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MSK > knee > Flashcards

knee Flashcards

1
Q

what type of joint is the knee?

A

a modified hinge joint that allows flexion, extension, and slight internal/external rotation

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2
Q

what is the largest and strongest bone of the body? what does it articulate with?

A

femur
patella bone and proximal tibia

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3
Q

what are the medial and lateral condyles of the distal femur covered in?

A

articular cartilage

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4
Q

what is the intercondylar fossa?
popliteal surface?

A

posterior groove between the condyles where vessels travel

creates the floor of the pop fossa on posterior surface

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5
Q

where and what is the tibial tuberosity?

A

on the anterior tibia, and is the insertion site for the patellar ligament

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6
Q

what are the 3 articular surfaces of the proximal tibia?

A

medial condyle
lateral condyle
fibular cartilage: surface on inferior aspect of lateral condyle (forms the tibiofibular joint)

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7
Q

what is the largest sesamoid bone in the body?

A

patella (kneecap)
embedded in the quad tendon on the anterior knee

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8
Q

what is the function of the patella?

A

strengthens the quad tendon for powerful knee extension and reduces friction between the tendon and knee joint

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9
Q

what is the insertion site of the biceps femoris?

A

apex of the fibular head (lateral side)

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10
Q

what is the interosseous membrane?

A

the membrane that separates the posterior and anterior leg muscles
also stabilizes the lower leg

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11
Q

what 4 muscles make up the quad tendon?

A

rectus femoris (front and center)
vastus medialis
vastus lateralis
vastus intermedius (deep to rectus)

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12
Q

how much of the common quad tendon inserts on the patella bone?

A

95%

other 5% travel over the top and contribute to the patellar tendon

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13
Q

where is the femoral articular cartilage seen?

A

on anterior/inferior surface of femur in the trochlear groove between the condyles

provides patellar stability and is covered by articular cartilage

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14
Q

where is the patellar tendon seen?
is it a tendon or ligament?

A

between the apex of patella and the tibial tuberosity
attached medially and laterally by the patellar retinaculum

technically a ligament

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15
Q

what is the size of the patellar tendon?

A

4x2x6cm

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16
Q

where is the Hoffa fat pad?

A

posterior to the patellar tendon

intracapsular but extra-synovial

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17
Q

what are the bursae of the patella?

A

prepatellar: lines superficial surface, not seen if normal
infrapatellar: between distal patellar tendon and anterior aspect of tibial epiphysis, trace fluid is normal

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18
Q

what is the other name for the tibial collateral ligament? where is it?

A

medial collateral ligament, between the medial condyle or femur and anterior aspect of medial tibia

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19
Q

what do the deep fibers of the MCL attach to?

A

the medial meniscus

20
Q

what are the medial and lateral meniscus made of?

A

crescent shaped bands of thick, rubbery cartilage on the superior border of the tibial bone
acts as shock absorbers and stabilizes the knee

21
Q

what is another name for the fibular collateral ligament?

A

lateral collateral ligament
attaches the lateral condyle of the femur to the fibular head
is NOT attached to the lateral meniscus

22
Q

what does the LCL share a common insertion site with?

A

biceps femoris

23
Q

what action of the knee does the biceps femoris have?
where do both heads of the biceps femoris insert?

A

flexion of the knee
inserts on lateral/anterior head of the fibula, superficial to the LCL and popliteus tendon

24
Q

what is the iliotibial band and where does it run?

A

broad thin fibrous band that connects the iliac crest to tibia

25
Q

where does the iliotibial band insert?
(which tubercle)

A

lateral tibial condyle: Gerdy’s tubercle

26
Q

what is the function of the iliotibial band?

A

supports internal hip rotation, flexion and extension while running
supports the knee while standing

27
Q

where is the common site for friction of the iliotibial band?

A

over the lateral condyle of the femur

susceptible to inflammation with overuse

28
Q

what are the tendons of the posterior knee?

A

semiteninosus muscle: part of the hamstrings responsible for extension
gracilis and semimenbranosus: flexes knee

29
Q

what is the nerve on the posterior knee?

A

saphenous nerve

crosses posteriorly and superficially over the tendons

30
Q

what is the bursa that causes a bakers cyst when extending with fluid?

A

semimembranosus and gastroc bursa of the posterior knee

31
Q

what is the popliteal neurovascular bundle composed of?

A

tibial nerve: branch of sciatic nerve
popliteal vein and artery

nerve can be damaged if the tibia suffers a fracture

32
Q

what does the sciatic nerve divide into at the popliteal crease?

A

common peroneal nerve and tibial nerve

33
Q

what does the common peroneal nerve divide into?

A

divides into superficial and deep branches that run over the fibular head, then deep to the peroneus muscle

34
Q

what does the peroneal nerve innervate?

A

front and side of the lower side, top of the foot

35
Q

what needs to be evaluated when a patient presents with swelling of the knee?

A

suprapatellar recess

excess fluid can cause feeling of fluid in the knee

36
Q

what causes quad tendon rupture?

A

from excess force injuries

37
Q

what are the underlying conditions that can weaken the tendons?

A

diabetes, gout or RA

38
Q

where do quad tears generally occur?

A

usually 1-2cm from insertion on patella

39
Q

Where do MCL tears occur?
LCL tears?

A

-superiorly from joint space
- anywhere along the length of the tendon

generally not treated

40
Q

where do friction tendinopathies of the IT band most often occur?

what is the second most common part?

A

lateral condyle of the femur

Gerdy’s tubercle

41
Q

what pathology of the meniscus can be evaluated by ultrasound?

A

tears, meniscal cysts or an extruded meniscus

42
Q

what is the 2nd most common pathology of the knee?

A

patellar tendinopathy:

jumpers knee: tendinopathy of the insertion
full/partial tears
degenerative changes of proximal deep fibers associated with calcific enthesopathy
complete rupture is rare

43
Q

what is the most frequently encountered pathology of the knee?

A

bakers cyst

44
Q

what can cause a bakers cyst?

A

prior surgery
obesity
trauma
advanced age

45
Q

how does a bakers cyst present?

A

palpable mass in pop fossa with or without pain

MSK (9 decks)

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