Joints of the Lower Limb

Question 1

The hip joint is a ball and socket type synovial joint formed by the articulation between the ____ of the pelvis and the ___ of the femur

Answer 1

acetabulum; head

Question 2

The hyaline cartilage-lined ___ surface of the acetabulum is incomplete inferiorly forming the acetabular notch, which is bridged by the ____ ____ ligament

Answer 2

lunate; transverse acetabular

Question 3

The acetabulum is deepened by the presence of the acetabular _____, a triangularly-shaped fibrocartilaginous rim around the periphery of the acetabulum

Answer 3

labrum

Question 4

The head of the femur is covered by articular cartilage except at the ___ for the ligament of the head

Answer 4

fovea

Question 5

The inverted Y-shaped _____ ligament (of Bigelow) has superior attachments to the acetabular rim and the ASIS and inferior attachments to the intertrochanteric line and lesser trochanter

Answer 5

iliofemoral

Question 6

The iliofemoral ligament prevents ____ at the hip joint

Answer 6

hyperextension

Question 7

The inferiorly placed _____ ligament has attachments to the pubic bone medially, while blending laterally with the iliofemoral ligament

Answer 7

pubofemoral

Question 8

The pubofemoral ligament prevents excessive _____ at the hip joint

Answer 8

abduction

Question 9

The posteriorly placed ____ ligament has attachments to the ischial part of the acetabular rim, then spiraling superolaterlally attaches to the neck of the femur by the greater trochanter

Answer 9

ischiofemoral

Question 10

Of the three hip ligaments, which one is the weakest?

Answer 10

ischiofemoral

Question 11

The three hip ligaments as a whole work to restrict ____ of the thigh

Answer 11

extension

Question 12

____ fibers encircle the fibrous joint capsule and constrict the joint capsule around the neck of the femur

Answer 12

orbicular

Question 13

The fibrous capsule of the hip joint is weakest ____ and _____

Answer 13

posteriorly and inferiorly

Question 14

Inside the joint space, what ligament arises form the margins of the acetabular notch and transverse acetabular ligament and attaches to the femoral head at the fovea

Answer 14

ligament of the head of the femur

Question 15

The ligament of the head of the femur is a weak ligament that provides no support to the joint, but serves to convey an artery to what?

Answer 15

the epiphysis of the developing femoral head

Question 16

The rectus femoris covers the hip joint capsule ____, the iliopsoas tendon reinforces the joint capsule ____ and ____, and the gluteus medius and minimum provide support _____

Answer 16

anteriorly; medially, inferiorly; superiorly

Question 17

Contraction of muscles that cross the hip joint provide considerable ___ force to keep the head of the femur seated in the acetabulum

Answer 17

shunt

Question 18

The most important blood supply to the hip joint, including the head and neck of the femur is by retinacular branches of what artery?

Answer 18

medial circumflex femoral artery

Question 19

The nerve supply to the hip joint follows ____ law, which states that nerves that supply muscles that cross a joint will also give sensory fiber innervation to the joint

Answer 19

Hilton’s

Question 20

Fracture of the femoral neck, commonly called a hip fracture, is a fairly common occurrence, especially in elderly women due to osteoporosis. In this case, the limb will appear to be ____ and ____ rotated

Answer 20

shortened; externally

Question 21

Intracapsular fractures are especially problematic since they interrupt the blood supply with can lead to ____ ____

Answer 21

avascular necrosis

Question 22

This joint is a modified hinge-joint and is the largest synovial joint in the

Answer 22

knee joint

Question 23

Due to the size difference between the articular surfaces of the femur and of the tibia, the knee joint is a mechanically weak joint that depends on muscles and ligaments for stability. True or false?

Answer 23

true

Question 24

Between the medial and lateral condyles of the femur, which one is larger?

Answer 24

medial condyle is larger both medial-laterally and antero-posteriorly

Question 25

The two femoral condyles are continuous onto the anterior surface of the distal femur where their union forms the articular surface for the patella (often termed the ____ ____)

Answer 25

patellar groove

Question 26

The superior surface of the tibia presents the ___ _____ formed of irregularly concave medial and lateral tibial condyles separated by an intercondylar eminence

Answer 26

tibial plateau

Question 27

This ligament of the knee arises from the anterior intercondylar area and passes posteriorly, laterally and superiorly to attach to the medial side of the lateral femoral condyle

Answer 27

ACL

Question 28

the ACL resists ____ displacement of the femur on the tibia during flexion, and functions to resist _____

Answer 28

posterior; hyperextension

Question 29

This ligament attaches to the posterior intercondylar area and extends anteriorly, medially, and superiorly to attach to the lateral side of the medial femoral condyle

Answer 29

PCL

Question 30

The PCL resists ____ displacement of the femur during extension and functions to resist ____

Answer 30

anterior; hyperflexion

Question 31

The ____ are crescent-shaped fibrocartilaginous plates applied to the margins of the tibial condyles

Answer 31

menisci

Question 32

The ends of each meniscus are firmly attached to the intercondylar area of the tibia and their anterior ends are joined by what ligament?

