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Anatomy > Lower Limb Joints > Flashcards

Lower Limb Joints Flashcards

1
Q

Anterior SI joint

A

. Synovial joint btw interlocking auricular surfaces of sacrum and ilium
. Auricular surfaces covered by articular cartilage

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2
Q

Posterior SI joint

A

. Syndesmosis btw tuberosties of sacrum and ilium

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3
Q

Intrinsic ligament of SI joint

A

. Ant./post. SI ligament

. Interosseous ligament

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4
Q

Ant. SI ligament

A

. Ant. Portion of fibrous joint capsule

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5
Q

Interosseous SI ligament

A

. Spans btw tuberosities of sacrum and ilium
. Strongest ligament in body
. Primary weight-bearing structure

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6
Q

Posterior SI ligament

A

Post. External continuation of interosseous SI ligament

. Blends w/ sacrotuberous ligament inf.

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7
Q

Extrinsic ligaments of SI joint

A

. Iliolumbar: connects transverse process of L5 to pos. Iliac crest, blends w/ ant. SI ligament, stabilizes SI joint, sometimes connected to L4
. Sacrospinous: prevent excessive ant. rotation
. Sacrotuberous (same as above)

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8
Q

Movement permitted by SI joint

A

. Small amount of gliding and rotation (pelvic tilt)

. Relatively immobile

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9
Q

Interosseous SI ligaments function

A

. Transmit weight of upper body to pelvic bones

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10
Q

Sacrospinous and sacrotuberous ligament function

A

. Resist ant. Rotation of sacrum in response to vertical loading of sacral base ant. To SI joint’s transverse axis

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11
Q

What percentage of femur head resides w/in the acetabulum?

A

More than 50%

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12
Q

Congenital hip dysphasia

A

. Development anomaly
. Causes intermittent dislocation of femur head from acetabulum
. Risks: family history, female, breech presentation
. Infants screened for this

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13
Q

Hip Joint surfaces that have articular cartilage

A

. Femoral head including its fovea

. Lunate surface of acetabulum

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14
Q

Hip joint surfaces not covered by articular cartilage

A

. Acetabulum fossa

. Has synovium covered acetabulum fat pad instead

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15
Q

Transverse acetabular ligament

A

. Spans acetabular notch
. Connects free ends of labrum
. Forms foramen for passage of nerves and vessels

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16
Q

Femoroacetabular impingement syndrome

A

. Bone spurs on femoral head and/or acetabular margin create friction and restrict movement
. Contact can erode articular cartilage or tear the labrum

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17
Q

Acetabular labrum

A

. Incomplete fibrocartilage ring
. Attaches to acetabular rim
. Deepens acetabulum

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18
Q

Joint capsule of hip joint

A

. fibrous capsule attaches to acetabular rim external to the labrum and to transverse acetabular ligament
. Encircles femoral neck
. Ant. Attaches to intertrochanteric line and base of greater trochanter
. Post. Cross neck sup. To intertrochanteric crest but is free margin
. Fibers have spiral course from pelvis to femur

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19
Q

Traumatic hip dislocation

A

. Caused by car accidents or falls
. 90% are post.
. Complications: acetabular fracture, sciatic n. Injury, interruption of femoral head blood supply
. Presents as shortened limb in fixed adducted med. rotated position

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20
Q

Intrinsic ligaments of hip joint

A

. Iliofemoral
. Pubofemoral
. Ischiofemoral

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21
Q

Iliofemoral ligament

A

. Strongest intrinsic ligament
. From AIIS and acetabular rim to intertrochanteric line
. Makes inverted Y
. Convers. Sup. And ant. Surfaces of joint
. Prevents hyperextension, limits rotation in standing, limits adduction

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22
Q

Pubofemoral ligament

A

. Second strongest
. Arises from pubic portion of acetabular rim
. Attaches distally to inf. End of intertrochanteric line
. Covers inf. Aspect of hip
. Limits extension, abduction, and lat. rotation

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23
Q

Ischiofemoral ligament

A

. Weakest
. From ischial portion of acetabular rim
. Attaches distally to base of greater trochanter
. Covers post. Aspect hip joint
. Limits extension, abduction, and med. rotation

