Knee Anatomy and Function Quiz
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Questions and Answers

What anatomical feature contributes to the greater anterior projection of the lateral femoral condyle?

The lateral femoral condyle is larger compared to the medial femoral condyle.

What are the two primary factors that help prevent the lateral dislocation of the patella?

The larger size of the lateral femoral condyle and the nearly horizontal insertion of vastus medialis fibers.

What is the mechanism of injury (MOI) commonly associated with patellar dislocation?

The mechanism of injury is sudden medial rotation of the knee.

How is the Q-angle related to the alignment of the knee joint?

<p>The Q-angle represents the angle formed by the pull of the quadriceps along the mechanical axis of the knee.</p> Signup and view all the answers

Describe the method used for measuring the Q-angle.

<p>The Q-angle is measured using a line from the ASIS through the patella and another line from the tibial tuberosity through the patella.</p> Signup and view all the answers

What are the primary differences in structure between the LCL and MCL?

<p>The LCL is a thinner cord-like structure attached proximally to the lateral epicondyle and distally to the head of the fibula, while the MCL is a flat strap with two bands anchored to the medial epicondyle of the femur and the proximal shaft of the tibia.</p> Signup and view all the answers

How do the collateral ligaments control the knee's lateral movement?

<p>Collateral ligaments prevent sideways movement of the knee by resisting varus and valgus forces, which are movements toward and away from the body's midline.</p> Signup and view all the answers

What factors contribute to the healing capacity of the menisci, particularly in the red zone?

<p>The red zone of the menisci has a greater degree of vascularisation, which directly enhances its capacity to heal.</p> Signup and view all the answers

In what position are the collateral ligaments taut and why is that significant?

<p>The collateral ligaments are taut in full extension, which is significant because this is when body load is applied to the knee joint, providing maximum support.</p> Signup and view all the answers

Describe the movement mechanics of the tibio-femoral joint during the transition from flexion to extension.

<p>The movement involves rolling and gliding, with the lateral side using its articular surface faster than the medial side, resulting in medial rotation of the femur in the last 15° of extension.</p> Signup and view all the answers

Describe the two bands of the MCL and their points of attachment.

<p>The MCL consists of a superficial band that attaches from the medial epicondyle of the femur to the proximal shaft of the tibia and a deep band that is anchored to the medial meniscus as well.</p> Signup and view all the answers

How does the popliteus muscle function in relation to the knee joint during extension?

<p>The popliteus muscle laterally rotates the femur to unlock the knee joint once it is fully extended.</p> Signup and view all the answers

What is the significance of the medial femoral condyle's surface usage compared to the lateral femoral condyle?

<p>The medial femoral condyle continues to extend until its surface is fully used, which contributes to the medial rotation of the femur during the final degrees of extension.</p> Signup and view all the answers

What is the role of collateral ligaments during the process of normal walking?

<p>During normal walking, collateral ligaments provide support in the extended position of the knee when body loads are applied, helping to maintain joint stability.</p> Signup and view all the answers

Why is the medial meniscus more prone to injury compared to the lateral meniscus?

<p>The medial meniscus is 20 times more likely to be injured due to its increased stability and attachment to the tibial plateau, which limits mobility and increases stress.</p> Signup and view all the answers

What are the periligamentous vessels that can leak blood inside the knee joint if ruptured?

<p>The inferior geniculate arteries.</p> Signup and view all the answers

At what angle should the knee be positioned to properly perform the Lachman’s Test?

<p>The knee should be at 30°.</p> Signup and view all the answers

What three structures are involved in the 'unhappy triad' injury?

<p>The ACL, MCL, and medial meniscus.</p> Signup and view all the answers

Which ligament is often taut during flexion of the knee?

<p>The posterior cruciate ligament (PCL).</p> Signup and view all the answers

What is the function of the infrapatellar fat pad in the knee joint?

<p>It acts as a cushion and prevents friction.</p> Signup and view all the answers

What condition is commonly associated with a Baker's cyst in the knee?

<p>Osteoarthritis of the knee.</p> Signup and view all the answers

Which bursa is most commonly affected by running injuries?

<p>The anserine bursa.</p> Signup and view all the answers

What is a common treatment for bursitis in the knee?

<p>Aspiration of excess fluid and using NSAIDs.</p> Signup and view all the answers

What type of joint is the knee, and what contributes to its stability?

<p>The knee is a modified hinge joint, and its stability comes from intra and extra-capsular ligaments.</p> Signup and view all the answers

Describe the shape and function of the menisci in the knee.

<p>The menisci are wedge-shaped intra-synovial articular discs that enhance joint stability and absorb shock.</p> Signup and view all the answers

What is the primary function of the Anterior Cruciate Ligament (ACL)?

