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ORTHO 560 > knee anatomy and biomechanics > Flashcards

knee anatomy and biomechanics Flashcards

(68 cards)

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1
Q

what joints make up the knee joint?

A

Patella-femoral joint
Tibiofemoral joint
Superior tibio-fibular joint

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2
Q

why is the knee joint susceptible to trauma

A

stuck in the center of two lever arms

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3
Q

what provides inert stability to the knee?

A

ligament
meniscuc
articular surfaces

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4
Q

what provides dynamic stability to the knee joint?

A

muscles

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5
Q

what forms the normal Q angle of the knee

A

line from asis to center of the patella and from center of patella to tibial tibercle

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6
Q

what is associated w/ an increase in Q angle of the knee

A

increased lateral translation and thus increase stress on the side of PF joint

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7
Q

what attaches the patella to tibial tuberosity

A

patellar tendon

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8
Q

what is the function of the PF joint

A

pulley for the quad muscles and allows to decrease the friction b/w the quad tendon and the femoral condyles

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9
Q

what happens at the PF joint as the knee begins to flex

A

patella moves inferiorly and engage in the intercondylar groove
shifts medially by being pushed by the large lat femoral condule and tibial MR

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10
Q

what happens at the PF joint as the knee past 30 degree flexion

A

patella will either remain stable or shift laterally

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11
Q

at 0 degree of knee flexion (knee extension) where does contact of the patella occur?

A

no contract b/w patella and torchlear groove

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12
Q

at 10-30 degrees of knee flexion where does contact of the patella occur?

A

inferior pole of patella and trochlear groove

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13
Q

45-60 degrees of knee flexion where does contact of the patella occur?

A

contact area moves towards the central pole of the patella

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14
Q

at 90 degrees of knee flexion where does contact of the patella occur?

A

the top of the patella is in contact w/ the patellar groove

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15
Q

at 135 degrees of knee flexion where does contact of the patella occur?

A

medial and lateral sides of the trochlea now serve as contact points

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16
Q

how is the congruency of the knee joint?

A

incongruent due to the different shape of the articulating surfaces; patellar surface is smaller than femoral articulating surface

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17
Q

what act as dynamic stabilizers for the patella

A

quad tendon
patellar tendon
ITB
rectus femoris muscle

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18
Q

what acts as static stabilizers of the patella

A

medial and lateral patellar retinaculum

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19
Q

what may influence the position of the patella

A

imbalances in passive tension or change ion the line of pull of the dynamic stabilizers

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20
Q

what determines the vertical position of the patella in the femoral sulcus?

A

lenght of the patellar tendon

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21
Q

what is patella alta

A

condition that arises when the patellar tendon is abnormally long; leading for a higher raised patella on the femoral sulcus

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22
Q

what are consequences associated to patella alta?

A

subluxation and PFPS

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23
Q

what is the normal and abnormal raio for modified insall-salvatti ratio and what does it measure?

A

Ratio patella tendon length: patella length
Normal ratio = 1.25 : 1
Abnormal ratio = >2: 1

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24
Q

what does the joint reaction force on the knee depend on?

