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BMS100 MSK Anatomy > Lecture 13 > Flashcards

Lecture 13 Flashcards

1
Q

What type of joint is the hip joint?

A

ball and socket synovial (3 DOF)

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2
Q

What are the movements of the hip joint?

A

flexion/extension

abduction/adduction

medial/lateral rotation

Circumduction

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3
Q

What is another name for hip joint?

A

iliofemoral joint

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4
Q

What are the articular surfaces of the hip joint?

A

head of femur w/ acetabulum (lunate surface)

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5
Q

What are the axes in the hip joint?

A

horizontal (flexion, extension), vertical (rotation), antero-posterior (abduction, adduction)

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6
Q

T/F: The femoral head forms about 2/3 of a sphere of diameter 4-5 cm. The head is supported by the neck of femur, the axis of which runs superiorly, medially and anteriorly

A

True

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7
Q

The head of the femur in the adult forms an angle of ~125 (Angle of __) with the femoral shaft to place the knee under the weight-bearing line of the head of the femur

A

Inclination

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8
Q

There is an impression on the head of the femur for the attachment of the round ligament of the head, called the __

A

fovea

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9
Q

The head of the femur in the adult forms an acute angle of 10-30 with the femoral plane (angle of __).

A

anteversion

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10
Q

Femoral anteversion can be determined by?

A

measuring the angle formed between the long axis of the femoral neck and a line parallel to the dorsal aspect of the femoral condyles

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11
Q

An increase in angle of anteversion is called __ and is one factor that is considered to cause in-toeing, or pigeon toes, as well as genu valgum

A

anteversion

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12
Q

A decrease in the angle of anteversion is called __, which may lead to out-toeing (external rotation) during standing and walking as well as genu varum during standing.

A

retroversion

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13
Q

The angle of anteversion normally ___ with growth and development of the child, causing orthopedists to be conservative in treatment of children who walk with in-toeing

A

decreases

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14
Q
A

anteversion

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15
Q
A

retroversion

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16
Q
A

angle of anterversion

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17
Q

HIp joint: Only the __ surface of the acetabulum is lined by a horseshoe-shaped articular cartilage, which is interrupted inferiorly by the deep acetabular notch

The central part of the cavity (__ fossa) is deeper and is non-articular.

The acetabulum is directed __, __, __

A

lunate

acetabular

laterally, inferiorly, and anteriorly.

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18
Q

Hip joint: The __ __ permits movement of the ligamentum teres and importantly serves as a reservoir for synovial fluid when the hip is heavily loaded

A

acetabular fossa

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19
Q

Hip joint: When joint forces are decreased, __ __ once again returns to the joint space to provide lubrication and nutrition to the articular cartilages.

A

synovial fluid

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20
Q

The acetabular __ is a fibrocartilaginous ring inserted into the acetabular rim. It deepens the acetabulum and fills out the various gaps of the acetabular rim.

__ __ ligament (TAL) is attached to either side of the acetabular notch and to the labrum

A

labrum

Transverse acetabular

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21
Q

The __ __ (LT) of the head of the femur (ligamentum capitis femoris) is a flattened fibrous band, which arises from the acetabular notch and runs at the floor of the acetabular fossa before its insertion into the fovea femoris capitis.

It is embedded in __-__ tissue within the acetabular fossa and is lined by the synovial membrane . This ligament is extremely strong (breaking force equivalent to 45 Kg. weight) and its primary function is to carry the __ supply to the head of the femur

A

ligamentum teres

fibro-adipose

vascular

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22
Q

Hip joint: The capsule is like a cylindrical sleeve running from the hip bone to the upper end of the femur. Medially it is inserted into the __ __ and laterally into a line which runs along the __ line and at the junction of the lateral and middle thirds of the __ neck

A

acetabular rim

intertrochanteric

femoral

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23
Q

Capsular ligament: Y-shaped ligament that has two thick borders known as superior and inferior bands. It covers the hip joint anteriorly and superiorly

A

iliofemoral ligament

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24
Q

Capsular ligament: What ligament is anterior and inferior to the hip, limiting lateral rotation & abduction?

