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1 - PBS2 > 76 - Knee Joint > Flashcards

76 - Knee Joint Flashcards

1
Q

Joints within knee joint capsule

A

Femur with tibia (tibiofemoral)

Femur with patella (patellofemoral)

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2
Q

Type of joint that knee joint is

A

Modified hinge joint (rotation occurs during flexion)

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3
Q

When is knee most stable?

A

In extension.

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4
Q

Relative sizes of tibial and femoral condyles

A

Medial condyles are longer than lateral, in antero-posterior direction.

Medial femoral condyle also extends further medially (upwards)

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5
Q

Part of knee that bears the most weight

A

Medial femoral condyle

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6
Q

Name for lateral displacement of bones of the leg, relative to tibia

A

Genu valgum (knock-kneed)

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7
Q

Name for medial displacement of bones of the leg, relative to tibia

A

genu varum (bow-legged)

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8
Q

Inter-condylar notch contents

A

Anterior cruciate ligament

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9
Q

Articular surfaces on tibial plateau

A

Almost flat, two articular surfaces.

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10
Q

Two groups of structures attaching to the tibial plateau

A 
Anterior and posterior cruciate ligaments 
Meniscal attachments (four of these, lateral and medial)
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11
Q

What attaches to the meniscal attachments of the tibial plateau?

A

Medial and lateral menisces of the tibial

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12
Q

Arrangement of attachments of horns of medial and lateral menisci to tibial plateau

A

Medial attach far apart.

Lateral attach close together

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13
Q

Supports of knee joint

1-4

A

1) Capsule reinforced by muscle
2) Cruciate ligaments (anterior, posterior)
3) Collateral ligaments (medial, lateral)
4) Menisci (medial, lateral)

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14
Q

When is the knee most susceptible to injury?

A

When flexed

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15
Q

Attachment of capsult of knee joint

A

Around articular margins

Incorporates patellofemoral joint and intracapsular structures (EG anterior, posterior cruciate ligaments, menisci)

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16
Q

Location of synovial membrane, relative to cruciate ligaments.

A

Cruciate ligaments develop posterior to knee, push into space between articular surfaces during development, pushing synovial membrane away.

Cruciate ligaments are extrasynovial

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17
Q

Are menisci intra- or extra-synovial?

A

Intrasynovial, but not lined by synovial membrane

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18
Q 
Capsular reinforcements of the knee joint 
1
2
3
4
A

Anteriorly - patellar tendon + retinacular fibres

Lateral - popliteus, biceps femoris, iliotibial tract

Medial – ‘pes anserinus’ tendons

Posterior – (oblique popliteal ligament - from semimembranosus muscle)

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19
Q

Muscle reinforcing knee laterally

A

Popliteus muscle

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20
Q

Pes anserinus

A

‘Goose’s foot’
Muscle insertions reinforcing medial knee joint
Sartorius, gracilis, bursa, semitendinous muscles

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21
Q

Attachments of PCL

A

Attaches to posterior tibia, attaches to medial femur

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22
Q

Attachments of ACL

A

Attaches to anterior tibia, passes to lateral femur

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23
Q

Ligament that can compensate for a weaker PCL

A

Meniscofemoral ligament

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24
Q

Primary role of ACL

A

Prevents tibia being displaced anteriorly, relative to femur

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25
When is ACL taut?
In extension, but also full flexion
26
Composition of ACL
Two fibres: anteromedial and posterolateral
27
Other role of ACL
Tightens in last 15-20 degrees of extension, acts as an axis for rotation (allows medial rotation on weight-bearing tibia).
28
When does ACL injury occur?
Rotation in lateral direction of weight-bearing knee
29
Sites for taking tendons for allografts for ACL injuries
Patellar tendon, pes anserinus
30
Thickness of PCL
About 2x as thick as ACL
31
What reinforces PCL?
Meniscofemoral rings
32
Primary role of PCL
Limits posterior displacement of tibia in knee flexion
33
When is PCL prone to injury?
Falling on flexed knee. | Bumper bar impact (being reversed into by a car)
34
Muscle required for unlocking of knee joint (from extension)
Popliteus muscle needs to contract
35
Role of popliteus
Rotates femur laterally on fixed tibia. | Unlocks knee joint (locking in extension)
36
Role of medial collateral ligament
Resists valgus (abduction) forces & lateral rotation of tibia - because of alignment (not vertical but A-P) limits anterior displacement of tibia when ACL damaged (2nd restraint)
37
Parts of medial collateral ligament 1 2 3
- long, flat superficial part - deep part blends with capsule & attaches to medial meniscus - taut in extension, slack in flexion
38
'Unhappy triad'
ACL, medial collateral ligament and medial meniscus often injured together
39
Lateral collateral ligament shape
Round cord.
40
Role of lateral collateral ligament
Resists adduction (varus) forces
41
How does lateral collateral ligament join knee?
Separated from lateral meniscus by popliteus tendon
42
Is the lateral or medial collateral ligament more-commonly injured?
Medial.
43
Roles of menisci 1 2 3
Shock absorb Weight distribution Separates joint into two cavities Increase articular surface by ~1/3
44
Movements of menisci
Move with femur in rotation
45
Location of menisci
Within synovial cavity, only bony attachments have covering.
46
Shape of menisci
Wedge-shaped
47
Meniscus which bears more weight
Lateral (covers more articular surface
48
Attachments of lateral meniscus
Attachment to PCL (via meniscofemoral ligaments), not lateral collateral ligament
49
When is the lateral meniscus in danger of compression?
``` Knee flexion (EG squatting). Can lead to posterior meniscal tears ```
50
Meniscal injury that is more common
Medial meniscal injury
51
Why is medial meniscus more likely to be injured? 1 2 3
It is longer Horns are further apart (so meniscus is less capable of moving than lateral) It is less mobile (because of attachment of deep fibres of medial collateral ligament)
52
Effect of meniscal injury
Can contribute to locked knee (can't fully extend)
53
Moderately common anomaly of the patella
Bipartite patella. | Benign
54
Largest bursa of the knee
Suprapatellar bursa. | About a hand's breadth above joint line of knee
55
Suprapatellar bursa
Communicates with knee joint cavity. Largest bursa of the knee. Projects superiorly to knee.
56
Relative sizes of femoral articular surfaces for patella
Lateral articular surface is larger than medial.
57
Gender in which patella is more likely to be dragged laterally
Females (because of greater angle between femur and tibia/fibula)
58
Structures maintaining normal alignment of patellofemoral joint 1 2 3
1) Strong vastus medialis muscle (active stabiliser) 2) Medial patellar retinaculum 3) Raised lip of lateral femoral condyle
59
Bursa of the knee that projects posteriorly
Popliteus or semimembranous bursa. | Commonly communicates with suprapatellar bursa (and therefore with joint cavity)
60
Effect of repeated flexion of knee on bursae
Can result in thickening of popliteus bursa, leading to 'Baker's cyst'.
61
Non-communicating bursae of knee 1 2 3
Prepatellar Superficial infrapatellar Deep infrapatellar All protect tendons of knee joint
62
Location of fat pad in knee
Infrapatellar fat pad lies external to synovial membrane. | Inferior to patella.
63
Patello-femoral joint
Within knee joint capsule. | Articulation between patella and patellar surface of the femur
64
Why should knees be mobilised quickly after injury and repair?
Vastus medialis stabilises patella, and is vulnerable to atrophy if kept immobile, which increases risk of patellar subluxation
65
Name for mechanical problem of tracking of patella in femoral groove
Chondromalacia patella (leads to degeneration of cartilage)

1 - PBS2 (96 decks)

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