Knee joint. The Knee Joint Knee joint: 1- the largest joint in body 2- the most complex one {...
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Transcript of Knee joint. The Knee Joint Knee joint: 1- the largest joint in body 2- the most complex one {...
Kneejoint
The Knee Joint
Knee joint:1 -the largest joint in
body2 -the most complex
one {allow mobility (flexion/extension), stability(weight bearing joint) }
3-The most injured one
actually 2 joints within the articular capsule
1 -tibio-femoral2-patello-femoral
type and variety of the knee joint
•tibio-femoral joint (the articulation between the femur and tibia, which is weightbearing)
•Type: •synovial joint
Varity :modified hinge joint (flexion
and extension is primary motion , Some lateral and medial rotation (is possible when the knee is flexed
•patello-femoral joint
(the articulation between the patella and the femur)
Type: •it is saddle joint (the patella slides within
the patello-femoral groove)
Articulating Bones
FemurTibia
PatellaNot part of the knee
joint:fibula - it does not
articulate with the femur or the patella
Articular surfaces
covered by hyaline cartilageThe major surfaces are:
Lower end femur (medial and lateral femoral condyles )
upper end tibia (medial and lateral tibial condyles )
posterior aspect of the patella
Enlarged femoral condyles articulate on
enlarged tibial condyles
on the anterior surface of the of the
femur the two condyles join to form
V-shaped articular surfaces between the
femur and posterior aspect of the patella
Joint capsule
External fibrous layer (fibrous capsule)
Internal synovial membrane
The fibrous capsule capsule is extensive and thin ,However it has a few thickend part that make up the intrinsic ligaments Incomplete in some areas reinforced by extensions from tendons of the surrounding muscles
encloses the articular cavity and the intercondylar region
superiorly Attaches to the femur , proximaly to
articular margins of the condylesInferiorly Attaches to tibia , superior articular
surface (tibial plateau)
1 -anteriorly: It is absent and replaced by
quadriceps tendon, patella, and ligamentum patellae, vastus lateralis
and vastus medialis tendinons which merge
above with the quadriceps femoris tendon and below
with the patellar ligament , fibrous layer is
continuous with the lateral and medial margins of
these structures .
2 -medially: blends with the tibial
collateral ligament and is attached to the
medial meniscus restricting its mobility
4-Laterally: the fibular collateral ligament
which separated from joint capsule by fibular
bursa , the internal surface of the fibrous
membrane is not attached to the lateral
meniscus.
3-Posteriorly:enclose the condyles and the
intercondylar fossa and has an opening for popliteus tendon to pass out the joint
capsule and attach to the tibia
anterolaterally: reinforced by from the iliotibial
tractPosteromedially : reinforced by oblique
popliteal ligament which is an extension from the semimembranosus tendon
Synovial membrane
Lines the fibrous capsule medially and laterally and attaches to the margins of the articular surfaces(fermoral and tibial condyles) ,outer margins of the menisci and the posterior surface of patella ,reflects anteriorly into the intercondylar region to cover the cruciate ligaments excluding them from the articular cavity , but they are enclosed within the fibrous membraneAnteriorly, the synovial membrane is separated from the patellar ligament by an infrapatellar fat pad also
Bursae
more than 10 bursae in & around knee
bursa communicating with the articular cavity
suprapatellar bursa: a large bursa that is a continuation of the articular cavity ,superior to patella between the distal end of the shaft of femur and the quadriceps femoris muscle
subpopliteal recess: extends posterolaterally from the articular cavity and lies between the lateral meniscus and the tendon of the popliteus muscle
bursae that are not communicating with the
articular cavitysubcutanous prepatellar bursa: over the knee
capDeep infra-patellar bursae:underneath the
patellar ligament Subcutaneous or superfacial infra-patellar
bursae: over the patellar ligament
Cruciate ligaments
Cruciate ligaments(L.crux,a cross): anterior and posterior cruciate ligament that crisscross within the joint capsule in the inercondylar fossa and outside synovial cavity
anterior cruciate ligament(ACL): weaker than posterior one,attaches laterally in the inercodyar fossa to the medial side of lateral femoral condyle descend medialy to to the anteroir intercondylar area of the tibia just posterior to attachement of medial meniscus
ACL limits the sliding of tibia too far forward (thus prevent the hyperextension of knee )and femoral condyles too far backward
posterior cruciate ligament: stronger than the anteroir one, attaches medially in the inercodyar fossa to the lateral side of medial femoral condyle descend laterally to to the posterior intercondylar area of the tibia
PCL limits the sliding of tibia too far backward(thus prevent the hyperflexion of knee )and femoral condyles too far forward