Podcast
Questions and Answers
Which ligament is responsible for preventing the tibia from sliding backward on the femur?
Which ligament is responsible for preventing the tibia from sliding backward on the femur?
- Medial collateral ligament
- Anterior cruciate ligament
- Lateral collateral ligament
- Posterior cruciate ligament (correct)
What is the primary function of the patella ligament?
What is the primary function of the patella ligament?
- Joins the medial and lateral menisci
- Prevents lateral movement at the knee
- Provides stability to the tibia
- Facilitates knee extension (correct)
Where does the medial collateral ligament attach?
Where does the medial collateral ligament attach?
- To the posterior tibial intercondylar area
- To the anteromedial tibial condyle and medial meniscus (correct)
- To the head of the fibula
- To the lateral epicondyle of the femur
Which ligament is specifically designed to prevent motion of the menisci?
Which ligament is specifically designed to prevent motion of the menisci?
What distinguishes the lateral collateral ligament from the medial collateral ligament?
What distinguishes the lateral collateral ligament from the medial collateral ligament?
What is the primary role of synovial fluid in a synovial joint?
What is the primary role of synovial fluid in a synovial joint?
Which ligament assists with pivoting at the knee?
Which ligament assists with pivoting at the knee?
How does the joint capsule contribute to knee motion?
How does the joint capsule contribute to knee motion?
Which type of joint movement primarily occurs at the knee joint?
Which type of joint movement primarily occurs at the knee joint?
Which ligaments are considered intracapsular ligaments in the knee joint?
Which ligaments are considered intracapsular ligaments in the knee joint?
What is the main role of the coronary ligaments?
What is the main role of the coronary ligaments?
What is the function of the menisci in the knee joint?
What is the function of the menisci in the knee joint?
Which characteristic of the knee joint contributes to its stability when straight?
Which characteristic of the knee joint contributes to its stability when straight?
Which of the following statements is true regarding the structure of the knee?
Which of the following statements is true regarding the structure of the knee?
What can increase the risk of injury to the structures surrounding the knee joint?
What can increase the risk of injury to the structures surrounding the knee joint?
Which muscle is responsible for unlocking the knee by externally rotating the femur?
Which muscle is responsible for unlocking the knee by externally rotating the femur?
What is one of the key roles of the cruciate ligaments in the knee?
What is one of the key roles of the cruciate ligaments in the knee?
Which of the following muscles is classified as a knee flexor only?
Which of the following muscles is classified as a knee flexor only?
Which arteries contribute to the anastomosis around the knee joint?
Which arteries contribute to the anastomosis around the knee joint?
Which nerve is responsible for innervating the popliteus muscle?
Which nerve is responsible for innervating the popliteus muscle?
What is the action of the popliteus muscle during the unlocking of a straight knee?
What is the action of the popliteus muscle during the unlocking of a straight knee?
Which of the following muscles are NOT part of the extensors at the knee?
Which of the following muscles are NOT part of the extensors at the knee?
How does the knee locking mechanism improve stability?
How does the knee locking mechanism improve stability?
Which cutaneous area is NOT typically associated with nerve supply surrounding the knee?
Which cutaneous area is NOT typically associated with nerve supply surrounding the knee?
What is the role of the arcuate popliteal ligament?
What is the role of the arcuate popliteal ligament?
Which veins drain into the popliteal vein?
Which veins drain into the popliteal vein?
Which structure does NOT contribute to the knee's stability?
Which structure does NOT contribute to the knee's stability?
What is the predominant motion of the knee joint?
What is the predominant motion of the knee joint?
Which joint is formed by the patella and the femur?
Which joint is formed by the patella and the femur?
Which anatomical structure is located posterior-lateral to the pes anserinus bursa?
Which anatomical structure is located posterior-lateral to the pes anserinus bursa?
What type of knee deformity is characterized by a hyperextension condition?
What type of knee deformity is characterized by a hyperextension condition?
Which type of cartilage covers the deep side of the patella?
Which type of cartilage covers the deep side of the patella?
How can the muscles that act at the knee be categorized?
How can the muscles that act at the knee be categorized?
Which knee motion is primarily observed during the stance phase of gait?
Which knee motion is primarily observed during the stance phase of gait?
Which condition is NOT typically symptomatic but can be associated with lateral tracking of the patella?
Which condition is NOT typically symptomatic but can be associated with lateral tracking of the patella?
Which ligament primarily prevents posterior translation of the tibia on the femur?
Which ligament primarily prevents posterior translation of the tibia on the femur?
What anatomical structure serves as the largest sesamoid bone in the body?
What anatomical structure serves as the largest sesamoid bone in the body?
Which knee structures are primarily responsible for stability against lateral forces?
Which knee structures are primarily responsible for stability against lateral forces?
Which ligament provides strength specifically to the posterior aspect of the knee joint capsule?
Which ligament provides strength specifically to the posterior aspect of the knee joint capsule?
What type of bursa is directly associated with the semimembranosus tendon?
