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Regional Gross Anatomy > Region 8 - Hip, Thigh, Gluteal region and Knee > Flashcards

Region 8 - Hip, Thigh, Gluteal region and Knee Flashcards

1
Q

How does the sciatic nerve and the gluteal vessels and nerve transition from the pelvis to the lower limb?

A

Via greater sciatic foramen

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2
Q

How does the femoral nerve and vessels transition from the pelvis to the lower limb?

A

Via subinguinal space

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3
Q

How does the fobturator nerve and vessels transition from the pelvis to the lower limb?

A

Obturator canal

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4
Q

What are the root values for the femoral nerve?

A

Posterior divisions of anterior rami L2-L4

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5
Q

What compartment does the femoral nerve supply?

A

Anterior thigh

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6
Q

What are the root values for the obturator nerve?

A

Anterior divisions of anterior rami L2-L4

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7
Q

What compartment does the obturator nerve supply?

A

Medial thigh

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8
Q

Where does the great saphenous vein start? What forms it?

A

Dorsum of foot
Formed from union of:
- Dorsal vein of great toe
- Dorsal venous arch of the foot

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9
Q

What is the course of the great saphenous vein?

A

Ascends:
- Anterior to medial malleolus
- Along anteromedial leg
Passes posterior to medial condyle of femur
Ascends along medial thigh
Transverse saphenous opening in fascia lata
Empties into femoral vein

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10
Q

What veins can drain into the great saphenous vein?

A

Accessory saphenous vein (may or may not be present)

Some anastomoses with small saphenous vein

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11
Q

Where does the small saphenous vein form? What forms it?

A

Posterolateral ankle

Dorsal venous arch

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12
Q

What is the course of the short saphenous vein?

A 
Ascends posterior to lateral malleolus
Ascends in midline of posterior leg
Penetrates deep fascia
Ascends between heads of gastrocnemius
Empties into popliteal vein
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13
Q

What nerve does the short saphenous vein run alongside?

A

Sural nerve

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14
Q

What do the medial nodes of the horizontal group of superficial inguinal lymph nodes drain?

A

Anterior abdominal wall

Lower half of anal canal

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15
Q

What do the lateral nodes of the horizontal group of superficial inguinal lymph nodes drain?

A

Posterior abdominal wall

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16
Q

What does the vertical group of superficial inguinal lymph nodes drain?

A

Superficial lower limb

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17
Q

What is the name for the deep fascia of the thigh?

A

Fascia lata

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18
Q

What is the name for the deep fascia of the leg?

A

Crural fascia

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19
Q

What is the iliotibial tract?

A

Lateral thickening of fascia lata

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20
Q

What is the course of the iliotibial tract?

A

From iliac tubercle

To anterolateral tibial tubercle

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21
Q

What are the functions of the iliotibial tract?

A

Shared aponeurosis for insertion of:
- Tensor fascia lata
- Gluteus maximus
Supports femur on tibia when standing

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22
Q

What structures form the roof of the femoral triangle?

A

Fascia lata
Cribriform fascia
Subcutaneous tissue
Skin

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23
Q

What is the saphenous hiatus/opening?

A

An opening in the fascia lata that allows the great saphenous vein to drain into the femoral vein

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24
Q

What is the structure of the saphenous hiatus?

A

Lies ~4cm inferolateral to pubic tubercle
Smooth medial margin
Superior, lateral and inferior margin is the falciform margin
Covered by cribriform fascia

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25
Q

What forms the base of the femoral triangle?

A

Inguinal ligament

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26
Q

What forms the lateral and medial boundaries of the femoral triangle?

A

Lateral - Sartorius

Medial - Adductor longus

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27
Q

What forms the floor of the femoral triangle?

A

Iliopsoas (laterally)

Pectineus (medially)

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28
Q

What are the contents of the femoral triangle from lateral to medial?

A 
Femoral:
- Nerve
- Artery
- Vein
Lymphatics
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29
Q

What is the femoral sheath?

A

A fascia surrounding the vascular structures and lymphatics in the femoral triangle
Does NOT surround the femoral nerve

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30
Q

Where does the femoral sheath lie?

A

Deep to inguinal ligament

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31
Q

What forms the femoral sheath?

A

Inferior prolongation of the fasciae of:

  • Transversalis
  • Iliopsoas
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32
Q

How does the femoral sheath end?