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24
Q

Ligament of femoral head

A

. Also called round ligament of femur, ligamentum teres Femoris
. Weak extrinsic ligament w/in hip joint capsule
. From borders of acetabular notch and transverse acetabular ligament
. Attaches to fovea of femoral head
. Enclosed in synovial fold that transmits acetabular branch of obturator a.
. Tightens during hip adduction, it not significant support

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25
Q

How capsular ligaments stabilize hip

A

. In standing or extension, winding of spiral fibers tightens hip capsule (esp. iliofemoral)
. Windings pulls femoral head into acetabulum and stabilizes joint w/ minimal muscular effort
. Flexion unwinds fibers for greater ROM
. Tonic contraction of med. and lat. rotators provide dynamic support

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26
Q

Range of hip flexion when knee is flexed is limited by ____

A

. Soft tissue contact

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27
Q

Straight leg flexion is limited by ____

A

Muscular tension

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28
Q

Hip extension is limited by _____

A

. Capsular ligaments to 10-20 degrees

. Esp. Iliofemoral

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29
Q

What ligament needs to be lax in gymnasts?

A

Iliofemoral

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30
Q

Hip joint blood supply

A

. Branches of med. and lat. femoral circumflex aa.

. A. To head of femur is small branch of obturator a. That courses w/in ligament of femoral head

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31
Q

What nn. Supply hip joint?

A

. Femoral
. Obturator
. Sup. Gluteal
. N. To quadratus femoris

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32
Q

Leg-calve-perthes

A

. Femoral head collapse from fracture that disrupts blood supply
. Disease is pediatric condition
. Risk factor: male, family history

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33
Q

Articulations in knee joint

A

. Medial and lateral tibiofemoral

. Patellofemoral

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34
Q

What structures in knee joint are covered w/ articular cartilage?

A

. Condyles and patellar surface of femur

. Condyles of tibia

35
Q

What surfaces in knee joint do not have articular cartilage?

A

. Intercondylar area of tibial plateau

. Provides attachments for ligaments and menisci

36
Q

What femoral condyle is larger?

A

Medial

. Larger w/ longer articular surface

37
Q

Q-angle

A

. Due to difference in condylar size
. Btw tibia and femur
. Males: 10-15 degrees
. Female: 15-18 degrees

38
Q

Lat. lip do femur’s patellar surface function

A

. Resists lat. displacement of patella

. Guides movement during fl/extension

39
Q

Fibrous capsule of knee joint

A

. Attached to margins of femoral articular surfaces and tibial plateau
. Thin post., strengthened med. and lat. by collateral ligaments
. Post. Capsule has arcuate popliteal ligament that is a gap that admits popliteus tendon
. Ant. Capsule replaced by quad tendon, patella, and patellar ligament

40
Q

Synovial membrane of knee joint

A

. Lines majority of capsule
. Post. Forms infrapatellar synovial fold that excludes intercondylar area
. Extends sup. Deep to quad tendon forming suprapatellar bursa continuous w/ joint cavity

41
Q

Infrapatellar synovial fold

A

. Encloses cruciate ligaments

. Subdivides synovial cavity into med. and lat. compartments

42
Q

Menisci attachments

A

. Peripheral margins attach to tibial condyles via coronary ligaments
. Horns attach to intercondylar area
. Med. meniscus attached to med. collateral ligament

43
Q

Menisci shape

A

. Thick peripherally and thinner centrally (wedge-shaped)
. Med. meniscus is crescent-shaped
. Lat. meniscus is circular shaped

44
Q

Med. Meniscus characteristics

A

. Attached to med. collateral ligament
. Less mobile
. More susceptible to injury

45
Q

Lat. meniscus characteristics

A

. Horns more closely spaced
. Less susceptible to injury
. Does NOT attach to lat. collateral ligament

46
Q

Zones of meniscus

A

. Peripheral red zone: better blood supply, heads more readily
. Central white zone: avascular

47
Q

What connects menisci?

