Knee Flashcards
(170 cards)
1
Q
how many articulating surfaces in the knee
A
3
2
Q
how many distinct joints?
A
2
3
Q
how many joint capsules
A
1
4
Q
what are the two joints called
A
patellofemoral and tibiofemoral
5
Q
what should be done at every visit
A
observation
6
Q
what types of swelling occur at the knee
A
localized and generalized
7
Q
localized swelling indicates
A
bursal
8
Q
generalized swelling indicates
A
intra-articular (synovitis)
9
Q
what test can be used for generalized swelling (synovitis) of the knee
A
bounce home
10
Q
tibia has a slight varus/valgus angulation in comparison to the femur?
A
valgus
11
Q
bowlegged
A
genu varus
12
Q
knock knee
A
genu valgus
13
Q
hyperextension of the knee
A
genu recurvatum
14
Q
genu recurvatum more popular in what gender
A
females
15
Q
people who have lax or long ligaments tend to have
A
genu recurvatum
16
Q
if person has long ligament the recurvatum will be present
A
in elbow as well
17
Q
two types of lax ligaments
A
acquired (gymnast) and gen isolated (golfer)
18
Q
tibiofemoral joint is made up of
A
distal end of femur and proximal end of tibia
19
Q
what separates the two femoral condyles
A
intercondylar eminece
20
Q
what type of joint is the knee
A
ginglymoid (modified hinge joint)
21
Q
the knee joint is complex and geometrically incongruous this lends
A
little inherent stability to the joint
22
Q
knee joint stability is dependent on
A
static restraints f jt capsule
ligaments
menisci
dynamic restraints of quads/ hamstrings/ gastroc
23
Q
where do the femoral condyles project
A
posteriorly from femoral shaft
24
Q
largest bone in the body
A
femur
25
intercondylar eminences are attachment points for
ACL and PCL
26
which condyle is smaller
Lateral
27
why is the lateral condyle smaller?
less weight and downward foce
28
why is the medial condyle larger
it bears the main amount of the body weight
29
lateral condyle is ____shaped and faces ______
ball shaped and outward
30
what shape is the medial condyle and where does it face
elliptical faces in
31
what originates on the lateral condyle
popliteus
32
what originates on the posterior lateral epicondyle
lateral head of gastrocnemius and LCL
33
what originates on the medial epicondyle
insertion of adductor magnus, medial head of gastroc, and MCL
34
anterior-posterior width medial femoral condyle
bigger than lateral by about 1.7cm
35
articular surface of the medial femoral condyle
longer than lateral
36
proximal tibia has what
two plateaus
37
what separates the plateaus
intercondylar eminence
38
tibial plateaus are concave in what direction
medial to lateral
39
anterior posterior direction medial tibial plateau is
concave
40
anterior posterior direction lateral tibial plateau is
convex
41
the convexity of lateral plateau produces
more asymmetry and increase in lateral mobility
42
how much more surface area is there in medial plateau
50%
43
how much thicker is the articular surface of medial side
3x
44
what attaches to these plateaus
meniscus
45
patello femoral joint complex articulation dependant of what types of restraints for function
dynamic and static
46
posterior surface of the patella include how many facets
up to 7 (11)
47
what type of bone is the patella
sesmoid
48
what side of the knee is more prone to injury
medial
49
where is the patella embeded
in the tendon of quadriceps femoris superiorly and patella tendon inferiorly
50
in flexion patella fixed or mobile
fixed
51
in extension patella fixed or mobile
mobile
52
some basic functions of patella
articulation low friction
protect distal femur and quads from attritional wear
improve cosmetic appearance of the knee
improve moment arm of quads
decrease anterior-posterior tibiofemoral shear stress on knee
53
Q angle
bisection of two line
1-ASIS>patella
2- patella>tibial tubercle
54
most common Q angle range for women
15-17
55
most common Q angle range for men
8-14
56
any angle greater than 20 degrees
abnormal
57
and increased Q angle can be called
bayonet sign
58
patellofemoral athralgia
when knee flexed at 30 degrees tibia fails to derotate normally- patella tendon fails to line up with anterior crest of tibia
59
sup/inf>flex/ext patella moves
5-7cm
60
if the patella tracks abnormally
muscular imbalance
61
the bad tracking and imbalance is probably because of
VMO and vastis lateralis
62
normal patellar posture for exerting deceleration forces in a functional 45 degrees patella should be
squarely against anterior femur
63
if patella is lower than normal
patella baja
64
if patella is higher than normal
patella alto
65
what in the largest synovial capsule in the body
knee
66
the synovial memb is strange why
it excludes cruciate ligaments but is within the jt capsule
67
cruciate ligaments are considered
extrasynovial but intra articular
68
repetitive micro trauma on the knee causing traction apophysitis at the tibial tuberosity.
