CATA: Knee Flashcards by President OATA

Which meniscus helps knee stability while knee is flexed to 90 degrees?

medial

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Outer menisci zone

Red-Red zone (best blood supply)

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ACL stabilizes tibia against which movements?

IR + Hyper extension +ant translation *Secondary for Vargas and valgus
stress

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PCL tantalizes tibia against which movements

IR + Hyperextension + ant translation

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MCL prevents excessive what?

valgus + ER

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MCL tears almost always tear the?

ACL

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LCL taut during? and relaxed during?

Extension, Flexion

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Gerdy’s tubercle =

Lateral tib tub

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IT band becomes tense during:

Flexion + Extension

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.Primary purpose of? is to attach medial meniscus to femur

Deep medial capsular ligament

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Screw home mechanism

As knee extends, tibia externally rotates (rotation due to the medial
femoral condyle being larger) *must occur for full

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First 15 degrees of extension

tibia externally rotates and the ACL Unwinds

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Blood + fluid NOT usually apparent until after 24-hour period in what injury?

1st time knee sprain

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Pain going up stairs may indicate:

Patella irritation + menisci tear

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Genu Valgum Aka? Associated w/?

(Knock Knees) -associated w/pronated feet, tension on medial ligs +
compression on lateral ligs + tight IT band + weak external rotators

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Genu varum aka associated w/?

Bowlegs Associated w/ hyperextended knees *rare in young patients

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Genu recurvatum Compensation for?

(hyperextended knees)
Compensation for lordosis+ swayback + weakness and stretching of
hamstrings

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Normal angulation of femoral neck Anteversion? Retroversion?

8-15 degrees
Increase in angle
Decrease in angle

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General rule of tibial torsion

General rule - IR + ER should equal 100 degrees
*IR greater than 70 degrees
Possible hip anteversion

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Hemarthrosis

Blood in joint

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Swelling from bursitis, tendinitis, or injury to one of the collaterals ligs tends to
localize over the injured structure and then gradually migrates downward toward
the foot and ankle b/c of?

Gravity

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Why is the MCL also tested at 30 degrees of knee flexion?

It is isolated at 30 degrees

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Appleby’s distraction test results

Pain would only occur is LIGAMENTS are torn NOT meniscus (appley compression)

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Why is Lachman’s test good to do immediately after injury?

it does not force knee into painful 90-degree range since it is 20-30
degrees of flexion

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Jerk test

reverse pivot shift test

Positive pivot shift test? indicates what?

Clunk - determines anterolateral rotary instability

Normal Q -angles (male/female) Abnormal?

Female-15 , Male-10 | Abnormal = 20+

A-angle measures what? abnormal angle?

Measures patellar orientation to the tibial tubercle 35 degrees +

Football players should have % quad strength?

66-70%

LCL resists what range?

Varus + IR

LCL injury can also damage what?

Peroneal nerve

ACL sprains occur mostly due to what type of mechanism?

non-contact. Athlete decelerating from a jump or forward running- foot contacts ground w/heel or in a flat-foot position, w/little plantar flexion

Trendelenburg sign increases chance of what Injury?

ACL

Athlete decelerating and changing directions w/foot planted, kneed abducted and contact from lateral posterior position into valgus causes what injury?

ACL

Major strength factors for ACL prevention

Strong quad activation during eccentric contraction

Dashboard injury =

PCL injury

PCL injury mechanism

Knee flexed at 90 degrees- a fall w/weight on anterior aspect of the bent knee w/ foot plantar flexed

Focus for PCL injury rehab

quad strength

Which meniscus has higher incidence of injury?

Medial

Meniscus bucket handle tear

Stretching the anterior and posterior horns of the meniscus (Vertical longitudinal)

Parrot beak tear

(Oblique tear) inner lateral meniscus tear from forceful knee extension w/ femur externally rotated

Meniscus zone very unlikely to heal

White-white zone

Knee plica 2 most common

Fetus has 3 synovial knee cavities, normally gradually absorbed to form 1 chamber but 20% of body's, fail to absorb these (plica) *most common is infrapatellar and 2nd is the suprapatellar

Surgery required is knee plica is causing?

Chondromalacia

Snap heard as knee passes 15-20 degrees flexion is major indication of what?

Knee plica *NOT meniscus

Osteochondral knee fractures? Can lead to?

rotation/direct trauma compressing cartilage b/w med/lat femoral condyles causing bone fracture -Can lead to development of osteoarthritis *If fracture fragment is still attached to bone, knee can be casted if not it must be reattached within 10 days of injury or removed arthroscopically

No activity for how many hours after joint contusion. What can happen if not resolved within a week?

24 hours a chronic condition of either synovitis or bursitis may exist, indicating need for rest or medical attention

Swelling in popliteal fossa may indicate a?

baker's Cyst- associated with semimembranosus bursa and occurs under medial head of gastrocnemius

Bipartite patella What is this confused with?

Patella with 2 portions in 3% of pop *Often misdiagnosed by patella fracture

Patellar Subluxation or dislocation creates injury to what structures?

ACL + PCL and or P/ACL

3 stages of chondromalacia patella

Stage 1: swelling and softening of articular cartilage Stage 2: fissuring of the softened articular cartilage Stage 3: deformation of the surface of the articular cartilage caused by fragmentation

LAST resort to rehab for chondromalacia patella

patella removal

Where does degenerative arthritis 1st occur in a case of chondromalacia patella?

1st occurs in deeper portions of the cartilage

Patellofemoral pain syndrome patients have apprehension when patella is forced in what direction?

Laterally

Key muscles to strengthen for PFPS

VMO + VL + hams + gastro

Osgood vs Sinding

Osgood- tib tub attachment | Sinding- inf pole patella

Rehab for Osgood and Sinding

Strengthening of quad and hams

Patella tendonitis (jumpers knee) 3 stages

Stage 1 -pain after activity Stage 2- Pain during and after activity Stage 3 - Pain during activity and prolonged after activity

Contraction of quads necessary for deceleration of lower leg during running

Eccentric

Types of muscular strengthening progression

Isometric → isotonic (eccentric +concentric) → isokinetic → plyometric

Hamstrings must contract what to decelerate lower leg in kicking motion

Eccentrically

Runners knee

general expression for repetitive overuse conditions | *often attributed to malalignments

Pes Anserinus Tendinitis or Bursitis is caused by?

Inflammation where sartorius gracilize and semitendinosus join to the tibia results from excessive genu valgum and weakness of VMO

IT band friction syndrome: what type of athletes? What causes this?

Runners and cyclist’s w/genu varum (bow legs) and pronated feet. Irritation develops at the band's insertion

In patella tendon rupture, the tendon normally moves in what direction?

Upward towards thigh

ER and IR both controlled by?

ER- biceps femoris | IR- semimem/tend + sartorious + popliteal + gracilis

Muscles they supply above knee: Sciatic Nerve, Tibial Nerve, Femoral nerve

Sciatic Nerve - Biceps femoris Tibial Nerve - Semimem/tend + pop + gastro Femoral nerve -Anterior muscles

What happens during the last 20 degrees of knee extension?

Rotation