Questions

Question 1

how would you describe the articular surfaces of the medial and lateral compartments of the patella?

Answer 1

medial compartment - concave moving on convex (provides room for adductors); larger meniscus
lateral compartment - convex moving on convex; larger surface, smaller meniscus

Question 2

what are the structural and functional roles of the menisci?

Answer 2

composed of cartilage; deepen the surface and help in shock absorption and weight distribution

Question 3

describe the differences in shape between the medial and lateral menisci

Answer 3

• Medial: C shaped, widespread attachments laterally, less mobile on tibial plateau than lateral meniscus
• Lateral: circular, smaller, more freely movable

Question 4

for the patellofemoral joint, how are the femoral articulating surfaces different for the patella in full flexion vs. full extension?

Answer 4

• full flexion - patella is at or below intercondylar groove

- full extension - patella is on condyles (less stable position)

Question 5

what structures of the knee are intracapsular?

Answer 5

ACL and PCL

Question 6

what structures of the knee are intrasynovial?

Answer 6

meniscus, suprapatellar bursa, popliteus bursa, anserine bursa, gastrocnemius bursa

Question 7

where do the LCL and MCL attach?

Answer 7

LCL: extends inferiorly from lateral epicondyle of femur to lateral surface of the fibular head
MCL: extends from the medial epicondyle of femur to the medial condyle and the superior part of the medial surface of tibia; also attaches to medial meniscus

Question 8

what is the function of the ACL?

Answer 8

(1) limits posterior rolling (turning and traveling) of femoral condyles on tibial plateau during flexion
(2) prevents posterior displacement of the femur on the tibia and hyperextension of knee joint
(3) prevents anterior translation of the tibia

Question 9

what is the function of the PCL?

Answer 9

(1) limits anterior rolling of the femur on the tibial plateau during extension
(2) prevents anterior displacement of the femur or posterior displacement of tibia on the femur
(3) in weight bearing, with knee flexed, it is the main stabilizing factor for the femur (walking downhill)

Question 10

what are the ligamentous attachments of the menisci?

Answer 10

(1) Coronary ligaments: connect the menisci to the joint capsule
(2) Transverse Ligament of the knee: anteriorly joins medial and lateral menisci

Question 11

what are the bursae anterior to the distal femur?

Answer 11

(1) Suprapatellar bursa
(2) Subtendinous Prepatellar Bursa
(3) Subcutaneous Prepatellar Bursa
(4) Deep Infrapatellar Bursa
(5) Subcutaneous Infrapatellar Bursa

Question 12

what nerves innervate the knee joint? (3)

Answer 12

(1) sciatic
(2) femoral
(3) obturator

Question 13

what muscle can pull the fibula upwards?

Answer 13

biceps femoris

Question 14

what are the fascial components that divide the leg into three compartments?

Answer 14

(1) Anterior intermuscular septum
(2) Posterior intermuscular septum
(3) Interosseous membrane

Question 15

what fascia separates the flexor hallucis longus from the soleus muscle?

Answer 15

transverse intermuscular septum

Question 16

what is the innervation of the muscles in the lateral compartment of the leg?

Answer 16

Superficial fibular (peroneal) nerve

Question 17

what is the innervation of the muscles of the superficial part of the posterior compartment of the leg?

Answer 17

tibial nerve

Question 18

what are the distal attachments of tibialis posterior and fibularis longus?

Answer 18

(1) tibialis posterior: Tuberosity of navicular, cuneifroms, cuboid and metatarsals 2-4
(2) fibularis longus: Base of 1st metatarsal

Question 19

what muscle lies immediately anterior to the Achilles tendon in the lowermost 1/4th of the leg?

Answer 19

flexor hallucis longus

Question 20

what muscles produce inversion and eversion at the ankle?

Answer 20

Eversion: fibularis longus, fibularis brevis, fibularis tertius
Inversion: tibialis anterior and tibialis posterior

Question 21

what are the main branches to the leg given off the posterior tibial artery below the knee?

Answer 21

Fibular artery, medial and lateral plantar arteries

Question 22

what nerve innervates the muscles of the anterior compartment of the lower leg?

Answer 22

deep fibular (peroneal) nerve

Question 23

you find the posterior tibial vessels and tibial nerve anterior to what fascia?

Answer 23

transverse intermuscular septum

Question 24

in what compartment do you find the fibular vessels?

Answer 24

deep posterior compartment of the leg

Question 25

what can be said about the oblique angle of the femur in regards to gender?

Answer 25

females have slightly more oblique femurs than males

Question 26

what bone transfers weight from the knee to the ankle?

