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Knee (Anatomy) Flashcards

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1
Q

Three articulating surfaces of knee joint.

A

Patella, proximal tibia, & distal end of femur

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2
Q

Anatomically and biomechanically the Tibiofemoral joint and the patellofemoral joint (PFJ) can be considered as _________.

A

separate entities

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3
Q

The types of knee injuries seen clinically can be generalized into the following categories:

A 
1. Unspecified sprains or strains, and other minor
injuries, including; 
2. Overuse injuries
3. Contusions,
4. Meniscal or ligamentous injuries
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4
Q

Consists of the distal end of the femur and the proximal end of the tibia.

A

TIBIOFEMORAL JOINT

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5
Q

The femur is the largest bone in the body represents approximately ___ of a person’s height.

A

25%

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6
Q

CLINICAL SIGNIFICANCE:

A narrow intercondylar notch has been associated with an increase in injuries to the ____.

A

ACL

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7
Q

A _________ has been associated with an increase in injuries to the ACL.

A

narrow intercondylar notch

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8
Q

It is a complex articulation, dependent on both dynamic and static restraints or its function and stability.

A

Patellofemoral joint

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9
Q

The thickness of the patella varies considerably, attaining a maximum height of ______ (0.77–1”) at its central portion.

A

2–2.5 cm

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10
Q

Posterior surface of the patella can include up to seven facets.

A smaller facet, known as the ______, exists medially and is delineated by a second vertical ridge.

A

odd facet

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11
Q

Give 5 PF Jt. functions.

A
  1. Provide the articulation with low friction.
  2. Protect the distal aspect of the femur from trauma and the quadriceps from attritional wear.
  3. Improve the cosmetic appearance of the knee;
  4. Improve the moment arm of the quadriceps.
  5. Decrease the amount of anteroposterior tibiofemoral shear stress placed on the joint.
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12
Q

Composed of a thin strong fibrous membrane and is the largest synovial capsule in the body

A

Knee JOINT CAPSULE AND SYNOVIUM

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13
Q

By lining the _____, the synovial membrane excludes the cruciate ligaments from the interior portion of the knee joint, making them extra-synovial yet intra-articular.

A

joint capsule

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14
Q

______, located superior to the patella, is thought to function to retract the knee capsule
during knee extension.

A

Articularis genu

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15
Q

It is an almost plane joint with a slight convexity on the oval tibial facet and a slight concavity on
the fibular head.

A

PROXIMAL TIBIOFIBULAR JOINT

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16
Q

The nerve supply for the proximal tibiofibular joint is provided by the _____.

A

common peroneal nerve

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17
Q

Provides the primary restraint to anterior translation and medial rotation of the tibia on
the femur and is a secondary restraint to valgus and varus rotation of the tibia.

A

Anterior cruciate ligament (ACL)

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18
Q

The two functional bundles of the ACL.

A

Anteromedial (AM) and posterolateral (PL) bundles

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19
Q

T or F

When the knee is in full flexion, the AM and PL bundles are under tension.

A

F (knee is in full extension)

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20
Q

T or F

When the knee is at 60 to 90 degrees of flexion, the PL bundle is lax and allows rotation of the tibia on the femur.

A

T

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21
Q

_____ limits anterior translation of the tibia at low angles of knee flexion (0–
30 degrees).

A

PL bundle of ACL

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22
Q

______ bundle primarily resists anterior translation of the tibia and undergoes less change in length than the PL bundle throughout the range of knee motion.

A

Anteromedial (AM)

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23
Q

Posterolateral (PL) bundle is maximally lengthened when the knee is in _______.

A

full extension

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24
Q

The AM bundle is under maximum tension when the knee is ______.

