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Functional and Clinical Anatomy of the Limbs > Knee Joint > Flashcards

Knee Joint Flashcards

1
Q

What are the features of the proximal end of the femur?

A
  1. Head
  2. Neck
  3. Greater trochanter
  4. Lesser trochanter
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2
Q

What is the function of the femur.

A

Transmission of weight from the ilium to upper end of the tibia

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3
Q

Articular cartilage covers the head of the femur except for what area?

A

Fovea capitis

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4
Q

What is the function of the fovea capitis?

A

Provides attachment for the ligament of the head of the femur.

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5
Q

What is the angle of the neck of the femur to the shaft of the femur?

A

125 degrees (varies slightly with age and sex)

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6
Q

Where does the anterior surface of the neck join the join the shaft?

A

Intertrochanteric crest

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7
Q

What marks the centre of the intertrochanteric crest?

A

Large quadrate tubercle

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8
Q

Where is the greater trochanter located?

A

Lateral aspect of the upper part of shaft lateral to the neck

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9
Q

Describe the borders of the greater trochanter.

A

Upper border –> marked by a tubercle
Anterior border –> marked by a depression
Posterior and inferior borders –> both roughened for muscular attachment

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10
Q

Where is the lesser trochanter located?

A

Medially behind and below the neck

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11
Q

Describe the features of the lesser trochanter.

A

Smaller than greater trochanter
Tip is drawn forwards
More conical in shape
Rough ridge running downwards and forwards

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12
Q

Describe features of the shaft.

A

Strong
Almost completely cylindrical aside from prominent posterior border.
Convex anteriorly

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13
Q

Describe the linea aspera.

A

Along posterior border.
Provides rough site for muscle attachment
Medial and lateral lips that diverge at proximal and distal ends

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14
Q

Describe the pectineal line

A

Marks upper surface medially
Narrow and vertical

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15
Q

Describe the patella.

A

Triangular sesamoid bone

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16
Q

Where is the patella found?

A

Suspended in the tendon of quadriceps femoris

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17
Q

Describe the orientation of the patella.

A

Apex points inferiorly
Base points superiorly

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18
Q

Describe the borders of the patella.

A

Superior
Lateral
Medial

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19
Q

What is the function of the tibia.

A

Transmission of body weight from medial and lateral condyles of the femur to the foot.

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20
Q

What are the main movements of the knee joint?

A

Flexion and extension

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21
Q

Describe medial and lateral rotation of the tibia with respect to the femur.

A

Knee in semiflexed position and foot off the ground

22
Q

What muscles flex the knee joint?

A
  1. Hamstrings (semitendinous, semimembranous, and bicep femoris) –> tibial branch of sciatic nerve
  2. Gastrocnemius –> tibial nerve S1,2
  3. Gracilis –> anterior division of obturator nerve L2,3
  4. Sartorius –> femoral nerve L2,3
  5. Popliteus –> tibial nerve L4-S1
23
Q

What muscles extend the knee joint?

A
  1. Rectus femoris
  2. Vastus lateralis
  3. Vastus medialis
  4. Vastus intermedius
    1-4 = quadriceps femoris –> femoral nerve L2-4
  5. Tensor Fascia Lata –> superior gluteal nerve (L4-5)
24
Q

What muscles laterally rotate the knee joint.

A

Biceps femoris –> tibial branch of sciatic nerve

25
Q

What muscles medially rotate the knee joint?

A
  1. Semitendinosus
  2. Semimembranosus
  3. Gracilis
  4. Sartorius
  5. Popliteus –> tibial division of the sciatic nerve L5
26
Q

What are the articular surfaces of the femurs?

A

Medial and lateral condyles
Patellar surface

27
Q

What is the angle of the anatomical axis of the femur?

A

84 degrees

28
Q

What is angle of the mechanical axis of the femur?

A

87 degrees

29
Q

What is the angle of the anatomical and mechanical axis of the tibia?

A

93 degrees.

30
Q

What type of joint is the knee?

A

Modified synovial hinge joint

31
Q

What are the articular surfaces of the tibia?

A

Cartilage covered areas on upper surface of the tibial condyles.

32
Q

Describe the articular surface of the patella?

A

Oval in shape
large lateral and small medial area

33
Q

What is the angle of the articular areas of the tibia?

A

3-5 degree posteroinferior inclination with respect to the horizontal

34
Q

Describe the joint capsule surrounding the knee joint.

