Arthrology and Syndesmology of the Knee Joint Flashcards Preview

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Flashcards in Arthrology and Syndesmology of the Knee Joint Deck (31):
1

Knee joint

• Largest joint in body
• Compound joint: 2 joints - tibia and femur (condylar joint) and patella and femur (saddle/sellar joint)
• One synovial membrane
• One cavity

2

Tibia femur condylar joint

- 10-12 degrees from midline
- Exaggeration of this angle is considered genu valgum

3

Movement of condyloid joint

o Hinge
o Gliding
o Rotation
o Mechanically weak- gains strength from tendons

4

Articular surfaces of knee joint

o Lined with articular cartilage
o Tibia- flat articular surface
o Femoral- rounded

5

Nerve supply to knee joint

o articular branches of femoral nerve
o obturator nerve
o common peroneal nerve
o tibial nerve

6

Blood supply to knee joint

o Genicular anastomosis from descending genicular branch of femoral artery
o Genicular popliteal artery
o Recurrent branches of anterior tibial artery
o Descending branch lateral femoral circumflex artery
o Circumflex fibular artery

7

Ligaments of articulating bones

- Articular capsule
- Quadriceps tendon
- Patellar ligament
- Lateral collateral ligaments
- Anterolateral ligament
- Medial collateral ligament
- Oblique popliteal ligament
- Arcuate popliteal
- Anterior cruciate ligament
- Posterior cruciate ligament
- Medial meniscus
- Lateral meniscus
- Transverse ligament

8

Articular capsule

- Incomplete anteriorly, replaced by medial and lateral retinacula of the quadriceps tendon
- Anteriorly attached to the margins of the articulating surface
- Laterally, the tendon of popliteus muscle pierces the articular capsule
- Inside the articular capsule there is synovial membrane

9

Quadriceps tendon

Inserts onto patella

10

Patellar ligament

o Continuation quadriceps tendon
o Attaches tibial tuberosity
o Strong flat band anterior/inferior part of joint
o 8 cm long
o Infrapatellar fat pad- Inferior surface separates synovial membrane
o Infrapatellar bursa- protects ligament from tibia

11

Lateral collateral ligaments

o Strong round fibrous
o Attaches proximally to lateral epicondle of femur above groove for poplieus muscle
o Attaches distally on the head of the fibula (lateral side)
o LCL is covered by tendon of biceps femoris muscle – splits for attachment onto fibular head on either side of LCL
o NOT attached to capsule or lateral meniscus
o Tendon of popliteus muscle runs deep to LCL
o Separated from lateral meniscus by articular capsule & tendon of popliteus muscle

12

Anterolateral ligament

o Proximal attachment to lateral femoral condyle anterior to proximal attachment of LCL w/ connecting fibers between the two ligaments
o Courses obliquely
o Distal attachment is to the anterolateral aspect of the tibia between Gerdy’s tubercle and the apex of the fibula
o Distal attachment is the lateral meniscus
o Function is to check internal rotation between 30-90 degrees of knee flexion

13

Medial collateral ligament

o Broad flat band 10 cm long
o Proximal attachment to medial epicondyle of femur below adductor tubercle
o Distal attachment to medial surface of tibia 2-3 cm long
o Pes anseurinum (SGT) crosses the medial collateral ligament superiorly
o Distal attachment site is the medial meniscus
o Capsule is found below ligament

14

Oblique popliteal ligament

- Strengthens knee joint posteriorly
- It is a distal expansion of the semimembranosus muscle
- It courses obliquely from the medial condyle of the tibia to the lateral condyle of the femur
- It forms the floor of the popliteal fossa
- Oblique popliteal ligament is perforated by the medial genicular artery on its way to the knee joint

15

Arcuate popliteal ligament

- Thickened capsular fibers are found over the popliteus tendon
- Arcuate popliteal ligament courses medially from the lateral condyle of the tibia and head of the fibula to the posterior intercondylar area of the tibia

16

Anterior cruciate ligament

o Attaches proximally on the anterior intercondylar area of tibia
o Travels superolaterally
o Inserts on the posterior meidal surface of lateral femoral condyle
o Functions to prevent hyperextnsion of knee – preventing the femur from sliding posteriorly on the tibia

17

Posterior cruciate ligament

o Stronger and shorter than the ACL
o Attaches on the posterior intercondylar tibia
o Travels obliquely upward crossing ACL
o Attach on the medial condyle (lateral surface)
o Functions to prevent hyperfelxion of knee – prevent femur forward sliding on tibial plateau

18

Menisci

o Semilunar fibrocartilage discs deepen the cavity of tibial condyles
o The outer border is thicker than the central area
o Central area is in contact with the femoral condyles
o The femoral condyles cover 2/3 of the condyles of the tibia
o Peripheral attachment: fibrous capsule (Coronary Ligament) which holds the menisci to the tibial condyles

19

Medial meniscus

o Semicircular
o Attached to tibia anterior to ACL at anterior intercondylar area
o Posterior attach posterior intercondylar area

20

Lateral meniscus

o Almost circular
o Tendon of popliteus muscle separates it from LCL
o Extends form anterior itnerconydlar area to posterior intercondylar area

21

Anterior and posterior meniscofemoral ligaments

- On the posterior side, the fibers extend to the medial condyle of the femur in 70% of cases

22

Transverse ligament

- Unites the two menisci anteriorly

23

Superior tibiofibular joint

- Fibular facet on lateral tibial condyle articulates with the articular facet on the medial aspect of the head of the fibula

24

Facets of superior tibiofibular joint

- Facets are circular in shape
- Size and direction are variable
- The fibrous capsule around the facets is thickened by ligaments
- This includes the anterior superior tibiofibular ligament and the posterior superior tibiofibular ligament

25

Type of joint in superior tibiofibular joint

PLANE synovial joint

26

Distal tibiofibular joint

- Triangular surface of distal fibula (in the inferior interosseous border) articulates with distal end of tibia

27

Distal tibiofibular joint type

Syndesmosis, fibrous joint

28

Ligaments of distal tibiofibular joint

- Interosseous tibiofibular ligament
- Anterior inferior tibiofibular ligametn
- Posterior inferior tibiofibular ligament

29

Interosseous tibiofibular ligament

- Distal continuation of interosseous membrane

30

Anterior inferior tibiofibular ligament

- Triangular shaped
- Directed inferolaterally

31

Posterior inferior tibiofibular ligament

- Quadrilateral shape
- Directed inferolaterally
- Superficially located
- Deep portion contains fibrocartilage creating the inferior transverse ligament
- The inferior transverse ligament is what forms a socket for the talus by extending from the lateral malleolar fossa to the margin of the medial malleolus