Lower extremity joints Flashcards
What provides attachment of the ligamentum teres?
hip joint
What artery sends a branch through the acetabular notch into the ligamentum teres to the head of the femur?
obturator artery
What can a femoral neck fracture cause?
avascular necrosis
What surrounds the inside of the capsule, acetabular labrum, and covers the ligamentum teres?
synovial membrane
What ligament is Y shaped, connects anterior inferior iliac spine to the intertrochanteric line, and is tense in extension?
iliofemoral ligament
What ligament is deep to the ileofemoral ligament and connects the iliopubic eminence to the undersurface of the femoral neck, and is tense in abduction?
pubofemoral ligament
What ligament is on the posterior hip that in spiral fashion connections the ischium below the acetabulum to the back of the femoral neck and is tense in abduction?
ischiofemoral ligament
What are the two types of hip dislocations?
congenital and traumatic
What is most vulnerable to dislocation in the hip?
medially roated, adducted hip w/ posterior and superior dislocation and rim of acetabulum could be fractured
What’s the hip joint arterial supply?
- femoral artery –> femoral circumflex arteries (medial, lateral, and wind around femur) and
- profunda femoris artery (passes btwn pectinus and adductor longus) perforating supplies hamstrings
they anastomose w/ each other including circumflex and gluteal arteries
What is the main supply of the femoral head?
retinacular vessels which arise from the trochanteric area – medial and lateral femoral circumflex arteries and pass around in 3 groups: posterosuperior, posteroinferior, and small, anterior retinacular arteries
Where do fractures of the femoral neck occur?
intracapsular (may disrupt blood supply) or extracapsular
usually elderly!
What are the 3 subjoints of the knee joint?
1) patella and front of lower end of femur
2) lateral femoral condyle and lateral tibial condyle
3) btwn medial femoral condyle and medial tibial condyle
Why is the capsule absent on the front of the knee?
permits the membrane to pouch upward forming suprapateller bursa
What are the knee ligaments?
1) Patellar ligament, connecting apex of patella to tibia
2) LCL –fibula
3) MCL – tibia
4) ACL – tense in hyperextension, limits tibia displacement
5) PCL - stronger, attached to posterior
What is attached to the medial collateral ligament making it more susceptible to injury?
medial mensci
lateral meniscus does not have attachment so tears are less common
What’s the unhappy/terrible triad?
1) ACL tear
2) MCL tear
3) medial meniscal tear
Where is the prepatellar bursae?
between patella & skin, “housemaid’s knee”
Where is the deep infrapatellar bursae?
between tibia & ligamentum patella
Where is the infrapatellar bursae?
between tibial tuberosity and skin, “parson’s knee”
Where is the suprapatellar bursae?
between femur and quadriceps tendon, communicates w/ knee joint
What is the conjoined tendons at the medial aspect of knee that insert onto tibia?
Pes anserine
Where does sublaxation usually occur?
laterally usually in young females and women
What is the most common bursitis of the knee?
prepateller bursa – common from excessive kneeling, wrestlers
What word should indicate a knee vessel?
genicular
What are the two joints of the tibia and fibula?
superior and inferior
superior - synovial joint between head of fibula and lateral tibial condyle - stable
inferior - syndesmosis joint w/ interosseus ligament that help deepen slot of ankle joint
What joint is formed by tibia above and medially, fibula laterally, talus below
talocrural ankle joint
What are the anterior and posterior tibulofibular ligaments a part of?
inferior tibiofibular joint –deepen ankle joint
What are the lateral ligaments of the ankle?
3 – anterior talofibular, posterior talofibular, calcaneofibular
What is the deltoid ligament?
medial side of ankle joint and joins medial malleous to the talus, crossed by tibialis posterior and flexor digitorium longus tendons
When is the ankle joint the least stable?
plantar-flexed
What does inversion strain likely result in?
talofibular ligament injury “sprained ankle”
Why is an eversion injury more severe when it eventually occurs?
deltoid ligament is strong!
What is the most vulnerable of the collateral ligaments?
anterior talofibular ligament
How does rupture occur in the leg?
forceful plantar flexion w/ knee extended in sprinting or jumping, can hear “pop” or sensation of being struck in the back of the leg
What is flat feet caused by?
loss of medial arch when foot is held in dorsiflexion or eversion
What are shin splints?
repetitive pulling of tibialis posterior tendon, stress on muscle –> stress fractures!
How do you know compartment syndrome is occuring in the leg?
anterior - excessive contraction of muscles, pain radiates down to ankle and dorsum
lateral - excessively weak ankle joints w/ hyperextension irritating lateral muscles
What are the 5Ps of compartment syndrome?
Pain
Pallor
Paresis
Paresthesia
Pulseless
What’s in the subtalar or talocalcanean joint?
interosseous talocalcanean ligament that lies in the sinus tarsi (which contains blood vessels supplying both bones)
