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academic weapon > KINES: Knee Complex > Flashcards

KINES: Knee Complex Flashcards

1
Q

what forms the knee complex

A

tibiofemoral and patellofemoral joint

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2
Q

what type of joint is the tibiofemoral joint

A

double condyloid or modified hinge joint

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3
Q

what are the 2 planes of movement of the knee joint

A

primary - sagittal for flex/ext

secondary - transverse for tibial ER and IR

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4
Q

what type of joint is the patellofemoral joint

A

non-synovial or false

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5
Q

between the 2 femoral condyles which is larger

A

larger medial condyle

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6
Q

compare the position of medial and lateral condyle

A

medial - shifted posteriorly and more distal

lateral - shifted anteriorly and more inline w shaft of femur

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7
Q

what results due to the larger medial condyle

A

greater radius of curvature and some rotatory movement due to the imbalance of the shape

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8
Q

which of the tibial plateaus are larger

A

media to match the condyles

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9
Q

discuss the tibiofemoral alignment

A

shaft of femur is not in line w tibia - obliquely oriented

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10
Q

normal physiologic valgus angle

A

175-185 degrees

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11
Q

anatomical/longtudinal axis of femur

A

oblique

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12
Q

anatomical/longtudinal axis of tibia

A

vertically oriented

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13
Q

what happens if physiologic angle is greater than 185

A

genu valgum/knock knees

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14
Q

what happens if physiologic angle is less than 185

A

genu varum/bow legs

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15
Q

what structure is stretched in genu valgum

A

medial collateral ligament

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16
Q

what structure is stretched in genu varum

A

lateral collateral ligament

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17
Q

what is mechanical axis

A

weight bearing line - passes at center of hip joint, knee joint and ankle joint

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18
Q

what happens to mechanical axis during single leg stance

A

axis shifts medially - compressive force on medial and distractive on lateral

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19
Q

normal value of Q angle

A

10-15 degrees

males - 14 degrees
female - 17 degrees

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20
Q

why do females have higher q angles

A

bcs of wider pelvis and short stature

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21
Q

what does the q angle represent

A

the vector for combines pull of the quads and patella tendon; influences amount of force generated

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22
Q

where is q angle measured

A

ASIS-midpoint of patella
tibial tubercle to midpoint of patella

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23
Q

what are menisci

A

fibrocartilaginous discs - gel like structure

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24
Q

purpose of menisci

A

increases concavity of tibial plateau and increases congruence

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25
Q

3 functions of menisci

A

shock absorber and pressure distribution
friction reduction
absence results to injuries

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26
Q

compare the medial and lateral menisci

A

lateral - smaller and circle
medial - larger and C-shaped

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27
Q

describe the structure of menisci

A

thick on outer/periphery and thinner on central area

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28
Q

compare the periphery and central area of menisci

A

cappilaries only present on periphery

inner aspect is avascular

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29
Q

explain the healing process in menisci

A

injuries on outer periphery will have better prognosis than inner aspect

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30
Q

what connects the 2 anterior horns of menisci

A

transverse ligament

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31
Q

what are the attachments of the menisci

A

transverse ligament
collateral ligaments
joint capsule
tendons
coronary ligaments

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32
Q

function of coronary ligaments

A

stabilizes meniscus betw femur and tibia

keeps menisci kept in place in all motions - absence = unstable

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33
Q

attachments of medial meniscus

A

MCL
ACL - anterior horn
PCL - posterior horn
semimembranosus

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34
Q

attachments of lateral meniscus

A

LCL
ACL - common tibial attachment
popliteus

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35
Q

what influences meniscal motion

A

structures around it dictate amount of stabilization

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36
Q

compare medial and lateral meniscus in terms of stabilization

A

medial has more attachments kaya greater risk for injury kase not as freely movable

