Module 7: LE #1 - Hip/Thigh/Knee Flashcards
1
Q
What are the bony landmarks of the lower extremity?
A
Pelvia
Femur
Patella
Tibia
Fibula
Foot
2
Q
What are the bony landmarks of the femur?
A
Head
Neck
Greater Trochanter
Lesser Trochanter
Adductor tubercle
Medial/Lateral Condyles
Medial/Lateral Epicondyles
Patellar Surface
Intercondylar Fossa
Poplitical Fossa
3
Q
What is clinically important about the neck of the femur?
A
Site for fracture (either traumatic/pathological)
4
Q
What are the bony landmarks of the tibia?
A
Medial/Lateral Condyles
Tibial Tuberosity
Medial/Lateral Plateaus
Medial Malleolus
5
Q
What are the bony landmarks of the fibula?
A
Head of the fibula
Lateral malleolus
6
Q
What are the bony landmarks of the foot?
A
Tarsals
Metatarsals
Phalanges
7
Q
What are the names of the tarsal bones?
A
Calcaneous
Talus
Cuboid
3 Cuneiforms
Navicular
8
Q
How many phalanges make up the individual toes?
A
Great toe = 2
Other 4 toes = 3
9
Q
What comprises the hip joint?
A
Femoral head articulating w/ the acetabulum of the pelvis
10
Q
What are the 4 parts of the acetabulum?
A
Margin
Lunate
Acetabular notch
Acetabular labrum
11
Q
What is the important part of the head of the femur in the hip joint?
A
Fovea capitis
12
Q
What are the 3 childhood conditions that affect the hip joint?
A
Legg Calve Perthes
Transient Synovitis
Slipped Capital Femoral Epiphysis (SCFE)
13
Q
What is the most common cause of hip dislocation?
A
Trauma
Usually from motor vehicle accident
14
Q
How is the hip usually dislocated when caused by trauma?
A
Posterior Dislocation
15
Q
In kids, when would you see a hip dislocation?
A
In newborns –> congenital hip dislocation
16
Q
What are the ligaments of the hip joint?
A
Iliofemoral Ligament = Y ligament
Pubofemoral Ligament
Ischiofemoral Ligament
Ligamentum Teres = round ligament of the head of the femur
17
Q
What is the largest ligament of the hip?
A
Iliofemoral Ligament
18
Q
Where is the iliofemoral ligament (Y ligament) located in the hip joint, and what does it do?
A
Anterior
Resists Extension (especially while standing)
19
Q
Where is the pubofemoral ligament located in the hip joint, and what does it do?
A
Anterior and Inferior
Resists Abduction
20
Q
Where is the ischiofemoral ligament located in the hip joint, and what does it do?
A
Posterior
Resists Extension/Medial Rotation
21
Q
Where does the ligamentum teres attach in the hip joint?
A
Fovea Capitis of Femur Head
22
Q
What does the ligamentum teres do?
A
Provides pathway for ace tabular branch of obturator artery
**critical pathway for blood supply to femoral head during growth
23
Q
What supplies blood to the hip?
A
Medial/lateral circumflex arteries
Acetabular branch of obturator artery
24
Q
What is a clinical concern about the blood supply of the hip?
A
Avascular necrosis (AVN)
25
What are the muscles involved in hip flexion?
Iliopsoas
Rectus Femoris
Sartorius
26
What are the muscles involved in hip adduction?
Pectineus
Adductor Longus
Adductor Brevis
Adductor Magnus
Gracilis
27
What are the muscles involved in hip abduction?
Gluteus Minimus
Gluteus Medius
TFL (Tensor Fascia Lata)
28
What are the muscles involved in hip extension?
Gleutus Maximus
Biceps Femoris (long head)
Medial Hamstrings:
Semimembranosus
Semitendinosus
29
What are the muscles involved in external rotation of the hip?
Piriformis
Superior Gemellus
Obturator Internus
Inferior Gemellus
Quadratus Femoris
Obturator Externus
Gluteus Maximus
Biceps Femoris
Sartorius
30
What muscles make up the "6 lateral rotators" aka the short external rotators
Piriformis
Superior Gemellus
Obturator Internus
Inferior Gemellus
Quadratus Femoris
Obturator Externus
31
What are the muscles involved in internal rotation of the hip?
