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Anatomy AT 521 > Functional Anatomy of the Knee > Flashcards

Functional Anatomy of the Knee Flashcards

(122 cards)

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1
Q

Genu Valgum-Frontal Plane

A

Defined as medial TF angle > 195

  • increased compressive forces=lateral condyles
  • increased tensile forces= medial structures
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2
Q

Genu Varum-Frontal Plane

A

Defined as medial TF angle >180

  • increased compressive force=medial condyles
  • increased tensile forces=lateral structures
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3
Q

Normal Anatomical Position (Sagittal plane)

A

LOG passes slightly anterior to knee joint
Normal TF angle= 180
Little to no muscle activity required in static posture
support provided by posterior structures

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4
Q

Genu Recurvatum-Sagittal Plane

A
  • LOG very anterior to knee jt
  • Post. jt capsule and related structures under considerable stress
  • Results in adaptive lengthening
  • increased compressive forces anterior femoral condyles and tibial plateaus
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5
Q

Femoral Condyles

A

Medial condyle is larger and projects further distally

Covered w/ articular cartilage

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6
Q

TIbiofemoral Jt. Classification

A 
Diarthrodial (synovial)
Bicondylar
Biaxial
Cmpd-more than one articulating surfaces
Complex-menisci
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7
Q

TF Jt. fxns

A 
hinge joint (flexion and extension)
Some rotation in transverse plane
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8
Q

Members of Knee Jt

A

Femoral condyles
Intervening Menisci
Tibial plateaus and condyles

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9
Q

Medial tibial condyle or plateau

A

Longer in the AP direction

~50% larger

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10
Q

Lateral tibial condyle or plateau

A

Shorter in AP direction
Circular in shape
Articular cartilage is thicker than that of the medial

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11
Q

TF Jt. Osteokinematics

A

Normal knee flexion= 140
Normal knee extension= 0

With hip extended, knee flexion ROM may be limited to 120

With hip flexed, knee flexion ROM may increase to 150-160

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12
Q

TF Jt Fxnal ROM (sagittal plane)

A

Gait= 60 knee flexion
Stair climbing= 80 knee flexion
Sitting in a chair= at least 90 knee flexion

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13
Q

TF Arthrokinematics

A

Tibial articular surfaces are concave

Femoral articular surfaces are convex

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14
Q

Open Chain TF Arthrokine

A

Concave on Convex

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15
Q

Closed Chain TF Arthrokine

A

Convex on Concave

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16
Q

Open Kinetic Chain in a non-weight bearing position (screw home mechanism)

A

30* from full extension
Lateral tibial condyle completes arthrokinematics first
Extension continues the medial tibial condyle arthrokins continue
Results in ER of the tibia
Brings joint into a closed pack position

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17
Q

Closed Kinetic Chain in a weight bearing position (screw home mechanism)

A

30* from full extension
Lateral femoral condyle completes arthrokins first b/c it is smaller than the Medial femoral condyle
Ext. continues the MFC arthrokinematics continues
Results=IR of the femur
Brings Jt into the closed pack position=majority of the supporting ligaments to become taut

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18
Q

Unlocking the Knee

A

First 30* flexion
Brings knee into OPP

OC=medial tibial condyle moves first, followed by lateral condyle causing IR of TIBIA

CC=medial femoral condyle moves first, followed by lateral condyle causing ER of FEMUR

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19
Q

Capsular Kinesiology (TF Jt)

A

Close Pack Position: full knee ext w/ full ER

Open Pack Position: 20-30* knee flexion

Capsular pattern: greater limitation in flexion vs ext.

