Lower Limb: Anteromedial Thigh, Hip and Knee Joints Flashcards

1
Q

Most of the adductor muscles of the thigh attach to where?

A

the posterior aspect of the femur - linea aspera

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What allows greater mobility of the femur at the hip joint because it places the head and neck more perpendicular to the acetabulum?

A

angle of inclination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is advantageous for bipedal walking; however, it imposes considerable strain on the neck of the femur?

A

angle of inclination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

If the angle of inclination decreases, what is there a higher risk of?

A

fracture because there would be more weight on the head and neck of the femur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What forms the connection between the lower limb and the pelvic girdle?

A

the hip joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What type of joint is the hip joint?

A

a multiaxial ball and socket type of synovial joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What joint is designed for stability over a wide range of movement?

A

the hip joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

During standing, the weight of the upper body is transferred through the (1) to the (2)

A
  1. hip bones
  2. heads of femurs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

The head of the femur is covered with articular cartilage, except for a medial placed depression or pit, the (…)

A

fovea for the ligament of the head of the femur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the hip joint reinforced by?

A
  • anteriorly and superiorly: iliofemoral ligament
  • inferiorly and anteriorly: pubofemoral ligament
  • posteriorly: ischiofemoral ligament
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is a strong ligament that attaches to the AIIS, acetabular rim proximally, and the inertrochanteric line to prevent hyperextension of the hip joint during standing?

A

iliofemoral ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What ligament arises from the obturator crest of the pubic bone and merges with the fibrous layer of the joint capsule, tightens during extension and abduction of the hip joint, and resists excessive abduction of the hip joint?

A

pubofemoral ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What ligament is weak and arises from the ischial part of the acetabular rim and attaches to the neck of the femur, medial to the base of the greater trochanter?

A

ischiofemoral ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What do each of these ligaments do:
- iliofemoral ligament
- pubofemoral ligament
- ischiofemoral ligament

A
  • resists extension
  • resists abduction
  • resists extension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What pulls the femoral head medially into the acetabulum, increasing stability and are reciprocally balanced when doing so?

A

Both hip muscles (medial and lateral rotators of the thigh) and ligaments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the hip movements?

A
  • flexion, extension
  • abduction, adduction
  • medial, lateral rotation
  • circumduction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the deep fascia of the lower limb called? What does it do?

A

fascia lata
- limits contraction (outward extension of contracting muscles)
- increases venous compression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What does the fascia lata attach to and is continuous with?

A
  • superiorly, the inguinal ligament, pubic arch, body, and tubercle
  • Scarpa’s fascia of the inferior abdominal wall inferior to the inguinal ligament
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

The thigh muscles are separated into three fascial compartments, (…), formed by the (…)

A
  • anterior, medial, and posterior compartment
  • formed by the fascia lata
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

The walls of the thigh compartments are formed by the fascia lata and three (…) that arise from the deep aspect of the fascia lata and attach to the (…) on the posterior aspect of the femur

A
  • fascial intermuscular septa
  • linea aspera
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

The (…) intermuscular septum is strong; the other two septa are relatively weak. The (…) is continuous with the lateral intermuscular septum.

A
  • lateral
  • iliotibial tract
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

The (…) is deep to the skin and consists of loose connective tissue that contains a variable amount of fat, cutaneous nerves, superficial veins, lymphatic vessels, and lymph nodes

A

subcutaneous tissue (superficial fascia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

The subcutaneous tissue of the hip and thigh is continuous with what?

A
  • inferior part of the anterolateral abdominal wall
  • buttocks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

The (…) of the thigh is especially strong, investing the limb like an elastic stocking. This fascia limits (…) of contracting muscles, making muscular contraction more efficient in compressing the veins to push blood toward the heart. This fascia is also called the (…)

