Conference 8: Knee Flashcards
1
Patella
2
Femoral condyles
3
Intercondylar fossa
4
Tibial condyles
5
Fibular head
6
Fibular neck
1
Patella
2
Tibial condyle
3
Tibial tuberosity
4
Femoral condyles
5
Fibular head
6
Fibular neck
What does swelling indicate?
Tissue damage/swelling in joint cavity
1
Patella
2
Patellar ligament
3
Tibial tuberosity
4
Joint interval
5
Femoral condyles
6
Tibial condyles
7
tibial (medial) collateral ligament
8
fibular (lateral) collateral ligament
9
fibular head
10
Fibular neck
11
Common fibular nerve (wraps around neck of fibula)
In physical exam of posterior aspect of knee, how would you locate the biceps femoris, semitendinosus and semimembranosus muscles?
Biceps femoris is posterolateral
Semimembranosus is posteromedial, and just lateral to that is the semitendonosus (which is more superficial and more palpable)
How would you position the lower limb to palpate the popliteal pulse?
Passive flexion at the knee, relax the popliteal fossa, hamstrings and gastrocnemius
Why is the popliteal pulse so hard to palpate?
The popliteal artery is the deepest of the neurovascular structures in the popliteal fossa
In what position is the knee most stable osteologically and why?
Extension
Because the area of contact between the femur and tibia is greatest in extension
In what position are the collateral ligaments of the knee most taut?
In full extension
What type of traumatic force would tend to tense and injure the tibial (medial) collateral ligament?
Leg abduction and or rotation
(MAB) - medial abduction
What type of traumatic force would tend to tense and injure the fibular (laterla) collateral ligament?
leg adduction and/or rotation
How would you test the integrity of the tibial collateral ligament?
attempt to abduct the leg
How would you test the integrity of the fibular (lateral) collateral ligament?
Attempt to adduct the leg.
What is the course of the anterior cruciate ligaments from its tibial attachment to its femoral attachment?
superior, posterior and lateral
What is the course of the posterior cruciate ligament from its tibial attachment to its femoral attachment?
superior, anterior and medial
How would you test the integrity of the ACL?
by attempting anterior displacement of the tibia relative to the femur
How would you test the integrity of the PCL?
by attempting posterior displacement of the tibia relative to the femur
Describe what is wrong
Supracondylar fracture of femur with posterior displacement of the distal fragment
What causes bone fragments to override in a femoral fracture?
Spasm of all muscles crossing the fracture site: hamstrings, quadriceps, sartorius and adductors
What would cause the distal fragment of the fractured femur to move posteriorly?
Spasm of the knee-flexing gastrocnemius muscle to stabilize the knee joint
(all muscles would be in spasm but this one has the biggest hold on the knee there)
What structure in the deepest part of the popliteal fossa could be lacerated or compressed by the sharp edges of the posteriorly displaced distal fragment?
Popliteal artery
What injury is suggested by the pain and “clicking” on knee motion ?
A torn meniscus
Why is the medial meniscus more prone to injury than the lateral meniscus?
The medial meniscus is less mobile because of its attachment to the medial collateral ligament
Why was the posterior horn of the medial meniscus injured?
1.The posterior horns of both the medial and lateral menisci are loaded in flexion
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2.With the knee in flexion, the forced medial rotation of the femur causes greatest loading of the posterior horn of the medial meniscus