<p>The primary function of the ACL is to prevent anterior displacement of the tibia in relation to the femur.</p> Signup and view all the answers

How does the PCL differ in function from the ACL?

<p>The PCL prevents posterior translation of the tibia and excessive forward movement of the femur.</p> Signup and view all the answers

Explain the movements allowed by the tibiofemoral joint.

<p>The tibiofemoral joint allows for flexion and extension, with a normal range of 0 to 135 degrees.</p> Signup and view all the answers

Describe the positioning of the ACL during knee extension.

<p>During knee extension, the ACL is taut and is tightened further by the locking mechanism of the knee.</p> Signup and view all the answers

What are 'genu valgum' and 'genu varum'?

<p>'Genu valgum' refers to knock-knees, while 'genu varum' refers to bow-leggedness.</p> Signup and view all the answers

How do the patellofemoral and tibiofemoral joints interact?

<p>The patellofemoral joint works with the medial and lateral tibiofemoral joints to facilitate knee movement and stability.</p> Signup and view all the answers

What is the importance of the Valgus Stress Test?

<p>The Valgus Stress Test is important for assessing the integrity of the medial collateral ligament (MCL).</p> Signup and view all the answers

Identify two major muscle groups that cross the knee joint and their primary functions.

<p>The quadriceps group extends the knee, while the hamstring group is involved in knee flexion.</p> Signup and view all the answers

What mechanism protects the knee during walking or running?

<p>During walking or running, the PCL and the tightness of the extensor mechanism (contracting quadriceps) help protect the knee.</p> Signup and view all the answers

What does the term 'Valgus' refer to in relation to knee stress tests?

<p>The term 'Valgus' refers to a stress test that applies pressure to the knee from the lateral side, affecting the MCL.</p> Signup and view all the answers

List the primary vascular structures supplying blood to the knee joint.

<p>The popliteal artery and its branches, including genicular arteries, supply blood to the knee joint.</p> Signup and view all the answers

What are the consequences of sudden medial twisting of the knee when extended?

<p>Sudden medial twisting of the knee while extended can lead to ligament injuries, especially to the thinner ACL.</p> Signup and view all the answers

What common clinical problems are associated with the patello-femoral joint?

<p>Common problems include patellar tendinitis and patellofemoral pain syndrome.</p> Signup and view all the answers

What anatomical feature does the ACL insert into on the femur?

<p>The ACL inserts into the lateral surface of the medial femoral condyle posteriorly.</p> Signup and view all the answers

Discuss the role of bursae in the knee joint.

<p>Bursae in the knee joint reduce friction between tissues and support joint movement.</p> Signup and view all the answers

What is the significance of the knee's incongruency?

<p>The knee's incongruency allows for mobility but also increases the potential for dislocations.</p> Signup and view all the answers

Flashcards

Patello-femoral Dislocation

Most patella dislocations occur laterally due to the patella's medial stability. A sudden medial rotation often causes the dislocation. The quads tendon pulls the patella upwards; however, forces from the vastus lateralis and intermedius muscles pull the patella laterally, potentially leading to dislocation.

Preventing Patello-femoral Dislocation

Two key factors prevent patello-femoral dislocation: the larger lateral femoral condyle, and the horizontal insertion of vastus medialis fibers to the patella. These fibers counter the pull from other muscles.

Q-Angle Definition

The Q-angle is formed by the line extending from the center of the patella to the ASIS and another line extending from the tibial tuberosity through the center of the patella.

Q-Angle Influence

The Q-angle is affected by factors like excessively wide hips, knee valgus, tibial torsion, or abnormal patella positions (e.g., alta or displaced).

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Patella Articular Surfaces

Medial and lateral articular surfaces of the patella interact with the corresponding femoral condyles. A vertical ridge separates these surfaces.

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Knee joint type

A modified hinge joint, relatively stable due to intra- and extra-capsular ligaments.

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Knee articulation

The knee joint's articulation points include the patellofemoral joint and the medial and lateral tibiofemoral joint.

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Knee menisci function

Intra-synovial articular discs that deepen the joint socket, improve congruence, and absorb shock.

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Knee muscle: anterior group

Quadriceps group, crossing the knee via patella, extends the knee.

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Knee muscle: posterior group

Hamstrings and gastrocnemius (and others), responsible for knee flexion and stability

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Knee flexion range

Knee flexion is from 0 degrees to 135 degrees.

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Knee blood supply

Supplied by anastomoses (branches) of the popliteal artery and genicular arteries; from the hip and thigh.

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Genu valgum

Bowlegged - knock-knees deformity.

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Genu varum

Bowlegged - inwardly angled knee deformity.

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Patellofemoral joint

The joint between the kneecap (patella) and the femur, often prone to problems.

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Meniscus vascularization & healing

The blood supply (vascularization) of the meniscus directly affects its healing ability. The red zone, having more blood vessels, heals better than the less vascularized areas.

