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MSK II > Final Exam Review > Flashcards

Final Exam Review Flashcards

1
Q

what is special about the medial condyle of the femur

A

it is larger, and extends further distally, so it helps with the screw home mechanism

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2
Q

describe the differences between the medial and lateral condyle or plateau about the tibia.

A

the lateral is circular, and the medial is oval and long, and has 3x thicker cartilage

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3
Q

what type of joint is the knee joint

A

hinge

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4
Q

what three joints make up the knee

A

the patellafemoral, tibiofemoral and the tibiofibular.

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5
Q

what kind of joint is the tibiofemoral joint, and what motions does it allow for

A

it is a double condyloid, and it accounts for flexion and extension, and rotation, but no frontal plane movement.

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6
Q

the tibial articular surface/plateau slopes

A

posterioinferiorly

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7
Q

which side absorbs more force and why

A

the medial, and that is because it is thicker and bigger

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8
Q

what are the functions of the meniscus

A

stability, decrease friction, increase contact area, and proprioception. it also attenuates force.

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9
Q

which meniscus is c shaped, and what are its properties

A

the medial, and it is thicker posteriorly

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10
Q

is the MCL and LCL attached to the meniscus

A

only the MCL

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11
Q

what happens in terms of load with a meniscectomy

A

2x more load on the femur, and 6-7x more on the tibial condyle. then it also decreases shock absorption

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12
Q

how are the menisci vascularized

A

as we age, the vascularity decreases. blood will flow from the capsule and synovial membrane.

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13
Q

what are the zones of the menisci

A

red-red: most lateral, and most vascularized, and then good healing
red-white: some vascularization
white-white: inner, no vascularity or healing

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14
Q

the MCL and LCL are taut in

A

extension

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15
Q

theACL attaches where

A

posterior on the lateral femoral condyles.

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16
Q

what are the three bundles of the ACL and where are they lax and taut in

A
  • the anteriomedial (lax in extension, and taut in flexion)
  • posterolateral (lax in flexion and taut in extension)
  • intermediate
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17
Q

the ACL works with ___ to prevent valgus

A

the MCL

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18
Q

the PCL is the strongest in the body (true or false?)

A

true

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19
Q

genu valgum

A

TF angle less than 165. increased lateral forces (lateral meniscus tear)

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20
Q

genu varum

A

TF angle above 180 (bow leg). increased medial compressive forces, and medial meniscus tear

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21
Q

where is the Q angle measured from

A

the ASIS to the mid patella then down to the tibial tuberosity

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22
Q

Q angles in males and females

A

males: 10-14
females: 15-17

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23
Q

knee flexion is _____ WNL and extension is ___

A

130-140

5-10 hyperextension

24
Q

genu recurvatum

A

excessive hyperextension

25
what is the screw home mechanism
the last 5 degrees of extension when the tibia laterally rotates, or the femur IR. the medial condyle is bigger, so it has to continue to move on the femur.
26
describe what happens wth flexion and unlocking CKC and OKC
CKC the femur will move on the tibia, so there will be lateral rotation of the femur OKC tibia MR on the femur
27
what does the popliteus do with open and closed kinetic chain knee flexion
it will ER the femur with CKC and MR tibia with OKC
28
which facet of the patella bears the most force
the middle facet
29
what is the posterior surface of the patella made of
hyaline cartilage
30
when is the first consistent Patellafemoral contact
10-20 degrees knee flexion
31
what happens to patellafemoral contact by 90 degrees
all facets are in contact except for the odd facet
32
at 135 degrees, what is the contact of the patellafemoral joint
the odd and lateral facets
33
where is the greatest patellafemoral joint compression
90 degrees knee flexion
34
what happens to patellafemoral contact with full quad extension
there is little PF contact. This is why quad sets are so safe
35
what is the PF forces like at foot strike with knee in 10-15 degrees flexion, 60 knee flexion and 130 knee flexion
at knee 10-15, 50% BW 60 degrees knee flexion 3.3x BW 130 7.8x BW
36
what provides stability to the PF joint
the transverse are the VL and VM, the medial and lateral retinaculum, and the MPFL. then the quads and patella tendon. ITB too
37
what is the most common meniscal tear
the longitudinal, then bucket handle
38
what is the MOI of a meniscus tear
twisting
39
what is a meniscus tear S and S
``` pain with movement and better with rest locking joint line tenderness acute effusion sudden onset less 40 years old chronic, no MOI over 50 ```
40
what kind of meniscus tear has locking
bucket handle
41
what kinds of things give you a good prognosis for a meniscus tear
age less than 35, peripheral damage, longitudinal tear, short, acute injury, stable knee
42
bad prognosis of meniscus tear
older, central damage, complete tear, bucket handle, chronic and unstable.
43
what are some findings associated with a meniscus injury
joint line tenderness, effusion, (+) McMurrays, Apley's, Squat. quad inhibition (can't fully /)
44
is there a difference between surgery and PT for meniscus tear
no, try PT first
45
what are the three ways to manage a meniscus tear
``` the debridement (good RTF/ADL, restore gait, decrease swelling) repair (traumatic in vascular zone, and longer than 8mm) transplant: cadaver, this is not very common ```
46
what are the goals with a menisci tear
to know the surgery, cadaver, graft type, rest, WB status, don't push ROM, restore gait, function and strength and proprioception
47
what are some characteristics of articular cartilage damage
palpation, malalignment, painful crepitis, catching, locking and grinding, quad atrophy, weather changes, pain and a deep dull ache
48
what are the four surgical management techniques for the articular cartilage damage
- debridement/lavage: clean it up, no function restored, little difference in improvement of pain - microfracture: pick holes and induce blood flow, replaced with fibrocartilage, and WB controlled. Good for sedentary people - ACI (autologous chondrocyte implant): 2 parts, one you need to harvest some cartilage, and digest it with enzymes, then you release chondrocytes, and then you implant them with a periosteal flap - Osteochondral autograft transplantation system (OATS): full thickness defect, remove a plug of bone from a NWB surface, and fit the plug into the lesion, like a mosaic.
49
what are some rehab principles of articular cartilage surgeries
know the procedure and the WB status, and PROM like a CPM 24/7, then you want slow and progressive, and you hardly return to sport, ADL is the focus.
50
what is the pain generator in knee OA. What structure causes pain
the articular cartilage, hyaline. it usually bears and distributes forces and friction between surfaces/
51
what are risk factors of knee OA:
- genetics (bone, chondrocytes and function) - BMD: higher= more OA (obesity) - occupation: squatting, lifting heavy and kneeling. - physical activity: no evidence that increased activity increases risk - age (Increase, increase risk) - sex (70/30 female to male) - obesity: increase in incidence and progression - previous knee injury (ACL or meniscus) - knee alignment: varum and valgum on medial and lateral compartments.
52
if you have a leg length discrepancy, you are ___ more likely to have OA
2X
53
what are we looking for on imaging related to knee OA
osteophytes, joint space narrowing, sclerotic changes in subchondral bone.
54
what are the grades of knee OA
0: normal 1: minute osteophyte formation 2: definite osteophyte with unimpaired space 3: same with mod narrowing 4: same with severe narrowing, and sclerosis and flat plateau
55
what are the ARC criteria for knee OA with and without radiograph
clinic and radiograph: knee pain and 1/3 of wither age over 50, stiff in morning less 30 min, crepitis and osteophytes just clinic: knee pain and 3/6: age over 50 morning stiff, crepitis, tenderness, bony enlargement, no palpable warmth
56
what are some sources of knee OA
not articular cartilage, because it is not innervated. more like synovium, bone, and nerves.

MSK II (2 decks)

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