The Knee Joint and Leg

Question 1

What are the epicondyles of the femur for?

Answer 1

muscle attachment

Question 2

What muscle attaches to the adductor tubercle of the femur?

Answer 2

adductor magnus

Question 3

What are condylar surfaces covered in?

Answer 3

myelin cartilage

Question 4

What do the condyles of the femur articulate with?

Answer 4

tibia

Question 5

What is the groove between femoral condyles is…

Answer 5

intercondylar groove/fossa

Question 6

What bony landmark does the quadiceps attach to for the extension of the knee?

Answer 6

quadriceps

Question 7

What type of bone is a patella?

Answer 7

sesamoid

Question 8

What tendon does the patella sit in?

Answer 8

quadriceps tendon

Question 9

What bony landmark does the patella sit on?

Answer 9

patella surface of femur

Question 10

Classify the knee joint

Answer 10

synovial, biaxial, hinge joint (modified hinge joint as it can slightly rotate when locking)

Question 11

What are the movements of the knee

what axis/plane do these movements occur on?

Answer 11

flexion and extension

transverse axis

Question 12

What does locking of the knee bone allow?

Answer 12

muscles to relax as bones are supporting weight

Question 13

What does the bursa in the knee prevent?

Answer 13

tendons rubbing on bone

Question 14

What condyle of the femur is larger?

Answer 14

medial larger than lateral

Question 15

Describe the menisci of the knee

Answer 15

Lateral almost circular, medial is a crescent shape.

Question 16

How is the menisci held in place?

Answer 16

anchored down by ligaments to joint surfaces of the tibia

Question 17

What is the function of the menisci?

Answer 17

shock absorption and support

Question 18

True or false, cruciate ligaments lie between the menisci

Answer 18

true

Question 19

What are the two cruciate ligaments?

Answer 19

Anterior and posterior (ACL and PCL)

- named in relation to their location on the tibia

Question 20

What type of ligaments are the ACL and PCL?

Answer 20

intracapsular

Question 21

What does the ACL limit?

Answer 21

medial rotation and anterior slide of the tibia on femur

Question 22

What does the PCL limit?

Answer 22

medial rotation and posterior slide of tibia on femur

Question 23

What are the two extracapsular ligaments that support the knee?

Answer 23

Fibular (lateral) collateral and Tibia (medial) collateral ligaments (LCL and MCL)

Question 24

Describe the LCL

Answer 24

long, thin, cord-like ligament that limits extension and prevents adduction

Question 25

Describe the MCL

Answer 25

flat band that limits extension and prevents abduction

Question 26

What is the process of locking the knee?

Answer 26

• Lateral side of joint completes motion sooner than medial side as it is smaller
• Movement continues in the medial compartment results in slight rotation of the joint (if tibia fixed, femur rotates medially)
• Takes the knee into a locked position

Question 27

What is beneficial about locking the knee?

Answer 27

no muscle effort required to hold up body

Question 28

What makes locking the knee a stable position?

Answer 28

Maximum contact between joint surfaces, tibial tubercles logged in the intercondylar notch, ligaments tense = stable joint position

Question 29

What is unique about the relationship between muscles crossing the joint surface and their action?

Answer 29

• anterior = extension
• posterior = flexion
  due to the nature of the hinge (opposite of elbow hinge)

Question 30

List flexors of the knee

Answer 30

• hamstrings: biceps femoris, semimembranosus and semitendinosus

Question 31

What are the hamstrings innervates by?

Answer 31

sciatic nerve

Question 32

Describe the passage of the sciatic nerve

Answer 32

• comes out of greater sciatic notch
• travels down posterior aspect of leg
• travels through popliteal fossa
• supplies most of the lower limb

Question 33

List the extensors of the knee

Answer 33

quadriceps: rectus femoris, vastus lateralis, vastus medialis and vastus intermedialis

Question 34

What is the attachments of rectus femoris?

Answer 34

ilium to quadriceps tendon

Question 35

What quadriceps muscle is the deepest?

Answer 35

vastus medialis (under rectus femoris)

Question 36

What is the general attachment of the quadriceps muscles?

Answer 36

femur to quadriceps tendon to tibial tuberosity

Question 37

What are the quadriceps innervated by?

Answer 37

femoral nerve

Question 38

Describe the muscles engaged during the different stages of gait.

Answer 38

1. Heel strike – gluteus maximus, posterior capsule and tibialis anterior
2. Loading response – quadriceps femoris
3. Midstance – triceps surae
4. Terminal stance (heel off) – triceps surae
5. Pre-swing (toe off) – deep plantar flexors, flexors of toes, intrinsic foot muscles, rectus femoris
6. Initial and Mid-swing – contralateral abductors of the hip, iliopsoas and rectus femoris
7. Terminal swing - hamstrings, quadriceps femoris and tibialis anterior

Question 39

What is the lumbosacral plexus?

Answer 39

large plexus of nerves that supplies the lower limb

Question 40

What are the two main branches of the lumbosacral plexus?

Answer 40

tibial and common perineal (fibular) - supplies posterior of thigh and everything from the knee down

Question 41

What is the anterior thigh supplied by?

Answer 41

femoral nerve

Question 42

What does the obturator nerve supply?

Answer 42

adductors and medial aspect

Question 43

What muscles does the tibial nerve supply?

Answer 43

gastrocnemius, soleus, tibialis posterior, flexor hallucis longus & flexor digitorum longus

Question 44

What muscles does the superficial peroneal supply?

Answer 44

peroneus longus and brevis

Question 45

What muscles does the deep peroneal supply?

Answer 45

tibialis anterior, extensor digitorum longus, extensor hallucis longus and peroneus tertius