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118 Cards in this Set
- Front
- Back
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What is the valgus test?
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test MCL
push knee "in" to test integrity of MCL |
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What is the Varus test?
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test LCL
puch knee"out" to test integrity |
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what is the lunate surface
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articular surface on the hip (cart)
cresent shaped transfers body weigth |
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what extends the hip socket?
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labrum
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what is the opening in the lunate surface called? what is it closed by
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acetabular notch
transverse acetabular ligament |
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fovea capitis
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pit in head of femur
where ligament of the head of the femur connects artery to the head of the femur is there (from obturator) |
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what ligament helps hold the femur to the hip?
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ligament of the head of the femur
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name the 3 ligs that connect the os coxea to the femur
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iliofemoral
pubofemoral ischiofemoral |
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what is the strongest lig that hold the femur and os coxea together? is it anterior or posterior
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anterior is stronger!
iliofemoral is strong. its Y shaped |
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what lig is from AIIS to intertrochanteric line?
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iliofemoral
strongest! |
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what lig is from superior pubic ramus to greater trochanter?
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pubofemoral
anterior iliopectineal bursea |
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where does the iliopectineal bursa lie? what structures does it protect?
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on the anterior side of the hip joint capsule.
lies btwn iliofemoral and pubofemoral ligs. protects the ligs from rubbing the iliopsoas |
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what is the lig that connects the hip joint posteriorly to greater trochanter?
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ischilfemoral
not as strong post (only 1 lig) |
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easiest position for hip dislocation?
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hip flexed
adducted medially rotated *think getting out of a car **the femur can slip right out of the back of the socket |
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what blood supply to neck of femur
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retinacular branched from medial/lateral circumflex femoral aa
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what is the fundamental relationship btwn the iliospoas and the vessels supplying the head of the femur
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medial circumflex wraps around the iliopsoas tendon
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what a supplies the head of the femur? what is its course? what does it branch from?
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the obturator gives a branch called the artery to the head of the femur, it runs in the ligament to the head of the femur
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what prevents necrosis if the medial/lateral circumflex femoral aa are damaged?
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artery to the head of the femur
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what is Legg Calve Perths Disease
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when the blood supply is interrupted to the head of the femur bc the growht plate of femoral head seperates. the femur head undergoes necrosis
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who has a larger than normal hip angle? who has a smaller than normal hip angle?
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old ppl have short angles: coxa vara
babies have large angles: coxa valga |
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coxa vara
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Vara: old folks, the angle is more 90*
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coxa valga
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Valga: babies, the angle is more 180*
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what is the angle of anterversion? what is it normally? what does it tell us about?
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compare the axis of femoral neck to axis of femoral condyle
usually 12 angle of anterversion it gives us "toeness" pigeon toed |
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what do you knoe about someone who is pigeon toed
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toes point in
angle of anterversion greater than 12 **neck of femur is rotated medially compared to the horizontal axis of femoral condyles |
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what happens to the angle of anterversion when a person walks with their toes facing out
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angle of anterversion is less than 12.
neck of femur lines up with axis of condlyes |
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what bone has the patellar groove?
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femur
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what is the fibulas role in the knee joint?
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nothing! no articulation but it is an attachment side for mm and does some support
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what mm attach to fibula?
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biceps femoris
FHL fibularis |
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what is the action of the knee? does the action change when it is flexed vs extended?
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an extended knee cant rotate
a flexed knee can medially/laterally rotate |
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when is a knee more likely to be injured? why?
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when it is flexed
the joint is less stable **an extended knee cant rotate |
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the knee joint isnt a perfect fit like the hip? in teh knee what bone is round, what bone is flat
is this strong? |
round: femur
Flat: tibia (tibial plateau) NOT stong! |
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menisci
lateral medial |
lateral has a Little space
Medial has a more comma shape **interact with condyles |
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Coxa Vera/Coxa Valga deal with...
Angle of Anterversion deals with Geno Varum/Genu Valgus/ Genu recurvatum (Mediolateral Misalignments deal with) |
Coxa Vera/Valga deal with the angle of femur relative to where the hip is (leg length)
Anterversion deals with axis of hip relative to axis of condlyes (toedness) Mediolateral Misalignments: knee position: bow legs, knock knees, back ward knees |
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what happens when there is more space btwn the knee joint on the lateral side?
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bow legs
Genu Varum |
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what happens when there is more space btwn the knee joint on the medial side?
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Knock Knees
Genu Valgus |
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What is bow legs called? what is knock knees called?
