Lecture 2: Hip, Knee Complex And Ankle Joint Flashcards
A structure projecting in the posterior ischium which intervenes the greater and lesser sciatic notches.
Ischial spine
It is where hamstring muscles originate.
Ischial tuberosity
Obturator foramen is filled by —— membrane
Obturator membrane
Maximum contact or closed packed position of the hip joint
Flexion
Slight external rotation
Slight abduction
Inferior deficient margin of acetabulum
Acetabular notch
Articular surface of acetabulum
Lunate surface
Angle of torsion in hip joint.
12-15 degrees
Angle of inclination of hip joint
126 degrees
A ligament contained inside the acetabular fossa
Ligamentum teres
Tension in ligamentum teres occurs during:
Add+flexion+external rotation
Add+ext+internal rotation
Small depression in the head o femur
Fovea capitis
Normal orientation of femur neck
Downward, backward, laterally
Extends SUPERIORLY from the shaft and lateral to the region where the shaft joins the neck and femur
Greater trochanter
It is where quadrate tubercle is found
Intertrochanteric crest
Angle created by shaft along the vertical axis from lateral to medial
7 degrees
It is where muscles and intermuscular septa are attached.
Linea aspera
Linea aspera diverge superiorly into ——- in superior medial direction, and ——— in superior lateral direction.
Pectineal
Gluteal tuberosity
Linea aspera diverge inferiorly into —— and ——-
Medial supracondylar ridge and lateral supracondylar ridge
A flat triangular surface on the posterior inferior shaft.
Popliteal surface
Lateral and medial condyles are separated posteriorly by ——.
Intercondylar notch
——- tubercle found in the medial epicondyle. It is where adductor muscles insert.
Adductor tubercle in the medial epicondyle
The cavity of the acetabulum is deepened by ——-
Acetabular labrum
Ligament that bridges that acetabular notch
Transverse acetabular ligament
Nerve supply in the hip joint
Sciatic, obturator, femoral, nerve to quadratus femoris
3 Ligaments of the hip joint
Ischiofemoral
Pubofemoral
Iliofemoral
Strong inverted y-shaped ligament of bigelow.
Attached to AIIS
Insert to trochanteric line
Iliofemoral ligament
Action of iliofemoral ligament
limits overextension
Action of pubofemoral ligament
Limits both extension and ABDUCTION
Action of ischiofemoral ligament (a spiral shaped ligament)
Limits extension
What are the movements possible in the hip joint?
Flex, extend, abd, add, lateral and medial rotation, circumduction
Flexor muscles of the hip joint
Iliopsoas
Rectus femoris
Sartorius
Pectineus
Extensor muscles of the hip joint
Gluteus maximus and hamstring muscles (except the short head of biceps femoris)
ROM of extension and flexion at hip joint
Ext: 0-10 degrees
Flex: 120 degrees (if knee is flexed) and 70-90 degrees if knee is extended
Limitation of flexion when knee joint is extended is due to tension in the hamstring muscles.
Abductor muscles of the hip joint
Gluteus medius,
gluteus minimus,
tensor fascia lata,
piriformis
ROM of hip joint abduction
45 degrees
Abduction in the hip joint is limited by what ligament.
Pubofemoral ligament
Adductor muscles of the hip joint
Adductor group
Pectineus
Gracilis
ROM of adduction in the hip joint.
30 degrees
What limits adduction in the hip joint?
Contact with the opposite limb and
Tension in the ligament in the head of femur
Lateral/external rotator muscles of the hip joint
Piriformis Deep gluteal muscles -quadratus femoris -gemelli inferior and superior -obturator externus and internus Gluteus maximus Biceps femoris long head
Internal/medial rotator muscles of the hip joint
Gluteus minimus
Gluteus medius
Tensor fascia lata
SECONDARY ACTORS Semimebranosus Semitendonosus Adductor magnus Adductor longus
ROM of medial rotation in hip joint
60 degrees
ROM of lateral rotation in the hip joint
30 degrees
Bones included in the knee complex
Tibia, femur, patella
No fibula!
Joints in the knee complex
Femorotibial joint
Patellofemoral joint
Femorotibial joint is most stable in ———
Extension
What joint type does patellofemoral joint belong?
Plane gliding joint
This joint functions as pulley for the quadriceps femoris group.
