Knee

Question 1

What kind of joint is the knee?

Answer 1

Bicondylar type synovial joint

Question 2

What does the knee joint allow for?

Answer 2

Mainly flexion and extension

Small degree of medial and lateral rotation

Question 3

What is the knee joint formed by?

Answer 3

Articulations between the patella, femur and tibia

Question 4

What does the shape of the knee joint mean?

Answer 4

It’s relatively weak, and so relies on muscle and ligaments to ensure stability

Question 5

What does the knee joint consist of?

Answer 5

Two articulations, tibiofemoral and patellofemoral

Question 6

What is involved in the tibiofemoral articulation?

Answer 6

The medial and lateral condyles of the femur articulating with tibia

Question 7

What is involved in the patellofemoral articulation?

Answer 7

The anterior and distal part of the femur articulating with the patella

Question 8

What is the weight-bearing joint of the knee?

Answer 8

The tibiofemoral joint

Question 9

What does the patellofemoral joint allow?

Answer 9

The tendon of the quadriceps femoris (the main extensor of the knee) to be inserted directly over the knee, increasing the efficiency of the muscle

Question 10

What are both joint surfaces of the knee lined with?

Answer 10

Hyaline cartilage

Question 11

What are the joint surfaces of the knee enclosed within?

Answer 11

A single joint cavity

Question 12

Where is the patella formed?

Answer 12

Within the tendon of the quadriceps femoris

Question 13

What is the result of the presence of the patella?

Answer 13

It minimises wear and tear on the tendon

Question 14

What are the medial and lateral menisci?

Answer 14

Fibrocartilage structures in the knee

Question 15

What is the function of the medial and lateral menisci?

Answer 15

To deepen the articular surfaces of the tibia, thus increasing the stability of the joint
To act as shock absorbers

Question 16

What shape are the menisci?

Answer 16

C shaped

Question 17

Where are the menisci attached?

Answer 17

At both ends of the intercondylar area of the tibia

Question 18

What is the medial meniscus attached to?

Answer 18

The tibial collateral ligament and joint capsule

Question 19

What does any damage to the tibial collateral ligament result in?

Answer 19

Tearing of the medial meniscus

Question 20

Why is the lateral meniscus fairly mobile?

Answer 20

Because its smaller and does not have any extra attachments

Question 21

What is a bursa?

Answer 21

A synovial fluid filled sac

Question 22

Where are bursa found?

Answer 22

Between moving structures in a joint

Question 23

What is the aim of bursa?

Answer 23

To reduce wear and tear on moving structures

Question 24

What bursa are found in the knee joint?

Answer 24

Suprapatella bursa
Prepatella bursa
Infrapatella bursa
Semimembranosus bursa

Question 25

What is the suprapatella bursa?

Answer 25

An extension of the synovial cavity of the knee

Question 26

Where is the prepatella bursa found?

Answer 26

Between the apex of the patella and the skin

Question 27

What is the infrapatella bursa split into?

Answer 27

Deep and superficial

Question 28

Where does the deep infrapatella bursa lie?

Answer 28

Between the tibia and patella ligament

Question 29

Where does the superficial infrapatella bursa lie?

Answer 29

Between the patella ligament and the skin

Question 30

Where is the semimembranosus bursa located?

Answer 30

Posteriorly in the knee joint, between the semimembranosus muscle and the medial head of the gastrocnemius

Question 31

What are the major ligaments in the knee joint?

Answer 31

Patellar ligament Collateral ligaments  Cruciate ligaments

Question 32

What is the patellar ligament?

Answer 32

A continuation of the quadriceps femoris tendon distal to the patella

Question 33

What does the patellar ligament attach to?

Answer 33

The tibial tuberosity

Question 34

What are the collateral ligaments?

Answer 34

Two strap-like ligaments, the tibial (medial) collateral ligament and the fibular (lateral) collateral ligament

Question 35

What do the collateral ligaments act to do?

Answer 35

Stabilise the hinge motion of the knee, preventing any medial or lateral movement

Question 36

What shape is the tibial collateral ligament?

Answer 36

Wide and flat

Question 37

Where is the tibial collateral ligament found?

Answer 37

On the medial side of the joint

Question 38

Where does the tibial collateral ligament attach to proximally?

Answer 38

The medial epicondyle of the femur

Question 39

Where does the tibial collateral ligament attach to distally?

