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anatomy > week 5 > Flashcards

week 5 Flashcards

1
Q

Convex-concave golden rules

A

Rule #1: Where the “male” joint surface is moving then roll and glide occur in opposite directions
Rule #2: Where the “female” joint surface is moving then roll and glide occur in the same directions

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2
Q

What is the screw home mechanism?

A
  • SPIN
    *The rotation between the tibia and the femur that occurs during terminal knee extension
    ➢Medial femoral condyle is larger than the lateral femoral condyle
    *“Knee locking”
    When does it occur
    *During extension, the lateral side of the joint completes the motion, resulting in the tibia laterally rotating in the last 20o of knee extension.
    *Lateral rotation causes a passive tension in the ACL which creates a fulcrum for lateral rotation and causes it to cross over the PCL and “lock” the knee joint into extension.
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3
Q

How does the patella move?

A
  • Extension: the patella is NOT in contact with the trochlear groove
    • 10-20° of knee flexion: the inferior margin of patella articulates with trochlear groove of femur
    • As knee flexion increases the contact area of the patella moves proximally
    • As knee flexion increases the contact area of the condyles moves posteriorly
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4
Q

Factors contributing to stability at the knee joint

A
  1. STATIC(passive):combination of non contractile and bony elements
    e.g. menisci, ligaments, capsule, articular cartilage, ITB
  2. DYNAMIC (active): muscles acting on or across the
    knee joint
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5
Q

Static: Menisci functions at knee joint

A
  1. withstand load bearing forces
    2. increase contact area at the tibiofemoral joint → reduces stress at the joint surfaces
    3. assist in movement of femoral condyles
    4. assist in stabilising translatory movements
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6
Q

what attaches to Medial meniscus

A
  • medial collateral lig
    • anterior and posterior cruciate ligs
  • semimembranosus
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7
Q

what attaches to Lateral meniscus

A
  • posterior cruciate lig
    • medial femoral condyle via meniscofemoral ligs
  • popliteus
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8
Q

Movements of the menisci

A

Considerable distortion throughout range
* Both move posteriorly during flexion (lateral > medial)
* Keeps the menisci under the femoral condyles
*Both active and passive elements contribute to movt.

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9
Q

Static: Ligaments

A
  • Combinations of structures provide stability at the knee – no single structure in isolation
    * Concept of primary and secondary restraints
    * ✓work together to provide stability
    ✓primary restraints – ‘workers’
    ✓secondary restraints – ‘helpers’
    * If primary restraint is damaged, the secondary restraint takes the load -> deterioration and increased joint instability
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10
Q

static- anterior tibial displacement 1st & 2nd restraint

A

primary- ACL
secondary- MCL,ITB

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11
Q

static- posterior tibial displacement 1st & 2nd restraint

A

primary- PCL
secondary- MCL,LCL, obligue popliteal ligament

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12
Q

static- abductor (valgus) 1st & 2nd restraint

A

primary- MCL
secondary- ACL, PCL, posterior oblique ligament

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13
Q

static- adduction (varus) 1st & 2nd restraint

A

primary- not ligamentous
secondary- LCL, posterolateral corner

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14
Q

static-internal tibial rotation 1st & 2nd restraint

A

primary- MCL, posteromedial corner
secondary- ACL, PCL

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15
Q

static- external tibial rotators 1st & 2nd restraint

A

primary- posteolateral corner complex
secondary- ACL, PCL

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16
Q

Dynamic: Iliotibial band (ITB)

A
  • Part of the more extensive fascia lata
    • Attachments:
      • From the fascia surrounding tensor fascia lata and gluteus maximus and medius
      • Extends to the anterolateral tibia
  • Crosses both hip and knee
  • Has fibrous connections to biceps femoris, vastus lateralis and the lateral patellar retinaculum – may influence patella tracking through these connections
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17
Q

iliotibial band functions

A
  • Affords some lateral joint stability particularly in flexion
    Assists ACL in preventing anterior slide of tibia on femur
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18
Q

