quiz #5 - knee

Question 1

knee joints

Answer 1

tibiofemoral (knee)
patellofemoral

proximal/ superior tibiofibular
mid tibiofibular
distal tibiofibular

Question 2

tibiofemoral (knee) joint - type & movements

Answer 2

synovial, hinge, diarthrosis, biaxial

gliding, flexion, extension, hyperextension, lateral/external rotation, medial/internal rotation

Question 3

tibiofemoral (knee) joint - articular surfaces

Answer 3

convex medial & lateral femoral condyles
with concave medial & lateral superior articular surfaces of tibia (tibial plateaus)

Question 4

tibiofemoral (knee) joint - ligaments

Answer 4

EXTRACAPSULAR: fibrous capsule, patellar (P), medial & lateral patellar retinaculum, tibial/ medial collateral (P), fibular/ lateral collateral (P), oblique popliteal & arcuate popliteal

INTRACAPSULAR: ACL, PCL, posterior meniscofemoral, transverse, coronary (P), medial & lateral menisci

Question 5

intracapsular/ extracapsular

Answer 5

intra: ACL, PCL

extra: MCL, LCL

Question 6

anterior cruciate ligament (ACL)

Answer 6

from medial aspect of lateral femoral condyle
to anterior aspect of tibial intercondylar eminence

Question 7

what does the ACL resist & what is it taut in

Answer 7

resists anterior translation & medial rotation of tibia on femur

taut in hyperextension

Question 8

posterior cruciate ligament (PCL)

Answer 8

from posterior aspect of intercondylar eminence to lateral aspect of medial femoral condyle

Question 9

what does the PCL resist & what is it taut in

Answer 9

resists posterior translation of tibia on femur

taut in hyperflexion

Question 10

medial collateral ligament (MCL) - (tibial collateral Ligament)

Answer 10

resists VALGUS forces

Question 11

lateral collateral ligament (LCL) - (fibular collateral Ligament)

Answer 11

resists VARUS forces

Question 12

MENISCUS - function

Answer 12

acts to disperse weight evenly & to reduce friction with movement

Question 13

medial meniscus

Answer 13

attached to MCL & semimembranosus muscle/tendon

Question 14

lateral meniscus

Answer 14

attached to PCL & popliteus muscle

Question 15

how are meniscus attached to each other?

Answer 15

menisci attached to each other ANTERIORLY by TRANSVERSE ligament of knee, & to margins of head of tibia by coronary ligaments

Question 16

BURSAE

Answer 16

suprapatellar, superficial & deep infrapatellar, prepatellar, popliteal & semimembranosus

4 additional bursae related to: tendon of insertion of biceps femoris, tendons on insertion of sartorius, gracilis & semitendinosus, origins of lateral & medial heads of gastrocnemius

Question 17

4 main bursa

Answer 17

suprapetella
prepatella
infrapatella
semimembranosus

Question 18

tibiofemoral (knee) joint - loose packed position

Answer 18

25º flexion

Question 19

tibiofemoral (knee) joint - close packed position

Answer 19

full extension, lateral rotation of tibia

Question 20

tibiofemoral (knee) joint - capsular pattern of restriction

Answer 20

flexion first, then extension

Question 21

NORMAL end feel

Answer 21

flexion: soft tissue or bony approximation

extension: elastic/firm, tissue stretch

Question 22

ABNORMAL end feel

Answer 22

boggy: joint effusion, ligamentous pathology

springy block: loose body (displaced meniscus)

Question 23

tibiofemoral (knee) joint - ROM

Answer 23

Flexion: 0-135º
Extension: 0-15º
Internal Rotation: 20-30º
External Rotation: 30-40º

Question 24

flexion & extension - roll & slide

Answer 24

FLEX: roll = POSTERIOR, slide = POSTERIOR
EXT: roll = ANTERIOR, slide = ANTERIOR

Question 25

open kinetic chain (kicking a ball)