A
  • deep fascia
  • outward extension
  • fascia lata
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
- What are the main actions of the anterior thigh compartment? - What are the main actions of the medial thigh compartment? - What are the main actions of the posterior thigh muscles?
- knee extension, hip flexion - hip adduction - knee flexion, hip extension
26
As generalization, what innervates this compartments: - anterior thigh compartment (ilium) - medial thigh compartment (pubis) - posterior compartment (ischium)
- femoral nerve (L2-L4) - obturator nerve (L2-L4) - tibial branch of sciatic nerve (L4-S3)
27
What are the exceptions of innervation to the thigh compartments and what do they innervate?
- superior gluteal nerve: tensor fascia lata - common fibular (peroneal n): biceps femoris-short head m
28
- Increasing the angle at a joint is (1) - Decreasing the angle at a joint is (2)
1. flexion 2. extension
29
Innervation of the lower limb arises from what?
ventral rami of spinal nn (dorsal rami innervate the back)
30
What nerves form the lumbosacral plexus (L1-S4)?
A. subcostal (T12) B. iliohypogastric (L1) C. ilioinguinal (L1) D. genitofemoral (L1-L2) E. lateral femoral cutaneous (L2-L3) F. femoral (L2-L4) G. obturator (L2-L4) H. lumbosacral trunk (L4-L5)
31
What is a mnemonic for the lumbosacral plexus?
"I, I Get Laid On Fridays" iliohypogastric, ilioinguinal, genitofemoral, lateral femoral cutaneous, obturator, femoral
32
What nerve is near the psoas major?
genitofemoral nerve
33
What nerve passes through the deep inguinal ring into the inguinal canal and out via the superficial inguinal ring? (goes through both rings)
genitofemoral n (L1-L2)
34
What nerve passes into the inguinal canal through a space between the IAO and transversus abdominis exit via the **superficial inguinal ring only**?
ilioinguinal n (L1)
35
- In men, the genital branch of the genitofemoral n innervates the (...) and terminates (...) - In women, it accompanies the (...) and terminates (...)
- cremasteric muscle (GSE) - on the skin in the upper, anterior part of scrotum (GSA) - the round ligament of uterus - on the skin of the mons pubis and labium majora (GSA)
36
The genital branch of the genitofemoral nerve provides GSE (motor) and GSA (sensory) where?
- GSE: cremasteric m - GSA: anterior scrotum + skin over labia majora
37
What nerve arises from the anterior rami of nerves L1 and L2 and pierces the psoas major muscle?
genitofemoral nerve
38
The femoral branch of the genitofemoral nerve provides what type of fibers?
GSA - sensory
39
The femoral branch of the genitofemoral nerve passes into the thigh, crossing under the (...) where it is (...) to the femoral artery. It passes superficially to innervate the (...)
- inguinal ligament - lateral - skin over the upper central part of the anterior thigh
40
What provides cutaneous innervation to the femoral triangle area and anterolateral scrotum?
femoral branch of genitofemoral nerve
41
What provides cutaneous innervation to the upper medial thigh, root of the penis, and anterior scrotum so it is important in males?
ilioinguinal nerve
42
The lumbosacral plexus derives from the ventral primary rami of the lumbar and sacral plexuses, which provides (...) fibers
motor and sensory fibers
43
The lumbar plexus provides motor and sensory nn to where?
- abdominal wall - pelvic areas - anterior and medial compartment of the thigh
44
The sacral plexus provides motor and sensory nn to where?
- part of the pelvis - posterior thigh, leg, ankle, and foot muscles (tibial n) - most of the lower leg, ankle and foot muscles (common fibular n) - entire foot
45
What nerves of the lumbosacral plexus are purely cutaneous? What about cutaneous and motor?
- ilioinguinal n. and lateral femoral cutaneous n. (GSA) - genitofemoral n. (GSA & GSE)
46
Most terminal branches of the lumbosacral plexus are (...)
mixed fiber nerves (mixed functional modalities)
47
Skeletal muscles receive GSE fibers, which are (...) and GSA fibers, which are (...)
- somatic motor fibers - somatic sensory fibers
48
Proprioception describes the feeling in space where your body parts are. There is more proprioception in the (...); so if proprioception is off, you will have (...) issues
- feet/legs - balance issues
49
Cutaneous innervation has GSA fibers provided by (...) and GVE fibers provides by (...)
- somatic sensory fibers - sympathetic fibers
50
Innervation of glands and blood vessels, erector pili mm in the skin are innervated by what?
only sympathetic (GVE) fibers
51
Dermatomes are areas of the skin supplied by branches of a single spinal nerve. What do these parts of the spinal cord provide dermatome innervation to? - lumbar spinal cord - upper sacral cord - lower sacral cord
- anterior and medial aspects of thigh - posterior aspect of thigh - largely confined to perineum
52
