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anatomy - physio > the knee, leg and tibiofibular joints > Flashcards

the knee, leg and tibiofibular joints Flashcards

1
Q

what bones (&their parts) articulate in order to form the** knee joint**?

A
  • femur- distal end of femur - medial and lateral condyles
  • tibia- proximal end of tibia - tibial plateau
  • posterior aspect of patella
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2
Q

Describe the** osteology **of the distal femur

A
  • lateral and medial condyles
  • lateral and medial epicondyles
  • patellar surface
  • supracondylar line
  • intercondylar fossa
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3
Q

describe the osteology of the tibia

anteroirly and posteriorly

A

anterior :
* head of the tibia
* tibial tuberosity
* shaft of the tibia
* medial malleolus
* intercondylar eminence
posterior:
* soleal line - where soleus muscle attaches

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4
Q

Describe the osteology of the fibula (anterior and posterior view)

A

anterior & anterior :
* head of fibula
* neck of fibula
* shaft
* lateral malleolus

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5
Q

what are the 2 tibiofibular joints called?

A
  • proximal tibiofibular joint
  • distal tibiofibular joint
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6
Q

what are menisci?

A

the menisci are fibrocartilage crescent shaped plates found between the articulating surfaces of the femur and tibia

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7
Q

what are the functions of the menisci?

A
  • deepen the articular surface
  • act as a cushion for the bones
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8
Q

where are the menisci located?

A
  • between the femoral and tibial condyles
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9
Q

what type of membrane lines the interior capsule of the menisci?

A
  • a synovial membrane
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10
Q

what are the 2 menisci of the knee?

A

lateral and medial

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11
Q

what are the extracapular ligaments of the knee?

A
  • NB found outside the joint capsule
  • patellar ligament
  • medial collateral
  • lateral collateral
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12
Q

what are the intracapsular ligaments of the knee?

A
  • NB found within the joint capsule
  • anterior cruciate ligament
  • posterior cruciate ligament
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13
Q

Describe the medial collateral ligament

A
  • broad and flat
  • medial femoral epicondyle to medial tibia
  • NB ATTACHED TO MEDIAL MENISCUS
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14
Q

Describe the **lateral collateral ligament **

A
  • thin and cord like
  • lateral femoral epicondyle to head of fibula
  • NB not attached to lateral meniscus or joint capsule
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15
Q

describe the** patellar ligament**
(structure and function)

A

* strong, thick, fibrous band that is a distal continuation of the quadriceps femoris tendon
* plays a major role in stabilising the patella and **preventing its displacement **

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16
Q

Describe the **anterior cruciate ligament **

attachments and functions

A

attachments:
* lateral femoral condyle
* anterior tibial plateau
functions:
* prevents femur sliding posterioly on tibia
* prevents hyperextension of the knee joint

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17
Q

Describe the posterior cruciate ligament - attachments & functions

A

attachments
* medial femoral condyle
* posterior tibial plateau
functions
* prevents femur sliding anteriorly on the tibia- especially in flexed knee eg when walking down hill

note - better blood supply and stronger than ACL

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18
Q

what is a good abbreviation for learning the attachments of the intracapsular ligaments?

A

LAMP
ACL
- Lateral femoral condyle
- Anterior tibial plateau
PCL
- Medial femoral condyle
- Posterior tibal plateau

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19
Q

what type of joint is the knee joint?

A
  • hinge joint but modified hinge joint - as there can be some medial & lateral rotation
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20
Q

what are the 2 main movements that the knee joint can carry out?

A

flexion & extension

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21
Q

what muscles are involved in flexion of the knee?

A

the 3 hamstring muscles
* bicep femoris
* semimembranosis
* semitendonosis

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22
Q

what muscles are involved in extension of the knee & what nerve innervates these muscles?

A

the 4 quadriceps femoris muscles
* rectus femoris
* vastus lateralis
* vastus medialis
* vastus intermedius

innervation - the femoral nerve (L2-L4)

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23
Q

what is ‘locking of the knee’?

A
  • the knee joint in full extension
  • femur rotates medially on the tibia
  • knee becomes rigid
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24
Q

what is ‘unlocking’ of the knee?

A
  • the ligaments become untwisted and relaxed
  • popliteus muscle laterally rotates the femur on tibia
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25
Q

what are synovial bursae, where are they found and what are their functions?

A
  • fluid filled sac like cavities
  • found wherever skin, muscle or tendon rub against the bone
    functions - reduce friction and facilitate movement
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26
Q

what are the** 5 bursae of the knee joint**?

A
  • suprapatellar bursa - above patella
  • prepatellar bursa (lies in front of the patella)
  • infrapatellar bursa (located under the patella)
  • semimembranosus bursa
  • popliteal bursa
27
Q

Describe the blood supply to the knee joint

A
  • blood supply involves the genicular arteries from the popliteal artery
28
Q

what nerves innervate the knee joint?

A
  • femoral nerve
  • tibial nerve
  • common peroneal nerve
29
Q

What are special tests that can be done for ACL & PCL injury?

A
  • ACL - anterior drawer or lachman test
  • PCL - posterior drawer test
30
Q

how would you test for collateral ligament injuries?

A
  • with leg straight, try to abduct and adduct the knee… should be little movement
31
Q

why are there a higher rate of medial meniscal injuries over lateral ones?

A

as the medial meniscus is attached to the medial colateral ligament

32
Q

what is housemaids knee?

A

bursitis (inflammation of the bursae) - of the prepatellar bursa

33
Q

what is clergyman’s knee?

