Week 3 Knee 🦵🏻 Flashcards
O’Donoghue’s Unhappy Triad?
Rupture of MCL, ACL and damage to medial meniscus.
Palpate all boney areas on distal femur and cartilage on the skeleton / person (13)
Medial and lateral condyles and epicondyles, adductor tubercle, patella (trochlear) groove/surface, intercondylar fossa, medial and lateral supracondylar line, linea aspera, popliteal surface, lateral buttress wall, articular hyaline cartilage.
Palpate on skeleton or human all boney features on the proximal tibia (10)
Medial and lateral condyles (tibia has no epicondyles), tibial tuberosity, anterior border of tibia, tibial plateau, intercondylar eminences, pes anserine (anteromedial aspect of tibia), soleal line, articular facet of fibular head
What are the 3 boney parts of the patella? Also describe the inferior and superior aspect.
Most medial = odd, middle area = medial, and most lateral = lateral.
Most inferior aspect = apex, most superior aspect = base.
Fibular or peroneal nerve is located where and innervates what?
Posterior fibular head, winds antero-inferiorly around neck of fibular and splits into superficial fibular nerve: fibularis longus and brevis that evert the foot, and deep fibular nerve: tibialis anterior, extensor digitorum longus (extends four toes and dorsiflexion) and extensor hallucis longus (big toe extension, inversion). Damage can result in foot drop.
Patella is triangular shaped and what sort of bone? What is the joint called at the patella?
Sesamoid bone. Patello-femoral joint.
What kind of joint is the knee joint? Name the joint and degrees and freedom.
Synovial bicondylar modified hinge, articulating the femoral and tibial condyles and mensci connecting the two. Two degrees of freedom, flexion / extension and medial / lateral rotation.
Describe the femoral medial and lateral condyle shape?
Medial femoral condyle = projects more distally and is thinner. Lateral femoral condyle = outer stouter, shorter, wider and projects more anteriorly.
Describe the medial and lateral meniscus.
Semi lunar articulating fibro elastic cartilage. Peripheral / outer meniscus is vascular and thicker, and inner meniscus is avascular and thinner.
Medial (mediC) is C shaped, lateral (laterO) is O shaped. Medial meniscus is less rigid, more commonly damaged and blends with the joint capsule. Lateral meniscus is rigid, and no blending with the capsule.
The intracondylar spine separates the two menisci and is concave to receive convex femoral condyles. Both have an anterior (ventral) and posterior (dorsal) horn.
What is the function of the patella?
Acts as a pulley to improve mechanical efficiency of the quads by increasing the movement arm and increasing angular torque.
What is the Q Angle? Normal for men and women, and abnormal values?
The angle between the quadriceps (Q) and patella. The femur sits at an oblique angle. ASIS to central patella line, and central patella to tibial tuberosity.
Men = 13° Women = 18° Abnormal = <13° and >18°
More than 18° can predispose the patella to lateralisation.
What is alta / baja patella?
Patella sits too high / long patella tendon = patella alta
Patella sits too low / short patella tendon = patella baja
What soft tissues and boney landmarks maintain patella stability / position?
Vastus medialis, medial retinaculum,
Vastus lateralis, lateral retinaculum, lateral buttress wall, IT Band
Vastus lateralis and medialis ratio
Vastus intermedius and rectus femoris
Superior tibia-fibular joint - type and describe.
Synovial plane joint that can be palpated as you dorsiflex and plantarflex.
Articulating surfaces = head of fibular, lateral tibial condyle and knee joint capsule.
3 purposes of the menisci (fibro elastic cartilage)
1) Deepens tibial articular surface and therefore increases tibial femoral joint stability
2) Shock absorbers
3) Conforms to changing shape of femoral condyles during movement
