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Locomotor > The knee > Flashcards

The knee Flashcards

1
Q

What are the 3 muscle groups and one canal within the thigh

A
  • anterior
  • medial
  • posterior
  • adductor canal
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2
Q

what is the anterior compartment innervated by and what muscles does it contain

A

= this is the largest of the three compartment,
= the main muscle that you find is the quadriceps
- they are innervated by the femoral nerve (L2,3,4),

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3
Q

what movement does the anterior compartment do

A
  • knee extension

- hip flexion

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4
Q

what nerve innervated the medial compartment and what muscles does it contain

A

Obturator nerve (L2,3,4)
Adductors
Hip adduction

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5
Q

what nerve innervates the posterior compartment and what muscles are in it

A
  • Sciatic nerve- Tibial branch (L5,S1,S2)

- Hamstrings

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6
Q

what movements can the posterior compartment do

A
  • Knee flexion

- And hip extension

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7
Q

what goes through he adductor canal

A
  • Major arteries pass through this in the thigh
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8
Q

what is the spinal segments of the femoral nerve

A

L2,3,4

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9
Q

what are the spinal segments of the obtrustor nerve

A

L2,3,4

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10
Q

what are the spinal segments of the tibial branch of the sciatic nerve

A

L5,S1,S2

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11
Q

what muscles make up the anterior compartment

A
  • Lliopsoas (psoaso major and illacus) – major flexor of the hip joint
  • Sartorois – flexes hip and knee– attaches to the ASIS and the back to the tibia
  • Quadriceps - rectus femoris
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12
Q

what is the liopsoas made up of

A

psoaso major and illacus

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13
Q

what are the 4 heads of the quadriceps

A

Vastus medialis, vastus lateralis, vasutus intermedialis and Rectus femoris

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14
Q

what is the only head of the quadriceps that acts on the hip joint

A

rectus femoris

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15
Q

where do the quadriceps insert onto

A
  • they insert onto the quadriceps tendon anteriorly
  • run to the knee joint and the patella bone is embedded within he tendon
  • this is the patella ligament and patella tendon and pulls the knee into extension
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16
Q

what makes up the adductors of the medial comparment

A 
•	Adductor Magnus
•	Adductor Longus
•	Adductor Brevis
•	Gracilis
-	They attach to the pelvis and distilling to the linea asperea
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17
Q

what innervates the adductors of the medial comparemtn

A
  • They are all innervated by the obstruator nerve (other than hamstring part of adductor magnus)
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18
Q

what makes up the border of the femoral triangle

A
  • Superior border – inguinal ligament
  • Lateral border - satorius muscle
  • Medial border - Adductor longus
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19
Q

what runs through the femoral triangle from lateral to medial

A
  • Femoral nerve – innervates the anterior comparmtnet of the thigh runs under the inguinal ligament and starts to innervate the thigh
  • femoral artery
  • Femoral vein
  • Deep inguinal nodes and lymphatics
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20
Q

what does the great saphenous vein drain into

A

femoral veins

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21
Q

what is the femoral ring

A

Femoral ring is a weak area in the anterior abdominal wall through which abdominal contents may herniate

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22
Q

where do the hamstrings attach

A
  • All hamstrings have their origin at the ischial tuberosity and a distal attachment on the tibia via the hamstring tendons
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23
Q

what compartment is the hamstrings in

A

posterior

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24
Q

what is the action of the hamstrings

A
  • Flex the knee joint and extend the hip (only weak hip extensors)
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25
Q

what innervates the hamstrings

A
  • Innerbated by the tibial division of the sciatic nerve
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26
Q

what muscles make up the hamstrings

A

• Semitendinosus
• Semimembranosus
• Biceps femoris (long head and short head (short head comes from the posterior aspect of the femur)
- Semimembranous s and semitendinous – more medial whereas the biceps femoris is more lateral

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27
Q

what is the pes anserinus

A

Insertion of

  • Sarorius
  • Gracillis
  • Semitendinosus
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28
Q

what is the largest joint in the body

A

the knee

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29
Q

what are the 3 articulations of the knee

A
  • lateral femoral and tibial condyles with corresponding meniscus
  • medial femoral and tibial condyles with corresponding meniscus
  • patella and femur
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30
Q

they 3 articulates of the knee all share the same..

