MSK compartments of the thigh

Question 1

what are the borders of the femoral triangle?

Answer 1

pectineus- base
sartorius- lateral border
adductor longus - medial border
inguinal ligament - superior border

Question 2

Actions of anterior thigh muscles?

innervation?

Answer 2

Rectus femoris
Vastus medialis/intermedius/lateralis
sartorius
pectinous - obturator
iliopsoas - psoas major= anterior rami

> femoral nerve
- EXTEND the knee joint (except sartorius and pectineus)

pectineus-adducts and flexes thigh at hip joint
sartorius- flexes, abducts, externally rotates thigh at hip joint.
flexes and internally rotates tibia at knee joint

Question 3

Actions of posterior thigh muscles?

innervation?

Answer 3

biceps femoris- flexes knee joint
semitend/membranosus - flexes leg at knee (also extends hip)

tibial branch of sciatic nerve
(short head of biceps femoris is common peroneal/ fibular)

Question 4

Actions of medial thigh muscles?

innervation?

Answer 4

Adductor Magnus/brevis/ longus
Pectineus
Obturator Externus
Gracillus

> obturator nerve (but hamstring part of adductor Magnus is tibial branch of sciatic nerve)
ADDUCTORS

Question 5

what is the origin of all adductor muscles?

Answer 5

pubis

Question 6

actions of Sartorius?

Answer 6

flexes, abducts and laterally rotates the hip joint and flexes the knee joint’.

contrary to the other anterior compartment muscles (rectus femoris and vests triplets) which extend the knee joint.

Question 7

which bones articulate to form the knee joint?

Answer 7

patella
femur
tibia

Question 8

what does the tibiofemoral articulation consist of?

Answer 8

medial and lateral condyles of femur articulating with the tibia

Question 9

what does the patellofemoral articulation consist of?

Answer 9

anterior part of distal femur articulating with patella

Question 10

roles of the patella?

Answer 10

• protection from trauma
• increases mechanical efficiency of quadriceps femoris muscle by minimising friction and allowing tendon to go directly over anterior surface of knee

Question 11

what is hiltons law?

Answer 11

all muscles that cross a joint supply the joint itself (nerve)

Question 12

which nerves supply knee joint?

Answer 12

Femoral nerve, tibial nerve, common peroneal (fibular) nerve

Question 13

What are the two main functions of the menisci in the knee?

Answer 13

• To deepen the articulating surface of the tibia, thereby increasing stability of the joint
• To act as shock absorbers by increasing area to further dissipate forces

Question 14

Which is the main stabiliser of a weight-bearing flexed knee?

Answer 14

The PCL

prevents the femur from sliding off the anterior edge of the tibia e.g. when walking down stairs or down a slope.

Question 15

what is the attachments of ACL?

Answer 15

ACL attaches proximally to the posterolateral aspect of the femoral intercondylar fossa
passes distally and anteromedially to attach to the anterior aspect of the intercondylar eminence of the tibia,
also attaches to medial meniscus

Question 16

what is the attachments of PCL?

Answer 16

PCL attaches proximally to the medial border and roof of the intercondylar fossa.
passes distally and posterolaterally to attach to the posterior intercondylar area of the tibia.

Question 17

which muscles do flexion at the knee joint?

nerve supply?

Answer 17

posterior muscles of thigh:-
biceps femoris
semitendinosus
semimembranosus 
> tibial nerve

gracilis (medial thigh)
> obturator nerve

sartorius (anterior thigh)
> femoral nerve

gastrocnemius
plantaris
popliteus
> tibial nerve

Question 18

which muscles do extension at the knee joint?

nerve supply?

Answer 18

quadriceps femoris (its 4 components)

> femoral nerve

Question 19

which muscles do lateral rotation at the knee joint?

nerve supply?

Answer 19

Biceps femoris

> tibial nerve

Question 20

which muscles do medial rotation at the knee joint?

nerve supply?

Answer 20

Popliteus
Semimembranosus
Semitendinosus
> tibial nerve

Gracilis > obturator nerve

Sartorius > femoral nerve

Question 21

whats the typical mechanism of injury in patella dislocation?

movement?

Answer 21

trauma
- twisting injury/ direct blow to knee

internal rotation of femur on a planted foot while flexing the knee (e.g. sudden changing direction in sports)

Question 22

symptoms of septic arthritis?

Answer 22

pain
fever
reduced range of motion

Question 23

most common joint for septic arthritis?

common pathogen?

Answer 23

knee

staphlococcus aureus

Question 24

pain characteristics of osteoarthritis in knee?

Answer 24

• wose when sitting for long periods/ getting out of bed in morning.
• intermittent Knee pain (comes and goes), > chronic low level of pain punctuated by more severe flare-ups
• Pain precipitated by bending, kneeling, squatting or climbing stairs

Question 25

Why do some patients with osteoarthritis of the knee describe their knee giving way or buckling?

Answer 25

painful stiff knee > move the joint less >muscle weakness (quadriceps muscles) > instability of the joint.

Quadriceps weakness : reduced power of knee extension, and therefore the patient experiences sudden flexion (‘giving way’) of their knee.

Question 26

In a collateral ligament tear, if there is a medial angulation of the distal segment, which type of deformation exists?

Answer 26

varus deformity,

because the tibial plateau sits medially to where it should be.

Question 27

what is varus and what is valgus?

Answer 27

Whenever the distal part is more lateral, it is called VALGUS.
(Gum sticking knees together)- like need a wee

… Whenever the distal part is more medial, it is called VARUS.
knees pointing out
(Rum pushing knees apart)

Question 28

Which test would be used for a posterior cruciate ligament tear?

Answer 28

The drawer test

Question 29

Which structures are damaged in the Unhappy triad?

Answer 29

damage to the medial meniscus, anterior cruciate ligament and medial collateral ligament.
-caused by a direct blow to the lateral side of the knee.

Question 30

The inability to perform a straight leg raise is a clinical indication of which condition?

Answer 30

fracture to the patella.

> quadriceps tendon attaches to the patella, and so with the patella in pieces it cannot be used as an attachment.

Question 31

A blow to the back of the knee is more likely to cause…

Answer 31

damage to the ACL,

> ligament furthest from the site of force, so is the ligament put under more pressure.

Question 32

A popping sensation is commonly felt when you damage your…

Answer 32

Cruciate ligaments

Question 33

What is the technical name for ‘Clergyman’s knee’?

Answer 33

infra-patellar bursitis,

caused commonly by irritation to the front of the knee (typically by kneeling).

Question 34

What is the technical name for ‘Housemaids knee’?

Answer 34

pre patella bursitis

Question 35

What is Supra patella bursitis?

Answer 35

knee joint effusion

Question 36

What is Semi membranous bursitis?

Answer 36

popliteal (Bakers) cyst

Question 37

The lateral cutaneous nerve pierces which ligament?

Answer 37

inguinal ligament

Question 38

Which muscle contributes to the abduction of the proximal fragment of a femoral shaft fracture?

Answer 38

Gluteus medius

responsible for the abduction of the proximal fragment of the femur.

Question 39

The burning/stinging sensation felt in meralgia paresthetica is located over which aspect of the thigh?

Answer 39

lateral thigh,
because this is the area of sensory innervation of the lateral cutaneous nerve.
(see S6)