What is the anteversion of the femoral neck?
What is the articularis genu?
Small muscle on the anterior aspect of the distal femur deep to vastus intermedius
O: anterior surface of distal femur, deep to vastus intermedius
I: synovial membrane of knee
I: femoral nerve
A: pulls the suprapatellar bursa superiorly during knee extension, preventing impingement of the bursa between patellar and femur
What innervates adductor Magnus?
Obturator & sciatic (tibial portion)
What are the origins and insertions of biceps femoris?
O: Long head: ischial tubeosity (with semitendinosus) Short head: lateral linea aspera, lateral supracondylar ridge
I: fibular head, LCL, lateral tibial condyle
What comprises the conjoint tendon of the thigh?
Long head of biceps femoris & semitendinosus
Name the insertion sites of semimimbranosus:
Posterior medial tibial condyle, under MCL
Oblique popliteal ligament
Posterior oblique ligament
Posterior joint capsule
Posterior horn of medial meniscus
Expansion to aponeurosis of Popliteus
What are the borders of the adductor canal? Its contents?
Lateral: vastus medialis
Floor: adductor longus/Magnus
Femoral artery and vein
Femoral nerve branches: saphenous & nerve to vastus medialis
What vessels are included in the Cruciate anastamosis? Where is it located?
1st perforating branch of the profunda femoris (main)
Medial femoral circumflex artery
Lateral femoral circumflex artery
Inferior gluteal artery
Located at the inferior margin of quadratus femoris
What degree is the tibial slope?
8-10 degrees posterior
What is the average thickness of the largest sesamoid bone in the body?
23-25mm Note: in TKA, it should not be cut to a thickness of less than 12-15mm as this increases the risk of patellar fracture
Describe the anatomic axis of the femur and tibia?
A line that runs down the intramedullary canal of the femur and tibia, respectively
How do you measure Q-angle? What are normal values in men and women?
Angle between a line from ASIS to the patellar centre and another extending proximally from tibial tubercle through patellar centre Normal: Men: 14 degrees Women: 17 degrees
Name the 12 ligaments of the knee:
there are more than 12:
Oblique popliteal ligament
posterior oblique ligament
(ligamentum mucosum is not a ligament - misnomer - it is a plica)
Which ligaments of the knee contribute to the fibrous capsule of the knee posteriorly?
Medially: Oblique popliteal ligament: semimimbranosus to posterior wall of capsule
Laterally: Arcuate ligament: Y-shaped fibres from fibular head, popliteal muscle to the posterior capsule - Also, LCL contributes to joint capsule
Which ligaments of the knee have attachments to the menisci?
Coronary ligament: peripheral menisci to capsule/tibia
Transverse: aka anterior intermeniscal ligament
Wrisberg: behind PCL from posterior lateral meniscus to medial femoral condyle
Humphrey: in front of PCL from posterior lateral meniscus to medial femoral condyle
Which parts of the ACL and PCL are tight in flexion? Extension?
Tight in flexion: PCL: anterolateral ACL: anteromedial
Tight in extension: PCL: posteromedial ACL: posterolateral
When is the ACL tightest?
Name the layers of the medial aspect of the knee and each layer's contents:
Anterior: medial patellar retinaculum from vastus medialis
Medial: deep fascia of the thigh (Sartorius)
Posterior: deep fascia of the thigh (Gastroc/popliteus)
Posterior: tendon of semimembranosus
What are the layers of the lateral aspect of the knee and their contents?
Deep fascia of thigh
Lateral patellar retinaculum
Name the layers and structures of the posterolateral corner of the knee:
Mnemonic: "I Bet Little Papp Loves Popping Lots of Ass"
What part of the tibial plateau is concave and convexÉ
Medial is concave Lateral is convex
What is the insertion of the IT bandÉ
What is the insertion of the patellar tendon
What is the usual deformity of a proximal one third tibia fracture
valgus and procurvatum
(from Pes and extensor mechanism)
What attaches at the fibular head
LCL Biceps femoris tendon
What structure wraps around the neck of the fibula
Common peroneal nerve
What surface of the distal fibula is flat and accommodates plating
What type of joint is the proximal tibiofibular joint and what ligaments strengthen it
Plane gliding joint Stabilized by: - Anterior ligament of fibular head - Posterior ligament of fibular head
Name the four compartments of the leg
Anterior Lateral Superficial posterior Deep posterior
Name the components of the anterior compartment of the leg
Anterior tibial artery and vein
Deep peroneal nerve
Sometimes peroneus tertius (not in lateral compartment)