12: Bones, ligaments and joints of leg

Question 1

The patella is the the largest… bone of the body

Answer 1

Sesamoid

Question 2

The patella is suspended in….

Answer 2

The main extensor tendon of the knee

Question 3

The deep surface of the patella articulates with

Answer 3

The patellar surface of distal femur

Question 4

Tibia articulates with

Answer 4

Condyles of femur (superior)
Talus (inferior)

Question 5

Gerdy’s tubercle is an attachment point for…

Answer 5

The iliotibial tract + fascia of lateral thigh

Question 6

What are the two tibiofibular joints

Answer 6

Proximal tibiofibular joint
Distal tibiofibular syndesmosis

Question 7

Ligaments and membrane fibers of tibfib have an… direction

Answer 7

Oblique (inferolaterally from tibia towards fibula)

Question 8

Oblique fibre direction of interosseous membrane allows for…

Answer 8

Upward movement of the fibula during dorsiflexion when the wide end of the trochlea of the talus is wedged between the malleoli

Question 9

What type of joint is the proximal tibiofibular joint

Answer 9

Plane type synovial joint

Question 10

What Innervates the proximal tibiofibular joint

Answer 10

Common fibular nerve
Popliteal nerve

Question 11

What supplies the proximal tibiofibular joint

Answer 11

Inferior lateral genicular artery
Inferior tibial artery

Question 12

3 ligaments at distal tibiofibular syndesmosis

Answer 12

Interosseus tibiofibular ligament
Anterior tibiofibular ligament
Posterior tibiofibular ligament

Question 13

Inferior transverse ligament form….

Answer 13

Posterior wall of the malleolar mortise for the trochlea of the talus

Question 14

Blood supply for distal tibiofibular joint

Answer 14

Branch of fibular artery
Medial malleolar branches of anterior and posterior tibial arteries

Question 15

Innervation of distal tibiofibular joint

Answer 15

Deep fibular, tibial + saphenous nerves

Question 16

What type of joint is the knee joint

Answer 16

Hinge type synovial joint

Question 17

What are the 3 joints in the knee cavity

Answer 17

Lateral tibiofemoral joint
Medial tibiofemoral joint
Intermediate patellofemoral joint

Question 18

What makes up the lateral tibiofemoral joint

Answer 18

Lateral condyles of femur
Lateral meniscus
Lateral condyles of tibia

Question 19

What makes up the medial tibiofemoral joint

Answer 19

Medial condyle of femur
Medial meniscus
Medial condyle of tibia

Question 20

What makes up the intermediate patellofemoral joint

Answer 20

Patella
Patella surface of femur

Question 21

What is the weight bearing joint of the knee

Answer 21

Tibiofemoral joint

Question 22

What does the patellofemoral joint allow for?

Answer 22

The pull of the quadriceps femoris to be directed anteriorly over knee without tendon wear

Question 23

Superior border of knee joint capsule

Answer 23

Articular margins of femoral condyles

Question 24

Posterior border of knee joint capsule

Answer 24

Condyles and intercondylar fossa

Question 25

Inferior border of knee joint capsule

Answer 25

Margin of tibial plateau

Question 26

5 extracapsular ligaments of knee joint

Answer 26

Patellar ligament Fibular collateral ligament Tibial collateral ligament Oblique popliteal ligament Arcuate popliteal ligament

Question 27

Course of patellar ligament

Answer 27

From patella to tibial tuberosity

Question 28

Course of fibular collateral ligament

Answer 28

Lateral epicondyle of femur to lateral surface of fibular head

Question 29

Course of tibial collateral ligament

Answer 29

Medial epicondyle of femur to medial condyle and superior medial surface of tibia Attached to medial meniscus

Question 30

Function of oblique popliteal ligament

Answer 30

Reinforces capsule posteriorly

Question 31

Course of arcuate popliteal ligament (Y)

Answer 31

Y-shaped, goes from head of fibula to intercondylar area of tibia and lateral epicondyle of femur

Question 32

Cruciate ligaments limit medial rotation of femur to….. and lateral rotation to…..

