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 Knee joint.  The Knee Joint  Knee joint:  1- the largest joint in body  2- the most complex one { allow mobility (flexion/extension), stability(weight.

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Presentation on theme: " Knee joint.  The Knee Joint  Knee joint:  1- the largest joint in body  2- the most complex one { allow mobility (flexion/extension), stability(weight."— Presentation transcript:

1  Knee joint

2  The Knee Joint  Knee joint:  1- the largest joint in body  2- the most complex one { allow mobility (flexion/extension), stability(weight bearing joint ) }  3-The most injured one

3   actually 2 joints within the articular capsule  1- tibio-femoral  2-patello-femoral

4  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

5  patello-femoral joint (the articulation between the patella and the femur)  Type : i t is saddle joint (the patella slides within the patello-femoral groove) 

6  Articulating Bones  Femur  Tibia  Patella  Not part of the knee joint:  fibula - it does not articulate with the femur or the patella

7  Articular surfaces  covered by hyaline cartilage  The major surfaces are :  Lower end femur (medial and lateral femoral condyles )  upper end tibia (medial and lateral tibial condyles )  posterior aspect of the patella

8   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

9  Joint capsule  External fibrous layer (fibrous capsule)  Internal synovial membrane

10  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

11   superiorly Attaches to the femur, proximaly to articular margins of the condyles  Inferiorly Attaches to tibia, superior articular surface (tibial plateau)

12   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.

13   2- medially: blends with the tibial collateral ligament and is attached to the medial meniscus restricting its mobility

14   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.

15   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

16  anterolaterally: reinforced by from the iliotibial tract Posteromedially : reinforced by oblique popliteal ligament which is an extension from the semimembranosus tendon

17  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 membrane Anteriorly, the synovial membrane is separated from the patellar ligament by an infrapatellar fat pad also

18  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

19   bursae that are not communicating with the articular cavity  subcutanous prepatellar bursa: over the knee cap  Deep infra-patellar bursae:underneath the patellar ligament  Subcutaneous or superfacial infra-patellar bursae: over the patellar ligament

20  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

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22   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

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24   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


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