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MED221A/B Lectures > MSK 24 - Knee joint > Flashcards

MSK 24 - Knee joint Flashcards

1
Q

what are the 2 articulations in the knee joint

A

between the femur and tibia

between the femur and patella

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2
Q

what is on the back of the patella where it articulates with the femur

A

back is covered in cartilage

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3
Q

what movements are allowed by the knee joint

A

extension and flexion

no adduction or abduction

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4
Q

where does the patella bone sit

A

in the tendon of quadriceps muscles

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5
Q

where does the quadriceps tendon attach to distally

A

attaches to the tibial tuberosity of tibia

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6
Q

what does the patella do

A

protect the quadriceps tendon on surface that rubs a lot

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7
Q

what does the axis of the lower limb allow in terms of weight

A

weight of body is transmitted to centre of hip joints then down leg

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8
Q

what demographics tend to have varus limb axis orientation

A

babies and old people

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9
Q

what is varus orientation

A

apex of joint points out away from midline

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10
Q

what is valgus orientation

A

apex of joint points in towards the midline

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11
Q

what are the 5 major ligaments associated with the knee joint

A

patellar ligament/tendon

medial and lateral collateral ligaments

anterior and posterior cruciate ligaments

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12
Q

where does the patellar ligament attach to

A

superiorly it is attached to inferior margins of patella

inferiorly it is attached to the tibial tuberosity

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13
Q

what is the difference between ligaments and tendons in terms of attachment sites

A

tendon attaches muscle to bone

ligament attaches bone to bones in joints

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14
Q

where do the medial collateral ligaments attach

A

from medial femoral epicondyle to medial tibia plateau (posterior to attachment of the pes ansernius)

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15
Q

what does the MCL blend with at its insertion

A

it blends with the joint capsule and medial meniscus

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16
Q

where do the lateral collateral ligaments attach

A

lateral femoral epicondyle to fibula head

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17
Q

does the LCL blend with the joint capsule

A

no it is discrete

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18
Q

what is the function of the MLC and LCL

A

prevents knee going valgus or varus

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19
Q

are the cruciate ligaments intra or extracapsular

A

intracapsular

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20
Q

where does the ACL attach

A

from anterior tibial spine to lateral condyle of femur

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21
Q

where does the PCL attach

A

from posterior tibial spine to medial femoral condyle

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22
Q

what does the ACL do

A

prevent tibia from sliding forward on the femur

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23
Q

what does the PCL do

A

prevent posterior translation of tibia on the femur

prevents femur sliding forward on femur

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24
Q

where are the cruciate ligaments relative to the knee joint and articular cavity

A

within knee joint

outside articular cavity (not inside the synovium)

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25
Q

what side of the femur and tibia does the ACL to

A

lateral femur
medial tibia

26
Q

what side of the femur and tibia does the PCL to

A

medial femur
lateral tibia

27
Q

what is a joint capsule and where does it attach

A

fibrous membrane that encloses the articular cavity

attaches where the cartilage finishes

28
Q

where is the pre patellar bursa

A

infront/anterior to the patella

29
Q

where is the infrapatellar bursa

A

superficial and deep to patella ligament - inferior to patella itself

30
Q

do the pre and infra patella bursa communicate with the knee joint

A

no

31
Q

which patella bursa is continuous with the knee joint

A

suprapatella

32
Q

where does the suprapatella bursa sit

A

between the quads tendon and the distal femur

33
Q

where will fluid often accumulate in a knee joint effusion

A

suprapatellar bursa

34
Q

what reinforces the suprapatella bursa anteriorly

A

quads tendon and patella ligament

35
Q

where is the synovial membrane of the suprapatella bursa relative to the fibrous membrane and cruciate ligaments

A

deep to fibrous membrane

excludes anterior and posterior cruciate ligaments

36
Q

what material is the menisci made of

A

fibrocartilage

37
Q

what do the menisci - 2 things

A

increase articulation between femur and tibia as shape of surfaces change throughout the full range of motion

act as shock absorbers

38
Q

what shape is the medial and lateral menisci in the knee

A

medial = moonshaped

lateral = c shaped

39
Q

where is the medial meniscus attached

A

to joint capsule and MCL

40
Q

how mobile is the medial meniscus

A

not very mobile as its attached to the MCL

41
Q

which meniscus is larger

A

medial

42
Q

is the lateral meniscus attached to the joint capsule

A

no

43
Q

is the lateral meniscus mobile

A

yes as its not attached to the joint capsule of the knee

44
Q

do the menisci attach to the tibia - where and how

A

yes attach to tibia medially via ligaments anterior and posterior

45
Q

do you tear the ligament when you dislocate the patella

A

no

46
Q

what is a lipohaemarthrosis in terms of what causes it in the knee and what it looks like in a xray

A

caused by tibial plateau fractures in the knee

bone marrow leaks out from fracture and communicates with the knee joint

creates two layers top layer of fat above layer of blood

47
Q

where does the vascular supply to the knee come from

what anstomoses together

A

(superiorly) branches of femoral, lateral femoral circumflex and popliteal vessels

which anastomose with

(inferiorly) anterior tibial and circumflex peroneal arteries

48
Q

the knee joint is supplied by which 3 nerves

A

femoral nerve
sciatic nerve
obturator nerve

49
Q

what is the L2 myotome responsible for

A

hip flexion

50
Q

what is the L3 myotome responsible for

A

knee extension

51
Q

what is the L4 myotome responsible for

A

ankle dorsiflexion

52
Q

what is the L5 myotome responsible for

A

great toe extension

53
Q

what is the S1 myotome responsible for

A

ankle plantarflexion

54
Q

what is the pattern of myotomal supply

A

muscles with the same action have commonly segmental supply

ie all muscles taht act to do the same thing to a joint have the same myotome (or two)

55
Q

what muscles are responsible for knee - 6 groups (technically 8 muscles)

A

hamstrings (bicep femoris, semimembranosus and semitendinosus)

gracilis
sartorius

grastrocnemius
plantaris
popliteus

56
Q

what muscles are responsible for knee extension - 2 groups

A

anterior compartment

quads

57
Q

what muscles are responsible for knee medial/internal rotation of the leg

A

semimembranosus

semitendinosis

58
Q

what muscles are responsible for knee lateral/external rotation of the leg

A

biceps femoris

59
Q

what is the clinical importance of pes ansernius

A

tendons can be used to reconstruct a torn ACLw

60
Q

what is the clinical importance of the unhappy triad

A

common injury pattern resulting from valgus/lateral force to knee

61
Q

what are the 3 structures involved in the unhappy triad

A

medial collateral ligament

anterior cruciate ligament

medial/lateral meniscus

MED221A/B Lectures (23 decks)

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