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Orthopedic Diagnosis > The Knee Complex > Flashcards

The Knee Complex Flashcards

(69 cards)

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1
Q

The knee joint is made up of:

A

three articulating surfaces, forming two distinct joints contained within a single joint capsule

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2
Q

which joints make up the knee joint

A

patellofemoral and tibiofemoral

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3
Q

Two types of swelling seen in the knee

A

localized (bursal)

generalized (intra-articular or synovitis)

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4
Q

genu recurvatum

A

hyperextension of the knee

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5
Q

The incidence of hyperextension is higher among?

A

females and individuals with longer/lax ligaments

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6
Q

Tibiofemoral joint

A

distal end of the femur and proximal end of the tibia

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7
Q

What type of joint is the tibiofemoral joint?

A

ginglymoid or modified hinge

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8
Q

knee joint stability is dependent on:

A

static restraints of the joint capsule, ligaments, and menisci and the dynamic restraints of the quadriceps, hamstrings, and gastrocnemius

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9
Q

Femoral condyles

A

project posterior from the femoral shaft

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10
Q

Medial femoral condyle

A

elliptical shaped

faces inward

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11
Q

lateral femoral condyle

A

smaller, ball shaped, faces inward

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12
Q

the medial femoral condyle is

A

the insertions for adductor magnus and MCL

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13
Q

the lateral femoral condyle is

A

the origin for the lateral head of the gastrocnemius and LCL

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14
Q

patellofemoral joint

A

a complex articulation, dependent on both dynamic and static restraints for its function and stability

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15
Q

The quadriceps Angle

A

aka the q angle
formed by the bisection of two lines
one from ASIS to center of patella and the other drawn from the center of the patella to the tibial tubercle

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16
Q

Common ranges of the Q angle

A

8-14 in males and 15-17 in females

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17
Q

A q angle greater than what is considered abnormal?

A

angles greater than 20

may be indicative of potential displacement of the patella

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18
Q

Increased Q angle leads to what sign?

A

bayonet sign

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19
Q

patella baja

A

a lower posture of the patella

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20
Q

patella alta

A

a higher posture of the patella

makes the patella less efficient in exerting normal forces

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21
Q

Knee joint capsule

A

composed of a thin, strong fibrous membrane

largest synovial capsule in the body

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22
Q

the synovial mambrane excludes

A

the cruciate ligaments from the interior portion of the knee joint, making them extrasynovial yet intra-articular

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23
Q

Proximal tibiofibular joint

A

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

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24
Q

Osgood-Schlatter’s syndrome

A

Partial disruption at the patellar ligament- tuberosity attachment creating localized inflammatory changes

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25
predisposing factors to Osgood-schlatters
tight hamstrings, tight heel cord, and tight quadriceps
26
Who is osgood-schlatters commonly seen in
males more than females, ages 10-15
27
the static stability of the knee joint complex depends on
anterior cruciate ligament posterior cruciate ligament medial collateral ligament lateral collateral ligament
28
What ligament restrains anterior translation
ACL
29
What ligament restrains posterior translation
PCL
30
What ligament restrains valgas rotation
MCL
31
What ligament restrains varus rotation
LCL
32
What ligament restrains lateral rotation
MCL, LCL
33
What ligament restrains medial rotation
ACL, PCL
34
Cruciate Ligaments
intra-articular, extra-synovial | different from those of other joints in that they restrict normal motion rather then restrict abnormal motion
35
Which is one of the most important ligaments in knee stability?
ACL
36
ACL
serve as a primary restraint to anterior translation of the tibia relative to the femus and secondary restraint to both internal and external rotation in the non weight bearing knee
37
Most common MOI in an ACL tear
sudden deceleration with an abrupt change of direction/speed and a fixed foot (closed kinetic chain)
38
PCL
provides 90-95% of total restraint to posterior translation of the tibia on the femur
39
After the PCL, what provides restraint to posterior translation of the tibia on the femur?
the collateral ligaments, posterior portion of the joint capsule, and popliteus tendon
40
Common MOI in a PCL tear
excessive hyperflexion | hyperextension
41
Dashboard injury
with the knee in 90 degrees of flexion can drive the tibia posterior and cause a PCL tear
42
MCL
anterior fibers are taut in flexion, broad and fan shaped | posterior fibers are taut in extension and blend with the capsule
43
LCL
main function is to resist varus forces
44
Where does the LCL provide a majority of varus restraint?
at 25 degrees knee flexion and full extension
45
Secondary collateral restraints
hamstrings and quadriceps | patellar ligament, oblique popliteal ligaments, and the fabella
46
Medial meniscus
semi-lunar | larger and thicker than lateral meniscus
47
Lateral Meniscus
o-shaped sits atop the convex lateral tibial plateau attached by coronary ligaments more mobile than medial meniscus two meniscofemoral ligaments attach to the lateral meniscus
48
Functions of the Menisci
load transmission, shock absorption, joint lubrication, joint stability, and the guiding of movements
49
A meniscectomy can reduce the shock-absorbing capacity of the knee by
up to 20%
50
Triad of O'Donoghue
Rupture of ACL, MCL and medial meniscus | aka terrible triad
51
Housemaid's Knee
aka prepatellar bursitis | subcutaneous swelling over the lower half of the patella and upper half of the patellar ligament
52
MOI of housemaid's knee
overuse, as with frequent kneeling | direct blow to the area
53
Clergyman's knee
aka infrapatellar bursitis | swelling on both sides of the patellar ligament
54
MOI of clergyman's knee
repeated trauma to the region of the tibial tuberosity
55
Superior lateral border of the popliteal fossa
biceps femoris tendon
56
Superior medial border of the popliteal fossa
semitendinosus and semimembranosus tendons
57
inferior borders of the popliteal fossa
two heads of gastrocnemius
58
Contents of the popliteal fossa
posterior tibial nerve, popliteal artery and nerve
59
Baker's cyst
escaped synovial fluid in an enclosed membrane sac which is protruding through the joint capsule of the knee
60
What is baker's cyst associated with?
RA
61
Plica
represents a remnant of three separate cavities on the synovial mesenchyme of the developing knee
62
Retinacula
formed from structures in the first and second layers of the knee joint can be subdivided into medial and lateral
63
Major muscles that act on the knee joint complex
quadriceps, hamstrings, gastrocnemius, popliteus, and the hip adductors
64
Extension lag
the arc of flexion and extension should be smooth, pt may be unable to extend the knee through the last 10 degrees and may only finish with great effort
65
extension lag occurs with
quadriceps weakness
66
Helfet's helix
the knee cannot fully extend without some amount of external tibial rotation on the femur because of the physical configuration of the knee joint and its cruciate ligaments
67
the final locked knee extension allows
the patient to maintain knee extension for prolonged periods of standing without relying on muscles
68
Major blood supply to the knee comes from
femoral, popliteal, and genicular arteries
69
pain can be referred to the knee from
L3 through S2 nerve roots

Orthopedic Diagnosis (10 decks)

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