Knee joint Flashcards by Charlotte Muir

joints of the talus

ankle joint between talus and bones of leg
sub talar joint - talus and calcaneous
talonavicular joint - between talus and navicular

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joints of calcaneous

sub-talar joint

calcanocuboid joint

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plantar surface of navicular

tuberosity for tibialis posterior

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inferior surface of cuboid

groove for fibularis longus

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position of least congruence in knee

flexion

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what are the menisci

fibrocartilage
thicker at external margins
external edges attach the the fibrous capsule of the joint

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what improves the stability of the knee

ligaments inside the joint - ACL and PCL
ligaments outside the joint - fibular and tibial collateral ligaments
surrounding muscles

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patella ligament

continuation of quadriceps femoris tendon - inserts onto tibial tuberosity

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tibial (medial) collateral ligaments

medial epicondyle of femur to medial surface of tibia

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fibular (lateral) collateral ligament

lateral epicondly of femur to lateral femoral head

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anterior cruciate ligament

anterior intercondylar region of tibia

ascends posteriorly to attach to femur in intercondylar fossa

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posterior cruciate ligament

posterior intercondylar region of the tibia

ascends to attach at anterior intercondylar fossa of femur

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function of posterior cruciate ligament

prevents posterior displacement of tibia on femur
prevents hyperflexion
main stabiliser of flexed knee when weight baring

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function of anterior cruciate ligament

prevents anterior displacement of tibia oon the femur

prevents hyperextension

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what is the unhappy triad of knee injuries

excessive lateral twisting of the flexed knee or blow to the lateral side of the extended knee

tibial collateral ligament tears which then tears medial meniscus, ACL may also then tear as it is taut during flexion

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extension of the knee

quadriceps femoris - inserts onto tibial tuberosity

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flexion of the knee

produced by hamstrings, gracilis, popliteus and sartorius

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lateral rotation of the knee

biceps femoris

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medial rotation of the knee

semi- membranosus, semi-tendinosus, gracilis, sartorius, popliteus

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which muscles ‘unlocks’ the knee

popliteus

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dislocation of the knee is more common in which gender

females

- have a larger Q angle - the pull of vastus lateralis is greater

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genu varum

bow legged
knees point out
tibia adducted

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genu valgum

knees inwards

tibia abducted with respect to femur

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changes seen in osteoarthritis

reduced joint space
sclerosis
osteophyte

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stability of the ankle joint

good congriguity between the malleolar mortice and trochlear - the malleoli 'grip the talus very strong ligaments between the bones of the ankle joint - distal part of the interosseous membrane anterior and posterior tibiofibular ligaments

the malleoli grip the talus

trochlear of talus wider anteriorly during dorsiflexion the anterior part moves between malleoli spreads tibia and fibula increasing their grip on talus

most stable position of ankle joint

dorsiflexion

lateral ligaments of the ankle joint

anterior talofibular ligament posterior talofibular ligament calcaneofibular ligament

medial ligaments of the ankle joint

attached to medial malleolus and fans out to attach to the talus, navicular and calcaneous - deltoid ligament

muscles that plantarflex the foot

posterior compartment of leg except popliteus

nerve supply of muscles that plantar flex the foot

tibial

artery of muscles that plantarflex the foot

posterior tibial

muscles that dorsiflex the foot

anterior compartment of leg

nerve supply of muscles that plantar flex the foot

deep fibular (peroneal)

arterial supply to anterior compartment of the leg

anterior tibial

joint at which inversion and eversion occur

sub-talar - talus and calcaneous

ankle sprain movement

inversion injuries

weakest ankle ligament

lateral ligament - talofibular ligament

eversion injury effects

pull strong medial ligament causing avulsion of medial malleolus talus rotates laterally fracturing the fibula

function of the foot arches

distribute weight shock absorbers increase flexibility springboards for propulsion during walking, running and jumping

