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Anatomy II Fall 2023 > Knee Region > Flashcards

Knee Region Flashcards

1
Q

What structures attach to the medial condyle of the femur?

A
  • PCL
  • Posterior meniscofemoral ligament
  • medial head of gastrocnemius
  • vastus medialis
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2
Q

What structures attach to the lateral condyle of the femur?

A
  • Oblique popliteal ligament (OPL)
  • Arcuate popliteal ligament (APL)
  • Anterior Collateral ligament (ACL)
  • lateral head of gastrocnemius
  • popliteus
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3
Q

What structures attach to medial epicondyle of the femur?

A
  • MCL (TCL)
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4
Q

What structures attach to lateral epicondyle of the femur?

A
  • LCL (FCL)
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5
Q

What structures attach to adductor tubercle of the femur?

A
  • adductor magnus
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6
Q

What structures attach to the medial condyle of the tibia?

A
  • MCL
  • OPL
  • semimembranosus
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7
Q

What structures attach to the lateral condyle of the tibia?

A
  • IT band
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8
Q

What structures attach to the anterior intercondylar area of the tibia?

A
  • ACL
  • Medial meniscus
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9
Q

What structures attach to the posterior intercondylar area of the tibia?

A
  • PCL
  • medial meniscus
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10
Q

What structures attach to medial intercondylar tubercle of the tibia?

A
  • medial meniscus
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11
Q

What structures attach to the lateral intercondylar tubercle of the tibia?

A
  • lateral meniscus
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12
Q

What structures attach to gerdy’s tubercle?

A
  • IT Band
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13
Q

What structures attach to the Pes Anserinus?

A
  • sartorius
  • gracilis
  • semitendinosus
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14
Q

What structures attach to the tibial tuberosity?

A
  • patellar ligament
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15
Q

What structures attach to the Soleal line of the tibia?

A
  • soleus
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16
Q

What structures attach to fibular notch of the tibia?

A
  • fibula fits inside this notch
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17
Q

What structures attach to the head of the fibula?

A
  • LCL
  • APL
  • Biceps femoris
  • soleus
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18
Q

What structures run past the neck of the fibula?

A
  • common fibular nerve
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19
Q

What structures attach to the medial boarder of the patella?

A
  • medial patellar retinaculum
  • vastus medialis (attaches to retinaculum)
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20
Q

What structures attach to the lateral boarder of the patella?

A
  • lateral patellar retinaculum
  • vastus lateralis (attaches to retinaculum)
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21
Q

What structures attach to the medial meniscus?

A
  • MCL
  • anterior intercondylar area
  • posterior intercondylar area
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22
Q

What structures attach to the lateral meniscus?

A
  • posterior meniscofemoral ligament
  • popliteus tendon
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23
Q

What are the extracapsular ligaments?

A
  • patellar ligament
  • medial collateral ligament (MCL)
  • lateral collateral ligament (LCL)
  • oblique popliteal ligament
  • arcuate popliteal ligament
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24
Q

What are the intracapsular knee ligaments?

A
  • anterior cruciate ligament (ACL)
  • posterior cruciate ligament (PCL)
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25
Q

What are some of the unique features of the MCL?

A
  • resists valgus forces
  • weaker than LCL
  • strong and FLAT
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26
Q

What are some of the unique features of the LCL?

A
  • resists varus forces
  • strong and CORDLIKE
  • splits bicep femoris into two
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27
Q

What are some of the unique features of the ACL?

A
  • prevents anterior tibial translation
  • weaker than PCL
  • poor blood supply
  • anterior intercondylar area to lateral femoral condyle
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28
Q

What are some of the unique features of the PCL?

A
  • prevents posterior tibial translation
  • stronger than ACL
  • posterior intercondylar area to medial femoral condyle
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29
Q

What do the Oblique popliteal and arcuate popliteal ligaments do?

A
  • important for posterolateral knee joint stability
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30
Q

Describe the medial meniscus

A
  • less mobile than lateral
  • tears more
  • broader posteriorly
  • attaches to anterior/posterior intercondylar areas
  • more “C” shaped
  • only outer 1/3rd is vascularized and innervated
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31
Q

Describe the lateral meniscus

A
  • more mobile
  • more circular in shape
  • popliteal tendon attaches
  • posterior meniscofemoral ligament attaches
  • only other 1/3rd is vascularized and innervated
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32
Q

What are some notable bursae surrounding the knee?

A

Patellar:
- prepatellar
- infrapatellar

Synovial Cavity:
- suprapatellar
- popliteus
- pes anserinus
- gastrocnemius

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33
Q

Why are these bursae notable?

