Combo "The Leg and Knee Joint*" and 1 other

Lateral meniscus

"O" shaped meniscus

lateral patellar retinaculum

- fascial extension from the vastus lateralis muscle to the patella and patellar ligament - reinforces the knee joint anterolaterally

Quadriceps femoris muscle

-Made up of the rectus femoris, vastus lateralis, vastus intermedius, and vastus medialis -Share the action of the anterior compartment by extending the leg -Major blood supply of the lower limb (femoral artery and deep femoral artery) passes through the anterior compartment of the thigh -tendon of all four muscles unite to form the quadriceps femoris tendon which is attached to the patella and then ultimately the tibial tuberosity

What are the three muscle compartments of the leg?

1) Anterior (extensor compartment) 2) Lateral (fibular or peroneal) compartment 3) Posterior (flexor) compartment

What are the articular surfaces of the knee joint?

1) Femur - medial and lateral femoral condyles 2) Tibia - medial and lateral tibial condyles 3) Patella

What are the muscles of the lateral compartment of the leg?*****

1) Fibularis longus(CAN PLANTARFLEX FOOT AT ANKLE JOINT; AND EVERT FOOT) 2) Fibularis brevis (CAN PLANTARFLEX FOOT AT ANKLE JOINT)

What is the stability of the knee dependent on? What is the most important muscle for stabilizing the knee?

1) Knee stability is dependent upon the strength of surrounding muscles and ligaments. 2) The most important muscle in stabilizing the knee joint is the quadriceps femoris.

LCL limits _____stress (occurs with medial blow to knee, uncommon) prevents adduction of leg (limits varus stress, (prevents adduction of leg))

Varus

anterior and posterior tibiofibular ligaments

What are the names of the ligaments in the proximal tibiofibular joint?

joint congruence

What does menisci improve in the knee joint?

patellofemoral joint

What is the name of the joint that involves the patella?

C shaped

What shape is your medial meniscus?

flexion

When is the patella stable? (flexion or extension)

between the tibial and fibular shafts

Where is the medial tibiofibular joint located?

Medial meniscus

Which meniscus is more easily injured?

posterior cruciate ligament

a ligament connecting the posterior aspect of the intercondylar eminence with the lateral surface of the medial femoral condyle an intracapsular ligament located within the fibrous joint capsule of the knee but external to the synovial cavity of the knee; the posterior cruciate ligament limits the posterior movement of the tibia relative to the femur in all positions of joint movement

Patella

a small flat triangular bone in front of the knee that protects the knee joint

Tibial collateral ligament

aka medial collateral ligamentconnects the medial epicondyle of the femur to the medial aspect of the tibia

Lateral condyle of the femur

articular surface of the lateral side of femur. outside

anterior cruciate ligament

attached to anterior tibia and back of femur

tibial collateral ligament

broad, flat band of tissue that connects medial condyle of femur to medial condyle of tibia

knee extension

closed pack position of knee joint

semimembranosus muscle

flexes and rotates leg medially and extends thigh. Is a muscle in the back of the thigh. It is the most medial of the three hamstring muscles.

functions of the ACL

prevents anterior tibial translation (or posterior femoral translation) limits hyperextension and internal tibial rotation

Functions of the PCL

prevents posterior tibial translation(or anterior femoral translation) limits excessive flexion

posterior cruciate ligament

prevents the tibia from sliding too far backwards, helps to maintain the position of the tibia below the femur

tibial collateral ligament

reinforces medial surface of the knee joint

fibular collateral ligament

reinforces the lateral surface of the knee joint

Femur

the longest and thickest bone of the human skeleton

anatomic pulley

the patella is described as this when it's altering the line of pull of the quads and increasing the force generated by the quads

Suprapatellar bursa

the superior extension of the synovial membrane of the knee joint it passes deep to the quadriceps femoris tendon; the suprapatellar bursa reduces friction between the quadriceps femoris tendon and the femur

Patellar Ligament

transfers action of quadriceps muscles from patella to tibia

patellar ligament

transfers action of quadriceps muscles from patella to tibia

flexion, extension, slight internal and external rotation

motions of the tibiofemoral joint

medial patellar retinaculum

network of ligaments that reinforce the knee joint by extending from the quads to the patella and tibia

What is the second largest bone of the body?

Tibia

What muscles are within the posterior compartment? What groups are these muscles organized into?****

1) Superficial Group --Gastrocnemius (can flax leg) --Soleus (CANNOT MOVE KNEE JOINT) --Plantaris (can flax leg) 2) Deep Group --Popliteus (can flex leg): HAS AN ORIGIN OR INSERTION INTERNAL TO THE FIBROUS CAPSULE OF THE KNEE JOINT. --Flexor digitorum longus --Flexor hallucis longus --Tibialis posterior (cannot flex the leg)

What bursae are associated with the knee?

