Week 4 - knee joint, thigh Flashcards

1
Q

femoral triangle

A

triangular shaped depression in the proximal part of the anteromedial thigh
contains: femoral vein, artery and nerve

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2
Q

upper border

A

inguinal ligament

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3
Q

medial border

A

adductor longus

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4
Q

lateral border

A

sartorius - medial border

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5
Q

floor

A

iliopsoas, pectineus and adductor longus

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6
Q

roof

A

overlying fascia lata and superficial fascia

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7
Q

fermoral nerve

A

anterior compartment of thigh
- rectus femoris, vatus lateralis/medialis/intermedius, pectineus, sartorius

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8
Q

saphenous nerve

A

terminal branch of the femoral nerve, cutaneous only
travels with the femoral artery and vein in anteromedial thigh

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9
Q

femoral artery

A

medial structure of femoral triangle
provides entire blood supply to the lower extremity

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10
Q

profunda Femrosi artery

A

aka deep artery of thigh
main brain of the femoral artery

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11
Q

femoral vein

A

medial structure of triangle, provides entire blood supply to the lower extremity

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12
Q

femoral sheath

A

though fascial sheet that encloses the femoral artery, veins and lymph nodes
facilities gliding of the vessels under the inguinal ligaments during hip movement

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13
Q

anterior compartment of thigh - location

A

starts at the level of the inguinal ligament
extends to the knee joint

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14
Q

anterior thigh muscle (4 + 4)

A

sartorius
quadriceps femoris
- rectus femoris
- vastus lateralis
- vastus medialis
- vastus intermedius
iliacus
psoas major

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15
Q

anterior thigh actions

A

hip flexion and knee extension

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16
Q

anterior thigh nerve

A

femoral nerve only major nerve supplies all but the psoas major

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17
Q

anterior thigh blood supply

A

profunda femoris is the main artery

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18
Q

psoas major

A

origin: transverse processes, vertebral body and discs (T12, L5)
insertion: less trochanter
nerve supply: branch of lumbar plexus
nerve root: anterior rami L1 to L3

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19
Q

iliacus

A

origin: iliac fossa
insertion: less trochanter
nerve supply : femoral nerve
nerve roots: L2, L3

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20
Q

iliopsoas action

A

powerful hip flexor from standing or si up where hip felxes on a fixed femur

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21
Q

sartorius

A

origin: anterior superior iliac spine
insertion: anteromedial surface of proximal tibia
nerve: femoral nerve
nerve root: L2, L3

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22
Q

quadriceps + extensor mechanism (4)

A

all insert onto the tibial tuberosity via the extensor mechanism
- quads tendon, patella, patellar lig, tibial tuberosity

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23
Q

rectus femoris

A

origin: straight head - anterior iliac spine. reflected head - upper margin or acetabular rim
insertion: tibial tuberosity via quads mechanism
nerve supply: femoral nerve
root: L2, L3, L4

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24
Q

vastus lateralis

A

origin: lateral intertrochanteric line, gluteal tuberosity and upper 1/2 of lateral linea aspera
insertion: tibial tuberosity via quads mechanism
nerve: femoral
root: L2-L4