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Knee joint movement (flexion to extension)

Walking involves a combination of rolling and gliding within the tibiofemoral joint. The lateral side of the joint wears down faster during this motion, leading to medial rotation of the femur as extension is completed.

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Popliteus muscle's function

The popliteus muscle is essential in unlocking the knee joint from full extension. It laterally rotates the femur, enabling movement into flexion.

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Medial vs. lateral meniscus injury

The medial meniscus is significantly more prone to injury than the lateral meniscus, roughly 20 times more likely. This difference isn't explained in this text but likely relates to anatomical differences and movements.

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Knee joint close-packed position

The knee joint achieves a stable, solid position during full extension. This stability results from the tightening of various ligaments.

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Lateral Collateral Ligament (LCL)

A thin, cord-like ligament that prevents sideways movement of the knee joint against varus forces. It's attached to the lateral epicondyle of the femur and the head of the fibula.

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Medial Collateral Ligament (MCL)

A flat strap-like ligament with two bands that prevents sideways knee movement against valgus forces. Attached to the medial epicondyle of the femur and the proximal tibia, with a deep band that anchors to the medial meniscus.

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Collateral Ligaments Function

Prevent sideways movement of the knee, are taut in extension & relaxed in flexion, providing crucial support under body load during walking.

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Varus Force

A force that pushes the knee outward.

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Valgus Force

A force that pushes the knee inward.

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Pes Anserinus

A group of three tendons that insert on the medial aspect of the proximal tibia, forming a 'goose foot' shape. The tendons include the sartorius, gracilis, and semitendinosus.

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Valgus Stress Test

A test that assesses the stability of the medial collateral ligament (MCL) of the knee by applying a valgus force (pushing the knee inward) while the leg is extended.

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Varus Stress Test

A test that assesses the stability of the lateral collateral ligament (LCL) of the knee by applying a varus force (pushing the knee outward) while the leg is extended.

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ACL: Insertion

The anterior cruciate ligament (ACL) originates from the anterior intercondylar ridge of the tibia and inserts on the lateral surface of the medial femoral condyle, posteriorly (think 'hand in trouser pocket').

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PCL: Insertion

The posterior cruciate ligament (PCL) originates from the posterior intercondylar ridge of the tibia and inserts on the lateral surface of the medial femoral condyle, anteriorly.

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ACL Function

The ACL prevents anterior displacement of the tibia relative to the femur. It is taut during knee extension and further tightened by the knee locking mechanism.

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PCL Function

The posterior cruciate ligament (PCL) prevents posterior translation of the tibia and excessive forward movement of the femur. It is much thicker than the ACL.

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Cruciate Ligament Injury Risk

Cruciate ligaments are most vulnerable to injury when the knee is extended, as the ligaments are taut. Sudden medial/lateral twisting while the foot is planted can cause injury, especially to the ACL which is thinner.

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What is the Lachman's Test for?

The Lachman's Test is used to evaluate an ACL rupture by assessing the stability of the knee joint.

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What are the structures in an 'Unhappy Triad'?

An 'Unhappy Triad' involves damage to three knee structures: the Anterior Cruciate Ligament (ACL), the Medial Collateral Ligament (MCL), and the medial meniscus.

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What is the location of the cruciate ligaments?

The cruciate ligaments are located inside the knee joint capsule but are outside the synovial membrane (intracapsular but extrasynovial).

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What's the role of the Infrapatellar Fat Pad?

The Infrapatellar Fat Pad acts as a cushion, reduces friction, and fills gaps for stability within the knee joint.

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What is a Baker's Cyst?

A Baker's Cyst is a swelling caused by inflammation of the popliteal bursa, commonly seen in knee arthritis.

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Which bursa is commonly affected by running?

The Anserine Bursa is frequently affected by runners due to friction, rotation, and valgus stress.

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What is the treatment for Bursitis?

Bursitis, or inflammation of bursae, is treated by removing excess fluid with aspiration and using NSAID medications.

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What are the 5 structures protecting the lateral side of the knee?

The five structures protecting the lateral side of the knee are the lateral collateral ligament, fibular collateral ligament, biceps femoris tendon, popliteus tendon, and the iliotibial band.