A

bursitis of the infrapatellar bursa

34
Q

compare the superior vs inferior tibiofibular joints TYPE

A
  • superior - synovial joint
  • inferior - fibrous joint
35
Q

what is the popliteal fossa?

A
  • a diamond shaped depression located posteriorly to the knee joint
  • important nerves and vessels pass from the thigh to the leg by transversing through this fossa
36
Q

what are the** boundaries of the popliteal fossa**?

A
  • superior - semimembranosus (medial) and biceps femoris (lateral)
  • inferior - gastrocnemius - medial and lateral heads
  • floor - popliteal surface of femur, popliteus muscle, oblique popliteal ligament
  • roof - skin and fascia lata
37
Q

what are the** contents of the popliteal fossa**?

A
  • tibial nerve
  • common fibular nerve
  • popliteal artery
  • popliteal vein
  • small saphenous vein
  • fat
  • lymphatics
38
Q

what are the compartments of the leg?

A
  • anterior
  • lateral
  • posterior - superficial
  • posterior - deep
39
Q

what muscles are in the anterior compartment of the leg?

A
  • tibialis anterior
  • extensor digitorum longus (toe expect big toe extensor)
  • extensor hallucis (big toe) extensor
  • fibularis tertius
40
Q

what are the main actions of the anterior muscles of the leg?

A
  • dorsiflexors of foot at ankle joint
  • extensors of the toes
41
Q

what nerve innervates the muscles of the anterior compartment of the leg?

A
  • deep fibular nerve ( a branch of the common fibular nerve)
42
Q

what muscles make up the **posterior SUPERFICIAL compartment **of the leg?

A
  • gastrocnemius
  • soleus
  • plantaris
43
Q

what muscles make up the** posterior DEEP compartment** of the leg?

A
  • popliteus muscle
  • tibialis posterior
  • flexor digitorum longus
  • flexor hallucis longus
44
Q

what are the main actions of the muscles of the posterior compartment of the leg?

A
  • plantarflexion of foot and toes
  • flexing at the knee
45
Q

what nerve innervates the muscles of the posterior compartment of the leg?

A

tibial nerve

46
Q

what muscles are in the lateral compartment of the leg?

A
  • fibularis longus
  • fibularis brevis
47
Q

what is the main function of the muscles of the lateral compartment of the leg?

A

evert the foot at the sole

48
Q

what nerve innervates the muscles of the lateral compartment of the leg?

A

all superficial fibular (peroneal) nerve

49
Q

what are the main arteries of the leg?

A
  • popliteal artery (branch of femoral artery)
  • malleolar arteries
  • genicular arteries
50
Q

how does the sciatic nerve supply the posterior leg?

A
  • tibial nerve - posterior compartment of the leg
  • common peroneal / fibular nerve - wraps around head of fibula and splits into superficial and deep
51
Q

what is acute compartment syndrome?

A
  • occurs due to trauma of the leg - most commonly a fracture
  • the pressure within a closed muscle compartment exceeds the perfusion pressure and results in muscle and nerve ischemia
52
Q

what is the unhappy triad injury of the knee?

A

an injury involving the tearing of the anterior cruciate ligament, medial collateral ligament and the medial meniscus

53
Q

what can happen to the foot as a result of a common peroneal nerve injury?

A

dropped foot - as the anterior muscles of the leg act to dorsiflex the ankle and extend the digits , the lateral compartment of the leg everts the foot - damage to the fibular nerve results in a loss of these actions

54
Q

what is the origin and insertion of the tibialis anterior muscle?

(anterior compartment of leg)

A
  • origin - lateral tibial condyle
  • insertion - medial cuneiform bone and base of metatarsal bone 1
55
Q

what is the origin and insertion of the extensor hallucis longus muscle?

(anterior compartment of leg)

A
  • origin - medial surface of fibula and interosseous membrane
  • insertion - base of distal phalanx of great toe
56
Q

what is the origin and insertion of the extensor digitorum longus muscle?

(anterior compartment)

A
  • medial surface of fibula, lateral tibial condyle
  • insertion - distal and middle phalanges of 2-5
57
Q

what muscles of the leg are involved in dorsiflexion?

A
  • tibialis anterior
  • extensor hallucis longus
  • extensor digitorum longus
  • fibularius tertius
58
Q

what muscles are involved in eversion of the foot?

A
  • extensor digitorum longus
  • fibularis tertius
  • fibularis longus (lateral compartment)
  • fibularis brevis (lateral compartment)
59
Q

what muscles are involved in inversion of the foot?

A
  • tibialis posterior
  • flexor digitorum longus
  • flexor hallucis longus
60
Q

what is the origin and insertion of the gastrocnemius muscle?

posterior - superficial

A
  • lateral head - lateral femoral condyle
  • **medial **head medial femoral condyle
  • insertion - both heads onto the posterior surface of the calcaneus (ie calcaneal tendon)
61
Q

where does the soleus muscle originate and insert onto?

A
  • originates on the soleal line of the tibia, head of filbula
  • inserts onto the posterior surface of the calcaneous bone or the calcaneal tendon
62
Q

where does the tibialis posterior muscle originate and insert onto?

A
  • originates on the** posterior surface of the tibia**, **posterior surface of the fibula **
  • inserts onto the** tuberosity of the navicular bone**, all cuneiform bones and bases of metatarsals 2-4
63
Q

where does the flexor digitorum longus originate and insert?

A
  • O- posterior surface of tibia (inferior to soleal line)
  • I- bases of the distal phalanges 2-5
64
Q

where does the flexor hallucis longus originate and insert onto?

A
  • O- posterior surface of fibula, interosseus membrane
  • I- base of distal phalanx of great toe

anatomy - physio (17 decks)

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