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Lower Limb Joints Flashcards

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1
Q

Anterior SI joint

A

. Synovial joint btw interlocking auricular surfaces of sacrum and ilium
. Auricular surfaces covered by articular cartilage

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2
Q

Posterior SI joint

A

. Syndesmosis btw tuberosties of sacrum and ilium

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3
Q

Intrinsic ligament of SI joint

A

. Ant./post. SI ligament

. Interosseous ligament

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4
Q

Ant. SI ligament

A

. Ant. Portion of fibrous joint capsule

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5
Q

Interosseous SI ligament

A

. Spans btw tuberosities of sacrum and ilium
. Strongest ligament in body
. Primary weight-bearing structure

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6
Q

Posterior SI ligament

A

Post. External continuation of interosseous SI ligament

. Blends w/ sacrotuberous ligament inf.

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7
Q

Extrinsic ligaments of SI joint

A

. Iliolumbar: connects transverse process of L5 to pos. Iliac crest, blends w/ ant. SI ligament, stabilizes SI joint, sometimes connected to L4
. Sacrospinous: prevent excessive ant. rotation
. Sacrotuberous (same as above)

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8
Q

Movement permitted by SI joint

A

. Small amount of gliding and rotation (pelvic tilt)

. Relatively immobile

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9
Q

Interosseous SI ligaments function

A

. Transmit weight of upper body to pelvic bones

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10
Q

Sacrospinous and sacrotuberous ligament function

A

. Resist ant. Rotation of sacrum in response to vertical loading of sacral base ant. To SI joint’s transverse axis

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11
Q

What percentage of femur head resides w/in the acetabulum?

A

More than 50%

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12
Q

Congenital hip dysphasia

A

. Development anomaly
. Causes intermittent dislocation of femur head from acetabulum
. Risks: family history, female, breech presentation
. Infants screened for this

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13
Q

Hip Joint surfaces that have articular cartilage

A

. Femoral head including its fovea

. Lunate surface of acetabulum

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14
Q

Hip joint surfaces not covered by articular cartilage

A

. Acetabulum fossa

. Has synovium covered acetabulum fat pad instead

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15
Q

Transverse acetabular ligament

A

. Spans acetabular notch
. Connects free ends of labrum
. Forms foramen for passage of nerves and vessels

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16
Q

Femoroacetabular impingement syndrome

A

. Bone spurs on femoral head and/or acetabular margin create friction and restrict movement
. Contact can erode articular cartilage or tear the labrum

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17
Q

Acetabular labrum

A

. Incomplete fibrocartilage ring
. Attaches to acetabular rim
. Deepens acetabulum

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18
Q

Joint capsule of hip joint

A

. fibrous capsule attaches to acetabular rim external to the labrum and to transverse acetabular ligament
. Encircles femoral neck
. Ant. Attaches to intertrochanteric line and base of greater trochanter
. Post. Cross neck sup. To intertrochanteric crest but is free margin
. Fibers have spiral course from pelvis to femur

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19
Q

Traumatic hip dislocation

A

. Caused by car accidents or falls
. 90% are post.
. Complications: acetabular fracture, sciatic n. Injury, interruption of femoral head blood supply
. Presents as shortened limb in fixed adducted med. rotated position

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20
Q

Intrinsic ligaments of hip joint

A

. Iliofemoral
. Pubofemoral
. Ischiofemoral

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21
Q

Iliofemoral ligament

A

. Strongest intrinsic ligament
. From AIIS and acetabular rim to intertrochanteric line
. Makes inverted Y
. Convers. Sup. And ant. Surfaces of joint
. Prevents hyperextension, limits rotation in standing, limits adduction

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22
Q

Pubofemoral ligament

A

. Second strongest
. Arises from pubic portion of acetabular rim
. Attaches distally to inf. End of intertrochanteric line
. Covers inf. Aspect of hip
. Limits extension, abduction, and lat. rotation

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23
Q

Ischiofemoral ligament

A

. Weakest
. From ischial portion of acetabular rim
. Attaches distally to base of greater trochanter
. Covers post. Aspect hip joint
. Limits extension, abduction, and med. rotation

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24
Q

Ligament of femoral head

A

. Also called round ligament of femur, ligamentum teres Femoris
. Weak extrinsic ligament w/in hip joint capsule
. From borders of acetabular notch and transverse acetabular ligament
. Attaches to fovea of femoral head
. Enclosed in synovial fold that transmits acetabular branch of obturator a.
. Tightens during hip adduction, it not significant support

