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COMP ORTHO > Knee > Flashcards

Knee Flashcards

(78 cards)

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1
Q

Femur - mechanical axis

A

connects hip joint to knee joint

3 degrees from vertical

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2
Q

Femur - anatomical axis

A

along shaft of femur

6 degrees from vertical

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3
Q

Femur - trabecular system

A

weak zone at neck

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4
Q

Medial femoral condyle

A

Thinner

Longer

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5
Q

Lateral femoral condyle

A

sticks out more - more in line with femoral shaft

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6
Q

Femoral shaft obliquity

A

femur tilts towards lateral side

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7
Q

Patella surface

A

longer on lateral side

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8
Q

Tibia - condyles

A

medial is 50% larger and 3x thicker

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9
Q

Tibial condyles - concave/convex

A

Convexity is greater posteriorly so the joint is more congruent in extension

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10
Q

Transverse ligament

A

holds menisci from getting farther apart

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11
Q

Coronary ligament

A

connection btw menisci and rim of tibia

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12
Q

Medial meniscus attached to what

A

MCL and semimembranosus

More C shaped

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13
Q

Lateral meniscus attached to what

A

PCL and popliteal

More O shaped

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14
Q

Bowstring effect draws patella what direction

A

laterally

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15
Q

Genu valgum

A 
knock knees
abnormal angulation of tibia away from midline
mechanical axis is displaced laterally 
medial structures = tensile
lateral structures = compressive
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16
Q

Genu varum

A

bow legged
mechanical axis displaced medially
medial = compression
lateral = tensile

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17
Q

Genu recurvatum

A

mechanical axis displaced anteriorly
Ant = compression
Post = tensile
Excessive strain on ACL

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18
Q

Q angle

A

line between patellar tendon and patellar tendon tubercle

usually 14 degrees

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19
Q

Flexion - synovial flow

A

posteriorly

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20
Q

Extension - synovial flow

A

anteriorly

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21
Q

LCL
Resists what
Tight and slack in what

A

Resists varus stress and tibial ER
tight in ext, slack in flex
first resistance to force from medial side

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22
Q

MCL

A

Resists valgus stress, ER, and ant translation of tibis
Connects capsule and medial meniscus
tight in ext, slack in flex

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23
Q

ACL

A

resists ant tibial translation and tibial IR

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24
Q

PCL

A

resists post tibial translation and tibial IR

protects knee with flex

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25
Arcuate popliteal ligeamnt
Reinforces posterolateral capsule | resists varus stress
26
Oblique popliteal ligament
reinforces posteromed capsule resists valgua stress limits ER resists hyperextension
27
Parapatellar ligament (retinaculums)
helps hold patella in groove
28
Flexion
130
29
Extension
0?
30
IR
30
31
ER
40
32
Open chain arthrokinematics
Tibia on femur | concave on convex = SAME
33
Close chain arthrokinematics
Femur on tibia | convex on concave = OPP
34
screw home mechanism
flexion = tibia IR extension = fbular ER Most of rotation occurs over last 30 degrees of extension
35
Close packed
ext
36
Loose packed
flex 25 degrees
37
Lateral tibial torsion
knee is forward but foot goes out in lateral direction
38
Miserable mal alignment syndrome
femoral anteversion throws you into IR | Will have genu valgum, VMO weak, lateral tibial torsion, forefoot pronation
39
Camel sige
patellar tendon torn - secondary to patella alta
40
Squinting patella
Patella comes out too far medially | look for flat feet
41
Classification for articular cartilage damage
stage 1 - softening stage 2 - fibrillation stage 3 - deeper fissuring stage 4 - exposed bone
42
Gout
elevated serum uric acid and deposition of urate crystals in joint soft tissues and kidneys
43
Pseudogout
deposit of calcium pyroophosphate crystals
44
Gout - epidemiology
Males more than females | most common over age 40
45
Hemophillic arthritis
Medical emergency!!! | blood in joint leads to cartialge degeneration
46
OA - where most vulnerable
medial side
47
OA - nonsurgical treatment - when open vs. closed chain
Acute = open chain | Subacute - closed
48
Pyogenic arthritis
medical emergency! | Bacterial infiltration
49
Reiters
reactive arthritis from microbial pathogens | most common in males over 30
50
ACL injury
Contact or non | Hyperextension, valgus, or rotational force
51
ACL injury - clinical presentation
audible pop, rapid onset, unable to WB, instability/giving way Knee flexion as protection
52
Chondromalacia patellae is what
softening of cartilage on undersurface of patella due to overuse
53
Special tests for chrondromalcia patellae
Clarke's
54
Fat pad syndrome is what
irritation of infrapatellar fat pad due to impingement between femoral condyles and patella
55
Fat pad syndrome - clinical presentation
``` Genu recurvatum patella alta hypertrophied fat pad knee cap pain inferiorly titled patella ```
56
LCL injury caused by what
Varus stress contact not as common heals slowly
57
LCL - sprain grades
grade 1 = slight | grade 3 = complete tear
58
Special tests for LCL
varus stress at 0 and 30
59
MCL injury is caused by what
valgus stress contact with rotational force | often get ACL or meniscus issue too
60
Meniscus injury is caused by what
trauma with rotation, cutting movement, deep flexion degeneration (fraying, stable, tears, necrosis, CPPD) most likely to occur at 30 flexion
61
Meniscus injury is often associated with what
ACL and MCL injury if caused by trauma
62
Forced into myperextension can lead to
medial meniscus tear | poor blood supply - poor healing
63
Clinical presentation with meniscus tear
loacking at 10-30 degrees flexion instability click/snap symptomatic pop with pain at joint line
64
Special tests for meniscus
``` Apley joint line palpation valgus/varus stress mcmurray arthrogram mri (not easy to meniscus tear though) ```
65
Patellar dislocation caused by what
pivot turn and patella will dislocate | can be direct blow to knee or indirect patellar malalignment
66
Patella subluxation
More common than dislocation | F more than M
67
Clinical presentation - sublux
``` tenderness around patellar border Q angle more than 20 Instability click/slide/lock atrophy of VMO hypertrophy of VL ```
68
Patellar tendon rupture caused by
forceful eccentric contraction defect in inf pole more common 20-40
69
PCL injury how
post tibial translation - MVA with tibia on dash | varus, twisting motion
70
Pre-patella bursitis
prolonged kneeling or falling onto knees
71
Ottawa rules
``` Age 55+ Tender fibular head Isolated patellar tenderness Unable to flex knee to 90 Unable to WB for 4 steps immediately post trauma or in ER ```
72
Pittsburgh rules
Age less than 12 or more than 50 | Unable to walk 4 WB steps in ER
73
Distal femur fx types
``` A = extraarticular B = unicondylar C = bicondylar ```
74
Femoral shaft fracute -
life threatening because of considerable bleeding and fat embolism massive force required
75
Intercondylar (tibial spine) fracture
direct blow to proximal tibia with knee flexed or in rotation Hyperextension with varus/valgus stress
76
Bakers cyst
herniated synovial lining
77
Osgood Schlatters
due to overuse in young athletes | osteochondritis of tibial tubersotiy apophysis
78
Osteochrondritis dissecans
trauma causes separation of cartilage and subchondral bone piece becomes necrotis loose body in joint space

COMP ORTHO (11 decks)

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