Answer 32

transverse ligament of the knee

Question 33

This meniscus is the larger and more C-shaped. It is attached to the MCL and is often injured when the MCL is torn

Answer 33

medial meniscus

Question 34

This ____ meniscus is smaller and more circular. The tendon of ____ intervenes between the lateral meniscus and LCL

Answer 34

lateral; popliteus

Question 35

A small but strong _____ ligament attaches the posterior margin of the lateral lemniscus to the medial condyle of the femur, coursing on both sides of the PCL

Answer 35

meniscofemoral

Question 36

Medially, the capsule of the knee joint is reinforced by this broad, thick ligament that is attached to the medial femoral epicondyle and the supermodel surface of the tibia. It is fused to the fibrous capsule

Answer 36

MCL

Question 37

This ligament is found laterally on the knee. It is a strong cord-like structure that interconnects the lateral epicondyle of the femur and the head of the fibula.

Answer 37

LCL

Question 38

The tendon of the popliteus separates the fibular collateral ligament from what?

Answer 38

the lateral meniscus

Question 39

A reflection from the semimembranosus tendon forms the ____ ____ ligament that reinforces the capsule

Answer 39

oblique popliteal

Question 40

At the site where the tendon of the popliteus penetrates the capsule, the overlying thickening of the capsule forms what ligament

Answer 40

arcuate popliteal ligament

Question 41

The tibiofemoral and patellofemoral articular surfaces are inside the synovial cavity, but the space between the condyles including the cruciate ligaments is not. True or false?

Answer 41

true

Question 42

Superior to the patella, the synovial cavity extends deep to the vastus intermedium to some distance forming the _____ bursa

Answer 42

suprapatellar

Question 43

A small slip of muscle, the ____ ___ attaches to the superior tip of the suprapatellar bursa pulling it away from the joint space when the knee is extended

Answer 43

articularis genu

Question 44

A number of small, localized bursae protect muscles and/or tendons as they lie adjacent to bone, the knee joint capsule, or each other. Some are continuous with the joint cavity. Subcutaneous bursa superficial (____ bursa) and inferior to the patella help the skin glide smoothly over the bones as the knee is moved

Answer 44

prepatellar

Question 45

The most important muscle that stabilizes the knee joint is the ____ ____

Answer 45

rectus femoris

Question 46

The lower fibers of the vestus medialis and vestus lateralis extend over the anterior surface of the knee joint as ____ reinaculum and ____ ____ retinacula

Answer 46

medial; lateral patellar

Question 47

Posteriorly, the knee capsule is supported by the tendons of the ____ muscles as well as the heads of the ____

Answer 47

hamstring; gastrocnemius

Question 48

Primary vascular supply to the lower limb is from which arteries?

Answer 48

descending, superior lateral, inferior lateral, superior medial, and inferior medial genicular arteries which have connections with the femoral, popliteal, lateral circumflex femoral, circumflex fibular, and the anterior tibial arteries

Question 49

The genicular arteries form an anastomotic complex around the knee joint that is termed the ____ ____ ___

Answer 49

perimeniscal vascular ring

Question 50

The anastomotic complex formed by the genicular arteries is more prominent anteriorly where it forms what plexus?

Answer 50

infrapatellar vascular plexus

Question 51

This artery is a small branch off the popliteal artery which pierces the oblique popliteal ligament and supplies the ligaments and synovial membrane around the intercondylar eminence

Answer 51

middle genicular artery (intercondylar radiate artery)

Question 52

The nerve supply to the lower limb is by articular branches of what nerves

Answer 52

femoral, tibial, common fibular, and obturator

Question 53

A blow to the ____ side of the knee usually results in tearing of the ACL, MCL and medial meniscus (unhappy triad)

Answer 53

lateral

Question 54

The tibia and fibula are interconnected through most of their length by an interosseous membrane that has an opening superiorly for the ____ ____ vessels and inferiorly for the perforating branch of the ____ artery

Answer 54

anterior tibial; fibular

Question 55

The proximal tibiofibular joint is a synovial joint but allows for very little movement. The LCL spans this joint which is reinforced by what two ligaments?