A

Blends with the adventitia of femoral vessels

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33
Q

What is the femoral canal?

A

A potential space medially within the femoral sheath

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34
Q

What are the contents of the femoral canal?

A

Lymphatics

Fat

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35
Q

What is the function of the femoral canal?

A

Allows venous expansion when:

  • Increased lower limb venous return
  • Increased intra-abdominal pressure causes femoral vein stasis
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36
Q

What are the clinical implications of a femoral canal?

A

Femoral hernia:

- Abdominal viscerae herniate through femoral ring into femoral canal

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37
Q

What is the bony landmark lying inferior to the lesser trochanter on the posterior femur?

A

Pectineal line

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38
Q

What bony feature lies between the femoral trochanters on the anterior and posterior aspects of the femur?

A

Anterior - Intertrochanteric line

Posterior - Intertrochanteric crest

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39
Q

What ‘line’ runs along the posterior femur?

A

Linea aspera

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40
Q

What does the linea aspera divide into distally?

A

Medial and lateral supracondylar lines

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41
Q

What muscles of the anterior thigh are the hip flexors?

A

Iliacus
Psoas major
Pectineus
Sartorius

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42
Q

What are the origins of iliacus?

A

Iliac crest and fossa
Ala of sacrum
Anterior sacroiliac ligaments

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43
Q

What are the insertions of iliacus?

A

Psoas major tendon

Lesser trochanter

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44
Q

What is the innervation to iliacus?

A

Femoral nerve L2-L3

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45
Q

What are the origins of psoas major?

A

T12-L5 vertebral bodies and IV discs

All lumbar transverse processes

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46
Q

What is the insertion of iliacus?

A

Lesser trochanter of femur

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47
Q

What is the innervation to psoas major?

A

Anterior rami of L1-L3

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48
Q

Where does pectineus originate?

A

Superior ramus of pubis

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49
Q

Where does pectineus insert?

A

Pectineal line of femur

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50
Q

What is the innervation to pectineus?

A 
Femoral nerve (L2-L3)
(Sometimes branch from obturator nerve)
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51
Q

What are the functions of pectineus?

A

Adducts hip
Flexes hip
Medially rotates hip

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52
Q

What is the origin of sartorius?

A

ASIS

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53
Q

Where does sartorius insert?

A

Superior part of medial surface of tibia

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54
Q

What is the innervation to sartorius?

A

Femoral nerve (L2-L3)

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55
Q

What are the functions of sartorius?

A

Abducts hip
Flexes hip
Laterally rotates hip
Flexes knee

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56
Q

What are the origins of rectus femoris?

A

AIIS

Ilium superior to acetabulum

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57
Q

What are the origins of vastus lateralis?

A

Greater trochanter

Lateral lip of linea aspera

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58
Q

What are the origins of vastus medialis?

A

Intertrochanteric line

Medial lip of linea aspera

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59
Q

What are the origins of vastus intermedius?

A

Anterior and lateral surfaces of shaft of femur

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60
Q

What are the insertions of the four quadriceps muscles?

A

Base of patella:
- Via quadriceps tendon
Indirectly to tibial tuberosity via continuation as patellar ligament

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61
Q

What are the functions of the quadriceps muscles?

A 
All - Extend the knee
Rectus femoris:
- Flexes hip
- Steadies hip joint
Vastus medialis:
- Distal fibres act to prevent lateral patellar dislocation
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62
Q

What is the innervation to the quadriceps muscles?

A

Femoral nerve (L2-L4)

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63
Q

What is the pelvic course of the femoral nerve?

A

Originates with psoas major

Descends posterolaterally in the pelvis to midpoint of inguinal ligament

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64
Q

What is the course of the femoral nerve as it leaves the pelvis?

A

Deep to inguinal ligament into femoral triangle
Medial to ASIS
On iliopsoas tendon
Lateral to femoral vessels

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65
Q

What are the branches of the femoral nerve?

A 
Muscular branches -> Anterior thigh
Articular branches -> Hip and knee
Cutaneous branches -> Anteromedial thigh
Saphenous nerves:
- Cutaneous branch to anteromedial knee, leg and foot
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66
Q

What is the course of the saphenous nerve?

A

Passes through adductor canal

Becomes superficial by passing between sartorius and gracilis

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67
Q

What are the medial thigh muscles?