1) Suprapatellar bursa 2) Prepatellar bursa 3) Superficial infrapatellar bursa 4) Deep infrapatellar bursa

What is the calcaneal tendon reflex?

1) The ankle jerk reflex, also known as the Achilles reflex, occurs when the Achilles tendon is tapped while the foot is dorsi-flexed. A positive result would be the jerking of the foot towards its plantar surface. 2) The Achilles reflex checks if the S1 and S2[1] nerve roots are intact and could be indicative of sciatic nerve pathology. It is classically delayed in hypothyroidism. This reflex is usually absent in disk herniations at the L5—S1 level. 3) A reduction in the ankle jerk reflex may also be indicative of peripheral neuropathy.

Where is the body of the tibia most narrow? Why is this important clinically?

1) The body of the tibia is most narrow where the middle and the inferior thirds meet 2) this is the most frequent site of fracture.

What type of joint is the knee joint? What bones partcipate in the knee joint?

1) The knee joint is a massive hinge type of synovial joint that allows some rotation. 2) The femur, tibia and patella participate directly in the knee joint while the fibula does not.

What is the largest of all the joints? What is the largest joint in the body?

1) The synovial capsule is the largest of all the joints 2) The synovial cavity of the knee joint is the largest in the body.

What are the Menisci? name them.***

1) These are fibrocartilaginous plates on the articular surface of the tibia which deepen the articular surface and fill in gaps that would be present between the tibia and femur during movement of the joint. 2) Peripherally, they are attached to the capsule which holds them to the tibial condyles. 3) Medial and Lateral meniscus. 4) IN DIRECT CONTACT WITH SYNOVIAL FLUID

What is the derivation and primary action of the Anterior (extensor compartment)?

1) These muscles are derived from the original dorsal musculature. 2) Primary action of the compartment is dorsiflexion at the ankle joint.

What is the derivation and primary action of the Lateral (fibular or peroneal) compartment?

1) These muscles are derived from the original dorsal musculature. 2) Primary action of the compartment is eversion of the foot.

What is the derivation and primary action of the Posterior (flexor) compartment?

1) These muscles are derived from the original ventral musculature. 2) Primary action of the compartment is plantarflexion at the ankle joint.

Describe the medial meniscus:*

1) This "C" shaped cartilage is firmly attached to the tibial collateral ligament 2) It is more likely to be injured than the lateral meniscus.(esp in a tear of the tibial collateral ligament)

Describe the anterior cruciate ligament:

1) This extends from anterior part of intercondylar area of tibia to lateral femoral condyle. 2) It is weaker than the posterior cruciate ligament and acts to prevent posterior displacement of the femur on the tibia. 3) The anterior cruciate ligament is tight in extension and loose in flexion. 4) A torn anterior cruciate ligament is indicated by an ANTERIOR DRAWER SIGN. (TIBIA DISPLACED ANTERIORLY).

What is the articular capsule of the knee joint?

1) This is loose and thin, except where there are intrinsic ligaments. There is no complete independent capsule, but there are muscle tendons or expansions of them which surround the joint. 2) Articular capsule: surrounds a synovial joint, encloses the synovial cavity, and unites the articulating bones.

Describe the fibular collateral ligament:

1) This lies between the lateral epicondyle of the femur and the head of the fibula. 2) At its upper end it is fused with the fibrous capsule and is thus an intrinsic ligament. 3) At its lower end it is separate from the capsule and there it is an extrinsic ligament. 4) The fibular collateral ligament is NOT attached to the lateral meniscus.

Describe the tibial collateral ligament:****

1) This lies between the medial epicondyle of the femur and the medial surface of the tibia. 2) It is a broad, flat band that is a thickening of the fibrous capsule and is therefore an intrinsic ligament. 3) On its deep side it is firmly attached to the medial meniscus. This attachment is important clinically because injury to the ligament is frequently associated with injury to the medial meniscus. 4) NOTE THAT MEDIAL MENISCUS IS IN DIRECT CONTACT WITH SYNOVIAL FLUID

Describe the Ligamentum patellae:

1) This lies between the patella and tibial tuberosity and is a continuation of the tendon of the quadriceps femoris. 2) Its posterior surface is separated from the synovial membrane of the joint by the infrapatellar fat pad.

What is the main function of the fibula? Does it participate in joints?

1) This long pin-like bone functions mainly as a site for muscle attachment. 2) It does not participate in the knee joint 3) It acts just to stabilize the lateral aspect of the ankle joint.

What muscles are in the anterior compartment of the leg:****

1) Tibialis anterior 2) Extensor hallucis longus 3) Extensor digitorum longus 4) Fibularis (peroneus) TERTIUS

What is a compound fracture? What is the most common long bone in the body to be involved in a compound fracture?