A

flexed between 45 degrees and 60 degrees

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25
Compressive loading of the tibiofemoral joint, such as that occurs during WB, has been shown to reduce _____ and stiffen the joint when compared with the NWB. These changes appear to reflect the increased strain borne by the ACL during the transition from NWB to WB.
anteroposterior laxity
26
T or F There is popular belief in the beneficial effects of early WB and closed-kinetic chain exercises (CKCEs) following anterior cruciate reconstruction.
T
27
T or F Quadriceps-powered extensions of the knee cause high loads and strains on the ACL during ADLs.
T
28
Moving the knee from approximately _____ of flexion to full extension puts high strain on the ACL.
40 degrees
29
______ of the knee and/or excessive internal tibial rotation puts high loads on the ACL.
Hyperextension
30
Excessive _____ on the tibia may result in ACL tear..
varus or valgus stress
31
Provides the primary restraint to posterior translation and medial rotation of the tibia on the femur and is a secondary restraint to valgus and varus rotation of the tibia.
Posterior cruciate ligament (PCL)
32
The PCL is wider at its ___ and narrowest near the tibial insertion.
femoral origin
33
PCL is ____ thicker and has twice the tensile strength of the ACL.
50%
34
PCL is more vertical in ____ and horizontal in flexion.
extension
35
The 2 bundles of PCL.
Antero-lateral and postero-medial
36
T or F PCL is most lax with further flexion of the knee.
F (taut)
37
T or F The PCL antero-lateral bundle is taut in flexion, while the posterior medial bundle is taut in extension.
T
38
This are the extra-articular ligaments of the knee.
Medial (tibial) collateral ligament (MCL) & Lateral (fibular) collateral ligament (LCL)
39
Provides the primary restraint to valgus and lateral rotation of the tibia, and is a secondary restraint to the anterior and posterior translation of the tibia on the femur.
MCL
40
T or F Anterior MCL fibers are taut in flexion while posterior fibers are taut in extension.
T
41
MCL is the primary stabilizer of the ___ side of the knee against valgus forces, and external rotation of the tibia, especially when the knee is flexed.
medial
42
When combined with the posteromedial corner of the capsule, it is termed POSTERIOR OBLIQUE LIGAMENT.
Superficial band of the MCL
43
It is the first ligament injured when a valgus stress is applied.
Superficial band of the MCL
44
It blends with the medial meniscus and consists of an upper meniscofemoral portion and a lower menisco-tibial portion.
Deep band (medial capsular ligament) of the MCL
45
Provides the primary restraint to varus rotation of the knee, acts as a secondary restraint to external rotation and posterior displacement of the tibia and, during normal gait, is the primary passive structure resisting the knee adduction (varus) moment.
Lateral (fibular) collateral ligament
46
This part of the LCL consists of the joint capsule.
Anterior part of LCL
47
This part of the LCL is considered to be part of the iliotibial band (ITB) and covers the capsular ligament.
Middle LCL
48
This is a Y-shaped portion of the LCL that is thought to be part of the arcuate–ligamentous complex, which supports the posterior capsule.
Posterior LCL
49
______ strengthens the anterior portion of the knee joint and prevents the lower leg from being flexed excessively.
Patellar ligament/patellar tendon
50
Provides reinforcement to the lateral capsule, limits AM rotation of the tibia, and prevents hyperextension of the knee.
Oblique popliteal ligament
51
Located in the PL corner of the knee and may be osseous or cartilaginous in makeup.
Fabella
52
Helps prevent excessive internal rotation of the tibia and adds further ligamentous support on the lateral and PL aspects of the knee.
Fabella
53
Vascular supply of menisci.
Peri-meniscal capsular arteries (branches of genicular artery from popliteal artery)
54
Only outer ____ of the lateral meniscus is vascular.
10-25%
55
Outer ____ of the medial meniscus are vascularized (red zone: potential for healing)
10-30%
56
T of F Remaining inner portions (65-75%) are considered avascular and have less potential to heal.
T
57
Inner portion of the meniscus receive nourishment from the synovial fluid by _______.
