MS: hip/knee

Question 1

What is the orientation of the femoral head

Answer 1

superior, anterior, medial

Question 2

What is a normal angle of inclination

Answer 2

115-125

Question 3

What is the normal angle of antetorsion

Answer 3

10-15 (anteversion= 25-30+, retroversion= less than 10)

Question 4

What is the orientation of the acetabulum

Answer 4

laterally, inferior, anterior

Question 5

What is the acetabular notch?

Answer 5

area without articular cartilage at inferior aspect of acetabulum

Question 6

What part of the hip labrum is thickest?

Answer 6

superior

Question 7

Iliofemoral ligament

Answer 7

“Y” ligament
Two bands (lateral and medial)
Taut with extension and ER
Lateral band also taut with adduction

Question 8

Pubofemoral ligament

Answer 8

Blends with capsule, inserts along with medial iliofemoral

taut with extension, ER, abduction

Question 9

Ischifemoral ligament

Answer 9

Attaches to GT

taut with IR, abduction, and extension

Question 10

What is the zona orbicularis

Answer 10

circular band w/o bony attachment that helps hold femur in acetabulum

Question 11

Which femoral condyle descends further?

Answer 11

medial

Question 12

Which femoral condyle has larger surface area

Answer 12

lateral

Question 13

MCL

Answer 13

medial aspect of medial femoral condyle to upper tibia
blends with capsule
runs anteriorly, inferiorly, and obliquely (same as ACL)
taut in extension
prevents ER and stability against valgus forces

Question 14

LCL

Answer 14

lateral femoral condyle to fibular head
extracapsular
runs inferiorly, posteriorly, and obliquely (same as PCL)
taut in extension
prevents ER and stability against varus

Question 15

ACL

Answer 15

anterior intercond fossa of tibia to femur at medial aspect of lateral femoral condyle
extracapsular, but intra-articular
limits IR of tibia during flexion and anterior rotation

Question 16

Meniscofemoral ligament

Answer 16

Runs with PCl.

Attaches below posterior horn of lateral meniscus

Question 17

Oblique popliteal ligament

Answer 17

inserts into expansion of semimembranosus.

Becomes floor of popliteal fossa

Question 18

Arcuate popliteal ligament

Answer 18

Y shaped-fibular head to intercondylar area on tibia and lateral epicondyle of femur.

strengthens poserolateral capsule

Question 19

Transverse ligament

Answer 19

connects menisci anteriorly

Question 20

Medial meniscus shape

Answer 20

C

Question 21

Lateral meniscus shape

Answer 21

circular/oval

Question 22

Which meniscus is larger?

Answer 22

Medial

Question 23

Medial meniscus

Answer 23

Large, C shaped, stable

Attaches to MCL and semimebranosus

Question 24

Lateral meniscus

Answer 24

Smaller, oval.

Attaches to popliteus

Question 25

Function of menisci

Answer 25

``` Deepens fossa of tibia Increase congruency Add stability Shock absorption Lubrication ```

Question 26

How do the menisci move?

Answer 26

Along with tibia for flexion/extension, Along with femur for rotation.

Question 27

How is the medial meniscus pulled during flexion/extension?

Answer 27

during flexion: posterior by semimebranosus | during extension: pulled anteriorly by medial meniscopatellar ligament

Question 28

What causes the femoral condyles to glide anteriorly during flexion

Answer 28

The increased tension ACL (PCL does posterior glide during extension)

Question 29

Screw home mechanism

Answer 29

tibial external rotation during TKE

Question 30

What "unlocks" screw home mechanism

Answer 30

popliteus

Question 31

What causes the screw home mechanism?

Answer 31

1) lateral femoral condyle glides posteriorly better than medial 2) More medial femoral condyle joint surface-causes more rolling on joint side 3) Medial meniscus attachment to MCL tight during extension 4) twisted cruciates cause ER 5) Lateral pull of quads

Question 32

Proximal tib/fib mechanics during dorsiflexion

Answer 32

fibular head glides superiorly and posteriorly. Fibula rotates externally

Question 33

Proximal tib/fib mechanics during plantarflexion

Answer 33

fibular head glides anteriorly and inferiorly. Fibula rotates medially