Gluteus Minimus
Gluteus Medius
TFL
Medial Hamstrings:
Semimembranosus
Semitendinosus
32
What is the fascia of the thigh?
Deep = Fascia Lata
33
What is the fascia lata?
Dense layer of connective tissue between subcutaneous tissue and muscles
34
What does the fascia lata form?
Septa that separate muscles (also surrounds them)
35
What does the fascia lata do?
Works w/ contracting muscles to move blood and lymph towards thorax
36
What is the illiotibial tract?
Conjoint aponeurosis of tensor of fascia lata and gluteus maximus
37
Where does the illiotibial tract extend?
Iliac tubercle --> tubercle on lateral condyle of tibia (aka Gerdy's tubercle)
** I.T. band
38
Besides the fascia lata and illiotibial tract what are the other septum's of the thigh?
Medial Intermuscular Septum
Lateral Intermuscular Septum
Posterior Intermuscular Septum
39
What are the muscles that make up the iliopsoas?
Psoas Major
Psoas Minor
Illiacus
40
Describe the Psoas Major (Proximal Attachment, Distal Attachment, Innervation, Action)
P = T12-L5 vertebrae and discs; transverse processes of all lumbar vertebrae
D = Lesser Trochanter
N = Ventral Rami of lumbar nerves (L1, L2, L3)
A = Flex thigh @ hip; also influence posture of pelvis in weight bearing)
41
Describe the Psoas Minor (Proximal Attachment, Distal Attachment, Innervation, Action)
P = T12 - L5 vertebrae and discs
D = Pectineal line, iliopectineal eminence via iliopectineal arch
N = Ventral rami of lumbar nerves (L1, L2)
A = No direct influence on hip motion, suggested to provide stability in pelvis
42
Describe the Iliacus (Proximal Attachment, Distal Attachment, Innervation, Action)
P = Iliac Crest, Iliac Fossa, Ala of Sacrum, Anterior SI ligaments
D = Tendon of Psoas Major, Lesser Trochanter and Femur Distal to it
N = Femoral Nerve (L2, L3)
A = Flex thigh @ hip; influence posture of pelvis in weight bearing
43
Describe the Tensor of Fasciae Latae (Proximal Attachment, Distal Attachment, Innervation, Action)
P = Anterior Superior Iliac Spine (ASIS) and Anterior part of iliac crest
D = Iliotibial Tract that attaches to lateral tibial condyle
N = Superior Gluteal Nerve (L4 and L5)
A = Abducts, Medially (Internally) Rotates and Flexes Thigh; Helps keep knee extended; Steadies trunk on thigh
44
Describe the Sartorius (Proximal Attachment, Distal Attachment, Innervation, Action)
P = Anterior Superior Iliac Spine and Superior part of notch inferior to it
D = Superior part of medial surface of tibia
N = Femoral Nerve (L2 and L3)
A = Flexes, abducts, and laterally (externally) rotates thigh @ hip; flexes leg @ knee joint
45
What are the muscles that make up the Quadriceps Femoris?
Rectus Femoris
Vastus Lateralis
Vastus Medialis
Vastus Intermedius
46
Describe the Rectus Femoris (Proximal Attachment, Distal Attachment, Innervation, Action)
P = Anterior Inferior Illiac Spine to Acetabulum
D = Base of Patella and by Ligament to Tibial Tuberosity
N = Femoral Nerve (L2, L3, L4)
A = Extends Knee Joint; slightly flexes the hip
47
Describe the Vastus Lateralis (Proximal Attachment, Distal Attachment, Innervation, Action)
P = Greater Trochanter and Lateral Lip of Linea Aspera of Femur
D = Base of Patella; by ligament to Tibial Tuberosity
N = Femoral Nerve (L2, L3, L4)
A = Extends Knee Joint
48
Describe the Vastus Medialis (Proximal Attachment, Distal Attachment, Innervation, Action)
P = Intertrochanteric line and medial lip of line aspera of femur
D = Base of patella; by ligament to tibial tuberosity
N = Femoral Nerve (L2, L3, L4)
A = Extends Knee Joint
** Obliquus (VMO) distal fibers primarily help to prevent patella to track laterally
49
Describe the Vastus Intermedius (Proximal Attachment, Distal Attachment, Innervation, Action)
P = Anterior and Lateral surfaces of body of femur
D = Base of patella; by ligament to tibial tuberosity
N = Femoral Nerve (L2, L3, L4)
A = Extends Knee Joint
50
What is the Articularis Genu?
