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Extremities (2) > Unit 4- Knee > Flashcards

Unit 4- Knee Flashcards

1
Q

What type of joint is the knee joint?

What movements does it allow?

A

Hinge joint

Flexion and extension

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2
Q

The knee movements are accompanied by ____ and _____, in addition to:

A

Gliding
Rolling

Rotation about a vertical axis

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3
Q

When is the knee’s function most often at risk?

A

During hyperextension

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4
Q

Articulations of the knee:

A

2 femorotibial (between lateral and medial femoral and tibial condyles)

1 intermediate femoralpatellar (between the patella and femur)

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5
Q

Is the fibular involved in the knee joint?

A

No

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6
Q

Most important muscles in stabilizing the knee:

A

Quadriceps femoris

Particularly the fibers of the vastus lateralis

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7
Q

What does the stability of the knee joint depend on?

A

Strength and actions of surrounding muscle and tendons

Ligaments connecting the femur and tibia

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8
Q

What lines the internal surface of the articular cavity, not covered by articular cartilage, in the knee joint capsule?

A

Internal synovial membrane

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9
Q

Contents of the joint capsule

A

External fibrous layer

Internal synovial membrane

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10
Q

The fibrous layers attaches to the _______ Superiorly, just proximal to the:

A

Femur

Articular margins of the condyles

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11
Q

What does the joint capsule enclose posteriorly?

A

The condyles and the intercondylar fossa

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12
Q

The fibrous layer of the joint capsule has an opening posterior to the _____ _____ _____ to allow the _____ tendon to pass out of the joint capsule and attach to the ______

A

Lateral tibial condyle

Popliteus

Tibia

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13
Q

Inferiorly , the fibrous layer attaches to the margins of the:

A

Articular surface of the tibia (tibial plateau)

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14
Q

What are intimately applied to the fibrous capsule anteriorly?

A

Quadriceps tendon

Patella

Patellar ligament

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15
Q

What does the synovial membrane line?

A

The internal aspects of the fibrous capsule

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16
Q

What does the synovial membrane attach to?

A

The periphery of the patella and the edges of the cartilaginous menisci

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17
Q

The synovial membrane reflects from the ______ aspect of the joint anteriorly into the ____ ____, covering the ____ _____ and the ____ _____ ___ separating them for the articular cavity.

This creates a:

A

Posterior

Intercondylar region

Cruciate ligaments

Infrapatellar fat pad

Mediaian infrapatellar synovial fold

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18
Q

A vertical fold of synovial membrane that approaches the posterior aspect of the patella creating left and right femoral tibial articular cavities

A

Medial infrapatellar synovial fold

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19
Q

What do the fat filled lateral and medial alar folds cover?

A

The inner surface of the fat pads that occupy the space on each side of the patellar ligament internal to the fibrous layer

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20
Q

Where does the superapatellar bursa lie?

A

Superior to the patella (duh)

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21
Q

The knee cavity extends deep to the vastus lateralis as the:

A

Suprapatellar bursae

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22
Q

What forms the articular muscle of the knee?

A

Muscle fibers of the vastus intermedius

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23
Q

Muscle fibers of the vastus intermedius attach to the ___ _____.

What is its action?

A

Synovial membrane

Retracts the bursa during knee extension

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24
Q

What extracapsular ligaments strengthen the joint capsule?

A

Patellar ligament

Fibular (lateral) collateral ligament

Tibial (medial) collateral ligament

Oblique popliteal ligament

Arcuate popliteal ligament

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25
Q

Distal ligament to the quadriceps tendon

A

Patellar ligament

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26
Q

Pathway for the patella ligament

A

Passes from the apex and margins of the patella to the tibial tuberosity

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27
Q

The patellar ligament laterally receives aponeurosis expansions of the _____ ___ and _____.

These are important for:

A

Vastul lateralis and medialis (medial and lateral retinacula)

Maintaining the alignment of the patella

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28
Q

When are the collateral ligaments taut?

When are they lax?

A

In extension

In flexion- allows rotation of the knee

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29
Q

Pathway of the fibular (lateral) collateral ligament

A

Extends inferiorly from the lateral epicondyle of the femur

To the lateral surface of the head of the fibula

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30
Q

What tendon passes deep the the fibular (lateral) collateral ligament? What does this separate?

A

The tendon of the popliteus

The FCL from the lateral meniscus

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31
Q

The fibular collateral ligament splits what tendon?

A

Tendon of the biceps femoris

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32
Q

Tibial (medial) collateral ligament (TCL) pathway

A

Extends from the medial epicondyle of the femur

To the medial condyle and superior medial surface of the tibia

33
Q

The deep fibers of the TCL are attach to the:

A

Medial meniscus

34
Q

A reflected expansion of the tendon of semimembranosus that strengthens the joint capsule posteriorly

A

Oblique popliteal ligament

35
Q

Pathway of the oblique popliteal ligament

A

Arises from the medial tibial condyle

Passes superolaterally to the central part of the posterior aspect of the joint capsule

36
Q

What does the arcuate popliteal ligament strengthen?

