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Thigh and Knee Joint
Rinaldi 2/10/11 lecture
78
Anatomy
Undergraduate 4
02/09/2011

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Cards

Term
inferior margin of external oblique
Definition
what is the inguinal ligament derived from
Term
femoral sheath
Definition
extension of the fascia lata as the vessels come through
Term
external iliac artery and vein
Definition
what vessels come under the inguinal ligament before the enter the femoral sheath
Term
3
Definition
how many septa are in the deep fascia of the thigh
Term
crural fascia
Definition
what is the fascia lata continuous with?
Term
anterior, medial, posterior
Definition
list the 3 compartments of the thigh
Term
great and small saphenous
Definition
the main cutaneous veins of the lower limb
Term
dorsal venous arch
Definition
where do the great and small saphenous veins originate?
Term
just anterior to the medial malleoulus (and posterior to the medial condyle of the femur)
Definition
where can the great sapehnous vein ALWAYS be found
Term
femoral vein
Definition
where does the great saphenous vein drain
Term
ascends posterior to the LATERAL malleolus along the lateral boder of the calcaneal tendon
Definition
describe the path of the small saphenous vein
Term
popliteal vein
Definition
where does the small saphenous vein drain?
Term
perforating veins
Definition
provides communication between deep and superficial veins
Term
muscle actions and valves
Definition
what helps return venous blood more efficiently in the lower limb
Term
adductor hiatis -becomes femoral vein
Definition
when does the popliteal vein change names (what does it become?)
Term
great saphenous, must run backwards because of the presence of valves
Definition
this vein is/was commonly used as a graft but must be oriented special, what vein/orientation is this
Term
Quadriceps femoris:
1) rectus femoris
2) vastus lateralis
3) vastus intermedius
4) vastus medialis
Others:
5) articularis genu
6) sartorius
7) iliopsoas
8) pectineus
Definition
list the muscles of the anterior compartment of the thigh
Term
rectus femoris
vastus lateralis
vastus intermedius
vastus medialis
Definition
list the quadriceps muscles
Term
rectus femoris
Definition
most powerful knee extensor due to short fibers along the central raphe
Term
quadriceps tendon
Definition
tendon the patella is in
Term
the patellar tendon
Definition
above the patella, the quadriceps tendon is known as:
Term
femoral nerve
Definition
nerve that innervates the anterior compartment
Term
women-more lateral Q angle on knee joint, so vastus lateralus has a more direct pull on the knee cap
Definition
who is more susceptible to patellofemoral syndrome? why?
Term
- (old idea)vastus lateralus pulls the knee cap laterally causing pain as it is shoved into the lateral condyle

-may actually be caused by weak lesser gluteals putting pressure on the knee which stregnthens the vastus lateralus as it compensates
Definition
what causes patellofemoral syndrome?
Term
semimembranous, semitendonous, biceps femoris (long and short heads)
Definition
list the muscles of the posterior compartment
Term
adductor longus, adductor brevis, adductor magnus, gracillis
Definition
list the muscles of the medial compartment
Term
Superior: inguinal ligament
Medial: adductor longus
Lateral: sartorius
floor/posterior: iliopsoas and pectineus
roof/anterior: fascia lata
Definition
borders of the femoral triangle, GO!
Term
NAVEL! from lateral to medial
N: Femoral Nerve
A: Femoral Artery
V: Femoral Vein
E: Empty Space
L: Lymph
Definition
contents of the femoral triangle
Term
Femoral artery
Definition
what does the external iliac artery become when it crosses the inguinal ligament
Term
femoral sheath
Definition
funnel shaped tube extending 4cm below the inguinal ligament enclosing the femoral artery, vein, and deep lymphatics, comes off the epimysium of the iliopsoas and iliacus
Term
Femoral nerve
Definition
what is in the femoral triangle but not the femoral sheath?
Term
femoral canal/ring
Definition
most medial part of the femoral sheath
Term
medial compartment of femoral sheath-femoral canal/ring
Definition
common site of herniation in the thigh
Term
bowel, can cause bowel strangulation

-more common in females due to broader pelvis
Definition
what herniates through the femoral canal/ring? who more commonly?
Term
not the sheath! it comes in with the muscle compartment
Definition
how does the femoral nerve enter the femoral triangle?
Term
adductor hiatis
Definition
what gap is formed by the two parts of the abductor magnus?
Term
nerves, vessels, lymph ->pass through here to go from 1 side of thigh to other (anterior to posterior?)
Definition
what goes through the adductor hiatus?
Term
femoral artery
Definition
chief artery of the lower limb
Term
femoral artery
Definition
artery found half way between anterior superior iliac spine and pubic symphysis
Term
profunda femoris
Definition
what artery comes off the femoral artery within the femoral triangle
Term
through anterior thigh within the adductor canal to the adductor hiatus
Definition
where does the femoral artery continue beyond the femoral triangle?
Term
semimenbranous, semitendonous, biceps femoris -long head only