A

articular capsule

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31
Q

why is the fibula not involved in the knee joint

A
  • fibula is not involved in the knee joint this is because it does not articulate with the femur
32
Q

is the knee strong or weak

A
  • mechanically weak due to the way the bones articulate
33
Q

what does stability in the knee depend on

A

1 Strength and actions of surrounding muscles and their tendons
2 The ligaments that connect the femur and tibia

34
Q

describe the mechniacial axis in the knee and ankle joint and how that leads to equal waiting

A
  • The femur is positioned diagonally within the thigh
  • The tibia is almost vertical
  • This means that the knee joint is below the hip joint, this means that the mechanical axis passes straight through to the ankle joint, means you have equal waiting on the knee joint and the ankle joint
35
Q

define the Q angle

A
  • Drawn from ASIS to the centre of the patella
36
Q

what is the q angle in men and women

A
  • 14° Men

- 17 ° Women

37
Q

what is a small Q angle called

A
  • Genu varum - small Q angle
38
Q

what is a large Q angle called

A
  • Genu vaigum – large Q angle
39
Q

what happens in a deformed Q angle and what can this lead to

A

in both genu vacuum and genu vaigum the mechanical axis is either to one side or to the other side of the knee this provides unequal loading on the Knee joint
- exposes you to arthritis on you knee joint

40
Q

what are the ligaments in the knee

A
  • Illiotibial tract – lateral to the knee
  • Collateral ligaments
  • Patella ligament
  • Pes anserinus – medial to the knee
  • Semimembranssous tendon
  • Biceps tendon
41
Q

what type of bone is the patella

A

sesamoid bone

42
Q

what tendons are above and below the tendon

A
  • Above the patella the tendon is the patella tendon below the knee the tendon is the quadriceps tendon
43
Q

what is a sesamoid bone

A
  • It is a bone that it formed within a tendon
44
Q

what does the sesamoid bone do

A
  • They provide an articular surface with cartilage providing a smoother gliding action going over the anterior part of the knee joint
45
Q

what happens if you rupture the patella tendon

A
  • If you rupture the patella ligament then the patella shoots up into the thigh
46
Q

what happens if you rupture the quadriceps tendon

A
  • If you ruptute the qaudriceps tendon then the patella falls down in front of the articualing the knee
47
Q

what do the collateral ligaments do

A
  • Collateral ligaments support the hinge like movement of the knee joint
48
Q

describe the fibular collateral ligament

A
  • on the lateral side
  • this is a strong fibrous cord
  • not attached to the joint capsule or lateral meniscus
49
Q

describe the tibial collateral ligament

A
  • blended with the capsule,
  • broad flat ligament, thickening of the joint capsule
  • attached to the medial meniscus
50
Q

what are cruciate ligaments

A
  • these are cross shaped ligaments within the intercondylar region of the tibia
  • they connect the tibia and the femur to prevent displacement of the tibia relative to the femur.-
51
Q

what do cruciate ligaments prevent from happening

A
  • anterior posterior displacement
52
Q

what are the two types of cruciate ligaments

A

Posterior cruiciate ligament

Anterior cruiciate ligament

53
Q

what are the two types of collateral ligaments

A

fibular collateral ligament

tibial collateral ligament

54
Q

where does the posterior cruciate ligament run

A

• Runs from posterior aspect of intercondylar area of tibia and ascends anteriorly to attach to the medial wall of the femoral intercondylar fossa