A

Transverse ligament

. Coordinates movements during fl/extension

48
Q

Discoid meniscus

A

. Meniscus covers all or most of tibial condyle
. Prone to injury due to poor blood supply and altered joint mechanics
. 3% population has lat. one, 0.1% population has med. one

49
Q

Medial collateral ligament (MCL) and functions

A

. Broad, flat intrinsic ligament covering med. aspect of knee
. From med. epicondyle of femur to med. tibial condyle and shaft
. Deep fibers attach to med. meniscus
. Ligament gets tight during extension
. Resists lat. rotation and abduction

50
Q

Fibular (lat.) ligament (LCL)

A

. Strong, cord-like extrinsic ligament
. From lat. epicondyle of femur to head of fibula
. Tight in extension
. Resists lat. rotation and adduction of leg
. Superficial to tendon of popliteus m. Separating it from lat. menisci

51
Q

. Anterolateral ligament (ALL)

A

. Thickening of capsule btw lat. epicondyle and lat. tibial condyle post. To gerdy’s tubercle
. Deep fibers attach to lat. meniscus
. Resists adduction and med. rotation of leg

52
Q

Barn-door sign

A

. Identifies excessive opening of joint caused by damage to collateral ligaments

53
Q

Cruciate ligaments

A

. PCL and ACL
. Cord-like extrinsic ligaments w/in joint capsule but outside synovial cavity
. Enclosed by infrapatellar synovial fold
. Tight in extension
. Resist med. rotation of tibia and ab/dduction of knee

54
Q

ACL

A

. Attached to ant. Intercondylar area of tibia and posterolateral intercondylar notch of femur
. Resists ant. Displacement of tibia or post. Displacement of femur

55
Q

PCL

A

. Attaches to post. Intercondylar area of tibia and anteromedial intercondylar notch of femur
. Resist post. Displacement of tibia or ant. Displacement of femur

56
Q

Segond fracture

A

. Avulsion of ALL’s tibial attachment
. Occurs in 10% ACL rupture
. High incidence in ACL injuries in female athletes

57
Q

Sequence of knee extension

A

. Lat. femoral condyle reaches limit of articular surface sooner than med. one and ACL becomes taut
. Femur rotates med. using ACL as pivot
. Med. condyle glides post. And rotates to achieve max congruence w. Tibia and full extension

58
Q

Sequence of knee flexion

A

. Initiated by popliteus m. Which rotates femur lat.
. Moves med. condyle forward to unlock knee
. Movement completed by principal knee flexor muscles

59
Q

Why is fully extended knee so stable?

A

. Collateral ligaments taut

. Cruciate ligaments are tightly wound (screw-home position)

60
Q

What provides dynamic support of the knee?

A

. Quads
. Hamstrings
. Tensor fasciae latae and IT band provide lad. Stabilization

61
Q

Unhappy triad

A

. Blow to lat. knee when foot is planted when knee is extended
. Damage to med. collateral ligament, med. meniscus, and ACL

62
Q

Blood supply of knee joint

A

. Genicular aa. (Direct and indirect branches of femoral, popliteal, and ant. Tibial aa.)
. Form genicular anastomosis

63
Q

Innervation of knee joint

A

. Articular branches of femoral, tibial, common fibular, obturator, and saphenous nn.

64
Q

Superior tibiofibular joints

A

. Plane-type synovial joint btw lat. condyle of tibia and fibular head
. Supported by ant. And post. Ligaments of fibular head
. Joint permits sup. Translation of fibula during dorsiflexion of ankle

65
Q

Middle tibiofibular joint

A

. Syndesmosis formed by interosseous membrane of leg and shafts of tibia and fibulas

66
Q

Inferior tibiofibular joint

A

. Syndesmosis btw distal ends of tibia and fibula supported by ant., post., and interosseous tibiofibular ligaments

67
Q

Interosseous membrane of tibiofibular joint resists ____

A

Inf. Pull of leg muscles originating from fibula

68
Q

Talocrural (ankle) joint structure

A

. Hinge synovial joint btw distal surface and med. malleolus of tibia, lat. malleolus of fibula, and trochlea of talus
. Distal tibia and malleoli form mortise (deep socket) w/ 3 articulations for sup., med., and lat. trochlea
. Thin fibrous capsule reinforced med. and lat. by ligaments