A

Thick ligamentous sheath
Composed mainly of muscle tendons and their expansions
No complete, independent fibrous capsule uniting the 2 bones
Deficient anteriorly

35
Q

Describe capsular strengthening in the knee joint.

A

Majority of what is seen as capsule is ligamentous feltwork
Important as it provides capsule with strength as well as necessary control and restriction

36
Q

Describe the oblique popliteal ligament.

A

Strengthens central region of posterior part of the capsule
Expansion of the semimembranosus tendon
Passes upwards and laterally to intercondylar line of femur

37
Q

Describe the arcuate popliteal ligament.

A

Strengthens lower lateral aspect of capsule
From the back of the head of fibula arching upwards and medially over popliteus tendon
Most medial aspect arches down onto posterior part of intercondylar area of tibia

38
Q

Describe the ligamentum patellae.

A

Continuation of the quadriceps tendon
Strong flat band attaching around the apex of the patella
Continuous over front of patella
Extends to tibial tuberosity

39
Q

Describe the medial collateral ligament.

A

Tibial collateral ligament
Strong flat band
From medial epicondyle of femur passing downwards and slightly forwards to attach to the medial condyle of the tibia and medial side of the shaft
Superficial fibres of ligament descend below the level of the tibial tuberosity
Deep fibres from femur to tibia and spreading triangularly to attach to medial meniscus

40
Q

Describe the lateral collateral ligament.

A

Fibular collateral ligament
Rounded cord
Attached to lateral epicondyle of femur above and behind the groove for popliteus and passes down to attach to lateral surface of the head of fibula

41
Q

Describe the synovial membrane.

A

Synovial membrane lines joint capsule and reflected onto bone
Passes onto deep surface of anterior joint capsule
Reflections of infrapatellar fat pad are thrown into folds

42
Q

Describe the bursae of the knee joint.

A

Extends above the patella between the femoral shaft and quadriceps femoris
Communicates freely with joint space
Upper part attached to articularis genu
Fibres from vastus intermedius maintain bursa during extension

43
Q

Describe the anterior cruciate ligament (ACL)

A

Attached to tibia immediately anterolateral to anterior tibial spine
Passes beneath transverse ligament
Runs posteriorly, laterally, and proximally
Attaches to posterior part of the medial surface of the lateral femoral condyle (Not as strong as tibial attachment)
2 bands:
Anteromedial band attaching to the anteromedial region of the tibial attachment –> Taut in flexion
Posterolateral band constitutes the remainder of the ligament –> Taut in extension

44
Q

Describe the posterior cruciate ligament (PCL)

A

Attaches to a depression in the posterior intercondylar area of the tibia
Runs anteriorly, medially and proximally
Passes ACL medially
Attaches to anterior part of the lateral surface of the medial femoral condyle
Shorter and less oblique than ACL
Principle stabiliser

45
Q

What influences the strength of the cruciate ligaments?

A
  1. Tensile strength decreases with age
  2. Cyclical loading softens ligaments
  3. Immobilisation may cause a decrease in tensile strength of up to 60%
  4. Internal rotation reduces strength by 6%
46
Q

What are the functions of the menisci?

A
  1. Increase congruency between articular surfaces of the femur and tibia
  2. Weight bearing
  3. Shock absorption
  4. Aid lubrication
  5. Participate in locking mechanism
47
Q

Describe the medial meniscus.

A

Larger of 2
Posterior part broader
Anterior horn attached to anterior part of intercondylar area on the tibia immediately in front of the ACL
Most posterior fibres continuous with transverse ligament of knee
Posterior horn attaches to the posterior intercondylar area between the PCL and posterior horn of lateral meniscus anteriorly

48
Q

Describe the lateral meniscus.

A

Uniform breadth
2 horns attached close
Anterior horn attaches in front of the intercondylar eminence posterolateral to the ACL
Posterior horn attaches behind the intercondylar area anterior to the posterior horn of the medial meniscus

49
Q

Describe the blood supply to the knee.

A

Genicular anastomosis comprised of superficial and deep plexus
Descending branch of lateral circumflex artery
Descending genicular branch of femoral artery
Circumflex fibular artery
Anterior and posterior tibial recurrent branches of anterior tibial artery
Remaining arteries are branches from popliteal artery: Lateral superior and inferior, medial superior and inferior, and middle genicular artery
Venous drainage same

50
Q

Where does lymph drain to in knee?

A

Popliteal and inguinal nodes

Functional and Clinical Anatomy of the Limbs (2 decks)

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