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Flashcards in Lecture 28 In Class Deck (31):
1

What is another name for fibular?

Peroneal. 

2

What are the muscles of hte posterior compartment of the knee?

What are their actions?

  • Hamstring Muscles
    • semitendinosus
    • Semimembranosus
    • ​Biceps femoris
    • Adductor Magnus

extensors of the hip, flexors of the knee

all originate on ischial tuberosity!!!

3

What are the roots for sciatic nerve?

What does it do?

  • L4-S3
  • Innervate muscles of poterior thigh

 

  • Tibial part (most of them)
    • ​semitendinosus
    • semimenrbanosus
    • lg head of biceps femoris
    • hamstring part of add magnus

4

Semitendinosus (has a true tendon)

  1. ischial tuberosity--> medial tibia (with gracilis and sartoris)
  2. tibial sciatic (L4-S3)
  3. extend hip and flex knee

hamstring muscle

Posterior thigh muscle

5

What is the muscle to the left of the line?

Semimembranosus (looks like a tendon)

  1. ischial tuberosity --> medial tenondon condyl fibers refelct back up to fossa and become oblique tendon
  2. tibial part of sciatic (L4-S3) 
  3. extend hip, flex knee

hamstring muscle

Posterior thigh muscle

6

Biceps Femoris Long Head

  1. ischial tuberosity--> head of fibula
  2. tibial part of sciatic nerve (L4-S3)
  3. extend hip, flex knee

Hamstring muscle

poterior thigh muscle

7

What muscle is this? 

  1. What is its orgin and insertion?
  2. What is its innervation
  3. What is its actions?

Biceps Short head

  1. lateral lip of linea aspera--> ******head of fibula********
  2. common fibular part of scatitc  (L4-S2)
  3. flex knee 
    1. only one that does not extend the hip

Hamstring muscle

posterior thigh muscle

8

What muscle is this? 

  1. What is is Orgin/ insertion?
  2. What is its innervation
  3. What is its actions?

Adductor magnus (hamstring head)

  1. ischial tuberosity-->adductor tuberical of femor 
  2. tibial part of sciatic nerve (L4-S3)
  3. extend the hip 

Most of the floor of the posterior thigh

Hamstring muscle

posterior compartment of the thigh 

9

What is pes anserinus?

What is another name for it?

  • conjointed tendon of: 
    • sartorius m
    • Gracilis
    • semitendinosus
  • anteromedial tibial

10

what are the attachments for these places

  • addcutor tubericle: adductor magnus hamstring part
  •  

on medial side from top to bottom,

gracilis

semitendenosis

sartouris

11

What is the blood supply of the posterior thigh?

12

What are the boundreis of the popliteal fossa?

Where is it located?

  • Sup-med:
    1. ​​ semimembranosus
    2. semitendiosus
  • Sup-lat​​

​            3.biceps femoris

  • Inf-med

             4.medial head of gastrocnemius

  • Inf-lat

             5.lat head of gastrocnemius

             6. plantaris

POSTERIOR FEMUR

 

  • Roof
    1. ​ popliteal fascia
      • poterior femoral cutaneus
      • medial and lateral sural nn.
      • (f/ tibial {medial}
      • common fibular nerve {lateral nerve}
      • small saphenosus v --> popliteal v
  • Floor
    1. ​ femur
    2. oblique popliteal lig f/ semitenenosis 
      • stabalize the knee
    3. popliteus 

 

 

13

What are the contents of the popliteal fossa?

  1. tibial nerve  (L4-S3)
    1.  medial sural nerve
  2. popliteal vein
    1. small saphenous vein
  3. popliteal artery
    1. genicular anastomosis
    2. Common fibular nerve (L4-S2)
      1. lateral sural nerve

14

  1. What type of joint is the tibiofemoral joint?
  2. Articulations
  3. What does stibility depend on?

  1. modified hinge joint
  2. lateral/medial femoral condyly--> lateral/medial tibial plateau
  3. ligaments and surround muscles and tendons

15

Genu varum vrs. Genu Valgum 

Genu Varum

  • small Q angle bowleg

Genu Valgum

  • Large Q angle Knock-Knee
  • can increase potential for patellofemoral syndrome

 

Q angle: perpindicular line of gravity and asis line 

 

16

What are the movements of the knee and what does it?

