KNEE, FOOT, LEG + ANKLE JOINTS Flashcards by grace manserra

tibiofemoral kinematics

Convex vs Concave rules

convex (m): femur
- roll and slide in opposite directions
concave (f): tibia
- roll and slide in same direction

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Screw-home mechanism

Describe the locking mechanism at the knee joint and explain its functional significance

Rotation of the tibia and femur of the last 20º of knee extension
Bc medial femoral condyle is larger
Femur rotate medially when weight bearing
Tibia rotate lateral when non-weight bearing
Causing knee locking (greatest congruency) to allow to stand passively

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Screw-home mechanism

What is the movement between the tibia and femur during terminal knee extension?

Femur rotate medially when weight bearing
Tibia rotate lateral when non-weight bearing

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Screw-home mechanism

What is the reason for femoral medial condyle rotating medially ?

bc femoral M condyle bigger than L
then allow for rotation
due to Increase congruency

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non-weightbearing

With a fixed femur, in which direction does the tibia move?

Screw-home mechanism

Laterally

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weightbearing

With a fixed tibia, in which direction does the femur move?

Screw-home mechanism

Medially

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Screw-home mechanism

What happens to the ACL and PCL?

crosses to “lock” the knee
ACL and PCl are taut

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Screw-home mechanism

How do we “unlock the knee”?

Popliteus
Laterally rotate femur to unlock the knee

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Screw-home mechanism

Why do we lock the knee?

Passive stability

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Synovial joints

Roll then slide

2 bones stay together
max ROM

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Screw Home mechanism

What
Why
Results in

what:
- rot bw tib and femur during terminal knee ext (last 20º)
- “spin”
why:
- bc med fem cond = larger
results in..
- knee-locking

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spin, roll, slide

Knee flexion

tibia: (f) concave
eg. standing w knee @ 90º
- rolls post
- slide post

femur: (m) convex
eg. downwards phase of a squat
- rolls post
- slides ant

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spin, roll, slide

Knee extension

tibia: (f) concave
eg. standing w knee at 90º and extending knee out
- rolls ant
- slide ant

femur: (m) convex
eg. coming up from a squat
- rolls ant
- slides post

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Patellofemoral kinematics

Full knee extension

patella X in contact w pat surf of femur
0º flexion
DCR stability

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Patellofemoral kinematics

Knee flexion

as º of flexion INCR’s
contact area of:
a) patella: moves proximally
b) femur: moves posteriorly

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Tibiofemoral stability

Static (passive / non-contractile)
Dynamic (active / contractile)

Study These Flashcards

Static:
- meniscus
- ligaments

Dynamic:
- quad fem (vastus med, lat, intermed, rec fem)
- pes anserinus
- ITB (has musc that attach into it)

Tibiofemoral stability

Static - meniscus

structure and function

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structure:
- fibrocart discs bw condyles
function:
- absorb shock
- distrib WB forces
- INCR congurency bw condyles
- assist w lubric -> distr syn fluid w in knee joint cavity

TIbiofemoral stability

Static - meniscus

attachments

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Lateral:
- PCL

Medial:
- MCL

Tibiofemoral stability

Static - ligaments

ant tib disp
post tib disp
add stab
abd stab
int tib rot stab
ext tib rot stab

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1. ant tib disp:
P: ACL
S: MCL, ITB
2. post tib disp:
P: PCL
S: MCL, LCL, oblique pop lig
3. add stab:
P: MCL
S: ACL, PCL, post oblique lig
4. abd stab:
P:
S: LCL, acruate pop lig
5. int tib rot stab:
P: MCL, oblique pop lig, post oblique lig
S: ACL, PCL
6. ext tib rot stab:
P: LCL, acruate pop lig
S: ACL, PCL

tibiofemoral stability

Dynamic - quadraceps femoris

action and function

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action:
- knee ext
- last 15ºDCR mech adv
function:
- stabilise patella

tibiofemorall stabilty

Dynamic - Quad fem:
vastus medialis

Vastus medialis - functions

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VML:
- knee extensor
VMO:
- stablises patella medially
- prev lat dislocation of pat from VL
- realigns pull -> INCR effic of quads
- prev lat tracking dur patella ext

tibiofemoral stability

ITB

structure and function

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structure:
- thickening of feep fascia of thigh
- consistently taut
function:
- stablise pat laterally
- assist ACL -> prev ant tib slide

during flexion -> behind knee axis
during extension -> infront knee axis

tibiofemoral stability

pes anserinus

structure and function

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function:
- knee flexion
- int rotation
- stabilise ag. valgus stress

