Knee

Front 1

KNEE JOINT

Back 1

tibiofemoral articulation

Front 2

KNEE MOTION

Back 2

1. flexion

2. extension

3. external rotation

4. internal rotation

Front 3

1. FLEXION

Back 3

- motion of tibia in sagittal plane

- angle b.t tibia & femur relative to anterior aspect of body becomes greater

Front 4

2. EXTENSION

Back 4

- motion of tibia in sagittal plane

- angle b.t. tibia & femur relative to anterior aspect of body becomes smaller

Front 5

3. EXTERNAL ROTATION

Back 5

- motion of tibia in transverse plane about longitudinal axis

- anterior aspect of tibia moves toward lateral aspect of body

Front 6

4. INTERNAL ROTATION

Back 6

- motion of tibia in transverse plane about longitudinal axis

- anterior aspect of tibia moves toward midline

Front 7

KNEE BONES FROM ANTERIOR ASPECT

Back 7

1. diaphysis of femur

2. epiphysis of femur

3. medial condyle of femur

4. fibula

5. tibia

Front 8

1. DIAPHYSIS OF FEMUR

Back 8

- long narrow shaft

- very dense

- compact or lamellar bone

Hint 8

shaft

Front 9

2. EPIPHYSIS OF FEMUR

Back 9

- on distal and proximal aspects

- larger cross-sectional area

- cancellous bone

- enhances stability b.t articular bones

Hint 9

ends

Front 10

3. MEDIAL CONDYLE OF FEMUR

Back 10

- oblong ball of bone on medial aspect of femur within the distal epiphysis

Hint 10

ball

Front 11

4. FIBULA

Back 11

- articulates with tibia @ tibiofibular articulation

- fibula doesn't articulate w. femur

Hint 11

little bone

Front 12

5. TIBIA

Back 12

- primary weight bearing bone

- articular bone of the tibiofemoral articulation

Hint 12

big bone

Front 13

KNEE BONES FROM POSTERIOR ASPECT

Back 13

1. hyaline cartilage

2. intercondylar fossa

Front 14

1. HYALINE CARTILAGE

Back 14

- shiny white substance

- on medial & lateral condyles of femur

- articular cartilage

- limits friction b.t. articular bones

Front 15

2. INTERCONDYLAR FOSSA

Back 15

- distal aspect of femur on posterior aspect

- large gap b.t. medial & lateral condyles

- important because:

- large gap on tibial plateau b.t. medial & lateral tibial articular facets

Front 16

KNEE BONES FROM LATERAL ASPECT

Back 16

1. shape of articular aspect of femur

2. shape of articular aspect of tibia

3. movements of bones

Front 17

1. SHAPE OF ARTICULAR ASPECT OF FEMUR

Back 17

- convex

- femur = more stable bone in this articulation

Front 18

2. SHAPE OF ARTICULAR ASPECT OF TIBIA

Back 18

- concave

- tibia = more mobile bone in articulation

Front 19

3. MOVEMENTS OF BONES

Back 19

tibia glides on femur...

EXTEND KNEE:

tibia moves towards anterior aspect of femur in sagittal plane

FLEX KNEE:

tibia moves towards posterior aspect of femur in sagittal plane

INTERNAL/EXTERNAL ROTATION:

tibia rotates on femur in transverse plane about longitudinal axis

Front 20

LATERAL LIGAMENTS OF KNEE

Back 20

1. lateral collateral ligament

2. lateral meniscus

3. coronary ligament

Hint 20

Front 21

1. LATERAL COLLATERAL LIGAMENT

Back 21

- prevents excessive varus motion

*like if someone kicked you in medial aspect of knee

- round and thin ligament

Hint 21

Front 22

2. LATERAL MENISCUS

Back 22

- fibrocartilage disk

- dissipates compressive forces b.t. lateral femoral condyle & lateral tibial articular facet

- "torn cartilage" - but medial meniscus tears more often

Hint 22

Front 23

3. CORONARY LIGAMENT

Back 23

- attaches lateral meniscus to tibial plateau

- oriented vertically

Hint 23

Front 24

SUPERIOR VIEW OF TIBIAL PLATEAU:

MEDIAL v. LATERAL

Back 24

- tibial plateau articulates w. superior & posterior aspect of medial & lateral condyles

medial v. lateral:

1. articular facet surface area

2. meniscus diameter

3. meniscus thickness

Front 25

1. SURFACE AREA OF ARTICULAR FACET

Back 25

medial > lateral

Hint 25

Front 26

2. MENISCUS DIAMETER

Back 26

medial > lateral

Hint 26

Front 27

3. MENISCUS THICKNESS

& 2 IMPORTANT FUNCTIONS

Back 27

peripheral = thicker

center = thinner

SHAPE FUNCTIONS TO:

