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Kinesiology > Lower Quarter 1 (Hip and Knee-Tibiofemoral) > Flashcards

Lower Quarter 1 (Hip and Knee-Tibiofemoral) Flashcards

1
Q

what makes up the coxofemoral joint/

A

acetabulum of the pelvis

femoral head

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2
Q

what type of join is the coxofemoral joint?

A

ball-and-socket joint

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3
Q

how many degrees of freedom does the coxofemoral joint have/

A

three

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4
Q

Where is the acetabulum located in terms of the innominate?

A

on the lateral aspect

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5
Q

what are the faces of the acetabulum?

A

lateral
inferior
anterior

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6
Q

what are the three bones that contribute to the surface of the acetabulum?

A

ilium-2/5th (upper)
ischium-2/5th (posterior)
pubis-1/5th (front)

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7
Q

What is the innominate?

A

half the pelvis

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8
Q

What does the acetabulum do/

A

accepts the head of the humerus.

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9
Q

What is the fossa of the acetabulum?

A

the deepest portion of the acetabulum

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10
Q

what is the lunate surface of the acetabulum?

A

horseshoe-shaped articular cartilage

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11
Q

What is the labrum of the acetabulum?

A

wedge-shaped fibrocartilage that rings the acetabulum

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12
Q

What does the labrum do in the acetabulum?

A

deepens the socket

helps to maintain contact with the head of the femor.

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13
Q

What is part of the head of the femur?

A

fovea

articulating surface

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14
Q

what is part of the neck of the femor?

A

trochanters (greater and lesser)

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15
Q

What are the faces of the head of the femur?

A

medial
superior
anterior

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16
Q

Which face does both the femur and acetabulum have?

A

anterior face

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17
Q

what is the angle of inclination of the femur?

A

Frontal plane angle

Angle between an axis through the femoral head/neck and a longitudinal axis through the shaft

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18
Q

What are the different angle changes of the femur throughout life?

A

at birth-150 degrees
in adult-125 degrees
elderly- 120 degrees

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19
Q

What are some abnormalities of the angle of inclination of the femur?

A

coxa vara- decrease in the angle (towards 90) femur goes inward, angle goes medially, adduction
coxa valga-increase in the angle (towards 180) opening up the angle
femur goes outward, angle goes internally, abduction

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20
Q

What is the angle of torsion?

A

it’s in the transverse plane

it’s the angle between an axis through the femoral head/neck and an axis through the femoral condyles

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21
Q

How does the angle of torsion change throughout life?

A

at birth-40 degrees

adult-10-15 degrees-internal rotation

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22
Q

what is the normal angle of torsion called?

A

anteversion

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23
Q

What are some abnormalities of the angle of torsion?

A

Excessive anteversion-increase in the angle
results in lower extremity internal rotation
Retroversion-goes more towards zero point or a decrease in the angle
results in lower extremity external rotation

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24
Q

What are some non-osseous structures?

A

joint capsule

ligamentum teres

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25
Q

What does the joint capsule do?

A

covers femoral head and neck

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26
Q

is the femoral neck intracapsular or extracapsular?

A

intracapsular

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27
Q

are the trochanters intracapsular or extracapsular?

A

extracapsular

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28
Q

where is the joint capsule of the hip the thickest?

A

anteriorly

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29
Q

where does the ligamentum teres go between/

A

acetabulum

to fovea

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30
Q

what is an important aspect of the ligamentum teres?

A

it’s intra-articular but extrasynovial

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31
Q

Is ligamentum teres a stabilizer?

A

No

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32
Q

what does ligamentum teres do?

A

provides secondary source of blood for the femoral head/neck

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33
Q

What are the stabilizing ligaments of the hip joint?

A

iliofemoral ligament
pubofemoral ligament
ischiofemoral ligament

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34
Q

where is the iliofemoral ligament located

A

anterior

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35
Q

what is a defining aspect of the iliofemoral ligament?

A

it looks like a “y”

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36
Q

what is the strongest ligament of the hip?

A

the superior band of the iliofemoral ligament

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37
Q

where is the pubofemoral ligament located?

A

anterior

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38
Q

What is a defining aspect of the pubofemoral ligament?

