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Ortho DX > knee > Flashcards

knee Flashcards

1
Q

the knee includes three articulating surfaces which form two distinct joints …. name those joints

A

tibiofemoral

patellofemoral

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2
Q

describe the differences between the 2 types of swelling that occurs in the knee

A
  • localized – bursal

- generalized swelling — intra-articular (synovitis)

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3
Q

T/F

the knee usually has Varus angulation compared with the femur

A

False — Valgus angulation

— Varus is weight more lateral

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4
Q

What is it called when the incidence of hyperextension in the knee occurs? and who is most common in?

A

Called Genu Recurvatum

  • occurs mostly in females
  • or in individuals with longer or lax ligaments
  • could have this in elbow due to endocrine system
  • microtrauma
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5
Q

T/F the anterior and posterior intercondylar areas serve as attachments for The lateral collateral and medial collateral ligaments

A

False

it is the ACL and PCL attachments

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6
Q

T/F

The tibiofemoral joint is known a ginglymoid

A

True

or know as modified hinge joint

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7
Q

t/f

the bony configuration of the knee joint complex is geometrically congruous and has stability to the joint

A

False

is geometrically incongruous and tends little inherent stability to the joint

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8
Q

What it the joint stability more dependent on?

A

dependent upon the static restraints of the joint capsule, ligaments and menisci, and the dynamic restraints of the quadriceps, hamstrings and gaastrocnemius

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9
Q

T/F
In the distal end of the femur, the smaller lateral femoral condyle is elliptical- shaped faces inward and the medial femoral condyle is ball shaped that faces outward

A

False
the lateral femoral condyle ball- shaped and faces outward
the elliptical- shaped is the medial femoral condyle faces inward

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10
Q

name the structures that originate at the lateral epicondyle

A
  • lateral head of the gastrocnemius

- lateral collateral ligament

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11
Q

Name the insertion sites at the medial condyle of the knee

A
  • adductor magnus

- medial collateral ligament

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12
Q

T/F the lateral femoral condyle is greater than its medial by about 1.7 cm

A

False

the medial is greater than lateral about 1.7 cm

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13
Q

what type of x- ray view is preferred to take to see the tibial tubercles for possible degeneration

A

Sunrise view

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14
Q

what type concave direction are the tibial plateaus

A

in a medial - lateral direction

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15
Q

T/F
in the anterior posterior direction, the lateral tibial plateau is coves while the medial is concave which makes the knee complex more symmetrical and decreases in lateral mobility

A

False
the medial tibial plateau is more concave
the lateral is convex
producing more asymmetry and increase in lateral mobility

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16
Q

T/F

the lateral plateau has approximately 50% greater surface area than medial plateau

A

False

The medial plateau is greater

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17
Q

what is the patellofemoral joint most dependent on for its function and stability

A

dependent on both dynamic and static restraints

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18
Q

the posterior surface of the patella can include up to how many facets and what are the locations?

A
  • 7 Facets

- 3 on the medial and on the lateral surface

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19
Q

which orthopedic test should you do to look for retropatellar pain and facet issues?

A

Clark sign

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20
Q

T/F

the patella is most mobile during flexion

A

False

it is fixed in the trochlear groove in flexion and mobile in extension

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21
Q

what are the edges of the patella called

A

poles

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22
Q

Name all functions of the patellofemoral joint

A
  • provide and articulation with low friction
  • protect the distal aspect of the femur from trauma, and the quadriceps from attritional wear
  • improve the cosmetic appearance of the knee
  • improve the moment arm of the quadriceps
  • decrease the amount of anterior- posterior tibiofemoral shear stress placed on the knee joint
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23
Q

T/F

For the Q angle most common range cited for males are 15-17 degrees and females 8-14 degrees

A 
false 
opposite ( females will always have a larger Q angle)
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24
Q

T/F

Q angles greater than 20 degrees are considered abnormal and may be indicative of potential displacement of the patella

A

True

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25
Q

What is it called when there is an increased Q angle and why/

A

Bayonet sign

- Alignment of the quadriceps, patellar tendon and tibial shaft resembles a french bayonet

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26
Q

What is the most common finding in patients with Patellofemoral arthalgia (PFA)

A

when knee is flaxed at 30 degrees, there is failure of the tibia to derogate normally and failure of the patellar tendon to line up with the anterior crest of the tibia

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27
Q

Patella stability is dependent on what 2 factors

A
  • Static restraints

- Dynamic restraints

28
Q

T/F
the patella tendon is classified as a ligament since it serves as a connection between two bones , however because the structure attaches the quads to the tibia it functions as a tendon

A

true

29
Q

What muscles are involved for abnormal patellar tracking that is an imbalance in activity

A

Vastus medialis obliquus

Vastus lateralis

30
Q

The normal patellar posture for exerting deceleration forces in the functional position at what degree of the knee?

A
  • 45 degrees
31
Q

a lower posture of the patella represents what?

