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EPHE 355 > Knee > Flashcards

Knee Flashcards

1
Q

what position is the axis of the condyles of the femur and what is the relative size of teh condyles to each other

A

oblique relative to the vertical

larger medial condyle

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2
Q

what lives in the intercondylar fossa

A

cruciate ligaments

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3
Q

where does the patella live

A

on top of the femur

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4
Q

where is the pes anserine

A

slightly distal from level of fibula head but on the tibia

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5
Q

what is the tibial crest

A

proximal anterior ridge of the tibia (shin bone!)

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6
Q

what inserts in Gerry’s tubercle

A

IT band

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7
Q

how does the patella direct force of quadriceps

A

centralize force of quadriceps

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8
Q

how the patella effect teh strength of teh entire leg

A

increase by 30-35% via pulley mechanisms

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9
Q

how does the patella help with friction

A

reduces tendon and friction forces (tendon over patella vs tendon on femur)
thick articular cartilage between patella and femur

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10
Q

is patella protective

A

yes protects anterior surface fo knee

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11
Q

how does patella provide stability

A

limits extension of the leg

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12
Q

what is the formal name of knee joint

A

tibiofemoral joint

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13
Q

what type of joint is the tibiofemorla and what movements

A

synovial modified hinge with two DOF

IR/ER and FLEX/EX

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14
Q

what is the name of the mechanism what locks out the knee in WB extension

A

screw hole

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15
Q

what is the menisci and what is it made out of

A

fibrocartilage disc between tibia and femur

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16
Q

what are the parts of teh meniscus (shape and level fo mobility)

A

Lateral meniscus is oval shaped and very mobile

medial meniscus is c shaped and not mobile

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17
Q

what do teh coronary ligaments at the meniscus do

A

anchor the menisci to the tibia

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18
Q

what do does the transverse ligament at the meniscus do

A

holds the horns together

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19
Q

what do the mensicopatellar fibres do

A

anchor horns to patellar retinalculum

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20
Q

what is the function of the patella and meniscus working together

A

create stability during motion

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21
Q

what main knee ligaments attaches to meniscus

A

the deep MCL

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22
Q

muscle attachments to what sides of the meniscus

what is the function of these attachments

A

semimembranous to posterior medial meniscus
popliteus to lateral meniscus
–> helps the menisci “spot” the femoral condyles all teh way throughout motion
mensicofemoral ligaments to lateral meniscus

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23
Q

what part of meniscus has vascular and nervous tissue in it

A

none medially, present laterally

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24
Q

what side is meniscus thicker on

A

outer rim

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25
Q

in what direction does the meniscus move with knee motion and how much

A

moves anteriorly with knee extension
posteriorly with knee flexion
lateral meniscus moves up to 12mm

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26
Q

what occurs is meniscus does not move during knee movements

A

it can be ripped or crushed

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27
Q

meniscus functions (5)

A 
deepens socket (increasing congruency)
absorb and distribute force 
lubrication of joint 
prevents joint capsule from intruding on joint space 
partially protect against excess motion
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28
Q

function of collateral ligaments

A

provide medial and lateral stability

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29
Q

when are collateral ligaments tight and when are they loose

A

tight in full extension and loose in flexion

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30
Q

name collaterals and what are the size

A

medial (deep and superficial) –> HUGE

lateral –> TINY

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31
Q

what part of MCL is loose and what part is tight in flexion

A

anterior (superficial) is tight in flexion and posterior (deep) is loose in flexion and vice versa

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32
Q

is LCL extracapsular or capsular

A

extra capsular

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33
Q

name the two cruciate ligaments and what characteristic makes them unique and why are they named as they are?

A

anterior cruciate ligament and posterior cruciate ligament
anterior inserts anteriorly
posterior insert posteriorly
they are intracapsular but extrasynovial

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34
Q

what the the ACL limit?

A

anterior translation of teh tibia on teh femur

35
Q

in CKC does tibia move on femur or femur move on tibia? in OKC?

