PP 3 Flashcards
Hip articulation
Coxal or iliofemoral (ball and socket)
Major bursae of the hip
- Trochanteric
- iliopsoas
- Ischial
Another name for Iliofemoral
Y ligament/Bigelow
What is the role of the iliofemoral?
- Positioned to prevent excessive extension
- Plays important role in maintaining upright posture
How does the Ischiofemoral repond to extension and what is its purpose?
Winds tightly on extension, helping to stabilize extension
Purpose of Pubofemoral
Prevents excessive abduction of femur, limits extension
Strongest ligament of the body
Iliofemoral
- Sacrospinous
- Sacrotuburous
- Ischiofemoral
- Posterior
Sacrospinous function
together with the sacrotuberous ligament, it converts the greater sciatic notch into the greater sciatic foramen and the lesser sciatic notch into the lesser sciatic foramen, its main function is to prevent posterior rotation of the ilium with respect to the sacrum
Sacrotuberous function
Fascial connections that make it consistent with biceps femoris insertion, controls forward flexion of sacrum and restricts posterior rotation of ilium
pelvis: Posterior pelvis sacroiliac short ligament
sacrum to ilium, runs obliquely
pelvis: Posterior pelvis sacroiliac long ligament
PSIS to sacrum, restricts anterior ilial rotation
pelvis: Posterior sacroiliac interosseous ligament
intrarticular, toughest ligament in the body – it has been shown that, when forcibly opening the SI joint, the bone will fail before the ligament; it is important in maintaining the joint space during weightbearing
pelvis: Iliolumbar ligament
- attaches the fifth transverse process to the iliac crest
- Up until 3rd decade it is muscular
- It stabilizes the connection between the low back and pelvis, and limits side-flexion of the trunk
- iliolumbar
- Inguinal
- sacrospinous
- Iliofemoral
- Obturator membrane
Pelvis
- Posterior articulations:
- Anterior articulation:
- Movement:
- Posterior articulations: Sacroiliac
- Anterior articulation: Symphysis
- Movement: a little anterioposterior rotation
Pubic Symphysis
- The ends are covered with what?
- What connects the ends?
- hyaline cartilage
- fibrous cartilage (disc)
Sacroiliac joint articular cartilage on the ilium is ____ while the cartilage covering the sacrum is _____.
- fibrocartilage
- hyaline (thicker)
Sacroiliac joint: Joint is part ____ and part ____.
- synovial
- fibrous (syndesmosis)
Sacroiliac joint: Movement of sacrum on the ilium is usually referred to as ___ and ___.
- nutation (flexion)
- counter-nutation (extension)
Sacroiliac joint: The total mean rotation is around ___ and the total translation is ____.
- 4 degrees
- ~ 3 mm
Movement of the ilium on the sacrum is referred to as____.
torsion
Knee: What type of joint is tibiofemoral?
Modified hinge
Knee: What type of joint is patellofemoral?
gliding
- Movements of the knee? When do additional movements occur?
- Normal ROM?
- What happens at 20 degrees?
- What happens at 90 degrees?
- Flexion, extension, and with a flexed knee: internal and external rotation
- 140˚
- At 20˚ of flexion, tibia starts to glide and rotation is possible
- Maximum rotation at 90˚ of flexion possible
Screw home mechanism
conjunct rotation of external rotation of the tibia during terminal extension (20 deg), necessitated by the larger medial femoral condyle
What kind of joint is the patello-femoral joint?
diarthrodial, synovial gliding joint
ACL Function
- check anterior translation of tibia on femur
- Resist/prevent hyperextension of the knee
Posterior Cruciate Ligament function
Main function is to prevent posterior displacement of the tibia on the femur
Which is stronger? ACL or PCL?
PCL
Transverse (genual) ligament:
connects anterior portion of menisci
Coronary ligaments:
part of the capsule which connects the periphery of each meniscus with the margin of the tibia
Menisci
- How is the blood supply?
- How does it get most of its nutrition?
- What part is vascularized?
- Nerves?
- Poor
- Diffusion of synovial fluid
- periphery
- None
Which muscle is attached to the medial menisci?
The posterior horn is also attached to the semimembranous muscle via the posteriomedial capsule
Which muscle is attached to the lateral menisci?
The arcuate ligament and the popliteus muscle are both attached to the lateral meniscus
Which meniscus is shaped like a C and which an O?
- C = Medial meniscus
- O = Lateral meniscus
Ankle articulations
Talocrural or talotibial (hinge)
Most commonly injured ankle ligament
anterior talofibular (ATF) horizontal attachment from the talus to fibula
Superior Extensor Retinaculum (= tranverse crural):
binds down the foot extensors tendons by connecting to lateral distal fibula and medial distal tibia
Inferior Extensor Retinaculum (= Cruciate crural):
Y-shaped band that binds down the extensors;
Fibular Retinaculum:
band that binds down the peroneal (fibularis) tendons
Flexor Retinaculum:
medial aspect; retains and binds down the medial flexor muscle tendons
Intertarsals articulations
gliding
Tarsometatarsal articulations
gliding
Metatarsophalangeal articulations
condyloid - flexion, extension, adduction, abduction, and circumduction
Interphalangeal articulations –
hinge - flexion and extension
Subtalar Joint (talocalcaneal) articulated between what?
between the talus and calcaneus
The plantar calcano-navicular (spring) ligament does what?
completes the bony socket of the talocalcaneal joint
Open Chain Pronation
triplanar movement which combines the movements of calcaneal eversion, talar horizontal abduction and dorsiflexion
Open Chain Supination
triplanar movement which combines the movements of calcaneal inversion, talar horizontal adduction and plantar flexion
Plantar fascia
superficial covering of bottom of foot; three portions attach from calcaneus to the phalanges (plantar aponeurosis)
Long plantar
deeper structure of the foot, attaches from calcaneus to 3rd, 4th, and 5th metatarsals
Short plantar
plantar calcanocuboid lig
Plantar calcanonavicular (Spring) ligament;
important in maintaining the medial longitudinal arch