with or without avulsion
Osgood-Schlatter's
69
Osgood-Schlatter's is most common
preadolescent during growth spurt
70
predisposing factors for Osgood-Schlatter's
tight hamstrings
tight achilles
tight quads
71
Osgood-Schlatter's is more common in what gender
males
72
what ages does Osgood-Schlatter's effect
10-15
73
when is pain with Osgood-Schlatter's most prominant
going up or down stairs
74
Osgood-Schlatter's has a history
single violent injury or repetitive flexion-extension movement
75
what four major ligaments are important in static stability of the knee
ACL, PCL, MCL, LCL
76
Primary restraint of knee anterior translation
ACL
77
Primary restraint of knee posterior translation
PCL
78
Primary restraint of knee valgus rotation
MCL
79
Primary restraint of knee varus rotation
LCL
80
Primary restraint of knee lateral rotation
MCL, LCL
81
Primary restraint of knee medial rotation
ACL, PCL
82
cruciate ligaments restrict what type of motion
normal rather than abnormal
83
what is one of the most important ligaments to knee stability
ACL
84
is there a need to xray osgood schlaters
no
85
what is the treatment for osgood schlaters
conservative, stop activity, self limiting, anti inflammatories (food)
86
longer thinner cruciate ligament
ACL
87
shorter broader cruciate ligament
PCL
88
MOI or ACL rupture
sudden deceleration
abrupt change direction/speed/velocity
closed kinetic chain (foot on ground)
89
90-95% total restrain to posterior translation of tibia on femur
PCL
90
MOI for PCL tear
excessive hyperflexion
| hyperextension
91
common injury causing PCL tear
dashboard injury
92
broad and fas shaped collateral ligament
Medial Collateral ligament
93
difficult portion of MCL to palpate
posterior taut in extension blend with capsule and medial border of meniscus
94
aka for MCL
tibial collateral lig
95
primary function of MCL
stabilizer of medial side knee against valgus forces
96
Primary function of the LCL
resist varus forces
97
aka for LCL
fibular collateral ligament
98
how does the LCL differ from the MCL
develops independently
| remains free from joint capsule and lateral meniscus
99
what separates LCL from inner structures of the knee
popliteus tendon
100
secondary restrains of the knee
```
hamstrings
quadriceps
patellar lig
oblique popliteal ligaments
fabella
structures in the posterior-lateral and posterior- medial corners of the knee
```
101
what type of cartilage are the menisci made up of?
fibrocartilage
102
medial meniscus is shaped how
like a C
103
larger thicker meniscis
medial
104
wider in what direction
posteriorly than anteriorly
105
rounder O-shaped meniscus
laterl
106
more mobile meniscus
lateral
107
which has two meniscofemoral ligaments attaching to it
lateral
108
tear occurs in line with the circumferential fibers of the meniscus
longitudinal tear
109
extra long longitudinal tear that has flapped up
buckethandle tear
110
bucket-handle tear may displace into the intercondylar notch, where it may cause true locking of the knee joint.