A

pubofemoral ligament

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25
Q

Capsular ligament: What ligament is posterior and inferior, limiting medial rotation?

A

ischiofemoral ligament

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26
Q

What do the capsular ligaments do?

A

thicken the joint capsule

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27
Q

__ fibres linking two discs resemble those making up the tube-like fibrous layer of the hip joint capsule.

A

Parallel

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28
Q

When one disc (the femur) rotates relative to the other (the acetabulum), the fibers become increasingly __ and draw the two discs __

A

oblique

together

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29
Q

The __ of the hip joint winds (increases the obliquity of) the fibers of the fibrous layer, pulling the head and neck of the femur tightly into the acetabulum, increasing the stability of the joint

A

extension

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30
Q

Which movement of the hip joint loosens the joint capsule?

A

flexion (most injury occurs in this position)

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31
Q

In standing, a horizontal axis running in a side-to-side direction is used for __ and __

A

flexion and extension

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32
Q

The __ _ _ represents a line connecting the centers of the two femoral heads, with movement occurring about this axis when, for example, the pelvis rocks forward and backward in standing, or when both knees are pulled up to the chest from a supine lying position.

A

common hip axis

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33
Q

Active hip flexion with the knee flexed can be reached to __ degrees. With the knee extended, flexion is limited to - degrees by the hamstrings.

A

120

70-90

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34
Q

Passive hip flexion with knee flexed exceeds 145 degrees , but with knee extended would be less, due to __ __

A

hamstring stretching

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35
Q

__ of the hip is limited to 10-20 degrees by the iliofemoral ligament. (further motion is usually perceived when one attempts this movement, however, it is extension of the lumbar vertebrae which gives a misleading impression).

A

Hyperextension

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36
Q

Hyperextension of the hip joint is less when knee joint is flexed due to?

A

Fact that the hamstrings lose some of their efficiency as extensors of the hip because their contraction has largely been utilized in flexing the knee

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37
Q

The axis for abduction and adduction in the standing position is in a __-_-__ direction

A

front-to-back

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38
Q

Either the limb may move in relation to the __ (lifting the limb laterally), or the pelvis may move in relation to the __ (inclining the trunk to the side of the stance leg). In either case, either abduction or adduction of the hip is the correct term to use to describe these movements.

A

pelvis; limb

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39
Q

Hip __ is abut 45 degrees and is usually accompanied by elevation of the pelvis.

Hip __ is frequently described as contact between the two thighs, or 0 degrees. However, with the legs crossed about 30-40 degrees of adduction is possible.

A

abduction

adduction

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40
Q

Hip __ is easier to observe when the knee is flexed to 90 dgerees and the motion of the tibia from the neutral position is measured

A

rotation

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41
Q

The axis for medial and lateral rotation in standing is vertical, and identical to the?

A

mechanical axis of the femur

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42
Q

Flexor muscles lie __ to the frontal plane, which passes through the center of the joint

A

anterior

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43
Q

There are many flexor muscles of the hip joint and the most important of which are the?

A

Psoas major
Iliacus
Sartorius
Rectus femoris
Tensor fascia latae
Pectineus
Adductor longus
Gracilis
Anterior fibers of glutei medius and minimus

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44
Q

Which muslces produce flexion, abduction, and medial rotation of hip?

A

anterior fibers of glutei medius & minimus
tensor fascia latae

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45
Q

Which muscles produce flexion, adduction, and lateral rotation hip?

A

psoas major
iliacus
pectineus
adductor longus

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46
Q

__ muscles lie behind the frontal plane that passes through the center of the joint

A

Extensor

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47
Q

Extensor muscles that insert into the femur are?

A

Gluteus maximus
Posterior fibers of gluteus medius
Posterior fibers of gluteus minimus

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48
Q

Extensor muscles that insert into knee are?

A

Biceps femoris
Semitendinosus
Semimembranosus
Adductor magnus

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49
Q

__ muscles generally lie lateral to the sagittal plane which traverses the center of the joint

A

Abductor

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50
Q

What are the abductor muscles of the hip?

