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anatomy - physio > the knee, leg and tibiofibular joints > Flashcards

the knee, leg and tibiofibular joints Flashcards

1
Q

what bones (&their parts) articulate in order to form the** knee joint**?

A
  • femur- distal end of femur - medial and lateral condyles
  • tibia- proximal end of tibia - tibial plateau
  • posterior aspect of patella
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2
Q

Describe the** osteology **of the distal femur

A
  • lateral and medial condyles
  • lateral and medial epicondyles
  • patellar surface
  • supracondylar line
  • intercondylar fossa
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3
Q

describe the osteology of the tibia

anteroirly and posteriorly

A

anterior :
* head of the tibia
* tibial tuberosity
* shaft of the tibia
* medial malleolus
* intercondylar eminence
posterior:
* soleal line - where soleus muscle attaches

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4
Q

Describe the osteology of the fibula (anterior and posterior view)

A

anterior & anterior :
* head of fibula
* neck of fibula
* shaft
* lateral malleolus

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5
Q

what are the 2 tibiofibular joints called?

A
  • proximal tibiofibular joint
  • distal tibiofibular joint
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6
Q

what are menisci?

A

the menisci are fibrocartilage crescent shaped plates found between the articulating surfaces of the femur and tibia

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7
Q

what are the functions of the menisci?

A
  • deepen the articular surface
  • act as a cushion for the bones
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8
Q

where are the menisci located?

A
  • between the femoral and tibial condyles
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9
Q

what type of membrane lines the interior capsule of the menisci?

A
  • a synovial membrane
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10
Q

what are the 2 menisci of the knee?

A

lateral and medial

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11
Q

what are the extracapular ligaments of the knee?

A
  • NB found outside the joint capsule
  • patellar ligament
  • medial collateral
  • lateral collateral
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12
Q

what are the intracapsular ligaments of the knee?

A
  • NB found within the joint capsule
  • anterior cruciate ligament
  • posterior cruciate ligament
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13
Q

Describe the medial collateral ligament

A
  • broad and flat
  • medial femoral epicondyle to medial tibia
  • NB ATTACHED TO MEDIAL MENISCUS
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14
Q

Describe the **lateral collateral ligament **

A
  • thin and cord like
  • lateral femoral epicondyle to head of fibula
  • NB not attached to lateral meniscus or joint capsule
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15
Q

describe the** patellar ligament**
(structure and function)

A

* strong, thick, fibrous band that is a distal continuation of the quadriceps femoris tendon
* plays a major role in stabilising the patella and **preventing its displacement **

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16
Q

Describe the **anterior cruciate ligament **

attachments and functions

A

attachments:
* lateral femoral condyle
* anterior tibial plateau
functions:
* prevents femur sliding posterioly on tibia
* prevents hyperextension of the knee joint

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17
Q

Describe the posterior cruciate ligament - attachments & functions

A

attachments
* medial femoral condyle
* posterior tibial plateau
functions
* prevents femur sliding anteriorly on the tibia- especially in flexed knee eg when walking down hill

note - better blood supply and stronger than ACL

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18
Q

what is a good abbreviation for learning the attachments of the intracapsular ligaments?

A

LAMP
ACL
- Lateral femoral condyle
- Anterior tibial plateau
PCL
- Medial femoral condyle
- Posterior tibal plateau

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19
Q

what type of joint is the knee joint?

A
  • hinge joint but modified hinge joint - as there can be some medial & lateral rotation
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20
Q

what are the 2 main movements that the knee joint can carry out?

A

flexion & extension

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21
Q

what muscles are involved in flexion of the knee?

A

the 3 hamstring muscles
* bicep femoris
* semimembranosis
* semitendonosis

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22
Q

what muscles are involved in extension of the knee & what nerve innervates these muscles?

A

the 4 quadriceps femoris muscles
* rectus femoris
* vastus lateralis
* vastus medialis
* vastus intermedius

innervation - the femoral nerve (L2-L4)

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23
Q

what is ‘locking of the knee’?

A
  • the knee joint in full extension
  • femur rotates medially on the tibia
  • knee becomes rigid
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24
Q

what is ‘unlocking’ of the knee?

