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MSK > Knee Anatomy > Flashcards

Knee Anatomy Flashcards

1
Q

What happens to the Linea Aspera in distal femur

A

Medially-> Medial Supracondylar Line-> Ends at Adductor Tubercle
Laterally-> Lateral Supracondylar line-> Ends at Lateral Femoral Condyle

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2
Q

Which femoral condyle is more pronounced, why is this
Which is larger
What is the trochlear (Patellofemoral) groove

A

More pronounced- Lateral Femoral Condyle (Prevents lateral displacement of patella)
Larger- Medial Femoral Condyle

A depression on anterior surface, between the femoral condyles, that articulates between the patella

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3
Q

Identify 3 functions of the patella

A
  1. Acts as a fulcrum, enhancing the leverage exerted on the femur by the quadriceps tendon
  2. Protection of anterior knee
  3. Reduces frictional force between Quad. Tendon and femoral condyles during extension
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4
Q

What is attached at the Lateral/ Interosseus border

What is its function

A

Interosseus membrane binds tibia and fibula together

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5
Q

What is the main function of the fibula?

What are its 3 main articulations

A

Act as an attachment for muscles

Proximal tibiofibular joint: With lateral tibial condyle
Distal tibiofibular joint: With Fibular notch of tibia
Ankle joint: With talus bone of foot

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6
Q

Why is the common Fibular nerve at risk of damage during a Proximal Fibular Fracture

Is the lateral or medial malleosus more prominent

A

The nerve winds around the posterior and lateral surface of the neck

Lateral

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7
Q

What are the 2 articulations in the knee joint

A

Tibiofemoral: Medial and lateral condyles of tibia and femur articulate

Patellofemoral: Patella articulates with femur at the trochlear groove

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8
Q

What supplies the blood to the knee joint

What branches are these supplied by

A

Knee joint supplied by genicular anastomoses, which are supplied by genicular branches of the femoral and popliteal arteries

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9
Q

Identify 2 functions of the medial and lateral meniscus

Where is the blood supply to the menisci, how does this change with age and affect the healing when in adulthood

A

Deepen the Articular surface of tibia, increasing joint stability

Act as shock absorbers by increasing surface area

Blood flow is to meniscus periphery, decreases with age, so impaired healing in adulthood as it is avascular

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10
Q

Why is the medial meniscus more commonly injured than the lateral meniscus

What is the Posterior Meniscofemoral Ligament attached to, what is its function

A

Attached peripherally to the Medial Collateral Ligament, so is less mobile

It attaches the lateral meniscus to the Posterior surface of the Medial Femoral Condyle, to stabilise the posterior horn of the Lateral Meniscus

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11
Q

What are the 3 categories of ligaments in kne joint

A

Intracapsular: Cruciate ligaments

Extracapsular: Collateral + Patellar ligaments

Ligaments that strengthen the capsule: Oblique Popliteal

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12
Q

Describe the attachments of the Anterior Cruciate Ligament

What is its 2 functions

A

ACL: From Medical Meniscus AND Anterior Interchondylar Area of Tibia to Posterior of Lateral Femoral Condyle

Resists anterior dislocation of the tibia relative to femur
Resists medial rotation of the tibia relative to the femur

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13
Q

Describe the attachments of the Posterior Cruciate Ligament

What is its function

A

PCL: Posterior Interchondylar Area of Tibia to Medial Femoral Condyle

Resists posterior dislocation of tibia

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14
Q

Describe the attachments of the Oblique Popliteal Ligament

What muscle is it a continuation of

Where does the patellar ligament insert

A

Medial Tibial Condyle to Lateral Femoral Condyle
Semimembranosus

Tibial Tuberosity

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15
Q

Describe the attachments of the Medial (Tibial) Collateral Ligament

What is its function

A

Medial Femoral Epicondyle to Medial Tibial Condyle + Medial Meniscus

Resists valgus angulation of tibia, relative to femur

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16
Q

Describe the attachments of the Lateral (Fibular) Collateral Ligament

What is its function

A

Lateral Femoral Epicondyle to a Depression on The Lateral Surface of the Fibula Head

