Surface Anatomy and Examination of the Knee Joint Flashcards
Quadriceps
Rectus femoris
Vastus lateralis
Vastus medialis
Vastus intermedius
Distal quadriceps
Patella tendon (ligamentum patellae) Tibial tuberosity
Hamstrings
Biceps femoris: inserts laterally on fibula head
Semembranosus
Semtendubosus
Pes anserinus
Sortorius
Gracilis
Semitendinosus
Bursa
Adductors
Pectineus Adductor longus Adductor brevis Adductor magnus Gracilis
Adductor magnus
Adductor part: obturator nerve
Hamstring part: tibial nerve
Medial collateral ligament
Not palpable
Superficial and deep parts
10cm long
Origin just distal to the adductor tubercle
Lateral collateral ligament
5cm long
Palpable cord
Lateral epicondyle of femur to fibular head
Anterior cruciate ligament
Direction of ligament: ‘hands in pockets’ (superiorly, posteriorly and laterally)
Tibial insertion.
Posterior cruciate ligament
Tibial insertion.
Passes anteriorly and medially.
Outline of history process
Mechanisms of injury Symptoms Inspection Examination Movement Special tests
Symptoms
What did you notice at the time and straight after the injury?
How did it affect you functionally?
How does it feel now?
Are there any other problems? (swelling, instability, locking, crepitus or a pop).
What did you do to manage the injury?
Inspection
Gait Skin - bruising or scars Erythema Atrophy - especially VMO Deformity/postural abnormality Swelling - effusion/haematoma
Examination
(1) Palpation: bony structures, joint line, ligaments (MCL and LCL), other soft tissues effusion (if there is effusion perform swipe test or patella tap test)
Movement
Active, passive, resisted.
Flexion
Extension
Consider range, associated pain, crepitus
Genu varum
Bow leg deformity (legs bend outwards)
Normal at birth and corrects to neural by age 2 years
Genu valgum
Knock knee deformity (legs bend inwards)
Normal at age 2-5 year
Sciatic nerve
Enters buttocks halfway between PSIS and IT.
Enters thigh halfway between greater trochanter and IT.
Borders of the femoral triangle
Inguinal ligament
Adductor longus
Sartorius
Structures at the superior border of the femoral triangle
Nerve Artery Vein Empty space Lacunar lugament