  • Extension
    • Quadriceps femoris
      • rectus femoris
      • vastus medialis
      • vastus lateralis 
      • vastus inermedeus
  • Flexion
    • Hamstring
      • semimembronosus
      • semitendenosis 
    • Biceps femoris (both heads) 
    • Grastrocnemius
    • Popliteus
    • Gracilis
    • Sartouris 

17

Knee Flexion (as in the contacting surfaces) 

Round surfaces on the femoral condyles 

18

 knee extension as related to surfaces

flas surfaces of femoral condyle with tibial plataue

19

Locking and unlocking of the knee

  • Locking the knee
    • ​during extension passive locking with slight medial rotation femur on tibia (screw home mechinisum) 
  • Unlocking the knee
    • tibia is already exteneded a slight lateral rotation on it will initiate flextion. 
      • flexion is inniciated by popliteus 

20

Bursa of the knee

  • Suprapatellar bursa
    • ​extension of synovial capsual 
    • fibers from vastus medialsis 
    • apex attached articular genus m 
  • Prepatellar bursa
    • b/t pellar and skin 
    • kneeling down 
    • Housemaid's knee
  • subcutaneous and deep infrapatellar bursae
    • protect pellar ligametn from anterior petellar ligament 

21

What are baker's cyst?

What is another name for it?

  • When the synovial capsual will go back into posterior fosa and synovial fluid will go it
  • due to knee problems, cartligde prest 

22

Extracapsular Knee ligaments

Can see without going into knee joint 

  • ​​olique popliteal ligament
    • posterior 
    • extension of semimembronosus
  • arcutare popliteal ligament
    • over popliteus muscle
  • patellar ligament
    • attach to ---
  • lateral collateral ligament
    • prevents varus (outward) deformity
    • seperated f/ miniscus by popliteal
  • medial collateral ligament
    • prevents valgus (inward) deformity 

23

Intracapsular knee ligaments

  • Anterior cruciate lig
    • anterior tibieal--> lateral condyle of femur
    • prevent hyperextension
    • prevents anterior displacement of fixed tibia
  • Posterior cruciate ligament
    • prevents posterior displacemetn of fixed tibia
    • prevents hyper flexion of knee
    • posterior tibial--> medial condyle of femur

24

What is Drawers Sign and how do you test for it?

What does it test for?

  • Anterior Draw test
    • free tibial slides anteriorly on fixed femurs
    • anterior cruciate ligaments damage tested
  • Posterior Draw test
    • free tibial slides posteriorly under fixed femus
    • posterior cricuate ligaments 

25

What are the menisci of the knee?

between femur and tibia to support so we dont rub tibia and femur

  • Medial Meniscus
    • attached to capsule 
    • attached to tibial collateral ligament 
  • Lateral Meniscus 
    • smaller and more mobile 
      • because has popliteal tendon 
    • popliteus tendon passes between menisucu capusle
  • Ligaments
    • transverse ligament of knee
    • posterior meniscofemoral ligament
    • inside the capsule but outside synovial cavity

26

How do you test for Meniscus tears?

relativly a vascular so they dont heal well

Steinmann test

  • tear in central not to bad
  • periferal need to be stiched. 

27

What is an unhappy triad injury?

classic description

  • atnerior cruciate ligament
  • medial collateral ligament 
  • medial meniscus 

28

What is the innervation of the knee?

  • Anterior knee
    • Femoral n (L2-L4)
  • Posterior knee
    • Tibial N (L4-S3)
  • Lateral Knee
    • Common fibular (peroneal) (L4-S2)
  • Medial Knee
    • Obturator n (L2-4)

29

Blood supply of the knee

Genicular anastomosis 

  • descending genicular f/ femoral a
  • genicluar brances fo popliteal a (go into joint capsule) 
    • superior lateral  (above gastrocniemus)
    • superior medial 
    • inferior lateral (below gastrocniemus) 
    • inferior medial 
    • middle genicluar (may or maynot be there)
  • anterior tibial-->  recurrent and circumflex of fibular braches of tibial a 
  • descending branch of lateral circumflex femoral a. 

30

Patellofemoral joint

Diseases?

  • between petellar and two condyles of fibula
  • modify plane joint 
  • protect knee joint 
  • RUNNERS KNEE!

31

What  happenes in a total knee replacement?