Patellofemoral joint
2 types of ligaments in the knee complex
Extracapsular
Intracapsular
What are the 4 extracapsular ligaments found in the knee complex?
Ligamentum patellae
Oblique popliteal
Lateral collateral ligament
Medial collateral ligament
Ligament attached to the lower border of patella and below the tibial tuberosity.
Ligamentum patellae
Tendinous expansion of the SEMIMEMBRANOSUS muscle
Oblique popliteal ligament
Ligament attached above to lateral condyle of femur and below tibular head.
Lateral collateral ligament
Ligament attached above to medial condyle of femur and below tibular head.
Medial collateral ligament
Action of lateral collateral ligament.
Prevents adduction of tibia on femur
It is taut on extension, slack on flexion
Prevents abduction of tibia on femur
Medial collateral ligament
What are the 3 intracapsular ligaments found in the knee complex?
Menisci
Anterior cruciate ligament
Posterior cruciate ligament
C chaoed fibrocartilage sheet
Menisci
Prevents posterior displacement of the femur on tibia
Anterior cruciate ligament
Prevents anterior displacement of the femur on tibia
Posterior cruciate ligament
In drawers test:
If tibia translates anteriorly-it results to ——-
If tibia translates posteriorly-it results to ——-
ACL tear
PCL tear
Are peripheral borders attached to capsule
Inner border is thin and concave
Functions to deepen articular surface
Serves as cushion
Attached to tibia through their horns in the intercondylar fossa
Menisci
What are the bursae found in the anterior knee?
Suprapatellar
(inflammation: stiff knee)
Prepatellar
(inflammation: house maids knee)
Superficial interpatellar
Deep interpatellar (inflammation: vicars knee)
Extensor muscles of the knee joint.
Quadriceps femoris group
Flexor muscles of the knee joint
Posterior superficial muscles (biceps femoris, semitendosus and membranosus)
Gracilis
Popliteus
Medial rotators of the knee
Sartorius
Gracilis
Semitendonosus
Lateral rotator of the knee
Biceps femoris
ROM Flexion of the knee
120 to 150 degrees
ROM extension of the knee
Hyperextension not more than 15 degrees
Mechanism where in the last 20 degrees of knee extension, the tibia externally rotates 10-20 degrees on the fixed femur, the femur internally rotates on tibia
-it occurs in active and passive knee extension
Screw home
Joint between the tibia and the crus
Talocrural joint
Bones included in the ankle joint
Talus, medial malleolus of tibia, and lateral mallelus of fibula
2 types of ligaments in the ankle joint
Medial/deltoid ligament
Lateral ligament
What are the 4 medial collateral ligaments in the ankle joint?
Tibionavicular (superficial)
Calcaneotibial ligament (superficial)
Anterior talotibial ligament (deep) limits plantarflexion
Posterior talotibial ligament (deep) limite dorsiflexion
What are the 3 lateral collateral ligaments found in the ankle joint?
Anterior talofibular ligament (limits plantarflexion) Calcaneofibular ligament (from lateral malleolus to calcaneum) Posterior talofibular (limits dorsiflexion)
Muscles for dorsiflexion of ankle joint.
Anterior compartment of the leg
- extensor hallucis longus
- extensor digitorium longus
- tibialis anterior
- peroneus tertius
Muscles for plantarflexion of ankle joint.
Posterior and lateral muscles of the leg
- peroneus tertius brevis and longus
- gastrocnemius
- soleus
- tibialis posterior
- flexor hallucis longus
- flexor digitorium longus
ROM For plantarflexion of the ankle joint
35 degrees
ROM For dorsiflexion of the ankle joint
25 degrees
Nerve supply for ankle joints
Deep peroneal and tibial nerves
*choose one inside the parenthesis
Acute sprains of the lateral ankle is causes by excessive (INVERSION or EVERSION) of the foot with (PLANTARFLEXION OR DORSIFLEXION) of the ankle.
——— and ——- ligaments are partially torn, causing great pain and local swelling.
Inversion
Plantarflexion
Anterior talofibular
Calcaneofibular
*choose one inside the parenthesis
Acute sprains of the medial ankle is caused by excessive (INVERSION or EVERSION) of the foot.
——— ligament is affected.
Eversion
Medial/deltoid ligament
Fracture dislocations of the ankle joint is caused by forced ———-
External rotation and over eversion of the foot