A

Anterior fibers of gluteus medius
Gluteus minimus
Tensor fascia lata
Gluteus maximus (upper fibers)
Piriformis

+ sartorius, obturators, gemelli

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51
Q

__ muscles lie generally medial to the sagittal plane, which traverses the center of the joint

A

Adductor

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52
Q

What are the adductor muscles of the hip?

A

Adductor magnus
Gracilis
Semimembranosus
Semitendinosus
Biceps femoris
Gluteus maximus
Quadratus femoris
Pectineus
Obturator externus
Adductor longus
Adductor brevis

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53
Q

What the lateral rotators of the hip joint?

A

Piriformis
Obturator internus
Obturator externus
Quadratus femoris
Gluteus maximus
Gluteus medius (Posterior fibers)
Gemelli

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54
Q

What are the medial rotators of the hip joint?

A

Tensor fascia lata
Gluteus minimus (Anterior fibers)
Gluteus medius (Anterior fibers)

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55
Q

What type of joint is the knee joint?

A

synovial modified hinge joint

56
Q

Complex joint, consisting of three bones, 2 DOF, and three articulating surfaces

A

knee joint

57
Q

What are the 3 articulating surfaces of the knee joint?

A
  • Medial tibio-femoral
  • Lateral tibio-femoral
  • Patello-femoral
58
Q

T/F: All articulating surfaces of the knee joint are enclosed by common (same) joint capsule

A

True

59
Q

What are functions of the knee joint?

A
  • Withstanding large forces
  • Providing great stability
  • Enabling a large ROM
60
Q

What provides mobility of the knee joint? Stability?

A

Mobility is primarily provided by the knee bony structure

Soft tissues, including ligaments, muscles (most important), and cartilage, provide stability

61
Q

What type of joint is the tibiofemoral (lateral & medial - knee joint) and what movements does it provide?

A

modified hinge
- flexion
- extension
- internal rotation
- external rotation

62
Q

What type of joint is the patellofemoral (knee joint) and what movement does it provide?

A

planar
- slide/glide

63
Q

Knee joint: The articular surfaces of the femur represent a segment of a pulley, which recalls the twin undercarriage of an aeroplane. The two __ __ convex in both planes, form the two lips of the pulley, and they are extended anteriorly by the pulley-shaped __ surface

A

femoral condyles

patellar

64
Q

Knee joint: The __ surfaces are reciprocally curved and comprise two curved and concaved parallel gutters which are separated by a blunt eminence running antero-posteriorly. This eminence lodges the two __ tubercles, and if we prolong this eminence, it coincides with the vertical ridge on the deep surface of the patella

A

tibial

intercondylar

65
Q

Knee joint: To allow __ rotation, the tibial surface must be so modified as to shorten the intercondylar eminence. This is achieved by planning the two ends of the eminence and leaving its middle part to act as a pivot, which, by lodging in the __ notch, allows the tibia to rotate around it (axis R).

A

axial

intercondylar

66
Q

The knee joint capsule comprises complex passive and active connections among the?

A

menisci, ligaments, retinacula, bones, muscles, and the capsule itself

67
Q

The knee joint capsule forms a sleeve around the joint, attaching just above the __ condyles and below the __ condyles.

A

femoral; tibial

68
Q

__ and __ reinforce and become integral parts of the capsule

A

Retinacula; ligaments

69
Q

The proximal tendon of the __ muscle pierces the capsule to attach to the lateral femoral condyle

A

popliteus

70
Q

The semimembranosus muscle forms part of the __ __ ligament and gives off fibres to the MCL and its large bony attachment. It reinforces the joint capsule posteriorly

A

oblique popliteal

71
Q

The __ __ ligament also strengthens the joint capsule postero-laterally. It arises from the posterior aspect of the fibular head, passes supero-medially over the tendon of the popliteus, and spreads over the posterior surface of the knee joint

A

arcuate popliteal

72
Q

__ ligaments (medial & lateral) strengthen the articular capsule on its medial and lateral aspects. They are, therefore, responsible for the transverse stability of the knee during extension

A

Collateral

73
Q

The __ collateral ligament runs from the medial epicondyle of the femur to the upper end of the tibia just posterior to the pes anserine tendon. So it runs inferiorly and anteriorly

A

medial (tibial)

74
Q

The ___ collateral ligament runs from the lateral epicondyle of the femur to the head of the fibula

A

lateral

75
Q

The collateral ligaments are __ during extension and __ during flexion

A

stretched; slackened (relaxed)

76
Q

Which ligament attaches to the medial meniscus?

