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Module 204 MSK & Immune system > T2 L15 Anatomy of the knee > Flashcards

T2 L15 Anatomy of the knee Flashcards

1
Q

What is the knee joint?

A

Articulation between distal femur and proximal tibia

Articulation between femur and patella

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2
Q

What type of joint is the knee joint?

A

Synovial bicondylar hinge joint

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3
Q

What are the functions of the knee?

A

Weight bearing

Mobility

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4
Q

What factors strengthen the knee joint?

A 
Bony factors
 - bony expansions
 - locking mechanism 
 - femoral angle
Soft tissue factors
 - ligaments
 - menisci 
 - muscles
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5
Q

How do bony expansions strengthen the knee joint?

A

Provide strong base

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6
Q

Why does the locking mechanism strengthen the knee joint?

A

Reduces amount of energy required when extended

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7
Q

What are the 3 ways the locking mechanism strengthens the knee joint?

A

Shape of femur
- in flexion femoral surfaces are founded
- in extension the femoral surfaces are flat
Rotation
- medial rotation of femur on tibia in extension tightens the ligaments
Centre of gravity
- brings centre of gravity in front of knee to maintain extension

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8
Q

How does the femoral angle strengthen the knee joint?

A

Adducted femur brings knee joint directly under hip joint

Critical for weight bearing

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9
Q

What is the anatomical axis?

A

Follows long axis of femur

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10
Q

What is the mechanical axis?

A

Vertical line through centre of femoral head, centre of knee and centre of angle
Normal alignment of joint

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11
Q

How is the Q angle measured clinically?

A

Angle between anatomical and mechanical axis
Anatomical axis from ASIS to patella
Mechanical from tibial tuberosity through patella

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12
Q

What should the Q angle be?

A

Around 15 degrees

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13
Q

What is varus deformity?

A

Genu varum
Medial displacement of tibia pushes knees apart (bow-legged)
Decrease in Q angle
Common in children under 2 and rickets
Increased stress eventually results in joint degeneration

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14
Q

What is valgus deformity?

A

Genu valgum
Lateral displacement of tibia brings knees together (knock kneed)
Common in children aged 2-4, rickets, arthritis
Increased in Q angle
Increased stress eventually results in joint degeneration

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15
Q

What are the 2 groups of ligaments around the knee?

A

Extracapsular

Intracapsular

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16
Q

What are the 2 extracapsular ligaments?

A

Medial collateral ligament

Lateral collateral ligament

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17
Q

What are the 2 intracapsular ligaments?

A

Anterior cruciate ligament

Posterior cruciate ligament

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18
Q

What is the lateral / fibular collateral ligament and what does it do?

A

Strong round cord from lateral epicondyle of femur to head of fibular
Prevents medial displacement of tibia

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19
Q

What does a tear in the lateral collateral ligament cause?

A

Varus deformity

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20
Q

What is the medial / tibial collateral ligament and what does it do?

A

Broad, flat band from medial epicondyle on femur to medial condyle of tibia
Reinforces joint capsule
Prevents lateral displacement of tibia

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21
Q

What does a tear in the medial collateral ligament cause?

A

Valgus deformity

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22
Q

Describe the anterior cruciate ligament

A

Anterior in relation to tibia
Attaches to anterior intercondylar region of tibia, blends with medial meniscus and attaches to femur in intercondylar fossa
Passes upwards, backwards and laterally

23
Q

What is the role of the anterior cruciate ligament?

A

Prevent anterior dislocation of tibia onto femur

24
Q

How can the anterior cruciate ligament be injured and how would it present?

A

Common sports injury
Caused by sharp twisting of knee
Immediate decrease in range of movements

25
Q

What is the Lachman test for?

A

Indicates anterior cruciate ligament injury

26
Q

How is the Lachman test performed?

A

Patient in supine position with knee bent with 20-30 degrees of flexion
Move tibia anteriorly and posteriorly while maintaining position of femur
Laxity during this manoeuvre indicates anterior cruciate ligament injury

27
Q

Describe the posterior cruciate ligament

A 
Posterior in relation to tibia
Attaches to posterior intercondylar region of tibia and to anteromedial femoral condyle
Passes upwards, forward and medially
Stronger ligament
Principle stabiliser when knee is flexed
28
Q

What is the role of the posterior cruciate ligament?

A

Prevent posterior dislocation of tibia onto femur

29
Q

What are menisci?

A

Crescent-shaped plates of fibrocartilage

30
Q

What is the function of the menisci?

A

Deepen articulating surfaces / stability
Shock absorbers
Provides smooth viscous film for joint

31
Q

Which meniscus is larger?

A

Medial

32
Q

What do the horns of the menisci attach to?

A

Intercondylar areas of tibia

33
Q

Why is the medial meniscus less mobile?

A

Attached to medial collateral ligament

34
Q

What is the unhappy triad?

A

Injury to anterior cruciate ligament, medial collateral ligament and medial meniscus

35
Q

What can cause the unhappy triad?

A

Twisting on flexed knee / blow to lateral side
Contact sports
Locking of knee

36
Q

What is the function of the iliotibial tract?

A

Reinforces joint capsule

Stabilises extended knee

37
Q

What are the extensors of the leg?

A

Quadriceps

38
Q

What are the 4 heads of the quadriceps?

A

Rectus femoris
Vastus lateralis
Vastus intermedialis
Vastus medialis

39
Q

What prevents the patella moving laterally?

A

Oblique fibres of vastus medialis

40
Q

What is the function of the patella?

A

Protects quadriceps tendon from stresses during locomotion

Smooth oval facet of posterior surface for articulation with femur

41
Q

What flexes the leg?

A

Hamstrings

Gastrocnemius

42
Q

What 3 muscles make up the hamstrings?

A

Biceps femoris
Semimembranosus
Semitendinosus

43
Q

What is the function of the hamstrings?

A

Flexion at knee
Extension at hip
Medial and lateral rotation when knee is flexed

44
Q

What does popliteus do?

A

Laterally rotates femur on tibia when foot is on ground to loosen ligaments.

45
Q

Describe the synovial membrane

A

From margins of articular surfaces of femur to tibia
Attached to patella
Extends superiorly behind quadriceps tendon
Cuffs anterior surface of cruciate ligaments

46
Q

What are bursa?

A

Synovial fluid-filled sac lined by synovial membrane

47
Q

What is the function of bursae?

A

Protection

Reduce friction

48
Q

What is bursitis?

A

Inflammation of bursa

49
Q

What can cause bursitis?

A

Repetitive movements

Direct pressure

50
Q

What is pre patellar bursitis?

A

Housemaid’s knee
Seen in carpet fitters
Leaning forward on knees brings pre patellar bursa in contact with floor

51
Q

What is infrapatellar bursitis?

A

Clergyman’s knee

After prolonged periods of prayer, clergymen sat back on the heels bringing infrapatellar bursa in contact with floor

52
Q

What is a baker’s cyst?

A

Abnormal fluid filled sacs in popliteal fossa due to herniation of synovial membrane / bursa
Common in patients with chronic inflammatory joint disease
Presents as swelling in popliteal fossa
Can affect joint movement

53
Q

How is a baker’s cyst treated?

A

Aspiration

Cortisone injection

Module 204 MSK & Immune system (44 decks)

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