Lower Limb: Anteromedial Thigh, Hip and Knee Joints

Question 1

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

Answer 1

the posterior aspect of the femur - linea aspera

Question 2

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

Answer 2

angle of inclination

Question 3

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

Answer 3

angle of inclination

Question 4

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

Answer 4

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

Question 5

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

Answer 5

the hip joint

Question 6

What type of joint is the hip joint?

Answer 6

a multiaxial ball and socket type of synovial joint

Question 7

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

Answer 7

the hip joint

Question 8

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

Answer 8

1. hip bones
2. heads of femurs

Question 9

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

Answer 9

fovea for the ligament of the head of the femur

Question 10

What is the hip joint reinforced by?

Answer 10

• anteriorly and superiorly: iliofemoral ligament
• inferiorly and anteriorly: pubofemoral ligament
• posteriorly: ischiofemoral ligament

Question 11

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?

Answer 11

iliofemoral ligament

Question 12

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?

Answer 12

pubofemoral ligament

Question 13

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?

Answer 13

ischiofemoral ligament

Question 14

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

Answer 14

• resists extension
• resists abduction
• resists extension

Question 15

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

Answer 15

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

Question 16

What are the hip movements?

Answer 16

• flexion, extension
• abduction, adduction
• medial, lateral rotation
• circumduction

Question 17

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

Answer 17

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

Question 18

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

Answer 18

• superiorly, the inguinal ligament, pubic arch, body, and tubercle
• Scarpa’s fascia of the inferior abdominal wall inferior to the inguinal ligament

Question 19

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

Answer 19

• anterior, medial, and posterior compartment
• formed by the fascia lata

Question 20

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

Answer 20

• fascial intermuscular septa
• linea aspera

Question 21

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

Answer 21

• lateral
• iliotibial tract

Question 22

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

Answer 22

subcutaneous tissue (superficial fascia)

Question 23

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

Answer 23

• inferior part of the anterolateral abdominal wall
• buttocks

Question 24

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 (…)

Answer 24

• deep fascia
• outward extension
• fascia lata

Question 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?

Answer 25

- knee extension, hip flexion - hip adduction - knee flexion, hip extension

Question 26

As generalization, what innervates this compartments: - anterior thigh compartment (ilium) - medial thigh compartment (pubis) - posterior compartment (ischium)

Answer 26

- femoral nerve (L2-L4) - obturator nerve (L2-L4) - tibial branch of sciatic nerve (L4-S3)

Question 27

What are the exceptions of innervation to the thigh compartments and what do they innervate?

Answer 27

- superior gluteal nerve: tensor fascia lata - common fibular (peroneal n): biceps femoris-short head m

Question 28

- Increasing the angle at a joint is (1) - Decreasing the angle at a joint is (2)

Answer 28

1. flexion 2. extension

Question 29

Innervation of the lower limb arises from what?

Answer 29

ventral rami of spinal nn (dorsal rami innervate the back)

Question 30

What nerves form the lumbosacral plexus (L1-S4)?

Answer 30

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)

Question 31

What is a mnemonic for the lumbosacral plexus?

Answer 31

"I, I Get Laid On Fridays" iliohypogastric, ilioinguinal, genitofemoral, lateral femoral cutaneous, obturator, femoral

Question 32

What nerve is near the psoas major?

Answer 32

genitofemoral nerve

Question 33

What nerve passes through the deep inguinal ring into the inguinal canal and out via the superficial inguinal ring? (goes through both rings)

Answer 33

genitofemoral n (L1-L2)

Question 34

What nerve passes into the inguinal canal through a space between the IAO and transversus abdominis exit via the **superficial inguinal ring only**?

Answer 34

ilioinguinal n (L1)

Question 35

- In men, the genital branch of the genitofemoral n innervates the (...) and terminates (...) - In women, it accompanies the (...) and terminates (...)

Answer 35

- 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)

Question 36

The genital branch of the genitofemoral nerve provides GSE (motor) and GSA (sensory) where?

Answer 36

- GSE: cremasteric m - GSA: anterior scrotum + skin over labia majora

Question 37

What nerve arises from the anterior rami of nerves L1 and L2 and pierces the psoas major muscle?

Answer 37

genitofemoral nerve

Question 38

The femoral branch of the genitofemoral nerve provides what type of fibers?