A

together with iliofemoral ligament it forms a “Z” on the capsule

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39
Q

where is the ischiofemoral ligament located/

A

posterior

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40
Q

What does extension of the hip do to the ligaments

A

winds the ligaments up

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41
Q

what does flexion of the hip do to the ligaments?

A

unwinds the ligaments

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42
Q

What position is the femur in while standing neutral?

A

anterior head of femur is exposed

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43
Q

where is the greatest joint congruency of the hip joint?

A

flexion
abduction
external rotation

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44
Q

when is the hip the most stable?

A

in a closed pack position because of the ligaments

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45
Q

What is the closed pack position of the hip?

A

extension
slight abduction
internal rotation

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46
Q

what are the flexors of the hip?

A

iliopsoas
rectus femoris
tensor fascia lata
sartorius

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47
Q

what are the extensors of the hip?

A

gluteus maximus

hamstrings

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48
Q

what are the adductors of the hip?

A 
pectineus
gracillis
adductor magnus
adductor brevis
adductor longus
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49
Q

What are the abductors of the hip/

A

Gluteus medius

gluteus minimus

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50
Q

what are the external rotators of the hip?

A 
obturator internus
obturator externus
gemellus superior
gemellus inferior
quadratus femoris
piriformis-when hip is below 60 degrees
gluteus maximus
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51
Q

what are internal rotators/

A

gluteus minimus
gluteus medius-ant. fibers
TFL
piriformis-when hip above 60 degrees

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52
Q

Where does the piriformis attach?

A

to the summit of the greater trochanter

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53
Q

In hip extension, what type of moment arm does the piriformis have?

A

a long moment arm

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54
Q

In hip flexion, what type of moment arm does the piriformis have?

A

a short moment arm

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55
Q

when the piriformis has a short moment arm what action does it perform?

A

internal rotation

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56
Q

when the piriformis has a long moment arm what action does it perform?

A

external rotation

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57
Q

What are the motions of the hip complex

A

flexion/extension (sagittal plane and coronal (M/L axis)
Abduction/adduction (frontal plane, A/P axis)
internal/external rotation (transverse plane, vertical axis)

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58
Q

What are the motions of the pelvis?

A 
anterior pelvic tilt
posterior pelvic tilt
hip hiking
pelvic drop
forward rotation
backward rotation
59
Q

What is anterior pelvic tilt?

A

ASIS moves anterior and inferior

60
Q

What is posterior pelvic tilt?

A

ASIS moves posterior and superior

61
Q

What is hip hiking?

A

elevation of the contralateral iliac crest

62
Q

What is pelvic drop?

A

depression of the contralateral iliac crest

63
Q

what is forward rotation of the pelvis?

A

anterior rotation of the contralateral innominate

64
Q

What is backward rotation of the pelvis?

A

posterior rotation of the contralateral innominate

65
Q

What is the principle of the length tension relationship?

A

a two joint muscle is more able to act across one of the joints when it has been stretched across the other joint.

66
Q

When is the rectus femoris most effective

A

As a hip flexor when the knee is flexed

As a knee extensor if the hip is extended

67
Q

When does the rectus femoris have active insufficiency?

A

if the knee is extended when trying to flex the hip

68
Q

when are the hamstrings most effective?

A

As a hip extensor when the knee is extended

As a knee flexor when the hip is flexed

69
Q

What are the joints of the knee?

A

tibiofemoral joint

patellofemoral joint

70
Q

What type of joint is the tibiofemoral joint?

A

a double condyloid joint

71
Q

how many degrees of freedom in the tibiofemoral joint/

A

two degrees

72
Q

what is the closed-packed position of the tibiofemoral joint?

A

extension with external rotation (of tibia)

73
Q

what is the open-packed position of the tibiofemoral joint?

A

25 degrees of flexion-allows for the most volume

74
Q

Is the patellofemoral joint considered a real joint?

A

no

75
Q

where is the sesamoid bone located in the patellofemoral joint?

A

in the quadriceps tendon

76
Q

what are the bony structures on the distal femur?

A

lateral and medial epicondyles

adductor tubercle

77
Q

what are the bony structures located on the proximal tibia?

