knee

Question 1

what type of joint is the knee?

Answer 1

a modified hinge joint that allows flexion, extension, and slight internal/external rotation

Question 2

what is the largest and strongest bone of the body? what does it articulate with?

Answer 2

femur
patella bone and proximal tibia

Question 3

what are the medial and lateral condyles of the distal femur covered in?

Answer 3

articular cartilage

Question 4

what is the intercondylar fossa?
popliteal surface?

Answer 4

posterior groove between the condyles where vessels travel

creates the floor of the pop fossa on posterior surface

Question 5

where and what is the tibial tuberosity?

Answer 5

on the anterior tibia, and is the insertion site for the patellar ligament

Question 6

what are the 3 articular surfaces of the proximal tibia?

Answer 6

medial condyle
lateral condyle
fibular cartilage: surface on inferior aspect of lateral condyle (forms the tibiofibular joint)

Question 7

what is the largest sesamoid bone in the body?

Answer 7

patella (kneecap)
embedded in the quad tendon on the anterior knee

Question 8

what is the function of the patella?

Answer 8

strengthens the quad tendon for powerful knee extension and reduces friction between the tendon and knee joint

Question 9

what is the insertion site of the biceps femoris?

Answer 9

apex of the fibular head (lateral side)

Question 10

what is the interosseous membrane?

Answer 10

the membrane that separates the posterior and anterior leg muscles
also stabilizes the lower leg

Question 11

what 4 muscles make up the quad tendon?

Answer 11

rectus femoris (front and center)
vastus medialis
vastus lateralis
vastus intermedius (deep to rectus)

Question 12

how much of the common quad tendon inserts on the patella bone?

Answer 12

95%

other 5% travel over the top and contribute to the patellar tendon

Question 13

where is the femoral articular cartilage seen?

Answer 13

on anterior/inferior surface of femur in the trochlear groove between the condyles

provides patellar stability and is covered by articular cartilage

Question 14

where is the patellar tendon seen?
is it a tendon or ligament?

Answer 14

between the apex of patella and the tibial tuberosity
attached medially and laterally by the patellar retinaculum

technically a ligament

Question 15

what is the size of the patellar tendon?

Answer 15

4x2x6cm

Question 16

where is the Hoffa fat pad?

Answer 16

posterior to the patellar tendon

intracapsular but extra-synovial

Question 17

what are the bursae of the patella?

Answer 17

prepatellar: lines superficial surface, not seen if normal
infrapatellar: between distal patellar tendon and anterior aspect of tibial epiphysis, trace fluid is normal

Question 18

what is the other name for the tibial collateral ligament? where is it?

Answer 18

medial collateral ligament, between the medial condyle or femur and anterior aspect of medial tibia

Question 19

what do the deep fibers of the MCL attach to?

Answer 19

the medial meniscus

Question 20

what are the medial and lateral meniscus made of?

Answer 20

crescent shaped bands of thick, rubbery cartilage on the superior border of the tibial bone
acts as shock absorbers and stabilizes the knee

Question 21

what is another name for the fibular collateral ligament?

Answer 21

lateral collateral ligament
attaches the lateral condyle of the femur to the fibular head
is NOT attached to the lateral meniscus

Question 22

what does the LCL share a common insertion site with?

Answer 22

biceps femoris

Question 23

what action of the knee does the biceps femoris have?
where do both heads of the biceps femoris insert?

Answer 23

flexion of the knee
inserts on lateral/anterior head of the fibula, superficial to the LCL and popliteus tendon

Question 24

what is the iliotibial band and where does it run?

Answer 24

broad thin fibrous band that connects the iliac crest to tibia

Question 25

where does the iliotibial band insert? (which tubercle)

Answer 25

lateral tibial condyle: Gerdy's tubercle

Question 26

what is the function of the iliotibial band?

Answer 26

supports internal hip rotation, flexion and extension while running supports the knee while standing

Question 27

where is the common site for friction of the iliotibial band?

Answer 27

over the lateral condyle of the femur susceptible to inflammation with overuse

Question 28

what are the tendons of the posterior knee?

Answer 28

semiteninosus muscle: part of the hamstrings responsible for extension gracilis and semimenbranosus: flexes knee

Question 29

what is the nerve on the posterior knee?

Answer 29

saphenous nerve crosses posteriorly and superficially over the tendons

Question 30

what is the bursa that causes a bakers cyst when extending with fluid?

Answer 30

semimembranosus and gastroc bursa of the posterior knee

Question 31

what is the popliteal neurovascular bundle composed of?

Answer 31

tibial nerve: branch of sciatic nerve popliteal vein and artery nerve can be damaged if the tibia suffers a fracture

Question 32

what does the sciatic nerve divide into at the popliteal crease?

Answer 32

common peroneal nerve and tibial nerve

Question 33

what does the common peroneal nerve divide into?

Answer 33

divides into superficial and deep branches that run over the fibular head, then deep to the peroneus muscle

Question 34

what does the peroneal nerve innervate?

Answer 34

front and side of the lower side, top of the foot

Question 35

what needs to be evaluated when a patient presents with swelling of the knee?

Answer 35

suprapatellar recess excess fluid can cause feeling of fluid in the knee

Question 36

what causes quad tendon rupture?

Answer 36

from excess force injuries

Question 37

what are the underlying conditions that can weaken the tendons?

Answer 37

diabetes, gout or RA

Question 38

where do quad tears generally occur?

Answer 38

usually 1-2cm from insertion on patella

Question 39

Where do MCL tears occur? LCL tears?

Answer 39

-superiorly from joint space - anywhere along the length of the tendon generally not treated

Question 40

where do friction tendinopathies of the IT band most often occur? what is the second most common part?

Answer 40

lateral condyle of the femur Gerdy's tubercle

Question 41

what pathology of the meniscus can be evaluated by ultrasound?

Answer 41

tears, meniscal cysts or an extruded meniscus

Question 42

what is the 2nd most common pathology of the knee?

Answer 42

patellar tendinopathy: jumpers knee: tendinopathy of the insertion full/partial tears degenerative changes of proximal deep fibers associated with calcific enthesopathy complete rupture is rare

Question 43

what is the most frequently encountered pathology of the knee?

Answer 43

bakers cyst

Question 44

what can cause a bakers cyst?

Answer 44

prior surgery obesity trauma advanced age

Question 45

how does a bakers cyst present?

Answer 45

palpable mass in pop fossa with or without pain