Answer 38

GSA - sensory

Question 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 (...)

Answer 39

- inguinal ligament - lateral - skin over the upper central part of the anterior thigh

Question 40

What provides cutaneous innervation to the femoral triangle area and anterolateral scrotum?

Answer 40

femoral branch of genitofemoral nerve

Question 41

What provides cutaneous innervation to the upper medial thigh, root of the penis, and anterior scrotum so it is important in males?

Answer 41

ilioinguinal nerve

Question 42

The lumbosacral plexus derives from the ventral primary rami of the lumbar and sacral plexuses, which provides (...) fibers

Answer 42

motor and sensory fibers

Question 43

The lumbar plexus provides motor and sensory nn to where?

Answer 43

- abdominal wall - pelvic areas - anterior and medial compartment of the thigh

Question 44

The sacral plexus provides motor and sensory nn to where?

Answer 44

- 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

Question 45

What nerves of the lumbosacral plexus are purely cutaneous? What about cutaneous and motor?

Answer 45

- ilioinguinal n. and lateral femoral cutaneous n. (GSA) - genitofemoral n. (GSA & GSE)

Question 46

Most terminal branches of the lumbosacral plexus are (...)

Answer 46

mixed fiber nerves (mixed functional modalities)

Question 47

Skeletal muscles receive GSE fibers, which are (...) and GSA fibers, which are (...)

Answer 47

- somatic motor fibers - somatic sensory fibers

Question 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

Answer 48

- feet/legs - balance issues

Question 49

Cutaneous innervation has GSA fibers provided by (...) and GVE fibers provides by (...)

Answer 49

- somatic sensory fibers - sympathetic fibers

Question 50

Innervation of glands and blood vessels, erector pili mm in the skin are innervated by what?

Answer 50

only sympathetic (GVE) fibers

Question 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

Answer 51

- anterior and medial aspects of thigh - posterior aspect of thigh - largely confined to perineum

Question 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?

Answer 52

- 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

Question 53

What is a group of skeletal muscles innervated by a single spinal n?

Answer 53

myotome

Question 54

What is the clinical relevance of myotome testing?

Answer 54

Neurological examination: - intactness of nerve root (muscle weakness) - spinal cord nerve lesion/injury - location of injury

Question 55

- Myotome is (...) testing - Dermatome is (...) testing - DTR is (...) testing

Answer 55

- muscle testing - sensation testing (sharp and soft sensation) - reflex testing (integrity of sensory and motor neurons pathway)

Question 56

The hip flexor myotome (iliopsoas) are associated with what spinal nerve?

Answer 56

L2

Question 57

The knee extension myotome (quadriceps) are associated with what spinal nerve?

Answer 57

L3

Question 58

The ankle dorsiflexor myotomes (tibialis anterior) are associated with what spinal nerve?

Answer 58

L4

Question 59

The long toe extensor myotome (extensor hallucis and digitorum longus) are associated with what spinal nerve?

Answer 59

L5

Question 60

The ankle plantarflexor myotome (gastrocnemius/soleus) are associated with what spinal nerve?

Answer 60

S1

Question 61

The toe abductor myotome (abductor hallucis/plantar interossei) are association with what spinal nerve?

Answer 61

S2

Question 62

What are the 3 ways to test spinal nerve function? They are each tested bilaterally

Answer 62

- myotome - dermatome - DTR (deep tendon reflexes)

Question 63

- What muscles are included in the anterior thigh compartment? - What is this generally innervated by? - What are the common actions?

Answer 63

- iliopsoas, quadriceps femoris, sartorius, pectineus - femoral n - hip flexion and knee extension, rotation

Question 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?

Answer 64

- iliopsoas - quadriceps femoris - sartorius - pectineus

Question 65

What is the function of the rectus femoris m?

Answer 65

- hip flexion - knee extension

Question 66

(...) is formed by the merger of two muscles, the psoas major and iliacus. They lie in the posterior abdominal wall and greater pelvis

Answer 66

iliopsoas

Question 67

The (...) is a postural muscle, a active during standing in maintaining normal lumbar lordosis and, indirectly, the compensatory thoracic kyphosis

Answer 67

iliopsoas

Question 68

What is one of the most powerful muscles and is biarticular so it acts on two joints?

