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Appendicular anatomy > The knee region > Flashcards

The knee region Flashcards

1
Q

Femur (anterior distal)

A

adductor tubercle at distal aspect of supracondylar ridge, medial and lateral condyles and epicondyles, lateral buttress wall, patellar surface

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2
Q

Distal femur (posterior view)

A

linea aspera, medial and lateral supracondylar rige, medial and lateral condyles and epicondyles, popliteal surface, adductor tubercle, intercondylar fossa

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3
Q

Proximal tibia- bony features

A

medial and lateral tibial condyles, tibial plateau, intercondylar eminence (medial and lateral tubercles)- associated with ACL, tibial tuberosity, anterior tibial crest

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4
Q

Proximal fibula- bony features

A

head and neck of fibula, apex of fibula, interosseous membrane

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5
Q

Proximal fibula- nerve

A

common fibular nerve/ common peroneal nerve- wrap around the neck of the fibula- this is sensitive to trauma

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6
Q

Patella bony features

A

sesamoid bones, within quadriceps tendon, patella tendon, triangular shaped, base superior, apex inferior, medial and lateral borders

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7
Q

knee joint classification

A

synovial joint, 3 articulations, protection of underlying tissue, modified bicondylar hinge joint- between femoral and tibial condyles, menisci attaching to tibial articular surfaces, 2 degrees of freedom

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8
Q

patellofemoral joint

A

synovial saddle joint, between patellar and femoral articular surfaces

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9
Q

femoral articular surfaces

A

convex antero posteriorly and medio-laterally, lateral condyle shorter and wider, medial condyle projects more distally, lateral condyle projects more anteriorly, covered in articular cartilage

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10
Q

tibial articular surfaces- shape

A

concave centrally, flatter peripherally covered with semilunar cartilage (menisci),

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11
Q

tibial articular surfaces- articular cartilage

A

medial side is C shaped (inner and thinner), lateral is an O shape (outer and stouter)

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12
Q

patella articular surfaces- posterior- articular facets

A

lateral and medial, odd- only comes into full articulation with the femoral surface on the distal femoral condyle on full flexion

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13
Q

what is the patella function

A

improves mechanical efficiency of the quadriceps muscle group by: increasing lever arm, increasing angular torque

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14
Q

What is the quadriceps angle (Q angle)

A

defined as angle between the quadriceps muscles (in particular RF), and the patellar tendon.

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15
Q

How is the Q angle measured

A

measured as angle between line from ASIS to centre patella and line from centre patella to tibial tuberosity

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16
Q

what does the Q angle represent

A

represents angle of quadriceps muscle force

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17
Q

What is the normal Q angle

A

in men- 13°, in women 18°, <13 or or >18° considered abnormal

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18
Q

what does a Q angle of over 18° mean

A

it may predispose to patellar lateralization- means patella is more lateral than it should be

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19
Q

what is the patellofemoral joint stability dependent on

A

patella position, lateral femoral buttress wall, ratio between VMO and VL- forms muscular tension, tightness of lateral retinaculum

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20
Q

what is VMO and VL

A

VMO- vastus medialis obliquus- stabilizes knee cap and keeps it in line with your bent knee
VL- vastus lateralis muscle

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21
Q

what is alta and baja patella position

A

alta- This is the condition where a person is born with a kneecap (patella) positioned higher in the front of the knee than the average
baja- is an abnormally low lying patella

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22
Q

what is the need for patella femoral joint stability

A

it is all designed to keep patella in the patella groove, if all of this goes wrong, then the patella can dislocate laterally

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23
Q

classification of the superior tibio- fibular joint

A

synovial plane joint

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24
Q

articular surfaces superior tibio- fibular joint

A

articular surfaces- head of fibula, tibial lateral condyle, capsule attached around joint margins

25
Q

ligaments of the superior tibio- fibular joint

A

anterior and posterior ligaments of the fibular head

26
Q

superior tibio- fibular joint- movements

A

small rotational movements during ankle DF and PF (gliding)

27
Q

where does menisci sit

A

the top of the tibio femoral joint

28
Q

shape of menisci

A

medial C shaped, lateral O shaped, medial narrower and thinner, medial less mobile and therefore more easily damaged

29
Q

what are the 2 horns of menisci

A

anterior and posterior

30
Q

what is the medial and lateral meniscus attached to

A

the medial meniscus is blended to capsule and medial collateral ligament, lateral menisci is not attached to lateral capsule or lateral collateral ligament, meaning it is less mobile and less commonly damaged