Answer 26

the tibia; the fibula doesn't articulate with the femur and therefore doesn't bare weight

Question 27

where in the ankle is weight transferred from the distal tibia?

Answer 27

the talus

Question 28

what does the talus do from a weight distribution POV?

Answer 28

the talus distributes the weight evenly between the heel and forefoot

Question 29

what is the purpose of the alae, or wings of the illium?

Answer 29

provide broad surfaces for muscle attachments

Question 30

what is the purpose of the SI joint from a weight distribution standpoint?

Answer 30

it takes downward forces from the spine and transfer force laterally through the SI joint

Question 31

what's the purpose of the oblique angle of the femur?

Answer 31

for stability and weight distribution by adjusting the COM

Question 32

what bones form the acetabulum?

Answer 32

ischium, pubis, ilium

Question 33

what separates the greater sciatic notch from the lesser sciatic notch?

Answer 33

ischial spine

Question 34

where does the long axis of the femur run? the functional axis?

Answer 34

long axis: directly down the midline of femur | functional axis: through the head of femur straight down

Question 35

what direction does the acetabulum face?

Answer 35

inferiolaterally

Question 36

what is the heaviest and longest bone in the body?

Answer 36

the femur

Question 37

what direction does the head/neck of the femur project?

Answer 37

superiomedially

Question 38

what is the average angle of inclination in adults?

Answer 38

126 degrees

Question 39

is the angle of inclination greater in males or females?

Answer 39

less in females; due to more oblique shape

Question 40

what does having a smaller angle of inclination mean for mobility?

Answer 40

greater mobility at the hip

Question 41

what is the average torsion angle in males? females?

Answer 41

males: 7 degrees females: 12 degrees

Question 42

how many degrees of freedom does the hip have?

Answer 42

6

Question 43

what is the purpose of subcuteanous tissue of the lower limb? (3)

Answer 43

(1) insulates (2) stores fat (3) provides passage for lympahtics and veins

Question 44

what is the purpose of the deep fascia of the lower limb?

Answer 44

(1) limit outward bulging of muscles (2) facilitate venous return (3) separates the muscles into compartments

Question 45

what is anteversion of the femoral head? what is accompanied with anteversion?

Answer 45

excessive anterior rotation of the femoral head; accompanied by excessive internal rotation of the femur

Question 46

what is retroversion of the femoral head? what is accompanied with retroversion?

Answer 46

reduced anterior rotation of the femoral head; accompanied by excessive external rotation of the femur

Question 47

what angle is the glute max angled at?

Answer 47

45 degrees, down and lateral

Question 48

when is the glute max most active?

Answer 48

during loading, rising from a chair (squatting), walking upstairs/uphill

Question 49

where does the small saphenous vein drain?

Answer 49

into popliteal vein

Question 50

where does the great saphenous vein drain?

Answer 50

into femoral vein

Question 51

what is the longest muscle of the body?

Answer 51

sartorious

Question 52

how much does the acetabular labrum increase the acetabular articular area?

Answer 52

10%

Question 53

what direction of the hip causes winding of the capsular structures, thus limiting ROM?

Answer 53

extension, which is why flexion of the hip is much greater than extension

Question 54

what supplies blood to the head of the femur?

Answer 54

retincular arteries arising from medial and lateral circumflex arteries

Question 55

what is an advantage of having an angle of inclination? (2)

Answer 55

(1) allows for superior placement of the abductors of the thigh in the gluteal region (2) it facilitates bipedal walking by allowing weight to be shifted onto one leg

Question 56

what muscles make up the anterior compartment of the THIGH?

Answer 56

(1) pectineus (2) illiopsoas + psoas minor (3) sartorious (4) the 4 quad muscles

Question 57

what two nerves innervate the pectineus?

Answer 57

the femoral and obturator

Question 58

what is the primary hip flexor of the body?

Answer 58

the illiopsoas; it's the strongest hip flexor and has the longest range

Question 59

what muscle of the anterior compartment works primarily as a synergist, as none of it's actions are very strong?

Answer 59

sartorious

Question 60

what is the largest sesamoid bone in the body?

Answer 60

patella

Question 61

what makes up the medial and lateral retinacula of the knee?

Answer 61

the vastus medialis and vastus lateralis muscles

Question 62

what is the purpose of the retinacula? (2)

Answer 62

(1) reinforce joint capsule of the knee on each side | (2) keep the patella aligned

Question 63

what is the purpose of the patella?