Answer 68

quadriceps femoris

Question 69

What are the 4 muscles in the quadriceps femoris?

Answer 69

- rectus femoris - vastus lateralis - vastus intermedius - vastus medialis

Question 70

What is the great extensor of the knee joint that forms the main bulk of the anterior thigh muscles?

Answer 70

quadriceps femoris

Question 71

What is the "kicking muscle" that crosses the hip joint and helps the iliopsoas flex this joint?

Answer 71

rectus femoris

Question 72

The ability for the rectus femoris to extend the knee is compromised during (...)

Answer 72

hip flexion

Question 73

What is the largest component of the quadriceps, located on the lateral aspect of the full length of the thigh?

Answer 73

vastus lateralis

Question 74

What lies deep to the rectus femoris between the vastus medialis and vastus lateralis?

Answer 74

vastus intermedius

Question 75

What muscle covers the medial aspect of the distal two thirds of the thigh?

Answer 75

vastus medialis

Question 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?

Answer 76

sartorius

Question 77

When acting bilaterally, what muscle brings the lower limbs into the cross-legged sitting position?

Answer 77

sartorius

Question 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)

Answer 78

Sartorius

Question 79

Which anterior thigh muscle not only does hip flexion, assists in medial rotation of the hip, but also does thigh adduction?

Answer 79

pectineus

Question 80

Which nerves innervate the pectineus?

Answer 80

femoral nerve (90%) obturator nerve (10%)

Question 81

What is the superior ramus of the pubis innervated by?

Answer 81

obturator nerve

Question 82

What are the actions of the tensor fascia latae? - What does it run from? - What is it innervated by?

Answer 82

- abducts, medially rotates, and flexes the thigh - from ASIS to iliotibial tract - superior gluteal nerve

Question 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?

Answer 83

- adducts and flexes the thigh - flexes the thigh - flexes/laterally rotates thigh; flexes/medially rotates leg - abducts, medially rotates, flexes thigh

Question 84

- What are the proximal attachments of the sartorius muscle and tensor fascia lata? - What is the distal attachment of these mm?

Answer 84

- ASIS - medial surface of proximal tibia (sartorius) and iliotibial tract (TFL)

Question 85

- What is the distal attachment of the quadriceps femoris? - What are the actions? - What is it innervated by?

Answer 85

- tibial tuberosity - rectus femoris: flexes thigh, extends leg vastus mm: extends leg - femoral n

Question 86

What are the motor actions of the femoral nerve? Sensory?

Answer 86

**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

Question 87

Most of the thigh adductor muscles are proximally related to the (...) and distally to the (...)

Answer 87

- pubic bone (pubis) - posterior surface of femur (linea aspera)

Question 88

What are the actions of the medial thigh compartment?

Answer 88

- hip adduction - may also medially rotate the thigh

Question 89

What muscles are included in the medial thigh compartment?

Answer 89

- gracilis - adductor longus - adductor brevis - adductor magnus - obturator externus

Question 90

- What is the common attachment of the medial thigh compartment? - What is the common innervation of the medial thigh compartment?

Answer 90

- pubis - obturator nerve

Question 91

What is the most superficial medial thigh muscle and is the only adductor that crosses both the hip joint and knee joint?

Answer 91

gracilis

Question 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?

Answer 92

gracilis

Question 93

What does the gracilis muscle insert onto?

Answer 93

medial surface of the tibia

Question 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

Answer 94

- the anterior and posterior branches - separated by the **adductor brevis muscle** - posterior branch - anterior branch

Question 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?

Answer 95

- posterior branch - anterior branch

Question 96

What medial thigh muscle has dual innervation and what are the separate parts that receive that innervation with associated nerves?

Answer 96

**adductor magnus** - adductor part: obturator n - hamstring part: tibial n

Question 97

What does the hamstring part of the adductor magnus muscle do?

Answer 97

thigh extension

Question 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)

Answer 98

- inferior ischiopubic ramus - ischial tuberosity

Question 99

What are the actions of these muscles? - adductor longus - adductor brevis - adductor magnus - gracilis - obturator externus

Answer 99

- 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

Question 100

- What is the motor function of the obturator nerve? - What does the obturator nerve provide sensory information to?

