LE: Joints and Ligaments Flashcards
Are hinge-type (ginglymus) synovial joints that are enclosed by articular capsules and are reinforced by the plantar and collateral ligaments
Interphalangeal Joints
Resists inversion of the foot and may be torn during an ankle sprain (inversion injury
Lateral Ligament
Consists of the anterior talofibular, posterior talofibular, and calcaneofibular (cordlike) ligaments.
Lateral Ligament
Four parts of Medial (Deltoid) Ligament?
tibionavicular, tibiocalcaneal, anterior tibiotalar, and posterior tibiotalar ligaments
Extends from the medial malleolus to the navicular bone, calcaneus, and talus.
Medial (Deltoid) Ligament
Prevents overeversion of the foot and helps maintain the medial longitudinal arch
Medial (Deltoid) Ligament
Is a fibrous joint between the tibia and the fibula which prevents anterior and posterior slipping of the tibia and fibula on the talus.
Distal Tibiofibular Joint
Is a plane-type synovial joint between the head of the fibula and the tibia that allows a little gliding movement.
Proximal Tibiofibular Joint
A swelling behind the knee, caused by the knee arthritis, meniscus injury, or herniation or tear of the joint capsule.
Popliteal (Baker) Cyst
Inflammation of the infrapatellar bursa located between the patellar ligament and the skin (deep bursa lies between the patellar ligament and tibia)
Infrapatellar (superficial) bursitis (clergyman knee)
Inflammation and swelling of the prepatellar bursa
Prepatellar bursitis (housemaid knee)
What innervates the hip joint?
branches of the femoral, obturator, sciatic and superior gluteal nerves ,
nerve to the quadratus femoris (FOSSGQ)
A deformity in which the tibia is bent or twisted laterally.
Knock-knee (genu valgum)
Arises as a strong cordlike tendon from the lateral aspect of the lateral femoral condyle and runs between the lateral meniscus and the capsule of the knee joint deep to the fibular collateral ligament.
Popliteus Tendon
- Is an oblique expansion of the semimembranosus tendon and passes upward obliquely across the posterior surface of the knee joint from the medial condyle of the tibia.
- Resists hyperextension of the leg and lateral rotation during the final phase of extension.
Oblique Popliteal Ligament
Inflammation and swelling of the prepatellar bursa.
Prepatellar bursitis
Lies between the tibial collateral ligament and the tendons of the sartorius, gracilis, and semitendinosus muscles.
Anserine Bursa (Known as the Pes Anserinus [Goose Foot])
Consists of a subcutaneous infrapatellar bursa over the patellar ligament and a deep infrapatellar bursa deep to the patellar ligament.
Infrapatellar Bursa
Lies over the superficial surface of the patella.
Prepatellar Bursa
Lies deep to the quadriceps femoris muscle and is the major bursa communicating with the knee joint cavity (the semimembranosus bursa also may communicate with it)
Suprapatellar Bursa
A tap on the patellar tendon elicits extension of the knee joint. Femoral nerve (L2-L4)
Patellar tendon reflex
A deformity in which the tibia is bent medially.
Bowleg (genu varum)
Arises from the head of the fibula, arches superiorly and medially over the tendon of the popliteus muscle on the back of the knee joint, and fuses with the articular capsule.
Arcuate Popliteal Ligament
- Is a strong flattened fibrous band that is the continuation of the quadriceps femoris tendon. Its portion may be used for repair of the anterior cruciate ligament.
- Extends from the apex of the patella to the tuberosity of the tibia.
Patellar Ligament (Tendon)
Becomes taut on extension and limits extension and adduction of the leg.
Lateral (Fibular) Collateral Ligament
- Is a rounded cord that is separated from the lateral meniscus by the tendon of the popliteus muscle and also from the capsule of the joint.
- Extends between the lateral femoral epicondyle and the head of the fibula.
Lateral (Fibular) Collateral Ligament
Becomes taut on extension and thus limits extension and abduction of the leg.
Medial (Tibial) Collateral Ligament
Prevents medial displacement of the two long bones and thus abduction of the leg at the knee
Medial (Tibial) Collateral Ligament
Is firmly attached to the medial meniscus, and its attachment is of clinical significance because injury to the ligament results in concomitant damage to the medial meniscus
Medial (Tibial) Collateral Ligament
Is a broad band that extends from the medial femoral epicondyle to the medial tibial condyle
Medial (Tibial) Collateral Ligament
Which is more frequently torn in injuries because of its strong attachment to the tibial collateral ligament?
Medial meniscus
A forward sliding of the tibia on the femur due to a rupture of the ACL
Anterior drawer sign
Binds the anterior horns (ends) of the lateral and medial semilunar cartilages (menisci)
Transverse Ligament
- Lies outside the synovial cavity but within the joint capsule.
- Is nearly circular, acts as a cushion, and facilitates lubrication.
