the knee Flashcards

1
Q

what makes up the patellofemoral joint

A

distal femur and posterior patella

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2
Q

what is the honorable mention of th knee

A

proximal tibiofemoral joint

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3
Q

the tibiofemoral joint is joined anteriorly by the ____ ____

A

patellar groove

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4
Q

on the tibia there is a ____ degree posterior slop of the plateau

A

7-10

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5
Q

is the distal femur concave or convex

A

convex

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6
Q

genu valgum causes ___ forces on the laterla aspect of the tibiofemoral joint and ___ focrces on the medial aspect

A

compressive
tensile

(tensile on medial , compressive on lateral)

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7
Q

genu varum casues tensile forces in the ___ aspect of the tibiofemoral joint

A

lateral

compressive on medial and tensile on lateral

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8
Q

in genu valgum the weight bearing line passes ___ and for genu varum the weight bearing line passes ___

A

lateral
medial

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9
Q

what are the functions for the meniscus

A

• Improve congruence
• Transmit/distribute weightbearing loads (50-70%) • Reduce tibiofemoral friction
• Provide shock absorption
• Enhance joint stability

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10
Q

what shape is the medial and lateral meniscus

A

medial is C shaped
lateral is 4/5 of a circle

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11
Q

which ligament connects the menisci anteriorly

A

transverse

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12
Q

which meniscus is more restricted

A

medial

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13
Q

what firmly attaches medial mencius to the joint capsule

A

MCL

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14
Q

what attaches to the anterior horn of the medial meniscus

A

ACL

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15
Q

what attaches to the posteior horn of the meniscus

A

PCL

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16
Q

the medial meniscus is an attache sight for which mm

A

semimem

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17
Q

the anterior horn of the laterla mencius and ACL Share the ___ insertion site

A

tibial

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18
Q

which mencius attached to PCL thru meniscofemroal ligament

A

lateral

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19
Q

the lateral meniscus is an attached sit for which mm

A

popliteus

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20
Q

the horns are well vasucalized T./F

A

true

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21
Q

the bony congruence and ligaments tautness are maximal in full ___

A

extension (closed packed position)

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22
Q

the anterior border of the joint capsule of the knee consist of what four things

A

quad tendon
patella
patellar tendon
extensor mechanism

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23
Q

the synovial layer in the knee is extensive for ____ and ____

A

lubrication and nutrition

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24
Q

what 2 ligaments of the knee are intracapsular but extra synovial

A

ACL AND PCL

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25
Q

what are synovial plica

A

folds of synovial membrane

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26
Q

what is the thicket band in the medial reinaculum

A

medial patellofemoral ligament

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27
Q

varus stress on the knee causes ___ of tibia
valgus stresses on the knee casues ___ of the tibia.

A

add
abd

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28
Q

the MCL of the knee connects to the ___ femoral condyle to the ___ tibia

A

medial
proximal

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29
Q

the MCL is the primary restraint to excessive ___ and ___ tibia rotation

A

valgus
lateral

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30
Q

the MCL is ___ in hypertension but plays a key role in ___ as well

A

taut
flexion

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31
Q

what is the secondary role of the MCL

A

resist anterior translation of tibia on femur

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32
Q

the LCL attaches from the ___ femoral epicondyle to the ___ head

A

lateral
fibular

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33
Q

what MM does the LCL joint with

A

BF

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34
Q

what ligaments is Primary restraint for varus stress and limits excessive lateral rotation

A

LCL

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35
Q

the LCL also helps to prevent ______ rotators instability

A

posterolateral

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36
Q

the LCL is __- in full extension but also effective in ___

A

taut
flexion

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37
Q

the ACL extends ___ , ___ and ____

A

inferiorly, medially, and anteriorly

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38
Q

what Attaches to lateral and anterior aspect of medial intercondylar tibial spine

A

ACL

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39
Q

what is located on the Posteromedial aspect of lateral femoral condyle

A

ACL

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40
Q

how many bundles does the ACL have

A

2 (Anteromedial bundle (AMB) and posterolateral bundle (PLB))

