Lecture 13: Lower Extremity part 4 (joints)

Question 1

1) What type of joint is the hip joint?
2) What structures are involved?

Answer 1

1) Ball and socket synovial joint
2) Femoral head; acetabulum + labrum

Question 2

Define the orbicular zone

Answer 2

Thickened joint capsule; thick parts of the capsule form “ligaments” [around hip joint]

Question 3

The extent of synovium of the hip joint is proximal to the greater trochanter, but the ____________________ inserts at IT crest

Answer 3

fibrous joint capsule

Question 4

List 2 components of the hip’s fibrous layer joint capsule

Answer 4

1) Orbicular zone
2) Ligaments

Question 5

The retinaculum (fold) of the hip joint is located where?

Answer 5

Synovial membrane

Question 6

Where do most [hip] adductor muscles insert?

Answer 6

Onto femur shaft

Question 7

List the lateral rotator muscles of the hip

Answer 7

1) Obturator externus and internus
2) Piriformis
3) Gemelli
4) Quadratis femoris
5) Gluteus maximus
6+7) (Gluteus medius and minimus)

Question 8

List the medial rotators of the hip

Answer 8

1) Anterior parts of gluteus medius and minimus
2) Tensor fascaie latae

Question 9

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What are the extensors of the hip?

Answer 9

1) Gluteus maximus
2) Hamstrings:
-Semitendonosus
-Semimembranosus
-Biceps femoris (long head)
3) Adductor magnus (posterior pt)

Question 10

What are the 3 abductors of the hip?

Answer 10

1) Gluteus medius
2) Gluteus minimus
3) Tensor fasciae latae

Question 11

1) What artery mainly supplies the hip joint?
2) Where does this artery come from?
3) What else supplies the hip joint?

Answer 11

1) Profunda femoris a. (variation femoral a.)
2) Medial and Lateral Circumflex a.
3) Obturator a. to Acetabular branch. via ligament of head of femur

Question 12

Fractures of the femoral neck or dislocation of hip joint often disrupt what blood supply? What may this result in?

Answer 12

1) Medial circumflex and retinacular arteries
2) Avascular Necrosis of the proximal femoral head fragment

Question 13

1) True or false: The artery to head of femur is often NOT adequate.
2) Dislocation of femoral head may lead to injury to what artery?

Answer 13

1) True
2) Acetabular branch artery

Question 14

1) What type of joint is the knee? What are its 3 movements?
2) What leg bone is not involved with knee joint or weight bearing?
3) What stabilizes the knee joint?

Answer 14

1) Hinged synovial joint - glides, rolls, rotates
2) Fibula
3) Muscles and ligaments

Question 15

What are the 3 articular surfaces of the knee joint?

Answer 15

1) Lateral and medial (femoral & tibia condyles)
2) Patella

Question 16

What pulse is in the popliteal fossa?

Answer 16

Popliteal artery

Question 17

What parts of the knee joint are weight bearing?

Answer 17

Condyles of femur and tibia

Question 18

What parts of the knee joint are the articular surfaces?

Answer 18

Lateral and medial femoral and tibial condyles

Question 19

Ture or false: medial meniscus is attached to the medial collateral ligament (MCL) but lateral meniscus is NOT attached to the LCL

Answer 19

True

Question 20

What prevents anterior translocation of the knee?

Answer 20

ACL

Question 21

What ligament is the lateral meniscus protected by laterally?

Answer 21

Fibular collateral ligament

Question 22

1) What prevents or stabilizes excessive anterior movement of tibia relative to femur?
2) What does the PCL do?

Answer 22

1) ACL
2) Stabilizes posterior movement of tibia relative to femur

Question 23

1) What tests for integrity of the ACL?
2) What tests for integrity of the PCL?

Answer 23

1) Anterior drawer sign
2) Posterior drawer sign

Question 24

What allows stabilization of round femoral condyle on flat tibial condyle?

Answer 24

Medial and lateral menisci [of knee]

Question 25

What is the common triad injury to players hit from posterior lateral aspect of the knee?

Answer 25

1) MCL
2) Medial meniscus
3) ACL

Question 26

1) List 3 clinically relevant bursa of the knee
2) List 4 conditions that affect the bursa of the knee

Answer 26

1) Repatellar, suprapatellar with joint capsule, pes anserine
2) Baker’s cyst, joint effusion, Pes anserine bursitis, prepatellar bursitis

Question 27

1) Synovial capsule [of knee] is extensive and continuous with what?
2) Joint effusion will affect what?

Answer 27

1) Suprapatellar bursa
2) Suprapatellar bursa

Question 28

1) What arteries provide for the knee joint?
2) The branches of what 5 nerves innervate the knee joint?

Answer 28

1) Genicular arteries provide articular branches
2) Femoral, tibial, common fibular, obturator, & saphenous n.

Question 29

1) What type of joint is the proximal tib-fib joint?
2) What about the distal tib-fib joint? What is it made of?

Answer 29

1) Synovial
2) Fibrous (syndesmosis); thickening of the interosseous membrane

Question 30

What joint is a thickening of the interosseous membrane?

Answer 30

Distal tib-fib joint

Question 31

1) Cox refers to __________
2) Genu refers to ___________

Answer 31

1) hip
2) knee

Question 32

1) What is genu varum?
2) What about genu valgum?

Answer 32

1) Bow-legged
2) Knock-knees