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25
vastus medialis
inferomedial intertrochaneric line, medial lip of linea aspera and upper 1/3 medial supracondylar line insertion: tibial tuberosity vua quads mechanism nerve: femoral root: L2 - L4
26
vastus medialis - obliquus fibers
lowe fibers help track horizontally to help track the patellar medially
27
vastus intermedius
origin: upper 2/3 of the anterior and lateral shaft of femur insertion: tibial tuberosity of quads mechanism nerve supply: femoral nerve root: L2 -L4
28
femoral nerve - motor supply
rectus femoris, vastus lateralis/medialis/intermedius, pectineus and sartorius
29
femoral nerve cutaneous supply
skin on front of the thigh to anterior knee
30
femoral artery
continuation the external iliac, enters anterior thigh femoral triangle, femoral artery descends in anteromedial thigh
31
profunda femoris artery - branches
descends deep in the thigh and along its course gives 3-4 perforating branches which travel to the medial compartment and pierce the openings in adductors magnus to enter the posterior thigh
32
medial circumflex femoral artery
travels into the back of the thigh joins the inferior gluteal artery, provides branches to neck of femur
33
lateral circumflex femoral artery
has transverse, ascending and descending branches supplies adjacent quads head and neck of femur and anastomoses around knee
34
medial compartment of thigh location
on the anteromedial side of the thigh commonly referred to as the 'groin' muscles or adductor group
35
medial thigh muscles (5)
pectineus, adductor longus, adductor brevis, adductor magnus, gracilis
36
medial thigh actions
hip adduction, help with flexion and maybe hip internal rotation
37
anterior thigh nerves (2)
obturator nerve, saphenous nerve
38
adductor canal - medial thigh hunters canal, subsartorial canal
passageway for the femoral artery, vein and saphenous nerve - runs from femoral triangle, the adductors canal between sartorius and adductor longus
39
pectineus
origin: pectineal line of pubis insert: base of lesser trochanter to start of linea aspera nerve: femoral root: L2-L3
40
adductor longus
origin: body of pubs just inferior to pubic crest insert: middle third of medial lip of linea aspera nerve: obturator root: L2-L4
41
adductor brevis
origin: body and inferior ramus of pubic insert: pectineal line and upper 1/3 of medial lip of linea aspera nerve: obturator root: L2-L3
42
adductor magnus
largest and most powerful of adducotrs and is made of adductor part and hamstring part below the brevis
43
adductor magnus - adductor
origin pubic ramus and ramus of the ichium insert: below the greater trochanter medial lip of linea aspera to medial supracondylar line nerve supply: obturator root: L2-L4
44
adductor magnus - hamstring
origin: ischial tuberosity insert: adductor tubercle on distal femur nerve: sciatic - tibial part nerve root: L4
45
adductor Hiatus
opening between the distal attachment of the adductor and hamstring part of adductor magnus - passageway for femoral artery and vein to and from popliteal fossa
46
gracilis
origin: inferior pubic ramus insert: anteromedial side of prox. tibia nerve: obturator root: L2-L3
47
pes anserine tendon (3)
semitendinosus gracilis sartorius
48
adductor function
bidirectional action during walk, sprint and skate - weight bearing leg: stabilize the pelvis - non-weight bearing: helps flex and adduct the legs
49
obturator nerve anterior and posterior branch
ant: gracilis, adductor longus and brevis post: adductor magnus - adductor
50
obturator nerve - cutaneous supply
area of skin on medial side of the thigh
51
knee joint function
synovial modified hinge joint - large and complicated mobility and stability
52
knee joint movement
flexion, extension, internal and external rotation
53
knee joint articulation (3)
medial, lateral femorotibial and pateelofemoral
54
femorotibial articulations
medial and lateral condyles of femur sits on top of the medial and lateral condyles of tibia
55
bony congruence
rounded femoral condyle, flat tibial condyles, little bony congruence of articular surface
56
factors for stability knee joint
shape and thickness of menisci fibrous joint capsule integrity of ligs strength of muscles around
57
locking mechanism standing - knee
- occurs during the last 15 degrees of extension - mobile femur internally rotates on the fixed tibia - locks knee into place , increase bony congruence and reduces amount of muscle energy required for standing
58
medial meniscus
crescent-shaped, linger front to back, attached firmly around periphery to joint capsule and ML, less mobile
59
lateral meniscus
more round, shorter, and less firmly attached around the periphery, more mobile
60
transverse ligament of knee
connects anterior horn of medial and lateral menisci
61
patellofemoral articulation
formed by the articular surface on posterior aspect and the V-shaped patellar surface or groove of distal femur
62
patellofemoral articulation - joint surface
lateral side of femoral patellar surface is larger and steeper the corresponding lateral fascet is larger and steeper keeps patella in the groove and prevents lateral dislocation
63
fibrous joint capsule anterior
attaches ABOVE just prox. to the ant. margins of the femoral condyles attaches BELOW - just around the tibial articular margins reinforced in the front by quads tendon, patella and patellar lig.
64
fibrous capsule - posterior
encloses the femoral condyles and intercondylar fossa not complete - opening for tendon popliteus reinforced by the oblique popliteal ligament and arcuate popliteal ligament
65
synovial membrane
largest in the body covers femoral and tibial condyles, posterior surface of the patella and around the edges of the menisci
66
suprapatellar bursa
synovial membrane is particularly large at the front extends 3-4 fingerbreadths above patella articularis genu muscle pulls the bursa away from the knee joint surfaces during knee extension
67
infrapatellar fat
between the patellar lig and synovial membrane pushes synovial membrane into intercondylar area
68
knee ligaments (5)
lateral collateral lig medial collateral lig patellar lig oblique popliteal lig arcuate popliteal lig
69
MCL
blends closely with medial joint capsule attaches proximally from the femoral epicondyle just distal to the adductor tubercle attaches distally to the medial condyle and medial side of tibia
70
MCL function
force separates joint surface medially after valgus and it resists this
71
lateral collateral ligament
a stout cord like attaches prox from lateral femoral epicondyle attaches distally to the head of fibuls
72
lateral collateral ligament function
resist blow to inside of the knee - VARUS force
73
patellar tendon/ligament
front of knee is reinforced the lig is reinforced by the medial and lateral patellar retinaculum which hold the patella in place medially and laterally
74
oblique popliteal ligament
extension of semimembranosus attaches from medial tibial condyle and runs upwards and laterally to the insert on lateral femoral condyle resists knee hyperextension
75
oblique arcuate ligament
Y shaped, lower stem attached from head of fibular to run up to posterior joint capsule resist knee hyperextension
76
ACL
anterior attachment: anterior intercondylar area posterior attachment: medial aspect of lateral femoral condyle
77
ACL function
anterior translation of femur 86% restraint hyperextension medial displacement of tibia in relation to femur
78
PCL
posterior attachment: posterior intercondylar area anterior attachment: lateral aspect of the medial femoral condyle
79
PCL function
posterior translation of tibia about 94% restraint hyperflexion lateral displacement of tibia in relation to femur
80
knee joint blood supply (branches 5)
provided by the genicular arterial profunda femoris femoral popliteal posterior and anterior tibial artery
81
knee joint nerve supply (5 branches)
femroal saphenous tibial common peroneal obturator