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Y2 CONTROL & MOVEMENT > Posterior Thigh & Knee > Flashcards

Posterior Thigh & Knee Flashcards

1
Q

What are the 2 bones of the leg?

How are they positioned relative to each other?

A

the tibia and the fibula

the tibia is much larger and lies medially

the fibula is much thinner and lies laterally

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2
Q

What part of the fibula is involved in the knee joint?

A

the fibula is NOT involved in the knee joint

only the proximal tibia articulates with the distal femur to form the knee joint

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3
Q

Label the components of the tibia, femur and fibula

A
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4
Q

What are the 3 articulations of the knee joint?

A

femorotibial articulations:

there is a medial and a lateral femorotibial articulation

femoropatellar articulation:

this is between the distal femur and the patella

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5
Q

What does the proximal aspect of the tibia provide important attachments for?

A
  1. ligaments that stabilise the knee joint
  2. muscles that move the knee joint
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6
Q

label the important bony landmarks on the anterior and posterior surfaces of the proximal tibia

A
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7
Q

What group of muscles insert onto the tibial tuberosity?

A

the quadriceps femoris tendon and the associated muscles:

  1. rectus femoris
  2. vastus lateralis
  3. vastus intermedius
  4. vastus medialis

insert onto the tibial tuberosity and extend the leg at the knee joint

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8
Q

How is the proximal fibula involved in the knee joint?

A

it is not part of the knee joint but it acts as an attachment site for ligaments that stabilise the knee and muscles that move theknee

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9
Q

What nerve is vulnerable to injury in fracture of the proximal femur?

A

the common peroneal nerve

this winds around the neck of the fibula

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10
Q

label the features of the proximal fibula

A
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11
Q

What are the 4 hamstring muscles found in the posterior thigh?

A
  1. semimembranosus
  2. semitendinosus
  3. long head of biceps femoris
  4. hamstring part of adductor magnus
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12
Q

What nerve innervates the muscles of the posterior thigh?

A

sciatic nerve

this bifurcates into 2 major nerves as it travels down the posterior thigh:

  1. tibial nerve
  2. common fibular (peroneal) nerve
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13
Q

complete the table describing the hamstring muscles

A
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14
Q

What are the functions of semimembranosus and semitendinosus?

A
  1. flex the leg at the knee joint
  2. extend the thigh at the hip joint
  3. medially rotates the thigh at the hip joint and leg at the knee joint
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15
Q

Why is the short head of the biceps femoris not considered a hamstring muscle?

A

it originates from the posterior aspect of the femoral shaft

it is not considered a hamstring muscle as it does not originate from the ischial tuberosity meaning that it CANNOT EXTEND THE HIP

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16
Q

label the hamstring muscles

A
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17
Q

What is the insertion, action and innervation of the short head of biceps femoris?

A

insertion:

head of fibula

action:

flexion of the leg at the knee joint

innervation:

common fibular division of sciatic nerve

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18
Q

What are the functions of both the adductor and hamstring parts of adductor magnus?

A

they can both adduct the hip

the adductor portion can also flex the hip

the hamstring portion can extend the hip

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19
Q

What is the action of the adductor magnus on the knee?

A

the adductor magnus cannot act on the knee

it attaches to the distal femur so does not span the knee joint

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20
Q

What is the insertion, action and innervation of adductor magnus?

A

insertion:

adductor tubercle and supracondylar line

action:

adduction and extension of the hip

innervation:

tibial division of sciatic nerve (L2, L3, L4)

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21
Q

Label the components of adductor magnus

A
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22
Q

What is the vascular supply of the posterior thigh?

A

branches from the inferior gluteal artery and perforating branches of the profunda femoris artery

the perforating branches perforate the adductor magnus through the adductor hiatus

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23
Q

How is the popliteal artery formed?

A

the femoral artery passes through the adductor canal, which ends in the adductor ihatus

after passing through the adductor hiatus, the femoral artery becomes the popliteal artery

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24
Q

What are the divisions of the popliteal artery?

