Joints of the Lower Limb

Lateral ankle sprain: Most common. Lateral ligament of ankle injured when foot is forcefully inverted. Which ligament component is most commonly torn?

Anterior talofibular ligament

Unhappy triad injury is a simultaneous injury of which 3 knee structures?

1. Torn anterior cruciate ligament 2. Torn tibial (medial collateral ligament) 3. Torn medial meniscus

Hallux Valgus Lateral deviation (valgus) deformity of big toe (hallux). Deformity occurs at which joint?

1st metatarsophalangeal joint

Popliteus tendon (attached to lateral femoral condyle) rotates femur laterally how many degrees on tibial plateau?

5 degrees

Flex knee and pull anteriorly on tibia to test which ligament?

ACL

Which ligament is most commonly teared in a knee injury?

Anterior cruciate ligament (ACL)

Ankle Joint Structural classification: Functional classification: Uniaxial, diarthrosis

Hinge type of synovial joint

Which ligament is also known as the lateral collateral ligament of ankle, three ligaments reinforce lateral aspect of ankle joint, stabilizes ankle joint during foot inversion, and is frequently injured?

Lateral ligament of ankle

Which meniscus is not attached to fibular collateral ligament (popliteus tendon passes between lateral meniscus and ligament)?

Lateral meniscus W

Lateral tibiofemoral joint

Lateral tibial condyle + lateral femoral condyle

What are the 3 articulations of the knee joint?

Lateral tibiofemoral joint, medial tibiofemoral joint, and patellofemoral joint

Which ligament attaches to the tibia posteriorly, functions to prevent posterior sliding of the tibia under the femur, prevents hyperflexion of knee joint, is a strong ligament, and in weight-bearing flexed knee, PCL is main stabilizing ligament for the femur (e.g. when walking downhill)?

Posterior cruciate ligament (PCL)

What does the the distal tibia and the distal fibula form that articulates with trochlea of talus?

Malleolar mortise (wedge-shape)

Medial ligament of ankle injured when foot forcefully everted.

Medial ankle sprain

What is the structural classification of the tibiofemoral joint?

Modified hinge type of synovial joint

Patellofemoral joint

Patella + femur W

Which muscle unlocked the knee joint?

Popliteus muscle Contraction of popliteus muscle unlocks knee so knee joint can flexW

Which ligament attaches to tibia anteriorly, functions to prevent anterior slinging of tibia under femur, prevents hyperextension of knee joint, is weaker than the posterior cruciate ligament and is therefore more commonly damaged?

Anterior cruciate ligament (ACL)

What is the difference between a sprain and a strain?

Sprain= injury to ligament(s); (stressed beyond normal capacity) - Overstretching - Tear (incomplete or complete), rupture - Examine patient for ligament laxity and instability at joint Strain= stretched or partially torn muscle/tendon - Occurs when muscle contracts suddenly and powerfully

What is another name for the subtalar joint?

Talocalcaneal joint

What is the ankle joint also known as?

Talocrural joint

When does the knee joint passively "lock"?

When knee is fully extended while standing. Due to medial rotation of femoral condyle on tibial plateau. Makes lower limb solid and adapted for weight-bearing.

What is the posterior drawer sign a sign of?

Ruptured PCL

Dorsiflexion and plantarflexion occur at which joints?

Ankle joint movements

Knee Joint Articulating bones: Distal femur, patella and proximal tibia Classification of joint: Stability of joint: Unstable but supported by many ligaments Movements of joint: Flexion and extension; but also slight rotation

Biaxial (modified) hinge type of synovial joint

Deformity of the foot Congenital Ankle plantarflexion, foot inverted, for foot adducted

Clubfoot (Talipes Equinovarus)

What are 2 other names for the hip joint?

Coxal joint or the acetabulofemoral joint

Which ligament supports the lateral side of knee joint, not attached to lateral meniscus (separated from popliteus tendon), and is strong/cord-like?

Fibular collateral ligament (lateral collateral ligament)

Inversion and eversion movements occur at which joints?

Foot joint

What is the difference between genu varum vs. genu valgum?

