thigh and knee (brian)

Question 1

name the expansions/insertions of semimembranosus

Answer 1

posteromedial tibial plateau (under MCL)

oblique popliteal ligament

posterior capsule+posterior horn medial meniscus

posterior oblique ligament

popliteus aponeurosis

(5 total)

Question 2

what are the boundaries of Hunter’s canal?

Answer 2

vastus medialis (anterior/lateral)

floor: adductor longus (sup) and magnus (inf)
roof: sartorius

Question 3

contents of hunter’s canal

Answer 3

superficial fem a and v

femoral n branch to vastus medialis

saphenous n

Question 4

what fibrous structure encapsulates the structures of hunter’s canal?

Answer 4

vastoadductor membrane

Question 5

distal femur articular angle?

proximal tibia articular angle?

saggital slope of tibial plateau?

Answer 5

distal femur 9 degrees valgus relative to anatomic axis

proximal tibia 3 degrees varus relative to anatomic axis

tibial plateau has 10 degree posterior slope (with menisci acounted for, more like 3 degrees)

Question 6

which tibial plateau is concave/convex?

Answer 6

medial: concave
lateral: convex

remember the “medal pivot” TKA

Question 7

how many facet(s) are on the patella? name them

Answer 7

7 facets

3 medial

3 lateral

1 odd facet medial to medial facets

Question 8

bipartite patella - usualy occurs where?

Answer 8

superolateral pole

Question 9

the medial knee: list structures in the 3 layers

Answer 9

superficial:

medial patellar retinaculum (ant)

sartorial fascia (mid)

gastroc fascia (post)

middle:

MPFL (ant)

SMCL (mid)

semi-M tendon (post)

deep:

capsule

deep MCL

Question 10

the biceps femoris tendon inserts anterior or posterior to LCL on fibular head?

Answer 10

posterior.

LCL is most anterior structure on fibular head

Question 11

what structures comprise the posterolateral corner of the knee? PLC

Answer 11

ITB

biceps femoris

lateral retinaculum

popliteofibular ligament

lateral capsule

popliteus

LCL

arcuate ligament

Question 12

describe the dial test and what a positive result is

Answer 12

ER legs with knees at 30 deg and 90 deg.

>10 deg side to side difference at 30 deg knee flexion only is PLC injury. If occurs at both 30 and 90 deg knee flexion, then =PLC+PCL injury

Question 13

ligament connecting the menisci to the tibial plateau is called what?

Answer 13

coronary ligament

Question 14

What ligament lies anterior and posterior to the PCL insertion?

Answer 14

anterior: humphrey ligament
posterior: wrisberg ligament

Question 15

ACL bundles: name them, and when are they tight?

Answer 15

anteromedial: tight in flexion
posterolateral: tight in extension

Question 16

blood supply to ACL

Answer 16

middle geniculate a

Question 17

ACL insertion is in-line with what knee structure?

Answer 17

anterior horn of lateral meniscus

Question 18

PCL bundles: name them, and when are they tight?

Answer 18

anterolateral: tight in flexion
posteromedial: tight in extension

Question 19

blood supply to PCL

Answer 19

middle geniculate artery

Question 20

when does meniscal blood supply reach adult pattern?

Answer 20

age 10

Question 21

articularis genu muscle: OINA

Answer 21

from anterior femur to suprapatellar bursa

femoral n

pulls suprapatellar bursa during knee extension to avoid being pinched by PFJ

Question 22

popliteal fossa: boundaries?

Answer 22

semiM

biceps femoris

gastroc med and lat heads

Question 23

popliteal fossa: contents?

Answer 23

from lat to med:

common peroneal n

tibial n

pop v

pop a