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Study Notes

Knee Anatomy

  • The knee joint is a modified hinge joint, stabilized by intra and extra-capsular ligaments.
  • The articular surfaces of the knee are not perfectly congruent, creating potential for femoral condyles to slip off the plateaus.
  • The knee joint has two articulations (medial and lateral) between the femoral condyles and tibial condyles. The tibial condyles are flat plateaus, not knuckles as their name might imply.
  • The menisci (medial and lateral) are intra-synovial articular discs that improve stability, deepen the socket and offer shock absorption.
  • Medial meniscus is approximately 20 times more likely to be injured compared to the lateral meniscus, due to its restricted movement.
  • Several muscles cross the knee joint, including the quadriceps group (anterior) and hamstring & gastrocnemius groups (posterior). These muscles contribute to joint movement and stability.
  • The bony anatomy of the joint, including the shape and positions of articular surfaces, notably femoral and tibial condyles and the patellofemoral joint, is crucial.
  • The femoral and obturator nerves may refer knee pain to the hip, and vice versa.
  • Common clinical problems related to the patellofemoral joint (knee cap) are described.
  • The terms "genu valgum" (knock knees) and "genu varum" (bow legs) are defined and associated clinical concerns are outlined.
  • Ligaments of the knee joint, including their functions, are detailed.
  • The capsule and synovium of the knee joint, and associated bursae, and their symptoms/signs are discussed.
  • Proper functioning of the knee's vascularization (anastomoses of the popliteal artery, descending branches of genicular arteries) and innervation (nerves) are critical for joint health and pain management.

Knee Overview and Dislocation

  • The knee joint is susceptible to dislocation. This is more common as a posterior tibiofemoral dislocation, where rupture of 3 or 4 ligaments may occur and the popliteal artery is at the major risk during this.
  • The patella (kneecap) is a sesamoid bone, crucial to its function in knee flexion and extensions .
  • The patella is shaped like a upside-down triangle, and has attachments at the base.
  • The patella sits in a groove in the distal part of the femur, and does not articulate with the tibia.
  • The patellofemoral joint surfaces (medial and lateral) are described.

Knee Muscles

  • Muscles crossing the knee, like quadriceps and hamstrings, produce knee movement and stabilize the joint.
  • Their detailed anatomy is reviewed.

Measuring Q-Angle

  • The Q-angle, formed by connecting the anterior superior iliac spine (ASIS) and the tibial tubercle to the center of the patella, influences patellofemoral joint stability.
  • Females typically have wider hips leading to higher q-angles potentially resulting in higher risk of knee problems like dislocation.
  • The normal Q-angle in females ranges from 13-18° and 10-14° in males.

Knee Angles: Genu Valgum and Genu Varum

  • There are different types of knee angles ( Genu Valgum, Genu Varum).
  • These types of angles influence the stress on the medial and lateral collateral ligaments (MCL and LCL), and can affect the stability and potential for injuries of these ligaments and tendons.

Self-Assessment Questions Pt 1

  • Question 1. Understand the patella's role and structure
  • Question 2. Identify factors preventing patellofemoral dislocation
  • Question 3. Define genu valgum and genu varum

Self-Assessment Questions Pt 2

  • Question 1. Differentiate between medial and lateral femoral condyles.
  • Question 2. Explain why the medial meniscus is more prone to injury than the lateral.
  • Question 3. Describe the action of the popliteus muscle.

Self-Assessment Questions Pt 3

  • Question 1. Identify five lateral knee structures.
  • Question 2. Explain the status of a ligament during knee flexion
  • Question 3. Identify three structures involved in the unhappy triad.

Self-Assessment Questions Pt 4

  • Question 1. Name four bursae continuous with the knee cavity.
  • Question 2. Determine which bursa is implicated in medial knee pain.
  • Question 3. Specify the bursa involved in Clergyman's Knee.

Knee Joint Part 2: Tibiofemoral Joints

  • Tibiofemoral joint is described as a hinge, composed of 2 articulations between femoral and tibial condyles.
  • Different angles of joint flexion and extension are reviewed to determine possible stress placed on the ligaments.
  • Review and description of the action of the popliteus muscle, which rotates the femur for unlocking after full flexion.

Knee Joint Part 3: Ligaments

  • Collateral ligaments (MCL and LCL) prevent valgus and varus stresses and are described in detail.
  • cruciate ligaments (ACL and PCL) with their function, different locations, and potential for injury are reviewed.
  • Knee joint unlocking mechanics is examined and different tests (Lachman's test, varus and valgus stress tests) to evaluate knee ligament damage are noted.

Knee Joint Part 4: Bursae

  • Bursae of the knee joint (suprapatellar, prepatellar, deep and superficial infrapatellar, gastrocnemius, anserine) provide cushioning, and are reviewed as potential areas of inflammation or swelling (Baker's cyst).
  • The synovium of the knee joint is described as the membrane surrounding the cruciate ligaments, including the infrapatellar fat pad (Hoffa's fat pad).

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Knee Anatomy Slides - PDF

Description

This quiz explores the anatomical features and mechanics of the knee joint, focusing on the femoral condyles, patellar dislocation, and collateral ligaments. Test your understanding of the Q-angle, the healing capacity of the menisci, and the movement mechanics of the tibio-femoral joint. Perfect for students studying anatomy or physical therapy.

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