- The ilioinguinal n provides GSA fibers where? - The genitofemoral n provides GSA and GSE fibers where? - The lateral femoral cutaneous n provides GSA fibers where?
- skin of scrotum/labia majora, mons pubis, medial thigh - *genital branch*: GSA-anterior surface scrotum/labia majora; GSE-cremasteric m *femoral branch*: GSA: skin lateral to femoral triangle - skin on anterolateral thigh
53
What is a group of skeletal muscles innervated by a single spinal n?
myotome
54
What is the clinical relevance of myotome testing?
Neurological examination: - intactness of nerve root (muscle weakness) - spinal cord nerve lesion/injury - location of injury
55
- Myotome is (...) testing - Dermatome is (...) testing - DTR is (...) testing
- muscle testing - sensation testing (sharp and soft sensation) - reflex testing (integrity of sensory and motor neurons pathway)
56
The hip flexor myotome (iliopsoas) are associated with what spinal nerve?
L2
57
The knee extension myotome (quadriceps) are associated with what spinal nerve?
L3
58
The ankle dorsiflexor myotomes (tibialis anterior) are associated with what spinal nerve?
L4
59
The long toe extensor myotome (extensor hallucis and digitorum longus) are associated with what spinal nerve?
L5
60
The ankle plantarflexor myotome (gastrocnemius/soleus) are associated with what spinal nerve?
S1
61
The toe abductor myotome (abductor hallucis/plantar interossei) are association with what spinal nerve?
S2
62
What are the 3 ways to test spinal nerve function? They are each tested bilaterally
- myotome - dermatome - DTR (deep tendon reflexes)
63
- What muscles are included in the anterior thigh compartment? - What is this generally innervated by? - What are the common actions?
- iliopsoas, quadriceps femoris, sartorius, pectineus - femoral n - hip flexion and knee extension, rotation
64
- What is the chief hip flexor? - What is the great extensor of the knee? - What allows for hip and knee flexion and lateral hip rotation? - What allows for hip flexion, assists in medial hip rotation, AND adducts the thigh?
- iliopsoas - quadriceps femoris - sartorius - pectineus
65
What is the function of the rectus femoris m?
- hip flexion - knee extension
66
(...) is formed by the merger of two muscles, the psoas major and iliacus. They lie in the posterior abdominal wall and greater pelvis
iliopsoas
67
The (...) is a postural muscle, a active during standing in maintaining normal lumbar lordosis and, indirectly, the compensatory thoracic kyphosis
iliopsoas
68
What is one of the most powerful muscles and is biarticular so it acts on two joints?
quadriceps femoris
69
What are the 4 muscles in the quadriceps femoris?
- rectus femoris - vastus lateralis - vastus intermedius - vastus medialis
70
What is the great extensor of the knee joint that forms the main bulk of the anterior thigh muscles?
quadriceps femoris
71
What is the "kicking muscle" that crosses the hip joint and helps the iliopsoas flex this joint?
rectus femoris
72
The ability for the rectus femoris to extend the knee is compromised during (...)
hip flexion
73
What is the largest component of the quadriceps, located on the lateral aspect of the full length of the thigh?
vastus lateralis
74
What lies deep to the rectus femoris between the vastus medialis and vastus lateralis?
vastus intermedius
75
What muscle covers the medial aspect of the distal two thirds of the thigh?
vastus medialis
76
What is the tailor's muscle, a long, ribbon-like muscle that is the most superficial in the anterior thigh; it passes obliquely across the supero-anterior part of the thigh?
sartorius
77
When acting bilaterally, what muscle brings the lower limbs into the cross-legged sitting position?
sartorius
78
Which muscle is mainly a synergist, acting with other thigh muscles that produce movements such as thigh flexion, knee flexion and rotation? (isn't strong)
Sartorius
79
Which anterior thigh muscle not only does hip flexion, assists in medial rotation of the hip, but also does thigh adduction?
pectineus
80
Which nerves innervate the pectineus?
femoral nerve (90%) obturator nerve (10%)
81
What is the superior ramus of the pubis innervated by?
obturator nerve
82
What are the actions of the tensor fascia latae? - What does it run from? - What is it innervated by?
- abducts, medially rotates, and flexes the thigh - from ASIS to iliotibial tract - superior gluteal nerve
83
- What are the actions of pectineus? - What are the actions of iliopsoas? - What are the actions of sartorius? - What are the actions of tensor fascia lata?
- adducts and flexes the thigh - flexes the thigh - flexes/laterally rotates thigh; flexes/medially rotates leg - abducts, medially rotates, flexes thigh
84
- What are the proximal attachments of the sartorius muscle and tensor fascia lata? - What is the distal attachment of these mm?
- ASIS - medial surface of proximal tibia (sartorius) and iliotibial tract (TFL)
