Exam 1 - The Knee. Flashcards

1
Q

Knee

A
  • Largest joint in body
  • Structure: synovial
  • Function: diarthrodial
    Needs to provide
  • stability
  • mobility
  • shock absorption
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2
Q

Bones

A
Femur
Tibia
Fibula 
Patella 
   - sesamoid bone
   - knee cap
   - embedded in quad tendon 
   - increases force of the quad muscles
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3
Q

Joints

A

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4
Q

Tibiofemoral

A

“knee” - synovial and diarthrodial

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5
Q

Patellofemoral

A

“hinge” flexion and extension & some internal and external rotation

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6
Q

Ligaments

A

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7
Q

Medial collateral ligament

A

Medial knee
Femur to tibia
Thick and wide
Protects against lateral blows

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8
Q

Lateral collateral ligament

A

Lateral
Femur to fibula
Thin & narrow
Protects against medial blows

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9
Q

Anterior cruciate ligament

A

Femur to anterior tibia

Protects against excessive anterior tibial movement

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10
Q

Posterior cruciate ligament

A

Femur to posterior tibia

Protects against excessive posterior tibial movement

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11
Q

Medial patellofemoral ligament

A

Patella to medial femoral condyle
Helps stabilize patella
If ruptured, may lead to dislocation

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12
Q

Movements

A

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13
Q

Flexion

A

155 degree

Sagittal plane

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14
Q

Extension

A

0 to 20 degrees

Sagittal plane

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15
Q

Rotation

A
  • Transverse plane

- named by tibia

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16
Q

Muscles

A

17
Q

Extensors

A
  • quadriceps
18
Q

Rectus femoris

A
  • part of quadriceps
  • PA: illic spine
  • DA: tibial tuberosity
  • A: extends the knee
19
Q

Vastus lateralis

A
  • part of quadriceps
  • PA: lateral femur
  • DA: tibial tuberosity
  • A: knee extension
20
Q

Vastus medialis

A
  • part of quadriceps
  • PA: medial femur
  • DA: tibial tuberosity
  • A: knee ext
21
Q

Vastus intermedius

A
  • part of quadriceps
  • PA: femur
  • DA: tibial tuberosity
  • A: knee extension
22
Q

Flexors

A
  • hamstrings

- popliteus

23
Q

Biceps femoris

A
  • part of hamstrings
  • PA: ischial tuberosity
  • DA: lateral condyle of tibia & head of fibula
  • A: knee flexion
24
Q

Semimembranosus

A
  • part of hamstrings
  • PA: ischial tuberosity
  • DA: proximal medial tibia
  • A: knee flexion
25
Q

Semitendinosus

A
  • part of hamstrings
  • PA: ischial tuberosity
  • DA: proximal medial tibia
  • A: knee flexion
26
Q

Popliteus

A
  • part of flexors
  • PA: posterior lateral femur
  • DA: medial tibia
  • A: knee internal rotation & flexion
27
Q

External rotation

A
  • tibia externally rotates on the femur
  • happens when knee extends
  • due to shapes of bones and meniscus
  • screw home mechanism
28
Q

Internal rotation

A
  • popliteus unlocks the knee & internally rotates
29
Q

Injuries

A

30
Q

MCL Sprain

A
- can be minor or major 
MOI: lateral stress/force to knee, usually weight bearing
SYMPTOMS:
 - pain on inner side of knee
- knee "giving out"
- may feel pop
TEST:
- medial ligamentous stress test
REHAB:
- bracing, ROM, strength
SURGERY:
- rare
31
Q

Terrible Triad

A

ACL
MCL
Medial meniscus

32
Q

Osteoarthritis

A

MOI: insidious onset caused by breakdown/loss of joint cartilage
- hands, feet, spine, and weight bearing joints
Cause:
- associated with aging
Primary & secondary OA:
- obesity, trauma, surgery, diabetes
SIGNS:
- pain and stiffness in Joint
- usually affects medial knee compartment
REHAB:
- ROM & strengthening

33
Q

IT Band Syndrome

A
  • pain 2nd proximally to lateral joint line
34
Q

Total knee replacement

A
  • preferred surgery for end stage OA
  • 300,000/year in US
  • may replace medial compartment only
  • REHAB:
    ROM and strengthening
  • 6 months - year complete rehab
  • unable to kneel or squat
35
Q

Patellofemoral pain syndrome

A

MOI: usually repetitive stressful activity of the knee, maltracking of patella
SIGNS:
- retropatellar or peripatellar
ETIOLOGY
- multifactorial, biomechanjc
REHAB
- quad strengthening, hamstring, IT Band, calf stretching

36
Q

Q angle

A

Large Q angle may be predisposing factor for developing patellofemoral pain
- increased incidence in females

37
Q

Patellar tendinitis/otis

A

MOI
-sports and activity involving frequent jumping “jumpers knee”
SIGNS
- pain below patella to insertion of patellar tendon
ITIS: inflammation OTIS: degeneration

TREATMENT:
- modify activity, stretch/strengthen quads 
- patella strip band
SURGERY
- pain
- 6-12 month recovery 
- 24% no improvement
38
Q

Osgood - Schlatter Disease

A
MOI
- running or jumping activity during rapid bone growth
- high frequency in athletes
SIGNS
- pain, swelling, tenderness in tibial tuberosity
SEVERE CASES
- patellar tendon may rupture
REHAB
- quad stretching
- activity modification 
  • usually resolves after growth spurt