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Limbs > Knee joints > Flashcards

Knee joints Flashcards

1
Q

Describe the capsule in the knee joint

A

Capsule deficient anteriorly

  • Sesamoid patella has tendons
  • Tendons are outside joints

Has a synovium and many bursae

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2
Q

Name the 5 main ligaments in the knee joint and their general functions

A

Collateral (tibial and fibial), resist turning forces

Cruciate (ant and post), stabilise joint

Meniscofemoral (comes off post horn of lateral meniscus, ant and post ligament behind and infront of PCL)

Oblique popliteal (comes off popliteus tendon), strengthen back of joint

Arcuate, posterolateral stability around popliteus

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3
Q

Describe the 3 nerves that supply the knee joint

A

Femoral (from ant thigh)
Obturator (from med thigh)
Common fibular and tibial

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4
Q

Describe the blood supply of the arteries

A

Genicular arteries

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5
Q

Describe the 2 types of knee dislocation

A 
Anterior dislocation (tibia moves anteriorly)
Posterior dislocation (tibia moves posteriorly)

Condyles slip, patella separates from the rest of the knee

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6
Q

Describe the structure of the patella in the patella femoral joint

A

Attached to the the quadriceps tendon and patellar tendon

Patella itself has a lateral and medial surface.
Lateral surface is larger due to the greater lateral pull of the muscles

Lateral surface of patella is also larger on femur

Patella tendon attaches to tibial tuberosity

Patella apex at the bottom, base at the top

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7
Q

What is the function of the quadriceps tendon and muscle

A

Tendon and muscle extend leg

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8
Q

Describe how patella femoral dislocations occur

What is the normal functioning of the patella femoral region (muscles)

A

Normally, the vastus lateralis and intermedialis have a lateral pull
Vastus medialis counter this lateral pull => medially pull

If vastus medialis wastes away, patella gets pulled laterally => lateral dislocations for likely

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9
Q

What is the Q angle

What is the Q angle in males and females

A

Angle between quadriceps tendon and patella tendon in full extension

Females, 17
Males 14, due to females having a larger pelvis

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10
Q

What are the 5 situations that cause the Q angle to increase

A 
Genu valgum
Increased femoral anteversion
External tibial torsion
Lateral tibial tuberosity
Tight lateral retinaculum (bands of fibrous fascia that pass over tendons)
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11
Q

Describe the structure of the tibial femoral surface of the knee joint

A

Fibular collateral ligament not attached to lateral meniscus

Tibial collateral ligament attached to medial meniscus => stability

Medial meniscus is C shaped, has ant and post horns
Lateral meniscus is more O shaped, has ant and post horns

Transverse vehicular ligament between ant horn of medial meniscus and ant of lateral meniscus => stabilise joint

Posterior cruciate comes post => ant => medial
Anterior cruciate comes ant => post => lateral

Coronary ligaments attach to menisci laterally to tibia => stability

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12
Q

Describe the function of the menisci

A

Fibrocartilage structures that

  • Deepen articular surfaces of the tibia
  • Shock absorbers

Menisci filled with synovial fluid, like a sponge

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13
Q

Describe the articulating surfaces of the femur, tibia and patella

Why are they shaped like this

A

Lateral and medial surface articulate with lateral and medial surface of the femur

The lateral posterior side of the femur is more rounded than the medial posterior side

Medial femoral condyle is curved, when you run out of lateral condyle when you extend your leg => 15 rotation

Rotation tightens collateral and cruciate => stability

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14
Q

Describe how the meniscus can tear

A

Can rip completely => bucket handle

Can flip over and become stuck in the middle of the knee joint => locked knees

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15
Q

Describe how to popliteus muscle relates to the knee joint

How does it relate to the arcuate ligament

What is innervated by

What is its function

A

Attaches to lateral condyle of femur and post horn of lateral meniscus from medial side of tibia

Inserts under the arcuate ligament

Unlocks the knee

Tibial nerve L4-S3

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16
Q

Name the ligaments found on the lateral side of the joint

What are their functions

A

Iliotibial tract, stabilise lateral knee

Quadriceps and patella tendon

Retinaculum of vastus lateralis comes under iliotibial and patella tendon, support anterior

Fibular collateral attaches to fibula and femur, lateral support

Popliteus comes from medial of tibia => femur, lateral support

Biceps femoris attaches from fibula, stabilise posterior

17
Q

Name the ligaments found on the medial side of the joint

What are their functions

A

Tibial collateral attaches to tibial and femur, medial support, medial support

Retinaculum of vests medialis attaches from post femur to under the patella tendon, medial support

Pes anserinus (semitendinosus, sartorius, gracilis), medial support

18
Q

Describe the 2 angles of the knee that can arise and why

A

Genu varum

  • Lateral ligament weakens
  • Tibia inwards

Genu algum

  • Medial ligament weakens
  • Tibia outwards, lateral compression
  • Pes anserinus damage
19
Q

Describe the route of the anterior and posterior cruciate ligaments

A

Anterior cruciate
-Ant of tibia from intercondyle area => post => lateral

Posterior cruciate
-Post of tibia from intercondyle area => ant => medial

20
Q

What happens to the cruciates in extension and flexion

What is the function of the cruciates

How do you test for cruciate injuries

A

Extension
-Both are taut to lock the knee

Flexion

  • ACL relaxed
  • PCL taut

ACL prevents tibia from slipping forwards
PCL prevents tibia from slipping backwards

Test for CL injury by trying to displace tibia nand fibula

21
Q

What is the unhappy triad

What is it caused by

A

Injury to ACL, MCL, medial meniscus

-Caused by over twisting taut ligaments

22
Q

Describe the structure of the synovial membrane in the knee joint

Describe how fast structures in the synovium heal compared to structures outside the synovium

A

ACL, PCL in capsule but outside synovium
Alar fold ant to ACL
Synovial membrane surrounds both menisci

Structures outside synovium heal faster, have a blood supply

23
Q

Name the 6 main bursa found in the knee joint and their location

A

Suprapatellar, 8cm above patella behind quadricep tendon

Prepatellar, infront of patella

Infrapatellar, below patella, ant and post of patella ligament

Anserine, separates anserinus from tibia

Popliteus, between popliteus and lat condyle

Gastrocnemius, between medial head of gastrocnemius and tibia

24
Q

What are the symptoms of bursitis

A

Swelling
Redness
Pain

Location of swelling => which bursa is infected

Limbs (15 decks)

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