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Clinical Anatomy > Knee > Flashcards

Knee Flashcards

1
Q

What is the normal range of the internal angle of the knee?

A

185-190 // >190 = genu valga (knock knees) // <185 = genu vara (bow legged)

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2
Q

Where does the mechanical axis of the knee lie?

A

It begins at the head of the femur and runs straight through femur and tibia

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3
Q

Where does the anatomical axis of the knee lie?

A

It starts at the distal end of the neck of the femur and runs through the femur and tibia

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4
Q

How much larger is the medial tibial plateau when compared to the lateral tibial plateau?

A

As much as 50%

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5
Q

Lateral femoral condyle extends more in which direction?

A

Anteriorly

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6
Q

The medial femoral condyle extends more in which direction?

A

Distally

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7
Q

What is the closed pack position of the tibialfemoral joint?

A

Extension (and some external rotation)

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8
Q

What is the open pack position of the tibialfemoral joint?

A

25-30* of flexion - where most injuries happen

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9
Q

Genu Valgum increases the likelihood of OA on which side of the knees?

A

Lateral due to compression of lateral menisci/condyles

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10
Q

What is genu recurvatum?

A

Hyperextension of the knees

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11
Q

What are 3 possible causes of genu recurvatum?

A

Ligament laxity, weak quads, tight Achilles’ tendon

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12
Q

How many bursa does the knee joint capsule contain?

A

3 - suprapatellar bursa, subgastroc bursa, and subpopliteal bursa

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13
Q

Knee joint capsule fluid movement w/ extension

A

Moves from posterior to anterior and vice versa w/ flexion

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14
Q

The prepatellar bursa is associated w/ what condition?

A

Housemaid’s knee

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15
Q

Clergyman’s knee is associated with irritation of what bursa?

A

Superficial infrapatellar bursa

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16
Q

Where are the cruciate ligaments generally located?

A

In the fibrous layer of the joint capsule, but extrasynovial

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17
Q

LCL origin and insertion? Strengthened by what? Resists?

A

O: lateral femoral condyle
I: head of fibula

Strengthened by biceps femoris tendon

External rotation, becomes taut before MCL, this plays role in screw home mech
Also resists posterior displacement of tibia

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18
Q

When is LCL most taut? Lax?

A

Most taut in extension, most lax in flexion

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19
Q

MCL origin? Insertion?

A

O: medial aspect of medial femoral condyle
I: proximal tibia

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20
Q

Why does MCL heal faster than LCL?

A

MCL partial attaches to medial meniscus, it is apart of the joint capsule and receives nutrients from synovial fluid as well as blood

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21
Q

Posterior fibers of MCL orientation? Anterior fibers?

A

P: oblique
A: vertical

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22
Q

ACL origin and insertion

A

O: anterior medial surface of tibia
I: posterior lateral surface of femur w/in intercondylar notch

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23
Q

ACL comprised of 3 fibers

A

Anteromedial = most taut in flexion
Posterolateral = most taut in extension
Central

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24
Q

ACL resists (3) facilitates (1)

A

Anterior displacement of tibia on femur
Internal rotation
Valgus and varus forces @ knee
Facilitates normal glide/roll of femur on tibia

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25
Q

Terrible Triad

A

ACL, MCL, Meniscus

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26
Q

ACL commonly injured in what position of knee?

A

ACL more commonly injured in extension, closed-chain exercises are recommended for rehab

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27
Q

PCL origin, insertion, and bands?

A

O: posterior tibia in the intercondylar area (medial side of ACL)
I: Anteromedial femur on lateral aspect of medial femoral condyle
2 bands:
Anteromedial (taut in flexion)
Posterolateral (taut in extension)

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28
Q

PCL more commonly injured in what position of the knee?

A

Knee flexion (as opposed to ACL being more commonly injured in knee extension)

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29
Q

PCL resists what motion(s)?

A

Posterior displacement of tibia on femur
Internal rotation (especially at 90* of flexion)
Valgus/varus forces
Facilitates normal glide/roll

30
Q

PCL mech of injury

A

Forceful posterior translation of tibia - “dashboard injury”

31
Q

Oblique popliteal ligament origin and insertion + relation to popliteal fossa and artery

A

O: superior margin of intercondylar fossa of femur
I: posterior medial tibial condyle

Forms part of the floor of the popliteal fossa, popliteal artery rests on it

32
Q

Oblique popliteal ligament mech of injury

A

Dashboard injury, fall on fully flexed knee so tibia hits first - same as PCL = forceful posterior translation of the tibia