Reinforced by IT tract

Resists varus angulation of tibia, relative to femur

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17
Q

What is the purpose of a bursa

A

To reduce friction between bones and soft tissue (Muscles/ tendons) surrounding it

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18
Q

Name the 6 Bursae found at knee joint and their locations

A

Suprapatellar Bursa: Between Quadriceps Femoris and Femur

Prepatellar Bursa: Between patella and skin

Subcutaneous Infrapatellar Bursa: Between Patellar ligament and skin

Deep Infrapatelar Bursa: Between tibia and patellar ligament

Semimembranosus Bursa: Between Semimembranosus muscle and medial head of gastrocnemius (behind knee joint)

Subsartorial Bursa: Between medial tibial condyle and common insertion of pes anserinus tendons

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19
Q

Name 2 factors that resist lateral patellar displacement during knee extension

A
  • trochlear groove, which has more prominent lateral femoral condyle
  • Contraction of VMO fibres (Insert more distally and horizontally into patella than Vastus Lateralis)

VMO= Vastus Medialis Obliquus

20
Q

Name the muscles in anterior compartment of the thigh (Knee extensors)

The branches of which artery supply this compartment? What are the branches called

A

Quadriceps Femoris
Iliopsoas (Iliacus + Psoas Major)
Pectineus
Sartorius

Profounda Femoris + Medial, Lateral Femoral Circumflex Arteries are branches of the Femoral Artery

21
Q

Describe the origin and insertion of Iliopsoas

A

Psoas Major Origin: Transverse processes of T12-L5
Iliacus Origin: Iliac fossa

Iliopsoas Insertion: Lesser Trochanter

22
Q

Identify the action of Iliopsoas, and its innervations

A

Action: Hip Flexion + Lateral rotation

Iliacus innervation: L1-L3
Psoas Major innovation: Femoral nerve

23
Q

What are the muscles in Quadriceps Femoris

Describe their insertion and innervation

A

Rectus Femoris
Vastus Medialis/ Lateralis/ Intermedius

The 4 combine and insert onto patella base as the Quadriceps Tendon.

All innervated by femoral nerve

24
Q

Identify the origin of Vastus Lateralis

What is its action

A

Greater trochanter and lateral lip of linea aspera

Extends knee joint and stabilises knee joint

25
Q

Identify the origin of Vastus Intermedius

What is its action

A

Anterior and lateral surfaces of femoral shaft

Extends knee joint and stabilises patella

26
Q

Identify the origin of Vastus Medialis

What is its action

A

Intertrochanteric line and medial lip of linea aspera
Extends knee joint + Stabilises patella

(VMO fibre contraction resists lateral patella displacement)

27
Q

Identify the origin of Rectus Femoris

What is its action

A

Originates as 2 tendons
Anterior tendon origin: Anterior inferior iliac spine
Posterior tendon origin: Groove above acetabulum rim

Knee extension + hip Flexion (Only quad muscle to cross both hip and knee joints)

28
Q

Where does Sartorius originate and insert

What is its action

A

Origin: Anterior superior iliac spine
Insertion: Medial aspect of proximal tibia (part of pes anserinus)

Flexion, abduction and lateral rotation at hip joint
Flexion and medial rotation at knee joint

29
Q

Where does Pectineus originate and insert
What is its action

What is its innervation

A

Origin: Pectineal line on anterior surface of superior pubic ramus
Insertion: Pectineal line on femur

Adduction and Flexion at hip joint

Innervation: Femoral nerve, may receive branch from Obturator

30
Q

Name the muscles in the medial thigh compartment (Adductors)

What nerve innervates, what artery supplies blood

A

Gracilis
Obturator externus
Adductor Brevis/ Longus/ Magnus

Obturator nerve and Obturator artery

31
Q

What are the 2 components of adductor Magnus
State their origins and insertions

What is the adductor hiatus

A

Hamstring;