Small muscle in distal femur
51
Where does the articularis genu attach?
Proximal end of synovial membrane of the knee joint --> distal femur
52
What does the articularis genu do?
Appears to pull on synovial capsule to prevent pinching of synovium
53
Name the nerves of the anterior thigh
Lateral Femoral Cutaneous Nerve
Femoral Nerve
54
What does the lateral femoral cutaneous nerve do and supply?
Sensory Function
Supplies Lateral Thigh
55
Where does the femoral nerve enter the thigh?
Deep to the inguinal ligament in the femoral triangle
56
What are the motor functions of the femoral nerve?
Supplies muscles of quadriceps (rectus femurs, vast us lateralis, medialis, intermedius) and sartorius
57
What are the sensory functions of the femoral nerve?
Supplies sensation along anterior thigh
58
What are the boundaries of the femoral triangle?
Superior/base = Inguinal Ligament
Medially = Adductor Longus
Laterally = Sartorius
Floor = Adductor Longus/Pectineus/Iliopsoas
Roof = Fascia Lata/Cribiform Fascia
59
What is the apex of the femoral triangle?
Where Sartorius/Adductor Longus meet
60
What are the contents of the femoral triangle?
Femoral Vein
Femoral Artery
Femoral Nerve
Profunda Femoris Artery
Profunda Femoris Vein
Inguinal Lymph Nodes
61
What is the function of the saphenous opening?
Allows superficial great saphenous vein to connect to femoral vein
Allows superficial lymph vessels to connect to deep inguinal lymph nodes
62
What does the femoral sheath, ring and canal do?
Provides pathway for femoral artery/vein/lymph nodes to pass under inguinal ligament
63
What is the femoral sheath?
Funnel-shaped fascia
64
How is the femoral sheath divided?
3 Compartments:
Lateral Compartment
Intermediate Compartment
Medial Compartment
65
What is in the lateral compartment of the femoral sheath?
Femoral Artery
66
What is in the intermediate compartment of the femoral sheath?
Femoral Vein
67
What is the medial compartment of the femoral sheath?
Femoral Canal
68
What is the femoral ring?
Oval shaped opening to the femoral canal
69
What is clinically important about the medial compartment/femoral ring?
Site of femoral hernia
70
What is another name for the adductor canal?
Subsartorial Canal
71
Where does the adductor canal run?
From apex of femoral triangle --> adductor hiatus
72
What are the boundaries of the adductor (subsartorial) canal?
Anterior/lateral = Vastus Medialis
Posterior = Adductor Longus/Adductor Magnus
Medial = Sartorius (acts as roof)
73
What are the contents of the adductor (subsartorial) canal?
Femoral Artery (supplies leg/foot)
Femoral Vein (drains leg/foot)
Saphenous Nerve
Nerve to Vastus Medialis
74
What are the arteries that supply the thigh?
Femoral Artery
Deep Femoral Artery
Lateral Femoral Artery Artery
Medial Femoral Circumflex Artery
75
Describe how the femoral artery descends down the thigh
Descends in adductor canal
Passes through adductor hiatus
Enters posterior knee (popliteal fossa)
76
Where does the femoral artery supply?
Leg
Foot
77
What is the major artery to supply the thigh?
Deep Femoral Artery
78
What do the branches of the deep femoral artery supply?
Adductor Magnus
Hamstrings
79
What does the lateral femoral circumflex artery supply?
Hip
80
What does the medial femoral circumflex artery supply?
Hip
81
How is the blood of the lower extremity drained?
Via superficial/deep venous pathways that are connected via communicated venous system
82
What are the superficial veins that drain the lower extremity?
Great Saphenous Vein
Small (lesser) Saphenous Vein
83
Describe how the great saphenous vein travels up the leg and where it drains
Ascends along medial leg
Drains into femoral vein @ saphenous opening (just inferior to inguinal ligament)
84
How does the small (lesser) saphenous vein travel up the lev and where does it drain?
Ascneds along posterior leg
Drains into politeal vein in popliteal fossa
85
How do the deep veins ascend up the leg and what do they drain/merge into?
