Lecture 28 In Class Flashcards

Posterior thigh, popliteal fossa. knee joint

1
Q

What is another name for fibular?

A

Peroneal.

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2
Q

What are the muscles of hte posterior compartment of the knee?

What are their actions?

A
  • Hamstring Muscles
    • semitendinosus
    • Semimembranosus
    • ​Biceps femoris
    • Adductor Magnus

extensors of the hip, flexors of the knee

all originate on ischial tuberosity!!!

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3
Q

What are the roots for sciatic nerve?

What does it do?

A
  • L4-S3
  • Innervate muscles of poterior thigh
  • Tibial part (most of them)
    • ​semitendinosus
    • semimenrbanosus
    • lg head of biceps femoris
    • hamstring part of add magnus
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4
Q
A

Semitendinosus (has a true tendon)

  1. ischial tuberosity–> medial tibia (with gracilis and sartoris)
  2. tibial sciatic (L4-S3)
  3. extend hip and flex knee

hamstring muscle

Posterior thigh muscle

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5
Q

What is the muscle to the left of the line?

A

Semimembranosus (looks like a tendon)

  1. ischial tuberosity –> medial tenondon condyl fibers refelct back up to fossa and become oblique tendon
  2. tibial part of sciatic (L4-S3)
  3. extend hip, flex knee

hamstring muscle

Posterior thigh muscle

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6
Q
A

Biceps Femoris Long Head

  1. ischial tuberosity–> head of fibula
  2. tibial part of sciatic nerve (L4-S3)
  3. extend hip, flex knee

Hamstring muscle

poterior thigh muscle

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7
Q

What muscle is this?

  1. What is its orgin and insertion?
  2. What is its innervation
  3. What is its actions?
A

Biceps Short head

  1. lateral lip of linea aspera–> ******head of fibula********
  2. common fibular part of scatitc (L4-S2)
  3. flex knee
    1. only one that does not extend the hip

Hamstring muscle

posterior thigh muscle

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8
Q

What muscle is this?

  1. What is is Orgin/ insertion?
  2. What is its innervation
  3. What is its actions?
A

Adductor magnus (hamstring head)

  1. ischial tuberosity–>adductor tuberical of femor
  2. tibial part of sciatic nerve (L4-S3)
  3. extend the hip

Most of the floor of the posterior thigh

Hamstring muscle

posterior compartment of the thigh

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9
Q

What is pes anserinus?

What is another name for it?

A
  • conjointed tendon of:
    • sartorius m
    • Gracilis
    • semitendinosus
  • anteromedial tibial
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10
Q

what are the attachments for these places

A
  • addcutor tubericle: adductor magnus hamstring part

on medial side from top to bottom,

gracilis

semitendenosis

sartouris

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11
Q

What is the blood supply of the posterior thigh?

A
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12
Q

What are the boundreis of the popliteal fossa?

Where is it located?

A
  • Sup-med:
    1. ​​ semimembranosus
    2. semitendiosus
  • Sup-lat​​

3.biceps femoris

  • Inf-med
    4. medial head of gastrocnemius
  • Inf-lat
    5. lat head of gastrocnemius
    6. plantaris

POSTERIOR FEMUR

  • Roof
    1. ​ popliteal fascia
      • poterior femoral cutaneus
      • medial and lateral sural nn.
      • (f/ tibial {medial}
      • common fibular nerve {lateral nerve}
      • small saphenosus v –> popliteal v
  • Floor
    1. ​ femur
    2. oblique popliteal lig f/ semitenenosis
      • stabalize the knee
    3. popliteus
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13
Q

What are the contents of the popliteal fossa?

A
  1. tibial nerve (L4-S3)
    1. medial sural nerve
  2. popliteal vein
    1. small saphenous vein
  3. popliteal artery
    1. genicular anastomosis
    2. Common fibular nerve (L4-S2)
      1. lateral sural nerve
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14
Q
  1. What type of joint is the tibiofemoral joint?
  2. Articulations
  3. What does stibility depend on?
A
  1. modified hinge joint
  2. lateral/medial femoral condyly–> lateral/medial tibial plateau
  3. ligaments and surround muscles and tendons
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15
Q

Genu varum vrs. Genu Valgum

A

Genu Varum

  • small Q angle bowleg

Genu Valgum

  • Large Q angle Knock-Knee
  • can increase potential for patellofemoral syndrome

Q angle: perpindicular line of gravity and asis line

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16
Q

What are the movements of the knee and what does it?

