Lecture 49 - Hip and Knee Joints

Question 1

hip joint type:

Answer 1

ball-and socket type

Question 2

The ligaments of the hip joint

Answer 2

• articular
• iliofemoral
• pubofemoral
• ischiofemoral
• capitis femoris
• acetabular
• transverse acetabular

Question 3

Transverse acetabular ligament

Answer 3

 Continuation of acetabular labrum across the acetabular notch
 Contains no cartilage cells

Question 4

Acetabular labrum

Answer 4

 It is a fibrocartilaginous rim attached to the margin of acetabulum

Question 5

Ligament Capitis Femoris

Answer 5

 About 4cm long, can be absent
 Flat and triangular in shape
 Attached to fovea capitis femoris and by its base to the transverse ligament
 Lies within the joint and is covered by synovial membrane
 Becomes tense when flexed thigh is adducted

Question 6

Ischiofemoral (ischiocapsular) ligament

Answer 6

 It has a spiral arrangement
 Attached to the body of ischium below and behind acetabulum
 Fibers go up and laterally to attach to the femoral neck below the greater trochanter
 Becomes tense during extension of femur
 Checks hyperextension and internal rotation

Question 7

Pubofemoral (pubocapsular) ligament

Answer 7

 Triangular in shape
 Base attached to the superior ramus of pubis and obturator crest
 Apex blends with the iliofemoral ligament
 Checks hyperextension, abduction and external rotation

Question 8

Iliofemoral (iliotrochanteric) ligament

Answer 8

-largest, strongest, widest
 Triangular in shape (like an inverted “Y”)
 Lies in front of the joint
 Apex attached to anterior inferior iliac spine
 Base attached to intertrochanteric line
 Checks hyperextension and external rotation
 Helps to maintain erect posture

Question 9

Articular capsule hip

Answer 9

 Strong and dense fibrous structure
 Thicker along anterior and upper parts; thin posteriorly and inferiorly
 Fibers circular and longitudinal
 Zona orbicularis consists of circular fibers along neck of femur
 Fibers blend with those of other ligaments

Question 10

arteries feeding the hip joint derived from

Answer 10

o obturator
o medial and lateral circumflex femoral provide retinacular arteries
o inferior and superior gluteal
o 1st perforating

Question 11

nerves feeding the hip joint

Answer 11

• Femoral, obturator, superior gluteal, inferior gluteal and sciatic

Question 12

joint between tibia and femur is a

Answer 12

hinge joint –> condyloid joint

Question 13

ligaments of the knee joint

Answer 13

• articular
• quadriceps
• patellar
• fibular collateral
• tibial collateral
• oblique popliteal
• arcuate popliteal
• coronary
• intra articular

Question 14

Articular capsule knee

Answer 14

 Fairly strong - especially in some areas
 Incomplete at places where it is replaced by tendons of surrounding muscles
 Attached to the margins of articular surfaces
 On lateral side, it allows the tendon of popliteus muscle to go through
 The fibrous capsule is strengthened by ligaments of the joint

Question 15

Quadriceps tendon

Answer 15

• Medial and lateral patellar retinacula
• Encloses patella
• Bursa below the tendon

Question 16

Patellar ligament

Answer 16

 From patella to tuberosity of tibia
• 8 cm long
• Infrapatellar bursa

Question 17

Fibular collateral ligament

Answer 17

 Rounded cord-like structure; about 5cm long
 Covered by tendon of biceps femoris
 Biceps tendon divides to go on both sides of the ligament
 It extends from the lateral epicondyle of the femur to the head of fibula
 It is not attached to lateral meniscus
 Tendon of popliteus muscle deep to it

Question 18

Tibial collateral ligament

Answer 18

 Broad flat band - about 10 cm long
 Crossed by tendons of gracilis, semitendinous and sartorius
 It extends from the medial epicondyle of the femur (below the adductor tubercle) to the medial surface of tibia
 It is firmly attached to the medial meniscus
 Both collateral ligaments become tight during extension and stabilize the knee joint

Question 19

Oblique popliteal ligament

Answer 19

 It is an expansion of the tendon of semimembranosus muscle
 It strengthens the posterior aspect of the joint capsule
 Broad fibrous band with great strength
 Fibers go from medial condyle of tibia to lateral condyle of femur
 Forms part of the floor of popliteal fossa and the popliteal vessels rest on it

Question 20

Arcuate popliteal ligament

Answer 20

 Arches medially over tendon of popliteal muscle to attach to intercondylar area of tibia and to the fibular head

Question 21

Coronary Ligament

Answer 21

 Deep fibers of the capsule attached to the menisci

Question 22

Intra-articular Ligaments

Answer 22

1. Transverse ligament
    Connect the two menisci anteriorly
    Often absent
2. Anterior and posterior meniscofemoral
    Travel obliquely from the lateral menisci to the medial femoral condyle
3. Cruciate Ligaments
    Very strong
    Cross each other
    Named according to their tibial attachments
   A. Anterior Cruciate (ACL)
   • Longer but weaker of the two
    From anterior interchondral fossa to lateral condyle of femur
    Stops hyperextension at the knee
   B. Posterior Cruciate
    Shorter and stronger
    From posterior interchondral fossa to the medial condyle of femur
    Stops hyperflexion at the knee

Question 23

Menisci of the Knee Joint:

Answer 23

• The two menisci are C-shaped lamellae of fibrocartilage that are interposed between femoral and tibial condyles
• The two menisci are attached to the tibial condyles
• The peripheral area is thick and attached to the capsule via the coronary ligament.
• The inner surface is thin
• Their function is to deepen the articular surfaces

Question 24

Synovial Membrane

Answer 24

• Lines the articular capsule

* It is attached to the margins of articular surfaces and to the peripheral edges of the menisci

Question 25

Synovial Membrane - nerve supply

Answer 25

femoral, obturator, common peroneal and tibial

Question 26

Synovial Membrane - blood supply

Answer 26

• genicular anastomosis

- middle genicular

Question 27

Synovial Membrane- movements

Answer 27

• Flexion - biceps femoris, semitendinosus and semimembranosus
• Extension - quadriceps femoris