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Phase 2 - Musculoskeletal > the Knee and Osteoarthritis > Flashcards

the Knee and Osteoarthritis Flashcards

(94 cards)

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1
Q

what muscles are contained in the anterior compartment of the thigh

A

Iliopsoas
pectineus
Sartorius
The quadriceps

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2
Q

what 4 muscles comprise the quadriceps

A

rectus femoris
vastus lateralis
vastus medialis
vastus intermedius

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3
Q

what muscles comprise the medial compartment of the thigh

A

THE ADDUCTORS

obturator externus
gracilis
adductor brevis
adductor longus
adductor magnus

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4
Q

origin of the pectineus

A

superior ramus of pubis

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5
Q

insertion of the pectineus

A

pectineal line of femur, inferior to lesser trochanter

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6
Q

functions of the pectineus

A

flexor of the thigh
adductor of the thigh
assists with medial rotation of the thigh

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7
Q

innervation of the pectineus

A

femoral nerve (L2, L3)

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8
Q

origin of psoas major

A

sides of T12-L5 vertebrae and intervertebral discs, transverse processes of lumbar vertebrae

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9
Q

origin of iliacus muscle

A

iliac crest, iliac fossa, ala of sacrum, and anterior sacroiliac ligaments

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10
Q

insertion of the iliopsoas

A

common insertion for psoas major and iliacus

lesser trochanter of femur

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11
Q

common functions of iliopsoas

A

flexor of the thigh
stabilises the hip joint

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12
Q

innervation of psoas major

A

anterior rami of lumbar nerves (L1, L2, L3)

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13
Q

innervation of iliacus

A

femoral nerve (L2, L3)

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14
Q

origin of sartorius

A

anterior superior iliac spine (ASIS) and superior part of notch inferior to it

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15
Q

insertion of sartorius

A

medial surface of proximal tibia (pes anserinus)

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16
Q

functions of sartorius

A

flexor, abductor and lateral rotator of the thigh
flexor of the leg and the knee
medially rotate the leg when knee is flexed

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17
Q

innervation of sartorius

A

femoral nerve (L2, L3)

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18
Q

origin of the rectus femoris (Quad)

A

Anterior inferior iliac spine and ilium superior to acetabulum

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19
Q

origin of vastus lateralis (quad)

A

greater trochanter and lateral lip of linea aspera

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20
Q

origin of vastus medialis (quad)

A

intertrochanteric line and medial lip of linea aspera

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21
Q

origin of vastus intermedius (quad)

A

anterior and lateral surfaces of femoral shaft

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22
Q

common insertion of quadriceps

A

quadriceps tendon to patella and then indirect attachment via patellar ligament to tibial tuberosity