A

Hip adductors:
- Gracilis
- Adductor longus, brevis and magnus
Obturator externus

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68
Q

What are the origins of gracilis?

A

Body of pubis

Inferior ramus of pubis

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69
Q

What is the insertion of gracilis?

A

Superior part of the medial surface of the tibia

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70
Q

What is the innervation to gracilis?

A

Obturator nerve (L2-L3)

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71
Q

What are the functions of gracilis?

A

Adducts hip
Flexes knee
(Also helps medially rotate hip)

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72
Q

What is the origin of adductor longus?

A

Body of pubis inferior to pubic crest

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73
Q

What is the insertion of adductor longus?

A

Middle 1/3 of linea aspera

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74
Q

What is the innervation of adductor longus?

A

(Anterior division of) obturator nerve (L2-L4)

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75
Q

What is the function of adductor longus?

A

Adducts hip

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76
Q

What are the origins of adductor brevis?

A

Body of pubis

Inferior ramus of pubis

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77
Q

What are the insertions of adductor brevis?

A

Pectineal line

Proximal part of linea aspera

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78
Q

What is the innervation to adductor brevis?

A

(Anterior division of) obturator nerve (L2-L4)

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79
Q

What are the functions of adductor brevis?

A

Adducts hip

Assists in flexing hip

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80
Q

What are the origins of adductor magnus?

A 
Adductor part:
- Inferior ramus of pubis
- Ramus of ischium
Hamstrings part:
- Ischial tuberosity
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81
Q

What are the insertions of adductor magnus?

A 
Adductor part:
- Gluteal tuberosity
- Linea aspera
- Medial supracondylar line
Hamstring part:
- Adductor tubercle of femur
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82
Q

What is the innervation to adductor magnus?

A

Adductor part:
- (Posterior division of) obturator nerve (L2-L4)
Hamstrings part:
- Tibial part of sciatic nerve (L4)

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83
Q

What are the functions of adductor magnus?

A

Adducts thigh
Adductor part also flexes hip
Hamstring part also extends hip

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84
Q

What are the origins of obturator externus?

A

Margins of obturator foramen

External surface of obturator membrane

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85
Q

What is the insertion of obturator externus?

A

Trochanteric fossa of femur

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86
Q

What is the innervation to obturator externus?

A

Obturator nerve (L3-L4)

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87
Q

What are the functions of obturator externus?

A

Laterally rotates thigh

Steadies head of femur in acetabulum

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88
Q

What are the root values of the obturator nerve?

A

Anterior rami of L2-L4

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89
Q

What is the course of the obturator nerve?

A

Runs in extraperitoneal fat along lateral pelvic wall to the obturator canal (In obturator membrane)

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90
Q

What does the obturator nerve branch into?

A

Anterior and posterior branches relative to adductor brevis
Muscular branches -> Medial thigh
Cutaneous branch of ant. division -> Middle part of medial thigh

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91
Q

What is the alternative name for the adductor canal?

A

Subsartorial canal

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92
Q

What is the extent of the adductor canal?

A

Extends from apex of femoral triangle to adductor hiatus

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93
Q

What muscle does the adductor canal underlie?

A

Distal 1/2 of sartorius

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94
Q

What are the boundaries of adductor canal?

A 
Medial - Sartorius (also forms roof)
Anterolateral - Vastus medialis
Posterior:
- Adductor longus
- Adductor magnus
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95
Q

What are the contents of the adductor canal?

A

Femoral vessels

Saphenous nerve

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96
Q

What is the adductor hiatus?

A

Opening between distal insertions of adductor and hamstring parts of adductor magnus

97
Q

What is the function of adductor hiatus?

A

Allows passage of femoral vessels from anterior thigh to popliteal fossa

98
Q

Why doesn’t the saphenous nerve pass through the adductor hiatus?

A

It passes through sartorius to the anteromedial knee, leg and foot

99
Q

Where does the femoral artery begin?

A

It is a continuation of external iliac artery after inguinal ligament

100
Q

Where does the femoral artery become the popliteal artery?

A

Adductor hiatus

101
Q

What does the femoral artery supply?

A

Anterior and anteromedial thigh

102
Q

What surface of the femoral artery does profunda femoris originate from?

A

Lateral or posterior surface

103
Q

Where does profunda femoris run?

