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EPHE 355 > Knee > Flashcards

Knee Flashcards

(84 cards)

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1
Q

what position is the axis of the condyles of the femur and what is the relative size of teh condyles to each other

A

oblique relative to the vertical

larger medial condyle

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2
Q

what lives in the intercondylar fossa

A

cruciate ligaments

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3
Q

where does the patella live

A

on top of the femur

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4
Q

where is the pes anserine

A

slightly distal from level of fibula head but on the tibia

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5
Q

what is the tibial crest

A

proximal anterior ridge of the tibia (shin bone!)

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6
Q

what inserts in Gerry’s tubercle

A

IT band

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7
Q

how does the patella direct force of quadriceps

A

centralize force of quadriceps

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8
Q

how the patella effect teh strength of teh entire leg

A

increase by 30-35% via pulley mechanisms

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9
Q

how does the patella help with friction

A

reduces tendon and friction forces (tendon over patella vs tendon on femur)
thick articular cartilage between patella and femur

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10
Q

is patella protective

A

yes protects anterior surface fo knee

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11
Q

how does patella provide stability

A

limits extension of the leg

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12
Q

what is the formal name of knee joint

A

tibiofemoral joint

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13
Q

what type of joint is the tibiofemorla and what movements

A

synovial modified hinge with two DOF

IR/ER and FLEX/EX

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14
Q

what is the name of the mechanism what locks out the knee in WB extension

A

screw hole

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15
Q

what is the menisci and what is it made out of

A

fibrocartilage disc between tibia and femur

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16
Q

what are the parts of teh meniscus (shape and level fo mobility)

A

Lateral meniscus is oval shaped and very mobile

medial meniscus is c shaped and not mobile

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17
Q

what do teh coronary ligaments at the meniscus do

A

anchor the menisci to the tibia

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18
Q

what do does the transverse ligament at the meniscus do

A

holds the horns together

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19
Q

what do the mensicopatellar fibres do

A

anchor horns to patellar retinalculum

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20
Q

what is the function of the patella and meniscus working together

A

create stability during motion

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21
Q

what main knee ligaments attaches to meniscus

A

the deep MCL

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22
Q

muscle attachments to what sides of the meniscus

what is the function of these attachments

A

semimembranous to posterior medial meniscus
popliteus to lateral meniscus
–> helps the menisci “spot” the femoral condyles all teh way throughout motion
mensicofemoral ligaments to lateral meniscus