69
Q

Ankle ligaments

A

. Med. collateral ligament (deltoid): fan-shaped attaching med. malleolus to talus, navicular, and sustentaculum tali, fibers blend w/ plantar calcaneonavicular ligament, resists eversion and supports med. longitudinal arch
. Lat. collateral ligament: ant. Talofibular, calcaneofibular, and post. Talofibular ligaments arising from lat. malleolus, resists inversion

70
Q

Ankle sprain

A

. Most frequent injury in body
. Caused by inversion on planted foot typically
. ATF first, followed by calcaneofibular and post. Talofibular

71
Q

Ankle joint function

A

. Permits dorsi/plantar flexion and small amount of inversion/eversion in plantarflexed position
. During dorsiflexion, joint surfaces are tight-packed and stabilized by interosseous talofibular ligament making it stable

72
Q

Ankle joint blood supply

A

. Malleolus branches of ant. Tibial, post. Tibial, and fibular aa.

73
Q

Ankle joint innervation

A

. Articular branches of tibial and deep fibular nn.

74
Q

Subtalar joint

A

. Plane-type btw post. Articular surfaces of talus and calcaneus
. Fibrous capsule attaches to margins of articular surfaces
. Reinforced by intrinsic ligaments and interosseous talocalcaneal ligament
. Permits movement of inversion and eversion

75
Q

Talocalcaneonavicular joint

A

. 3 articulations: 2 plane type btw middle and ant. Articular surfaces of talus and calcaneus and talonavicular joint (ball and socket btw head of talus and prox. Navicular)
. Fibrous capsule reinforced on plantar surface by spring ligament that attaches to sustentaculum tali and navicular tuberosity
. Allows gliding and rotary movements in coordination w/ inversion/eversion of foot

76
Q

Sinus tarsi syndrome

A

. Tenderness, ankle instability, and pain on inversion and plantarflexion
. Due to issues w/ tarsal sinus and interosseous talocalcaneal ligament

77
Q

Transverse tarsal joint

A

. Compound joint formed by 2 transversely aligned joints (talonavicular and calcaneocuboid)
. Calcaneocuboid is plane-type joint btw ant. Calcaneus and post. Cuboid

78
Q

Ligaments in transverse tarsal joint

A

. Plantar calcaneocuboid (short plantar): attaches calcaneus to inf. (Plantar) surface of cuboid
. Long plantar ligament: from calcaneal tuberosity and attached to cuboid bone and bases of metatarsals II-V forming tunnel for fibularis longus tendon, superficial to short ligament

79
Q

3 major ligaments of mid foot

A

. Long and short plantar ligaments
. Plantar calcaneonavicular ligament
. Support foot’s longitudinal arches

80
Q

Intertarsal and tarsometatarsal joints

A

. Plant joints btw distal tarsals ( cuneiforms and cuboid) and metatarsals
. Allow limited gliding
. Strengthen transverse arch

81
Q

MP joints of foot

A

. Condyloid joints btw metatarsals and bases of prox. Phalanges
. Allow fl/extension and ab/dduction
. Fibrous joint capsule deficient dorsal where it is replaced by extensor tendons

82
Q

MP joint of foot ligaments

A

. Med. and lat. collateral ligaments (intrinsic) unite metatarsal head w/ prox. Phalangeal base and plantar plate, reinforce med. and lat. parts of fibrous capsule, tighten w/ flexion, limit ab/dduction of flexed joint
. Plantar plate ligament: fibrocartilage attaching metatarsal head to phalangeal base, reinforces ant. Capsule and creates socket for metatarsal head
. Deep transverse metatarsal ligaments: connect plantar plates

83
Q

IP joints of foot

A

. Hinge joints btw phalanges
. Have plantar plates should and joint capsules w/ med. and lat. collateral ligaments
. Only allow fl/extension

84
Q

Blood supply and innervationof foot joints

A

. Articular branches of med. and lat. planter nn. And aa.

Anatomy (49 decks)

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