Manual 57-62: Thigh and Patella Osteology Flashcards Preview

Anatomy Lower Limb > Manual 57-62: Thigh and Patella Osteology > Flashcards

Flashcards in Manual 57-62: Thigh and Patella Osteology Deck (154):
1

the knee is a compound joint made of what 2 joints

- condylar joint between condyles of tibia and femur
- saddle/sellar joint between patella and femur
- ONE synovial membrane and one cavity

2

what is the orientation of the condylar joint of knee

10-12 degrees from midline
greater than this is genu valgum

3

what type of joint is the knee

condyloid joint

4

what is the movemnt at knee joitn

hinge
glinding
rotation

5

describe the articualr surface of tibia? fibula?

- flat
- rounded

6

what is the n supply to the knee joint

- articular branches of femoral
- obturator
- common peroneal
- tibial

7

blood supply to knee joint

- genicular anastomosis from descending genicular branch of femoral
- genicular popliteal
- recurrent branches of anterior tibial
- descending branch lateral femoral circumflex a
- circumflex fibular a

8

where is the articular capsule incomplete

anteriorly
replaced by medial/lateral retinacula of quadricps tendon

9

the tendon of popliteus m pierces the articular capsule ..

laterally

10

continuation of quadriceps tendon

patellar ligament

11

how long is the patellar ligament

8 cm

12

what protects the patellar ligament from tibia

- infrapatellar bursa
- the infrapatellar fat pad - inferior surface separates synovial membrane

13

what are the attachments of lateral collateral ligament

- lateral epicondyle of femur above groove popliteus m
- head of fibula

14

what tendons cover the lateral collateral ligament

tendon of biceps femoris - splits attach fibular head either side of LCL

15

is the LCL attahced to the capsule?

no
also not attached to lateral meniscus (separated by articular capsule and tendon of popliteus)

16

how is the tendon of popliteus related to LCL

deep

17

what is the proximal attachment of the anterolateral ligament

lateral femoral condyle anterior to proximal attachment of LCL w/ connecting fibers b/w two ligaments
- has an oblique course

18

what is the distal attachment of anterolateral ligament?

- anterolateral aspect tibia b/w gerdy's tubercle and apex of fibula
- attaches also to the lateral meniscus

19

what is the function of the anterolateral ligament?

check internal rotation b/w 30-90 knee flexion

20

describe the medial collateral ligament. compare to lateral collateral

- broad flat band 10 cm long
- strong round fibrous

21

what are the proximal and distal attachments of MCL

proximal: medial epicondyle femur below adductor tubercle
distal: medial surface tibia 2-3 cm long
- also attaches to medial meniscus

22

what is above and below the MCL

- SGT cross superiorly
- capsule below ligament

23

what ligament serves to strengthen knee joint posteriorly

oblique popliteal

24

what ligament is the expansion of semimebranosus m

oblique popliteal
- passes obliquely from medial condyle tibia to lateral condyle of femure on the floor of popliteal fossa

25

what ligament is perforated by medial genicular on its way to knee joint

oblique popliteal

26

thickened capsular fibers over popliteus tendon

arcuate popliteal
- course mediallly from lateral condyle tibia and head fibula to posterior intercondylar area of the tibia

27

what is the function of anterior cruciate ligament

prevent hyperextensnion of knee - prevent femur from posterior sliding on tibia

28

what is the course of anterior cruciate ligament

travel superolateral from anterior intercondylar area on tibia to the posterior medial surface of lateral femoral condyle

29

how does the posterior cruciate ligament compare to the anterior

stronger and shorter

30

describe the course of the posterior cruciate ligament

- travels obliquely upward from the posterior intercondylar tibia crossing over ACL to attach on medial condyl (lateral surface)

31

what is the function of PCL

prevent hyperflexion of knee

32

what prevents femur forward sliding on tibial plateau

PCL

33

semilunar fibrocartilage discs the deepen the vacity of tibial condyles

menisci

34

which part of menisci are in contact with femoral condyles

central area

35

how much of condyle of tibia are covered by menisci

2/3

36

what is the peripheral attachment of menisci? aka what holds menisci to tibial condyles

fibrous capsule (coronary ligament) holds menisci to tibial condyles

37

shape of menisci

medial = semicircular
lateral = almost circular

38

what are the attachments of the medial meniscus

- attached to tibia anterior to ACL at anterior intercondylar area
- posterior attachment posterior intercondylar area