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23
Q

what part of meniscus has vascular and nervous tissue in it

A

none medially, present laterally

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24
Q

what side is meniscus thicker on

A

outer rim

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25
in what direction does the meniscus move with knee motion and how much
moves anteriorly with knee extension posteriorly with knee flexion lateral meniscus moves up to 12mm
26
what occurs is meniscus does not move during knee movements
it can be ripped or crushed
27
meniscus functions (5)
``` deepens socket (increasing congruency) absorb and distribute force lubrication of joint prevents joint capsule from intruding on joint space partially protect against excess motion ```
28
function of collateral ligaments
provide medial and lateral stability
29
when are collateral ligaments tight and when are they loose
tight in full extension and loose in flexion
30
name collaterals and what are the size
medial (deep and superficial) --> HUGE | lateral --> TINY
31
what part of MCL is loose and what part is tight in flexion
anterior (superficial) is tight in flexion and posterior (deep) is loose in flexion and vice versa
32
is LCL extracapsular or capsular
extra capsular
33
name the two cruciate ligaments and what characteristic makes them unique and why are they named as they are?
anterior cruciate ligament and posterior cruciate ligament anterior inserts anteriorly posterior insert posteriorly they are intracapsular but extrasynovial
34
what the the ACL limit?
anterior translation of teh tibia on teh femur
35
in CKC does tibia move on femur or femur move on tibia? in OKC?
CKC: femur on tibia OKC: tibia on femur
36
what does the PCL limit
posterior translation of the tibia on the femur
37
what degrees of flexion is the pCL most restrictive
90-120 degrees
38
what structure supports against torsional stress
fabellofibular ligaments and arcuate complex
39
goal of the whole capsule
protect knee from twisting and torsion
40
what is the supra patellar pouch
pocket just above kneecap that fills with fluid post injury
41
bursa in the knee (4 main)
semimembranous bursa supra patellar subcutaneous patellar subcutaneous infra patellar
42
ROM needed for regular ADLs
120 to 150 degrees
43
tightness where tends to limit knee flexion
Tightened in rectus femoris shorten and then hip must be extended at standing so knee cannot flex as much
44
knee extension is limited by
patella tightening capsule hamstrings
45
what is unique about the axis of motion of the knee throughout flexion
the axis of rotation changes because femoral condyles are larger than tibial condyles
46
how much rotation is available at the knee at 90 degree flexion
45 degree total (2:1 lateral to medial)
47
how do the femur and tibia move in relation to the knee in OKC to "lock out" the knee
20 degrees of lateral (external) tibia rotation, no femoral rotation
48
how do the femur and tibia move in relation to the knee in CKC to "lock out" the knee
tibia is fixed, femurs internally rotates
49
closed pack portion of the knee
full extension
50
resting position of the knee
25 degrees flexion
51
knee flexion ROM
130 - 150 degrees
52
degree of ROM of IR and ER of the tibia
IR: 15 ER: 25
53
what direction will the patella most likely dislocate
laterally
54
what tissues support the patella
retinaculum, vast medialis oblique, patellar tendon
55
in OKC does patella move on femur or femur on patella
patella on femur
56
in CKC does patella move on femur or femur on patella
femur on patella
57
closed packed position of patellofemoral joint
full flexion of the knee
58
open position of patellofemoral joint
full extension
59
where does the patella sit in full extension
in the intercondyler groove
60
position of patella in 90 degree flexion
flexed, lateral shift and lateral tilt
61
as knee flexed, how does patella move
move inferiorly, rotated, tilts and shifts
62
what is the Q angle
ASIS to patella and tibial tubercle straight up
63
do males are females have a larger q angle
females
64
functions of knee extensors
stabilize (isometric) decelerate (eccentric) accelerate (concentric)
65
name the quadriceps group
vastus medialis vastus lateralis vastus intermedius rectus femoris
66
what is the articulates genu
pulls capsule superiorly during extension to prevent impingement
67
what bony movement to the hamstrings limit
anterior tibia translation
68
what kinetic movement do the hamstrings decelerate
rotation
69
name hamstrings
``` semimembranosus (medial) biceps femoris (lateral) semitendinosus (medial) gracilis sartorius ```
70
what inserts at the pes anserine
sartorius gracilis semitendinosus
71
what muscles does the gastroc co contract with to stabilize the knee
quadriceps
72
tibial rotators
``` medial: semitendinosus and semimembranosus gracilis sartorius popliteus lateral: biceps femoris ```
73
explain the absorption and distribution of forces at the knee in unilateral stance
compression forces double from bilateral line of gravity passes medial to tibifemoral joint medial compartment = 60% of forces remaining forces are restrained by lateral restraints
74
peak torque position of the quadriceps
50-60 degrees knee flexion
75
what is extensor lag
lack of full extension at the knee due to quadriceps weakness and or pain
76
when is torque highest for knee flexors
full extension
77
normal strength ratio of hamstrings to quadriceps
2:3 hamstrings to quads
78
conditions that alter Normal torque of the knee
``` meniscal tears ligament instability ITB tightness obesity genu varus or valgum shortened femoral neck excessive pronation of feet changes in bony alignment due to fracture ```
79
what is the force couple during squatting
hamstrings act as hip extensor and quads act as knee extensors
80
explain length tension curve that occurs in a squat
as hip extends, knee extends as well for hamstrings and rectus femurs stay mid length
81
explain what occur at the muscles when someone squats down
eccentric actions control rate of knee flexion (quads) and hip flexion (hamstrings)
82
Mechano receptors are found in what parts of teh knee
ligaments capsule and synovial lingin menisci
83
what mechanorefelx occurs during knee effusion
reflex inhibition of the musculature --> reaction time several decreases
84
what is flexion contracture
a bent knee that cannot actively or passively be straightened

EPHE 355 (5 decks)

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