Answer 100

- motor: primarily adduction of thigh; flex and/or rotate thigh - sensory: medial cutaneous n of the thigh

Question 101

What are the transition areas of the leg, and what do they run from?

Answer 101

**femoral triangle** - from abdomen to thigh under inguinal ligament **popliteal fossa** - from thigh into leg **tarsal tunnel** - leg and foot

Question 102

What are the borders of the femoral triangle?

Answer 102

- Superior: inguinal ligament - Medial: adductor longus - lateral: sartorius - Apex: sartorius + adductor longus - Floor: iliopsoas + pectineus - Roof: fascia lata, cribiform fascia, subcutaneous tissue and skin

Question 103

What are the contents of the femoral triangle?

Answer 103

- femoral nerve - femoral artery - femoral vein

Question 104

- What forms the femoral sheath? - What are the different compartments of the femoral sheath? - What is located in each of these sheaths?

Answer 104

- 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

Question 105

What is not contained in the femoral sheath?

Answer 105

femoral nerve

Question 106

- What is the site of a femoral hernia? - Site for inguinal hernia? - Site for obturator hernia?

Answer 106

- femoral ring - superficial inguinal ring - obturator canal

Question 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?

Answer 107

femoral ring

Question 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?

Answer 108

- more common in **women** - strangulation of a femoral hernia

Question 109

- What are the boundaries of the adductor canal? - What does it span from?

Answer 109

- anterior and lateral: vastus medialis - posterior: adductor longus and magnus - medial: sartorius **apex of femoral triangle to adductor hiatus**

Question 110

What is an effective and commonly performed peripheral nerve block for knee and foot surgery?

Answer 110

adductor canal block

Question 111

What are the contents of the adductor canal?

Answer 111

- saphenous nerve - femoral artery and vein - nerve to vastus medialis

Question 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?

Answer 112

adductor canal - between sartorius and vastus medialis m

Question 113

What delivers the femoral vessels to the popliteal fossa where they become popliteal vessels?

Answer 113

adductor canal

Question 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

Answer 114

adductor hiatus

Question 115

The hiatus transmits the (...) from the anterior compartment of the thigh to the popliteal fossa posterior to the knee

Answer 115

femoral artery and vein

Question 116

What are the arteries that supply the thigh?

Answer 116

- 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)

Question 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?

Answer 117

femoral artery

Question 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?

Answer 118

deep artery of the thigh

Question 119

- What does the obturator artery arise from? - How many medial circumflex femoral arteries are there? lateral circumflex branches?

Answer 119

- internal iliac a - 1 medial circumflex branch - 3 lateral circumflex branches, ascending, transverse, and descending

Question 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?

Answer 120

- medial and lateral CFA - medial CFA - medial CFA

Question 121

What artery supplies the muscles of the lateral aspect of the thigh and lesser degree of the femoral head?

Answer 121

lateral CFA

Question 122

- What does the circumflex femoral aa supply? - 90% of hip dislocations happen (...)

Answer 122

- thigh mm and proximal femur - posterior

Question 123

- What does the obturator artery supply? - What are the branches of the obturator artery? - What do the branches supply?

Answer 123

- 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

Question 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?

Answer 124

the knee joint

Question 125

Although the knee joint is well constructed, its function is commonly impaired when it is (...)

Answer 125

hyperextended

Question 126

- What bone is not involved in the knee joint? - What does the stability of the knee joint depend on?

Answer 126

- the fibula - strength and actions of surrounding muscles and their tendons - ligaments connecting the femur and tibia

Question 127

The patella allows for (...)

Answer 127

gliding (gliding joint)

Question 128

- What term means directly in the joint? What term means above the joint?

Answer 128

- condyle - epicondyle

Question 129

- What are the two main bursa in the knee capsule? - Where are they located? - What do they allow for?

Answer 129

**suprapatellar bursa** - superior to patella, deep to vastus intermedius - extends the knee joint capsule **pes anserinus** - superficial to MCL - allows for tendinous expansion

Question 130

What forms the pes anserinus?

Answer 130

distal ends of the: - gracilis - sartorius - semitendinosus **each attach superficially to MCL to form pen anserinus**

Question 131

The knee joint capsule is reinforced by what?

Answer 131

- 4 capsular ligaments (intrinsic) - 1 extracapsular ligaments

Question 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?

Answer 132

**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)

Question 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 (...)