33
Q

Arcuate popliteal ligament origin and insertion

A

O:lateral posterior condyle of the femur
I: head of fibula

34
Q

Ligaments of knee in flexion vs extension

A

Slack in flexion, taut in extension - screw home mech

35
Q

Knee joint stability -Posterior Static

A

PCL, Oblique Popliteal, Arcuate Popliteal

36
Q

Knee stability - Posterior Dynamic

A

Hamstrings, popliteus, gastrocnemius

37
Q

Knee Stability - Medial Static

A

MCL, PCL

38
Q

Knee stability - medial dynamic

A

Pens anserinus group (semitendinosis, gracilis, sartorious)

39
Q

Knee stability - anterior static

A

ACL, MCL, LCL

40
Q

Knee stability - anterior dynamic

A

quads, extensor retinacula

41
Q

Knee stability - lateral static

A

LCL, IT band

42
Q

knee stability - lateral dynamic

A

Biceps femoris // “not much”

43
Q

menisci function (5)

A

Shock absorber (reduces joint reaction force by 40-60% during activity)
Increases articular surface area
Stabilization
Lubrication
Proprioception

44
Q

Mechanism of injury for menisci

A

Axial rotation w foot planted - medial meniscus injured twice as much as lateral - Valgus force can make it worse, putting strain on MCL, posterior medial capsule and thus medial meniscus

45
Q

What ligaments connect the medial and lateral anterior horns of the menisci?

A

Anterior transverse ligament

46
Q

What ligaments root the menisci to their respective tibial plateaus?

A

Coronary (meniscotibial) ligaments

47
Q

External attachments of medial meniscus (4)

A

ACL

MCL

semimembranosis (pulls posteriorly during flexion)

quads via meniscopatellar ligament (pulls anteriorly during extension)

48
Q

External attachments of lateral meniscus (3)

A

PCL

Popliteus (pulls posterior during flexion)

Quad via meniscopatellar ligament (pulls anterior during extension)

lateral meniscus most mobile

49
Q

Which area of menisci endure the most stress/force?

A

Posterior horns

50
Q

Injuries to menisci (area and comparative likelihood)

A

Medial > lateral
Posterior > rest

51
Q

How does ACL tear change osteokinematics of the knee?

A

More external rotation near full extension of the knee

52
Q

Axial rotation at the knee - internal vs external

A

2:1 external to internal

53
Q

Unlocking of screwhome mechanism involves? (Movement of bones/muscle?)

A

Either internal rotation of tibia on femur or external rotation of femur on tibia

Activation of popliteus

54
Q

Why does LCL become taut before MCL when knee is extending?

A

LCL more posteriorly positioned

55
Q

Which artery supplies the ACL?

A

Middle genicular

56
Q

Which side of the patella is larger?

A

Lateral side - related to lateral femoral condyle extending more anteriorly

57
Q

Which side of the patella does the odd facet lie?

A

Medial side

58
Q

The patella increases moment arm for the quad group by what percentage?

A

50-60%

59
Q

Patellafemoral pain disorders arise from what?

A

Lack of articular cartilage

60
Q

Knee OA typically refers to which joint?

A

Tibiofemoral

61
Q

Patellar shift w flex/ext?

A

Sits laterally at the start and end ranges, moves slightly medial in the middle of the range

62
Q

Which direction is the articulating surface of the patella facing in ext? Flex?

A

Posteriorly in extension
Superiorly in flexion

63
Q

What is circumferential displacement?

A

Term to describe the direction the articulating surface of the patella faces in flex, ext:

Faces posteriorly in extension
Faces superiorly in flexion

64
Q

What does the articularis genu serve to do in relation to the suprapatellar bursa?

A

Pulls Suprapatellar bursa anteriorly to prevent it being pinched between femur and patella when the knee is moving from flexion into extension

65
Q

The ________ surface of the patella articulates on the _______ surface of the femoral condyles in extension

A

INFERIOR surface of the patella articulates on the SUPERIOR surface of the femoral condyles
And vice versa as the knee moves into flexion

66
Q

Proper alignment of the patella during movement is determined by (4)

A

Vastus lateralis, medialis
Lateral and medial retinaculum

67
Q

Patellar stabilization (static?) (6)

A

Medial and lateral patellotibial ligaments
Medial and lateral patellofemoral ligaments
Medial and lateral retinacula

68
Q

Patellofemoral disorders can typically lead to?

A

Disactiviation of quads

69
Q

Q-angle definition, norm value?

A

Measurement of lateral line of pull of quads relative to the patella

15*

70
Q

Abnormal Q-angle?

A

Greater than or equal to 20* = increased lateral pull of patella

71
Q

Capsular pattern for knee

A

Greater loss of flexion

Clinical Anatomy (16 decks)

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