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25
How capsular ligaments stabilize hip
. In standing or extension, winding of spiral fibers tightens hip capsule (esp. iliofemoral) . Windings pulls femoral head into acetabulum and stabilizes joint w/ minimal muscular effort . Flexion unwinds fibers for greater ROM . Tonic contraction of med. and lat. rotators provide dynamic support
26
Range of hip flexion when knee is flexed is limited by ____
. Soft tissue contact
27
Straight leg flexion is limited by ____
Muscular tension
28
Hip extension is limited by _____
. Capsular ligaments to 10-20 degrees | . Esp. Iliofemoral
29
What ligament needs to be lax in gymnasts?
Iliofemoral
30
Hip joint blood supply
. Branches of med. and lat. femoral circumflex aa. | . A. To head of femur is small branch of obturator a. That courses w/in ligament of femoral head
31
What nn. Supply hip joint?
. Femoral . Obturator . Sup. Gluteal . N. To quadratus femoris
32
Leg-calve-perthes
. Femoral head collapse from fracture that disrupts blood supply . Disease is pediatric condition . Risk factor: male, family history
33
Articulations in knee joint
. Medial and lateral tibiofemoral | . Patellofemoral
34
What structures in knee joint are covered w/ articular cartilage?
. Condyles and patellar surface of femur | . Condyles of tibia
35
What surfaces in knee joint do not have articular cartilage?
. Intercondylar area of tibial plateau | . Provides attachments for ligaments and menisci
36
What femoral condyle is larger?
Medial | . Larger w/ longer articular surface
37
Q-angle
. Due to difference in condylar size . Btw tibia and femur . Males: 10-15 degrees . Female: 15-18 degrees
38
Lat. lip do femur’s patellar surface function
. Resists lat. displacement of patella | . Guides movement during fl/extension
39
Fibrous capsule of knee joint
. Attached to margins of femoral articular surfaces and tibial plateau . Thin post., strengthened med. and lat. by collateral ligaments . Post. Capsule has arcuate popliteal ligament that is a gap that admits popliteus tendon . Ant. Capsule replaced by quad tendon, patella, and patellar ligament
40
Synovial membrane of knee joint
. Lines majority of capsule . Post. Forms infrapatellar synovial fold that excludes intercondylar area . Extends sup. Deep to quad tendon forming suprapatellar bursa continuous w/ joint cavity
41
Infrapatellar synovial fold
. Encloses cruciate ligaments | . Subdivides synovial cavity into med. and lat. compartments
42
Menisci attachments
. Peripheral margins attach to tibial condyles via coronary ligaments . Horns attach to intercondylar area . Med. meniscus attached to med. collateral ligament
43
Menisci shape
. Thick peripherally and thinner centrally (wedge-shaped) . Med. meniscus is crescent-shaped . Lat. meniscus is circular shaped
44
Med. Meniscus characteristics
. Attached to med. collateral ligament . Less mobile . More susceptible to injury
45
Lat. meniscus characteristics
. Horns more closely spaced . Less susceptible to injury . Does NOT attach to lat. collateral ligament
46
Zones of meniscus
. Peripheral red zone: better blood supply, heads more readily . Central white zone: avascular
47
What connects menisci?
Transverse ligament | . Coordinates movements during fl/extension
48
Discoid meniscus
. Meniscus covers all or most of tibial condyle . Prone to injury due to poor blood supply and altered joint mechanics . 3% population has lat. one, 0.1% population has med. one
49
Medial collateral ligament (MCL) and functions
. Broad, flat intrinsic ligament covering med. aspect of knee . From med. epicondyle of femur to med. tibial condyle and shaft . Deep fibers attach to med. meniscus . Ligament gets tight during extension . Resists lat. rotation and abduction
50
Fibular (lat.) ligament (LCL)
. Strong, cord-like extrinsic ligament . From lat. epicondyle of femur to head of fibula . Tight in extension . Resists lat. rotation and adduction of leg . Superficial to tendon of popliteus m. Separating it from lat. menisci
51
. Anterolateral ligament (ALL)
. Thickening of capsule btw lat. epicondyle and lat. tibial condyle post. To gerdy’s tubercle . Deep fibers attach to lat. meniscus . Resists adduction and med. rotation of leg
52
Barn-door sign
. Identifies excessive opening of joint caused by damage to collateral ligaments
53
Cruciate ligaments
. PCL and ACL . Cord-like extrinsic ligaments w/in joint capsule but outside synovial cavity . Enclosed by infrapatellar synovial fold . Tight in extension . Resist med. rotation of tibia and ab/dduction of knee
54
ACL
. Attached to ant. Intercondylar area of tibia and posterolateral intercondylar notch of femur . Resists ant. Displacement of tibia or post. Displacement of femur
55
PCL
. Attaches to post. Intercondylar area of tibia and anteromedial intercondylar notch of femur . Resist post. Displacement of tibia or ant. Displacement of femur
56
Segond fracture
. Avulsion of ALL’s tibial attachment . Occurs in 10% ACL rupture . High incidence in ACL injuries in female athletes
57
Sequence of knee extension
. Lat. femoral condyle reaches limit of articular surface sooner than med. one and ACL becomes taut . Femur rotates med. using ACL as pivot . Med. condyle glides post. And rotates to achieve max congruence w. Tibia and full extension
58
Sequence of knee flexion
