FEMUR & KNEE

Question 1

TIBIOFEMORAL JOINT (knee joint) - type

Answer 1

synovial, hinge, diarthrosis, biaxial

Question 2

TIBIOFEMORAL JOINT - articular surfaces

Answer 2

convex medial & lateral femoral condyles

concave medial & lateral superior articular surfaces of tibia (tibia plateau)

Question 3

TIBIOFEMORAL JOINT - major knee ligaments

Answer 3

INTRACAPSULAR:
-anterior cruciate ligament (ACL)
-posterior cruciate ligament (PCL)
~medial & lateral menisci
EXTRACAPSULAR:
-medial collateral ligament (MCL)
-lateral collateral ligament (LCL)
~fibrous capsule
~patellar

Question 4

tibiofemoral joint - ANTERIOR CRUCIATE LIGAMENT

Answer 4

from medial aspect of lateral femoral condyle to anterior aspect of tibial intercondylar eminence
-resists anterior translation & medial rotation of tibia on femur
-TAUT in HYPEREXTENSION

Question 5

tibiofemoral joint - POSTERIOR CRUCIATE LIGAMENT

Answer 5

from posterior aspect of intercondylar eminence to lateral aspect of medial femoral condyle
-resists posterior translation of tibia on femur
-TAUT in HYPERFLEXION

Question 6

tibiofemoral joint - MEDIAL COLLATERAL LIGAMENT (MCL)

Answer 6

(tibial collateral ligament)
resists VALGUS forces

Question 7

tibiofemoral joint - LATERAL COLLATERAL LIGAMENT (LCL)

Answer 7

(fibular collateral ligament)
resists VARUS forces

Question 8

tibiofemoral joint - MENISCUS

Answer 8

acts to disperse weight evenly & reduce friction with movement

Question 9

medial & lateral meniscus

Answer 9

MEDIAL: attached to MCL & semimembranosus muscle/ tendon
LATERAL: attached to PCL & popliteus muscle

Question 10

TIBIOFEMORAL JOINT - movements

Answer 10

-flexion
-extension, hyperextension
-rotation (internal/external)
-rolling
-gliding

Question 11

tibiofemoral joint - BURSAE

Answer 11

SUPRAPATELLA
PREPATELLA
INFRAPATELLA
SEMIMEMBRANOSUS

Question 12

tibiofemoral joint - END FEELS

Answer 12

NORMAL:
-flexion: soft tissue/ bony approximation
-extension: elastic/ firm
ABNORMAL:
-boggy: joint effusion, ligamentous pathology
-springy block: loose body (displaced meniscus)

Question 13

tibiofemoral joint - OPEN KINETIC CHAIN

Answer 13

flexion: tibia rolls & glides on posterior femur
extension: tibia rolls & glides on anterior femur

Question 14

tibiofemoral joint - CLOSED KINETIC CHAIN

Answer 14

flexion: femur rolls & glides on posterior tibia (squatting)
extension: femur rolls & glides on anterior tibia (moving from squat to standing)

Question 15

GENU VALGUM

Answer 15

Q angle greater than 22° in women & 18° in men
“knocked knees”

Question 16

GENU VARUM

Answer 16

Q angle less than 0°, distal tibia points medially
“bow legs”

Question 17

GENU RECURVATUM

Answer 17

hyperextension of knee

Question 18

PATELLOFEMORAL JOINT - type

Answer 18

synovial, plane, diarthrosis, triaxial

Question 19

PATELLOFEMORAL JOINT - function

Answer 19

-patella = small bone in front of knee, embedded in quadriceps tendon
-sesamoid bone
-acts to INCREASE BIOMECHANICAL LEVERAGE of quadriceps muscle
-slides in groove of femur as knee flexes & extends
-“floats” -> dependant on proper muscle balance to maintain central position

Question 20

PATELLOFEMORAL JOINT - articular surfaces

Answer 20

concave posterior surface of patella

convex trochlear surface of distal anterior femur

Question 21

PATELLOFEMORAL JOINT - ligaments

Answer 21

patellar ligament, medial & lateral patellofemoral ligaments

Question 22

PATELLOFEMORAL JOINT - movements

Answer 22

superior/ inferior glide
medial/ lateral glide, tilt, rotation

Question 23

PROXIMAL/ SUPERIOR TIBIOFIBULAR JOINT

Answer 23

type: synovial, plane, diarthrosis, uniaxial
articular surfaces: articular facet on fibular head, facet on lateral tibial condyle
ligaments: fibrous capsule, anterior & posterior tibiofibular, lateral collateral, upper interosseous membrane
movements: gliding