1. sartorius
2. gracilis
3. semitendinosus

“say grace before tea”

Tibiofibular joints

3 types

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prox tibiofib joint
mid tibiofib joint
dist tibiofib joint (syndesmosis)

# tibiofibular joints prox VS dist and med

proximal: - synovial, plane - move fibula during planatrflex and dorsiflex distal and medial: - fibrous syndesmosis - maintain inregr of malleolus mortise

# tibofibular joint 1. prox TF joint | class, A/S, movement

class: - syn, multi, plane A/S: - head of fibula - fibula articular facet of tibia movement: - small gliding

# tibiofemoral joints medial and distal TF joints (syndesmosis) | class, s, movement

**MEDIAL** class: - fibrosus, syndesmosis s: - interosus membrane movement: - slight movem bc of long fibres **DISTAL:** class: - fibr, syndesmosis A/S: - fibular notch of tibia - dist fibula

# tibiofibular joints Ligaments: A-PTFL P-PTFL IOL TL

**Anterior Proximal Tibiofibular Ligament (A-PTFL):** - proximal tibia to the fibula. **Posterior Proximal Tibiofibular Ligament (P-PTFL):** - proximal tibia to the fibula. **Interosseous Ligament (IOL):** - - contin of inter mebr (bw tib + fib) INCR's stab **(inf) Transverse Ligament (TL):** - distal tibia and fibula at the distal end.

# Ankle (talocrural) joint Talocrural joint | Classification, movements, articular surfaces, joint caspule

**class:** - syn, uniaxial, hinge **movements:** - plantar (50º), dosri (30º) **articular surfaces:** **- tibia ->** trochlea surface **- tib + fibula ->** malleolar surfaces of tib + fib **- talus ->** trochelar surface = WB **joint capsule:** - weak/think ant + post so dosriflex/plantarflex can occur

# Ankle (talocrural) joint Ligaments - medial | M collateral ligs, calcaneofibula, i/o talocalc, plantar calcnav

**medial collateral lig🔺** 1. tibionavic lig - DCR abd 2. A tibiotalar lig - DCR plantar 3. P tibiotalar lig - DCR dorsi 4. calcaneofibular - DCR inversoin, dorsi 5. interosseous talocancalcaneal - INCR joint stab 6. plantar calcaneonavicular - support M longitudinal foot arch

# Transverse tarsal joint LaTeral and plantar ligaments | A/P talofib, calcfib, calccuboid short + long

1. A talofibular - DCR plantar 2. P talofibular - DCR dorsi 3. calcaneofibula - DCR dorsi + add 4. short calcaneocuboid lig - foot longitud arch 5. long calcaneocuboid lig - foot longitud arch

# tarsometatarsal joints (TMT) 1. Dorsal TMT lig 2. Plantar TMT lig 3. Cuneometatarsal I/O lig | class, movem, articular surf

**class:** - syn, plane, multi **movements:** - flex/ext - 1st joint = slight abd / rot (support balance uneven gorund) **articular surfaces:** 1. med cub -> B1stM 2. intermde cub -> B2ndM (recessed / least mobile) 3. lateral cub -> B3rdM 4. lateral cub -> cuboid + B4thM 5. cuboid + B5thM **1. dorsal TML:** - DCR flex meta **2. plantar TML:** - DCR ext meta **3. cuneometatarsal interosseous lig:** - 3 slips: med + lat cuneiforms - 2 slips: B2nd + 4th metatarsals

# interphalangeal joints 1. collateral lig 2. plantar ligs | class, movem, A/S

**class:** - syn, uniax, hinge **movements:** - flex/ext **A/S:** - head of phalanx - bases of adj phalanx **1. collateral ligament:** s: thick articular capsule on side f: DCR flex digits **2. plantar ligs:** s: fibrocart plates grooved for long flexor tendons f: DCR ext

# metatarsophalangeal joints (MTP) 1. collateral 2. plantar 3. deep transverse | class, A/S, movement of digits

**class:** - syn, biax, condyloid **A/S:** - head of metatarsals - base of prox phallanges **movement of digits:** - flex/ext - abd/add - circumduction **1. collateral** - thickening of capsule - DCR flex, abbd/add **2. plantar** - fibrocart, groove - DCR ext **3. deep transverse** - conn plantar ligs of MTP joints - assist w WB

KNEE, FOOT, LEG + ANKLE JOINTS Flashcards

(34 cards)