A
  • all important in reducing friction with knee motions
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34
Q

Explain the structure of the tibiofibular joints of the leg

A

Interosseous Membrane:
- fibers run inferior from tibia to fibula
- resists downward pull of fibula by muscles

Tibiofibular joint: (superior)
- has own capsule
- can not move without inferior joint moving also

Tibiofibular syndesmosis: (inferior)
- compound fibrous joint
- makes up what we think the “ankle” is
- comprised of 4 ligaments
- anterior/posterior/interosseous tibiofibular ligaments and inferior transverse ligament

35
Q

List the muscles that contribute to knee extension and the ligaments/structures that resist these motions

A

Muscles:
- Quads (vastus medialis, intermedius, lateralis; rectus femoris)
- TFL (weakly)

Ligaments/structures:
- lateral meniscus
- ACL

36
Q

List the muscles that contribute to knee flexion and the ligaments that resist these motions

A

Muscles:
Main:
- Hamstrings (semimembranosus/tendinosus, long head BF, short head)

Secondary:
- gracilis
- sartorius
- gastrocnemius
- popliteus

Ligaments/structures:
- calf contacts thigh
- length of hamstrings

37
Q

List the muscles that contribute to knee internal rotation and the ligaments that resist these motions

A

Muscles:
Main:
- semitendinosus (flexed)
- semimembranosus (flexed)
- popliteus (extended/NWB)

Secondary:
- gracilis
- sartorius

Ligaments/structures:
- collateral ligaments

38
Q

List the muscles that contribute to knee external rotation and the ligaments that resist these motions

A

Muscles:
- Biceps femoris (flexed)
- TFL can assist in maintaining position (@ end of rotation)

Ligaments/structures:
- collateral ligaments
(ACL becomes wound behind PCL)

39
Q

Describe the contents of the anterior compartment

A

Deep Fibular Nerve
- tibialis anterior
- extensor hallucis longus
- extensor digitorum longus
- fibularis tertius

40
Q

Describe the contents of the lateral compartment

A

Superficial Fibular Nerve
- fibularis longus
- fibularis brevis

41
Q

Describe the contents of the superficial posterior compartment

A

Tibial Nerve
- gastrocnemius
- soleus
- plantaris

42
Q

Describe the contents of the deep posterior compartment

A

Tibial Nerve
- popliteus
- flexor digitorum longus
- tibialis posterior
- flexor hallucis longus

43
Q

What is considered the Triceps Surae?

A
  • Gastrocnemius (2 heads)
  • Soleus
44
Q

List the order of structures from anterior to posterior under the flexor retinaculum

A
  • Tibialis posterior (tendon)
  • flexor digitorum longus (tendon)
  • Posterior tibial vein
  • posterior tibial artery
  • tibial nerve
  • flexor hallucis longus
45
Q

What is the strongest, thickest tendon in the lower leg?

A
  • calcaneal tendon
46
Q

Which muscles contribute to maintaining the longitudinal arch of the foot?

A
  • tibialis posterior
  • tibialis anterior
  • fibularis longus
47
Q

What landmark would test the S2 dermatome?

A
  • posteromedial thigh
  • arch of the foot
48
Q

What landmark would test the L4 dermatome?

A
  • over knee
  • medial malleolus
  • great toe
49
Q

What landmark would test the L5 dermatome?

A
  • outer shin
  • 3 middle toes
  • bottom of foot
50
Q

What landmark would test the S1 dermatome?

A
  • posterolateral thigh
  • lateral malleolus
  • pinky toe
51
Q

What landmark would test the saphenous nerve?

A
  • anteromedial leg
  • medial malleolus
52
Q

What landmark would test the lateral sural cutaneous nerve?

A
  • posterolateral leg
53
Q

What landmark would test the sural nerve?

A
  • lateral malleolus
54
Q

What action would you do to test the L3-4 myotomes?

A
  • knee extension
55
Q

What action would you do to test the L4-5 myotomes?

A
  • dorsiflexion
  • inversion
56
Q

What action would you do to test the L5-S1 myotomes?

A
  • knee flexion
  • eversion
57
Q

What action would you do to test the S1-2 myotomes?

A
  • plantarflexion
58
Q

What deficits will be present if the common fibular nerve is damage?

A
  • dorsiflexors
  • inverters
  • evertors
59
Q

What deficits will be present if the superficial fibular nerve is damage?

A
  • loss of eversion
  • weak plantarflexion
60
Q

What deficits will be present if the deep fibular nerve is damage?

A
  • all dorsiflexors
  • foot drop & foot slap
61
Q

What deficits will be present if the tibial nerve is damage?