3 arches of foot

medial longitudinal arch lateral longitudinal arch transverse arch

medial longitudinal arch

``` calcaneus talus navicular 3 cuneforms and medial metatarsals higher and more important than lateral ```

lateral longitudinal arch

calcaneous cuboid lateral 2 metatarsals

transverse arch

cuboid 3 cunieforms bases of 5 metatarsals

how is the stability of the arches maintained

passive support - ligaments and shape of the bones | dynamic - intrinsic and extrinsic muscles of the foot

what is pes planus

can be flexible or rigid flexible more common - arch not present when walking loose or degenerating ligament

treatment of pes planus

may be asymptomatic displacement of talus inferomedially causes misalignment of the ankle and knees causing pain treated with orthotics

movements of the foot joints

flexion and extension of the metatarsophalangeal and proximal and distal interphalangeal joints limited abduction and adduction

muscles in anterior compartment of the leg

tibialis anterior extensor digitorum longus extensor hallucis longus fibularis tertius

tibialis anterior origin

lateral tibia

tibialis anterior insertion

medial cuneiform and base of metatarsal 1

tibialis anterior innervation

deep fibular nerve

tibialis anterior function

dorsiflexion and eversion

extensor digitorum longus origin

lateral tibia and medial fibula

EDL insertion

tendon onto each toe

EDL innervation

deep fibular nerve

EDL function

extends 4 toes

extensor hallucis longus origin

medial fibular shaft

extensor hallucis longus insertion

base of distal phalanx of great toe

extensor hallucis longus innervation

deep fibular nerve

extensor hallucis longus function

extension of great toe and dorsiflexion

fibularis tertius origin

medial fibula

fibularis tertius insertion

metatarsal V

fibularis tertius function

dorsiflexion and eversion

fibularis tertius innervation

deep fibular nerve

fibularis longus origin

lateral fibula

fibularis longus insertion

travels under foot to insert onto medial cuneiform and base of metatarsal I

fibularis longus innervation

superficial fibular nerve

fibularis longus funtion

eversion and plantarflexion and support arches

fibularis brevis origin

inferolateral fibular shaft

fibularis brevis insertion

tubercle on metatarsal V

fibularis brevis innervation

superficial fibular nerve

fibularis brevis function

eversion

what nerve roots does that calcaneal reflex test

S1-2

muscles in the posterior compartment of leg

``` superficial - gastrocnemius - plantaris - soleus Deep - popliteus - tibialis posterior - flexor digitorum longus - flexor hallucis longus ```

gastrocnemius origin

medial head = medial condyle of femur | lateral head = lateral condyle

gastrocnemius insertion

muscle belly combines with soleus | forms calcaneal tendon

gastrocnemius innervation

tibial nerve

gastrocnemius function

plantarflex foot and flex knee

plantaris origin

lateral supracondylar line of femur

plantaris insertion

calcaneal tendon

plantaris innervation

tibial nerve

plantaris function

plantarflexes foot and flexes knee

soleus origin

soleal line of tibia and proximal fibula

soleus insertion

calcaneal tendon

soleus innervation

tibial nerve

soleus function

plantarflexion

popliteus origin

posterior surface of proximal tibia

popliteus insertion

lateral condyle of femur

popliteus innervation

tibial nerve

popliteus function

laterally rotates femur on tibia to unlock knee

tibialis posterior origin

IO membrane between tibia and fibula and associated posterior bones

tibialis posterior insertion

navicular and medial cuneiform bones

tibialis posterior innervation

tibial nerve

tibialis posterior funtion

plantarflex and invert foot

flexor digitorum longus origin

medial tibia

flexor digitorum longus insertion

plantar surfaces of 4 digits

flexor digitorum longus innervation

tibial nerve

flexor digitorum longus function

flexes toes

flexor hallucis longus origin

fibula

flexor hallucis longus insertion

plantar surface of great toe

flexor hallucis longus innervation

tibial nerve

flexor hallucis longus function

flex great toe