1
Q
What is different about the lateral condyle of the inferior femur?
A
Projects farther laterally
2
Q
how does the lateral condyle of the femur assist in functionality?
A
Patellofemoral stability
3
Q
How does the medial condyle of the femur assist in function?
A
Screw home mechanism
4
Q
What creates the extension of the lateral condyle of the femur?
A
Lateral pull of patella by muscles
5
Q
Which condyle of the tibia is 50% larger?
A
Medial
6
Q
What are the 3 facets of the patella?
A
Medial, lateral, odd
7
Q
What do the medial and lateral facets of the patella form in the trochlear groove?
A
“V”
8
Q
What are the 2 articulations of the Knee?
A
- Tibiofemoral
2. Patellofemoral
9
Q
What is 1 limitation and 1 functional advantage of the tibiofemoral joint?
A
Limitation: Poor congruence
Advantage: Large articular surface
10
Q
What is an advantage of the patellofemoral joint over the tibiofemoral joint?
A
Good congruence
11
Q
When is the congruence better in the patellofemoral joint?
A
In flexion
12
Q
What is the fibrous sleeve that invests the distal end on the femur and the proximal tibia?
A
Joint Capsule
13
Q
What is the inner surface of the joint capsule covered by?
A
Synovial lining
14
Q
What reinforces the joint capsule?
A
Ligaments for stability
15
Q
In extension, the joint capsule is loose ________ and tight ________ preventing ________.
A
Anteriorly, Posteriorly, Hyperextension
16
Q
In flexion, _________ aspect of capsule prevents femur from _______ _______
A
anterior, sliding, anteriorly
17
Q
Are the ACL & PCL within the synovium?
A
NO
18
Q
Where is the synovium found?
A
Lines joint capsule
19
Q
What does the synovium do posteriorly?
A
Invaginates
20
Q
Why do the ACL & PCL need their own blood supplies while the menisci do not?
A
ACL & PCL are not within the synovium
21
Q
What are 2 functions of the Bursae?
A
- Reduce friction
2. Increase surface area (reduce compressional stress)
22
Q
What are the 4 anterior bursae? (Superior to inferior)
A
- Suprapatellar bursa
- Prepatellar bursa
- Depp infrapatellar bursa
- Subcutaneous infrapatellar bursa
23
Q
Where are the posterior bursae located?
A
Under muscle bellies and tendon attachments
24
Q
What are 3 areas posterior bursae are found?
A
- Gastroc
- Popliteus
- Semimembranosis tendon
25
Which menisci have insertion sites that are far apart? (C-shaped)
Medial
26
Which Menisci have insertion sites that are close together? (Circular)
Lateral
27
What ligament has capsular attachments on the Medial Menisci?
MCL
28
What ligaments attach to the lateral menisci posteriorly?
Meniscofemoral (PCL)
29
What are the 4 ligaments about the Menisci?
1. Coronary
2. Transverse
3. Intercondylar
4. Meniscofemoral
30
Where do the coronary ligaments attach?
Menisci -> Tibia
31
Where do the transverse ligaments attach?
Anterior menisus -> anterior meniscus
32
Where do the intercondylar ligaments attach?
Meniscal horns -> intercondylar eminence
33
Where do the meniscofemoral ligaments attach?
Posterior horn of lateral meniscus -> medial femoral condyle
34
What are 3 functions of the Menisci?
1. Improve congruency
2. Assist in arthrokinematics
3. Distribute weight bearing forces
35
How do the menisci influence loading?
Greatly reduce external forces by increasing surface area.
36
What is needed of the menisci during tibiofemoral motion to improve congruency and distribute forces?
Movement
37
During flexion, menisci move _______
Posteriorly
38
During extension, menisci move _________
Anteriorly
39
Which menisci has twice as much motion?
Lateral
40
Which menisci are attached to the joint capsule?
Medial
41
What 4 structures does the stability of the knee depend on?