- Is separated laterally from the fibular (or lateral) collateral ligament by the tendon of the popliteal muscle and aids in forming a more stable base for the articulation of the femoral condyle.
Lateral Meniscus
- Lies outside the synovial cavity but within the joint capsule.
- Is C-shaped (i.e., forms a semicircle) and is attached to the medial collateral ligament and interarticular area of the tibia.
- Acts as a cushion or shock absorber and lubricates the articular surfaces by distributing synovial fluid in a windshield-wiper manner.
Medial Meniscus
Taut during flexion of the knee and is lax during extension
Posterior Cruciate Ligament (PCL)
Prevents backward sliding of the tibia on the femur (or anterior displacement of the femur on the tibia) and limits hyperflexion of the knee
Posterior Cruciate Ligament (PCL)
Shorter, straighter, and stronger than the anterior cruciate ligament
Posterior Cruciate Ligament (PCL)
- Lies outside the synovial cavity but within the fibrous joint capsule.
- Arises from the posterior intercondylar area of the tibia and passes upward, forward, and medially to insert into the lateral surface of the medial femoral condyle
Posterior Cruciate Ligament (PCL)
May be torn when the knee is hyperextended.
Anterior Cruciate Ligament (ACL)
Taut during extension of the knee and is lax during flexion
Anterior Cruciate Ligament (ACL)
Prevents forward sliding of the tibia on the femur (or posterior displacement of the femur on the tibia) and prevents hyperextension of the knee joint
Anterior Cruciate Ligament (ACL)
- Lies inside the knee joint capsule but outside the synovial cavity of the joint.
- Arises from the anterior intercondylar area of the tibia and passes upward, backward, and laterally to insert into the medial surface of the lateral femoral condyle.
Anterior Cruciate Ligament (ACL)
What innervates the knee joint?
branches of the sciatic, femoral, and obturator nerves (SFO)
What is the blood supply of knee joint?
genicular branches (superior medial and lateral, inferior medial and lateral, and middle) of the popliteal artery,
a descending branch of the lateral femoral circumflex artery,
an articular branch of the descending genicular artery, and the anterior tibial recurrent artery. (PLGA)
What stabilizes the knee joint?
laterally: biceps and gastrocnemius (lateral head) tendons,
iliotibial tract,
fibular collateral ligaments
What stabilizes the hip joint?
acetabular labrum;
fibrous capsule;
capsular ligaments such as the iliofemoral, ischiofemoral, and pubofemoral ligaments
Knee joint is a ___ between two condyles of the femur and tibia while a __ between the femur and the patella.
condylar type of synovial joint
saddle joint
Is the largest and most complicated joint.
Knee Joint
Is a fibrous band that bridges the acetabular notch and converts it into a foramen, through which the nutrient vessels enter the joint.
Transverse Acetabular Ligament
Ligamentum Teres Capitis Femoris (Round Ligament of Head of Femur) provides a pathway for the ____ from the ___, which is of variable size but represents a significant portion of the blood supply to the femoral head during childhood
artery of the ligamentum capitis femoris (foveolar artery)
obturator artery
Arises from the floor of the acetabular fossa (more specifically, from the margins of the acetabular notch and from the transverse acetabular ligament) and attaches to the fovea capitis femoris
Ligamentum Teres Capitis Femoris (Round Ligament of Head of Femur)
Limits extension and abduction
Pubofemoral Ligament
Reinforces the fibrous capsule inferiorly, extends from the pubic portion of the acetabular rim and the superior pubic ramus to the lower part of the femoral neck
Pubofemoral Ligament
Limits extension and medial rotation of the thigh
Ischiofemoral Ligament
Reinforces the fibrous capsule posteriorly, extends from the ischial portion of the acetabular rim to the neck of the femur medial to the base of the greater trochanter
Ischiofemoral Ligament
It resists hyperextension and lateral rotation at the hip joint during standing.
Iliofemoral Ligament
Is the largest and most important ligament that reinforces the fibrous capsule anteriorly and is in the form of an inverted Y.
Iliofemoral Ligament
Reinforcements of Fibrous Capsule
anteriorly: iliofemoral ligament,
posteriorly: ischiofemoral ligament,
inferiorly: pubofemoral ligament
- Is attached proximally to the margin of the acetabulum and to the transverse acetabular ligament.
- Is attached distally to the neck of the femur as follows: anteriorly to the intertrochanteric line and the root of the greater trochanter, and posteriorly to the intertrochanteric crest.
- Encloses part of the head and most of the neck of the femur.
Fibrous Capsule
Is a (in?)complete fibrocartilage rim that deepens the articular socket for the head of the femur and consequently stabilizes the hip joint.
Acetabular Labrum
What hip dislocation is the most common and which is rare?
Most common: Posterior dislocation of hip joint
Rare: Anterior dislocation of hip joint
An alteration of the angle made by the axis of the femoral neck to the axis of the femoral shaft so that the angle is less than 135 degrees and thus the femoral neck becomes more horizontal.