1) compound fractures (where bone fragments protrude through the skin). 2) Since the tibia lies subcutaneously, it is the most common long bone in the body to be involved in compound fractures.

Describe the posterior cruciate ligament:***

1) extends from the posterior part of the intercondylar area of the tibia to the medial femoral condyle 2) stronger than the anterior cruciate ligament. 3) It prevents anterior displacement of the femur on the tibia. 4) A torn posterior cruciate ligament will result in a POSTERIOR DRAWER SIGN. (POSTERIOR DISPLACEMENT OF THE TIBIA)

What are the exceptions etc of the rule that the muscles in the post compartment plantarflex?*****

1). The gastrocnemius and soleus form a tripartite muscle called the triceps surae, which forms the prominence of the calf and inserts on the calcaneus via the tendo calcaneus (Achilles tendon). 2). The gastrocnemius CAN FLEX THE KNEE + PLANTARFLEX ANKLE. Arises from the medial and lateral femoral condyles and thus crosses behind the knee joint. 3). The gastrocnemius is supplied with blood by sural arteries, branches of the popliteal artery. Since they are end arteries (without anastomoses), occlusion can lead to necrosis (death of tissue) of the part of the muscle that it supplies. 4). The popliteus arises from the lateral femoral condyle and inserts into the tibia above the soleus; it thus DOES NOT CROSS THE ANKLE JOINT. It does FLEX THE KNEE and ROTATE FEMUR LATERALLY or TIBIA MEDIALLY (depending on the point of fixation) at the beginning of flexion of the extended knee.

What are the Ligaments of the Fibrous Capsule of the knee?**

1. Ligamentum patellae 2. Fibular collateral ligament - NO DIRECT ATTACHMENT TO THE TIBIA 3. Tibial collateral ligament

Infrapatellar fat pad

1. part of the knee joint 2. just inferior to the patella 3. lined by synovial membrane 4. fills the gap created by the femur and the tibia

Anterior Cruciate Ligament

A ligament in the knee that attaches to the anterior aspect of the tibial plateau. restricting anterior movement of the tibia on the femur

What is the action of all the muscles of the anterior compartment of the leg? What else can they do individually?**

All four muscles DORSIFLEX the ankle joint and individually have other actions: 1) Tibialis anterior - also inverts foot 2) Extensor hallucis longus - also extends big toe 3) Extensor digitorum longus - also everts foot and extends lateral four toes 4) Fibularis tertius - also everts foot

medial and lateral femoral condyles tibial plateau

Articulating surfaces of the tibiofemoral joint (proximal then distal)

anterior cruciate ligament

Attaches to the anterior intercondylar area of the tibia.

POsterior cruciate ligament

Attaches to the posterior intercondylar area of the tibia.

Subcutaneous prepatellar bursa

Bursa which lies between the patella and the skin. It enables the skin to slide freely over the patella.

What are Tom , Dick ANd Harry again?

Tom Dick ANd Harry (medial side of the foot) 1) Tibialis posterior (Tom) 2) flexor Digitorum longus (Dick) 3) tibial Artery (And) 4) tibial Nerve (aNd) 5) flexor Hallucis longus (Harry)

What are the boundaries of the the anterior compartment of the leg? *****

Enclosed by the 1) crural fascia, 2) the tibia, the 3) interosseous membrane, 4) the fibula and the 5) anterior intermuscular septum. COMPARTMENT SYNDROME HERE IF YOU WALK IN SNOWSHOES FOR DAYS

What muscles use the knee joint to extend the leg?

Extension of the Leg (starred muscles are chiefly responsible for movement) 1) *Quadriceps femoris

Menisci

Fibrocartilage that sits on top of the tibial plateaus

What muscles use the knee joint to flex the leg?*

Flexion of the Leg (starred muscles are chiefly responsible for movement) 1) *Semimembranosus 2) *Semitendinosus 3) *Biceps femoris 4) Gracilis 5) Sartorius 6) Popliteus Extras from galen: 1) gastrocnemius 2) plantaris

What muscles use the knee joint to laterally rotate the tibia on the femur?*

Lateral Rotation of Tibia on Femur 1) *Biceps femoris

deep infrapatellar bursa

Located between proximal tibia and infrapatellar tendon. Helps reduce friction between this tendon and the tibial tuberosity.

What ligament is your medial meniscus attached to that causes it to be to be more suseptible to injury?

MCL

Valgus

MCL limits ___stress (occurs with lateral blow to knee, "clipping injury") (prevent abduction of leg (valgus))

What muscles use the knee joint to medially rotate the tibia on the femur?******

Medial Rotation of Tibia on Femur (starred muscles are chiefly responsible for movement) 1) *Popliteus [ THE MUSCLE MOST RESPONSIBLE FOR THE ROTATION OF THE TIBIA ON THE FEMUR (WHEN THE LEG IS FLEXED AT THE KNEE FROM A FULLY EXTENDED POSTITION); also most responsible for UNLOCKING the knee from a fully extended position. 2) *Semimembranosus 3) *Semitendinosus 4) Sartorius 5) Gracilis

What is the general and specific actions of the muscles in the lateral compartment?

