knee and leg Flashcards
largest synovial joint
hinge joint
articular surfaces of the knee
- two condyles of the femur = medial lateral
- two condyles of the tibia = medial lateral
- two meniscus = medial lateral
- patella
what are the five major ligaments that stabilize the knee
- patellar ligament
- tibial (medial) collateral ligament
- fibular (lateral) collateral ligament
- anterior cruciate ligament
- posterior cruciate ligament
ACL
attaches to facet on anterior part of intercondylar area of the tibia and ascends posteriorly to attach to a facet at the back of the lateral wall of the inter condylar fossa of the femur
PCL
attaches posterior aspect of intercondylar area of the tibia and ascends anteriorly to attach to the medial wall of the intercondylar fossa of femur
medial meniscus
attached around its margin to capsule of the joint and to tibial collateral ligament
lateral meniscus
- unattached to capusle
- more mobile
anastomotic network
- descending and genicular branches from the femoral
- popliteal
- lateral circumflex femoral arteries in the thigh
- circumflex fibular artery
- recurrent branches from the anterior tibial artery
all these vessels form an anastomotic netwrok around the joint
what nerves innervate the knee joint
- obturator
- femoral
- tibial
- common fibular
popliteal fossa
diamond shaped space behind the knee formed b/w muscles in the posterior compt of the thigh and leg
what are the margins and floor of the popliteal fossa made up of
- upper margins = formed medially by the distal ends of the semitendinosus and semimembranosus muscles and laterally by the distal end of the biceps femoris muscles
- lower margins = medially by the medial head of the gastrocneumius and laterally by plantaris and lateral head of gastrocnemius
- floor = capsule of knee joint
major contents of the popliteal from medial to lateral
- popliteal artery
- popliteal vein
- tibial and common fibular nerves
fibula and tibia
- fibula does not take part in the formation of the knee
- tibia is weight bearing one
muscles of the leg are orgnaized into three compartments
- posterior = plantarflex the foot and flex the toes
- lateral = muscles that evert the foot
- anterior = dorsiflex the foot and extend the toes
posterior compartment divided into and what are the muscles in each division
- superficial = gastronemuius, plantaris, soleus
- deep = popliteus, flexor hallucis longus, flexor digitorum longus, tibialis posterior
what are the muscles of the lateral compartment
- fibularis longus
- fibularis brevis
what are the muscles of the anterior compartmetn of the leg
- tibialis anterior
- extensor hallucis longus
- extensor digitorum longus
- fibularis tertius
arterial supply to the leg
femoral artery descends to become popliteal artery
- bifurcates into the anterior tibial artery and posterior tibial artery
(posterior tibial artery supplies to posterior and lateral compartment
superficial veins are
- great saphenous vein = originates from medial side of the dorsal arch then ascends up medial side of leg
- small saphenous vein =originates from lateral side of dorsal venous arch, ascends posterior then penetrates deep fascia to join the popliteal vein in posterior knee
sciatic nerve bifurcates into
- tibial nerve (posterior comp of leg)
- common fibular nerve (around neck of fibula)
superficial fibular- innervates lateral comp
deep fibular-innervates anterior compt of leg
clinical correlation
what is the modality of choice to assess meniscal tears, ligamentous tears, articular cartilage damage
MRI
collateral ligament injuries
- tibial collateral ligament
can be part of a so called unhappy triad invovles medial meniscus and anterior cruciate ligament
common fibular nerve injury
- injured through direct trauma (blow/laceration), or proximal fibular fracture
- footdrop = inability to dorsiflex
susceptible to injury as it passes lateral aspect of the neck of the fibula
