knee joint

Question 1

what kind of joint is the knee joint

Answer 1

modified synovial hinge joint

Question 2

what articulations make up the knee joint

Answer 2

3 separate articulations
- 1 femoropatellar
2x femorotibial

Question 3

describe the articular surfaces of the inferior surface of the femur

Answer 3

patellar surface anteriorly (the lateral side of which extends more anteriorly to resist lateral dislocation of patella)
medial and lateral condyles posteriorly
intercondylar fossa

Question 4

is the medial or lateral condyle of the femur larger

Answer 4

medial

Question 5

what shape is the patellar surface of the femur

Answer 5

concave

Question 6

what separates the medial and lateral condyles on the femur

Answer 6

intercondylar fossa

Question 7

describe the superior surface of the tibia

Answer 7

medial and lateral condyles separated by a non-articular ridge called the intercondylar eminence

Question 8

describe the articular (posterior) surface of the patella

Answer 8

apex pointing inferiorly
2 facets - larger lateral facet and smaller medial facet
- the lateral border of the femur extends more anteriorly to match larger lateral facet of patella

Question 9

capsular attachments on the femur largely follow what except where

Answer 9

margin of articular surface except posteriorly where intercondylar fossa is enclosed in the capsule

Question 10

anteriorly the capsule of the knee joint fuses with what

Answer 10

quadriceps tendon, patella and ligamentum patellae

Question 11

where does ligamentum patellae attach

Answer 11

tibial tuberosity

Question 12

describe the capsular attachments on the tibia

Answer 12

around the margins of the tibial plateau except posteriorly where there is a deficit behind lateral condyle to allow passage of popliteus

Question 13

describe the synovial membrane attachment on the patella and femur

Answer 13

attaches around the margins of the articular surfaces

Question 14

describe the synovial membrane attachment on the tibia

Answer 14

mostly follows the margins of the articular surfaces; forms an infrapatellar fold which excludes the intercondylar eminence from the synovial cavity and anteriorly there are alar folds covering fat pads on either side of patellar ligament

Question 15

what does the infrapatellar synovial connect

Answer 15

connects the intercondylar fossa on femur and intercondylar eminence on tibia - separates joint cavity into two separate spaces

Question 16

what bursae around the knee are in communication with the synovial cavity of the knee

Answer 16

suprapatellar
gastrocnemius
semimembranosus
popliteus

Question 17

what bursae around the knee are not in communication with the synovial cavity of the knee

Answer 17

• subcutaneous prepatellar
• subcutaneous infrapatellar
• deep infrapatellar
• anserine

Question 18

the anserine bursae is related to what tendons

Answer 18

gracilis, sartorius and semitendinosus

Question 19

the suprapatellar bursae extends superiorly on anterior aspect of knee and is held in place by deep fibres of what

Answer 19

vastus intermedius

Question 20

what are the extracapsular ligaments of the knee

Answer 20

oblique popliteal
arcuate popliteal
medial and lateral collateral

Question 21

what are the intracapsular ligaments of the knee

Answer 21

anterior and posterior cruciate

Question 22

the oblique popliteal is an expansion of what

Answer 22

semimembranosus

Question 23

what is the function of the oblique popliteal ligament

Answer 23

reinforces posterior capsule

Question 24

what is the arcuate ligament

Answer 24

thickening of capsule over popliteus

Question 25

what is the function of the arcuate ligament

Answer 25

strengthens posterolateral joint capsule

Question 26

describe the gross appearance of the medial (tibial) collateral ligament

Answer 26

strong, flat thickening of capsule that blends with capsule

Question 27

what are the attachments of the medial collateral ligament

Answer 27

medial epicondyle of the femur to the medial condyle and superior medial surface of tibia - also deep fibres attach to medial meniscus

Question 28

what do the collateral ligaments prevent

Answer 28

side to side movement within the joint - abduction and adduction

Question 29

which meniscus is more firmly attached to the tibial condyle

Answer 29

medial

Question 30

describe the gross appearance of the lateral (fibular) collateral ligament

Answer 30

strong and cord like and doesnt blend with capsule

Question 31

the lateral collateral ligament passes superficial to what tendon

Answer 31

popliteus

Question 32

the lateral collateral ligament causes what tendon to split

Answer 32

biceps femoris

Question 33

what are the attachments of the lateral collateral ligament

Answer 33

lateral epicondyle of femur to lateral head of fibula

Question 34

what is the function of the cruciate ligaments

Answer 34

maintain contact between femoral and tibial articular surfaces, particularly when knee is flexed

Question 35

how is medial rotation of the tibia limited to 10 degrees

Answer 35

PCL and ACL wind round eachother during this movement

Question 36

the PCL prevents the femur from sliding...