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20
Q

What kind of bone is a patella

A

Sesamoid

It is triangular with apex at inferior pole/posteriorly its surface should be smooth

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21
Q

Patellofemoral Joint Classification

A

Diarthrodial

Planar

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22
Q

Members of PF Jt

A

Posterior surface of patella and anterior surface of femoral condyles
Least congruent joint of the body

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23
Q

Patellar articular surfaces on the femoral condyles

A

Lateral patellar surface is larger (goes with larger medial condyle)
Medial patellar surface is smaller

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24
Q

Articulating (posterior) surface

A

vertical ridge divides posterior surface into 2 facets

Asymmetrical facets
1) lateral articular facets
2) medial articular facets
Odd facet is located medial to the medial facet

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25
Patella Tracking Tilt
Axis is superior/inferior - w/ knee extended, patella rests in slight lateral tilt - medial tilt occurs from 0-30 of flexion and > 100 - lateral tilt occurs between 30-100 of flexion
26
Patella Tracking Rotation
Axis is anterior/posterior Medial Rotation=inferior pole moves medially with tibial IR Lateral Rotation=inferior pole moves laterally with tibial ER
27
Patella Tracking Glide
medial glide=knee flexion | lateral glide=knee extension
28
Why is the patella important?
It is an anatomic pulley Alters angle of pull for patella tendon (quad muscles) Joint rxn force increases as knee flexion increases
29
Capsular Kinesiology (PF joint)
CPP=full flexion | OPP=full extension
30
Knee joint capsule
Encloses the tibiofemoral and patellofemoral joint - --Large and lax - -Composed of an 1) external or superficial fibrous layer 2) thinner internal synovial membrane
31
Fibrous Capsule-attachments
Attaches to post. aspect of femoral and tibial condyles-runs across the intercondylar notch Attaches medially and laterally along border of femur and tibia Anteriorly blends with tendons of VL and VM (patellar retinaculi) and attaches to edges of patella
32
Retinaculums
Lateral=reinforced by ITB, further down by patellofemoral and patellotibial ligaments
33
Synovial Capsule
Posteriorly attaches to condyles of tibia & femur Reflects of the fibrous capsule posteriorly and loops forward lining the contours of the condyles ***Intercondylar notch and eminence are enclosed by the fibrous capsule but outside the synovial space
34
Synovial membrane
Posterolaterally passes between the popliteus muscle and the lateral femoral condyle
35
ACL and PCL located
Intracapsular (inside the fibrous capsule) and extrasynovial (outside the synovial space)
36
Suprapatellar pouch
Formed from synovial capsule where it forms a large pocket that extends proximally a few cm b/w femur and quadriceps muscle essential for full mvmt of patella and knee
37
Patella Tendon (Ligament) Characteristics
Continuous with quadricep tendon Strong and thick Merges with fibrous capsule via rentinaculum
38
Patella Tendon attachments
inferior/anterior patella to tibial tuberosity
39
Patella Tendon associated structures
infrapatellar fat pad | bursa
40
Medial Collateral Ligament Attachments
Medial femoral condyle to medial tibial condyle and medial meniscus
41
MCL Function
checks against valgus forces and taut in extension taut in ER of tibia in OC taut in IR of femur and tibia in CC
42
Lateral Collateral Ligament Attachment
**Extracapsular and extrasynovial** | Lateral femoral condyle to lateral fibular head
43
LCL Functions
checks against varus force taut in extension Taut in IR of tibia in OC Taut in ER of femur and tibia in CC
44
Anterior Cruciate Ligament Attachments
**Intracapsular and extrasynovial** | Intercondylar region of tibia to posteromedial lateral femoral condyle
45
ACL Functions
