week 4

Question 1

Tibiofemoral joint- classification/ movements

Answer 1

classifications:
* Synovial
* Condyloid
* Biaxial

movement
Flexion 140o
* Extension 0-5o
* Internal/medial rotation 10-20degrees if flexed * External/lateral rotation 30-40 degrees if flexed

Question 2

Tibiofemoral Articular Surfaces

Answer 2

• Femoral condyles
• Convex
• Medial & lateral
• Essentially flat
• Separated by intercondylar area

Question 3

Patellofemoral- Articular Surfaces/ Classification / movements

Answer 3

articular surface-
* Patella surface of femur
* Articular surface of patella

classifications-
* Synovial
* Plane
* Movements

movements-
* Gliding- bone on front glides along patellar

Question 4

Patellofemoral- Articular Surfaces/ Classification / movements

Answer 4

Articular Surfaces-
* Patella surface of femur
* Articular surface of patella (facets)

Classification-
* Classification
* Synovial
* Plane

movements-
Gliding

Question 5

knee joint capsule

Answer 5

• Attaches to articular margins
• Femoral condyles
• Attaches to medial & lateral margins
• Tibial condyles
• Incomplete! And thin
• Anteriorly

Question 6

Knee Retinacula

Answer 6

• Medial & lateral patellar retinaculum
  
  • From vastus medialis & vastus
    lateralis
  • Medial retinaculum blends with periosteum of tibia
• Medial patellofemoral ligament (need to lean)
• Adductor tubercle to vastus medialis onto superomedial patella
  Lateral retinaculum blends with iliotibial tract

Question 7

Synovial Membrane of the knee

Answer 7

• Lines the joint capsule
  
  • Extensive and complex
• Anteriorly attaches to patella
• Posteriorly closes off intercondylar
  fossa
  
  • Does not enclose the cruciate ligaments
    Communicates with some bursa

Question 8

knee bursae

Answer 8

• Some to be aware of:
  
  • Pes anserine
• On medial tibia
  
  • Suprapatellar
• Extends 6cm superior to patella
  
  • Infrapatellar
    Prepatellar

Question 9

wheredoes the fibular collarteeral ligament attach and what does it limit and prevent

Answer 9

• Fibular/Lateral collateral ligament
• Attaches
  Lateral femoral epicondyle
  Lateral surface head of fibula
• Limits
  Extension
  Lateral rotation
• Prevents
  Adduction

Question 10

Popliteofibular ligament (extra capsular ligament)

Answer 10

• Attaches
• Popliteus tendon
• Apex of head of fibula
• Limits
• Lateral rotation of the tibia

Question 11

Patella ligament (extra capsular)

Answer 11

• From patella to tibial tuberosity
• Continuation of quadriceps tendon
• Receives the patellar retinacula
• Function
• Mechanical advantage in knee

Question 12

Tibial/Medial collateral ligament (extra capsular)

Answer 12

• Attaches to Medial femoral epicondyle, Medial tibial condyle & shaft and Medial meniscus
• Limits- Extension, Medial rotation
• Prevents- Abduction extension

Question 13

Oblique Popliteal (extra capsular)

Answer 13

• Strengthens central posterior joint
  capsule
  Is an expansion of the tendon of semimembranosus
• Travels superolaterally to femur

Question 14

Arcuate Popliteal (extra capsular)

Answer 14

Strengthens inferolateral posterior joint capsule
Is an expansion of the tendon of biceps femoris attachment
Travels superomedially over popliteus

Question 15

Anterolateral ligament (extra capsular)

Answer 15

• Attaches
• lateral femoral condyle
• midway between anterolateral tubercle (Gerdy’s tubercle) & head of fibula
• Some sources consider it part of the ITB
  stabiliser for rotation of the tibia?