Ascend w/ arteries of the leg
Drain/Merge into femoral vein
86
Clinically what could happen in the deep veins of the leg?
DVT (Deep Vein Thrombosis) formation
**Caused by immobilization/CHF/Obesity
87
What is the communicating venous system?
Veins that connect the superficial to deep veins
88
What is in the communicating veins?
Valves (force 1 way drainage from superficial --> deep veins)
89
What do the valves in the veins act like?
Muscular pump (push blood through system and up to the heart)
90
What happens if the valves in the veins of the legs fail?
Varicose Veins
**Blood flows from deep --> superficial and pool
91
What are the muscles of the medial thigh?
Pectineus
Adductor Longus
Adductor Brevis
Adductor Magnus
Gracilis
Obturator Externus
92
Describe the Pectineus (Proximal Attachment, Distal Attachment, Nerve, Action)
P = Superior Ramus of Pubis
D = Pectineal Line of Femur (just inferior to lesser trochanter)
N = Femoral Nerve (L2 and L3; maybe branch from obtrurator nerve)
A = Adducts/Flexes Thigh; Assists w/ Medial Rotation
93
Describe the Adductor Longus (Proximal Attachment, Distal Attachment, Nerve, Action)
P = Body of Pubis (inferior to pubic crest)
D = Middle 1/3 of Linear Aspera of Femur
N = Obturator Nerve; Branches of Anterior Division (L2, L3, L4)
A = Adducts Thigh
94
Describe the Adductor Brevis (Proximal Attachment, Distal Attachment, Nerve, Action)
P = Body and Inferior Ramus of Pubis
D = Pectineal Line and Proximal Part of Linea Aspera of Femur
N = Obturator Nerve; Branches of Anterior Division (L2, L3, L4)
A = Adducts Thigh; Some Flexion
95
Describe the Adductor Magnus (Proximal Attachment, Distal Attachment, Nerve, Action)
P = Adductor Part: Inferior Ramus of Pubis, Ramus of Ischium
Hamstring Part: Ischial Tuberosity
D = Adductor Part: Gluteal Tuberosity, Linea Aspera, Medial Supracondylar Line
Hamstring Part: Adductor Tubercle of Femur
N = Adductor Part: Obturator Nerve (L2, L3 and L4) Branches of posterior division
Hamstring Part: Tibial Part of Sciatic Nerve (L4)
A = Adducts Thigh
Adductor Part: Flexes Thigh
Hamstrings Part: Extends Thigh
96
What does the distal attachment of the adductor magnus form?
Adductor Hiatus
97
Describe the Gracilis (Proximal Attachment, Distal Attachment, Nerve, Action)
P = Body of Inferior Ramus of Pubis
D = Superior Part of Medial Surface of Tibia
N = Obturator Nerve (L2 and L3)
A = Adducts Thigh, Flexes Leg, Helps to Rotate Leg Medially
98
Describe the Obturator Externus (Proximal Attachment, Distal Attachment, Nerve, Action)
P = Margins of Obturator Forament and Obturator Membrane
D = Trochanteric Fossa of Femur
N = Obturator Nerve (L3 and L4)
A = Laterally Rotates Thigh; Steads Head of Femur in Acetabulum
99
What is the nerve of the medial thigh?
Obturator Nerve
100
What is the motor function of the obturator nerve?
Supplies Adductor Muscles (Adductor longus, brevis &magnus, gracilis)
101
What is the sensory function of the obturator nerve?
Supplies small oval patch along medial thigh
102
What are the two foramens of the posterior hip/gluteal region?
Greater Sciatic Foramen
Lesser Sciatic Foramen
103
How is the greater sciatic foramen formed?
Greater Sciatic Notch
Sacrospinous Ligament
104
How is the lesser sciatic foramen formed?
Lesser Sciatic Notch
Sacrotuberous Ligament
105
What are the muscles of the gluteal region?