A

at the lower border of popliteus, the popliteal artery bifurcates into:

  1. anterior tibial artery
  2. tibioperoneal trunk

The tibioperoneal trunk then divides into:

  1. posterior tibial artery
  2. fibular (peroneal) artery
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25
Q

label the arteries

A
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26
Q

What is the popliteal fossa?

A

a diamond-shaped depression located behind the knee

it is the main path by which vessels and nerves pass between the thigh and the leg

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27
Q

What are the borders of the popliteal fossa?

A

superomedial border:

semimembranosus

superolateral border:

biceps femoris

inferomedial border:

medial head of gastrocnemius

inferolateral border:

lateral head of gastrocnemius and plantaris

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28
Q

Label the borders of the popliteal fossa

A
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29
Q

What forms the floor and roof of the popliteal fossa?

A

Floor:

  • posterior surface of the knee joint and the posterior surface of the femur

Roof:

  • popliteal fascia and skin
  • the popliteal fascia is continuous with the fascia lata of the leg
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30
Q

What are the contents of the popliteal fossa?

A
  1. popliteal artery
  2. popliteal vein
  3. tibial nerve
  4. common fibular nerve (common peroneal nerve)
31
Q
A
32
Q

What other vein enters the popliteal fossa?

A

the small saphenous vein pierces the popliteal fascia to enter the diamond and enter into the popliteal vein

33
Q
A
34
Q

How can disease of the popliteal artery affect the leg and foot?

A

it seriously compromises perfusion to the leg and food

this can lead to irreversible ischaemia and loss of the foot and/or leg

35
Q

What are the 5 main ways in which the popliteal artery can become diseased?

A
  1. atherosclerosis
  2. popliteal artery aneurysm
  3. arterial embolus
  4. popliteal artery entrapment syndrome
  5. cystic adventitial disease
36
Q

How may the popliteal artery become injured?

A
  1. knee dislocation
  2. complex tibial plateau fractures
  3. supracondylar femur fractures
37
Q

How is the popliteal vein often diseased?

A

it is a deep vein that can become occluded by a blood clot in deep vein thrombosis

38
Q
A
39
Q

What type of joint is the knee joint?

How is it made stable?

A

it is a synovial hinge joint

the articular surfaces of the joint are incongruent, meaning that stability largely depends on surrounding soft tissue structures

(cartilage, ligaments and muscles)

40
Q

label the components of the knee joint

A
41
Q

What is the patella?

What is its structure like?

A

a triangular sesamoid bone that develops within the quadriceps tendon

it has a base, an apex and two surfaces (anterior and articular)

the articular surface has a medial and a lateral facet

42
Q

What does the patella articulate with?

A

femoral condyles

the medial facet articulates with the medial condyle

the lateral facet articulates with the lateral condyle

43
Q

what are these features of the patella?

A
44
Q

What are the 2 main fucntions of the patella?

A
  1. leg extension
  2. protection
45
Q

How is the patella involved in leg extension?

A

it enhances the leverage that the quadriceps tendon can exert on the femur

this increases the efficiency of the muscle

46
Q

How is the patella involved in protection?

A

it protects the anterior aspect of the knee joint from physical trauma

47
Q

What is meant by bipartite patella?

A

a condition in which the patella is composed of 2 separate bones

these bones usually fuse together in early childhood

48
Q

Why is the patella at risk of lateral displacement?

A

the patella would be at risk of being excessively pulled and displaced laterally by the powerful lateral pull of:

  1. rectus femoris
  2. vastus intermedius
  3. vastus lateralis

when they contract

49
Q

What are the 2 mechanisms that counteract the tendency of the patella towards lateral displacement?

A
  1. vastus medialis contracts to pull the patella medially at a horizontal/oblique angle

this counteracts lateral movement of the patella

  1. lateral femoral condyle projects more anteriorly than the medial femoral condyle to limit lateral movement of the patella
50
Q

What happens if the lateral condyle is underdeveloped?

A

recurrent dislocation of the patella may occur

51
Q

Why are patella dislocations more common in females?