85
- What is the distal attachment of the quadriceps femoris? - What are the actions? - What is it innervated by?
- tibial tuberosity - rectus femoris: flexes thigh, extends leg vastus mm: extends leg - femoral n
86
What are the motor actions of the femoral nerve? Sensory?
**motor** - chief flexor hip and postural mm - hip flexors - knee extension **sensory** - anteromedial thigh and leg (anterior cutaneous femoral n., saphenous n.) - lateral femoral cutaneous n
87
Most of the thigh adductor muscles are proximally related to the (...) and distally to the (...)
- pubic bone (pubis) - posterior surface of femur (linea aspera)
88
What are the actions of the medial thigh compartment?
- hip adduction - may also medially rotate the thigh
89
What muscles are included in the medial thigh compartment?
- gracilis - adductor longus - adductor brevis - adductor magnus - obturator externus
90
- What is the common attachment of the medial thigh compartment? - What is the common innervation of the medial thigh compartment?
- pubis - obturator nerve
91
What is the most superficial medial thigh muscle and is the only adductor that crosses both the hip joint and knee joint?
gracilis
92
What muscle in the medial thigh compartment is a synergist muscle that adducts the thigh (weakest), flexes the knee, and medially rotates the leg?
gracilis
93
What does the gracilis muscle insert onto?
medial surface of the tibia
94
- As the obturator nerve enters the thigh, it divides into two branches, the (...), which are separated by the (...) - the (...) branch descends behind adductor brevis m & on anterior surface of adductor magnus m - the (...) branch descends on the anterior surface of the adductor brevis m and is behind the pectineus and adductor longus m
- the anterior and posterior branches - separated by the **adductor brevis muscle** - posterior branch - anterior branch
95
- What branch of the obturator nerve supplies the obturator externus, adductor brevis muscles, and part of adductor magnus mm that attach to linea aspera? - What branch of the obturator nerve supplies the adductor longus, gracilis, and adductor brevis mm and often contributed to the supply of pectineus and cutaneous branches on medial side of thigh?
- posterior branch - anterior branch
96
What medial thigh muscle has dual innervation and what are the separate parts that receive that innervation with associated nerves?
**adductor magnus** - adductor part: obturator n - hamstring part: tibial n
97
What does the hamstring part of the adductor magnus muscle do?
thigh extension
98
- What is the proximal attachment of the adductor part of adductor magnus (front)? - What is the proximal attachment of the hamstring part of adductor magnus (back)
- inferior ischiopubic ramus - ischial tuberosity
99
What are the actions of these muscles? - adductor longus - adductor brevis - adductor magnus - gracilis - obturator externus
- adducts hip - adducts hip, some hip flexion - adducts hip, adductor part also flexes hip, hamstring part extends hip - adducts hip, flexes and medially rotates knee - laterally rotates hip, stabilizes hip
100
- What is the motor function of the obturator nerve? - What does the obturator nerve provide sensory information to?
- motor: primarily adduction of thigh; flex and/or rotate thigh - sensory: medial cutaneous n of the thigh
101
What are the transition areas of the leg, and what do they run from?
**femoral triangle** - from abdomen to thigh under inguinal ligament **popliteal fossa** - from thigh into leg **tarsal tunnel** - leg and foot
102
What are the borders of the femoral triangle?
- Superior: inguinal ligament - Medial: adductor longus - lateral: sartorius - Apex: sartorius + adductor longus - Floor: iliopsoas + pectineus - Roof: fascia lata, cribiform fascia, subcutaneous tissue and skin
103
What are the contents of the femoral triangle?
- femoral nerve - femoral artery - femoral vein
104
- What forms the femoral sheath? - What are the different compartments of the femoral sheath? - What is located in each of these sheaths?
- transversalis and iliopsoas fascia's - lateral compartment: **femoral artery - intermediate compartment: **femoral vein **great saphenous vein **deep vein of thigh - medial compartment: **femoral canal **femoral ring **fat, deep inguinal lymph nodes
105
What is not contained in the femoral sheath?
femoral nerve
106
- What is the site of a femoral hernia? - Site for inguinal hernia? - Site for obturator hernia?
- femoral ring - superficial inguinal ring - obturator canal
107
The (...) is a weak area in the lower anterior abdominal wall that is the site of a femoral hernia, a protrusion of abdominal viscera (often a loop of small intestine) through the femoral ring into the femoral canal?
femoral ring
108