diffusion or mechanical pumping
58
It is a crescent-shaped, or U-shaped, meniscus with the wider separation on its anterior and posterior horns, is larger and thicker than its lateral counterpart and sits in the concave medial tibial plateau. Wider posteriorly than anteriorly.
Medial Meniscus
59
Forms a C-shaped incomplete circle sits atop the convex lateral tibial plateau.
Lateral Meniscus
60
T or F The LM occupies a larger portion (approximately 80%) of the articular surface than the medial meniscus (approximately 60%) and is more mobile than its medial counterpart.
T
61
The LM is attached to __________
Ligament of Humphrey (anterior meniscofemoral ligament) & ligament of Wrisberg (posterior meniscofemoral ligament)
62
Menisci transmit 50–60% of the joint load when the knee is in extension, and _____ when the knee is in flexion.
85–90%
63
The lateral meniscus carries ___ of the compressive load in the lateral compartment, compared with just 40% of the medial meniscus in its respective compartment.
70%
64
During the normal gait pattern, the articular surface of the knee bears up to _____, with over 70% of that load borne by the medial tibial plateau.
6 times the body weight
65
______ bears most of this load during stance when the knee is extended.
Medial tibial plateau
66
_____ bearing more on the much smaller loads imposed during the swing phase.
Lateral tibial plateau
67
A meniscectomy can reduce the shock-absorbing capacity of the knee by 20%. Loss of just 20% of a meniscus can lead to a _____ increase in contact forces.
350%
68
Menisci assist in joint lubrication by helping to compress _____ into the articular cartilage, which reduces frictional forces during WB.
synovial fluid
69
The menisci deepen the articulating surfaces of tibial plateaus. This increases the _____ of the knee, especially during axial rotation and valgus–varus stresses.
stability
70
The menisci are capable of detecting ____ in formation in the knee joint, thus playing an important afferent role in the sensory feedback mechanism of the knee.
proprioceptive
71
During flexion of the knee, the menisci move ______.
posteriorly
72
T or F The medial meniscus is moved posteriorly about 5 mm by the pull of the semimembranosus tendon, and the lateral meniscus is pulled about 11 mm by the popliteus, resulting in an external rotation of the tibia.
T
73
Lateral meniscus has greater mobility because it does not attach to the ___, and, as mentioned previously, its capsular attachment is interrupted by the passage of the popliteus tendon.
LCL
74
During extension, the menisci move _____.
anteriorly
75
During external rotation of the tibia, the menisci will follow the displacement of the femoral condyles, which means that the medial meniscus is pushed _____, and the lateral meniscus is pulled _____. During internal rotation, the opposite occurs.
posteriorly-anteriorly
76
The ______ is stretched during external rotation of the tibia.
medial coronary ligament
77
The lateral coronary ligament is _____ during internal rotation of the tibia.
stretched
78
Reduce friction and acts as a cushion to the movement of one body part over another.
Bursae
79
Give the three bursae of the knee.
A. Superficial and deep infrapatellar bursae B. Prepatellar bursa C. Tibiofemoral bursa
80
A _____ may occur with fluid accumulation when there is a natural connection between the semimembranosus bursa and the knee joint.
“Baker cyst”
81
Give the functions of the fat pads in the knee.
o Synovial fluid secretion o Joint stability o Neurovascular supply o Occupies dead space
82
Give the 3 fat pads at the anterior knee.
o Quadriceps fat pad o Prefemoral fat pad o Infrapatellarfat pad
83
Represents a remnant of the three separate cavities in the synovial mesenchyme on the developing knee.
Plica
84
It is the most common plica in the knee.
Anterior or inferior plica, or mucous ligament
85
_____ are one of the causes of anterior knee pain in children and adolescents.
Symptomatic synovial plicae
86
Serve to connect the patella to a number of structures, including the femur, menisci, and tibia, both medially and laterally.
Retinacula
87
T or F Lateral retinaculum is stronger than the medial retinaculum.
T

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