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BOW: Genu varum
KNOCK: Genu Valgus |
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if you have bow legs what is likely going on at the hip? what is occuring at the knee? What are the fancy names
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Bow legs, space on lateral knee
Hips: larger than normal hip joint Coxa Valga @ hips Genu Varus @ Knee |
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if you have knock knees what is likely going on at the hip? what is occuring at the knee? What are the fancy names
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at the hip you have a smaller than normal angle
at the knee you have space on the medial side Coxa Vara @ hips Genu Valgus @ knee |
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Coxa Valga
Coxa Vara Genu Varum Genu Valgus Genu Recurvatum |
Coxa Valga: large angle
Coxa Vera: short angle Genu Varum: Bow Genu Valgus: Knock Genu Recurvatum: posterior bow |
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coxa vara goes with...
coxa valgus goes with... |
genu valgus
genu varum |
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the apex of the patella points...
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down (inferior)
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on the articular surface of the patella how can you determine the lateral surface? why?
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is Larger
lateral surface resists the pull of vastus lateralis |
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where does the patella articulate?
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on the patellar groove on the femur
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Name the 4 bursea associated with the knee
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1. suprapatella: continuation of synovial joint. deep to quads
2. Prepatellar: btwn skin and patella 3. Superficial Infrapatellar: btwn skin and patellar lig 4. Deep Infrapatellar: btwn patellar lig and tibia |
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what is it called when you knee gets super inflammed due to bursea irritation
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bursitis
**common to inflame prepatellar bursa |
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How would you aspirate fluid from the knee? what position is the knee in? medial or lateral? landmarks
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flexed knee
lateral lateral epicondyle of femur apex of patella lateral tubercle of tibia |
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what ligs support the hinge function of the knee?
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LCL
MCL |
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what lig is attached to the medial mediscis (how can you tell the meniscus is medial?
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MCL
its comma shaped |
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are the MCL LCL part of the joint capsule?
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nope, they are extracapsular
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where does the MCL attach?
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Femur: medial epicondyle
Tibia: medial condyle |
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Where does the LCL attach?
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Femur: lateral epicondyle
Fibula: head |
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what is the attachment of the ACL
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Superior: lateral
Inferior: medial |
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what is the attachment of the PCL
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Superior: medial
Inferior: lateral |
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Are the ACL/PCL intracapsular?
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yep
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what is stronger? ACL or PCL
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PCL
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what motion does the ACL prevent?
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anterior motion of tibia
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what motion does the ACL prevent?
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posterior motion of the tibia
**stabilized knee when it is flexed and bearing weight (walking down hill) |
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Valgus Test
Verus Test |
Valgus: tests MCL
Varus: tests LCL |
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Valgus
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tests MCL and is the one when knees are medial (knock knees)
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Varus
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tests LCL adn is the one when knees are lateral (bow legs)
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Anterior Drawer Test
Posterior Drawer Test |
Anterior: tests ACL by moving knee forward
Posterior: tests PCL by poving knee post |
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what is the best position for a knee to be in for an ACL injury
What is the best position for the knee to by in for a PCL injury/ |
ACL: resists anterior movement of tibia, extended knee with anterior blow, hyper extension, excessive lateral rotation of femur on fixed tibia
PCL: resistes posterior motion of tibia, excessive post displacement of tibia ie fall on tibial tuberosity on flexed knee |
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a blow to the medial or lateral knee will likely result in what ligament being damaged?
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MCL
LCL |
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what is the unhappy tirad?
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knee injury
knee flexed knee rotated knee gets a lateral blow! 1. MCL tear 2. Medial Meniscus tears 3. ACL tears |
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what motion does the proximal tibiofibular joint allow?
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slides when you dorsi/plantarflex the foot
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what type of joint is the proximal tibiofibular? distal?
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proximal: synovial
distal: fibrous |
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what role does the distal tibiofib joint play on the ankle joint
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stability
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what foot bone does the lateral malleolus of the fibula interact with
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talus
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what maintains the position of the tib/fib?
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interossuous membrane
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what is the main distal tib/fib ligament?
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interosseous ligament. (inferior most portion of interosseous membrane)
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besides the interosseous ligament. what 2 other ligs support the distal tib/fib joint?
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anterior inferior tibiofibular ligament
posterior inferior tibiofibular joint |
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the mortise of the ankle is what?
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its the distal tibio/fib joint that articulates with the talus
medial/lateral malleolus distal tib ant/post inferior tibiofibular ligs |
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what is the articular portion of the talus?
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trochlea, it interacts with the mortise of the talocrural joint (ankle)
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describe the shape of the trochlea of the talus
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its wedge shaped and more narrow posteriorly
**when foot is plantar flexed there is less articulation and the joint is weaker |
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most common postion for ankle injury?
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plantar flexed
sudden inversion |
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what is the strong medial ligament for ankle support? what are its portions
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deltoid
stabilizer during eversion connects the medial malleolus of the tibia to the: calcaneous, talus, navicular tibiocalcaneal tibiotalar tibionavicular |
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what makes the ankle harder to evert?