39

what separates the lateral meniscus from LCL

tendon of popliteus

40

span of lateral meniscus

from anterior intercondylar area to posterior intercondylar area

41

what are the anterior/posterior meniscofemoral ligaments

posterior side
70% cases fibers extend to medial condyle of femur

42

what unites two meniscis anteriorly

transverse ligament

43

what facets meet in the superior tibiofibular joint

- fibular facet of lateral tibial condyle
- articular faet of medial aspect head of fibula

44

what are the shape of facets in superior tibiofibular jt

circural shaped

45

what ligaments are associated with superior tibiofibular jt

anterior and posterio superior tibiofibular ligaments

46

what type of joint is the superior tibiofibular jt

plane synovial jt

47

what type of joint is the distal tibiofibular jt

syndesmosis, fibrous jt

48

what forms the distal tibiofibular jt

- triangular surface of distal fibula (in inferior interoseous border)
- distal end of tibia

49

what ligaments are associated with distal tibiofibular jt

- interosseous tibiofibular lig
- anterior inferior tiiofibular ligament
- posterior inferior tibiofibular ligament

50

distal continuation of interosseous membrane

interosseous tibiofibular ligament

51

what shape is the anterior inferior tibiofibular ligament

triangular directly inferolaterally

52

what shape is the posterior inferior tibiofibular ligament

quadrangular shape directed inferolaterally

53

deep pportion of the posterior inferior tibiofibular ligament =

inferior transverse ligament (contains fibrocartilage)
- forms socket for talus
- extends from lateral malleolar fossa to margin of medial malleolus

54

the patella forms within ...

tendon of quadriceps femoris m

55

shape of head of femur

ball-shaped
2/3 spherical covered by hyaline cartilage *not at pit/fovea where the ligament of head of femur attaches

56

the head of femurs lies ____ in articular capsule of hip joint

entirely

57

where does the femur articulate with hip bones

acetabulum

58

joins head and shaft of femur

neck

59

when is the femoral angle of inclination the greatest

at birth
- sex and body size determine angle
- adult male 125
- adult female 105 (wider bony pelvis)

60

what is the angle of declination

projection of neck of femur from the shaft 12-14 degrees

61

what is the shape of the neck of femur

hourglass (thinnest at middle)

62

what are the two surfaces of neck of femur

anterior and posterior

63

describe the anterior surface of neck of femur

- entirely in joint capsule of hip joint
- convex superior to inferior
- concave side to side
- intertrochanteric line

64

where is the intertrochanteric line and what is it?

- between greater and lesser trochanters of femur
- anterior surface of neck of femure
- continuous inferiorly with spiral line

65

describe the posterior surface of neck of femur

- more curved than anterior
- upper 1/2 to 2/3 lies within the joint capsule
- fewer but larger vascular formaina than anterior

66

which portion of the neck of the femur is grooved by tendon of obturator externus

lower portion of posterior surface

67

what forms at the joining of posterior surface of neck of femur with shaft of femur

intertrochanteric crest
- ridge of bone b/w greater and lesser trochanters

68

what are the borders of neck of femur

superior and inferior
- superior is short and thick and courses horizontally
- inferior is long and thin and courses vertically

69

which border of neck of femur ends at greater trochanter? lesser trochanter?

superior border
inferior border

70

what is the shape of the greater trochanter

qudrilateral-shaped
- located at lateral end of superior border of neck of femur
- projects lateral and posterior

71

what two surfaces are on the greater trochanter

lateral and medial

72

what is the shape of the lateral surface of greater trochanter

quadrilateral
- larger palpable surface (compared to medial)

73

there is an oblique bony ridge on lateral surface of greater trochanter, why?

insertion of gluteus medius

74

what divides the lateral surface of greater trochanter into 2 triangular areas

oblique bony ridge
- upper triangular area = bursae for gluteus medius
- lower triangular area = bursae for gluteus maximus

75

major feature of medial surface of greater trochanter

trochanteric fossa
- depression for insertion of obturator externus

76

tendon that inserts anterior to trochanteric fossa on greater trochanter

obturator internus tendon
- superior and inferior gemelli m terminate/insert into tendon of obturator internus