A

tibial collateral ligament

77
Q

In the anterior view of the knee joint, the __ ligaments are seen in the center of the joint, being largely contained within the intercondylar notch and fossa

A

cruciate

78
Q

The __ __ __, the weaker of the two cruciate ligaments, is attached to the anterior intercondylar area of the tibia. It runs superiorly, posteriorly and laterally and is attached to the internal aspect of the lateral condyle of the femur

A

anterior cruciate ligament (ACL)

79
Q

Which collateral ligament is more likely to be injured?

A

tibial collateral ligament

80
Q

The __ __ __ is attached to the posterior intercondylar area of the tibia. The ligament runs obliquely medially, anteriorly, and superiorly to be inserted into the edge of the lateral surface of the medial femoral condyle

A

posterior cruciate ligament (PCL)

81
Q

Cruciate ligaments stabilize the knee in the __-__ direction and allow the joint to work as a hinge while keeping the articular surfaces in contact

A

antero-posterior

82
Q

Cruciate ligaments are intracapsular but extra __

A

synovial

83
Q

The interposition of the menisci (semi-lunar fibrocartilages) corrected the lack of __ in the articular surfaces

A

congruency

84
Q

extrinsic intracapsular ligament of the knee?

A

cruciate ligaments

85
Q

These rings (mensici) are incomplete in the region of the intercondylar tubercles of the tibia so that they are crescent-shaped with an __ and a __ horn.

The horns of the lateral meniscus come closer to each other so that the meniscus is almost a complete circle. Whereas the medial meniscus is?

A

anterior; posterior

C-shaped

86
Q

anterior cruciate ligament, posterior cruciate ligament, medial mensicus are more prone to?

A

damage

87
Q

Menisci have important attachments from a functional point of view. Each horn is anchored to the __ condyle in the anterior and posterior intercondylar areas respectively

A

tibial

88
Q

What are the important ligament attachments of the menisci?

A
  • The two anterior horns are linked by the transverse ligament of the knee
  • The medial collateral ligament of the knee is attached to the medial meniscus.
  • The lateral collateral ligament of the knee is separate from its corresponding meniscus by the tendon of popliteus, which sends a fibrous expansion to the posterior border of the lateral meniscus
89
Q

What movements can the knee joint complete?

A

flexion/extension

axial rotation

90
Q

__ ranges from 120-150 degrees depending on the size of the muscle mass in the calf and posterior thigh as they make contact

__ of the knee is minimal, and usually will not exceed 15 degrees

A

Flexion

Hyperextension

91
Q

Which plane does axial rotation of the knee occur in?

A

transverse plane when knee is flexed

92
Q

With the knee flexed to 90 degrees the ligaments are slackened, allowing for a considerable amount of __ to occur

A

rotation

93
Q

Rotation of the knee joint is limited by?

A

limited by capsular and ligamentous structures, including the collateral, cruciate, and oblique popliteal ligaments as well as the retinacula and the Iliotibial tract

94
Q

There is also a type of automatic axial rotation called __-__ __ because it is inevitably and involuntarily linked to movements of flexion and extension.

It occurs especially at the end of extension or the start of flexion.

When the knee is __ the foot is laterally (EXTernally) rotated; hence the mnemonic EXTension and EXTernal rotation. When the knee is __ the leg is medially rotated. When the knee is fully extended with the foot on the ground, the knee passively “locks” because of lateral rotation of the tibia on the femoral condyles

A

Screw-Home Mechanism

extended

flexed

95
Q

The quadriceps femoris is the extensor muscle of the knee. It is composed of four heads known as?

A

Vastus intermedius
Vastus lateralis
Vastus medialis
Rectus femoris

96
Q

The __ increases the efficiency of the quadriceps muscle up to 33%

A

patella

97
Q

The flexor muscles of the knee are the hamstrings and some other muscles which consist of?