Genu varum (bow-leg) Genu valgum (knock-knee)

What is the articulation between talus and calcaneus? Inversion and eversion of the foot occur at this joint.

Subtalar joint or talocalcaneal joint

Which ligament supports the medial side of the knee joint, firmly attaches to medial meniscus, and is weaker and commonly damaged?

Tibial collateral ligament (medial collateral ligament)

What is another name for the knee joint?

Tibiofemoral joint

Normally, there is a natural tendency towards lateral pull on patella, but is counterbalanced by medial pull of which stronger muscle?

Vastus medialis muscle

What is another name for the medial ligament of the ankle?

Deltoid ligament

What are the articulating bones of the knee joint?

Distal femur, patella, and proximal tibia

Which ligament limits hyperextension of the hip joint during standing and connects the ilium with the femur?

Iliofemoral ligament

What are the 3 capsular ligaments of the hip joint?

Iliofemoral ligament, pubofemoral ligament, and ischiofemoral ligament

Which ligament stabilizes the hip joint posteriorly and connects the ischial part of the acetabulum to the neck of the femur?

Ischiofemoral ligament

Which ligament is also called ligamentum teres femoris or round ligament of the femur and functions to conduct the "artery to head of femur"?

Ligament of head of femur

Fracture, dislocation, or vascular pathology reduces blood flow of which artery and results in avascular necrosis of femoral head? Insufficient blood supply causes tissue such as bone to die.

Medial circumflex femoral artery

Which ligament is strong; four ligaments reinforce medial aspect of ankle joint, and stabilizes ankle during foot eversion?

Medial ligament of ankle or deltoid ligament of ankle

What meniscus is partly attached to tibial collateral ligament; therefore can be commonly damaged?

Medial meniscus

Medial tibiofemoral joint

Medial tibial condyle + medial femoral condyle

What is a crescent-shaped fibrocartilage pad and functions in shock absorption and to deepen articular surface between tibia and femur?

Meniscus

Hip Joint Articulating bones: head of femur and acetabulum of hip bone Classification of joint: Stability of joint: Strong and very stable due to joint capsule, attachments of muscles and ligaments Joint movements: (Very moveable); flexion, extension, abduction, adduction, medial/lateral rotation; circumduction Neurovasculature of joint: Blood and nerve supply to joint the same as muscles and skin surrounding the joint

Multi-axial, ball-and-socket type of synovial joint

What is a common complication in femoral neck fractures in the elderly? Cause: Car accident, osteoporosis, fall. Affected limb shortened and laterally rotated (due to pull of lateral rotator muscles of hip joint)

Necrosis of the femoral head

Which bone most commonly dislocates laterally? Due to normal angulation of femur and angle of lateral pull of quadriceps femoris m. If vastus medialis m. Is weak then vastus lateralis muscle will pull patella laterally

Patella

Which ligament is a strong, attaches from apex of patella to tibial tuberosity (is a continuation of distal part of quadriceps tendon), and functions to maintain alignment of patella relative to femor?

Patellar ligament

What syndrome is also known as "runner's knee"? Pain/inflammation deep to patella due to abnormal gliding of patella over surface of femur Abnormal alignment of patella Causes: excessive downhill running, direct trauma to patella, osteoarthritis, weakness of vastus medialis

Patellofemoral syndrome also known as patellofemoral pain syndrome

Absence of normal supportive arch of foot "fallen arches"

Pens Planus (Flat Foot)

Ankle Joint Articulating bones: tibia, fibula, and talus Classification of joint: uniaxial, hinge type of synovial joint Stability of joint: ligaments Movements:

Plantarflexion and dorsiflexion

Anterior movement of tibia is called what sign?

Positive Anterior Drawer Sign

Posterior movement of tibia is called what sign?

Positive Posterior Drawer Sign

Which ligament prevents overabduction (hyperabduction) of the hip joint and connects the pubic bone part of the acetabulum to the neck of the femur?

Pubofemoral ligament

Posterior Dislocation of Hip Joint Type of acquired hip joint dislocation. Strong force pushes femoral head posteriorly out of normal position with acetabulum. Joint capsule/ligaments rupture. Which nerve may be injured as a result of a posterior hip dislocation?

Sciatic nerve