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41
Q

the ACL is primary restraint against ___ translation of the tibia on femur

A

anterior

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42
Q

what bundle of the=he ACL becomes taut in extension and which becomes taut in > 15° of knee flexion

A

PLB
AMB

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43
Q

what is Also responsible for resisting hyperextension (PLB) and rotatory instability of the knee

A

ACL

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44
Q

when do most ACL injuries occur

A

when the knee is slightly flexion and in a valgus position combined with anterior tibial translation

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45
Q

what are Muscles that act to translate tibia anteriorly relative to the femur

A

quad and gastroc

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46
Q

what are Muscles that act to translate tibia posteriorly on the femur

A

hamstrings and soleus

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47
Q

Co-contraction of hamstrings and quadriceps allow the hamstrings to counter the ___ translation imposed by the ____

A

anterior

quadriceps

48
Q

___ can resist anterior translation of tibia if foot is on the ground

A

Soleus

49
Q

what is located on the Anterolateral aspect of medial femoral condyle to posterior tibial surface between posterior horns of two menisci

A

PCL

50
Q

is the pcl or acl bigger

A

pcl

51
Q

what band of the PCL is taut near full extension and which is taut at 80-90 of knee flexion

A

posterior medial bundle
ALB

52
Q

the PCL Resists ___ tibial displacement

A

posterior

53
Q

____ and quad shares role of PCL; ____ and gastroc increase posterior shear

A

Popliteus

hamstring

54
Q

which ligament is a tendinous expansion of semimembranosus

A

oblique popliteal lig

55
Q

which lig of the posterior capsule is taut in EXT; resists varus/valgus

A

posteior oblique lig

56
Q

which ligaments of the post capsule taut in EXT; resist varus/valgus and rotation

A

arcuate lig

57
Q

what is PLRI

A

interruption/damage to LCL, popliteus, arcuate and popliteofibular ligament

58
Q

what is Extension of fascia covering the tensor fascia latae (TFL) and gluteus maximus muscles

A

ITB

59
Q

where is the primary attachenment of ITB

A

Gerdy’s tubercle + distal femur/lateral border of patella

60
Q

the ITB Increases ____ stability

A

lateral

61
Q

the ITB is Traditionally believed to “____” over lateral femoral condyle during
knee FLX/EXT

A

roll

62
Q

during closed chain flexion of the knee joint the femur rolls ____ and glides ___

A

posteriorly
anteriorly

63
Q

for closed chain extension at the knee joint the femur rolls____ and glides ____

A

anteriorly
posteriorly

64
Q

during open chain flexion at the knee joint the tibia rolls and glides ____

A

posteriorly

65
Q

during open chain extension at the knee joint the tibia rolls and glides ____

A

anteriorly

66
Q

when the femur moves on the knee it is ___ on ____

A

convex femur on concave knee

67
Q

when the tibia moves on the knee during open chain it is ___ on ____

A

concave on convex

68
Q

how much knee flex does walking require

A

60-70°

69
Q

how much knee flexion does stairs need

A

80°

70
Q

how much knee flexion do u need to sit to stand

A

> 90°

71
Q

knee extension may be limited to fixed ankle ___ or tightness of___

A

DF
PF

72
Q

tightness of PF may also present with genu ___ at the knee in standing

A

recurvatum

73
Q

in probe knee flexion may be limited by passive insufficiency of ___ ____

A

rectus femoris

74
Q

close chain knee flexion casues which ligament to become taut
closed chain knee extension causes which ligament to become taut

A

ACL
PCL

75
Q

menisci shape and deformation help steer roll and slide, there will be a ___ deformation with flexion and a ____ deformation with extension.

