Lecture 5 Popetial Flashcards
Knee Joint
__ joint (hinge)
Distal femur, proximal tibia
Patella: sesamoid bone (pulley, protection)
Mechanically weak: __
Typical knee imaging series includes AP and lateral views. May include other specialized views (skyline). Used to look for signs of osteoarthritis, osteophyte formation, joint effusion.
Stability provided predominantly by __
-most stable when __
Synovial joint (hinge)
Distal femur, proximal tibia
Patella: sesamoid bone (pulley, protection)
Mechanically weak: poor congruence
Typical knee imaging series includes AP and lateral views. May include other specialized views (skyline). Used to look for signs of osteoarthritis, osteophyte formation, joint effusion.
Stability provided predominantly by muscles, also ligaments
-most stable when fully extended (“locked”)
Taut during full extension
Permit knee rotation when slack
Named for their distal attachment
____ (medial) collateral lig. (______)
Medial Femoral ____
-Attached to ______
______ (lateral) collateral lig. (______)
Lateral femoral ______
Taut during full extension
Permit knee rotation when slack
Named for their distal attachment
Tibial (medial) collateral lig. (TCL)
-Medial femoral epicondyle to tibial condyle
-Attached to medial meniscus
Fibular (lateral) collateral lig. (FCL)
Lateral femoral epicondyle to fibular head Cord-like
Knee Joint – Intracapsular ligaments
Anterior cruciate ligament (ACL): Medial-lateral course from (XXX)
Limits anterior movement of (XXX)
Posterior cruciate ligament (PCL): Lateral-medial course from (XXX) Limits posterior movement (XXX)
Anterior cruciate ligament (ACL): Medial-lateral course from **tibia to femur **
Limits anterior movement of tibia Weaker, poor blood supply
Posterior cruciate ligament (PCL): Lateral-medial course from** tibia to femur** Limits posterior movement of tibia Stronger
Knee Joint - Menisci
Lateral meniscus
Nearly (XXX) Attached to the (XXX) More mobile
(XXX)-shaped, deeper Attached to the (XXX)
Lateral meniscus
Nearly circular Attached to the PCL More mobile
C-shaped, deeper Attached to the TCL
Suprapatellar bursa
(XXX) of joint capsule
-between (XXX) tendon
Prepatellar bursa
-between (XXX)& (XXX)
(XXX) & (XXX) infrapatellar bursae
-on either side of
the (XXX) ligament
Articularis genu
– pulls (XXX) bursa superiorly during knee (XXX)
Suprapatellar bursa
-extension of joint capsule
-between femur & quadriceps tendon
Prepatellar bursa
-between skin & patella
Deep & superficial infrapatellar bursae
-on either side of
the patellar ligament
Articularis genu
– pulls suprapatellar bursa superiorly during knee extension
Anterior drawer sign: (XXX)
Posterior drawer sign: (XXX)
Anterior drawer sign: anterior movement of free tibia indicates ACL tear
Posterior drawer sign: posterior movement of free tibia indicates PCL tear
Varus stress test: (XXX)
Valgus stress test: (XXX)
Varus stress test: medial movement of distal leg indicates FCL tear
Valgus stress test:** lateral movement of distal leg indicates TCL tear**
Clinical note: “Unhappy triad” –(XXX)
Clinical note: “Unhappy triad” –** tearing of the TCL, medial meniscus, and ACL. Knee is typically twisted, flexed, and sustains a lateral blow.**
Q-angle – used to assess alignment of (XXX)
Genu varum: (XXX)
Genu valgum: (XXX)
Q-angle – used to assess alignment of femur/tibia and evaluate valgus/varus stress at knee
Genu varum: decreased Q-angle
Body weight falls medial to center of knee, FCL overstressed
Genu valgum: increased Q-angle
Body weight falls lateral to center of knee, TCL overstressed, increased lateral pull on patella
Diamond-shaped region posterior to the knee joint
Passageway for (XXX)
(XXX) forms a strong protective covering
Structures and (XXX)palpated when knee is (XXX)
Diamond-shaped region posterior to the knee joint
Passageway for **neurovascular structures to cross the knee **
Popliteal fascia forms a strong protective covering
Structures and popliteal pulse palpated when knee is semi-flexed
Popliteal Fossa - Neurovasculature
Clinical note: Swelling within the (XXX) can be caused by aneurysm, abscess, tumor, popliteal (Baker’s) cyst. Causes pain during (XXX)
Clinical note: Swelling within the** popliteal fossa** can be caused by aneurysm, abscess, tumor, popliteal (Baker’s) cyst. Causes pain during knee extension.
PA
DA
ACT
INN
PA: Lateral head: Superior to lateral condyle of femur
Medial head: Superior to medial condyle of femur
DA: Calcaneal tuberosity via calcaneal tendon
Act: Plantarflexes when knee extended, knee flexion
Inn: Tibial n. (S1, S2)
PA: Lateral supracondylar line
DA: Calcaneal tuberosity
Act: Weak plantarflexion
Inn: Tibial n. (S1, S2)
PA: Head of fibula, soleal line of tibia
DA: Calcaneal tuberosity via calcaneal
tendon
Act: Plantarflexion
Inn: Tibial n. (S1, S2)
Clinical note: Ruptured calcaneal tendon – Audible “snap” heard during forceful plantarflexion. Rupture typically occurs 1-2 cm proximal to calcaneal tuberosity. Most common in males > 40. Repair can be surgical or non-surgical (brace, boot, splint, cast).
Flexor digitorum longus
Flexor digitorum longus
PA: Medial side of posterior tibia DA: Bases of distal phalanges 2-5 Act: Flex digits 2-5, plantarflexion,
supports longitudinal arches of foot Inn: Tibial n. (S2, S3)
Tibialis posterior
PA: Interosseous membrane; posterior tibia and fibula
DA: Navicular, cuboid, sustentaculum tali, cuneiform, bases of metatarsals 2-4
Act: Inversion, plantarflexion, supports medial longitudinal arch
Inn: Tibial n. (L4, L5)
Flexor hallucis longus
Flexor hallucis longus
PA: Posterior fibula; Interosseous membrane DA: Base of distal phalanx of hallux
Act: Flex digit 1, weak plantarflexion,
supports medial longitudinal arch Inn: Tibial n. (S2, S3)
NeuroVasc