displaced bucket handle
111
innbebition
displace fluid
112
how does meniscus lubricate
imbibe via movement
113
generally at the junction of the posterior and middle thirds small flap tear occurs
parrot beak
114
extend from the inner free margin toward the periphery
radial tear
115
why are radial tears difficult
avascular, generally wont heal- most medial aspect
116
function of meniscus
```
load transmission
shock absorption
joint lubrication
joint stability
guide movement
```
117
meniscectomy reduces shock-absorbing capacity by
20%
118
triad of O'donoghue
terrible triad
unhappy triad
MCL, ACL, medial meniscus rupture
119
what do bursae do
reduce friction and cushion the movement of one body part over another
120
what are the main bursae of the knee
```
deep infrapatellar
gastroc
pes anserine
prepatellar
superficial infra patellar
```
121
prepatellar bursitis aka
housemaids knee
122
MOI prepatellar bursitis
overuse
kneeling while leaned forward
direct blow
123
clergyman's knee
infrapatellar bursitis
swelling both sides of the patellar lig
kneeling leaned back on heels
124
borders of popliteal fossa
superior lateral- biceps femoris
superior medial- semitendinosus/membranosus
inferior- 2 heads of gastroc
125
what are within the borders of popliteal fossa
posterior tibial nerve, popliteal artery and nerve
126
escaped synovial fluid enclosed in a membrane sac protruding through the joint capsule of the knee
bakers cyst
127
bakers cysts cause what distally
pooling in the foot and ankle
128
bakers cysts are associated with
RA
129
baker cysts are considered
femoral tibial joint disorder
130
two tests used to confirm
bowstring and bounce home
131
pain in the region of the knee that feels like meniscal tear. when surgeons go looking it is a clear meniscus.
won't find it unless you are looking for it
plica
132
synovial mesenchymal reminant
plica
133
major muscles that act on the knee
```
quads
hamstrings
gastroc
popliteus
hip adductors
```
134
lateral restraints of the patella
retinaculum
135
which retinaculum is torn more often
lateral
136
what tests can be done to ensure stability of the retiaculum
patellar apprehension test
137
extension lag (last 10 degrees) of the knee is because of
weak quads
138
knee extension comes with some amount of tibial rotation this is called
helfets helix
139
how can it be determined extension lag is weak quads
circumferential mensuration three inches up from patella. atrophy
140
how do you asses proper motion of the tibia at the knee
screw home method
| two dots one on patella and one on tib tub
141
completely locking the knee causes
deficant venous return cause people to pass out
142
major vessels of the knee
femoral
popliteal
genicular
143
major nerves
saphenous N
common peroneal N- palpate at fib neck
tibial N
144
tests that relate to sciatic N issues
```
SLR
Bragard
buckling
bowstring
lasegue
bechterew
anterior innominate/mazion/ advancement sign
toe walk
```
145
biceps femoris action at the knee
flexion and external rotation
146
bicep femoris nerve supply
sciatic
147
bicep femoris N root derivation
L5, S1-2
148
Semimembranosus nerve supply
sciatic
149
Semimembranosus N root derivation
L5, S2-2
150
semitendinosus N supply
sciatic
151
semitendinosus N root derivation
L5 S1-2
152
Gracilis action
knee flexion
153
gracilis N supply
obturator
154
gracilis N root derivation
L2-3
155
Sartorius action
flexion knee
156
sartorius N supply
femoral
157
sartorius N root derivation
L2-3
158
popliteus action
flexion knee
159
popliteus N supply
tibial
160
popliteus N root derivation
L4-5 S1
161
Gastroc action
flexion knee
162
gastroc N supply
tibial
163
gastroc N root derivation
S1-2
164
tensor fascia lata action
flexion and extension of knee
165
tensor fascia lata N supply
sup glute
166
tensor fascia lata N root derivation
L4-5
167
rectus femoris
vastus medialis
vastus intermedius N supply
vastus lateralis
femoral
168
rectus femoris
vastus medialis
vastus intermedius N root derivation
vastus lateralis
L2-4
169
acute phase of intervention
```
reduce pain swelling
control inflammation
regain ROM
min muscle atrophy
maintain fitness
```
170
functional phase intervention
full painless ROM
restore normal jt kinematics
improve muscle strength
restore normal force couple relationships