A

Motor loss:
- plantarflexion
- toe flexion

Sensation loss:
- sole of foot

62
Q

Describe the branching of arteries from the knee to the foot

A

External iliac -> Femoral -> popliteal -> Anterior & posterior tibial arteries (circumflex fibula artery from either/or)

1) Anterior tibial -> perforating branches to lateral compartment & changes to dorsalis pedis @ ankle

2) Posterior tibial -> fibular artery & medial/lateral plantar arteries
A) fibular artery -> perforating branches to lateral compartment/dorsal foot & lateral calcaneal branch to heel & lateral malleolar branch to arterial anastomosis of ankle

63
Q

Describe the branching of veins from the foot to the knee

A

Superficial
- Great saphenous vein -> femoral vein
- small saphenous vein -> popliteal fossa -> popliteal vein

Deep
- medial/lateral plantar veins -> posterior tibial vein/fibular veins
- dorsal venous network -> anterior tibial veins

both deep vein networks drain into popliteal vein then femoral vein

64
Q

Describe the arteries involved in the Genicular Anastomosis

A

the “Circle of Willis” for the knee

1) superior lateral genicular artery
2) superior medial genicular artery
3) middle genicular artery
4) inferior lateral genicular artery
5) inferior medial genicular artery

65
Q

What are the boundaries of the popliteal fossa?

A

Superolateral: Biceps femoris
Superomedial: Semimembranosus
Inferolateral & medial: Gastrocnemius heads
Roof: skin & popliteal fascia

66
Q

What are the contents of the popliteal fossa?

A
  • small saphenous vein termination
  • popliteal artery/vein
  • tibial & common fibular nerves
  • posterior femoral cutaneous nerve
  • popliteal lymph nodes & vessels
67
Q

What is chondromalacia patella and why does it occur?

A
  • softening of articular cartilage on posterior surface of patella

Causes:
- running
- patellar maltracking (quad imbalance)
- repetitive stress @ end range (deep squats)

68
Q

What is the Q-angle?

A

The angle the line of gravity makes after “connecting the dots” with ASIS, patella, tibial tuberosity

13 degrees in men
18 degrees in women

69
Q

What is Genu Varus?

A
  • decreased Q angle, distal tibia toward midline

Results in:
- pulled LCL
- compressed medial compartment of knee

70
Q

What is Genu Valgus?

A
  • increased Q-angle, distal tibia away from midline

Results in:
- pulled MCL
- compresses lateral compartment of knee

71
Q

How does patellofemoral syndrome happen?

A

Causes:
- increased Q-angle
- Genu valgus
- lateral pull of quads on patella

Results in:
- maltracking of patella
- deteriorates articular cartilage of patellofemoral joint

72
Q

What is the “unhappy triad” of the knee & how does it occur?

A

Tears in:
- MCL
- Medial meniscus
- ACL

Causes:
- blow to lateral knee
- excessive twisting

73
Q

What clinical presentation can we expect to see with a rupture of the ACL?

A
  • tibia will slide anteriorly on fixed femur
  • anterior drawer sign
74
Q

What clinical presentation can we expect to see with a rupture of the PCL?

A
  • tibia will slide posterily on fixed femur
  • posterior drawer sign
75
Q

What do meniscal tears have trouble healing and what is the most often injured meniscus?

A
  • there is not a great source of blood flow to the meniscus
  • medial meniscus is more injured than lateral due to it being more fixed and more attachments
76
Q

What is the prepatellar bursitis?

A
  • b/w the skin and patella
  • usually from excessive pressure or repeated friction
  • front of the knee
  • inflammation of either prepatellar, subcutaneous infrapatellar, or deep infrapatellar bursa
77
Q

What is a Baker Cyst?

A
  • back of the knee
  • could be from herniation of gastrocnemius or semimembranosus bursa through joint capsule
  • complication of knee joint effusion
78
Q

Which bones are replaced during a total knee arthroplasty?

A
  • distal femur, proximal tibia, & posterior patella

not great for active people

79
Q

What is compartment syndrome and what could be some consequences of this condition?

A
  • increased pressure within the compartments of the leg
  • Nerve/vessel compression leads to ischemia & damage to tissues within or distal to the compartment
80
Q

Which nerve roots are tested by the patellar tendon reflex?

A
  • L2-4

femoral nerve

81
Q

Which nerve roots are tested by the calcaneal tendon reflex?

A
  • S1-2

tibial nerve

82
Q

What are varicose veins and why do they occur?

A
  • dilated veins usually found in the lower legs
  • vessel walls become weakened from too much pressure which leads to valves malfunctioning and blood pooling
  • prolonged bed rest
  • muscular inactivity
83
Q

What is a potential deadly consequence of varicose veins?

A
  • DVT leading to a PE
  • thrombophlebitis

Anatomy II Fall 2023 (11 decks)

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