Muscles - 1) In general, the two muscles arise from the fibula and evert the foot. 2) Since both fibular muscles pass behind the ankle joint they also plantarflex the foot. 3) The fibularis longus also helps to maintain the longitudinal and particularly the transverse arch of the foot since its tendon passes obliquely across the sole.

What is the action in general of the muscles in the posterior compartment?*

Muscles - In general, the muscles of the posterior compartment PLANTARFLEX the foot.

What structures divide the muscles of the leg into compartments?

Muscles of leg are divided into compartments by: 1) The tibia 2) The fibula, 3) The interosseous membrane, 4) Two intermuscular septa (anterior and posterior) that arise from the fibula.

When are the collateral ligaments tight and when are they loose? What movement of the bones do they permit?

NOTE: Both collateral ligaments are tight in extension and loose in flexion. In flexion they permit rotation of the femur on the tibia.

Tibiofemoral Joint

Name the Knee Joint

fibular collateral ligament

Strong, rounded ligament on the lateral surface of the joint - extends from the lateral condyle of the femur to the lateral side of the head of the fibula. - strengthens the lateral aspect of the joint.

What is the coronary ligament?

The coronary ligament is that part of the capsule that lies between the menisci and the tibia.

Tendon of quadriceps femoris

The tendons of the four components of the quadriceps femoris muscle unite to form a strong flat tendon

Where are the intra-articular ligaments? Name them.

These are within the capsule but outside the synovial cavity of the joint. 1) Anterior Cruciate Ligament 2) Posterior Cruciate Ligament

Describe the lateral meniscus:

This cartilage, also "C" shaped, is more nearly circular and is NOT attached to the fibular collateral ligament.

Lateral meniscus

is a fibrocartilage band that spans the lateral side of the interior of the knee joint. It is one of two menisci of the knee, the other being the medial meniscus. It is nearly circular and covers a larger portion of the articular surface than the medial. It can occasionally be injured or torn by twisting the knee or applying direct force.

modified hinge joint

knee joint (tibiofemoral joint) is also known as this unique type joint...

patellar ligament

knee ligament that is a continuation of large muscle group in the thigh. It consists of a strong, flat band that extends from the margin of the patella to the tibial tuberoisty.

patellar ligament

runs between patella and tibial tuberosity (continuation of quad insertion)

Anterior Cruciate Ligament (ACL)

runs from anterior tibia to medial aspect lateral femoral condyle

Lateral Collateral Ligament (LCL)

runs from lateral epicondyle of femur to fibular head

Posterior Cruciate ligament (PCL)

runs from posterior tibia to lateral aspect medial femoral condyle

Medial collateral ligament (MCL)

runs from the medial epicondyle of femur to medial proximal tibia

Articular Capsule

sleevelike structure around a synovical joint composed of a fibrous capsule and synovial membrane

Synovial cavity

space between bones at a synovial joint; contains synovial fluid produced by the synovial membrane

fibular collateral ligament

the collateral ligament of the knee that connects the lateral epicondyle of the femur with the head of the fibula an extracapsular ligament, not part of the fibrous capsule of the knee; external ligament of the knee; becomes tight only during extension to prevent hyperextension of the knee joint (not easily injured)

Tibia

the inner and thicker of the two bones of the human leg between the knee and ankle

posterior surface of patella and intercondylar groove of femur

what are the articulating surfaces of the patellofemoral joint?

patellar subluxation and/or patellofemoral joint dysfunction

what are two possible results from lateral tracking of the patella?

femoral condyles

what does the patella protect from trauma?

quads and femoral condyles

what does the patella reduce friction between?

femur rotates internally on the tibia

what happens during closed chain knee extension? (final 30degrees of terminal knee extension)

the tibia rotates externally on the femur

what happens during open chain knee extension? (final 30degrees of terminal knee extension)

tracking

what is it called as the patellar moves along the femur?

proximal tibiofibular joint

what joint is located between the lateral tibial condyle and the fibular head?

superior and inferior patellar gliding

what motions occur at the patellofemoral joint?

middle and distal tibiofibular joints

what two joints in the leg have an interosseous membrane?

interosseous membrane

what type ligament is in the medial tibiofibular joint?

knee flexion

when does inferior patellar gliding occur?

knee extension

when does superior patellar gliding occur?

intercondylar groove of femur

where does the patella sit during knee flexion?

medial side of the lateral malleolus of the fibula and the fibular notch of the distal tibia

where is the distal tibiofibular joint located?

lateral tibial condyle and fibular head

where is the proximal tibiofibular joint located?