A

the knee is positioned under the hip to return the centre of gravity to the midline

as females have wider pelves relative to the length of their femurs, their femurs lie at a relatively more oblique angle

a strong quad contraction is more likely to displace the patella

52
Q

How is the patella often fractured?

A

by a direct blow

the patella can shatter or split but the fragments are not avulsed as the quadriceps expansion remains intact

53
Q
A
54
Q

What causes cartilage within the knee joint to become worn and torn?

What happens?

A

it can be worn and torn by repetitive use, traumatic injury, obesity and increasing age

when the cartilage wears away, the bony articular surfaces are exposed to each other

this is osteoarthritis

55
Q

What is septic arthritis?

A

this occurs when there is infection within a joint

a septic knee is red, inflamed, warm and painful

56
Q

What is meant by the tibial plateau?

What is the main issue with this?

A

the articular surfaces of the tibial condyles are practically flat - this area is the tibial plateau

a flat surface is a poor fit for the rounded femoral condyles

57
Q

What are the menisci and what is their main function?

A

they are specialised cartilage that covers part of the tibial plateaus

this shapes and deepens the tibial articular surface so it is a better fit for the femoral condyles

58
Q

What are the intercondylar tubercles attachment sites for?

A

the anterior and posterior cruciate ligaments

they are NOT covered by menisci

59
Q

label the menisci

A
60
Q

What are the 2 pairs of ligaments within the knee joint?

A
  1. anterior and posterior cruciate ligaments
  2. medial (tibial) and lateral (fibular) collateral ligaments
61
Q

label the ligaments of the knee joint

A
62
Q

What type of ligaments are the cruciate ligaments?

How are they repaired when damaged?

A

they are intra-articular ligaments that connect the tibia to the femoral condyles

they are repaired by using a tendon from another site to reconstruct the damaged cruciate

63
Q

What is the origin, insertion and primary function of the anterior cruciate ligament?

A

origin:

intercondylar fossa of femur

insertion:

anterior intercondylar region of tibia

primary function:

prevents anterior dislocation of the tibia onto the femur

64
Q

What is the origin, insertion and primary function of the posterior cruciate ligament?

A

origin:

medial femoral condyle

insertion:

posterior intercondylar region of tibia

primary function:

prevents posterior dislocation of the tibia onto the femur

65
Q

How may the cruciate ligaments be injured?

A
  1. partially or completely torn
  2. completely avulsed from the tibia
66
Q

What type of ligaments are the collateral ligaments?

A

extra-articular ligaments

67
Q

What is the origin, insertion and primary function of the medial (tibial) collateral ligament?

A

origin:

medial femoral condyle

insertion:

medial margin and medial surface of tibia

primary function:

resists outwards turning forces on the knee

68
Q

What is the origin, insertion and primary function of the lateral (fibular) collateral ligament?

A

origin:

lateral femoral condyle

insertion:

head of fibula

primary function:

resists inwards turning forces on the knee

69
Q

What usually causes tears of the collateral ligaments?

A

tearing or stretching of the ligaments caused by forces which push the knee sidewayds

70
Q

What usually causes a medial collateral ligament tear?

What other structure is often also injured?

A

a direct blow to the outside of the knee

this pushes the knee inwards (towards the other knee)

the tibial collateral ligament is attached to the medial meniscus, meaning they are often injured together

71
Q

What usually causes a lateral collateral ligament tear?

A

a blow to the inside of the knee that pushes the knee outwards

72
Q

What is meant by locking of the knee?

What is the benefit of this mechanism?

A

as the knee reaches full extension, there is a small degree of medial rotation of the distal femur on the tibia

locking increases the stability of the knee

73
Q

What is meant by unlocking of the knee?

When does it occur?

A

when the knee is flexed from full extension, the first thing that occurs is unlocking

this involves a small degree of lateral rotation of the femur on the tibia

this is achieved by contraction of popliteus

74
Q

What vessels create an anastomotic network around the knee joint?

A

the genicular arteries that arise from the popliteal artery

Y2 CONTROL & MOVEMENT (69 decks)

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