What type of bursa is directly associated with the semimembranosus tendon?
What position should the patient be in for the Posterior Sag test of a PCL rupture?
What position should the patient be in for the Posterior Sag test of a PCL rupture?
Which method is used to potentially identify MCL damage during a collateral ligament test?
Which method is used to potentially identify MCL damage during a collateral ligament test?
Which symptom is commonly associated with a meniscal injury?
Which symptom is commonly associated with a meniscal injury?
During the Apley Compression Test, what specific movement is performed?
During the Apley Compression Test, what specific movement is performed?
What group is notably at a higher risk for Patellofemoral joint syndrome?
What group is notably at a higher risk for Patellofemoral joint syndrome?
What factor is crucial when assessing the effectiveness of muscle function intervention for patellofemoral joint syndrome?
What factor is crucial when assessing the effectiveness of muscle function intervention for patellofemoral joint syndrome?
What is a common clinical sign during palpation of patellofemoral joint syndrome?
What is a common clinical sign during palpation of patellofemoral joint syndrome?
What is NOT a characteristic of the Apley Compression Test?
What is NOT a characteristic of the Apley Compression Test?
Flashcards
Joint Capsule of the Knee
Joint Capsule of the Knee
A tough fibrous connective tissue that surrounds the knee joint, continuous with the periosteum. It's thicker and stronger at the sides, allowing free movement in the front and back. Provides stability and contains small blood vessels and nerves.
Anterior Cruciate Ligament (ACL)
Anterior Cruciate Ligament (ACL)
A strong ligament that prevents the tibia from sliding forward on the femur. It also controls rotation and assists with pivoting.
Posterior Cruciate Ligament (PCL)
Posterior Cruciate Ligament (PCL)
A ligament that stops the tibia from sliding backwards on the femur. It also prevents hyperextension and controls rotation.
Transverse Ligament of the Knee
Transverse Ligament of the Knee
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Medial & Lateral Coronary Ligaments
Medial & Lateral Coronary Ligaments
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Medial Collateral Ligament (MCL)
Medial Collateral Ligament (MCL)
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Lateral Collateral Ligament (LCL)
Lateral Collateral Ligament (LCL)
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Patella Ligament
Patella Ligament
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What is a synovial joint?
What is a synovial joint?
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What is the knee joint?
What is the knee joint?
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What is hyaline cartilage?
What is hyaline cartilage?
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What are ligaments?
What are ligaments?
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What are menisci?
What are menisci?
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What are the cruciate ligaments?
What are the cruciate ligaments?
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What is the joint capsule?
What is the joint capsule?
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What is the knee locking mechanism?
What is the knee locking mechanism?
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Rectus Femoris
Rectus Femoris
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Quadriceps
Quadriceps
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Gluteus Maximus
Gluteus Maximus
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Hamstring Muscles
Hamstring Muscles
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Popliteus Muscle
Popliteus Muscle
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Knee Locking Mechanism
Knee Locking Mechanism
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Popliteal Fossa
Popliteal Fossa
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Patella (Kneecap)
Patella (Kneecap)
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Arcuate Popliteal Ligament
Arcuate Popliteal Ligament
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Oblique Popliteal Ligament
Oblique Popliteal Ligament
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Patella
Patella
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Patellofemoral Joint
Patellofemoral Joint
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Knee Joint
Knee Joint
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Collateral Ligaments
Collateral Ligaments
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Cruciate Ligaments
Cruciate Ligaments
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Menisci
Menisci
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Knee Joint Motion
Knee Joint Motion
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Open and Closed Kinetic Chains in Knee Movement
Open and Closed Kinetic Chains in Knee Movement
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Knee Motion in Gait
Knee Motion in Gait
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Genu Recurvatum
Genu Recurvatum
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Genu Varum
Genu Varum
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Genu Valgum
Genu Valgum
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Squinting Patellae
Squinting Patellae
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What is the PCL Rupture Test?
What is the PCL Rupture Test?
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What is the Collateral Ligament Test?
What is the Collateral Ligament Test?
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What is an Apley Compression Test?
What is an Apley Compression Test?
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What is Patellofemoral Joint Syndrome?
What is Patellofemoral Joint Syndrome?
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How is Patellofemoral Joint Syndrome treated?
How is Patellofemoral Joint Syndrome treated?
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What is the role of the PCL?
What is the role of the PCL?
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What is the function of the MCL?
What is the function of the MCL?
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What is the role of the menisci in the knee?
What is the role of the menisci in the knee?
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Study Notes
Knee Joint Overview
- The knee is the largest synovial joint in the body, a modified hinge joint with two articulations: the tibiofemoral joint and the patellofemoral joint.
- It's remarkably stable, despite a lack of congruence between articular surfaces.
- Stability comes from passive and dynamic structures around the joint, including ligaments and the locking mechanism.
- Common injuries to the knee are mentioned as part of the aims.
Synovial Joint Structure
- Synovial joints, like the knee, are characterized by free movement.