A

Biceps femoris
semitendinosus
Semimembranosus
Gracilis
Sartorius
Gastrocnemius

98
Q

Rotators of the knee

A
99
Q

Pelvis support and protection to the pelvic organs

A

pelvic girdle

100
Q

T/F: Pelvic girdle transmits forces from the head, arms, and trunk to the lower extremities

A

True

101
Q

What are the 7 joints of the pelvis region?

A

Lumbosacral
Sacroiliac
Sacrococcygeal
Symphysis pubis
Hip

102
Q

Hip joints are the most structurally stable, yet most __ joints in the body

A

mobile

103
Q

Which joint transmits large forces between the trunk and the ground?

A

hip joint

104
Q

Which joint sustains more than three times the body weight with each step?

A

hip joint

105
Q

The __ joint can be a sight of low back pain, often following childbirth due to injuries of ligaments, hyper- and hypo-mobility, or inflammatory conditions

A

sacroiliac (SI)

106
Q

What type of joint is the sacroiliac joint?

A

synovial planar (gliding)

107
Q

What are the articular surfaces of the sacroiliac joint?

A

ilium part of the hip bone and sacrum

108
Q

SI joint: The __ surface is covered in hyaline cartilage and the __ surface is covered in fibrocartilage

A

sacral

iliac

109
Q

On the posterior side of the sacrum, the __ ligaments fill the space between the sacrum and the inner side of the iliac tuberosity

A

interosseous

110
Q

Several layers of the posterior __ ligaments cover the interosseous ligaments and the posterior aspect of the sacrum

On the anterior aspect lie the anterior __ ligaments

A

sacroiliac

111
Q

The __ and __ ligaments are connecting to the spinous process and ischial tuberosity, providing them with excellent leverage to hold the distal aspect of the sacrum in place against the anterior weight-bearing forces

A

sacrotuberous; sacrospinous

112
Q

Because the fibers of the interosseous and posterior sacro-iliac ligaments run obliquely upward and outward from the sacrum, the axial weight pushing down on the sacrum pulls the ilia inward (medially) so that they compress the sacrum between them, locking the irregular but congruent surfaces of the sacro-iliac joints together. The iliolumbar ligaments are accessory ligaments to this mechanism. This is called a __-__ __

A

self-locking mechanism

113
Q

What type of joint is the sacrococcygeal joint?

A

may be classified as a synovial planar (gliding) joint or as a symphysis (secondary cartilaginous) synarthrosis joint, depending on the subject’s age

114
Q

What type of joint is the intercoccygeal joints?

A

synarthrosis

115
Q

Motion increases between which joints during pregnancy, and ossification of the joints occurs with aging?

A
  • sacrococcygeal
  • intercoccygeal
116
Q

Pubic symphysis: The articulating surfaces of the pubic bones are separated by a fibrocartilaginous interpubic disc, hence its classification as a cartilaginous symphysis (secondary cartilaginous) __ __ __ joint

A

amphiarthrosis cartilaginous symphysis

117
Q

Even small motions occurring at the __ joints must be accompanied by motion at the symphysis pubis, as the symphysis pubis completes the closure of the ring of the pelvic articulations

A

SI (sacroiliac)

118
Q

Extensor digitorum brevis

A

Ori: Dorsal surface of calcaneus

Ins: Lateral side of the tendon of extensor digitorum longus for toes # 2 - 4

Function: extension of toes 2-4 @ MTP & DIP, PIP joints

Innervation: deep fibular (peroneal) nerve

119
Q

Extensor hallucis brevis

A

Ori: Dorsal surface of calcaneus

Ins: Proximal phalanx of big toe

Function: extension of big toe @ MTP joints

Innervation: deep fibular (peroneal) nerve

120
Q

How many layers of muscle are in the sole of the foot?

A

4

121
Q

What muscles are in the 1st layer?

A

1) Abductor hullucis
2) Flexor digitorum brevis
3) Abductor digiti minimi

122
Q

Which layer of the sole of the foot is most superficial?

A

one

123
Q

Which layer of the sole of the foot is deepest?

A

fourth

124
Q

What is in the second layer of the sole of the foot?

