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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
Q

When is ACL taut?

A

In extension, but also full flexion

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26
Q

Composition of ACL

A

Two fibres: anteromedial and posterolateral

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27
Q

Other role of ACL

A

Tightens in last 15-20 degrees of extension, acts as an axis for rotation (allows medial rotation on weight-bearing tibia).

28
Q

When does ACL injury occur?

A

Rotation in lateral direction of weight-bearing knee

29
Q

Sites for taking tendons for allografts for ACL injuries

A

Patellar tendon, pes anserinus

30
Q

Thickness of PCL

A

About 2x as thick as ACL

31
Q

What reinforces PCL?

A

Meniscofemoral rings

32
Q

Primary role of PCL

A

Limits posterior displacement of tibia in knee flexion

33
Q

When is PCL prone to injury?

A

Falling on flexed knee.

Bumper bar impact (being reversed into by a car)

34
Q

Muscle required for unlocking of knee joint (from extension)

A

Popliteus muscle needs to contract

35
Q

Role of popliteus

A

Rotates femur laterally on fixed tibia.

Unlocks knee joint (locking in extension)

36
Q

Role of medial collateral ligament

A

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
Q

Parts of medial collateral ligament
1
2
3

A
  • long, flat superficial part
  • deep part blends with capsule & attaches to medial meniscus
  • taut in extension, slack in flexion
38
Q

‘Unhappy triad’

A

ACL, medial collateral ligament and medial meniscus often injured together

39
Q

Lateral collateral ligament shape

A

Round cord.

40
Q

Role of lateral collateral ligament

A

Resists adduction (varus) forces

41
Q

How does lateral collateral ligament join knee?

A

Separated from lateral meniscus by popliteus tendon

42
Q

Is the lateral or medial collateral ligament more-commonly injured?

A

Medial.

43
Q

Roles of menisci
1
2
3

A

Shock absorb
Weight distribution
Separates joint into two cavities
Increase articular surface by ~1/3

44
Q

Movements of menisci

A

Move with femur in rotation

45
Q

Location of menisci

A

Within synovial cavity, only bony attachments have covering.

46
Q

Shape of menisci

A

Wedge-shaped

47
Q

Meniscus which bears more weight

A

Lateral (covers more articular surface

48
Q

Attachments of lateral meniscus

A

Attachment to PCL (via meniscofemoral ligaments), not lateral collateral ligament

49
Q

When is the lateral meniscus in danger of compression?

A 
Knee flexion (EG squatting).
Can lead to posterior meniscal tears
50
Q

Meniscal injury that is more common

A

Medial meniscal injury

51
Q

Why is medial meniscus more likely to be injured?
1
2
3

A

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
Q

Effect of meniscal injury

A

Can contribute to locked knee (can’t fully extend)

53
Q

Moderately common anomaly of the patella

A

Bipartite patella.

Benign

54
Q

Largest bursa of the knee

A

Suprapatellar bursa.

About a hand’s breadth above joint line of knee

55
Q

Suprapatellar bursa

A

Communicates with knee joint cavity.
Largest bursa of the knee.
Projects superiorly to knee.

56
Q

Relative sizes of femoral articular surfaces for patella

A

Lateral articular surface is larger than medial.

57
Q

Gender in which patella is more likely to be dragged laterally

A

Females (because of greater angle between femur and tibia/fibula)

58
Q

Structures maintaining normal alignment of patellofemoral joint
1
2
3

A

1) Strong vastus medialis muscle (active stabiliser)
2) Medial patellar retinaculum
3) Raised lip of lateral femoral condyle

59
Q

Bursa of the knee that projects posteriorly

A

Popliteus or semimembranous bursa.

Commonly communicates with suprapatellar bursa (and therefore with joint cavity)

60
Q

Effect of repeated flexion of knee on bursae

A

Can result in thickening of popliteus bursa, leading to ‘Baker’s cyst’.

61
Q

Non-communicating bursae of knee
1
2
3

A

Prepatellar
Superficial infrapatellar
Deep infrapatellar

All protect tendons of knee joint

62
Q

Location of fat pad in knee

A

Infrapatellar fat pad lies external to synovial membrane.

Inferior to patella.

63
Q

Patello-femoral joint

A

Within knee joint capsule.

Articulation between patella and patellar surface of the femur

64
Q

Why should knees be mobilised quickly after injury and repair?

A

Vastus medialis stabilises patella, and is vulnerable to atrophy if kept immobile, which increases risk of patellar subluxation

65
Q

Name for mechanical problem of tracking of patella in femoral groove

A

Chondromalacia patella (leads to degeneration of cartilage)

1 - PBS2 (96 decks)

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