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37
Q

CPP of knee

A

full knee extension with tibial ER

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38
Q

OPP of knee

A

25-30 deg flexion

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39
Q

what are the layers of joint capsule

A

fibrous capsule and synovial membrane

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40
Q

which is the superficial layer of the joint capsule

A

fibrous capsule

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41
Q

which is the deep layer of the joint capsule

A

synovial membrane

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42
Q

attachments of the fibrous capsule

A

distal femur, proximal tibia, patella, quadriceps and patellar tendon

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43
Q

function of fibrous capsule

A

creates a tight seal and encloses synovial fluid

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44
Q

what forms the extensor retinaculum

A

fibrous capsule
lateral patellar retinaculae
medial patellar retinaculae

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45
Q

function of synovial membrane

A

secrete and absorb synovial fluid

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46
Q

what is the position of synovial fluid in knee extension

A

pushed anteriorly

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47
Q

what is the position of synovial fluid in knee flexion

A

pushed posteriorly

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48
Q

what is the position of synovial fluid in knee OPP

A

even distribution of fluid

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49
Q

what happens to synovial fluid in injury

A

inflammation or swelling - compression of structures nd pain

patient assumes semiflexed bcs comfort

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50
Q

function of fat pads

A

shock absorbers
reduce frictional surgace

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51
Q

what are the fat pads

A

anterior suprapatellar
posterior suprapatellar
infrapatellar

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52
Q

other name for infrapatellar fat pad

A

hoffa’s fat pad

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53
Q

describe innervation in fat pad

A

very rich kaya very sensitive cla

too muhc compression = pain = fat pad impingement syndrome

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54
Q

describe the synovial membrane in embryonic stage

A

separated into lateral and medial compartments

divided by synovial septum

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55
Q

describe the synovial membrane in 12 wks

A

synovial membrane is partially resorbed; mga na rretain = plicae

56
Q

what are plicae

A

pain sensitive and can be irritated and inflammed = patellar plicae syndrome

57
Q

locations of plicae

A

inferior - superior - medial - lateral

58
Q

bursa between patella and skin

A

prepatellar

59
Q

bursa between quads tendon and femur

A

suprapatellar

60
Q

bursa between tendon and skin in front of patellar tendon

A

superficial infrapatellar

61
Q

bursa between tendon and skin behind of patellar tendon

A

deep infrapatellar

62
Q

bursa on pes anserinus muscles

A

pen ansirinus or subsartorial

63
Q

bursa between semimebranosus and bone

A

semimebranosus

64
Q

small bursa found posteriorly

65
Q

ligament that controls varus forces

66
Q

what does LCL merge with

A

biceps femoris tendon; conjoined tendon

67
Q

LCL is a secondary restraint for

68
Q

ligament that controls valgus forces

69
Q

MCL is a secondary restraint for

A

excessive anterior tibial translation

70
Q

attachment of ACL

A

medial tibial plateau to medial surface of lateral femoral condyle

71
Q

direction of ACL

72
Q

location of ACL

A

intracapsular and extrasynovial

73
Q

unidirectional control of ACL fixed femur

A

prevent excessive anterior translation of tibia

74
Q

unidirectional control of ACL fixed tibia

A

prevents posterior rotation of femur on fixed tibia

HYPEREXTENSION

75
Q

multidirectional control of ACL

A

supports knee joint laterally and provides stabilazation anterolaterally and anteromedially