- They are enclosed by a fibrous capsule, lined with a synovial membrane that secretes fluid for lubrication.
- The articular ends of the bones are coated with hyaline cartilage.
- Fibrocartilage pads (menisci) are present between bone ends in some joints, adding to the knee's complex structure.
- Ligaments, fatty pads, and bursae also contribute to joint stability and function.
Knee Bones
- The three main bones in the knee joint are the femur, tibia, and patella.
- X-rays can be used to visualize these structures.
Cartilage in the Knee Joint
- Hyaline cartilage covers the articulating surfaces of the femur, tibia, and patella, absorbing and distributing force.
- Fibrocartilage forms the menisci, acting as shock absorbers and providing stability by fitting into grooves in the tibial plateau.
Ligaments of the Knee Joint
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Ligaments connect bones and other structures, adding significant stability to the knee.
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Intracapsular ligaments (cruciate ligaments: ACL and PCL, transverse ligament) and extracapsular ligaments (patellar, medial and lateral collateral ligaments, oblique and arcuate popliteal ligaments) play different crucial roles.
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The joint capsule is a tough fibrous connective tissue, running continuously with periosteum. It's particularly strong at the sides of the joint capsule and thinner anteriorly and posteriorly.
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Provides stability to the knee, and has some integral thickenings (eg. patellar retinacula).
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Contains vascular structures and nerves.
Cruciate Ligaments (ACL and PCL)
- The ACL connects the anterior tibia to the posterior part of the femur, preventing anterior tibial translation and rotation control.
- The PCL connects the posterior tibia to the anterior part of the femur, preventing posterior tibial translation and rotation control.
Knee Locking Mechanism
- The knee's locking mechanism is a fundamental principle that relates its stability with the straight position.
- Internal rotation of the femur on the tibia improves joint stability and strengthens ligaments, effectively locking the knee in the straight position. Popliteus is vital for controlling this process.
- Popliteus is essential to unlock the knee by externally rotating the femur. This allows flexor muscles to function.
Surface Anatomy of the Knee
- Key surface landmarks like the popliteal fossa, patella, tibial tuberosity, MCL, LCL and joint margin are important for anatomical location for assessment, diagnosis, and procedures.
Nerve Supply to the Knee
- Motor nerves control muscle activation that moves the knee.
- Branches from the femoral, tibial, common peroneal and obturator nerves provide joint innervation.
- The skin surrounding the knee is innervated by cutaneous nerves, including the saphenous, femoral cutaneous(lateral, intermediate, medial, posterior). Lateral cutaneous calf and some obturator branches.
Vascular Structures of the Knee: Arteries
- Eight main arteries supply the knee, forming an anastomosis around the joint.
- Sources are the popliteal, tibial, and femoral arteries via their related genicular branches.
Vascular Structures of the Knee: Veins
- Veins accompany the arteries and drain blood from the region.
- They drain into the popliteal vein and connected to the anterior and posterior tibial veins
- Connected to long and small saphenous veins.
Lymphatics of the Knee
- Lymph nodes in the popliteal fossa are associated with the fatty tissue.
- These drain proximally toward the deep inguinal lymph nodes.
Bursae of the Knee
- Specific bursae such as the prepatellar, deep infrapatellar, and superficial infrapatellar bursa are located near the knee joint to assist in lubrication and movement.
Patellofemoral Joint (PFJ)
- The PFJ is the articulation of the patella and femur. The patella is the largest sesamoid bone in the body.
- It's located within the tendon of the quadriceps femoris muscle, between the femoral condyles, supported by medial, lateral, and infrapatellar retinacula.
Muscles Acting at the Knee
- Muscles that act on the knee can be grouped by their actions (extensors, flexors) and/or their involvement (acting at the hip and knee simultaneously as well as only at the knee or knee and ankle).
- Special muscles are mentioned, including popliteus, which is essential for unlocking the knee and controlling internal rotation.
Knee Joint Motion
- The knee primarily moves through flexion and extension.
- Some medial and lateral rotation is possible with knee extension.
- Motion is related to the locking mechanism.
- Examples are related to gait phases.
Abnormal Knee Positions
- Knee positions in planes (sagittal, frontal, transverse) can be seen as abnormal or a sign of a problem.
- Examples of abnormalities in each plane are given.
Patellofemoral Pain Syndrome
- PFPS is a common condition associated with pain around the kneecap.
- Related factors and observations (e.g. biomechanics during standing and lying)
- Causes and incidence are noted.
Knee Exam: Observation
- Proper viewing and exposure of both knees for observation, including stance assessment for problems, are needed for a thorough examination.
- Signs of Baker's cyst or other protrusion of the synovial membrane are observed.
Tests for Injury to Specific Knee Structures
- Specific procedures/testing methods exist to assess the health of ligaments (ACL, PCL) and menisci.
- Tests for ligament stability and tears (anterior and posterior drawer signs, Lachman test, and posterior sag test) are described.
- Apley compression test is detailed for assessing meniscal injury.
Treatment
- Treatment strategies are not included in the summaries.
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