A

Deep to adductor longus

104
Q

What are the branches of profunda femoris?

A

3 or 4 perforating branches through adductor magnus

Medial and lateral circumflex femoral arteries

105
Q

Where does the obturator artery arise?

A

From internal iliac artery

106
Q

What does the anterior division of the obturator artery supply?

A

Medial compartment

107
Q

What does the posterior division of the obturator artery supply? Why?

A

Posterior compartment and adductor magnus

All attach to ischial tuberosity

108
Q

What arteries contribute to the cruciate anastomosis?

A

Inferior gluteal
Medial circumflex femoral
Lateral circumflex femoral
1st perforating branch of profunda femoris

109
Q

Where is the cruciate anastomosis?

A

Upper posterior thigh

110
Q

What is the angle of inclination of the femur?

A

Angle between:

  • Long axis of head and neck of femur
  • Long axis of shaft
111
Q

What is the value for the angle of inclination of femur?

A

~120 degrees

112
Q

Why is the angle of inclination of the femur smaller in females?

A

Wider pelvis means long axis of shaft of femur begins more laterally

113
Q

What is the angle of anteversion/torsion of the femur?

A

Head angled anteriorly to femoral condyles

114
Q

What is the value for the angle of anteversion/torsion of the femur?

A

12 degrees

115
Q

What muscles in the gluteal region are lateral rotators of the hip?

A 
Gluteus maximus
Piriformis
Obturator internus
Gemelli
Quadratus femoris
116
Q

What muscles in the gluteal region are medial rotators and abductors of the hip?

A

Gluteus medius

Gluteus minimus

117
Q

What muscle in the gluteal region acts as support?

A

Tensor fasciae latae

118
Q

What are the origins of gluteus maximus?

A

Ilium posterior to posterior gluteal line (external surface)
Sacrum (and coccyx)
Sacrotuberous ligament

119
Q

What are the insertions of gluteus maximus?

A

Iliotibial tract:
- Most fibres (~3/4) -> Lateral condyle of tibia
Gluteal tuberosity of femur (1/4)

120
Q

What is the innervation to gluteus maximus?

A

Inferior gluteal nerve (L5-S2)

121
Q

What are the functions of gluteus maximus?

A 
Extends thigh (especially if flexed)
Assists in lateral rotation of hip
122
Q

What are the origins of tensor fascia lata?

A

Anterior iliac crest

ASIS

123
Q

What is the insertion of tensor fascia lata?

A

Iliotibial tract:

- To the lateral condyle of tibia

124
Q

What is the innervation to tensor fascia lata?

A

Superior gluteal nerve (L4-S1)

125
Q

What are the functions of tensor fascia lata?

A

Tenses fascia lata and iliotibial tract

Supports femur on tibia when standing

126
Q

What is the origin of gluteus medius?

A

Ilium between anterior and posterior gluteal lines (external surface)

127
Q

What is the insertion of gluteus medius?

A

Lateral surface of greater trochanter

128
Q

What is the innervation to gluteus medius?

A

Superior gluteal nerve (L4-S1)

129
Q

What are the functions of gluteus medius?

A

Abducts hip

Medially rotates hip

130
Q

What is the origins of gluteus minimus?

A

Ilium between anterior and inferior gluteal lines (external surface)

131
Q

Where does gluteus minimus insert?

A

Anterior surface of greater trochanter

132
Q

What is the innervation to gluteus minimus?

A

Superior gluteal nerve (L4-S1)

133
Q

What are the functions of gluteus minimus?

A

Abducts hip

Medially rotates hip

134
Q

What are the origins of piriformis?

A

Anterior sacrum

Sacrotuberous ligament

135
Q

What is the insertion of piriformis?

A

Superior border of greater trochanter

136
Q

What is the innervation to piriformis?

A

Nerve to piriformis (anterior rami S1-S2)

137
Q

What are the functions of piriformis?

A

Lateral rotation of hip (when extended)

[Abducts hip (when flexed)]

138
Q

What are the origins of obturator internus?

A

Pelvic (internal) surface of obturator membrane and surrounding bones

139
Q

What is the insertion of obturator internus?

A

Medial surface of greater trochanter -> Trochanteric fossa (via lesser sciatic foramen)

140
Q

What is the innervation to obturator internus?

A

Nerve to obturator internus (L5-S1)

141
Q

What are the functions of obturator internus?

