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Knee Anatomy


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