A
  • Extension
    • Quadriceps femoris
      • rectus femoris
      • vastus medialis
      • vastus lateralis
      • vastus inermedeus​
  • Flexion
    • Hamstring
      • semimembronosus
      • semitendenosis
    • Biceps femoris (both heads)
    • Grastrocnemius
    • Popliteus
    • Gracilis
    • Sartouris
17
Q

Knee Flexion (as in the contacting surfaces)

A

Round surfaces on the femoral condyles

18
Q

knee extension as related to surfaces

A

flas surfaces of femoral condyle with tibial plataue

19
Q

Locking and unlocking of the knee

A
  • Locking the knee
    • ​during **extension **passive locking with slight medial rotation femur on tibia (screw home mechinisum)
  • Unlocking the knee
    • tibia is already exteneded a slight **lateral **rotation on it will initiate **flextion. **
      • flexion is inniciated by popliteus
20
Q

Bursa of the knee

A
  • Suprapatellar bursa
    • ​extension of synovial capsual
    • fibers from vastus medialsis
    • apex attached articular genus m
  • Prepatellar bursa
    • b/t pellar and skin
    • kneeling down
    • Housemaid’s knee
  • subcutaneous and deep infrapatellar bursae
    • protect pellar ligametn from anterior petellar ligament
21
Q

What are baker’s cyst?

What is another name for it?

A
  • When the synovial capsual will go back into posterior fosa and synovial fluid will go it
  • due to knee problems, cartligde prest
22
Q

Extracapsular Knee ligaments

A

Can see without going into knee joint

  • ​​olique popliteal ligament
    • posterior
    • extension of semimembronosus
  • arcutare popliteal ligament
    • over popliteus muscle
  • patellar ligament
    • attach to —
  • lateral collateral ligament
    • prevents varus (outward) deformity
    • seperated f/ miniscus by popliteal
  • medial collateral ligament
    • prevents valgus (inward) deformity
23
Q

Intracapsular knee ligaments

A
  • Anterior cruciate lig
    • anterior tibieal–> lateral condyle of femur
    • prevent hyperextension
    • prevents anterior displacement of fixed tibia
  • Posterior cruciate ligament
    • prevents posterior displacemetn of fixed tibia
    • prevents hyper flexion of knee
    • posterior tibial–> medial condyle of femur
24
Q

What is Drawers Sign and how do you test for it?

What does it test for?

A
  • Anterior Draw test
    • free tibial slides anteriorly on fixed femurs
    • anterior cruciate ligaments damage tested
  • Posterior Draw test
    • free tibial slides posteriorly under fixed femus
    • posterior cricuate ligaments
25
Q

What are the menisci of the knee?

A

between femur and tibia to support so we dont rub tibia and femur

  • Medial Meniscus
    • attached to capsule
    • attached to tibial collateral ligament
  • Lateral Meniscus
    • smaller and more mobile
      • because has popliteal tendon
    • popliteus tendon passes between menisucu capusle
  • Ligaments
    • transverse ligament of knee
    • posterior meniscofemoral ligament
    • inside the capsule but outside synovial cavity
26
Q

How do you test for Meniscus tears?

A

relativly a vascular so they dont heal well

Steinmann test

  • tear in central not to bad
  • periferal need to be stiched.
27
Q

What is an unhappy triad injury?

A

classic description

  • atnerior cruciate ligament
  • medial collateral ligament
  • medial meniscus
28
Q

What is the innervation of the knee?

A
  • Anterior knee
    • Femoral n (L2-L4)
  • Posterior knee
    • Tibial N (L4-S3)
  • Lateral Knee
    • Common fibular (peroneal) (L4-S2)
  • Medial Knee
    • Obturator n (L2-4)
29
Q

Blood supply of the knee

A

Genicular anastomosis

  • descending genicular f/ femoral a
  • genicluar brances fo popliteal a (go into joint capsule)
    • superior lateral (above gastrocniemus)
    • superior medial
    • inferior lateral (below gastrocniemus)
    • inferior medial
    • middle genicluar (may or maynot be there)
  • anterior tibial–> recurrent and circumflex of fibular braches of tibial a
  • descending branch of lateral circumflex femoral a.
30
Q

Patellofemoral joint

Diseases?

A
  • between petellar and two condyles of fibula
  • modify plane joint
  • protect knee joint
  • RUNNERS KNEE!
31
Q

What happenes in a total knee replacement?

A