Question 16

Anterior Cruciate Ligament ACL (Intracapsular)

Answer 16

• Attaches
• anterior intercondylar area of tibia
• posteromedial surface of lateral femoral condyle
• Extra-synovial
• Limits
• anterior slide of tibia on femur
• medial rotation
• Memory tip - 3 anteriors on this slide

Question 17

Posterior Cruciate Ligament PCL (intracapsule)

Answer 17

Attaches
* posterior intercondylar area of tibia
* lateral surface of medial femoral condyle
* lateral meniscus
* Extra-synovial
* Limits
* posterior slide of tibia on femur
* medial rotation
* Memory tip - 3 posteriors on this slide

Question 18

Medial & Lateral Meniscus

Answer 18

• Crescent shaped wedges of fibrocartilage, thicker at ‘edges’
• Shock absorption
• Increase congruence
• Medial meniscus
• Larger, C-shaped, less mobile as more attachments
• Lateral meniscus
• Smaller, almost circular

Question 19

STABILITY OF THE HIP

Answer 19

1. Articular fit(reasonable congruency)
   
   2. Acetabular labrum (deepens the socket and increases congruency)
   3. Strong capsule, reinforced by capsular ligaments
   4. Angle of inclination (increases contact area)
      Muscles

Question 20

Factors contributing to MOBILITY at the hip joint

Answer 20

1. Acetabular labrum – provides increased surface area for femoral head
2. Ball and socket joint (multi-axial – three degrees of freedom)

Question 21

Important steps to analyze movements

Answer 21

1. Name the movement at the hip joint
   
   2. List the muscles acting as movers in this activity
   3. List the muscles acting as stabilisers
   4. For each of the muscles above, list all other actions they produce
2. List muscles acting as synergists

Question 22

stabilisers of the hip

Answer 22

• Iliopsoas
• Pectineus
• Deep lateral rotators
• Gluteus medius, gluteus minimus

Question 23

satorius actions/ prox and distal attachment/ nerve supply

Answer 23

action: hip flexion /knee flexion

prox attachments: anterior superior iliac spine

distal attachment: medial surface of tibia/ medial collateral ligament of the knee

nerve supply: femoral nerve

Question 24

rectus femoris actions/ prox and distal attachment/ nerve supply

Answer 24

action: hip flexion/ knee extension

prox attachment: anterior inferior iliac spine/ superior to the acetabulum

distal attachment: tibia tuberosity via the patellar ligament

Question 25

vastus lataralis actions/ prox and distal attachment/ nerve supply

Answer 25

action: knee extension prox attachment: intertrochanteric line/ lower greater trochanter/ upper half of the lateral lip of linea asparea dist attchments: tibia tuberocity via patellar ligament/ condyle of tibia

Question 26

vastus medialis actions/ prox and distal attachment/ nerve supply

Answer 26

action: knee extension prox attachment: lower medial part of intertrochanteric line/ medial aspect of the proximal femoral shaft/ medial lip of the line aspera/ upper 2/3 of medial supracondylar line dist attachment: tibia tuberocity via tendon of rec fem and patellar ligament/ medial condyle of tibia

Question 27

vastus inermedialas

Answer 27

action: knee extension prox attachment: upper 2/3 of anterior and lateral surface of the femur distal attachment: tibial tuberocity via rec fem and patellar ligament

Question 28

bicep femoris actions/ prox and distal attachment/ nerve supply

Answer 28

action: hip extension prox attachment: medial part of asocial tuberocity and sacrotuberous ligament/ upper part of the lateral supracondylar line of the femur distal attachment: head of fibula

Question 29

semitendinous actions/ prox and distal attachment/ nerve supply

Answer 29

action: hip extension/ knee flexion prox attachment: medial ischial tuberocity distal attachment: medial surface of the upper part of the shaft of the tibia

Question 30

semimembranosus actions/ prox and distal attachment/ nerve supply

Answer 30

action: hip extension/ knee flexion proximal attachment: lateral aspect of ischial tuberocity distal attachment: posteromedial surface of the medial tibial condyle