Mainly prevents anterior translation of tibia on femur Anteromedial bundle-taut in full flexion and extension Posterolateral bundle-taut in full extension All taut in tibial and femoral internal rotation in CC
46
Posterior Cruciate Ligament Attachments
Posterior tibia, intercondylar region to anteromedial aspect of medial femoral condyle
47
PCL Functions
shorter, thicker and stronger than ACL Checks against posterior displacement of tibia on femur taut in full flexion, full extension and IR of femur
48
Accessory Ligaments of the Knee
Oblique Popliteal Ligament Arcurate Popliteal Ligament **Reinforce posterior capsule**
49
Oblique Popliteal Ligament
Located b/w semimembranosus tendon and LFC | Taut in full extension
50
Arcurate Popliteal Ligament
Originates from fibular head then divides
51
Menisci Characteristics
Fibrocartilage Located on the articular surfaces of tibia -lateral covers more than medial they are wedged-shaped (thicker on periphery/thinner centrally)
52
Menisci Attachments
Centrally: Small ligaments attaching to horns Peripherally: coronary ligaments Innervated=aneural Have red zone-red/white- and white
53
Menisci Fxn
1. Protect against compressive and rotational forces (shock absorption) 2. Increase contact area between tibia and femur 3. Stabilization
54
Medial Meniscus
"C" shaped Broader posteriorly than anteriorly--increases its risk of injury Attaches to deep portion of MCL Less tibial coverage (leads to increased contact area b/w femur and tibia)
55
Lateral Meniscus
More crescent shaped smaller and more mobile than MM Separated from LCL by popliteus tendon Covers more tibial area, decreasing contact area b/w tibia and femur
56
Anterior & Posterior Horns
Each horn is firmly attached to tibia plateau below Meniscal motion on the tibia is limited by multiple attachments to surrounding structures Medial Mens. has greater ligamentous and capsular restraints, limits translation to a greater extent than the lateral mens.
57
Coronary Ligaments
attaches to periphery of meniscus to tibial plateau
58
transverse tibial ligaments
attaches anterior horns of medial and lateral meniscus
59
Medial Meniscal attachments
deep fibers of MCL Anterior horn of the MM attached to ACL Posterior horn of the MM attached to PCL Through capsular connections via semimebranosus
60
Lateral Meniscal attachments
Meniscofemoral ligament connects LM to the PCL and medial femoral condyle Tendon of the popliteus muscle through capsular attachments - --helps control mobility - --separates the LM from LCL
61
Bursae of the knee
Fxn: lubrication and nutrition Communicating bursa are evaginations of synovial membrane of jt --suprapatellar bursa --popliteus bursa
62
Non-communicating bursa
``` prepatellar bursa subcutaneous infrapatellar bursa deep infrapatellar bursa pes anserine bursa gastrocnemius bursa ```
63
Prepatellar bursa
located b/t skin and anterior aspect of patella
64
subcutaneous infrapatellar bursa
b/t skin and tibial tuberosity
65
deep infrapatellar bursa
b/t patellar tendon and anterior aspect of infrapatellar fat pad (superficial to tibial tube)
66
Fat Pad
Deep infrapatellar fat pad highly innervated good vascularization
67
Retinaculum
Extension of fibrous layer of knee joint | medial and lateral
68
Plica
Superior band Medial band-most prominent Inferior band
69
ITB attachments
Tendon of the TFL-thickening of fascia lata Attaches to lateral tibia at Gerdy's tubercle Also has fibers that blend to lateral retinaculum and patella, therefore fibrous layer of joint
70
ITB fxn
At 30* flexion ITB runs posterior to lateral epicondyle; When its straight it's anterior "full flex" > 30* flexion "straight" < 30* flexion
71
Popliteal Fossa Borders
Posteriorly-gastrocnemius (both heads) Floor-popliteus muscle and femur Superolateral- biceps femoris muscle Superomedial- semimembranosus and semitendinosus muscles
72
Popliteal Fossa Contents
popliteal artery and vein, tibial and common peroneal nerve
73
Popliteus PA
PA: Lateral femoral condyle on an impression on the distal most portion of the lateral supracondylar line