- Femoral hernias are more common in who? - What may occur and interfere with blood supply to the herniated intestine, and vascular impairment may result in death of the tissues?
- more common in **women** - strangulation of a femoral hernia
109
- What are the boundaries of the adductor canal? - What does it span from?
- anterior and lateral: vastus medialis - posterior: adductor longus and magnus - medial: sartorius **apex of femoral triangle to adductor hiatus**
110
What is an effective and commonly performed peripheral nerve block for knee and foot surgery?
adductor canal block
111
What are the contents of the adductor canal?
- saphenous nerve - femoral artery and vein - nerve to vastus medialis
112
What can be a site of disease of suffer damage by trauma and is an increasingly common site for administration of regional anesthetic for knee, ankle, and foot surgeries? - Where is the nerve block done?
adductor canal - between sartorius and vastus medialis m
113
What delivers the femoral vessels to the popliteal fossa where they become popliteal vessels?
adductor canal
114
The (...) is an opening between the distal aponeurotic attachment of the adductor part of the adductor magnus and the tendon of its hamstring part
adductor hiatus
115
The hiatus transmits the (...) from the anterior compartment of the thigh to the popliteal fossa posterior to the knee
femoral artery and vein
116
What are the arteries that supply the thigh?
- femoral artery - deep artery of the thigh - circumflex femoral artery **medial circumflex femoral a **lateral circumflex femoral a (gives off anterior, transverse, and descending branches)
117
What is the main artery of the lower limb that enters the femoral triangle deep to the inguinal ligament, can be found lateral to the femoral vein, and becomes the popliteal artery when it exits the adductor canal via the adductor hiatus?
femoral artery
118
What is the largest branch of the femoral artery, is the main artery of the thigh, has perforating arteries (3-4) branching off that supply the adductor magnus, hamstrings and vastus lateralis?
deep artery of the thigh
119
- What does the obturator artery arise from? - How many medial circumflex femoral arteries are there? lateral circumflex branches?
- internal iliac a - 1 medial circumflex branch - 3 lateral circumflex branches, ascending, transverse, and descending
120
- What are the arteries of the femoral head and neck? - Which provides most of the blood to the head and neck? - Which artery is more at risk of damage during a neck fracture/hip dislocation?
- medial and lateral CFA - medial CFA - medial CFA
121
What artery supplies the muscles of the lateral aspect of the thigh and lesser degree of the femoral head?
lateral CFA
122
- What does the circumflex femoral aa supply? - 90% of hip dislocations happen (...)
- thigh mm and proximal femur - posterior
123
- What does the obturator artery supply? - What are the branches of the obturator artery? - What do the branches supply?
- assists deep artery of thigh adductor mm - anterior branch: **pectineus **adductors of thigh **gracilis **obturator externus - posterior branch (acetabular): **head of femur **mm ischial tuberosity
124
What is primarily a hinge type of synovial joint, allowing flexion and extension; however, the hinge movements are combined with gliding and rolling with rotation about a vertical axis?
the knee joint
125
Although the knee joint is well constructed, its function is commonly impaired when it is (...)
hyperextended
126
- What bone is not involved in the knee joint? - What does the stability of the knee joint depend on?
- the fibula - strength and actions of surrounding muscles and their tendons - ligaments connecting the femur and tibia
127
The patella allows for (...)
gliding (gliding joint)
128
- What term means directly in the joint? What term means above the joint?
- condyle - epicondyle
129
- What are the two main bursa in the knee capsule? - Where are they located? - What do they allow for?
**suprapatellar bursa** - superior to patella, deep to vastus intermedius - extends the knee joint capsule **pes anserinus** - superficial to MCL - allows for tendinous expansion
130
What forms the pes anserinus?
distal ends of the: - gracilis - sartorius - semitendinosus **each attach superficially to MCL to form pen anserinus**
131
The knee joint capsule is reinforced by what?
- 4 capsular ligaments (intrinsic) - 1 extracapsular ligaments
132
- What are the 4 capsular ligaments that reinforces the knee joint capsule? - What is the 1 extracapsular ligament that reinforces the knee joint capsule?
**capsular (intrinsic) ligaments** 1. patellar ligament 2. tibial collateral ligament (MCL) 3. oblique popliteal ligament 4. arcuate popliteal ligament **extracapsular ligament** 1. fibular collateral ligament (LCL)
133
The patellar ligament, the distal part of the (...), is a strong, thick, fibrous band passing from the apex and adjoining margins of the patella to attach to the (...)