A

tibial plateaus
gerdy’s tubercle-IT band inserts here
tibial tubercle-Quads insert here

78
Q

What are the bony structures of the proximal fibula?

A

head-biceps femoris inserts here

79
Q

what are the bony structures of the patella?

A

base-on top
apex-on bottom
medial border
lateral border

80
Q

What are the three facets of the patella?

A

lateral facet
medial facet
odd facet-located medial to medial facet

81
Q

What are the non-osseous structures of the knee joint?

A 
joint capsule
synovial lining
plicae
bursae
menisci
82
Q

Is the joint capsule of the knee thick or thin?

A

Thin

83
Q

What is the joint capsule of the knee reinforced by?

A

anteriorly-patella, quad tendon and patellar ligament
posteriorly-muscle, popliteal and arcuate ligament
medially-medial collateral ligament
laterally-lateral collateral ligament

84
Q

what is the most extensive and complex aspect of the body?

A

the synovial lining of the knee

85
Q

Where does the synovial lining adhere?

A

to the inner wall of the capsule except posteriorly where it follow the inercondylar notch
to the ACL and PCL

86
Q

What are the ACL and PCL?

A

intracapsular, but extrasynovial-they are within the capsule, but not within the capsule synovial

87
Q

What are plicae?

A

Folds or pleats in the synovial tissue-crunchy and cause pain

88
Q

In what percent of the population do plicae exist?

A

20-70% of the population

89
Q

Where are plicae usually located?

A

infrapatella
suprapatella
medial

90
Q

What are bursae?

A

flat sacs of synovial membrane containing fluid

91
Q

How many bursae in the knee?

A

as many as 14

92
Q

Where are bursae formed?

A

in inter-tissue junctions that are subject to high friction during movement

93
Q

What are menisci?

A

assymetrical fibrocartilaginous discs

94
Q

What do menisci do/

A

deepens articular surfaces
smooths synovial surface to 200x smoother than ice
provides symmetry to the TF joint
acts as a shock absorber

95
Q

What does the lateral meniscus look like/

A

a “d”

96
Q

what does the medial meniscus look like?

A

a “c”

97
Q

How does the menisci move/

A

must move with the tibia during flexion and extension
menisci move as people move, if they don’t they tear
flexion-pulls posteriorly
extension-shifts anteriorly

98
Q

what prevents impingement of the menisci?

A

muscular attachments

99
Q

what are the ligaments of the knee?

A

medial collateral ligament
lateral collateral ligament
anterior cruciate ligament
posterior cruciate ligament

100
Q

What does the medial collateral ligament look like?

A

broad and flat, slops anteriorly

101
Q

where does the medial collateral ligament attach?

A

to the medial condyle of femur and medial aspect of proximal tibia
some fibers attach to medial capsule and medial meniscus

102
Q

what does the medial collateral ligament resist?

A

valgus stress

checks external rotation of the tibia

103
Q

when is the medial collateral ligament most taunt?

A

in extension

104
Q

what does the lateral collateral ligament look like?

A

strong cord

105
Q

where does the lateral collateral ligament attach?

A

to lateral condyle of femur and head of fibula

106
Q

what does the lateral collateral ligament resist?

A

varus stress

checks external rotation

107
Q

When is the lateral collateral ligament most taunt?

A

in extension

108
Q

Where does the anterior cruciate ligament run to?

A

from anterior tibia to the medial side of the lateral femoral condyle

109
Q

what does the anterior cruciate ligament resist?

A

anterior tibial or posterior femoral displacement
resists extension- prevents hyperextension
checks rotation

110
Q

What does the anterior cruciate ligament assist in

A

screw home mechanism- it gets taunt as you go into extension and gives a little twist.

111
Q

where does the posterior cruciate ligament run from and to

A

from the posterior tibia to the lateral side of the medial femoral condyle

112
Q

Compared to the ACL, what does the PCL look like?

A

shorter and more oblique compared to ACL

113
Q

what does the PCL resist?

A

posterior tibial or anterior femoral displacement
resists flexion
checks rotation

114
Q

Where does the PCL attach?

A

to the lateral meniscus via the posterior meniscofemoral ligament

115
Q

What is the patellar tendon?