A

The second layer of the muscles in the sole includes two muscles and two tendons:
1) Flexor hallucis longus tendon
2) Flexor digitorum longus tendon
3) Quadratus plantae ( Flexor accessorius) Lumbricals
4) Lumbricals (4 muscles)

125
Q

What muscles are in the third layer of the sole of the foot?

A

1) Flexor hallucis brevis
2) Adductor hallucis
3) Flexor digiti minimi brevis pedis

126
Q

What muscles are in the fourth layer of the sole of the foot?

A

Two groups of muscle:
1) Plantar interossei (3 muscles)
2) Dorsal interossei ( 4 muscles)

127
Q

Abductor hallucis

A

Ori:
- Medial process of tuberosity of the Calcaneus
- Plantar fascia

Ins: Base of the proximal phalanx of the big toe

Function: abduction of big toe @ MTP joint

Innervation: medial plantar nerve

128
Q

Flexor digitorum brevis

A

Ori:
- Medial process of tuberosity of the calcaneus
- Plantar fascia

Ins: The sides of the middle phalanx of toe #2-5

Function: flexion of toes #2-5 @ MTP, PIP Joints

Innervation: medial plantar nerve

129
Q

Abductor digiti minimi

A

Ori:
- Lateral process of the tuberosity of the Calcaneus
- Plantar fascia

Ins: Base of the proximal phalanx of 5th toe

Function: abduction of toe #5 @ MTP joint

Innervation: lateral plantar nerve

130
Q

Quadratus plantae (flexor accessorius)

A

Ori: Calcaneus

Ins: Tendon of the flexor digitorum longus

Function: assists flexor digitorum longus to flex toes #2-5 @ MTP & IP joints

Innervation: lateral plantar nerve

131
Q

Lumbricals

A

Ori: tendon of the flexor digitorum longus

Ins: Dorsal digital expansion of toes #2-5

Function:
- Flexion of toes #2-5 @ MTP joints
- Extension of toes #2-5 @ PIP & DIP joints

Innervation:
- Lumbrical #1: medial plantar nerve
- Lumbrical #2-4: lateral plantar nerve

132
Q

Flexor hallucis brevis

A

Ori:
- Cuboid
- 3rd (lateral) cuneiform

Ins: Medial and lateral sides of proximal phalanx of great toe (the tendon contains sesamoid bones)

Function: flexion of big toe @ MTP joint

Innervation: medial plantar nerve

133
Q

Flexor digiti minimi brevis pedis

A

Ori:
- Base of 5th metatarsal
- Tendon of fibularis longus

Ins: Proximal phalanx of 5th toe

Function: flexion of 5th toe @ MTP joint

Innervation: lateral plantar nerve

134
Q

Adductor hallucis

A

Ori:
Oblique head:
- The base of metatarsals # 2 – 4
- Tendon of fibularis longus

Transverse head :
- Plantar metatarsophalangeal ligaments

Ins: Base of the proximal phalanx of great toe

Function: adduction of big toe @ MTP joint

Innervation: lateral plantar nerve

135
Q

Dorsal interossei

A

Ori: Adjacent sides of metatarsal bones.

Ins: Bases of the proximal phalanges (and dorsal digital expansion).
- 1st is inserted into the medial side of the 2nd toe
- other 3 are inserted into the lateral sides of the 2nd, 3rd, and 4th toes

Function:
- Abduction of toes #2-4 @ MTP joint
- Flexion of toes #2-4 @ MTP joint
- Extension of toes #2-4 @ DIP, PIP joint

Innervation: lateral plantar nerve

136
Q

Plantar interossei

A

Ori: Metatarsal bones #3 - 5

Ins: Bases of proximal phalanges (and dorsal digital expansion).
- 1st is inserted into the medial side of the 3rd toe
- other 2 are inserted into the medial sides of the 4th & 5th toes

Function:
- Adduction of toes #3-5 @ MTP joints
- Flexion of toes #3-5 @ MTP joints
- Extension of toes #3-5 @ DIP, PIP joints

Innervation: lateral plantar nerves

BMS100 MSK Anatomy (9 decks)

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