- quadriceps tendon - tibial tuberosity
134
Laterally, the patellar ligament receives what?
- medial and lateral patellar retinacula - aponeurotic expansions of vastus medialis and lateralis m - overlying deep fascia
135
What plays an important role in maintaining alignment of the patella relative to the patellar articular surface of the femur?
patellar retinacula
136
The extensive (...) lines the internal aspect of the fibrous capsule and attaches to the periphery of the patella and the edges of the menisci
synovial membrane of the knee joint
137
The (...) lines the fibrous layer laterally and medially, but centrally, it becomes separated from the fibrous layer
synovial membrane of the knee joint
138
What does the synovial membrane of the knee joint reflect to?
the cruciate ligaments
139
What are the intracapsular structures found within the knee?
1. cruciate ligaments 2. menisci 3. tendon of popliteus
140
What are the features of the fibular collateral ligament (LCL)?
- strong, cord-like - extends from lateral epicondyle of femur to head of fibula - splits biceps femoris tendon into 2 parts - tendon of popliteus passes deep to LCL
141
What are the features of the tibial collateral ligament (MCL)?
- strong flat band - extends from medial epicondyle of femur to medial epicondyle of tibia - weaker than fibular (LCL) - attaches to medial meniscus
142
- Because the MCL is weaker than the LCL, what happens more often? - What does the MCL attach to? - What are commonly injured, especially in sports like football and ice hockey?
- MCL is damaged more often - attaches to medial meniscus - TCL and medial meniscus are commonly injured
143
What ligaments strengthen the knee joint capsule posteriorly?
- oblique popliteal ligament - arcuate popliteal ligament
144
The oblique popliteal ligament is a reflected expansion of the tendon of the (...) that strengthens the joint capsule posteriorly and arises posterior to the (...)
- semimembranosus - medial tibial condyle
145
The arcuate popliteal ligament arises from the (...)
posterior aspect of the fibular head
146
What is also named the "unlocking muscle" as it unlocks the knee from the locked position?
popliteus
147
What are the two cruciate ligaments?
- ACL - PCL
148
What are the 4 main ligaments in the knee that connect the **femur (thigh bone)** to the **tibia (shin bone)**?
- ACL - PCL - MCL - LCL
149
- What is the travel pattern of the ACL? - What is the travel pattern of the PCL?
**ACL** APEX: Anterior tibia, (travels) Posteriorly and EXternally (laterally to femur lateral condyle **PCL** PAIN: Posterior tibia, (travels) Anterior and INternally (medially) to femur medial condyle
150
What is the weaker cruciate ligament with poor blood supply?
ACL
151
What are the actions of the ACL?
- prevents posterior displacement of femur on tibia - prevents hyperextension of knee - When knee is flexed 90 degrees, tibia cannot be pulled anterior
152
- The ACL is slack when the knee is (...), and tightens when (...)
- flexed - fully extended
153
What are the actions of the PCL?
- prevents anterior displacement of femur on tibia - prevents hyperflexion of knee
154
The PCL tightens when knee is (...)
flexed
155
In the weight-bearing flexed knee, the PCL is the (...) (e.g., when walking downhill)
main stabilizing factor for the femur
156
- What meniscus is c-shaped and becomes broader posteriorly? - What meniscus is almost circular, smaller, and freely movable?
- medial meniscus - lateral meniscus
157
The medial meniscus firmly adheres to the deep surface of the (...)
tibial collateral ligament
158
The tendon of the (...) separates the lateral meniscus from the (...). A strong tendinous slip, the (...), joins the lateral meniscus to the PCL and the medial femoral condyle
- popliteus - fibular collateral ligament - posterior meniscofemoral ligament
159
What does the posterior meniscofemoral ligament join?
- lateral meniscus to PCL - medial femoral condyle
160
What are the actions of the meniscus?
- deepen articular surface - act as shock absorbers
161
What are crescentic plates of fibrocartilage on the articular surface of the tibia that deepen the surface and play a role in shock absorption?
meniscus
162
What are are capsular fibers that attach the margins of the menisci to the tibial condyles?
coronary ligament
163
A slender fibrous band, the (...), joins the anterior edges of the menisci (Fig. 7.53C), allowing them to move together during knee movements.
transverse ligament of knee
164
What occurs in unhappy triad syndrome?
- ruptured MCL - torn medial meniscus - ruptured ACL
165
What is the anterior, posterior, lateral, and medial innervation of the knee?
- anterior: femoral n - posterior: tibial n - lateral: common fibular n - medial: obturator and saphenous cutaneous nerves