77

what are the four borders on greater trochanter

superior, inferior, anterior and posterior

78

superior border on greater trochanter is insertion for

piriformis

79

anterior border on greater trochanter is insertion for

gluteus minimus

80

inferior border on greater trochanter is insertion for

vastus lateralis (partial origin)

81

only border or surface of greater trochanter with no muscular attachment

posterior border
- free rounded edge inferiorly that blends with intertrochanteric crest

82

location of lesser trochanter

- medial, near junction of femoral neck and shat
- directed posteromedially

83

attachment to lesser trochanter

iliopsoas is only attachment
- psoas major inserts at apex
- iliacus inserts at base and between spiral and pectineal lines

84

where is the intertrochanteric line located?

- anterior on femur between greater and lesser trochanters at junction of neck and shaft

85

attachments to intertrochanteric line

- iliofemoral ligament (part of fibrous capsule of hip)
- vastus lateralis (partial origin)
- vastus medialis (partial origin)

86

where is the intertrochanteric crest

- posterior between greater and lesser trochanters

87

attachments to intertrochanteric crest

- NOT hip joint capsule
- quadratus femoris via the quadrate tubercle

88

site of insertion of quadratus femoris m on intertrochanteric crest

- quadrate tubercle mid-intertrochanteric location

89

describe the quadrate tubercle

- extends vertically 5 cm, superior extent located along itnertrochanteric crest
- posterior side of femur obvi
- at times a quadrate line can be present instead of tubercle

90

what are the borders of shaft of femur

medial, lateral and posterior
- medial and lateral are rough and poorly defined

91

major feature of posterior border of shaft of femur

linea aspera
- crest, posterior border, middle 1/3 femur
- medial and lateral lips with rough intermediate area

92

superioly the linea aspera is joined by ...

3 lines/ridges
- spiral line
- pectineal line
- lateral line

93

describe the spiral line on shaft of femur

- joins linea aspera distally
- medial line
- proximally continuous with intertrochanteric line

94

describe the pectineal line of femur

- intermediate line
- ends proximally at lesser trochanter
- distally continuous with medial lip of linea aspera

95

what m inserts on pectineal line

pectineus m

96

describe the lateral line of femur

- extends from greater trochanter to lateral lip of linea aspera
- vertical
- gluteal tuberosity located on line

97

what m inserts on gluteal tuberosity

partial insertion of gluteus maximus (also inserts on iliotibial band)

98

if proximal portion of the gluteal tuberosity is enlarged and elongated it is ...

called the third or guteal trochanter

99

what m. takes partial origin from medial lip of linea aspera

vastus medialis

100

what m attaches superiorly b/w adductor magnus and vastus medialis

iliacus and pectineus and adductor brevis and adductor longus

101

what m attaches on linea aspera superior to the adductor longus

adductor brevis

102

what m attaches on linea aspera inferior to adductor brevis

adductor longus

103

what are the attachments on adductor magnus on posterior shaft of femur (LOTS)

- linea aspera (extensive)
- gluteal tuberosity (superior - partial insertion)
- lateral line (partial)
- lateral lip of linea aspera (partial)
- medial lip of line aspera (lower fiber insertion)
- medial supracondylar line (lower fiber insertion)
- adductor tubercle (lower fiber insertion)

104

what m attaches to the gluteal tuberosity superiorly

gluteus maximus and adductor magnus both partially
- biceps femoris short head attaches inferior to the glut max

105

what are the posterior attachments on femur of vastus lateralis

lateral lip of linea aspera (partial) and greater trochanter (small origin)

106

the lateral and medial lip of linea aspera diverge as ..

lateral and medial supracondylar lines/ridges

107

distinct ridge extending toward the lateral epicondyle

lateral supracondylar ridge

108

ridge ending at adductor tubercle

medial supracondylar ridge

109

the medial and lateral supracondylar ridges form a triangular area called ..

popliteal surface of femur

110

m attachments to anterior surface of femur

vastus intermedius (upper 2/3) and articualris genu (distal)