Answer 63

(1) provides bony surface to withstand compression placed on quad tendon when kneeling and friction caused by running (2) places quad tendon more anteriorly, providing a mechanical advantage

Question 64

what muscles attach to the trochanteric fossa? (4)

Answer 64

obturator externus muscle, obturator internus, superior gemellus, inferior gemellus

Question 65

to which muscles does the iliotibial tract provide attachment? (2)

Answer 65

TFL, glute max

Question 66

what bony structure marks the superior end of the greater sciatic notch?

Answer 66

PIIS

Question 67

What is the normal range of femoral neck inclination in adults?

Answer 67

115-140 degrees

Question 68

what muscle attaches between the anterior and posterior gluteal lines?

Answer 68

gluteus medius

Question 69

what muscle attaches between the anterior and inferior gluteal lines?

Answer 69

gluteus minimus

Question 70

what nerves provide cutaneous innervation to the posterior gluteal region?

Answer 70

superior, middle, and inferior clunial nerves

Question 71

what muscles attach to the ischial tuberosity? (6)

Answer 71

(1) adductor magnus (2) long head of biceps femoris (3) semimembranosus (4) semitendinosus (5) quadratus femoris (6) inferior gemellus

Question 72

what non-muscular structures attach to the ischial tuberosity?

Answer 72

sarcotuberous ligament

Question 73

what spinal nerve roots are associated with internal rotation of the hip?

Answer 73

L4/L5

Question 74

what spinal nerve roots are associated with external rotation of the hip?

Answer 74

L5/S1

Question 75

what spinal nerve roots are associated with flexion of the hip?

Answer 75

L2/L3

Question 76

what nerve innervates the abductors of the hip?

Answer 76

superior gluteal nerve

Question 77

what are the deep muscles of the posterior gluteal region? (5)

Answer 77

(1) piriformis (2) obturator internus (3) superior gemellus (4) inferior gemellus (5) quadtraus femoris

Question 78

what is the functional significance of the abductors of the hip?

Answer 78

keeps the pelvis horizontal during single leg stance and is important during gait (swing phase)

Question 79

where do the inferior and superior gluteal veins exit the pelvis?

Answer 79

through the greater sciatic foramen

Question 80

what 3 muscles form the pes anserine?

Answer 80

sartorius, gracilis and semitendinosus

Question 81

what muscles are found in the medial compartment of the THIGH?

Answer 81

(1) adductor longus (2) adductor brevis (3) adductor magnus (4) gracilis (5) obturator externus

Question 82

what is the functional role of the illiopsoas?

Answer 82

helps with posture and initiates forward swing during gait

Question 83

what is the functional difference between the rectus femoris and the vastus muscles?

Answer 83

the rectus femoris is the only part of the quadriceps that crosses the hip joint, so it's the only quad that flexes the hip

Question 84

what is the key role of the articularis genu muscle?

Answer 84

it pulls the bursa superiorly during knee extension

Question 85

how is the ability of the rectus femoris to extend the knee affected by hip flexion and hip extension?

Answer 85

the ability of the rectus femoris to extend the knee is compromised during hip flexion. (Active Insufficiency)

Question 86

for what reasons can you call the pectineus a transitional muscle between the anterior and medial compartments?

Answer 86

due to its dual nerve supply and muscle actions; innervated by the femoral and obturator nerves

Question 87

what muscles of the three compartments of the thigh act across both the hip and the knee joints?

Answer 87

``` Anterior -Sartorius -rectus femoris Medial -Gracilis Posterior -Semitendinosus -Semimembranosus - LH of Biceps femoris ```

Question 88

how can you describe the functional significance of the muscles of the medial compartment of the thigh? (2)

Answer 88

(1) stabilize stance when standing on both feet | (2) correct a lateral sway of the trunk when side-to-side shift during standing

Question 89

what are the boundaries of the femoral triangle?

Answer 89

``` Superior - Inguinal ligament Medial - Adductor longus Lateral - Sartorius Floor/Posterior - Iliopsoas (laterally) and pectineus (medially) Roof/anterior - fascia, fat, and skin ```

Question 90

what are the main branches of the femoral nerve?

Answer 90

splits into cutaneous branches after entering femoral triangle: anterior cutaneous branches - innervate skin of anterior and medial aspect of thighs saphenous nerve - innervates skin on medial side of leg and foot

Question 91

what muscle in the posterior compartment is a one-joint muscle?

Answer 91

short head of the biceps femoris

Question 92

what are the main branches off the internal iliac artery?

Answer 92

(1) Superior gluteal artery (2) Inferior gluteal artery (3) Internal pudendal artery