A

infrapatellar

attaches patella to tibial tuberosity

116
Q

what is the quadriceps tendon?

A

suprapatellar

attaches quadriceps to the patella

117
Q

what is the iliotibial band and the lateral retinaculum?

A

fibrous bands of connective tissue that support the lateral knee joint

118
Q

Where do the iliotibial band and the lateral retinaculum attach?

A

on the patella

119
Q

What can the iliotibial and lateral retinaculum cause?

A

abnormal alignment of the patella due to excessive lateral pulling on the patella

120
Q

what are the prime flexors of the knee?

A

hamstring (semimembranosus, semitendinosus, biceps femoris)
gracilis
sartorius

121
Q

What are the prime extensors of the knee?

A

quadriceps (vastus medialis, vastus lateralis, vastus intermedius)
rectus femoris

122
Q

what are the internal rotators of the knee?

A 
semitendinosus
semimembranosus
popliteus
gracilis
sartorius
123
Q

what are the external rotators of the knee?

A

biceps femoris

124
Q

What motions occur at the knee?

A

flexion/extension- sagittal plane, coronal axis

internal/external rotation- transverse plane, vertical axis

125
Q

What are the open chain arthrokinematics of the tibiofemoral Joint?

A

concave tibia moves on convex femoral condyles
extension-anterior glide
flexion-posterior glide

126
Q

What are the open chain arthrokinematics of the tibiofemoral joint?

A

convex femoral condyles moving on concave tibia.
extension-posterior glide
flexion-anterior glide

127
Q

What is the screw home mechanism with a fixed femur?

A

during the final 30 degrees of knee extension, the tibia externally rotates 10 degrees on the femur in the transverse plane (open chain)

128
Q

What is required to unlock the knee in the screw home mechanism?

A

flexion which is accomplished by the popliteus muscle

129
Q

What factors are creating motion in the screw home mechanism?

A

shape of medial condyle
tension of ACL
Lateral pull of the quads

130
Q

What occurs during open kinematic chain at the knee?

A

lateral tibial condyle moves posteriorly
medial tibial condyle moves anteriorly slightly
results in external rotation of the tibia

131
Q

What occurs during closed kinematic chain at the knee?

A

lateral femoral condyle spins slightly
medial femoral condyle glides posteriorly
results in internal rotation of femur on the fixed tibia

132
Q

What is the normal joint position of the knee?

A

normal Genu Valgum
shaft of femur angles medially due to inclination of femur
knee assumes a slight valgus position

133
Q

What are some frontal plane abnormalities at the knee?

A

excessive genu valgum-greater than 15 degrees valgus position
genu varum- reversal of the genu valgum position

134
Q

What are some sagittal plane changes that can occur at the knee?

A

genu recurvatum

135
Q

What is genu recurvatum?

A

excess motion in extension (normal to have 5-10 degrees of hyperextension)

136
Q

What’s normal patellofemoral alignment when the knee is in full extension (last 20-30 degrees)?

A

patella lies in front of the intercondylar groove

contact on the femur is at the inferior patellar pole

137
Q

What’s normal patellofemoral alignment when the knee is flexed between 60-90 degrees?

A

Patella shifts below intercondylar groove

contact on the femur shifts inferiorly to the mid-patella

138
Q

what’s normal patellofemoral alignment when the knee is flexed at 135 degrees?

A

patella is well below the intercondylar groove

contact on the femur is at the odd facet and lateral edge.

139
Q

What’s the Q-angle stand for?

A

Quadriceps angle

140
Q

What is the Q-angle?

A

the angle at which the quadriceps pull on the tibia.

141
Q

How is the Q-angle measured?

A

by comparing the line from the ASIS to the mid-patella and the line from the mid-patella to the tibial tuberosity. The patella is pulled to the side of the angle.

142
Q

What are the normal degrees of Q-angles for men and women

A

Men-14 degrees

Women- 17 degrees

143
Q

What is the length tension relationship when the hip is flexed and the knee extended?

A

Rectus femoris is actively overshortened

Hamstrings are passively overstretched

144
Q

what is the length tension relationship when the hip is extended and the knee is flexed?

A

hamstrings actively overshortened

Rectus femoris is passively overstretched.

Kinesiology (7 decks)

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