A 
Laterally rotates hip
Abducts hip (when flexed)
142
Q

What are the origins of the gemelli muscles?

A

Superior gemellus:
- Ischial spine
Inferior gemellus:
- Ischial tuberosity

143
Q

What are the insertions of the gemelli muscles?

A

Medial surface of greater trochanter (blend with obturator internus tendon)

144
Q

What is the innervation to the gemelli muscles?

A

Superior gemellus:
- Nerve to obturator internus (L5-S1)
Inferior gemellus:
- Nerve to quadratus femoris (L5-S1)

145
Q

What is the function of the gemelli muscles?

A

Laterally rotate hip

146
Q

What is the origin of quadratus femoris??

A

Lateral border of ischial tuberosity

147
Q

What are the insertions of quadratus femoris?

A

Quadrate tubercle of intertrochanteric crest and an area inferior to it on femur

148
Q

What is the innervation to quadratus femoris?

A

Nerve to quadratus femoris (L5-S1)

149
Q

What is the function of quadratus femoris?

A

Laterally rotate hip

150
Q

Where does obturator externus originate?

A

External obturator membrane

151
Q

What is the insertion of obturator externus?

A

Trochanteric fossa

152
Q

What is the innervation to obturator externus?

A

Obturator nerve (L3-L4)

153
Q

What is the function of obturator externus?

A

Laterally rotates hip

154
Q

Where do the branches of the sciatic nerve leave?

A 
Tibial division BELOW piriformis
Common fibular division can leave:
- Below piriformis
- Above piriformis
- Through piriformis
155
Q

What is the course of the superior gluteal vessels and nerves?

A

Leave greater sciatic foramen above piriformis

Course laterally in plane between gluteus medius and minimus

156
Q

What is the course of the inferior gluteal vessels and nerves?

A

Leave greater sciatic foramen below piriformis

Course deep to inferior part of gluteus maximus

157
Q

What are the root values of the posterior cutaneous nerve of thigh?

A

Anterior and posterior rami of S1-S3

158
Q

Where does the posterior cutaneous nerve of thigh lie in relation to the sciatic nerve?

A

On its posterior surface

159
Q

What is the cutaneous distribution of the posterior cutaneous nerve of thigh?

A

Inferior 1/2 of buttocks (via inferior cluneal nerves)
Posterior thigh and popliteal fossa
Lateral perineum and upper medial thigh (via perineal branch)

160
Q

What is the pelvic articular surface of the hip joint known as?

A

Lunate surface of acetabulum

161
Q

What lies in the middle of the pelvic part of the hip joint?

A

Fat pad in acetabular fossa

162
Q

What lies around the rim of the pelvic articular surface of the hip joint?

A

Acetabular labrum

163
Q

What structure courses between the two ends of the pelvic surface of the acetabulum? What does it bridge?

A

Transverse acetabular ligament

Bridges acetabular notch

164
Q

What are the proximal attachments of the fibrous layer of the hip joint capsule?

A

Just peripheral to acetabular rim

Transverse acetabular ligament

165
Q

What are the distal attachments of the fibrous layer of the hip joint capsule?

A

Anteriorly:
- Along intertrochanteric line and root of greater trochanter
Posteriorly:
- Just proximal to intertrochanteric crest (NOT on it)

166
Q

Where does the iliofemoral ligament lie in relation to the hip joint?

A

Anteriorly

Superiorly

167
Q

What is the shape of the iliofemoral ligament?

A

Y-shaped

168
Q

What are the proximal attachments of the iliofemoral ligament?

A

ASIS

Acetabular rim

169
Q

What is the distal attachment of the iliofemoral ligament?

A

Intertrochanteric line

170
Q

What are the bands of the iliofemoral ligament?

A

Upper

Lower

171
Q

What are the functions of the iliofemoral ligament?

A

Act to limit:

  • Extension
  • Lateral rotation
  • Adduction (upper band)
  • Abduction (lower band)
172
Q

Where does the pubofemoral ligament lie in relation to the hip joint?

A

Anteriorly

Inferiorly

173
Q

What is the proximal attachment of the pubofemoral ligament?

A

Iliopubic eminence

174
Q

What is the distal attachment of the pubofemoral ligament?

A

Lower intertrochanteric line (blends with joint capsule)

175
Q

What are the functions of the pubofemoral ligament?