Answer 55

anterior and posterior tibiofibular ligaments

Question 56

The distal tibiofibular joint is _____

Answer 56

syndesmotic

Question 57

The ligamentous attachments of the distal tibiofibular joint allow for limited ____ displacement of the lateral malleolus

Answer 57

lateral

Question 58

Disruption of the anterior tibiofibular ligament will result in what?

Answer 58

high ankle sprain

Question 59

The ankle joint allows what two movements of the foot?

Answer 59

dorsiflexion, plantarflexion

Question 60

Because the anterior part of the talar articular surface is wider than the posterior part, the joint is more stable during _____ than during ____

Answer 60

dorsiflexion; plantarflexion

Question 61

The ____ ligament is triangular-shaped and strong on the medial side of the ankle. This ligament has 4 separate components that interconnect the tibia and medially located bones of the foot.

Answer 61

deltoid (medial)

Question 62

What are the 4 components of the deltoid ligament? What do they limit?

Answer 62

anterior tibiotalar, tibionavicular, tibiocalcaneal, and posterior tibiotalar; limit eversion of the foot

Question 63

The lateral ligament located on the lateral side of the ankle has 3 components. What are they? What do they limit?

Answer 63

anterior talofibular, posterior talofibular, and calcaneofibular; limit inversion of foot

Question 64

Vascular perfusion of the ankle joint is supplied by Malleolar branches of what two arteries?

Answer 64

anterior tibial and preoneal arteries

Question 65

Innervation of the ankle joint is by branches of what nerve?

Answer 65

deep peroneal nerve

Question 66

Ankle sprains (low ankle sprains) are common injuries and most frequently involve what ligament?

Answer 66

anterior talofibular ligament nemonic: always tears first

Question 67

The inferior surface of the talus supports a large concave ____ facet on its posterior aspect

Answer 67

calcaneal

Question 68

The superior surface of the calcareous supports a convex ____ ___ facet near the middle of the bone

Answer 68

posterior talar

Question 69

This ligament attaches to the lateral surface of the talus just anterior to the fibula; the distal attachment on the calcareous is shared with the more superficial calcaneofibular ligament

Answer 69

lateral talocalcaneal ligament

Question 70

The medial talocalcaneal ligament spans from the ____ ____ of the talus to the posterior surface of the ____ ____

Answer 70

medial tubercle; sustenaculum tali

Question 71

The strongest link between the talus and calcaneum is what ligament?

Answer 71

interosseus talocalaneal ligament

Question 72

Inflammation of the interosseus talocalcaneal ligament can impinge on the venous plexus, small artery, and branch of deep peroneal nerve located in sinus between two bones. What is this condition called?

Answer 72

tarsal sinusitis

Question 73

This joint separates the hindfoot and midfoot and is actually a complex of two joints, the calcaneocuboid and the talocalcaneonavicular joints. It is the main site of rotational displacement of the foot

Answer 73

transverse tarsal joint

Question 74

Directly covering the inferior surface of the calceocuboid joint is the plantar calcaneocuboidal ligament also known as?

Answer 74

short plantar ligament

Question 75

Immediately superficial to the short plantar ligament is the ____ ____ ligament which attaches further posteriorly on the calcaneum and spans the cuboid to attach to the base of metatarsals 2-5

Answer 75

long plantar

Question 76

This ligament attaches to the anterior surface of the posterior tarsal facet of the calcaneum then courses anteriorly the superolateral surface of the calcaneum and forms a soft-tissue floor to the tarsal sinus

Answer 76

bifurcate ligament

Question 77

The bifurcate ligament spans both the calcaneocuboid and talocalcaneonavicular joints. True or false?

Answer 77

true

Question 78

The interosseous talocalcaneal ligament supports the talocalcanonavicular joint but the primary support is by way of which ligament

Answer 78

plantar calcaneonavicular ligament (spring ligament) note: attaches to the sustentaculum talk of the calcaneum, courses anteromedial over the inferior surface of the navicular

Question 79

Tearing or stretching of the weight bearing ligaments that span the inferior surface of the transverse tarsal joints can cause disruption of what?

Answer 79

spring ligament, short and long plantar ligaments (longitudinal arches of foot)