Answer 133

- quadriceps tendon - tibial tuberosity

Question 134

Laterally, the patellar ligament receives what?

Answer 134

- medial and lateral patellar retinacula - aponeurotic expansions of vastus medialis and lateralis m - overlying deep fascia

Question 135

What plays an important role in maintaining alignment of the patella relative to the patellar articular surface of the femur?

Answer 135

patellar retinacula

Question 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

Answer 136

synovial membrane of the knee joint

Question 137

The (...) lines the fibrous layer laterally and medially, but centrally, it becomes separated from the fibrous layer

Answer 137

synovial membrane of the knee joint

Question 138

What does the synovial membrane of the knee joint reflect to?

Answer 138

the cruciate ligaments

Question 139

What are the intracapsular structures found within the knee?

Answer 139

1. cruciate ligaments 2. menisci 3. tendon of popliteus

Question 140

What are the features of the fibular collateral ligament (LCL)?

Answer 140

- 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

Question 141

What are the features of the tibial collateral ligament (MCL)?

Answer 141

- strong flat band - extends from medial epicondyle of femur to medial epicondyle of tibia - weaker than fibular (LCL) - attaches to medial meniscus

Question 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?

Answer 142

- MCL is damaged more often - attaches to medial meniscus - TCL and medial meniscus are commonly injured

Question 143

What ligaments strengthen the knee joint capsule posteriorly?

Answer 143

- oblique popliteal ligament - arcuate popliteal ligament

Question 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 (...)

Answer 144

- semimembranosus - medial tibial condyle

Question 145

The arcuate popliteal ligament arises from the (...)

Answer 145

posterior aspect of the fibular head

Question 146

What is also named the "unlocking muscle" as it unlocks the knee from the locked position?

Answer 146

popliteus

Question 147

What are the two cruciate ligaments?

Answer 147

- ACL - PCL

Question 148

What are the 4 main ligaments in the knee that connect the **femur (thigh bone)** to the **tibia (shin bone)**?

Answer 148

- ACL - PCL - MCL - LCL

Question 149

- What is the travel pattern of the ACL? - What is the travel pattern of the PCL?

Answer 149

**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

Question 150

What is the weaker cruciate ligament with poor blood supply?

Answer 150

ACL

Question 151

What are the actions of the ACL?

Answer 151

- prevents posterior displacement of femur on tibia - prevents hyperextension of knee - When knee is flexed 90 degrees, tibia cannot be pulled anterior

Question 152

- The ACL is slack when the knee is (...), and tightens when (...)

Answer 152

- flexed - fully extended

Question 153

What are the actions of the PCL?

Answer 153

- prevents anterior displacement of femur on tibia - prevents hyperflexion of knee

Question 154

The PCL tightens when knee is (...)

Answer 154

flexed

Question 155

In the weight-bearing flexed knee, the PCL is the (...) (e.g., when walking downhill)

Answer 155

main stabilizing factor for the femur

Question 156

- What meniscus is c-shaped and becomes broader posteriorly? - What meniscus is almost circular, smaller, and freely movable?

Answer 156

- medial meniscus - lateral meniscus

Question 157

The medial meniscus firmly adheres to the deep surface of the (...)

Answer 157

tibial collateral ligament

Question 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

Answer 158

- popliteus - fibular collateral ligament - posterior meniscofemoral ligament

Question 159

What does the posterior meniscofemoral ligament join?

Answer 159

- lateral meniscus to PCL - medial femoral condyle

Question 160

What are the actions of the meniscus?

Answer 160

- deepen articular surface - act as shock absorbers

Question 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?

Answer 161

meniscus

Question 162

What are are capsular fibers that attach the margins of the menisci to the tibial condyles?

Answer 162

coronary ligament

Question 163

A slender fibrous band, the (...), joins the anterior edges of the menisci (Fig. 7.53C), allowing them to move together during knee movements.

Answer 163

transverse ligament of knee

Question 164

What occurs in unhappy triad syndrome?

Answer 164

- ruptured MCL - torn medial meniscus - ruptured ACL

Question 165

What is the anterior, posterior, lateral, and medial innervation of the knee?

Answer 165

- anterior: femoral n - posterior: tibial n - lateral: common fibular n - medial: obturator and saphenous cutaneous nerves