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Pther 350 > Week 4 - knee joint, thigh > Flashcards

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
Q

vastus medialis

A

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

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26
Q

vastus medialis - obliquus fibers

A

lowe fibers help track horizontally to help track the patellar medially

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27
Q

vastus intermedius

A

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

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28
Q

femoral nerve - motor supply

A

rectus femoris, vastus lateralis/medialis/intermedius, pectineus and sartorius

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29
Q

femoral nerve cutaneous supply

A

skin on front of the thigh to anterior knee

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30
Q

femoral artery

A

continuation the external iliac, enters anterior thigh femoral triangle, femoral artery descends in anteromedial thigh

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31
Q

profunda femoris artery - branches

A

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

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32
Q

medial circumflex femoral artery

A

travels into the back of the thigh
joins the inferior gluteal artery, provides branches to neck of femur

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33
Q

lateral circumflex femoral artery

A

has transverse, ascending and descending branches
supplies adjacent quads head and neck of femur and anastomoses around knee

34
Q

medial compartment of thigh location

A

on the anteromedial side of the thigh
commonly referred to as the ‘groin’ muscles or adductor group

35
Q

medial thigh muscles (5)

A

pectineus, adductor longus, adductor brevis, adductor magnus, gracilis

36
Q

medial thigh actions

A

hip adduction, help with flexion and maybe hip internal rotation

37
Q

anterior thigh nerves (2)

A

obturator nerve, saphenous nerve

38
Q

adductor canal - medial thigh
hunters canal, subsartorial canal

A

passageway for the femoral artery, vein and saphenous nerve
- runs from femoral triangle, the adductors canal between sartorius and adductor longus

39
Q

pectineus

A

origin: pectineal line of pubis
insert: base of lesser trochanter to start of linea aspera
nerve: femoral
root: L2-L3

40
Q

adductor longus

A

origin: body of pubs just inferior to pubic crest
insert: middle third of medial lip of linea aspera
nerve: obturator
root: L2-L4

41
Q

adductor brevis

A

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
Q

adductor magnus

A

largest and most powerful of adducotrs and is made of adductor part and hamstring part below the brevis

43
Q

adductor magnus - adductor

A

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
Q

adductor magnus - hamstring

A

origin: ischial tuberosity
insert: adductor tubercle on distal femur
nerve: sciatic - tibial part
nerve root: L4

45
Q

adductor Hiatus

A

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
Q

gracilis

A

origin: inferior pubic ramus
insert: anteromedial side of prox. tibia
nerve: obturator
root: L2-L3

47
Q

pes anserine tendon (3)

A

semitendinosus
gracilis
sartorius

48
Q

adductor function

A

bidirectional action during walk, sprint and skate
- weight bearing leg: stabilize the pelvis
- non-weight bearing: helps flex and adduct the legs

49
Q

obturator nerve
anterior and posterior branch

A

ant: gracilis, adductor longus and brevis
post: adductor magnus - adductor

50
Q

obturator nerve - cutaneous supply

A

area of skin on medial side of the thigh

51
Q

knee joint function

A

synovial modified hinge joint - large and complicated
mobility and stability

52
Q

knee joint movement

A

flexion, extension, internal and external rotation

53
Q

knee joint articulation (3)

A

medial, lateral femorotibial and pateelofemoral

54
Q

femorotibial articulations

A

medial and lateral condyles of femur sits on top of the medial and lateral condyles of tibia

55
Q

bony congruence

A

rounded femoral condyle, flat tibial condyles, little bony congruence of articular surface

56
Q

factors for stability knee joint

A

shape and thickness of menisci
fibrous joint capsule
integrity of ligs
strength of muscles around

57
Q

locking mechanism standing - knee

A
  • 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
Q

medial meniscus

A

crescent-shaped, linger front to back, attached firmly around periphery to joint capsule and ML, less mobile

59
Q

lateral meniscus

A

more round, shorter, and less firmly attached around the periphery, more mobile

60
Q

transverse ligament of knee

A

connects anterior horn of medial and lateral menisci

61
Q

patellofemoral articulation

A

formed by the articular surface on posterior aspect and the V-shaped patellar surface or groove of distal femur

62
Q

patellofemoral articulation - joint surface

A

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
Q

fibrous joint capsule anterior

A

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
Q

fibrous capsule - posterior

A

encloses the femoral condyles and intercondylar fossa
not complete - opening for tendon popliteus
reinforced by the oblique popliteal ligament and arcuate popliteal ligament

65
Q

synovial membrane

A

largest in the body
covers femoral and tibial condyles, posterior surface of the patella and around the edges of the menisci

66
Q

suprapatellar bursa

A

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
Q

infrapatellar fat

A

between the patellar lig and synovial membrane
pushes synovial membrane into intercondylar area

68
Q

knee ligaments (5)

A

lateral collateral lig
medial collateral lig
patellar lig
oblique popliteal lig
arcuate popliteal lig

69
Q

MCL

A

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
Q

MCL function

A

force separates joint surface medially after valgus and it resists this

71
Q

lateral collateral ligament

A

a stout cord like
attaches prox from lateral femoral epicondyle
attaches distally to the head of fibuls

72
Q

lateral collateral ligament function

A

resist blow to inside of the knee - VARUS force

73
Q

patellar tendon/ligament

A

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
Q

oblique popliteal ligament

A

extension of semimembranosus
attaches from medial tibial condyle and runs upwards and laterally to the insert on lateral femoral condyle
resists knee hyperextension

75
Q

oblique arcuate ligament

A

Y shaped, lower stem attached from head of fibular to run up to posterior joint capsule
resist knee hyperextension

76
Q

ACL

A

anterior attachment: anterior intercondylar area
posterior attachment: medial aspect of lateral femoral condyle

77
Q

ACL function

A

anterior translation of femur 86% restraint
hyperextension
medial displacement of tibia in relation to femur

78
Q

PCL

A

posterior attachment: posterior intercondylar area
anterior attachment: lateral aspect of the medial femoral condyle

79
Q

PCL function

A

posterior translation of tibia about 94% restraint
hyperflexion
lateral displacement of tibia in relation to femur

80
Q

knee joint blood supply (branches 5)

A

provided by the genicular arterial
profunda femoris
femoral
popliteal
posterior and anterior tibial artery

81
Q

knee joint nerve supply (5 branches)

A

femroal
saphenous
tibial
common peroneal
obturator

Pther 350 (4 decks)

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