Knee joint and tibiofibular joints

Question 1

Knee joint

Answer 1

• Involves the femur, tibia and patella
• There are three joint divisions: medial femoro-tibular, lateral femoro-tibular and femoro-patellar divisions

Question 2

Medial femoro-tibial division

Answer 2

• Between the medial condyle of the femur and the facies articularis medialis on the proximal tibial end
• Joint surfaces are disproportionate (incongruence) and are balanced by meniscus medialsis (semilunar shaped fibrocartilaginous plate)
• Frontal and dorsal ends of the meniscus are attached to the area intercondylaris anterior et posterior of the tibia

Question 3

Lateral femoro-tibial division

Answer 3

• Between the lateral condyle of the femus and the facies articularis lateralis of the proximal tibial end
• Balanced by meniscus lateralis (circular shape)
• Its free ends are attached to tuberculum intercondylare laterale

Question 4

Femoro-patellar division

Answer 4

• Between the facies articularis patellae and the facies patellaris femoris

Question 5

Joint capsule of knee joint

Answer 5

• Strong and spacious
• On femur reaches 1cm proximal from margins of the joint surface
• Synovial membrance is insreted from the medial and alteral sides of the cruciate ligaments - anteriorly protrudes as plica synovialis patellae

Question 6

Corpus adiposum genus

Answer 6

• Located below the patella, inserted between synovial and fibrous layers of the joint capsule
• Laterally it continues into two plicae (plicae alares) padded by an adipose tissue layer

Question 7

Joint cavity of the knee joint

Answer 7

• In the infrapatellar area
• Incompletely sagitally separated into medial and lateral parts

Question 8

Tendon of m. quadriceps femoris

Answer 8

• Blends into anterior margin of joint capsule
• Attaches to the patella

Question 9

Patellar ligament

Answer 9

• Runs from apex patellae and descends to attach to the tibial tuberosity

Question 10

Medial and lateral patellar retinaculi

Answer 10

• Two longitudinal bands which run fom the tendons of m. vastus medialis and m. vastus lateralis to the corresponding margin of the patella

Question 11

Tibial collateral ligament

Answer 11

• Runs from the medial epicondyle of the femur down to the proximal part of the medial tibial margin (grows with joint capsule)
• Has superficial and deep fibres

Question 12

Fibular colalteral ligament

Answer 12

• Runs from the lateral epicondyle of the femur to caput fibulae
• Extraarticularly located

Question 13

Oblique popliteal ligament

Answer 13

• Located on the posterior side of the knee joint
• Is a tendinous expansion of the semimembranosus muscle
• Runs from the Medial condyle of the tibia to the lateral condyle of the femur
• Forms part of te floor of the popliteal fossa
• Popliteal artery rests on it

Question 14

Anterior cruciate ligament

Answer 14

• Runs from area intercondylaris anterior tibiae ascends proximally, dorsally and alterally to the medial plane of condylus lateralis femoris

Question 15

Posterior cruciate ligament

Answer 15

• Runs from the area intercondylaris posterior and attaches on the fibular plane of condylus medialis femoris

Question 16

Cruciate ligaments

Answer 16

• Anterior and posterior
• Connect area intercondylaris tibialis with the fossa intercondylaris femoris
• Laterally covered by synovial layer of the joint capsule
• This layer is frontally directed to the patella as plica synovialis patellae which separates the joint cavity into an internal and external part
• Located intraarticularly in relation to the fibrous layer and extraarticularly in relation to the synovial layer

Question 17

Synovial bursas of the knee joint

Answer 17

• Bursa suprapatellaris
• Bursa praepatellaris
• Bursa praepatellaris subcutanea
• Can sometimes directly communicate with joint cavity

Question 18

Knee joint - type and movement

Answer 18

• Composed compliated joint
• Monoxial trochlear joint
• Allows flexion and extension
• Extension restricted by cruciate ligaments
• During flexion these ligaments are relaxed and mild rotational movements along the axis are possible
• Longitudinal axis of femur and tibia creates an obtuse angle in the frontal plane, it is open laterally - physiological abduction of knee-joint

Question 19

Tibiofibular junctions

Answer 19

• Articulation tibiofibularis
• Mombrana interossea cruris
• Syndesmosis tibiofibularis
• Position of both bones is practically unchanged, they form a mechanical unit
• Fibular movements are only possible in the sense of a slight spring-shaped elastic movements

Question 20

Articulatio tibiofibularis

Answer 20

• Between faceies articularis capitis fibulae and facies articularis fibularis tibiae
• Joint surface are flat and straight
• Short joint capsule is attached to margins of joint surfaces
• Reinforced by ligamentum capisit fibulae (anterius et posterius)
• Shifting movements are negligible

Question 21

Membrana interossea cruris

Answer 21

• Stretched between margo interosseus tibiae and fibulae
• Serves as a division site of some crus muscles

Question 22

Syndesmosis tibiofibularis

Answer 22

• Located distally
• Slightly movable fibrous junction joined by connective tissue
• Insertion of the distal end of the fibula into incisura fibularis tibiae
• Not an articular junction
• Secured by strong ligaments which run from the tibia to margo anterior and posterior of maleolus lateralis (ligamentum tibiofibulare anterius et posterius)