111

more pronounced, broader condyle on femur

lateral
the medial condyle is longer

112

where does the medial condyle begin

adductor tubercle

113

what are the articulations of the medial and lateral condyles of femur

- posterior surface of patella
- repsective condyles of tibia

114

describe the femur's condyles

large, rounded
knob-like
project further POSTERIOR than anterior

115

what do you call the sulcus/groove on each femoral condyle

lateral and medial sulci menisci
- separate patellar and tibial surfaces of femoral condyles

116

completely separates patellar surface (lateral femoral condyle) from tibial surface

lateral sulci menisci

117

deficient laterallly wehre tibial and patellar surfaces are continuous

medial sulcus menisci

118

separates femoral condyles posteriorly

intercondylar notch/fossa

119

posterior boundary of the intercondylar notch

intercondylar line
- forms base of popliteal surface of femur

120

attachments to the intercondylar notch (3)

- ACL (medial surface of lateral condyle - posterior attachment on femur)
- PCL (lateral surface of medial condyle - anterior attachment of femur)
- meniscofemoral ligament

121

where are the medial and lateral epicondyles

lie above the respective condyles

122

larger epicodyle

medial
- locaetd just below the adductor tubercle

123

what attaches to the adductor tubercle

adductor magnus tendon

124

what attachments are there to the medial epicondyle

- tibial (medial) collateral ligament
- medial head of gastrocnemius m (just post to adductor tubercle)

125

what attaches to the lateral epicondyle?

fibular/lateral collateral ligament

126

what two grooves are one the lateral epicondyle

- oblique groove (flexed knee)
- vertical groove (extended knee)
- located on lower portion of epicondyle for the popliteus tendon which shifts with knee movement

127

proximal extremity feeders to femur

- obturator (supplies femoral head)
- medial femoral circumflex (branch of profunda femoris)
- lateral femoral circumflex (enters at neck)
- inferior gluteal (enters at neck)
- first perforating (enters at neck)

128

what blood supply is especially important ininfants, children, teens during ossification of femur

obturator a
- supplies femoral head
- unimportant in adults

129

major supply to femoral head in adults

medial femoral circumflex
- enters at neck of femur

130

what a courses within ligament of head of femur

branch of obturator to supply the femoral head

131

femoral shaft arterial feeder

nutrient a (branch of second perforating artery)

132

where is the nutrient canal of femur located?

- posterior, upper end of linea aspera
- directed away from growing end of bone during development (obliquely upward)

133

*** for all long bones, the nutrient canal is directed ...

obliquely away from the growing end of bone

134

distal extremity feeder areteries for femur

- superior lateral genicular a
- superior medial genicular a
- descending genicular a
- descending branch of lateral femoral circumflex a

135

how many centers of ossification in femur

5
1 primary (shaft)
4 secondary

136

the femur is the first bone to begin with this type of ossification

endochondral ossification

137

the femur is the ______ bone to ossify

second earliest
(clavicle is first via intramembranous method)

138

femur primary ossification

shaft starting at 7th fetal week and ending at puberty

139

femur secondary ossification (4)

- distal extremity near birth to 16-18
- head 6mo to 17
- greater trochanter 4 y to 16
- lesser trochanter 12-14 y to 15 yo

140

largest sesamoid in body

patella (forms in quadratus femorus tendon)

141

the patella articulates with

femur (part of knee joint(

142

shape of patella

triangular (apex directed inferiorly)

143

borders of patella

superior (thick base(
medial
lateral

144

attachments to superior border of patella

- rectus femoris
- vastus intermedius
- vastus lateralis (lateral superior portion)

145

attachements to medial border of patella

- vastus medialis
- vastus lateralis

146

how is the anterior surface of patella shaped

convex with longitudinal stria and small nutrient foramina

147

what attaches to the longitudinal stria of patella

quadratus tendon

148

describe the upper 4/5th of posterior surface of patella

smooth, oval shaped

149

what separates the two patellar facets

vertical ridge

150

what does the vertical ridge of the patella articulate with...

intercondylar groove of femur

151

which of the patellar facets is larger

lateral facet
also deeper and more concave than medial

152

what attaches at the lower 1/5th of posterior surface of patella

patellar ligament
- nutrient foramen are also located on this surface

153

what is the blood supply to the patella

branches of gneicular arteries (by supplying the quadriceps tendon)

154

when does the patella ossify?

variable # centers
appear 3-6 yrs; additonal later in childhood
ossifies by puberty