(posterior compartment except biceps short head)
Definition
what makes up the hamstrings
Term
medial and lateral femoral circumflex arteries
Definition
what does the profunda femoris give rise to?
Term
genicular arteries (medial/lateral superior & inferiors-4 total)

+

tibial and peroneal
Definition
what comes off the popliteal artery
Term
saphenous nerve
Definition
cutaneous branch of the femoral n. in the medial leg
Term
articular cartilage
Definition
the condyles are covered with ___
Term
superior, suprapatellar bursa
Definition
the synovial joint cavity extends ____ to the joint surfaces and deep to the quadriceps tendon as the _____
Term
synovial membrane
Definition
what lines the infrapatellar fat pad's internal surface
Term
between the patellar tendon and the joint cavity
Definition
where is the infrapatellar fat pad located
Term
no, synovial membrane reflects around them
Definition
are the cruciate ligaments included in the joint cavity proper?
Term
the suprapatellar is continuous with the synovial joint cavity so it can get involved in inflammation and infection of the knee joint
Definition
what's inflamed in suprapatellar bursitis, how does it happen?
Term
the subcutaneous prepatellar bursa can become inflamed as a result of compression or friction between skin and the patella
Definition
what's inflamed in housemaid's knee, how does it happen?
Term
the subcutaneous INFRApatellar bursa can become inflamed as a result of friction between skin and the tibial tuberosity (from kneeling)
Definition
what's inflamed in Vicar's knee, how does it happen?
Term
the deep infra patellar bursa lies between the patellar tendon and the tibia.

It can become inflamed as a result of overuse or in assoc. with the disease-repeated avulsion/heal/avulsion of the tibial tuberosity

this occurs in young people because their muscles pull on the tibial tuberosity, a secondary center of ossification, and causes an avulsion
Definition
what's inflamed in Osgood-Schlatter's disease, how does it happen?
Term
rolling and gliding
Definition
flexion of the knee involves both ___ and ___ movements of the joint surfaces relative to one another
Term
medial,lateral,medial,lateral

results in screwing home or locking of the knee during full extension
Definition
the ___ condylar surface of the femur is longer than the ____ condylar surface, thus the ____ condyle continues to travel longer than the _____ condyle during knee flexion


what does this cause?
Term
the femur undergoes slight medial rotation movement relative to the tibia
Definition
what motion does the femur do when the knees lock
Term
since the knee is stable without muscle help, the muscles(soleus in particular) are not being used to pump blood back up and so there is a shortage of blood to the head
Definition
why do locked knees cause fainting?
Term
medial and lateral collateral ligaments
Definition
thickenings of the fibrous capsule of the knee that function to restrict the movement of the joint to hinge only
Term
the medial
Definition
which collateral ligament of the knee is wider?
Term
extends from the femur to the tibia, attached firmly to medial meniscus
Definition
describe the attachment/path of the medial collateral ligament
Term
medial collateral ligament (MCL)
Definition
which collateral ligament of the knee is more commonly injured
Term
extends from femur to head of fibula (NOT attached to medial meniscus)
Definition
describe the path/attachment of the lateral collateral ligament
Term
the lateral collateral ligament
Definition
which collateral ligament of the knee is more cord like?
Term
fibrocartilage
Definition
the menisci are c shaped and adapt to the surface of the knee joint throughout the full range of movement, what are they made from that allows this?
Term
ends: horns
periphery: coronary ligaments
Definition
what attaches the menisci at the ends and periphery?
Term
deepen the articular surfaces to changing curvature of the femur during movements
Definition
what is the function of the menisci
Term
runs from the medial side of the lateral femoral condyle to the anterior intercondylar area of the tibia
Definition
what is the path/attachment of the ACL?
Term
runs from the lateral side of the medial femoral condyle to the posterior intercondylar area of the tibia
Definition
what is the path/attachment of the PCL?
Term
ACL
Definition
what prevents the femur from moving posteriorly on a planted tibia
Term
PCL (posterior cruciate ligament)
Definition
what prevents the femur from moving anteriorly on a planted tibia
Term
cruciate ligaments (both)
Definition
stabilizes the knee joint in an anterior and posterior direction
Term
cruciate ligaments
Definition
what does anterior/posterior drawer sign evaluate?
Term
set patient laying on a table with hip and knee flexed and see if their bent knees push back or pull forward too far

"gross" anterior/posterior movment = bad
Definition
how are the cruciate ligaments evaluated?
Term
torn meniscus, cruciate ligament tear
Definition
what are 2 common knee injuries?
Term
semimembranous (remember that m is below t in the alphabet)
Definition
which is deeper semimebranous or semitendonous?
Term
Obturator nerve
Definition
common innervation of the medial compartment of the thigh
Term
tibial tuberosity
Definition
common insertion of quadriceps femoris
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