A

Patella baja

32
Q

A higher patella posture represents what

A

patella alta

33
Q

T/F

Patella baja makes the patella less efficient in exerting normal forces

A

False

its the patella alta

34
Q

T/F

the knee joint capsule is the largest synovial capsule in the body

A

true

35
Q

Proximal tibiofibular joint is an almost plane joint with a slight _____ on the oval tibial facet and a slight ____ of the fibular head

A
  • convexity

- concavity

36
Q

T/F

The proximal tibiofibular joint has less motion than its distal partner

A

false

has more motion

37
Q

Describe what Osgood- Schlatter’s Syndrome is

A

it is partial disruption at the patellar ligament- tuberosity attachment creating localized inflammatory changes (peritendonis insertion)

38
Q

What usually causes Osgood- Schlatter’s Syndrome

A

repetitive stress on the knee causing traction at the tibial tuberosity

39
Q

The osgood- Schlatter’s syndrome is also commonly known as what during preadolescent

A

Growth spurt

40
Q

Name the predisposing factors in osgood- Schlatter’s Syndrome

A
  • tight hamstring
  • tight achilles tendon
  • tight quadriceps muscles
41
Q

T/F

Osgood- Schlatter syndrome is more common in females than males

A

false

42
Q

what is the most common age for Osgood

A

10-15

43
Q

Name some symptoms for Osgood - Schlatter syndrome

A
  • pain and swelling and tenderness over tibial tubercle
  • pain ascending or descending stairs
  • history of single violent injury or repetitive flexion- extension movement
  • more repetitive trauma on tibia tuberosity
  • a traction apophysis
44
Q

The static stability of the knee joint complex depends on which 4 major knee ligaments

A
  • Anterior Cruciate
  • Posterior Cruciate
  • Medial Collateral
  • Lateral Collateral
45
Q

What type of ligaments are the Cruciate ligaments and explain why

A

intra- articular/extra synovial

- because of the posterior invagination or the synovial membrane

46
Q

T/F

the Cruciate ligaments are different from others in that they restrict in abnormal motion rather than normal motion

A

False

they restrict in NORMAL motion

47
Q

Which is considered the most important ligament in the knee for stability

A

ACL

48
Q

What are primary and secondary restraints for the Anterior Cruciate Ligament

A
  • primary = anterior translation of the tibia relative to the femur
  • seondary - both internal and external rotation in the non- weight bearing knee
49
Q

What is the most common MOI of an ACL tear

A

sudden deceleration with an abrupt change of direction/speed and or velocity and a fixed foot (closed chain foot)

50
Q

which ligaments are involved in posterior restraint of the knee and which one provides the total restraint

A
  • collateral ligaments
  • posterior portion of medial and lateral capsules and the popliteus tendon
  • PCL provides 90-95% of it
51
Q

MOI where PCL tear can happen

A
  • Excessive hyperflexion - falling onto shin

- hyperextension

52
Q

Name the Secondary restraints of the collateral ligaments

A
  • structures in posterior- lateral and posterior- medial corners of the knee
  • the hamstrings and quadriceps
  • patellar ligament, oblique popliteal ligaments and the fabella
53
Q

T/F

The medial Meniscus is wider anteriorly than posteriorly

A

False

wider posteriorly

54
Q

T/F

The medial meniscus is a rounder O shaped than lateral

A

False

Lateral

55
Q

Name the functions of the Menisci

A
  • load transmission
  • shock absorption
  • joint lubrication
  • joint stability
  • guiding of movements
56
Q

O’ Donohue’s Terrible Triad include

A
  • Rupture of
  • MCL
  • ACL
  • Medial meniscus
57
Q

Name the AKA for Prepatller Bursitis

A

Housemaid’s

58
Q

MOI of housemaid’s knee

A
  • overuse
  • direct blow to the area
  • chronic friction
  • pain and swelling over the front of the knee
  • pain when bending or straightening the leg
59
Q

T/F

The AKA for Infrapatellar Bursitis is called Housemaid’s knee

A

False

Clergyman’s knee

60
Q

Describe what happens in Clergyman’s knee

A

Redness and swelling of left infra patellar bursa

- swelling occurs on both sides of the patellar ligament near the tibial tuberosity

61
Q

What is MOI for Clergyman’s knee

A
  • repeated trauma to the region of the tibial tuberosity includes:
  • roofers, painters and floor layers is common for them
62
Q

Name the borders of the popliteal fossa

A
  • Superior Lateral border = biceps femoris tendon
  • Superior Medial border= Semitendinosus and semimembranous
  • Inferior borders= 2 heads of gastocnemius
  • contents:
  • posterior tibial nerve
  • popliteal artery and nerve
63
Q

Describe what Baker’s Cysts are

A
  • escaped synovial fluid in an enclosed membrane sac which is protruding through the joint capsule of the knee
  • associated RA
  • Femorotibial joint disorder
64
Q

Explain Plica

A

a remnant of the three separate cavities in the synovial mesenchyme of the developing knee

65
Q

Name the major muscles that act on the knee joint

A
  • quadriceps
  • hamstrings
  • gastrocnemius
  • popliteus
  • hip adductors
66
Q

What is considered extension lag and when does it usually occur

A

the last 10 degrees of motion may be difficult to achieve without great effort - occurs with weak quads

67
Q

T/F

In a patient with Helfet’s helix the knee cannot fully extend without some internal tibial rotation on the femur

A

False
external rotation
-

Ortho DX (6 decks)

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