. Initiated by popliteus m. Which rotates femur lat. . Moves med. condyle forward to unlock knee . Movement completed by principal knee flexor muscles
59
Why is fully extended knee so stable?
. Collateral ligaments taut | . Cruciate ligaments are tightly wound (screw-home position)
60
What provides dynamic support of the knee?
. Quads . Hamstrings . Tensor fasciae latae and IT band provide lad. Stabilization
61
Unhappy triad
. Blow to lat. knee when foot is planted when knee is extended . Damage to med. collateral ligament, med. meniscus, and ACL
62
Blood supply of knee joint
. Genicular aa. (Direct and indirect branches of femoral, popliteal, and ant. Tibial aa.) . Form genicular anastomosis
63
Innervation of knee joint
. Articular branches of femoral, tibial, common fibular, obturator, and saphenous nn.
64
Superior tibiofibular joints
. Plane-type synovial joint btw lat. condyle of tibia and fibular head . Supported by ant. And post. Ligaments of fibular head . Joint permits sup. Translation of fibula during dorsiflexion of ankle
65
Middle tibiofibular joint
. Syndesmosis formed by interosseous membrane of leg and shafts of tibia and fibulas
66
Inferior tibiofibular joint
. Syndesmosis btw distal ends of tibia and fibula supported by ant., post., and interosseous tibiofibular ligaments
67
Interosseous membrane of tibiofibular joint resists ____
Inf. Pull of leg muscles originating from fibula
68
Talocrural (ankle) joint structure
. Hinge synovial joint btw distal surface and med. malleolus of tibia, lat. malleolus of fibula, and trochlea of talus . Distal tibia and malleoli form mortise (deep socket) w/ 3 articulations for sup., med., and lat. trochlea . Thin fibrous capsule reinforced med. and lat. by ligaments
69
Ankle ligaments
. Med. collateral ligament (deltoid): fan-shaped attaching med. malleolus to talus, navicular, and sustentaculum tali, fibers blend w/ plantar calcaneonavicular ligament, resists eversion and supports med. longitudinal arch . Lat. collateral ligament: ant. Talofibular, calcaneofibular, and post. Talofibular ligaments arising from lat. malleolus, resists inversion
70
Ankle sprain
. Most frequent injury in body . Caused by inversion on planted foot typically . ATF first, followed by calcaneofibular and post. Talofibular
71
Ankle joint function
. Permits dorsi/plantar flexion and small amount of inversion/eversion in plantarflexed position . During dorsiflexion, joint surfaces are tight-packed and stabilized by interosseous talofibular ligament making it stable
72
Ankle joint blood supply
. Malleolus branches of ant. Tibial, post. Tibial, and fibular aa.
73
Ankle joint innervation
. Articular branches of tibial and deep fibular nn.
74
Subtalar joint
. Plane-type btw post. Articular surfaces of talus and calcaneus . Fibrous capsule attaches to margins of articular surfaces . Reinforced by intrinsic ligaments and interosseous talocalcaneal ligament . Permits movement of inversion and eversion
75
Talocalcaneonavicular joint
. 3 articulations: 2 plane type btw middle and ant. Articular surfaces of talus and calcaneus and talonavicular joint (ball and socket btw head of talus and prox. Navicular) . Fibrous capsule reinforced on plantar surface by spring ligament that attaches to sustentaculum tali and navicular tuberosity . Allows gliding and rotary movements in coordination w/ inversion/eversion of foot
76
Sinus tarsi syndrome
. Tenderness, ankle instability, and pain on inversion and plantarflexion . Due to issues w/ tarsal sinus and interosseous talocalcaneal ligament
77
Transverse tarsal joint
. Compound joint formed by 2 transversely aligned joints (talonavicular and calcaneocuboid) . Calcaneocuboid is plane-type joint btw ant. Calcaneus and post. Cuboid
78
Ligaments in transverse tarsal joint
. Plantar calcaneocuboid (short plantar): attaches calcaneus to inf. (Plantar) surface of cuboid . Long plantar ligament: from calcaneal tuberosity and attached to cuboid bone and bases of metatarsals II-V forming tunnel for fibularis longus tendon, superficial to short ligament
79
3 major ligaments of mid foot
. Long and short plantar ligaments . Plantar calcaneonavicular ligament . Support foot’s longitudinal arches
80
Intertarsal and tarsometatarsal joints
. Plant joints btw distal tarsals ( cuneiforms and cuboid) and metatarsals . Allow limited gliding . Strengthen transverse arch
81
MP joints of foot
. Condyloid joints btw metatarsals and bases of prox. Phalanges . Allow fl/extension and ab/dduction . Fibrous joint capsule deficient dorsal where it is replaced by extensor tendons
82
MP joint of foot ligaments
. Med. and lat. collateral ligaments (intrinsic) unite metatarsal head w/ prox. Phalangeal base and plantar plate, reinforce med. and lat. parts of fibrous capsule, tighten w/ flexion, limit ab/dduction of flexed joint . Plantar plate ligament: fibrocartilage attaching metatarsal head to phalangeal base, reinforces ant. Capsule and creates socket for metatarsal head . Deep transverse metatarsal ligaments: connect plantar plates
83
IP joints of foot
. Hinge joints btw phalanges . Have plantar plates should and joint capsules w/ med. and lat. collateral ligaments . Only allow fl/extension
84
Blood supply and innervationof foot joints
. Articular branches of med. and lat. planter nn. And aa.

Anatomy (49 decks)

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