Gluteus Maximus
Gluteus Medius
Gluteus Minimus
Piriformis
Obturator Internus
Superior Gemellus
Inferior Gemellus
Quadratus Femoris
Obturator Externus
106
Describe the Gluteus Maximus (Proximal Attachment, Distal Attachment, Nerve, Action)
P = Ilium Posterior to Posterior Gluteal Line, Dorsal Surface of Sacrum/Coccyx, and Sacrotuberus Ligament
D = Most = Iliotibial Tract (inserts into lateral condyle of tibia); Some = Gluteal Tuberosity of Femur
N = Inferior Gluteal Nerve (L5, S1, S2)
A = Extends, Assists in Lateral Rotation, Steadies Thigh; Assists rising from sitting position; Stabilizes Knee
107
Describe the Gluteus Medius (Proximal Attachment, Distal Attachment, Nerve, Action)
P = External Surface of Ilium Between Anterior/Posterior Gluteal Lines
D = Lateral Surface of Greater Trochanter of Femur
N = Superior Gluteal Nerve (L5, S1)
A = Abducts/Medially Rotates Thigh; Keeps Pelvis Level When Opposite Leg is Raised
108
Describe the Gluteus Minimus (Proximal Attachment, Distal Attachment, Nerve, Action)
P = External surface of ilium between anterior surface of
109
Describe the Piriformis (Proximal Attachment, Distal Attachment, Nerve, Action)
P = Anterior Surface of Sacrum and Sacrotuberous Ligament
D = Superior Border of Greater Trochanter
N = Branches of Ventral Rami (S1, S2)
A = Laterally Rotates/Extends Thigh; Abducts Flexed Thigh; Steady Femoral Head in Acetabulum
110
Describe the Obturator Internus (Proximal Attachment, Distal Attachment, Nerve, Action)
P = Pelvic Surface of Obturator Membrane/Surrounding Bones
D = Medial Surfaec of Greater Trochanter (Trochanteric Fossa of Femur)
N = Nerve to Obturator Internus (L5, S1)
A = Laterall Rotates Extended Thigh/Abducts Flexed Thigh; Steady Femoral Head in Acetabulum
111
Describe the Superior Gemellus (Proximal Attachment, Distal Attachment, Nerve, Action)
P = Superior: Ischial Spine
Inferior: Ischial Tuberosity
D = Blends w/ Obturator Internus Tendon as it Attaches to Greater Trochanter of Femur
N = Nerve to Obturator Internus (L5, S1)
A = Laterally Rotates Extended Thigh/Abducts Flexed Thigh; Stead Femoral Head in Acetablum
112
Describe the Inferior Gemellus (Proximal Attachment, Distal Attachment, Nerve, Action)
P = Superior: Ischial Spine
Inferior: Ischial Tuberosity
D = Blends w/ Obturator Internus Tendon as it Attaches to Greater Trochanter of the Femur
N = Nerve to Quadratus Femoris (L5, S1)
A = Laterally Rotates Extended Thigh/Abducts Flexed Thigh; Steady Femoral Head in Acetabulum
113
Describe the Quadratus Femoris (Proximal Attachment, Distal Attachment, Nerve, Action)
P = Lateral Border of Ischial Tuberosity
D = Quadrate Tubercle on Intertrochanteric Crest of Femur and Area Inferior to it
N = Nerve to Quadratus Femoris (L5, S1)
A = Laterally Rotates Extended Thigh/Abducts Flexed Thigh; Steady Femoral Head in Acetabulum
114
Describe the Obturator Externus (Proximal Attachment, Distal Attachment, Nerve, Action)
P = Margins of Obturator Foramen and Obturator Membrane
D = Trochanteric Fossa of Femur
N = Obturator Nerve (L3, L4)
A = Laterally Rotates Extended Thigh/Abducts Flexed Thigh; Steadies Femoral Head in Acetabulum
115
Where do the nerves from the gluteal region arise from?
Sacral Plexus
116
Name the nerves of the gluteal region
Sciatic Nerve
Superior Gluteal Nerve
Inferior Gluteal Nerve
Nerve to Obturator Internus
117
What are the components of the sciatic nerve?
Tibial
Common Fibular (perineal)
118
Where does the sciatic nerve exit the pelvis?
Through Greater Sciatic Forament
119
Where does the sciatic nerve go after it exits the pelvis?
Passes by priformis (can go inferior/super or partially/wholly through priformis)
Travels down posterior thigh
120
What is the motor function of the sciatic nerve?
Supplies Hamstrings
Supplies ALL muscles below knee
**No gluteal muscle supply**
121
What is the sensory function of the sciatic nerve?
Sensation of:
Posterior Thigh
Posterior/Later/Anterior Leg
All of foot except MEDIAL foot
122
Where does the superior gluteal nerve exit the pelvis?
