Week 7 - The knee

Question 1

What joints make up the knee joint?

Answer 1

Femorotibial and Patellofemoral joint

Question 2

What type of joint is the knee joint?

Answer 2

Synovial joint

Question 3

What types of movements occur at the knee joint?

Answer 3

Flexion, extension, medial and lateral rotation in flexion

Question 4

What degrees of rotation can occur in flexion?

Answer 4

10 degrees medial and 30 degrees lateral. This will vary amongst the population.

Question 5

Where is the flexion axis at the knee?

Answer 5

Through the centre of the femoral condyle

Question 6

What accessory movements is the knee capable of?

Answer 6

Rolling and gliding

Question 7

What is the screw home mechanism at the knee and when does it occur?

Answer 7

Normal knee can ‘lock’ at the end range extension, to conserve energy in stand. The femur medial rotates on the tibia to lock into place.

Question 8

What is varus and valgus forces?

Answer 8

Varus forces (horse rider) legs bow outward at the knee, valgus forces (L) legs bow inward at the knee

Question 9

Extrasynovial: medial and lateral retinaculum - proximal and distal attachments, and what does it limit?

Answer 9

P: medial and lateral aspect of the patella and patellar tendon/ligament

D: ITB, collateral ligaments

Limits: Lateral and medial patella glide

Question 10

Extrasynovial: Medial (Tibial) Collateral ligament (MCL) proximal and distal attachments and what does it limit and what assists it?

Answer 10

P: medial epicondyle femur

D: superior medial tibia

Limits: genu valgum
Assisted by: Pes anserinus

Question 11

What bony landmarks does the patella ligament insert into?

Answer 11

Tibial tuberosity

Question 12

What muscles insert into Pes anserinus

Answer 12

Say Grace before Tea - Sartorius, Gracillis, Semitendinosus

Question 13

Extrasynovial: Lateral (Fibular) Collateral ligament (LCL) proximal and distal attachments and limits and what assists this ligament?

Answer 13

P: lateral epicondyle femur

D: superior lateral fibula

Limits: genu varum
Assisted by: ITB

Question 14

Extrasynovial: Medial (Tibial) Collateral ligament (MCL) proximal and distal attachments which limits what movements? What assists this ligament?

Answer 14

P: medial epicondyle femur

D: superior medial tibia

Limits: genu valgum
Assisted by: Pes Anserinus

Question 15

What are the two popliteal ligaments, where are their attachments and and what are their limits?

Answer 15

Arcuate popliteal and Oblique popliteal

Attachments: posterior

Limits: limits screw home mechanism and hyperextension

Question 16

What would need to tear if the patella dislocated and tracked laterally?

Answer 16

Medial patella retinaculum

Question 17

Intrasynovial: Anterior Cruciate ligament (ACL) attachments and limits

Answer 17

P: posterior part of the medial surface of the lateral femoral condyle

D: anterior intercondylar area of the tibia

Limits: hyperextension, anterior tibial glide on the femur, posterior glide of femur on tibia, posterior rolling of condyle. Internal rotation of the tibia on the femur.

Question 18

Intrasynovial: Posterior Cruciate Ligament (PCL) attachments and limits

Answer 18

P: anterior part of the lateral surface of the medial femoral condyle

D: posterior intercondylar area of the tibia

Limits: hyperflexion, posterior tibial glide on the femur, anterior femur glide on the tibia, anterior rolling of the femoral condyles.

Question 19

Medial meniscus attachments and function

Answer 19

A: Anterior intercondylar area of tibial
plateau anterior to ACL

P: Posterior intercondylar area on Tibial
plateau anterior to PCL

Function: deepen the articulation,
absorb shock and migrate to
accommodate rolling and rotation of the
femoral condyles

Question 20

What is the relationship between the medial meniscus to the medial collateral ligament and why is this important?

Answer 20

The medial meniscus is attached to the medial collateral ligament. And this is important, because if one is damaged, the might also be damaged.

Question 21

Lateral meniscus attachments and function

Answer 21

A: Intercondylar fossa on Tibial plateau close
to posterior attachment of medial meniscus

P: Intercondylar fossa on Tibial plateau close
to anterior attachment of medial meniscus

Function: deepen the articulation, absorb
shock and migrate to accommodate rolling
and rotation of the femoral condyles

Question 22

How many Bursae does the knee have? What are the three main ones?

Answer 22

12,

Suprapatellar bursa

Subcutaenous prepatellar bursa

Infrapatellar bursa

Question 23

Infrapatellar (Hoffa’s) fat pad

Answer 23

One of the knee fat pads interposed between the joint capsule and the synovium just below and deep to the patella

Question 24

Extensors of the knee and synergist

Answer 24

Rectus femoris, vastus lateralis, vastus medialis and synergist is TFL

Question 25

Flexors of the knee and synergist

Answer 25

Semitendinosus, Semimembranosus, Bicep femoris

Synergist: adductor magnus