Origin: Ischial Tuberosity
Insertion: Adductor Tubercle and Medial Supracondylar Line

Adductor;

Origin: Inferior pubic ramus and Ischium
Insertion: Linea Aspera

A gap that separates the 2 components of Adductor Magnus

32
Q

What are the actions of the components of Adductor Magnus

Identify their innervations

A

Hamstring: Adduction, Hip extension
Adductor: Adduction, Hip Flexion

Hamstring: Tibial nerve
Adductor: Obturator nerve

33
Q

State the origin and insertion of adductor longus

A

Origin: Pubic body
Insertion: Middle third of linea aspera

Action: Adduction

34
Q

State the origin and insertion of adductor Brevis

State it’s action

A

Origin: Pubic body and inferior pubic ramus
Insertion: Linea aspera, proximal to adductor longus

Action: Adduction

35
Q

State the origin and insertion of Gracilis

State it’s action

A

Origin: Pubic body and inferior pubic ramus
Insertion: Medial aspect of proximal tibia, (between tendons of sartorius and semitendinosus as part of Pes Anserinus)

Action: Adduction and knee Flexion

36
Q

State the origin and insertion of Obturator Externus

State it’s action

A

Origin: External surface of Obturator membrane
Insertion: Posterior greater trochanter

Action: Adduction and lateral rotation

37
Q

What are the 3 borders of the Femoral Triangle and what are they formed by

A

Superior border: Formed by inguinal ligament (ASIS to Pubic Tuberosity)

Lateral Border: Medial border of sartorius muscle

Medial Border: Adductor Longus

38
Q

What compose the femoral triangle’s roof and base

Which lies anteriorly

A

Roof: Formed by fascia lata (Lies anteriorly)
Base: Formed by Pectineus, Adductor Longus, Iliopsoas

39
Q

Name 4 contents of the Femoral Triangle from lateral to medial

A

NAVEL

Femoral nerve
Femoral artery 
Femoral vein 
Empty space 
Lymphatics

Last 2 are both in canal

40
Q

What structures are in the Femoral Sheath

A

Artery
Vein
Canal

41
Q

How can you locate the artery in the femoral triangle

What is the Mid-point of the Inguinal Ligament

A

Use MIPA: Mid-Inguinal Point= Artery

Mid-Inguinal Point is midway between ASIS and Pubis Symphisis

Midpoint between ASIS and Pubic Tuberosity

42
Q

What are the 4 borders of the femoral canal

A

Medial border: Lacunar ligament
Lateral border: femoral vein
Anterior border: inguinal ligament
Posterior border: Pectineal ligament and superior pubic ramus

43
Q

What is the femoral ring
What is its closed by
What is the purpose of empty space in the femoral canal

A

The opening to the femoral canal at superior border
Closed by a CT layer- Femoral Septum

Empty space allows distension of femoral vein

44
Q

What is the adductor canal

What are the borders of the canal

A

A passageway from apex of femoral triangle to adductor hiatus

Anterior: Sartorius
Lateral: Vastus Medialis
Posterior: Adductor longus and Magnus

45
Q

What do you call the femoral artery/ vein as it passes through the adductor canal

A

Popliteal

46
Q

Outline the femoral nerve pathway to thigh

A
  1. Descends from lumbar plexus, passes through Psoas Major and exits the muscle through lateral border
  2. Passes behind fascia iliaca to the Mid-Point of the Inguinal Ligament
  3. Passes behind the inguinal ligament into thigh, splits into anterior and posterior
47
Q

After entering thigh, outline how the femoral nerve innervates the anteriomedial thigh and leg/ foot

A
  1. Passes through femoral triangle splits into Saphenous nerve (Terminal Cutaneous branch) and Anterior cutaneous branch
  2. Anterior branches supply the anteriomedial thigh
  3. Saphenous nerve goes through adductor canal to supply medial leg and foot

MSK (21 decks)

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