Answer 32

10 degrees 40 degrees

Question 33

ACL attachments

Answer 33

Anterior intercondylar area of tibia Posterior part of medial side of lateral condyle of femur

Question 34

ACL limits

Answer 34

Rolling of femoral condyles on tibial plateau during flexion

Question 35

ACL prevents (2)

Answer 35

Posterior displacement of femur on tibia Hyperextension of knee

Question 36

PCL attachments (2)

Answer 36

Posterior intercondylar area of tibia Anrerior part of lateral side of medial condyle of femur

Question 37

PCL limits

Answer 37

Rolling of femoral condyles on tibial plateau during extension

Question 38

PCL prevents

Answer 38

Anterior displacement of femur on tibia Hyperflexion of knee

Question 39

Function of menisci of knee joint

Answer 39

Deepens surface to provide passive joint stabilisation Shock absorption

Question 40

Where is the suprapatellar bursa

Answer 40

Between quadriceps and femur

Question 41

Where is the subcutaneous prepatellar bursa

Answer 41

Between apex of patella and skin

Question 42

Where is the infrapatellar bursa

Answer 42

Deep between tibia and patellar ligament Superficial between patellar ligament and skin

Question 43

Where is the semimembranosus bursa

Answer 43

Between semimembranosus and gastrocnemius muscles

Question 44

10 vessels form…. around knee

Answer 44

peri-articular genicular anastomoses

Question 45

Middle genicular branches of popliteal artery supply

Answer 45

Cruciate ligaments, synovial membrane and peripheral

Question 46

What type of joint is the ankle

Answer 46

Hinge type synovial joint

Question 47

Bracket shaped socket made of tibiofibular ligaments is known as

Answer 47

A mortise

Question 48

3 lateral collateral ligaments

Answer 48

Anterior talofibular ligament Posterior talofibular ligament Calcaneofibular ligament

Question 49

Medial collateral ligament proximal attachment (ankle)

Answer 49

Medial malleolus

Question 50

Medial collateral ligament distal attachment (ankle)

Answer 50

Talus (tibiotalar parts) Calcaneus (tibiocalcaneal part) Navicular (tibionavicular part)

Question 51

Function of lateral collateral ligament

Answer 51

Stabilises ankle during inversion

Question 52

Function of medial collateral ligament

Answer 52

Stabilises ankle during eversion and prevents subluxation

Question 53

Blood supply of ankle joint

Answer 53

Malleolar branches of fibular and anterior and posterior tibial arteries

Question 54

Nerve supply of ankle joint

Answer 54

Saphenous Tibial Sural Superficial and deep fibular nerves

Question 55

Foot drop occurs due to…

Answer 55

Damaged peroneal nerve

Question 56

Terrible Triad

Answer 56

Cruciate ligament Medial collateral ligament Medial fibrocartilage meniscus

Question 57

Dislocation of knee is usually…..due to….

Answer 57

Anterior Hyperextension of knee

Question 58

Dislocated knee damages

Answer 58

Popliteal artery

Question 59

ACL injuries occur when

Answer 59

Bones of the leg twist in opposite directions under full body weight

Question 60

Total knee replacement involves

Answer 60

Distal end of femur Proximal end of tibia Posterior surface of patella

Question 61

What is Housemaid’s knee

Answer 61

Prepatellar bursitis

Question 62

What is Clergyman’s knee

Answer 62

Infrapatellar bursitis

Question 63

What is a bakers cyst

Answer 63

Popliteal cyst

Question 64

Cause of prepatellar bursitis

Answer 64

Excessive and repeated friction between skin and patella (kneeling)

Question 65

Cause of infrapatellar bursitis

Answer 65

Excessive friction betwen skin and tibial tuberosity

Question 66

What is a popliteal cyst and what is its cause

Answer 66

Fluid filled sacs in synovial membrane in popliteal fossa region Usually a complication of chronic knee joint effusion

Question 67

How does tibiofibular syndesmosis injury occur

Answer 67

Dorsiflexion and eversion of the ankle with internal rotation of tibia

Question 68

Radiography criteria for tibiofibular syndesmosis injury

Answer 68

Widening of tibiofibular clear space to <6mm

Question 69

What is the most vulnerable ankle ligament

Answer 69

Anterior talofibular ligament