1. increase congruency b.t. femur & tibia

2. allows synovium to pump around articular structures during bone motion

Hint 27

Front 28

OVERLYING MUSCULATURE ON LATERAL KNEE

Back 28

1. IT-band

A. tensor fascia latae

2. biceps femoris

Front 29

1. ILIOTIBIAL BAND (IT-BAND)

Back 29

- dynamic stabilizer of LCL

Hint 29

Front 30

1a. TENSOR FASCIA LATAE

Back 30

- contractile unit of IT-band

- contracts + generates compressive force applied to knee

- stimulating this muscle produces varus force & protects LCL

- inserts into anterior fibers of IT-band

Front 31

2. BICEPS FEMORIS

Back 31

- inserts into proximal head of fibula

Hint 31

Front 32

MEDIAL LIGAMENTS OF KNEE

Back 32

1. medial collateral ligament

Front 33

1. MEDIAL COLLATERAL LIGAMENT

Back 33

- prevents valgus motion

*generated by being hit on lateral aspect of knee - causes medial joint space to increase

- thick, broad, long

- disruption = cant be repaired

Hint 33

Front 34

OVERLYING MUSCULATURE ON MEDIAL KNEE

Back 34

pes anserinus:

1. sartorius

2. gracilis

3. semitendinosus

= dynamic stabilizers for MCL

Hint 34

Front 35

POSTERIOR LIGAMENTS OF KNEE

Back 35

1. posterior cruciate ligament

Front 36

1. POSTERIOR CRUCIATE LIGAMENT

Back 36

- prevents excessive posterior translation of tibia on femur

*AKA keeps knee from moving backwards on femur

- origin = anterior & medial aspect of medial condyle

- inserts: intercondylar area of posterior tibial plateau

- strongest ligament in knee

- when we flex knee - posterior trans of tibia on knee

Hint 36

Front 37

OVERLYING MUSCULATURE ON POSTERIOR KNEE

Back 37

- dynamic stabilizers for ACL

1. biceps femoris

2. semitendinosus

3. semimembranosus

Front 38

1. BICEPS FEMORIS (independent & with...)

2. SEMITENDINOSUS

3. SEMIMEMBRANOSUS

Back 38

BICEPS FEMORIS:

- on posterior & lateral knee

- contract...

INDEPENDENTLY:

- dynamic stabilizer for LCL

W. SEMI'S:

- dynamic stabilizer for ACL

Hint 38

Front 39

ANTERIOR LIGAMENTS OF KNEE

Back 39

1. anterior cruciate ligament

Front 40

1. ANTERIOR CRUCIATE LIGAMENT

Back 40

- prevents excessive anterior translation of tibia on femur

*AKA keeps knee from moving forward on femur

- origin = posterior & medial aspect of lateral condyle of femur

- inserts = medial aspect of intercondylar area of anterior tibial plateau

- smaller than PCL

- takes 1/2 of the force needed to disrupt PCL to disrupt ACL

Front 41

ACL MECHANISMS OF INJURY

Back 41

1. HYPEREXTENSION:

2. EXCESSIVE TIBIAL ROTATIN

- when ruptured - cant heal

- cause proximal & distal segments separate

- wound edges "unravel"

- ACL disruption thus requires reconstruction, won't heal

Hint 41

Front 42

OVERLYING MUSCULATURE ON ANTERIOR KNEE

Back 42

1. patella

2. quadriceps tendon

3. medial patellar retinaculum

4. lateral patellar retinaculum

5. patellar ligament

Hint 42

Front 43

1. PATELLA

Back 43

- AKA kneecap

- largest sesamoid bone in body

sesamoid bone = one found within tendon

Hint 43

Front 44

2. QUADRICEPS TENDON

Back 44

- connects 4 quad muscles w. patella

Hint 44

Front 45

3. MEDIAL PATELLAR RETINACULUM

Back 45

- ligamentous-like structure

- stabilizes patella against excessive lateral movement of patella on femur

Hint 45

Front 46

4. LATERAL PATELLAR RETINACULUM

Back 46

- ligamentous-like structure

- stabilizes patella against excessive medial movement of patella on femur

Hint 46

Front 47

5. PATELLAR LIGAMENT

Back 47

- falls b.t. medial & lateral patellar retinaculum

- attaches inferior pole of patella to tibial tuberosity

Hint 47