A
  • the ligaments become untwisted and relaxed
  • popliteus muscle laterally rotates the femur on tibia
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25
what are synovial bursae, where are they found and what are their functions?
* fluid filled sac like cavities * found wherever skin, muscle or tendon rub against the bone functions - reduce friction and facilitate movement
26
what are the** 5 bursae of the knee joint**?
* **suprapatellar** bursa - above patella * **prepatellar** bursa (lies in front of the patella) * **infrapatellar** bursa (located under the patella) * **semimembranosus** bursa * **popliteal** bursa
27
Describe the blood supply to the knee joint
* blood supply involves the **genicular arteries from the popliteal artery**
28
what nerves innervate the knee joint?
* femoral nerve * tibial nerve * common peroneal nerve
29
What are special tests that can be done for ACL & PCL injury?
* ACL - anterior drawer or lachman test * PCL - posterior drawer test
30
how would you test for collateral ligament injuries?
* with leg straight, try to abduct and adduct the knee... should be little movement
31
why are there a higher rate of medial meniscal injuries over lateral ones?
as the medial meniscus is attached to the medial colateral ligament
32
what is housemaids knee?
bursitis (inflammation of the bursae) - of the prepatellar bursa
33
what is clergyman's knee?
bursitis of the infrapatellar bursa
34
compare the superior vs inferior tibiofibular joints TYPE
* superior - synovial joint * inferior - fibrous joint
35
what is the popliteal fossa?
* a diamond shaped depression located posteriorly to the knee joint * important nerves and vessels pass from the thigh to the leg by transversing through this fossa
36
what are the** boundaries of the popliteal fossa**?
* superior - semimembranosus (medial) and biceps femoris (lateral) * inferior - gastrocnemius - medial and lateral heads * floor - popliteal surface of femur, popliteus muscle, oblique popliteal ligament * roof - skin and fascia lata
37
what are the** contents of the popliteal fossa**?
* tibial nerve * common fibular nerve * popliteal artery * popliteal vein * small saphenous vein * fat * lymphatics
38
what are th**e compartments of the leg**?
* anterior * lateral * posterior - superficial * posterior - deep
39
what muscles are in the anterior compartment of the leg?
* tibialis anterior * extensor digitorum longus (toe expect big toe extensor) * extensor hallucis (big toe) extensor * fibularis tertius
40
what are the main actions of the anterior muscles of the leg?
* dorsiflexors of foot at ankle joint * extensors of the toes
41
what nerve innervates the muscles of the anterior compartment of the leg?
* deep fibular nerve ( a branch of the common fibular nerve)
42
what muscles make up the **posterior SUPERFICIAL compartment **of the leg?
* gastrocnemius * soleus * plantaris
43
what muscles make up the** posterior DEEP compartment** of the leg?
* popliteus muscle * tibialis posterior * flexor digitorum longus * flexor hallucis longus
44
what are the main actions of the muscles of the posterior compartment of the leg?
* plantarflexion of foot and toes * flexing at the knee
45
what nerve innervates the muscles of the posterior compartment of the leg?
tibial nerve
46
what muscles are in the lateral compartment of the leg?
* fibularis longus * fibularis brevis
47
what is the main function of the muscles of the lateral compartment of the leg?
evert the foot at the sole
48
what nerve innervates the muscles of the lateral compartment of the leg?
all superficial fibular (peroneal) nerve
49
what are the main arteries of the leg?
* popliteal artery (branch of femoral artery) * malleolar arteries * genicular arteries
50
how does the sciatic nerve supply the posterior leg?
* tibial nerve - posterior compartment of the leg * common peroneal / fibular nerve - wraps around head of fibula and splits into superficial and deep
51
what is acute compartment syndrome?
* occurs due to trauma of the leg - most commonly a fracture * the pressure within a closed muscle compartment exceeds the perfusion pressure and results in muscle and nerve ischemia
52
what is the unhappy triad injury of the knee?
an injury involving the **tearing** of the **anterior cruciate ligament**, **medial collateral ligament** and the **medial meniscus**
53
what can happen to the foot as a result of a common peroneal nerve injury?
dropped foot - as the anterior muscles of the leg act to dorsiflex the ankle and extend the digits , the lateral compartment of the leg everts the foot - damage to the fibular nerve results in a loss of these actions
54
what is the origin and insertion of the tibialis anterior muscle? | (anterior compartment of leg)
* origin - lateral tibial condyle * insertion - medial cuneiform bone and base of metatarsal bone 1
55
what is the origin and insertion of the extensor hallucis longus muscle? | (anterior compartment of leg)
* origin - medial surface of fibula and interosseous membrane * insertion - base of distal phalanx of great toe
56
what is the origin and insertion of the extensor digitorum longus muscle? | (anterior compartment)
* medial surface of fibula, lateral tibial condyle * insertion - distal and middle phalanges of 2-5
57
what muscles of the leg are involved in dorsiflexion?
* tibialis anterior * extensor hallucis longus * extensor digitorum longus * fibularius tertius
58
what muscles are involved in **eversion** of the foot?
* extensor digitorum longus * fibularis tertius * fibularis longus (lateral compartment) * fibularis brevis (lateral compartment)
59
what muscles are involved in inversion of the foot?
* tibialis posterior * flexor digitorum longus * flexor hallucis longus
60
what is the origin and insertion of the gastrocnemius muscle? | posterior - superficial
* **lateral** head - lateral femoral condyle * **medial **head medial femoral condyle * insertion - both heads onto the **posterior surface of the calcaneus** (ie calcaneal tendon)
61
where does the soleus muscle originate and insert onto?
* originates on the soleal line of the tibia, head of filbula * inserts onto the posterior surface of the calcaneous bone or the calcaneal tendon
62
where does the tibialis posterior muscle originate and insert onto?
* originates on the** posterior surface of the tibia**, **posterior surface of the fibula ** * inserts onto the** tuberosity of the navicular bone**, **all cuneiform bones** and **bases of metatarsals 2-4**
63
where does the flexor digitorum longus originate and insert?
* O- posterior surface of tibia (inferior to soleal line) * I- bases of the distal phalanges 2-5
64
where does the flexor hallucis longus originate and insert onto?
* O- posterior surface of fibula, interosseus membrane * I- base of distal phalanx of great toe

anatomy - physio (17 decks)

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