A

posteior
anterior

76
Q

there is More motion of the ____ tibia/femur than ____

A

lateral

medial

77
Q

medial rotation (tibia on femur)→ deformation of MED meniscus ____ and LAT meniscus ____

A

posteriorly

anteriorly

78
Q

in 90° of flexion at the knee how much IR and ER is there

A

IR - 15
ER- 20

79
Q

what is loose and closed packed position of the knee

A

loose - 30° of knee flexion
closed- full extension

80
Q

Terminal knee extension is accompanied by ____ rotation (open chain) of the tibia

A

lateral

81
Q

Flexion from full extension requires unlocking – ___ rotation of tibia (open chain) or ____ rotation of femur (closed chain)

A

medial

lateral

82
Q

Flexion from full extension requires unlocking – medial rotation of tibia (open chain) or lateral rotation of femur (closed chain)… what mm does this

A

popliteus

83
Q

___ and _____ can assist knee EXT in weightbearing

A

Soleus

Glute Max

84
Q

In full EXT, line of gravity passes ____ to knee axis creating ____ moment

A

anterior

extension

85
Q

In squat, gravity pulls into knee FLX and ___ eccentrically control flexion

A

quads

86
Q

Quads are typically twice as strong as ____

A

hamstrings

87
Q

in Open chain (NWB) quads must generate more torque (and more force) as the knee approaches
full ____q

A

extension

88
Q

in Closed chain (WB) the quads generate more force as the knee _____ to control the increasing
moment arm (and torque)

A

flexes

89
Q

Open Chain: MA of resistance increases as knee extends, greater quad force is required as extension progresses; produces ____ tibial shear especially at 10-20 deg

A

anterior

90
Q

Closed Chain: MA of resistance is minimal in full extension and increases with squat; squats and leg press result in ____ tibial shear especially at 85-105 deg

A

posterior

91
Q

what 5 things limit anterior tibial translation

A

ACL,
ITB,
hamstrings,
soleus,
Glute Max

92
Q

what 5 things limit posterior tibial translation

A

PCL
MFL
quads
pop
gastroc

93
Q

the MCL, ACL, PCL, arcuate, POL, medial muscles, pes anserinus muscles all limit kne ___

A

valgus

94
Q

the LCL, ITB, ACL, PCL, arcuate, POL, lateral muscles all limit ____

A

varus

95
Q

ACL, PCL, PM Capsule, MFL, BF all limit ___ rotation of the tibia

A

medial

96
Q

PL Capsule, MCL, LCL, medial muscle all limits ___ rotation of the tibia

A

lateral

97
Q

what is the patella attached to

A

quad and patellar tendon

98
Q

is the patella congruent or incongruent

A

incon

99
Q

in an extended knee the patella sits on the ___ ___

A

femorla sulucs

100
Q

Patella translates and rotates on ____ condyles

A

femoral

101
Q

when the knee flexion there is an ____ glide on the patella and ___ slide during extension

A

inferior
superior

102
Q

are the compression forces of the patellofemoral joint larger in extension or flexion

A

flexion

103
Q

when is open/loose pack for the patello femoral joint

A

when the knee joint is in closed packed

104
Q

Physiologic valgus of femur/tibia causes patella to be pulled slightly ___ by quad and patellar tendon forces

A

laterally

105
Q

what are the longitudinal stabilizes of the patellofemoral joint

A

Patellar tendon inferior and quad tendon superior

106
Q

at the patellofemoral shaft if there Excessive extension (genu recurvatum) will increase the potential for frontal plane ___

A

instability

107
Q

the Superficial extensor retinaculum from vastus medialis and lateralis are ___ stabilizers of the patellofemorall joint

A

transverse

108
Q

• Weak VMO
• Tight ITB/TFL
• Genu Valgum
• Femoral anteversion
• Lateral tibial torsion
• Foot pronation
• Stretched medial structures

all of these are from ___ patellar forces

A

lateral

109
Q

an increased Q angle will present with genu ___

A

valgum

110
Q

what is the normal Q angle

A

10-15

111
Q

May need to avoid last 30 deg of extension in non-weight bearing exercises for what type of pain

A

patellofemoral pain

112
Q

Plica irritation is from what

A

sitting, stairs, extension exercise

113
Q

Meniscal injuries from what

A

rotation on a fixed tibia; microtrauma

114
Q

Ligament tears from what

A

excessive high forces or low level repetitive stresses

115
Q

Bone and cartilage damage:

A

high load or fall

116
Q

Bursa and tendon from what

A

direct blow or repetition

117
Q

what is chondromalacia

A

cartilage changes