Knee & Ankle joints
KNEE JOINT
It is the largest■
and most
complicated joint in
.the body
TYPE
A synovial joint of the ■
hinge variety
between the medial
and lateral condyles
of the femur and the
corresponding tibial
condyles with some
.degree of rotation
CAPSULE
.It is absent Anteriorly■
It is■
: Replaced by■
Quadriceps femoris■
.tendon
.Patella■
.Ligamentum patellae■
CAPSULE
: Posteriorly■
: Superior )a(■
Attached proximal to■
the articular margins
of the femoral
condyles and to the
.intercondylar fossa
It is deficient above■
the lateral condyle for
the passage of
.tendon of popliteus
CAPSULE
: Inferior )b(■
Attached to the■
tibia EXCEPT when
the tendon of
Popliteus crosses
.the bone
EXTRACAPSULAR LIGAMENTS
Ligamentum .1■
Patellae
It is the inter mediate ■
part of the tendon of
quadriceps femoris .It is
supported by the
patellar retinaculi
(expansions from the
vasti)
They strengthen the■
.capsule on each side
TIBIAL (MEDIAL) .2
COLLATERAL
.A flat band■
:Attachment■
Above to the medial■
.condyle of the femur
Below to the medial■
surface of the shaft of
.the tibia
Firmly attached to the■
.medial meniscus
LATERAL (FIBULAR) .3
COLLATERA
.Cord like■
: Attachment■
Above : lateral condyle of ■
.the femur
.Below : head of the fibula■
Separated from the■
lateral meniscus by the
.tendon of popliteus
OBLIQUE POPLITEAL .4
An expansion of■
the
Semimembranos
.us
It strengthens the■
.capsule posteriorly
INTRA CAPSULAR
STRUCTURES
CRUCIATE .1■
.LIGAMENTS
.MENISCI .2■
TENDON OF .3■
.POPLITEUS
CRUCIATE LIGAMENTS
They are the main bond■
between the femur and
tibia throughout the
.joint’s movements
They Cross each other■
.within the joint cavity
They are named■
Anterior and Posterior
according to their tibial
.attachments
ANTERIOR CRUCIATE
: Tibial attachment■
Anterior intercondylar ■
.area
: Course■
Upward, backward and■
.laterally
:Femoral attachment■
Posterior part of medial ■
surface of the lateral
.condyle
ANTERIOR CRUCIATE
FUNCTION■
Prevent posterior ■
displacement of the
femur on the tibia
and the tibia from
being pulled
anteriorly when the
.knee joint is flexed
It is taught in hyper ■
.extension
POSTERIOR CRUCIATE
: Tibial attachment■
posterior intercondylar ■
.area
:Direction■
upward, forward and■
.medially
:Femoral attachment■
Anterior part of the■
lateral surface of the
.medial condyle
POSTERIOR CRUCIATE
:Function■
prevents anterior■
displacement of
the femur on the
tibia and the tibia
from being pulled
posteriorly when
the knee joint is
.flexed
It is taught in■
.hyper flexion
MENISCI
C shaped sheets of fibro■
.cartilage
The peripheral border is■
thick and attached to
.the capsule
The inner border is thin ■
and concave and forms
.a free edge
MENISC
The upper concave■
surfaces are in contact
with the femoral
.condyles
The lower flat ■
surfaces are in contact
.with the tibial condyles
MENISCI
: Functions■
Deepen the .1■
tibial articular
.surfaces
Act as cushions .2■
between the two
.bones
MEDIAL MENISCUS
Crescentic in■
.shape
More liable to■
injury due to its
attachment to the
medial collateral
ligament and to
.the capsule
It is relatively■
.immobile
LATERAL MENISCUS
.More rounded in shape■
Its anterior and posterior ■
ends lie within the ends of
.the medial meniscus
Posteriorly it is separated■
from the fibular collateral
ligament by the tendon of
.popliteus
.Less liable to injury■
MOVEMENTS
FLEXION .1■
Hamstrings( suppli■
ed by the sciatic
.nerve)
Assisted by■
sartorius, popliteus
.and gracilis
Checked by back of •
calf in contact with the
.back of the thigh
MOVEMENTS
EXTENSION .2 •
Quadriceps Femoris •
(supplied by the femoral
nerve.)
Limited by tension of the •
cruciate and collateral
.ligaments
MOVEMENTS
ROTATION .3 •
MEDIAL: )A( •
Sartorius, gracilis and
.semitendinosus
LATERAL : )B( •
Biceps femoris
NERVE SUPPLY
.Femoral■
.Obturator■
.Sciatic■
.Common peroneal■
.Tibial■
UNLOCKING
At the Flexion of the■
.extended knee
: Aim■
To slack the ligaments■
.especially the cruciate
FEMUR: Lateral rotation ■
(the foot is on the ground)
.TIBIA: Medial rotation■
Muscle: POPLITEUS■
LOCKING
The joint assumes the■
.position of full extension
.It becomes a rigid structure■
The menisci are■
compressed between the
.tibial and femoral condyles
Tightening of all the major ■
.ligaments
The femur is medially■
.rotated on the tibia
ANKLE JOINT
TYPE ■
Hinge synovial ■
ARTICULATING ■
BONES
Lower end of the .1 ■
tibia
.Two malleoli .2 ■
.Body of the talus .3 ■
The inferior .4 ■
transverse
tibiofibular ligament
deepens the socket
for the body of the
.talus
ANKLE JOINT CONT’D
CAPSULE ■
Encloses the joint and ■
attached near the
articular margins except
anteriorly where
anteriorly it is attached
to the neck of the talus
in front of the articular
.edge
It is thin in front and ■
.behind
Posteriorly it fuses with ■
the inferior transverse
.tibiofibular ligament
SYNOVIAL MEMBRANE
.Lines the capsule■
Reflected anteriorly■
on to the neck of
the talus as far as
the articular
.cartilage
May extend a short■
distance between
.the tibia and fibula
LATERAL LIGAMENT ■
.Weaker than the medial ■
It consists of three bands ■
ANTERIOR TALOFIBULAR .1 ■
Between the lateral malleolus ■
and the lateral surface of the
.talus
CALCANEOFIBULAR .2 ■
From the tip of the lateral ■
malleolus to the lateral surface
.of the calcaneum
POSTERIOR .3■
TALOFIBULAR
Between the lateral■
malleolus and the
posterior tubercle
.of the talus
STABILITY OF THE JOINT
.Shape of the articulating bones .1■
.Strength of the ligaments .2■
.The surrounding tendons.3■
RELATIONS
MOVEMENTS
DORSIFLEXION■
Tibialis anterior, extensors of the digits ■
.and big toe, peroneus tertius
LIMITED BY■
.Tension of tendo calcaneus ■
.Posterior fibers of the medial ligament ■
.Calcaneofibular ligament ■
PLANTAR FLEXION■
Tibialis posterior, peroneus (longus and ■
.brevis) gastrocnemius
LIMITED BY■
.Tension of opposing muscles ■
.Anterior fibers of the medial ligament ■
Anterior talofibular ligament ■
THANKS