Quadriceps femoris – function

A
  • Major extensor of knee
  • All parts of quadriceps femoris work
    throughout the range of knee extension
  • Stabilises the patella within trochlear groove
  • Greatest force needs to be developed at the end of extension range – final 15degs greatest mechanical disadvantage
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19
Q

Vastus medialis – actions and functions

A
  • Vastus medialis – longitudinal fibres (strongly bound to vastus intermedius proximally)
  • Knee extensor
  • Vastus medialis – oblique fibres
  • Weak knee extensor
  • Prominent activation in last 40o of knee extension
  • Medial patella stabiliser – prevents vastus lateralis from laterally dislocating the patella
  • Increases the efficiency of vastus lateralis in knee extension by realigning pull
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20
Q

Tibiofibular joints

A
  • Three joints:
    • Superior tibiofibular joint
    • synovial, mulitaxial, plane
    • Intermediate tibiofibular joint
    • fibrous(syndesmosis)
    • interosseusmembrane
    • long fibres
    • Inferior tibiofibular joint
    • fibrous(syndesmosis)
    • short fibres
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21
Q

Ankle (talocrural) joint Classification and movement

A
  • Classification
  • Synovial, uniaxial, hinge
  • Movements
  • Dorsiflexion 30°
    Plantarflexion 50°
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22
Q

Articular surfaces

A
  • Tibia – “female” surface
     Inferior (trochlear) surface of the tibia
     Medial (tibial) and lateral (fibular) articular facets
  • Talus - male surface
     Tibiotalar surface is weightbearing
     Medial and lateral articular facets are non- weightbearing
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23
Q

Articular structures

A
  • Joint capsule
  • Attaches to the articular margins of the bones involved
  • More extensive anteriorly where it extends onto the neck of the talus
  • Collateral ligaments provide medial and lateral reinforcement to the capsule
24
Q

Medial collateral (deltoid) ligament

A

extensive, triangular in shape
* superficial parts
- tibionavicular
- tibiocalcaneal
- together prevent
abduction at ankle
* deep parts
- anterior tibiotalar
limit plantarflexion
- posterior tibiotalar
limit dorisflexion

25
Q
  • Lateral collateral ligaments
  • Three separate bands
A
  1. Anterior talofibular
    ○ limits plantarflexion
    ○ preventsposterior slide of tib and fib on talus
  2. Posterior talofibular
    ○ limits dorsiflexion
    ○ preventsanterior slide of tib and fib on talus
    3) Calcaneofibular
    ○ limits dorsiflexion
    ○ preventsadductionat ankle
26
Q

Movements between tarsals

A
  • Inversion
    • plantarflexion
    • adduction
    • supination
    • Eversion
    • dorsiflexion
    • abduction
      • pronation
27
Q

Subtalar joint & its classification

A
  • Classification:
  • Synovial, multiaxial, plane
  • Articular surfaces
  • facet on under surface of the talus (female)
  • posterior facet on upper surface of calcaneus (male)
28
Q

Subtalar joints - ligaments

A
  • Interosseous (talocalcaneal) ligament
    ○ two bands both anterior to the joint
    ○ Run almost vertical lyin the space between talus and calcaneus
  • calcaneal parts of the ankle ligaments also cross this joint
29
Q

Talocalcaneonavicular joint (TCN)

A
  • classification: synovial, multiaxial, ball & socket
  • articular surfaces
  • anterior facet on upper surface of calcaneus (female)
  • sometimesintwoparts
  • posterior facet of the navicular (female)
  • plantar calcaneonavicular (spring) ligament
    -head and (partially) neck of the talus (male)
30
Q

TCN - ligaments

A

 Plantar calcaneonavicular (spring) ligament
bifurcate ligament= medial part only

31
Q

Calcaneocuboid joint

A

classification: synovial, multiaxial, plane
* articular surfaces
* facet on anterior surface of calcaneus
* posterior facet of the cuboid

32
Q

Calcaneocuboid joint - ligaments

A
  • plantar calcaneocuboid (short plantar) ligament
  • long plantar ligament
     bifurcate ligament (lateral part only)
33
Q