A

quad force and knee angle

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25
what happens to the patella and joint rxn force when the knee is in increased flexion?
patella gets pulled up by the quad tendon and inferiorly by the patellar tendon leading to posterior compression
26
when is the compression force on the patella minimal?
w/ knee extension
27
when is compression force on the patella worse?
in 90 degree flexion and w/ quad contractions
28
what is the approximate compression force on the patella w/walking?
~25-50% BW
29
what is the approximate compression force on the patella w/ running
5-6x BW
30
when does the knee joint reaction force increase w/ CKC
w/ knee flexion
31
when does the knee joint reaction force increase w/ OKC
w/ knee extension
32
describe the osteokinematics of the TF joint?
Flexion= caudal glide Extension: cranial glide Tibia IR: lateral glide Tibial ER: medial glide
33
what type of joint is the PF joint?
modified ovoid joint
34
what are the articulating surfaces of the TF joint
Femoral condyles: convex | Tibial plateau: concave
35
what are the abd and add mvmts of the knee considered as?
not physiological mvmt but can be assessed w/ glides
36
expain the arthrokinematics of the TF joint
flexion: posterior glide extension: anterior glide abd: lateral glide add: medial glide
37
what is the resting position of the knee
30 degree flexion
38
what is the CPP of the knee
full extension and ER
39
what is the capsular pattern of the knee
greater limitation of flexion > extension
40
where is the prepatellar bursae of the knee?
b/w skin and anterior patella
41
what is the most commonly affected bursae of the knee?
prepatellar bursae
42
what is the suprapatellar bursae?
located b/w rectus femoris ms and femur
43
where is the deep infrapatellar bursae
b/w patellar tendon and tibia
44
where is the superficial/subcutaneous infrapatella bursa?
b/w skin and tibial tuberosity
45
where is the semimembranosis bursae located?
located b/w medial head of gastroc and capsule of the knee
46
where is the semitendinosis bursa
between tibia and pes anserine
47
when is the ST bursae generally an issue?
w/ knee over use injuries
48
how is the MCL of the knee
broad and flat shapes | ranges from medial femoral epicondyle to medial proximal shaft of the tibia and attachments to medial menisus
49
what happens on brush test w/ MCL tear of the knee
negative brush test (no effusion) since its a extra articular ligament
50
what is the function of MCL of the knee
prevents valgus stress and tibia IR
51
how is the LCL of the knee
round in shape | extends from lateral epicondyle of the femur to the upper end of the lateral fibula
52
does the LCL of the knee attach to meniscus
no
53
what happens on brush test w/ LCL of knee rupture?
- brush test since extraarticular
54
what is the function of LCL of the knee
prevents varus stress
55
where does the ACL of knee extend from?
From anterior medial aspect of the tibia and extends superiorly/ posteriorly to femoral condyle
56
what type of ligament is the ACL of the knee?
intra articular thus lot of swelling when injured
57
what is the fct of ACL of the knee?
Restrains anterior translation of tibia on femur Backwards sliding of the femur and hyperextension of the knee Controls tibia IR on the femur in femoral extension of 0-30 degrees
58
is there a difference b/w strain on ACL in CKC or OKC?
no difference
59
what can help control force on ACL in CKC
the hamstrings co-contraction
60
where does the PCL of the knee extend from
From posterior tibia and extends superiorly and anteriorly to medial femoral condyle
61
what type of ligament is the PCL?
Intra-articular and extra synovial ligament: issue will lead to knee effusion
62
what is the function of the PCL?
restrains posterior translation of the tibia on the femur
63
describe the medial meniscus?
c shaped longer than lateral meniscus adherent to MCL thus less mobile than LCL covers ~50% of medial articular surface of tibia (less than lateral) and thus more prone to OA
64
describe the lateral meniscus?
u shaped covers ~75% of tibial articular surface no attachment to LCL thus more mobile
65
explain the vascularization of the meniscus?
peripheral 1/3 is well vascularized, inner 1/3 not well
66
what are the main function of the meniscus?
* Vital for knee stability * Lubrification * Nutrition * Improve weight distribution * Reduce friction * Prevents excessive HE * Prevents capsule from getting into the jt * Shock absorption: protects/minimizes the amount of stress on articular cartilage
67
what happens in the event of a hyperpronated foot?
clacaneal valgus and thus increased stress on tendon halux valgus of 1st MTP increased tibia and femur IR leg appears shorter increase in Q angle leadingh to increased lateral translation of the patella increased stress on lateral side of PF joint
68
what happens in a hyper supinated foot?
decreased shock absorption increase stress in joint above decreased tibia and femur IR

ORTHO 560 (7 decks)

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