74
Popliteus DA
DA: a triangular area on the posterior tibia proximal to the soleal line
75
Popliteus Innervation
Tibial N. L4-S1
76
Actions of Popliteus
Generally unlocks the extended knee (starts knee flexion) OC: medially rotates the tibia CC: laterally rotates the femur
77
Knee Extensors
Quadriceps Femoris - Rectus Femoris - Vastus Medialis - Vastus Lateralis - Vastus Intermedius Tensor Fascia Latae Articularis Genu
78
Rectus Femoris PA
Straight head: AIIS | Reflected head: groove of the ilium superior to the acetabulum; fibrous capsule of hip joint
79
Rectus Femoris DA
Patella via the quadriceps tendon; tibial tuberosity via the patellar tendon
80
Rectus Femoris Actions
Hip flexion; Knee extension
81
Rectus Femoris Innervation
Femoral nerve L2,3,4
82
Vastus Medialis PA
medial intertrochanteric line, medial lip of linea aspera, proximal 2/3 supracondylar line, medial intermuscular septum, VMO arises from tendon of adductor magnus
83
Vastus Medialis DA
Medial patella by quadriceps tendon, tibial tuberosity by patellar tendon, blends with medial aspect of fibrous joint capsule of knee
84
Vastus Medialis Actions
Knee extension; patella stabilization
85
Vastus Medialis Innervation
femoral nerve L2,3,4
86
Vastus Lateralis PA
Intertrochantic line, anterior and inferior borders of the greater trochanter, lateral lip of gluteal tuberosity, proximal 1/2 of linea aspera and lateral intermusuclar septum
87
Vastus Lateralis DA
Lateral patella by quadriceps tendon, tibial tuberosity by patellar tendon, blends with lateral aspect of fibrous joint capsule of knee
88
Vastus Lateralis Actions
Extends knee and stabilizes patella
89
Vastus Lateralis Innervation
Femoral Nerve L2,3,4
90
Vastus Intermedius PA
proximal 2/3 of femur along its anterior and lateral surfaces, distal aspect of lateral intermuscular septum
91
Vastus Intermedius DA
patella by quad tendon, tibial tuberosity by patellar tendon
92
Vastus Intermedius Actions
extends the knee
93
Vastus Intermedius Innervation
Femoral Nerve L2,3,4
94
Tensor Fascia Latae PA
PA: Anterior iliac crest, lateral surface of ASIS
95
Tensor Fascia Latae DA
DA: ITB to Gerdy's Tubercle
96
Tensor Fascia Latae Actions
Extends and ER the knee; Flexes and IR the hip
97
TFL Innervation
Sup. Gluteal Nerve L4-S1
98
Articularis Genu PA
distal anterior aspect of femur
99
Articularis Genu DA
suprapatellar bursa
100
Articularis Genu Actions
prevents impingement of the bursa during knee extension
101
Articularis Genu Innervation
Femoral n. L2,3,4
102
Knee Flexors
Biceps femoris long head Biceps femoris short head Semitendinosus Semimembranous
103
Biceps Femoris PA
Long head- upper ischial tuberosity | Short head-lateral lip of linea aspera, proximal 1/2 of lateral supracondylar line
104
Biceps Femoris DA
fibular head, LCL, lateral tibial condyle
105
Biceps Femoris Actions
flexes knee, extends hip, ER hip and knee
106
Biceps Femoris Innervation
Long head-tibial division of sciatic nerve L5-S2 | Short head-common peroneal division of sciatic nerve L5-S2
107
Semitendinosus PA
Inferomedial aspect of ischial tuberosity
108
Semitendinosus DA
pes anserine
109
Semitendinosus Actions
flexes knee, extends hip, IR hip and knee
110
Semitendinosus Innervation
Tibial division of sciatic nerve L5-S2
111
Semimembranosus PA
Superolateral aspect of ischial tuberosity
112
Semimbranosus DA
posterior aspect of medial tibial condyle
113
Semimembranosus Actions
flexes knee, extends hip, IR hip and knee
114
Semimembranosus Innervation
Tibial division of sciatic nerve L5-S2
115
Sartorius PA
ASIS
116
Sartorius DA
Pes Anserine
117
Sartorius Actions
flexes hip, ER hip, ABD hip/Flexes knee, IR knee
118
Sartorius Innervation
Femoral Nerve L2,3
119
Gracilis PA
lower 1/2 pubic body, lower aspect of inferior pubic ramus and adjoining ischial ramus
120
Gracilis DA
Pes Anserine
121
Gracilis Actions
flexes and IR knee, adducts the hip
122
Gracilis Innervation
obturator nerve L2,3

Anatomy AT 521 (3 decks)

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