Tarsometatarsal joint

A
  • classification
  • synovial, multiaxial, plane
  • movements
  • flexion & extension
  • some ab & rotation at the first joint
34
Q

Tarsometatarsal joint

A
  • Articular surfaces
  • 1st metatarsal with medial cuneiform
  • 2nd (recessed) with intermediate cuneiform, as well as medial & lateral cuneiforms
  • 3rd with lateral cuneiform
  • 4th with lateral cuneiform & cuboid
    5th with cuboid
35
Q

Tarsometatarsal joints - ligaments

A

Dorsal & plantar tarsometatarsal ligaments
* limit flexion and extension, respectively
* Cuneometatarsal interosseous ligaments
* 3 slips
* stabilise the tarsometatarsal joint complex
medial part known as Lisfranc ligament

36
Q

Metatarsophalangeal joints classification and movement

A
  • classification
  • synovial, biaxial, condyloid
  • movements
  • flexion and extension
  • abduction and adduction
  • articular surfaces
  • head of the metatarsal
    base of the adjacent phalanx
37
Q

Metatarsophalangeal joints - ligaments

A

Collateral ligaments
* limit flexion
* prevent add and abd in flexion
* Plantar ligaments
* forms part of the articular surface
* Limits extension
* deep transverse metatarsal ligaments
* keeps the metatarsal heads together, particularly important in weight bearing

38
Q

Interphalangeal joints classifications and movements

A
  • classification
  • synovial, uniaxial, hinge
  • movements
  • flexion and extension
  • ligaments
  • collateral ligaments limit flexion
  • plantar ligaments limit extension
39
Q

where is the interosseous border on tibia

A

lateral side of shaft next to solar line on tibia

40
Q

soleal line of tibia

A

medial part of shaft of tibia

41
Q

what type of the synovial joint is the ankle

A

hinge. plantar flexion and dorsiflexion

42
Q

why is the foot being able to do inversion and eversion so important

A

allows to adjust to uneven surfaces/ allows efficiency in gait

43
Q

where is the medial collateral ligament of the ankle

A

medial side/ triangle in shape
sperfitical parts- tibionavicular & tibiocaneal
deep part- anterior tibiotalar & posterior tibiotalar

44
Q

where is the lateral collateral ligament of the ankle and what to those

A

anterior talofibular
posterior talofibular
calcaneofibular

45
Q

what does the anterior talofibular ligament prevent/ limit

A
  • limits plantarflexion
  • preventsposterior slide of tib and fib on talus
46
Q

what does the posterior talofibular ligament limit/ prevent

A
  • limits dorsiflexion
  • preventsanterior slide of tib and fib on talus
47
Q

what does the calcaneofibular ligament limit/ prevent

A
  • limits dorsiflexion
  • preventsadductionat ankle
48
Q

where is the subtler joint located

A

between the posterior part of the navicular and the calcareous

49
Q

where is the talocalcaneonavicular joint located

A

between the talus/ calcareous and navicular

50
Q

where is the calcaneocuboid joint located

A

between posterior calcaneous and posterior cuboid

51
Q

what movements cause inversion (iPADS)

A
  • plantarflexion
  • adduction
  • supination
52
Q

what movements cause eversion

A
  • dorsiflexion
  • abduction
  • pronation
53
Q

where is the pet anserine located and does it communicate with the capsule

A

located between the MCL and the tendons for
sartorius, gracillis and semitendinosis.

This bursa does not
communicate with the synovial capsule of the knee.

54
Q

where is the suprapatellar bursa located and does it communicate with the capsule

A

between the quads tendon and superior surface of the patella and the lower anterior femoral shaft.

This bursa communicates with the synovial capsule of the knee.

55
Q

where is the prepatellar bursa located and does it communicate with the capsule

A

between the anterior surface of the patella and the skin overlying the knee.

does not communicate with capsule

56
Q

where is the infrapatellar bursa located and does it communicate with the capsule

A

deep infrapatellar bursa - between the patella ligament and the anterior superior surface of the tibia.
superficial infrapatellar bursa - between the patella ligament and the overlying skin.

Neither communicates with the synovial capsule.

57
Q
A

anatomy (23 decks)

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