31
Q

medial meniscus attachment- anterior horn

A

intercondylar area + ACL

transverse and coronary ligaments

32
Q

medial meniscus attachment- posterior horn

A

PCL and posterior horn of lateral meniscus, blends with capsule and medial collateral ligament

33
Q

lateral meniscus attachment- anterior horn

A

anterior intercondylar eminence posterior to ACL

sits inside posterior horn of medial meniscus

34
Q

lateral meniscus attachment- posterior horn

A

posterior intercondylar area anterior to posterior

sits inside posterior horn of medial meniscus

35
Q

meniscus function- stability

A

enhances tibio-femoral joint stability by deepening tibial articular surfaces

36
Q

meniscus function- shock

A

act as shock absorber

37
Q

meniscus function- changing shape

A

conforms to changing shape of femoral condyles during the knee movement

38
Q

meniscus function- borders

A

outer borders- thick and vascular

inner borders- thin and avascular- less able to recover- become mechanical block

39
Q

coronary ligaments

A

medial and lateral, attaches borders of meniscus to tibial plateau

40
Q

knee joint capsule attachments- posteriorly

A

posterior femoral condyles and intercondylar fossa, posterior tibial condyles

41
Q

knee joint capsule attachments- medially

A

blends with gastrocnemius and semimembranosus, medial articular margins femoral and tibial condyles, blends with medial collateral ligament

42
Q

knee joint capsule attachments- laterally

A

lateral femur above popliteus, lateral tibial condyle, fibula head

43
Q

knee joint capsule attachments- anteriorly

A

patella and retinaculum, capsule replaced by quadriceps tendon

44
Q

synovial membrane knee joint capsule

A

synovial membrane projects in posteriorly to envelop but exclude cruciate ligaments (i.e. cruciate are extra synovial but intracapsular)

45
Q

how is the postero- lateral capsule reinforced

A

it is reinforced by extension of semimembranosus tendon called the oblique popliteal ligaments and the ligaments of humphrey and wrisberg- strengthening in posterior capsule

46
Q

anterior cruciate ligament attachments

A

anterior intercondylar area of tibia, runs posteriorly, laterally superiorly, posterior part of intercondylar area of lateral femur condyle

47
Q

Posterior cruciate ligament attachment

A

posterior part of intercondylar area of tibia, runs anteriorly, medially and superiorly, lateral surface of medial femoral condyle

48
Q

what is the action of the cruciate ligament

A

if femur is stationary ACL prevents tibia from translating anteriorly, PCL prevents posterior translation of the tibia on the femur

49
Q

medial (tibial) collateral ligament

A

broad flat ligament, fan shaped, approx 10cm long, medial epicondyle of femur, medial proximal shaft of tibia, blends with knee joint capsule and medial meniscus

50
Q

lateral (fibular) collateral ligament

A

strong rounded cord, proximal: lateral femoral epicondyle, distally: apex of head of fibula, no connection with the capsule of meniscus

51
Q

collateral ligament function

A

MCL limits valgus movement of the tibia on the femur

LCL limits varus movement of the tibia on femur

52
Q

Accessory movement of the knee complex- patello- femoral joint

A

longitudinal caudal excursion, med slide glide, lat side glide

53
Q

Accessory movement of the knee complex- superior tibio fibular joint

A

AP glide, PA glide

54
Q

Accessory movement of the knee complex- knee joint

A

AP glide, PA glide, med slide glide, lat slide glide

55
Q

Accessory movement of the knee complex- patellofemoral medial and lateral slide glide

A

patient is supine with the knee slightly flexed. Medial glide- both hands press on the inferior and superior aspects of the medial patella and deliver a force to glide the patella in a lateral direction. (opposite for lateral)

56
Q

Accessory movement of the knee complex- superior tibio fibular joint- AP glide

A

Often performed with the patient supine and the lower leg propped, reach maximal or near maximal extension. The proximal tibia is stabilized with one hand and the mobilising hand is placed on the distal femur. A posteriorly directed force is applied directly downward through the distal femur.

57
Q

Accessory movement of the knee complex- superior tibio fibular joint- PA glide

A

patient lied in supine with the knee slightly flexed and a prop placed under the distal femur. The stabilizing hand is used to prop the distal femur and the mobilising hand is placed over the proximal tibia just below the tibial tuberosity. The mobilization is performed by a force perpendicular to the line of the tibia.

58
Q

Tibial articular surfaces- condyles

A

medial tibial condyle projects further antero-posteriorly to accommodate medial femoral condyle, lateral condyle is short and thin, covered in articular cartilage

Appendicular anatomy (20 decks)

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