Coxa vara
An alteration of the angle made by the axis of the femoral neck to the axis of the femoral shaft so that the angle exceeds 135 degrees and thus the femoral neck becomes straighter.
Coxa valga
It occurs through a posterior tearing of the joint capsule, accounts for approximately 90% of hip dislocations, and the fractured femoral head lies posterior to the acetabulum or the ischium, as occurs in a head-on collision.
Posterior dislocation of the hip joint
What is the blood supply of Hip (Coxal) Joint?
branches of the medial and lateral femoral circumflex arteries
superior and inferior gluteal arteries
obturator arteries (FGO)
What movements does Hip (Coxal) Joint allow?
abduction and adduction,
flexion and extension,
circumduction and rotation
Is a multiaxial ball-and-socket synovial joint between the acetabulum of the hip bone and the head of the femur
Hip (Coxal) Joint
- Is attached proximally to the margin of the acetabulum and to the transverse acetabular ligament.
- Is attached distally to the neck of the femur as follows: anteriorly to the intertrochanteric line and the root of the greater trochanter, and posteriorly to the intertrochanteric crest.
- Encloses part of the head and most of the neck of the femur.
- Fibrous Capsule
Is the largest and most important ligament that reinforces the fibrous capsule anteriorly and is in the form of an inverted Y.
- Iliofemoral Ligament
It resists hyperextension and lateral rotation at the hip joint during standing.
- Iliofemoral Ligament
Reinforces the fibrous capsule posteriorly, extends from the ischial portion of the acetabular rim to the neck of the femur medial to the base of the greater trochanter
- Ischiofemoral Ligament
Limits extension and medial rotation of the thigh
- Ischiofemoral Ligament
Reinforces the fibrous capsule inferiorly, extends from the pubic portion of the acetabular rim and the superior pubic ramus to the lower part of the femoral neck
- Pubofemoral Ligament
What stabilizes the knee joint?
laterally: biceps and gastrocnemius (lateral head) tendons,
iliotibial tract,
fibular collateral ligaments
Prevents forward sliding of the tibia on the femur (or posterior displacement of the femur on the tibia) and prevents hyperextension of the knee joint
Anterior Cruciate Ligament (ACL)
- Lies outside the synovial cavity but within the joint capsule.
- Is nearly circular, acts as a cushion, and facilitates lubrication.
- Is separated laterally from the fibular (or lateral) collateral ligament by the tendon of the popliteal muscle and aids in forming a more stable base for the articulation of the femoral condyle.
d. Lateral Meniscus
Binds the anterior horns (ends) of the lateral and medial semilunar cartilages (menisci)
e. Transverse Ligament
Is a broad band that extends from the medial femoral epicondyle to the medial tibial condyle
Medial (Tibial) Collateral Ligament
Arises as a strong cordlike tendon from the lateral aspect of the lateral femoral condyle and runs between the lateral meniscus and the capsule of the knee joint deep to the fibular collateral ligament.
Popliteus Tendon
Lies over the superficial surface of the patella.
Prepatellar Bursa
• Is a plane-type synovial joint between the head of the fibula and the tibia that allows a little gliding movement.
Proximal Tibiofibular Joint
- Is a plane synovial joint (part of the talocalcaneonavicular joint), and is formed between the talus and calcaneus bones.
- Allows inversion and eversion of the foot.
Talocalcaneal (Subtalar) Joint
Most commonly injured ligaments in ankle sprain
Anterior talofibular and calcaneofibular
- Is part of the transverse tarsal joint and resembles a saddle joint between the calcaneus and the cuboid bones.
- Is supported by the short plantar (plantar calcaneocuboid) and long plantar ligaments and by the tendon of the peroneus longus muscle.
- Calcaneocuboid Joint
Is a ball-and-socket joint (part of the transverse tarsal joint), and is formed between the head of the talus (ball) and the calcaneus and navicular bones (socket).
Talocalcaneonavicular Joint
- Are plane synovial joints that strengthen the transverse arch.
- Are united by articular capsules and are reinforced by the plantar, dorsal, and interosseous ligaments.
Tarsometatarsal Joints
• Is a collective term for the talonavicular part of the talocalcaneonavicular joint and the calcaneocuboid joint. The two joints are separated anatomically but act together functionally. Is important in inversion and eversion of the foot.
Transverse Tarsal (Midtarsal) Joint
A lateral deviation of the big toe and is frequently accompanied by swelling (bunion) on the medial aspect of the first metatarsophalangeal joint.
Hallux valgus
A localized swelling at the medial side of the first metatarsophalangeal joint (or of the first metatarsal head) that is caused by an inflammatory bursa and is unusually associated with hallux valgus.
Bunion
Are ellipsoid (condyloid) synovial joints that are joined by articular capsules and are reinforced by the plantar and collateral ligaments.
Metatarsophalangeal Joints