A

Acts to limit:

  • Extension
  • Lateral rotation
  • Abduction
176
Q

Where does the ischiofemoral ligament lie in relation to the hip joint?

A

Posteriorly

177
Q

What is the proximal attachment of the ischiofemoral ligament?

A

Ischial spine

Posterior acetabular rim

178
Q

What is the course of the ischiofemoral ligament?

A

Spirals superolaterally to medial aspect of greater trochanter

179
Q

What is the function of the ischiofemoral ligament?

A

Acts to limit:

  • Extension
  • Medial rotation
  • Adduction
180
Q

What is the blood supply to the hip joint?

A

Profunda femoris artery:
- Medial and lateral circumflex femoral arteries
Artery to head of femur

181
Q

What is the course of the artery to head of femur?

A

Arises from obturator artery

Runs in ligament to head of femur

182
Q

What are the hamstring muscles?

A

Semitendinosus
Semimembranosus
Biceps femoris

183
Q

What are the functions of the hamstring muscles?

A

Extend hip

Flex knee

184
Q

What is the origin of semitendinosus?

A

Ischial tuberosity

185
Q

What is the insertion of semitendinosus?

A

Medial surface of superior part of tibia

186
Q

What is the innervation to semitendinosus?

A

Tibial part of sciatic nerve (L5-S2)

187
Q

What is the origin of semimembranosus?

A

Ischial tuberosity

188
Q

What is the insertion of semimembranosus?

A

Posterior surface of medial condyle of tibia

189
Q

What is the innervation to semimembranosus?

A

Tibial part of sciatic nerve (L5-S2)

190
Q

What are the origins of biceps femoris?

A 
Long head:
- Ischial tuberosity
Short head:
- Linea aspera
- Lateral supracondylar line of femur
191
Q

What is the insertion of biceps femoris?

A

Lateral side of the head of fibula

192
Q

What splits the common tendon of biceps femoris?

A

Lateral (fibular) collateral ligament

193
Q

What is the innervation to biceps femoris?

A

Long head:
- Tibial nerve (L5-S2)
Short head:
- Common fibular nerve (L5-S2)

194
Q

What muscle can laterally rotate knee when flexed?

A

Biceps femoris

195
Q

What muscles can medially rotate knee when flexed?

A

Semimembranosus
Semitendinosus
Gracilis
Sartorius

196
Q

Where does the sciatic nerve run in the gluteal and posterior thigh regions?

A

Deep to gluteus maximus and biceps femoris

197
Q

Where does the sciatic nerve bifurcate?

A

Apex of popliteal fossa

198
Q

What forms the roof (posterior boundary) of the popliteal fossa?

A

Skin
Subcutaneous tissue
Deep fascia

199
Q

What pierces the deep fascia of the popliteal fossa?

A

Short saphenous vein

Sural nerve

200
Q

What structures form the superior border of the popliteal fossa?

A

Superolaterally - Biceps femoris
Superomedially:
- Semimembranosus
- Semitendinosus (more lateral)

201
Q

What structures form the inferior border of the popliteal fossa?

A

Inferolaterally:
- Lateral head of gastrocnemius
Inferomedially:
- Medial head of gastrocnemius

202
Q

What structures form the floor/anterior border of the popliteal fossa?

A

Popliteal surface of femur
Capsule of knee joint
Popliteus muscle

203
Q

What structures are found at the floor of the popliteal fossa?

A

Oblique popliteal ligament:
- Expansion of semimembranosus
- Reinforces knee joint capsule
Middle genicular vessels

204
Q

What is the course of the middle genicular vessels?

A

Pierce joint capsule
Supply:
- ACL
- PCL

205
Q

What are the contents of the popliteal fossa from medial and deep to lateral and superficial?

A

Popliteal artery
Popliteal vein (and termination of short saphenous vein)
Tibial nerve
Common fibular nerve

206
Q

Where does the popliteal artery run from and to?

A

From adductor hiatus

To inferior border of popliteus

207
Q

What are the 5 genicular branches of the popliteal artery?

A 
Medial superior
Medial inferior
Lateral superior
Lateral inferior
Middle
208
Q

What is the function of the genicular branches of the popliteal artery?