A

CKC: femur on tibia
OKC: tibia on femur

36
Q

what does the PCL limit

A

posterior translation of the tibia on the femur

37
Q

what degrees of flexion is the pCL most restrictive

A

90-120 degrees

38
Q

what structure supports against torsional stress

A

fabellofibular ligaments and arcuate complex

39
Q

goal of the whole capsule

A

protect knee from twisting and torsion

40
Q

what is the supra patellar pouch

A

pocket just above kneecap that fills with fluid post injury

41
Q

bursa in the knee (4 main)

A

semimembranous bursa
supra patellar
subcutaneous patellar
subcutaneous infra patellar

42
Q

ROM needed for regular ADLs

A

120 to 150 degrees

43
Q

tightness where tends to limit knee flexion

A

Tightened in rectus femoris shorten and then hip must be extended at standing so knee cannot flex as much

44
Q

knee extension is limited by

A

patella
tightening capsule
hamstrings

45
Q

what is unique about the axis of motion of the knee throughout flexion

A

the axis of rotation changes because femoral condyles are larger than tibial condyles

46
Q

how much rotation is available at the knee at 90 degree flexion

A

45 degree total (2:1 lateral to medial)

47
Q

how do the femur and tibia move in relation to the knee in OKC to “lock out” the knee

A

20 degrees of lateral (external) tibia rotation, no femoral rotation

48
Q

how do the femur and tibia move in relation to the knee in CKC to “lock out” the knee

A

tibia is fixed, femurs internally rotates

49
Q

closed pack portion of the knee

A

full extension

50
Q

resting position of the knee

A

25 degrees flexion

51
Q

knee flexion ROM

A

130 - 150 degrees

52
Q

degree of ROM of IR and ER of the tibia

A

IR: 15
ER: 25

53
Q

what direction will the patella most likely dislocate

A

laterally

54
Q

what tissues support the patella

A

retinaculum, vast medialis oblique, patellar tendon

55
Q

in OKC does patella move on femur or femur on patella

A

patella on femur

56
Q

in CKC does patella move on femur or femur on patella

A

femur on patella

57
Q

closed packed position of patellofemoral joint

A

full flexion of the knee

58
Q

open position of patellofemoral joint

A

full extension

59
Q

where does the patella sit in full extension

A

in the intercondyler groove

60
Q

position of patella in 90 degree flexion

A

flexed, lateral shift and lateral tilt

61
Q

as knee flexed, how does patella move

A

move inferiorly, rotated, tilts and shifts

62
Q

what is the Q angle

A

ASIS to patella and tibial tubercle straight up

63
Q

do males are females have a larger q angle

A

females

64
Q

functions of knee extensors

A

stabilize (isometric)
decelerate (eccentric)
accelerate (concentric)

65
Q

name the quadriceps group

A

vastus medialis
vastus lateralis
vastus intermedius
rectus femoris

66
Q

what is the articulates genu

A

pulls capsule superiorly during extension to prevent impingement

67
Q

what bony movement to the hamstrings limit

A

anterior tibia translation

68
Q

what kinetic movement do the hamstrings decelerate

A

rotation

69
Q

name hamstrings

A 
semimembranosus (medial)
biceps femoris (lateral)
semitendinosus (medial)
gracilis 
sartorius
70
Q

what inserts at the pes anserine

A

sartorius
gracilis
semitendinosus

71
Q

what muscles does the gastroc co contract with to stabilize the knee

A

quadriceps

72
Q

tibial rotators

A 
medial:
semitendinosus and semimembranosus 
gracilis
sartorius 
popliteus 
lateral: biceps femoris
73
Q

explain the absorption and distribution of forces at the knee in unilateral stance

A

compression forces double from bilateral
line of gravity passes medial to tibifemoral joint
medial compartment = 60% of forces
remaining forces are restrained by lateral restraints

74
Q

peak torque position of the quadriceps

A

50-60 degrees knee flexion

75
Q

what is extensor lag

A

lack of full extension at the knee due to quadriceps weakness and or pain

76
Q

when is torque highest for knee flexors

A

full extension

77
Q

normal strength ratio of hamstrings to quadriceps

A

2:3 hamstrings to quads

78
Q

conditions that alter Normal torque of the knee

A 
meniscal tears 
ligament instability 
ITB tightness 
obesity 
genu varus or valgum 
shortened femoral neck 
excessive pronation of feet 
changes in bony alignment due to fracture
79
Q

what is the force couple during squatting

A

hamstrings act as hip extensor and quads act as knee extensors

80
Q

explain length tension curve that occurs in a squat

A

as hip extends, knee extends as well for hamstrings and rectus femurs stay mid length

81
Q

explain what occur at the muscles when someone squats down

A

eccentric actions control rate of knee flexion (quads) and hip flexion (hamstrings)

82
Q

Mechano receptors are found in what parts of teh knee

A

ligaments
capsule and synovial lingin
menisci

83
Q

what mechanorefelx occurs during knee effusion

A

reflex inhibition of the musculature –> reaction time several decreases

84
Q

what is flexion contracture

A

a bent knee that cannot actively or passively be straightened

EPHE 355 (5 decks)

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