A

The capsule posterolateral

37
Q

Pathway of the arcuate popliteal ligament

A

Arises from the posterior aspect of the fibular head

Passes supero-medially over the popliteal tendon and attaches to the post surface of the knee joint

38
Q

Intra-articular ligaments

A

Crusiate

Menisci

Popliteus

39
Q

Cruciate ligaments join the ___ to the _____, crossing _____ the joint but outside the:

A

Femur

Tibia

Within

Articular cavity

40
Q

How do the cruciate ligaments cross?

A

Obliquely

41
Q

During medial rotation of the tibia on the femur, the cruciate ligaments do what?

This limits:

A

They wind around each other

Limits the amount of medial rotate to 10 degrees

42
Q

Cruciate ligaments allof ____ of lateral rotation when the knee is flexed at >90 degrees

A

Approx 60 degrees

43
Q

The cross over point of cruciate ligaments serves as an axis for:

A

Rotatory movements

44
Q

Which cruciate ligament is weaker of the 2?

A

Anterior cruciate ligament

45
Q

The anterior cruciate ligament (ACL) pathway

A

Extends superiorly posteriorly and laterally to the post part of the medial side of the lateral condyle of the femus

46
Q

What does the ACL limit?

A

The post rolling of the femoral condyles on the tibial plateau during flexion converting it into rotation

47
Q

The ACL prevents:

A

Post displacement of the femur on the tibia and hyperextension of the knee joint

48
Q

Because of the ACL, when the joint is flexed, the tibia (CAN/CANNOT) be pulled anteriorly

A

Cannot

49
Q

Pathway of the posterior cruciate ligament (PCL)

A

Arises from post. Condylar area of the tibia

Passes superiorly and anteriorly of the medial side of the ACL
Attaches to the ant part of the lateral surface of the medial condyle of the femur

50
Q

The PCL limits what?

A

Anterior rolling of the femus on the tibial plateau during extension, converting it to rotation

51
Q

The PCL also prevents anterior displacement of:

Or posterior displacement of:

A

The femur on the tibia

The tibia on the femur
Helps prevent hyperflexion of the knee joint

52
Q

PCL function in the weight bearing flexed knee

A

It is the main stabilizing factor for the femur

53
Q

Between ACL and PCL, which is under tension when knee is extended?

When knee is flexed?

A

ACL

PCL

54
Q

Cresent-shaped plated of fibrocartilage on the articular surface of the tibia. They serve to deepen the joint surface and provide shock absorption

A

Menisci of the knee

55
Q

Where are the menisci thicker?

A

At the outer margins

They taper to thin inner margins

56
Q

Menisci are firmly attached where?

A

At their ends to the intercondylar area of the tibia

57
Q

Where are the external margins of the Menisci attached?

A

To the fibrous joint capsule

58
Q

Capsular fibers that attach the margins of the menisci to the tibial condyles

A

Coronary ligaments

59
Q

Ligament that joins the anterior margins of the menisci together

A

Transverse ligament

60
Q

C shaped meniscus that is broader posteriorly

A

Medial meniscus

61
Q

Anterior horn of the medial meniscus attaches where?

A

To the anterior intercondylar area anterior to the attachment of the ACL

62
Q

The posterior end of the medial meniscus attaches where?

A

To the posterior intercondylar area anterior to the attachment of the PCL

63
Q

The medial meniscus is firmly adherent to the:

A

Deep surface of the tibial collateral ligament

64
Q

Circular, smaller and more mobile meniscus

A

Lateral meniscus

65
Q

What separates the lateral meniscus from the fibular collateral ligament?

A

The tendon of popliteus

66
Q

What ligament joins the lateral meniscus to the PCL and the medial femoral condyle?

A

Posterior meniscofemoral ligament

67
Q

How many bursa are around the knee joint?

Why?

A

At least 12

Most tendons run parallel to the bones and pull lengthwise across the joint during knee movements

68
Q

Where are the subcutaneous prepatellar and infrapatellar bursae located?

What do they allow?

A

At the convex surface of the joint

Allow the skin to be able to move freely during knee movements

69
Q

4 bursae that communicate with the articular cavity of the knee joint

A

Suprapatellar bursa (deep to the distal quads)

Popliteus bursa

Anserine bursa

Gastrocnemius bursa

70
Q

Arteries supplying the knee joint that form the perigenicular anastomoses around the knee

A

Popliteal

Superior lateral, superior medial, middle, inferior lateral, inferior medial and descending genicular arteries

Descending branch of the lateral femoral circumflex artery

Anterior tibial recurrent branch of the tibial artery

71
Q

Major blood supply to knee ligaments and synovial joint capsule

A

Middle genicular artery

72
Q

Hilton’s law

A

The nerves supplying the muscles acting on the knee also innervate the joint

73
Q

What nerves supply the anterior knee?

A

Articular branches of the femoral nerve

74
Q

Nerve supply to the posterior knee

A

Tibial nerve

75
Q

Nerve supply of the lateral aspect of the knee:

A

Common fibular nerve

76
Q

Nerves that supply genicular articular branches

A

Obturator and saphenous nerves

77
Q

Movements of the knee

A

Flexion and extension

Some rotation when also flexed

78
Q

What causes the knee to “lock”?

A

When leg is extended, this causes medial rotation of the femur on the tibia, allowing weigh bearing without muscular exertion by the leg muscles

79
Q

How to unlock the knee

A

The popliteus contracts rotating the femur lateral approx 5 degrees on the tibial plateau allowing flexion to occur

Extremities (2) (28 decks)

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