1. Collateral Ligaments
2. Cruciate Ligaments
3. Capsular Ligaments
4. Muscles/tendons
42
What structure increases the surface area of the knee extensor mechanism?
Patellar Retinacula
43
How would medial external force affect the knee?
load the lateral side (varus)
44
How would lateral external force affect the knee joint?
Medial loading (valgus)
45
Which type of loading (Valgus or varus) is more common?
Valgus
46
Which cruciate ligament is ccapsular?
MCL
47
Which cruciate ligament is Extrinsic?
LCL
48
When is the MCL most effective?
Extension (taut in this position)
49
What muscle attachment does the LCL run underneath?
Biceps femoris
50
What does the LCL primarily resist?
Varus Stress
51
What does the MCL primarily resist?
Valgus stress
52
What are 2 secondary restraints of the LCL?
1. Tibial Lateral Rotation
| 2. Posterior tibial displacement
53
slide 38
slide 38
54
Which condyle of the femur extends farther distally and laterally?
Medial
55
What forms the Iliotibial Band proximally?
Fascia investing TFL & glut max
56
Where does the IT band insert?
Lateral Tibial Condyle
57
Which side of the knee does the IT band reinforce
Lateral
58
How does the IT band assist the ACL?
Resists tibial IR and posterior displacement of the femur when tibia is fixed.
59
What are the Posterior reinforcing ligaments of the knee
1. Oblique Popliteal
| 2. Arcuate
60
What are the proximal and distal attachment sites of the oblique popliteal ligament?
Proximal: Lat condyle of femur
Distal: Med Condyle tibia
61
What are the Proximal and distal Attachment sites of the Arcuate ligament?
Proximal: Lat condyles of femur and tibia
Distal: head of fibula
62
The cruciates are within the _________ _________ but outside of the _________ ___________
1. Articular Capsule
| 2. Synovial Capsule
63
The Cruciates are stabilizing ligaments that resist ________ and anterior/posterior ________ of the tibia
1. Rotation
| 2. Translation
64
What are the attachments of the ACL?
Lateral Femoral condyle -> Anterior intercondylar fossa
65
What innervates the ACL?
Tibial Nerve
66
What two forces does the ACL primarily resist?
Anterior tibial Translation & Internal Tibial Rotation
67
The ACL secondarily resists ______ and _______ stresses
Varus and valgus
68
What are the attachment sites of the PCL?
Medial femoral condyle -> posterior intercondylar fossa
69
What are the attachment sites of the meniscofemoral ligaments?
posterior horn of lateral meniscus -> lateral wall of medial femoral condyle
70
What does the PCL primarily resist?
Posterior translation of tibia or anterior translation of femur
71
At what range of flexion is the PCL least effective at?
70-90
72
What is the Screw-home mechanism?
Femur rotates medially in relation to the tibia or vice versa upon extension: locking/unlocking the knee
73
Which segment (femur or tibia) moves in the screw-home motion?
Whichever has least amount of inertia.
74
What muscle works to unlock/lock the knee?
Popliteaus
75
What is the average angle of the patellar facet angle?
138 degrees
76
What is an incomplete fusion of the epiphyseal disc in the patella?
Bipartite Patella
77
What is the Patella embedded in?
Quad Tendon
78
What does the patella articulate with?
Trochlear groove of femur
79
How do the muscles typically pull the patella?
Along Diaphesis of femur
80
What does the Q Angle measure
line from ASIS (femoral shaft) to center of patella
Line from tibial tuberosity to patella
81
Know how to draw the Q-angle
Draw it.
82
What is the function of the patella?
Provides mechanical advantage by placing torque further from the axis of rotation
83
Draw PFJ
DRAW IT
84
What is a high-riding patella called?
Patella Alta
85
What is the normal patella ligament hight / patellar height ratio
Should be bout 1.3/1
86
What happens fuctionally when the patella rides high on the femur?