Through Greater Sciatic Foramen
Passes SUPERIOR to Piriformis
123
Which muscles are supplied by the superior gluteal nerve?
Gluteus Medius
Gluteus Minimus
TFL
124
Where does the inferior gluteal nerve exit the pelvis?
Through Greater Sciatic Foramen
Passes INFERIOR to Periformis
125
What muscle is innervated by the inferior gluteal nerve?
Gluteus Maximus
126
What muscles are supplied by the nerve to quadrates femoris?
Quadratus Femoris
Inferior Gemellus
127
Describe how the Pudendal Nerve travels
Pass through greater sciatic foramen (inferior to piriformis)
Passes lateral to sacrospinus ligament
Re-enters pelvis through lesser sciatic foramen
128
What muscles are supplied by the pudendal nerve?
Perineal Muscles
**Supplies NO structures in gluteal region
129
What is the sensory function of the pudendal nerve?
Sensation in perineal region
130
What is another name of the muscles of the posterior thigh?
Hamstrings
131
What are the muscles of the posterior thigh?
Biceps Femoris (Long Head)
Biceps Femoris (Short Head)
Semitendinosus
Semimembranosus
132
Describe the Biceps Femoris (long head) (Proximal Attachment, Distal Attachment, Nerve, Action)
P = Ischial Tuberosity
D = Lateral Side of Head of Fibula (tendon is split y fibular collateral knee ligament)
N = Tibial Division of Sciatic Nerve (L5, S1, S2)
A = Flexes Leg/Rotates Leg Laterally When Knee Flexed; Extends Thigh @ Hip Joint
133
Describe the Biceps Femoris (short head) (Proximal Attachment, Distal Attachment, Nerve, Action)
P = Linear Aspera/Lateral Supracondylar Line of Femur
D = Medial Surface of Superior Part of Tibia
N = Tibial Division of Sciatic Nerve (L5, S1, S2)
A = Flexes Leg/Rotates Leg Laterally
134
Describe the Semitendinosus (Proximal Attachment, Distal Attachment, Nerve, Action)
P = Ischial Tuberosity
D = Medial Surface of Superior Part of Tibia
N = Tibial Division of Sciatic Nerve (L5, S1, S2)
A = Extend Thigh; Flex Leg; Rotate Leg Medially w/ Knee Flexed
135
Describe the Semimembranosus (Proximal Attachment, Distal Attachment, Nerve, Action)
P = Ischial Tuberosity
D = Posterior Part of Medial Tibial Condyle; Reflective Attachment Forms Oblique Popliteal Ligament (to lateral femoral condyle)
N = Tibial Division of Sciatic Nerve (L5, S1, S2)
A = Extend Thigh; Flex Leg; Rotate Leg Medially w/ Knee Flexed
136
What is the artery of the posterior thigh?
Profunda Femoris Artery (deep femoral)
137
What is the profunda femoris artery?
Largest branch of femoral artery
Chief Artery of the Thigh
138
Where does the profunda femoris artery lie?
Deep to Femoral Artery
139
What does the profunda femoris artery supply?
Adductor Magnus/Hamstring via perforating femoral arteries
140
What are the perforating femoral arteries branches of?
Usually Deep Femoral Artery
Can also be direct branches of Femoral Artery
141
What does the perforating femoral arteries do?
Encircle the Thigh
Anastomose w/ each other and other arteries to supply thigh muscles/proximal end of the femur
142
What is the popliteal fossa?
Diamond Shaped Depression of the Posterior Aspect of the Knee
143
What are the boundaries of the popliteal fossa?
Superolateral = Biceps Femoris
Superomedial = Semimembranosus/ Semitendinosus
Inferior = 2 Heads of the gastrocnemius
Roof (posteriorly) = Skin and Fascia
Floor (Anteriorly) = Popliteal surface of Femur/Oblique Popliteal Ligament/Exansion of Semimembranous Tendon/Popliteus Fascia
144
What are the contents of the popliteal fossa?
Popliteal Artery
Popliteal Vein
Small Saphenous Vein
Tibial/Common Fibular Nerves
Popliteal Lymph Nodes
Lymphatic Vessels
145
Where does the popliteal artery start and end?
