MSK Session 9 Flashcards Preview

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Flashcards in MSK Session 9 Deck (83):
0

Why can the knee be locked in extension?

To reduce energy needed to remain upright

1

How is the knee locked and unlocked in extension?

Femur rotates internally over tibia to lock
Popliteus helps rotate femur externally to unlock

2

Which muscles are used for movement at the knee joint?

Flexion: hamstrings
Extension: quad
Medial rotation: semitendinous
Lateral rotation: biceps femoris

3

When can rotation of the knee joint occur?

When flexed

4

Why must the knee joint be deepened?

To stabilise the mismatch b/w shapes on the tibial plateau

5

How is the knee joint deepened?

Deepening the articular surface of the tibial element w/the menisci

6

What shape do the medial and lateral menisci have?

Wedge
Thicker at edges than in middle

7

What shape are the medial menisci?

C-shaped

8

Which menisci are more circular and more mobile?

Lateral

9

What ensures synovial fluid is distributed evenly in the knee?

Menisci

10

What do the menisci attach to?

Intercondylar areas
Joint capsule via coronary ligaments
Each other by transverse ligament of the knee

11

What supplies blood to the knee joint?

10 vessels of peri-articular be ocular anastomoses around knee

12

What especially stabilises the knee joint?

Inferior fibres of vastus medialis and vastus lateralis

13

What supports the knee laterally?

Iliotibial tract

14

Which blood vessels are involved in supplying the knee?

Femoral, popliteal, anterior and posterior recurrent branches of the anterior tibial recurrent and circumflex fibular arteries

15

How are the medial and lateral tibial condyles distinguished?

Medial - slightly concave
Lateral - slightly convex

16

Where is the adductor tubercle on the femur?

On the medial epicondyle

17

Why is the medial epicondyle of the femur larger than the lateral?

Bears more weight

18

What are the intracapsular ligaments which cross over and are named by their attachment to tibia?

Cruciate

19

What is the path of the posterior cruciate ligament?

Passes anterior and inserts medially

20

What is the lathe of the anterior cruciate ligament?

Passes posterior and inserts laterally

21

What is the function of the posterior cruciate ligament?

Prevents tibia moving posteriorly in relation to femur

22

What is the function of the anterior cruciate ligament?

Prevents tibia moving anteriorly in relation to femur

23

Which is the stronger cruciate ligament?

Posterior

24

Which is the main stabiliser cruciate ligament in weight bearing flexed knee?

Posterior

25

What does the posterior cruciate ligament limit?

Hyperflexion

26

What does the anterior cruciate ligament limit?

Hyperextension

27

What is the blood supply to the anterior cruciate ligament like?

Poor

28

What supports the knee anteriorly?

Patellar ligament

29

What is the oblique popliteal ligament an extension of?

Tendon of semitendinous

30

What supports the knee posteriorly by strengthening the capsule?

Oblique and arcuate popliteal ligaments

31

Which ligaments are the extra-capsular ligaments of the knee?

Medial/tibial collateral
Lateral collateral

32

Where do the collateral ligaments of the knee extend from?

Femoral epicondyles

33

Where does the medial collateral ligament extend to?

Medial condyle of tibia at midpoint of medial meniscus

34

Why does injury of the medial collateral ligament typically cause injury of the medial meniscus?

Due to attachment

35

Why is the medial collateral ligament injured more than the lateral collateral ligament?

It is part of the fibrous capsule

36

What does the lateral collateral ligament extend to?

Lateral surface of fibula head

37

What reinforces the lateral collateral attachment to the lateral surface of the fibula head?

Iliotibial tract

38

What is the unhappy triad?

Blow to side of knee --> lateral twisting of flexed knee --> medial meniscus torn, medial collateral torn, ACL torn

39

What is damaged in hyperextension?

Anterior cruciate ligament

40

What do you use to test damage to the anterior cruciate ligament?

Anterior draw sign

41

What is damaged by falling onto tibial tuberosity with flexed knee?