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23
Q

common function of quadriceps

A

flexion of the thigh
extensor of the lower leg

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24
Q

function of rectus femoris alone

A

helps in flexion of the hip joint

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25
common innervation of quadriceps
femoral nerve (L2, L3, L4)
26
origin of obturator externus
hip bone around external obturator foramen and membrane
27
insertion of obturator externus
trochanteric fossa
28
functions of obturator externus
lateral rotator of the thigh
29
innervation of obturator externus
obturator nerve (L3, L4)
30
origin of gracilis
body and inferior ramus of pubis
31
insertion of gracilis
medial surface of proximal tibia (pes anserinus)
32
functions of gracilis
adductor of the thigh flexor of the leg at the knee joint
33
innervation of gracilis
obturator nerve (L2, L3)
34
origin of adductor brevis
body and inferior ramus of pubis
35
origin of adductor longus
body of pubis inferior to pubic crest
36
insertion of adductor brevis
pectineal line and proximal part of linea aspera of femur
37
insertion of adductor longus
middle third of linea aspera of femur
38
common function of adductors longus and brevis
adductor of the thigh
39
common innervations of adductor brevis and longus
obturator nerve and branch of anterior division (L2, L3, L4)
40
origin of adductor magnus
adductor part: inferior ramus of pubis and ramus of ischium hamstring part: ischial tuberosity
41
insertion of adductor magnus
adductor part: gluteal tuberosity and linea aspera hamstring part: adductor tubercle
42
functions of adductor magnus
powerful adductor of the thigh adductor part: flexes the thigh hamstring part: extends the thigh
43
innervation of the adductor magnus
adductor part: obturator nerve (L2, L3) hamstring part: tibial division sciatic nerve (L4)
44
what is the adductor hiatus formed by
the insertions of adductor magnus (both adductor and hamstring part)
45
what is the adductor hiatus
a gap in the thigh that allows the femoral artery and vein to pass from the anterior thigh to the posterior lower leg
46
what does the femoral artery become through adductor hiatus
popliteal artery
47
what does the popliteal vein become through adductor hiatus
femoral vein
48
Describe the knee joint
Synovial hinge joint = extension and flexion BUT The hinge movements are combines with gliding and rolling and with rotation about a vertical axis
49
What are the 3 bones articulating the knee joint
Femur Tibia Patella
50
what is the joint between the femur and tibia
Femerotibial
51
What is the contact area between the patella and femur
Femeropatellar
52
What are the five extracapsular ligaments of the knee
Patella ligament Fibular (lateral) collateral ligament = cord-like Tibial (medial) collateral ligament = broad Oblique popliteal ligament = posterior Arcuate popliteal ligament = posterior
53
What are the 2 intra-articular ligaments
Anterior cruciate ligament (ACL) Posterior cruciate ligament (PCL)
54
How do you test for ACL tears
Lachman test ACL intact = firm feel ACL tear = soft feel
55
Describe the shape of the medial meniscus
C Shaped Semi-circular
56
Describe the shape of the lateral meniscus
O shaped Almost circular
57
Describe the movements of the knee
Extension - locking mechanism or scre-home mechanism of the knee Flexion Medial rotation - foot turns with knee flexed Lateral rotation - foot turns with knee flexed
58
What is the popliteal fossa
Area posterior to the knee joint Fat filled space Flexed knee - diamond shaped or rhomboid shaped depression Contents - important anatomical structures (arteries, veins, nerves)
59
What are the boundaries of the popliteal space
Roof = popliteal fascia and skin Superolateral = biceps femoris Superomedial = semimembranosus/semitendinosus Inferolateral = lateral head of gastrocnemius Inferomedial = medial head of gastrocnemius Floor = capsule of the knee joint, distal femur, proximal tibia
60
Superficial contents of the popliteal fossa
Small saphenous vein (drain into popliteal vein) 3 cutaneous nerves: - posterior femoral cutaneous (from sacral plexus) - medial sural cutaneous nerve - lateral sural cutaneous nerve
61
deep contents of the popliteal fossa
from superficial to deep: - tibial and common fibular nerves (sciatic nerve divisions) - popliteal vein (will become femoral vein) - popliteal artery (continuation of femoral artery)
62
origin of the popliteus muscle
lateral femoral condyle, posterior horn of lateral meniscus of knee joint
63
insertion of popliteus muscle
posterior tibial surface
64
functions of popliteus muscle
knee flexor medial rotator of knee major stabiliser of the knee posteriorly during weight-bearing activities
65
innervation of the popliteus muscle
tibial nerve (L4, L5, S1)
66
function of articular cartilage
smoothe lubricated surface for articulation, facilitate load transmission and low friction movement
66
composition of articular cartilage
chondrocytes, macromolecules, water
66
when is healing not stimulated
when the injury doesn't breach the tide mark. injury must penetrate subchondral bone to reach blood vessels.
67
what are chondrocytes derived from
mesenchymal stem cells
68
function of chondrocytes
synthesise and maintain ECM
69
what is the main type of collagen in the ECM
type 2
70
define osteoarthritis
chronic degenerative change of damaged articular cartilage (and the attempted repair process)
71
what is varus
bow legging
72
what is valgus
knee knocking
73
what are the four signs of osteoarthritis on an x-ray
narrowing joint space subchondral cysts periarticular sclerosis osteophytes
74
basic steps in bone remodelling
1. activation: osteoclasts 2. resorption: bone matrix 3. osteoblast recruitment 4. osteoid formation 5. mineralisation 6. quiescence
75
briefly describe the RANK/RANKL/OPG system
M-CSF expressed by osteocytes/blasts stimulates RANK expression RANKL binds to receptor RANK on inactive osteoclasts Results in osteoclast maturation and rapid bone resorption Meanwhile, OPG is a decoy receptor for RANKL - secreted by osteoblasts/cytes - inhibits osteoclastic bone resorption
76
describe the role of PTH in control of bone remodelling
Increases bone resorption and so builds calcium levels in the blood. However, when released in a pulse-like manner it can enhance bone formation
77
What is calcitonin
Hormone secreted by the thyroid gland. (Opposite to PTH)
78
Role of sex hormones in bone remodelling
oestrogen and androgens stimulate bone formation and inhibit resorption
79
role of thyroid hormones in bone remodelling
directly stimulate osteoblast differentiation and mineralisation
80
role of growth hormone and IGF1 in bone remodelling
increases bone turnover - stimulates osteoblastic bone formation > resorption - small net increase in bone mass
81
non-modifiable risk factors for Osteoporosis
previous history of fracture parental history of osteoporosis history of early menopause
82
modifiable risk factors for osteoporosis
low BMI (<20) smoking alcohol (>3.5 units/day)
83
describe the effect of oral glucocorticoids on osteoporosis
initial and transient reduction in osteoclastic bone resorption, followed by prolonged reduction in bone formation and resorption leads to bone loss and poorer quality bone
84
describe bisphosphonates (examples, action and complications)
alendronic acid, zoledronic acid inhibits osteoclasts - osteonecrosis of the jaw, atypical femoral fracture
85
mechanism of denosumab
monoclonal antibody against RANK-L risk of hypocalcaemia
86
describe teriparatide
synthetic PTH increases bone formation more than resorption
87
What is osteomalacia
Disorder arising from defective mineralisation of bone If it occurs before bone growth is complete = rickets
88
Most common causes of osteomalacia
Decreased exposure to light Decreased calcium intake Chronic kidney disease Genetic causes
89
What is Paget's disease
Increased osteoclast and osteoblast activity resulting in disorganised bone tissue prone to fracture Aetiology unknown
90
what is septic arthritis
infection of the joint new onset joint pain (not traumatic)
91
what is osteomyelitis
infection of the bone can be acute or chronic can be spread by blood stream or from nearby tissues, or caused by trauma, surgery or prosthetic material
92

Phase 2 - Musculoskeletal (6 decks)

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