Answer 36

anteriorly on the tibia, particularly when the knee is flexed

Question 37

the ACL prevents the femur from sliding...

Answer 37

posteriorly on the tibia - preventing hyperextension of the knee

Question 38

the ACL also prevents ... rotation of the femur when the foot is planetd

Answer 38

medial rotation

Question 39

are the cruciate ligaments intracapsular

Answer 39

yes - intracapsular but extrasynovial

Question 40

the cruciate ligaments are named based on what

Answer 40

attachment on intercondylar eminence i.e. ACL is more anterior on tibia and more posteriorly on femur

Question 41

why is there a greater degree of lateral rotation at the knee than medial rotation

Answer 41

during medial rotation the cruciates wind round eachother

Question 42

what are the attachments of the ACL

Answer 42

anterior intercondylar eminence to the medial side of the lateral condyle of the femur (goes posterolaterally)

Question 43

what are the 2 bands of the ACL

Answer 43

anteromedial and posterolateral

Question 44

the anteromedial band of the ACL limits

Answer 44

flexion

Question 45

the posterolateral band of the ACL limits

Answer 45

extension

Question 46

the ACL spirals through ___ degrees between tibia and femur

Answer 46

110

Question 47

what is the advantage of having 2 bands in the cruciate ligaments

Answer 47

ligament is in part taut in all positions

Question 48

what are the attachments of the PCL

Answer 48

posterior intercondylar eminence to the lateral side of the medial condyle of femur (goes anteromedially)

Question 49

what are the two bands of the PCL

Answer 49

anterolateral and posteromedial

Question 50

the anterolateral band of the PCL limits

Answer 50

flexion

Question 51

the posteromedial band of the PCL limits

Answer 51

extension

Question 52

the PCL is closely aligned to what

Answer 52

centre of rotation of knee

Question 53

what does the alignment of the PCL with the centre of rotation of the knee mean for this ligament

Answer 53

it is the ligament that supports the weight of the body when knee is flexed

Question 54

what are the menisci made of

Answer 54

fibrocartilage

Question 55

what is the function of the menisci

Answer 55

deepen articular surface to maximise contact surface and shock absorption

Question 56

what shape is the medial meniscus

Answer 56

C shape

Question 57

what shape is the lateral meniscus

Answer 57

circular

Question 58

the medial meniscus is broad where

Answer 58

posteriorly

Question 59

the medial meniscus is firmly attached to what

Answer 59

medial collateral ligament

Question 60

is the lateral meniscus fixed

Answer 60

no, freely moveable

Question 61

the lateral meniscus provides attachment for what

Answer 61

popliteus

Question 62

what is the function of the MCL

Answer 62

prevent abduction

Question 63

when is the MCL most likely to be injured

Answer 63

lateral force injury

Question 64

if the foot is planted in a lateral force injury tearing the MCL what else will be damaged and what is this called

Answer 64

unhappy triad - MCL attached to medial meniscus so this tears and if it is a rotational force, the ACL will tear - unhappy triad

Question 65

what are the proximal attachments of popliteus

Answer 65

starts within the joint capsule attached to lateral epicondyle of the femur and some fibres on lateral meniscus

Question 66

what does popliteus do during flexion

Answer 66

pulls lateral meniscus into a better position to accomodate the lateral femoral condyle

Question 67

what is the anastomosis around the knee called

Answer 67

periarticular genicular anastomosis

Question 68

what vessels contribute to the periarticular genicular anastomosis

Answer 68

- 4 x genicular branches from popliteal artery - descending genicular artery from femoral artery - descending branch from lateral circumflex femoral artery - branches from the anterior tibial recurrent artery - can also have branch from posterior tibial recurrent

Question 69

what are the 5 genicular branches of the popliteal artery

Answer 69

- middle which pierces joint capsule - superior and inferior medial - superior and inferior lateral

Question 70

where does the femoral artery run between

Answer 70

inguinal ligament to adductor hiatus

Question 71

what does the femoral artery become at the adductor hiatus

Answer 71

popliteal artery

Question 72

what does the popliteal artery terminate as

Answer 72

anterior and posterior tibial arteries