55
Q

what does the posterior cruciateligament do

A
  • Stops tibia moving backward on femur
  • Stronger the ACL
  • Helps stabilise knee especially in flexion
  • Also prevents tibia twisting outward (external rotation)
  • Stops it moving posteriorly
56
Q

where does the anterior cruciate ligament run

A
  • Runs from facet on the anterior part of the intercondylar area of tibia and ascends posteriorly to attach to the back of the lateral wall of the intercondylar fossa of the femur
57
Q

what does the anterior cruciate ligament do

A
  • Stops tibia moving forward on femur
  • Stabilise knee in extension and prevents hyperextension and excessive internal rotation
  • Stops it moving anteriorly
58
Q

what does the ACL prevent

A
  • The ACL prevents the femur sliding posterior on the tibia so rupture results in the anterior drawer sign – anterior draw test
59
Q

what does the PCL prevent

A
  • The PCL prevents the femur sliding anteriorly on the tibia, so rupture results in the posterior drawer sign
60
Q

how do you do an ACL graft

A
  • bone tendon bone graft

- hamstring tendon graft

61
Q

what is a bone tendon bone graft

A

bone tendon bone graft this can be inserted in to the knee joint – part on femur and part on the tibia, the tendon in between acts as the ACL

62
Q

what is a hamstring tendon graft

A

– hamstring tendons – semitendinous and gracilis tendons are plaited together and they can be used as an ACL graft

63
Q

what are menisci

A
  • Plates of fibrocartilage which help deepen the knee joint and help with shock absorption
64
Q

what are the two types of menisci

A

lateral and medial

65
Q

what is the difference between the lateral and medial menisci

A

medial

  • C shaped
  • can’t move that well
  • attached to the ACL

lateral

  • nearly circular
  • can move better than the medial
  • attached to the PCL
66
Q

what is the medial menisci also attached to

A
  • Firmly adhered to the tibial collateral ligament these attachments are important as if you tear the medial minscus then you end up tearing the medial mensicous, ACL, tibila collateral ligament as they are all anatomically linked to each toehr this is refered to as the unhappy triad
67
Q

what are the bursae

A

Almost all the bursa are extensions of the knee synovial cavity and are filled with synovial fluid.

68
Q

what do the bursae act as

A

They act as cushions against friction and rubbing of the tendons, ligaments and bones around the knee joint

69
Q

what is the most clinically important bursa

A
  • Prepatellar bursa – not linked to synovial joint or linked to knee joint there for doesn’t effect the knee joint that much
  • This most commonly becomes inflamed
  • Leads to prepatellar bursitis
70
Q

what is bakers cyst

A
  • May form from a normal bursa or herniation of the joint capsule
  • Often associated with meniscal tears or degenerative arthritis of the knee
  • These can restrict knee movements if they become very large
71
Q

what are the extracapsular ligaments and what do they do

A
  • Quadriceps tendon and patella ligament these prevent forward movement of the tibia on the femur
  • Medial and lateral collateral ligaments reinforce hinge joint
  • Lateral - Limits extension and adduction of leg
  • Medial limits extension and abduction of the leg
72
Q

what are the intracapsular structures

A
  • Meniscus medial and lateral

- Anterior cruciate and posterior cruciate

73
Q

what makes up the popliteal fossa

A
  • Makes up superior borders of the fossa are the semimembranous and semitendinous and the biceps femoris
  • Inferior border – two heads of gsatrocenemius
74
Q

what runs through the popliteal fossa

A
  • Popliteal artery
  • Popliteal vein
  • Common peroneal nerve
  • The tibial nerve – one of the main branches for the sciatic nerve
75
Q

what are the two branches that the sciatic nerve breaks into

A
  • Sciatic nerve breaks into two major branches – tibial(runs through the popliteal fossa) and common peroneal nerve (runs laterally out of the popiliteal fossa)
  • There is a small cubtaneous nerve which can branch from the tibial or common peroneal or from both, supplies posterior aspect of the leg
76
Q

where does the small saphenous drain

A

popliteal vein

Locomotor (22 decks)

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