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Knee Anatomy
Anatomy
| Question | Answer |
|---|---|
| Knee: actions | Flexion/ ext; Slight rotation (Locked knee) |
| Largest synovial joint in body | knee |
| Knee: 2 articulations | Femur & tibia; Femur & patella (no fib involvement) |
| Knee joint components: | Menisci; Ligs; Synov capsule; Joint capsule; patella |
| Menisci: fn | increase congruency btw knee & tibia |
| Menisci: C-shaped cartilages | Medial & Lateral meniscus |
| Both Menisci attached to: | intercondylar region of tibial plateau |
| Menisci connected anteriorly (to intercondylar region) by: | transverse lig of the knee |
| Medial meniscus attached to: | intercondylar region (tib plateau); joint capsule & tib coll lig |
| Collateral ligs | Tibial coll lig (medial); Fibular coll lig (lateral) |
| Collateral ligs: fn | Stabilize hinge-like motion of the knee |
| ACL: fn | Prevents ant displacement of tib relative to femur |
| PCL: fn | Prevents post displacement of tib relative to femur |
| ACL & PCL named for: | where they attach on the tibial plateau |
| Knee joint surrounded by: | synovial membrane |
| Synovial membrane attached to: | menisci & margins of articular surfaces |
| Synovial membrane does not enclose: | cruciate ligaments |
| Synovial membrane separated from patellar lig via: | infrapatellar fat pad |
| Synovial membranes expand into: | suprapatellar bursa to decrease friction at joint |
| Entire knee joint & syn mem surrounded by: | fibrous membrane |
| fibrous membrane around knee joint blends with: | coll ligs |
| fibrous membrane around knee joint reinforced by | tendons of mxs crossing knee & IT tract |
| Patella forms inside: | tendon of quadriceps femoris |
| Patella: Superior attachment = | quadriceps tendon |
| Patella: Inferior attachment = | patellar ligament |
| Patella: Pulled laterally by: | quad femoris & (bicondylar) angle of femur |
| Patella: medial lip is higher than lateral lip: prevents: | Patellar dislocation |
| Ext & medial rotation of knee results in: | locking knee into position |
| results of locking knee: | Tightens ligs to reduce energy nec for standing; brings flatter surfaces of femur into contact w/ tib plateau; makes joint more stable |
| Unlocking of knee caused by: | popliteus mx (initiates lat rotation of femur on tib) |
| Knee: Soft tissue injuries = | ACL & PCL tear; Meniscal tears; Trauma to coll ligs |
| Most common knee injury: | ACL tear |
| ACL tear: MOA | planting foot & then quickly twist or change direction |
| Patellofemoral syndrome AKA | PFS; chondromalacia patella; runners knee) |
| Bakers cyst AKA | popliteal cyst |
| Young pts: injury can pull tib lig (on tib tuberosity) away from growth plate | Osgood-Schlatter dz |
| Muscles that cross knee | Quad femoris; Sartorius; Gracilis; Semimem; Semitend; Biceps femoris; Gastroc; Plantaris; Popliteus |
| Ms insert into Pes anserinus: | sartorius, gracilis, semitendinosus |
| Pop Fossa: lateral border: | biceps fem |
| Pop Fossa: medial border: | semimembranosus mx |
| Pop Fossa: inferior border: | gastrocnemius (med/lat) |
| Pop Fossa: contents: | popliteal a. & v.; tibial n.; common fib n.; sm saphenous v. |
| femoral a. & v. pass thru _____ & become popliteal a/v | adductor hiatus |
| Sciatic n. descends to pop fossa & splits into: | tibial n. & common fib n. |
| Anterior compartment fn | Dorsiflex foot, extend toes, invert foot; deep fibular n. innervation |
| Lateral compartment fn | Evert foot; superficial fibular nerve innervation |
| Posterior compartment fn | Flex knee, plantarflex & invert foot, flex toes; tibial n. innervation |
| Innervation: posterior leg | tibial n. |
| Movements of the Posterior Leg | Flex knee; Plantar flex foot; Invert foot; Flex toes |
| Soleus mx does not: | cross knee (other 2 mx do cross) |
| Superficial mx of posterior leg: variably absent | Plantaris (5-10%) |
| All Superficial mx of posterior leg come together to form: | calcaneal (Achilles) tendon |
| Superficial mx of posterior leg = | gastroc, plantaris, soleus |
| Mx often harvested for tendon transplant | plantaris |
| Deep Muscles of the Posterior Leg: Actions | 1 mx acts on knee, 3 act on foot |
| Poplit art splits into: | Anterior tibial art; Posterior tibial art |
| Anterior tibial artery: passes thru _____ to get to anterior leg | inteross mem |
| Posterior tibial artery: runs: | down length of posterior leg into sole of foot |
| Posterior tibial artery: gives off: | fibular artery (to lateral leg) |
| Sciatic n. splits into: | tib & common fibular n. in popliteal fossa |
| Tibial n. runs: | down length of post leg & into sole of foot |
| Common fibular nerve: route | wraps around head of fibula & runs to lat & ant compartments |
| Tendons of deep post leg, post tib a., & tib n. run into foot via: | tarsal tunnel |
| Tendons in tarsal tunnel held down by: | flexor retinaculum |
| Found in tarsal tunnel: | Tib post, FDL, post tib a., tib n., FHL |
| Leg: Anterior compartment: fn | Dorsiflex foot, extend toes, invert foot |
| Leg: Anterior compartment: innervation | Deep fib n. |
| Leg: Lateral compartment: fn | Evert foot |
| Leg: Lateral compartment: innervation | Superficial fib n. |
| Movements of Anterior Leg | Dorsiflex ankle; extend MTP/ IP joints; Invert foot |
| Movements of Lateral Leg | Evert foot only |
| Mx of Anterior Leg | Tibialis anterior; EHL; EDL |
| EDL mx: forms: | dorsal digital expansions (sim to dorsal hoods in upper ext/ phalanges) |
| Mx of Lateral Leg | Fibularis longus; fib brevis |
| Fibularis longus; fib brevis run just posterior to: | lateral malleolus |
| Mx of Lateral Leg: innervation | superficial fib n. |
| LE retinacula = | Extensor (sup & inf) & Fibular Retinacula |
| LE retinacula have extensive system of: | synovial sheaths lubricating tendons movements |
| Common fib n.: course | wraps around fib head & splits into deep & superficial fib branches |
| Common fib n.: Superficial fib branch innervates: | Lateral compartment |
| Common fib n.: Deep fib branch innervates: | Ant compartment |
| Common fib n.: Deep fib branch runs: | w/ ant tib artery into dorsum of foot |
| Common fib n.: injury results in: | loss of dorsiflexion & toe extension (foot drop) |
| Shin splints: usu result of: | overexertion |
| Repeated microtrauma to tibialis ant mx = | Shin splints |
| Small tears in periosteum of tibia = | Shin splints |
| Swelling or bleeding causes compression of a./n. running in compartments = | Compartment syndrome |
| Compartment syndrome: tissue cannot expand superficially due to: | deep fascia of leg |
| Test for ant compartment syndrome: | check sensory distribution of deep fib n. (btw 1st & 2nd digits) |
| Compartment syndrome: procedure to relieve pressure: | fasciotomy |
| Mx of Deep compartment of post leg | Popliteus; FDL; FHL; Tibialis posterior |
Created by:
Abarnard
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