Answer 39

The medial surface of the tibia

Question 40

How does the fibular collateral ligament differ from the tibial?

Answer 40

It is thinner and rounder

Question 41

Where does the fibular collateral ligament attach to proximally?

Answer 41

The lateral epicondyle of the femur

Question 42

Where does the fibular collateral ligament attach distally?

Answer 42

To a depression on the lateral surface of the fibular head

Question 43

What do the cruciate ligaments do?

Answer 43

Connect the femur and the tibia, and in doing so cross each other

Question 44

What are the cruciate ligaments?

Answer 44

Anterior cruciate ligament | Posterior cruciate ligament

Question 45

What course does the anterior cruciate ligament take?

Answer 45

Attaches at the anterior intercondylar region of the tibia and ascends posteriorly to attach to the femur, in the intercondylar fossa

Question 46

What does the anterior cruciate ligament do?

Answer 46

Prevents anterior dislocation of the tibia onto the femur

Question 47

What course does the posterior cruciate ligament take?

Answer 47

Attaches at the posterior intercondylar region of the tibia, and ascends anteriorly to attach to the femur in the intercondylar fossa

Question 48

What does the posterior cruciate ligament do?

Answer 48

Prevents posterior dislocation of the tibia onto the femur

Question 49

What are the main movements that the knee joint permits?

Answer 49

Extension  Flexion  Lateral rotation  Medial rotation

Question 50

How is extension at the knee joint produced?

Answer 50

Quadriceps femoris

Question 51

Where does the quadriceps femoris insert that allows it to produce extension at the knee?

Answer 51

The tibial tuberosity

Question 52

What produces flexion at the knee?

Answer 52

Hamstrings, gracilis, sartorius and popliteus

Question 53

What produces lateral rotation at the knee?

Answer 53

Biceps femoris

Question 54

What produces medial rotation at the knee?

Answer 54

Semimembranosus, semitendinosus, gracilis, sartorius and popliteus

Question 55

What is the most common pathology affecting the knee joint?

Answer 55

Injury to the collateral ligaments

Question 56

What causes injury to the collateral ligaments?

Answer 56

A force being applied to the side of the knee when the foot is placed on the ground

Question 57

How can damage to the collateral ligaments be assessed?

Answer 57

By asking the patient to medially rotate and laterally rotate the leg

Question 58

What does pain on medial rotation of the leg indicate?

Answer 58

Damage to the medial collateral ligament

Question 59

What does pain on lateral rotation of the leg indicate?

Answer 59

Damage to the lateral ligament

Question 60

What is likely if the tibial collateral ligament is damaged?

Answer 60

That the medial meniscus is torn

Question 61

What can be anterior cruciate ligament be torn by?

Answer 61

Hyperextension of the knee joint  | Application of a large force to the back of the knee with the joint partly flexed

Question 62

How can you test for a town anterior cruciate ligament?

Answer 62

You can perform an anterior drawer test, where you attempt to pull the tibia forward

Question 63

What has happened if the you can pull the tibia forward?

Answer 63

The ligament has been torn

Question 64

What is the most common mechanism of posterior cruciate ligament damage?

Answer 64

The ‘dashboard injury’- when the knee is flexed and a large force is applied to the shins, pushing the tibia posteriorly

Question 65

How else can the posterior cruciate ligament be torn?

Answer 65

Hyperextension of the knee joint  | Damage to the upper part of the tibial tuberosity

Question 66

How is posterior cruciate ligament damage tested for?

Answer 66

The posterior draw test- hold the knee in flexed position, and push the shin posteriorly. If there is movement, the ligament has been torn

Question 67

What can friction between the skin and patella cause?

Answer 67

The prepatella bursa to become inflamed, producing a swelling on the anterior side of the knee, known as housemaids knee

Question 68

What can friction between the skin and tibia cause?

Answer 68

The infrapatella bursa to become inflamed, resulting in whats known as ‘clergyman’s knee’

Question 69

What can damage to the medial collateral ligament cause?

Answer 69

Damage to the medial meniscus, due to its attachment

Question 70

What can rupture the the medial collateral ligament?

Answer 70

A lateral force to the extended knee

Question 71

What happens when the medial collateral ligament is ruptured?

Answer 71

The medial meniscus and the ACL are damaged, producing an ‘unhappy triad'