76
Q

what are the 2 bundles of ACL

A

AMB and PKB

77
Q

where is AMB taut

A

flexion beyond 90 and hyperext

78
Q

where is PLB taut

A

hyperextension

79
Q

what happens in traumatic hyperex of ACL

A

injures both bundles

80
Q

where is ACL laxed

A

at midrange

81
Q

attachment of PCL

A

lateral tibial plateau to lateral surface of medial femoral condyle

82
Q

direction of PCL

83
Q

location of PCL

A

intracapsular and extransynovial

84
Q

unidirectional control of PCL on fixed femur

A

prevents excessive posterior translatin of tibia

85
Q

unidirectional control of PCL on fixed tibia

A

prevents excessive anterior translatin of femur

86
Q

multidirectional of PCL

A

stabilies posterolaterally and posteromedially

87
Q

ACL or PCL

larger cross-sectional area

88
Q

ACL or PCL

less oblique

89
Q

ACL or PCL

stronger

90
Q

ACL or PCL

shorter

91
Q

ACL or PCL

more commonly injured

92
Q

what does PCL resist secondarily

A

varus forces and too much tibial IR

93
Q

expansion of semimembranosus muscle

A

oblique popliteal ligament

94
Q

attachment of oblique popliteal ligament

A

posterior joint capsule to posterior medial tibial condyle

95
Q

function of oblique popliteal ligament

A

posteromedial control/support

96
Q

attachement of posterior oblique ligament

A

adductor tubercle and MCL joing to the posteromedial tibia and medial meniscus

97
Q

fucntion of Posterior oblique ligament

A

Reinforces the posteromedial aspect

98
Q

function of arcuate ligament

A

reinforces posterolateral aspect

99
Q

what is the meniscofemoral ligament

A

not a true ligament bcs does not attach to 2 bones

100
Q

attachement of meniscofemoral ligament

A

lateral meniscus to PCL and medial femoral condyle

101
Q

name for anterior fibers of meniscofemoral lgiament

A

ligament of Humphry

102
Q

name for posterior fibers of meniscofemoral lgiament

A

ligament of wrisberg

103
Q

discuss the arthrokinematics in OKC knee ext

A

concave tibia moves

tibial will roll and glide anteriorly

104
Q

discuss the arthrokinematics in OKC knee flex

A

tibial rolls and glides posteriorly

105
Q

discuss the arthrokinematics in CKC knee flex

A

convex femur moves

femur roll posteriorly but glides anteriorly

106
Q

discuss the arthrokinematics in CKC knee ext

A

femur rolls anteriorly and glide posteriorly

107
Q

how many degrees of freedom does the knee have

108
Q

what is the screw home mechanism

A

locking mechanism of knee at terminal extension to avoid buckling during WB

109
Q

factors of screw home mechanism

A

bone and joint
ligament
muscle

110
Q

explain the bone nd joint factor of SHM

A

larger medial femoral condyles and medial tibial plateau

111
Q

explain the ligament factor of SHM

A

ACL in ext pulls tibia = ER

112
Q

explain the muscle factor of SHM

A

q angle or lateral pull of quads = ER of tibia in ext

113
Q

muscle responsible for unlocking SHM

114
Q

muscle responsible for locking SHM

A

inhibiting popliteus

115
Q

what divides the medial and lateral facets of the patella

A

vertical ridge

116
Q

what separates the medial and odd facet

A

secondray vertical ridge

117
Q

5 facets of the patella

A

superior
inferior
lateral
medial
odd

118
Q

fucntion of pattela

A

anatomic pulley of quads - increases moment arm - increase toruque

reduces friction bet quads and patellar tendon and femoral and tibial condyles

119
Q

patellar contact when knee is ext

A

only inferior pole

120
Q

patellar contact when knee is 20 deg flexion

A

inferior facet in contact

121
Q

patellar contact when knee is 45 deg flexion

A

middle portion in contact

122
Q

patellar contact when knee is 90 deg flexion

A

superior portion in contact

123
Q

patellar contact when knee is 135 deg

A

more contact on odd facet than lateral

124
Q

what is insall-salvati index

A

ratio of length of patellar tendon to length of patella

determiens patellat heigh

125
Q

insall-salvati index 1:1

126
Q

insall-salvati index >1.2

A

patella alta

127
Q

insall-salvati index <0.8

A

patella baja

128
Q

movement of patella in x-axis

A

patellar flexion and extension

129
Q

movement of patella in y-axis

A

medial and lateral tilting

130
Q

movement of patella in z-axis

A

medial and lateral rotation

131
Q

discuss patellofemoral joint stress in not flexed much

A

compressive force is shorter

132
Q

discuss patellofemoral joint stress as flexion increases

A

lie in deep squat = excessive comprresion = patelofemoral joint syndrome

133
Q

discuss patellofemoral joint instabillity

A

frontal plane instbability in full ext - bcs of lateral pull of quads and ITB tas weak VMO

134
Q

where is PFPS felt during WB

A

deep flexion

135
Q

where is PFPS felt during NWB

A

terminal extension - due to contraction of quads

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