Question 24

MID-TIBIOFIBULAR JOINT

Answer 24

type: fibrous, interosseous, amphiarthrosis, uniaxial
articular surfaces: interosseous membrane connecting shafts of tibia & fibula
ligaments: interosseous membrane
movements: slight

Question 25

DISTAL/ INFERIOR TIBIOFIBULAR JOINT

Answer 25

type: fibrous, syndesmosis, amphiarthrosis, uniaxial articular surfaces: articular area on inferior end of fibula, facet on inferior end of tibia ligaments: interosseous membrane (lower), anterior & posterior inferior tibiofibular movements: gliding

Question 26

SCREW HOME MECHANISM

Answer 26

*key element to knee stability for standing upright -knee extension: tibia glides anteriorly on femur & PCL elongates -during last 20° of knee extension, anterior tibial glide persists on medial condyle of tibia -prolonged anterior glide on medial side = external tibial rotation -reverses during knee flexion

Question 27

screw home mechanism - GATE CYCLE

Answer 27

-tibia internally rotates during swing phase (knee flexion) -tibia externally rotates during stance phase (knee extension)

Question 28

FEMORAL TRIANGLE

Answer 28

-inguinal ligament -sartorius -adductor longus

Question 29

ADDUCTOR/ SUBSARTORIAL/ HUNTER'S CANAL - borders

Answer 29

-anteromedial: sartorius -lateral: vastus medialis -posterior: adductor longus & magnus

Question 30

POPLITEAL FOSSA - borders

Answer 30

-semimembranosus -biceps femoris -plantaris -gastrocnemius (long & short head)

Question 31

PES ANSERINE

Answer 31

insertion point for 3 muscles: -sartorius -gracilis -semitendinosus (hamstring)

Question 32

SESAMOID BONES

Answer 32

-small independent bone/ bony nodule that develops in a tendon that passes over an angular structure -PATELLA = largest sesamoid bone in body -example: FABELLA -> occurs in tendon of lateral head of gastrocnemius (present in 39%)

Question 33

ANTERIOR FEMORAL GROUP

Answer 33

-tensor fascia lata (TFL) -sartorius -quadriceps: rectus femoris, vastus lateralis, vastus intermedius, vastus medialis -articularis genu

Question 34

MEDIAL FEMORAL GROUP

Answer 34

-adductor longus -adductor brevis -adductor magnus -pectineus -gracilis

Question 35

POSTERIOR FEMORAL GROUP

Answer 35

-hamstrings: biceps femoris, semimembranosus, semitendinosus

Question 36

QUADRICEPS

Answer 36

-rectus femoris -vastus lateralis -vastus intermedius -vastus medialis

Question 37

HAMSTRINGS

Answer 37

-biceps femoris (long & short head) -semimembranosus -semitendinosus

Question 38

ADDUCTORS

Answer 38

-pectineus -adductor brevis -adductor longus -adductor magnus -gracilis

Question 39

ANTERIOR CRURAL MUSCLE GROUP - actions & nerve

Answer 39

-tibialis anterior -extensor digitorum longus -extensor hallucis longus *fibularis (peroneus) tertius ~all dorsiflex foot ~deep fibular (peroneal) nerve

Question 40

LATERAL CRURAL MUSCLE GROUP - actions & nerve

Answer 40

-fibularis (peroneus) longus -fibularis (peroneus) brevis ~all plantar flex & evert foot ~superficial fibular (peroneal) nerve

Question 41

POSTERIOR CRURAL MUSCLE GROUP (DEEP) - actions & nerve

Answer 41

-tibialis posterior -flexor digitorum longus -flexor hallucis longus ~all plantar flex foot ~tibial nerve

Question 41

POSTERIOR CRURAL MUSCLE GROUP

Answer 41

-plantaris -gastrocnemius -soleus -popliteus ~tibial nerve

Question 42

PLANTAR FLEXION (muscles)

Answer 42

-soleus -gastrocnemius -plantaris -tibialis posterior -peroneus (fibular) longus & brevis -flexor digitorum longus -flexor digitorum hallucis

Question 43

DORSIFLEXION (muscles)

Answer 43

-tibialis anterior -extensor digitorum longus -extensor digitorum hallucis

Question 44

INVERSION (muscles)

Answer 44

-tibialis anterior -tibialis posterior

Question 45

EVERSION (muscles)

Answer 45

fibularis longus, brevis, tertius

Question 46

what two muscles insert into the IT band?

Answer 46

TFL gluteus maximus

Question 47

where does the IT band insert?

Answer 47

Gerdy's tubercle of tibia close to knee