Answer 25

-flexion: concave tibial plateau rolls & glides posterior on convex femoral condyles -extension: concave tibial plateau rolls & glides anterior on convex femoral condyles

Question 26

closed kinetic chain (squat)

Answer 26

-flexion: femoral condyles roll & glide posterior on tibial plateau (squatting) -extension: femoral condyles roll & glide anterior on tibial plateau (moving from squatting to standing)

Question 27

genu valgum

Answer 27

Q angle greater than 22° in women & 18° in men = “knocked knees”

Question 28

genu varum

Answer 28

Q angle less than 0°, distal tibia points medially = “bow legs”

Question 29

genu recurvatum

Answer 29

hyperextension of knee

Question 30

patellofemoral joint - location

Answer 30

small bone in front of knee, embedded in quadriceps (thigh muscle) tendon called a sesamoid bone

Question 31

patellofemoral joint - function

Answer 31

acts to increase the biomechanical leverage of quadriceps muscle

Question 32

patella slides in groove of femur as the knee...

Answer 32

flexes & extends

Question 33

patella 'floats' within substance of quadriceps...

Answer 33

tracking of this bone in femoral groove is dependent on proper mm balance to maintain a central position

Question 34

patellofemoral joint - type & mvoements

Answer 34

synovial, plane, diarthrosis, triaxial superior/inferior glide, medial/lateral glide, tilt, rotation

Question 35

patellofemoral joint - articular surfaces

Answer 35

concave posterior surface of patella convex trochlear surface of distal anterior femur

Question 36

patellofemoral joint - ligaments

Answer 36

patellar ligament (tendon) medial & lateral patellofemoral ligament

Question 37

patellofemoral joint - loose packed position

Answer 37

full extension

Question 38

patellofemoral joint - close packed position

Answer 38

full flexion

Question 39

patellofemoral joint - capsular pattern of restriction

Answer 39

flexion first, then extension

Question 40

proximal/ superior tibiofibular joint - type & movements

Answer 40

synovial, plane, diarthrosis, uniaxial gliding

Question 41

proximal/ superior tibiofibular joint - articular surfaces

Answer 41

articular facet on fibular head facet on lateral tibial condyle

Question 42

proximal/ superior tibiofibular joint - ligaments

Answer 42

fibrous capsule, anterior & posterior superior tibiofibular, lateral collateral, upper interosseous membrane

Question 43

mid-tibiofibular joint - type & movements

Answer 43

fibrous, (interosseous) syndesmosis, amphiarthrotic, uniaxial slight

Question 44

mid-tibiofibular joint - articular surfaces

Answer 44

interosseous membrane connecting shafts of tibia & fibula

Question 45

mid-tibiofibular joint - ligaments

Answer 45

interosseous membrane

Question 46

distal/ inferior tibiofibular joint - type & movements

Answer 46

fibrous, syndesmosis, amphiarthrosis, uniaxial gliding

Question 47

distal/ inferior tibiofibular joint - articular surfaces

Answer 47

articular area on inferior end of fibula facet on inferior end of tibia

Question 48

distal/ inferior tibiofibular joint - ligaments

Answer 48

interosseous membrane (lower), anterior & posterior inferior tibiofibular ligaments

Question 49

distal/ inferior tibiofibular joint - movement: 1-2mm during dorsiflexion at ankle joint

Answer 49

dorsiflexion causes fibula to move superiorly, which also causes proximal/superior tibiofibular joint to be stressed

Question 50

screw home mechanism

Answer 50

= key element to knee stability for standing upright -during knee extension, tibia glides anteriorly on femur & PCL elongates -during last 20º of knee extension, anterior tibial glide persists on tibia medial condyle (articular surface longer) prolonged anterior glide on medial side produces EXTERNAL tibial rotation ("screw-home" mechanism) *reverses during knee flexion

Question 51

gait cycle

Answer 51

tibia internally rotates during swing phase (knee flexion) tibia externally rotates during stance phase (knee extension)