A

Form the genicular anastomosis:

- Maintain blood supply to leg when flexed as flexing the knee can kink the popliteal artery

209
Q

What are the terminal branches of the popliteal artery?

A

Anterior tibial artery

Posterior tibial artery

210
Q

What type of joint is the knee joint?

A

Modified synovial hinge joint

211
Q

What are the articulations of the knee joint?

A

Femoropatellar

Femorotibial (x2)

212
Q

What does the fibrous capsule of the knee joint fuse with anteriorly?

A

Quadriceps tendon
Patella
Ligamentum patellae

213
Q

What is the structure of the fibrous capsule of the knee joint posteriorly?

A

Encloses intercondylar fossa of femur
Open posterior to lateral tibial condyle:
- Allows popliteus attachment

214
Q

What muscles lie over the medial aspect of the knee? (From anterior to posterior)

A

Sartorius
Semimembranosus and semitendinosus
Gracilis

215
Q

What are the attachments of the synovial membrane of the knee joint?

A

Periphery of articular cartilages of femoral and tibial condyles
Infrapatellar synovial fold
Medial and lateral alar folds:
- Cover inner surface of fat pads on either side of patellar ligament

216
Q

What bursae of the knee joint are in communication with synovial cavity of the knee joint?

A

Suprapatellar
Gastrocnemius
Semimembranosus
Popliteus

217
Q

What are the other bursae of the knee joint?

A 
Subcutaneous prepatellar
Subcutaneous infrapatellar
Deep infrapatellar
Anserine (medial):
- Gracilis
- Sartorius
- Semitendinosus
218
Q

What are the extracapsular knee ligaments?

A

Oblique popliteal
Arcuate popliteal
LCL and MCL

219
Q

What are the intracapsular knee ligaments?

A

ACL

PCL

220
Q

What is the oblique popliteal ligament and what does it do?

A

Expansion of semimembranosus tendon

Reinforces posterior knee capsule

221
Q

What is the arcuate ligament and what does it do?

A

Thickening of capsule over popliteus

Strengthens posterolateral joint capsule

222
Q

What is the origin of the MCL?

A

Medial epicondyle of femur

223
Q

What are the insertions of the MCL?

A

Medial condyle of tibia
Superior medial surface of tibia
Medial meniscus (via deep fibres)

224
Q

What is the origin of the LCL?

A

Lateral epicondyle of femur

225
Q

What is the insertion of the LCL?

A

Lateral head of fibula

226
Q

What muscles are related to LCL?

A

Tendon of popliteus lies deep to it

Tendon of biceps femoris divides in 2 around it

227
Q

What is the function of the cruciate ligaments?

A

Maintain contact between femoral and tibial articular surfaces when the knee is flexed
Wind around each other during medial tibial rotation:
- Limit it to 10 degrees

228
Q

What cruciate ligament is the stronger of the two?

A

PCL

229
Q

What is the origin of PCL?

A

Posterior intercondylar area of tibia

230
Q

What is the course and insertion of the PCL?

A

Passes anterosuperiorly

Inserts on anterolateral surface of medial femoral condyle

231
Q

What are the functions of the PCL?

A 
Prevents femur sliding anteriorly on tibia (especially on flexion)
Limits flexion (anterolateral band)
Limits extension (posteromedial band)
232
Q

Where does ACL originate?

A

Anterior intercondylar area of tibia

233
Q

What is the course and insertion of ACL?

A

Extends superiorly, posteriorly and laterally

Inserts on posteromedial surface of lateral femoral condyle by spiralling 110 degrees

234
Q

What are the functions of ACL?

A

Prevents femur sliding posteriorly on tibia
Limits medial rotation of femur when foot planted
Limits flexion (anteromedial band)
Limits extension (posterolateral band)

235
Q

What are the menisci?

A

Wedges of fibrocartilage

236
Q

What are the functions of the menisci?

A

Deepen articular surface

Shock absorption

237
Q

What are the features of the medial meniscus?

A

C-shaped
Broad posteriorly
Firmly attached to MCL

238
Q

What are the features of the lateral meniscus?

A

Circular
Freely moveable
Attachment for popliteus

239
Q

What is the blood supply to the knee?

A

5 genicular branches from popliteal artery
Descending genicular artery from femoral artery
Descending branch from circumflex femoral artery
Recurrent branches from anterior and posterior tibial arteries

Regional Gross Anatomy (14 decks)

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