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Anatomy > Disorders Of The Knee > Flashcards

Disorders Of The Knee Flashcards

1
Q

What is the standard X-ray series for he knee

A

AP, lateral and patella axial (skyline)

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2
Q

In a femoral shaft fracture, how does the musculature act as a deforming force

A

Proximal fragment abducted due to pull of gluteal medius and minimus on the greater trochanter

Flexed due to the action of iliopsoas on the lesser trochanter

The distal fragment is addicted due to adductor Magnus and gracilus and extended due to gastrocnemius

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3
Q

What is the volume of blood loss in a closed femoral fracture

A

1000-1500ml

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4
Q

In a distal femoral fracture, which artery may be involved

A

Popliteal

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5
Q

Where do tibial plateau fractures occur

A

Articulating surface of the tibia within the knee joint.

Lateral condole most common

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6
Q

What is the usual mechanism of a tibial plateau fracture

A

Varus or valves anglation of the knee with loading

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7
Q

What are some common causes of a patellar fracture

A

Direct impact - knee against dashboard

Eccentric contraction of the quadriceps

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8
Q

Where does the most important blood supply to the patella come from

A

The inferior pole

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9
Q

If the fracture completely splits the patella distal to the insertion of the quadriceps, what with the patient to be able to do
?

A

Perform a straight leg raise

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10
Q

What is a bipartite patella

A

The patella is in two parts as there is a failure of union of a secondary ossification centre with the main body of the patella

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11
Q

What is the most common direction for a patella to dislocate

A

Laterally

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12
Q

What are the 5 factors that can pre-dispose to a patellar dislocation

A

1) generalised ligamentous laxity
2) weakness of the quadricepts esp VMO
3) shallow trochlear (patellofemoral) groove with a flat lateral lip
4) long patellar ligament
5) previous dislocation

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13
Q

How do meniscal injuries occur

A

Sudden twisting motion of a weight bearing knee in a high degree of flexion

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14
Q

In a meniscal injury, why is swelling a delayed symptom

A

Swelling due to a reactive effusion or not at all, as menisci are largely avascular

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15
Q

How does a patient with a meniscal injury present at examination

A

Joint line tenderness
Restricted motion due to pain or swelling
A mechanical block to motion or locking

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16
Q

What ligaments normally prevent excessive posterior motion of the tibia on the femur

A

Medial and lateral collateral ligaments

Posterior cruciate

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17
Q

What is varus angulation of the knee

A

Medial angulation of the distal segment

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18
Q

What is valgus angulation of the knee

A

Lateral angulation of the distal segment

L=Lateral

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19
Q

In acute valgus (lateral) strain, which ligament is at risk

A

Medial collateral ligament

20
Q

The medial collateral ligament is more commonly injured but it is the LCL that causes more knee instability, why?

A

Medial tibial plateau forms a deeper and more stable socket for the femoral condyle

21
Q

In a collateral ligament injury, when does the patient experience swelling

A

Immediately after the injury

22
Q

What is the unhappy triad AKA blown knee

A

Injury to the anterior cruciate ligament

Medial collateral ligament

Medial meniscus

23
Q

Why is the anterior cruciate ligament more commonly injured than the posterior

A

It is weaker

24
Q

How does a patient with an ACL injury present

A

Popping sensation
Immediate swelling
Instability of the knee, the tibia slides anteriorly under the femur

25
Q

A defect in the ACL can lead to what instability

A

Anterorlateral rotatory instability

The tibia rotates medially during flexion of th knee and opens up laterally

26
Q

What is the most common mechanism for a PCL injury

A

Dashboard injury
Knee flexed
Large force on upper tibia , displacing it posterially

27
Q

What test can detect A & P CL injuries

A

Anterior and posterior drawer tests

28
Q

What test can be used to detect an ACL injury

A

Lachmans test

29
Q

To dislocate a knee, how many ligaments must be ruptured

A

3/4

Mcl, lcl

Acl, pcl

30
Q

Which artery is proximal tethered to the patella and is implicated in a knee dislocation

A

Popliteal

31
Q

What is a knee effusion

A

An accumulation of fluid in the knee joint

32
Q

What does a haemoarthrosis of the knee joint indicate

A

An ACL rupture until proven otherwise

33
Q

What does a lipo-haemoarthrosis indicate

A

A fracture until proven otherwise as fat has been released from the bone marrow

34
Q

What is bursitis

A

Inflammation of a bursa

35
Q

What is housemaids knee

A

Inflammation of the pre-patella bursa

36
Q

What is a clergymans knee

A

Inflammation of the infrapatella bursa

37
Q

How many bursae make up the infrapatella bursa

A

2

38
Q

The suprapatella bursa is an extension of the synovial cavity of the knee joint, a knee effusion therefore presents with swelling in the suprapatella pouch. It indicates significant pathology in the knee joint. What can cause this effusion

A 
Osteoarthritis
RA
Infection
Gout and pseudogout 
Repetitive microtrauma to the joint - running on soft or uneven surfaces.
39
Q

Semimembranosus bursitis is also known as?

A

A popliteal cyst or bakers cyst

40
Q

What is Osgood-Schlatters disease?

A

Inflammation of the apophysis of the patellar ligament into the tibial tuberosity

41
Q

Name 3 typical symptoms of OA in the knee

A

Knee pain, stiffness, swelling

42
Q

Is OA in the knee worse after prolonged rest and inactivity or from long term use

A

Prolonged rest an activity, in the morning when just got up

43
Q

What is septic arthritis

A

Invasion of the joint space by microorganisms

44
Q

What microorganism is commonly the cause of septic arthritis

A

Staph aureus

45
Q

Why is the use of polymethacrylate cement in joint replacement a risk factor for septic arthritis

A

Inhibits complement and white blood cell function

Anatomy (7 decks)

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