List the 3 steps in ‘locking the knee’
1) Cruciate ligaments tighten
2) Causes medial and lateral collateral ligaments and popliteal ligaments to tighten
3) Tensor fasciae latae and gluteus maximus tighten the iliotibial tract
List the 2 steps in ‘unlocking the knee’
1) Popliteus laterally rotates femur on the fixed tibia
2) The previously locked ligaments can then loosen and hamstrings then flex the knee
Why is ‘locking the knee’ desirable?
It shifts the centre of gravity in front of the knee so muscle energy does not have to be used to maintain posture
Why is ‘locking the knee’ desirable?
It shifts the centre of gravity in front of the knee so muscle energy does not have to be used to maintain posture
In what kind of injury is torn PCL most often seen?
Dashboard injury in car accidents, large force on shins pushes tibia posteriorly
Name the 3 injuries part of the ‘unhappy triad’
Torn ACL
Torn MCL
Torn medial meniscus
What does the lateral facet of the patella articulate with?
Lateral condyle of femur
What does the medial facet of patella articulate with?
Medial condyle of femur
Does apex of patella face interiorly or superiorly?
Apex of patella faces inferiorly
Name the 2 most common injuries to the patella
Patella dislocation
Patellar fracture
What is the importance of the popliteal fossa?
It is the main path in which structures move from the thigh to the leg
What shape is the popliteal fossa?
Diamond shaped
What is the superomedial border of the popliteal fossa?
Semimembranosus and semitendinosus
What is the superolateral border of the popliteal fossa?
Biceps femoris
What is the inferomedial border of the popliteal fossa?
Medial head of gastrocnemius
What is the inferolateral border of the popliteal fossa?
Lateral head of gastrocnemius and plantaris
What is the floor of the popliteal fossa?
Posterior surface of the knee joint capsule and posterior surface of femur
What is the roof of the popliteal fossa?
Popliteal fascia (from fascia lata) and skin
List the contents of the popliteal fossa
Popliteal artery
Popliteal vein
Sciatic nerve (tibial and common fibular divisions)
Genicular branches
Lymph
Fat
Medial and lateral sural cutaneous branches
Name the 2 structures found on the roof of the popliteal fossa
Small saphenous vein
Posterior cutaneous nerve of thigh
The popliteal artery is ____ to both the popliteal vein and tibial nerve
Deep
What is the anastomoses around the knee called?
Genicular anastomoses
Name the 11 main arterial branches in the genicular anastomosis
Lateral circumflex femoral artery
Popliteal artery
Descending genicular artery
Superior medial genicular artery
Superior lateral genicular artery
Inferior medial genicular artery
Inferior lateral genicular artery
Circumflex fibular artery
Recurrent branch of anterior tibial
Anterior tibial artery
Posterior tibial artery
What arteries join to the descending genicular artery?
Superior medial genicular artery
Inferior medial genicular artery
What arteries join the the superior medial genicular artery?
Superior lateral genicular artery
Descending genicular artery
Popliteal
What arteries join to the superior lateral genicular artery?
Lateral circumflex femoral artery
Inferior lateral genicular artery
Superior medial genicular artery
Popliteal
What arteries join to the inferior lateral genicular artery?
Circumflex fibular branch
Superior lateral genicular artery
Superior medial genicular artery
Popliteal
What arteries joint to the recurrent branch of anterior tibial artery?
Inferior medial genicular artery
Circumflex fibular branch
What arteries join to the inferior medial genicular artery
Descending genicular branch
Superior medial genicular artery
Inferior lateral genicular artery
Recurrent branch of anterior tibial
What arteries join to the anterior tibial artery?
Recurrent branch of anterior tibial
Popliteal
What dies the popliteal artery become after the anterior tibial artery branches off?
Posterior tibial artery