Posterior cruciate ligament

42

What is used to assess posterior cruciate ligament damage?

Posterior draw sign
May be visible looking side on

43

Is injury to the ACL or PCL more common?

ACL

44

Why is the lateral meniscus saved form injury and able to heal relatively well?

Relatively mobile

45

What are the three bursae of the knee?

Supra-patellar
Pre patellar
Superficial infra-patellar

46

What is Housemaid's knee?

Inflammation of the pre patellar bursa typically from kneeling

47

What is Clergyman's knee?

Inflammation of the infra-patellar bursa typically from kneeling

48

Why is osteoarthritis common in the knee?

Weight-bearing joint

49

When is rheumatoid arthritis seen in the knee?

In severe progression

50

What are Bakers cysts?

Abnormal fluid filled sacs of synovium in popliteal fossa due to chronic knee effusion

51

What can popliteal cysts connect to?

Synovium of knee joint

52

How quickly can popliteal cysts arise?

Overnight

53

Which muscles are in the posterior thigh?

Semitendinous
Semimembranous
Biceps femoris

54

What is the main action of the semitendinous?

Extend thigh
Flex leg
Medially rotate leg when flexed
Can extend trunk when thigh and leg flexed

55

What is the main action of semimembranous?

Extend thigh
Flex leg
Rotate leg medially when flexed
Can extend trunk when thigh and leg flexed

56

What innervates the posterior thigh muscles?

Sciatic nerve

57

What is the main action of biceps femoris?

Flexes leg
Laterally rotates leg when knee is flexed
Extends thigh

58

Which muscle is used to accelerate mass during first step of gait?

Biceps femoris

59

What is the popliteal fossa?

Diamond shaped area on posterior leg through which most structures pass from the thigh to the leg

60

What forms the superiomedial border of the popliteal fossa?

Semimembranous

61

What forms the superiolateral border of the popliteal fossa?

Biceps femoris

62

What forms the inferio lateral border of the popliteal fossa?

Lateral head of gastrocnemius and plantaris

63

What forms the inferio medial border of the popliteal fossa?

Medial head of gastrocnemius

64

What forms the floor of the popliteal fossa?

Posterior surface of knee joint capsule
Posterior surface of femur

65

What forms the roof of the popliteal fossa?

Popliteal fascia and skin

66

What is the popliteal fascia continuous with?

Fascia lata of leg

67

What is the contents of the popliteal fossa from medial to lateral?

Popliteal artery
Popliteal vein
Tibial nerve
Common fibular nerve

68

What is the most superficial in the popliteal fossa?

Nerves

69

What are the tibial and common fibular nerve branches of?

Sciatic nerve

70

What is the deepest structure in the popliteal fossa?

Popliteal artery

71

What is the popliteal artery?

Continuation of the femoral artery which supplies the leg w/blood

72

What pierces the popliteal fascia to empty into the popliteal vein?

Small saphenous vein

73

What lies at the termination of the small saphenous vein?

Small lymph node

74

Describe the location of deep lymph nodes in the popliteal fossa.

Surround vessels and follow femoral vessels to deep inguinal lymph nodes

75

What does Baker's cyst aUsually arise in conjunction with?

Osteo or rheumatoid arthritis

76

What does rupture of a popliteal cyst cause?

DVT symptoms

77

Does a Baker's cyst usually self resolve?

Yep

78

Why does popliteal aneurysm cause compression of popliteal fossa contents?

Popliteal fascia layer is inextensible

79

What is particularly susceptible to compression in popliteal aneurysm?

Tibial nerve

80

What does tibial nerve compression in popliteal aneurysm cause?

Leg anaesthesia or loss of motor function

81

How can a popliteal aneurysm be detected clinically?

Obvious palpable pulsation w/abnormal arterial sounds

82

What are rarer causes of popliteal mass than popliteal cyst or aneurysm?

DVT
Adventitial cyst of the popliteal artery
Various neoplasms