Less congruence and stability
87
at what angle of flexion does the patellar tendon compress the anterior portion of the patella?
90degree
88
at what angle of flexion does the patellar tendon compress the middle portion of the patella?
45deg
89
at what angle of flexion does the patellar tendon compress the Posterior portion of the patella?
20Deg
90
at greater flexion angles, quad tendon contacts ______
femur
91
What are the only anterior muscles that control extension?
Quads
92
Vastus Intermedius prox Origin
Anterior femoral shaft
93
Vastus lateralis Prox Origin
Lateral Lip of Linea Aspera (Lat Greater trochanter)
94
Vastus Medialis prox origin
Med lip of linea aspera (distal intertrochanteric line)
95
All Vasti Distal ins
Tibial Tuberosity (via patellar ligament)
96
Vasti Muscles innervation
Femoral N
97
functions of Vasti Muscles
1. Extend Knee
| 2. Prevent entrapment of capsule
98
Rectus Femoris Prox Origin
AIIS and Sup (roof) acetabulum
99
Rectus Femoris Dist Ins
Tibial tuberoosity (via patellar ligament)
100
Rectus Femoris Innervation
Femoral N
101
Functions of Rectus Femoris
1. Extends Knee
| 2. Flexes Hip
102
All Hamstring muscles Prox origin
Ischial Tuberosity
103
biceps Femoris long head dist ins
Head of fibula
104
Semimembranosis dist ins
Medial Tibial Condyle
105
Semitendinosus dist ins
Pes Anserinus
106
Innervation of all hamstrings (except biceps femoris short head)
Tbial N
107
Function of all Hamstrings (except biceps Femoris, short head)
1. Flex Knee
2. IR Tibia (semimem & semitend)
3. ER Tibia (BF long head)
4. Extend hip
108
Biceps femoris short head prox orig
Linea Aspera (lateral lib in middle 1/3 of femur)
109
Biceps femoris short head dist ins
Head of fibula
110
Innervation of Biceps Femoris short head
Common Fibular N
111
What are the functions of the biceps femoris short head?
1. Flexes Knee
| 2. ER Tibia
112
Popliteus Prox origin
Lateral Femoral Condyle
113
Popliteus Dist ins
Posterior Tibial Surface
114
Popliteus Innervation
Tibial N
115
Functions of Popliteus
1. Flexes Knee
2. IR Tibia
3. ER Femur
4. Limits Hyperextension
116
Sartorius Prox Origin
ASIS
117
Sartorius Dist Ins
Medial Tibial Condyle (pes anserinus)
118
Sartorius Innervation
Femoral N
119
Functions of Sartorius
1. Flexes Knee
2. Flexes Hip
3. Abducts Hip
4. ER Hip
120
Gracilis Prox Origin
Inferior Pubic Ramus
121
Gracilis Dist Ins
Medial to the tibial Tuberosity (pes anserinus)
122
Gracilis Innervation
Obturator N
123
Functions of the Gracilis
1. Flex Knee
2. IR Tibia
3. ADD Hip
4. Flex Hip
124
What is the sequence of tendon insertions into the Pes Anserinus (sup -> inf)
Sup: Sartorius
Mid: Gracilis
Inf: Semitendinosus
125
Gastroc med head Prox Origin
Med Epicondyle of Femur
126
Gastroc Lat Head prox origin
Lat Epicondyle of Femur
127
Gastroc (both heads) dist Ins
calcaneal tubrosity via Achilles Tendon
128
Plantaris prox origin
Lat Epicondyle of Femur
129
Plantaris dist Ins
Calcaneal Tuberosity via Achilles Tendon
130
What Innervates the gastroc and Plantaris
Tibial N
131
Functions of the Gastrocnemius and Plantaris
1. Flex knee
2. Plaantar-flex Ankle
3. Invert intertarsal
musculoskeletal anatomy
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Decks in class (6)
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