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Flashcards in Knee Deck (109)
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1

What is a plica?

Remnants of synovial divisions from development; most common locations are the suprapetellar, mediopatellar plica, lateral synovial plica, infrapatellar plica (the most common plica and least symptomatic of all)

2

Describe symptoms of an irritated plica?

Most common symptoms location is along the medial (inside) of the knee. Symptoms mimic PFPS and can refer pain to the medial meniscus and cause paients pain "under the kneecap". Pain with prolonged sitting, prompting the term "moviegoer's sign" because it is less painful in ext; may cause pseudo-locking, may cause a pop beneath the patella or snap over the medial femoral condyle.

3

Describe the patellar trochlear groove contact from full ext to flexion:

0-20 no patellar femoral contact until 30 where the distal third contact the uppermost part of the femoral condyles; @45 the middle third contacts; @ 90 the distal third contacts; end range the odd facets contact

4

Patella baja may result from adhesions from what bursa?

infrapatellar bursa; most likely to occur after medialization of the tibial tuberosity or patellar tendon graft for an ACL repair

5

Describe the "lateral blow out" sign of the knee

the ant lateral portion of the capsule is thin and swelling will bulge outward in this area especially in knee flexion; may indicate lateral meniscus tear

6

Discuss the role of the posterior oblique ligament:

predominant ligamentous structure on the post-med corner of the knee; prevents posterior translational

7

What important does the arcuate complex provide:

each step at heel stroke with the near full ext exerts tremendous force across the posterior lateral knee (posterior one third of lateral supporting structures: LCL, arcuate lig an ext of the popliteus) helps control IR of the femur on a fixed tibia or ER during open chain

8

Function of the ACL

prevents recurvatum prevents IR of the tibia in open chain and and ER in closed chain, stops ant translation of the femur on the on the fixed tibia

9

Function of the PCL

stop posterior translation of the tibia of the tibia on the femur; decelerator of the femur

10

Function of the IT Band

aids in ext, but when the knee is bent past 30 degrees it slides back and becomes a flexor; also contribute to prevent pivot shift to aid the ACL

11

Anatomic reasons for patellar instability?

High Q-angle (norm for males 13 females 18), loose retinaculum, patella alta, weak or dysplastic vastus medialis obliquus muscle, flattened lateral femoral condyle

12

Do cruiciate ligaments really cross?

yes, the twist upon themselves during knee flexion and extension

13

What is the normal measurement of tibial torsion?

12-18 degress of lateral tibial torsion, so the lateral malleloi will be more posterior than the medial

14

Which meniscus is most commonly injured and why?

medial meniscus, it is adhered to the medial collateral ligament; there is also increased WB'ing on the medial portion of the knee

15

What is the function of popliteus?

unlocking and IR rotating the knee during flexion, aids with stabilization for balance, protects the latearl mensicus, prevents ant translation of the femur

16

What is the q-angle?

Angle from the ASIS to the center of the patella to the tibial tuberosity

17

What may increase a Q angle?

femoral anteversion, external tibial torsion, genu valgum, pes planus

18

What anatomic structures encourage lateral tracking of the patella

dysplastic patella, patella alta, shallow intercondylar groove, tight rentiaculum, tight IT band

19

Function of VMO

prevents subluxation of the patella, counter acts vastus laterallis; acting alone it is unable to ext the knee works harmoniously with the rest of the quad

20

What is lateral pressure syndrome?

A tight lateral retinaculum pulls and tilts the patella laterally, increases lateral facet

21

Define bipartite patella?

The patella will still have an intact ossification center, and may be mistaken as a fracture

22

What is the difference between Osgood-Schlatter disease and sinding larsen-johansson disease

Osgood is an apophysitis of the tibial tubercle and sinding larsen-johanssen disease is apophysitis of the inferior patellar pole

23

Since articular cartilage is anueral what tissues around the PF joint cause pain?

subchondral bone

24

Define Hoffa's disease

Fat pad syndrome manifests as pain and swelling of the infrapatellar fat pad, usually from direct trauma to the anterior knee, particularly during activities

25

Treatment approach for instability?

avoid terminal knee ext, suggest ex from 90-30 degrees, use braces and tape

26

Tx for knee muscle and tendon injuries?

open and closed chain ex with emphasis on eccentrics, stretching

27

Tx for friction knee injuries

avoid repeated flexion and extension exercises, exercise in pain free ROM; exercise above and below painful ROM

28

Tx for knee articular injuries

increase quad function, pain free ROM in unloaded environment

29

Tests for plica syndrome

Stutter and Hughston's plica tests

30

Housemaid's knee?

Prepatellar bursitis either from blunt trauma over repetitive microtrauma over the anterior knee