Starts = as it exits posterior through adductor hiatus
Ends = @ Division of Anterior/Posterior Tibial Arteries
146
What is the popliteal artery a continuation of?
Direct Continuation of Femoral Artery (after it passes through adductor hiatus)
147
What does the popliteal artery divide into?
Anterior Tibial Artery
Posterior Tibial Artery
**divides @ inferior border of politeus
148
What do the genicular branches of the popliteal artery form?
Genicular Anastomoses
149
How many genicular branches are there?
5:
Superior: Medial/Lateral
Middle
Inferior: Medial/Lateral
150
Where does the popliteal vein come from?
Posterior Tibial Vein as it enters fossa
151
What does the popliteal vein become as it enters adductor hiatus?
Femoral vein
152
Where does the small saphenous vein travel and what does it do?
Ascends in Posterior Leg
Drains into Popliteal Vein
153
What do the tibial and common fibular nerves supply?
ALL muscles of the leg/foot
154
What is the muscle of the popliteal fossa?
Popliteus
155
Describe the popliteus (Proximal Attachment, Distal Attachment, Innervation, Action)
P = Lateral Surface of Lateral Condyle of Femur and Lateral Meniscus
D = Posterior Surface of Tibial Superior to Soleal Line
N = Tibial Nerve (L4, S1)
A = Internally Rotates Tibia on Femur; "Unlock" Knee to Allow it to Flex During Gait
156
What joints make up the knee joint?
Tibiofemoral Joint
Patella-Femoral Joint
157
What is the motion of the knee joint?
Flexion/Extension
Small amount of Medial/Lateral Rotation
158
What are the menisci?
Fibrocartilage discs
159
What do the menisci do?
Deepen Joint Surface
Reduce Shock
Provide Proprioceptive Feedback
160
How are the menisci attached?
Unattached in interior of joint
Ends attached to intercondylar area of tibia
Exteneral Margins attach to fibrous capsule
161
Describe the shape of the medial meniscus
Semilunar (C-shaped)
Broader Posterior than Anterior
162
Where does the medial meniscus attach?
Strongly to deep surface of the medial tibial collateral ligament
163
Describe the shape of the lateral meniscus
Circular
Nearly circular and smaller than medial meniscus
164
How does the lateral meniscus move?
More freely than medial meniscus
165
What are the main ligaments of the knee joint?
Medial Collateral Ligament = MCL
Lateral Collateral Ligament = LCL
Anterior Cruciate Ligament = ACL
Posterior Cruciate Ligament = PCL
166
Where does the MCL attach?
Medial Epicondyle --> Medial tibia Plateau
167
What does the superficial layer of the MCL look like?
Broad band
168
What does the deep layer of the MCL do?
Blends into Joint Capsule
Blends into Medial Meniscus
169
What is the function of the MCL?
Resists Valgus Stress (force going from lateral --> medial knee
170
Where does the LCL attach?
Lateral epicondyle --> Head of the Fibula
171
Describe the structure of the LCL?
Cord like
**easy to palpate in the figure 4 position
172
What passes deep to the LCL?
Popliteus Tendon
173
What does the LCL do to the biceps femurs tendon?
Splits it in 2 parts
174
What is the function of the LCL?
Resist Varus Stress (force going medial --> lateral knee)
175
What does it mean that the Cruciate ligaments are intraarticular?
Located w/in articular joint capsule BUT located outside synovium
176
Where does the ACL attach?
Anterior Tibia --> Posterior lateral femoral condyle
177
What is the function of the ACL?
Resist anterior translation of the tibia on the femur
178
What are ACL injuries a result of?
Forced Hyperextension
179
What is OKC activity?
Terminal knee extension (0-30 degrees), quad pulls tibia anterior
180
What is CKC activity?
Increasing knee flexion, reactive forces pushing tibia anterior
181
What happens to the ACL if the Mcl is damaged?
ACL takes over valgus resistance when knee is flexed
182
Where is the PCL attached?
Posterior Tibia --> Inner Aspect of Medial Femoral Condyle
183
What is the function of the PCL?
Resist Posterior Translation of the Tibia on the Femur
184
How is the PCL injured usually?
Trauma that directly puts posterior force onto the tibia plateau
Genearlly motor vehicle accidents
185
Where does the patellar tendon attach?
Attachment of patella and tibial tuberosity