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the SUPER stong deltoid ligament on the medial side
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what connects to the sustentaculum tail? what bone is the sustentaculum tail on?
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on calcaneous
the tibiocalcaneal part of the deltoid ligament attaches here |
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what ligament supports the lateral side of the ankle?
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the LCL of the ankle
3 parts: anterior talofibular posterior talofibular calcaneofibular |
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why is it easir to invert your foot?
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weak lateral ligament, strong medial (deltoid) ligament
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what is an avulsion fracture?
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breaking part of malleolus
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on x rays distinguish growth plates and fractures
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growth plates are seen in ALL bone ends
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Potts Fracture
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forced eversion!
medial malleolus avulsion, talus forces lateral malleouls to break |
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what vessels supply the malleoui
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malleolar branches from teh ant/post tibial a
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what n can be compressed on the anterior part of ankle?
what n can be compressed on the medial side of ankle? |
deep fibular
tibial N (tarsal tunnel) |
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where is the tarsal tunnel?
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flexor retinaculum
medial malleolus to calcaneous |
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what happens in tarsal tunnel syndrome?
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tibial N is compressed in flexor retinaculum.
post tibial A Edema synovial sheath inflammation pain in heel motor/sensory disruption |
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what is the joint btwn the calcaneous and talus? what does it allow?
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subtalar
inversion/eversion |
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what are the transverse tarsal joint? what is this supposedly good for? what motion do they allow?
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calcaneocuboid
talonavicular good location for amputation but its not ususlly done here, its dont more distally, transmetatarsal inversion eversion |
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what joints allow for inversion/eversion
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subtalar
transverse tarsal |
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what ligament extends from plantar surface of calcaneous to cuboid?
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long plantar lig
superficial |
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where does the short plantar lig attach?
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deep to long plantar lig
calcaneous to cuboid |
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what is anotehr name for the spring ligamnet? where does it attach? function?
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plantar calcaneonavicular
sustentaculum tail to navicular support talus/medial longitudinal arch |
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what ligament supports the talus?
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spring (plantalcalcaneonavicular)
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what ligs attach to the sustentaculum tail?
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spring
tibiocalcaneal |
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what do the arches of the foot allow? where are they located
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weight transfer from tibia to talus
talus then distrubutes weight to calcaneous and metatarsals arches are btwn the weight bearing point of the foot |
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medial longitudinal arch is supported by what?
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sping ligament
weight btwn calcaneous and metatarsals, withthe talus as the keystone |
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what is a key diffrence btwn the lateral and medial longitudinal arch
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lateral is a shallow arch and rests on the ground when standing
less weight transfer |
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Transverse Arch of the Foot: location/
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across the bases of the metatarsals (tarsal metatarsal joints
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what supports arch integrity?
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interlocking natrue of bones
tendons of mm plantar lig plantar aponeurosis |
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name 4 ligs that support arches?
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1. plantar aponeurosis
2. plantar calcaneonavicular (spring) 3. plantar calcaneocuboid (short plantar) 4. Long plantar |
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what mm tendons support the medial arch?
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1. TA
2. FHL 3. AbD Hallucis 4. FDL 5. FDB |
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what mm supports the transverse arch?
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fibularis longus
adductor hallucis |
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what happens when the medial is no longer supported
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pes planus
flat foot, medial structures Tom Dick and harry are stressed |
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What is the opposite of Pes Planus
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pes cavus
claw foot, tall lateral arch |
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waht aa supply the subtalar joint?
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posterior tibial and fibular (talus/calcaneous)
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what aa supply the transverse tarsal joint?
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anterior tibial
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what is the action of MTP joints?
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AB/ADduct
flex/extend |
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plantar lig
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on the MTP joint of one phlange
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deep transverse metatarsal ligament
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connect metatarsals at the MTP joint
prevent spread of rays |
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what is a bunion
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hallux valgus
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what causes hallux valgus
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sesamoid bones btwn ray 1 and ray 2
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what ligaments are found on PIP and DIP? what aa supply these joint?
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collateral ligaments (sides)
plantar ligaments (plaves, on the phlange) dorsal and plantar digital aa |
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where is the deep arch? plantar or dorsal?
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Deep plantar arch
the dorsal foot has the arcruate |
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what is a bunion
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hallux valgus
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what causes hallux valgus
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sesamoid bones btwn ray 1 and ray 2
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what ligaments are found on PIP and DIP? what aa supply these joint?
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collateral ligaments (sides)
plantar ligaments (plaves, on the phlange) dorsal and plantar digital aa |
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where is the deep arch? plantar or dorsal?
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Deep plantar arch
the dorsal foot has the arcruate |
