Knee Flashcards
1
Q
The Tibia’s medial plateau is longer than the lateral in the ________ direction
A
anterior/posterior
2
Q
How much of a slope is on the tibial plateau?
A
7-10 degrees posterior
3
Q
The normal tibiofemoral angle is….
A
180-185 degrees
4
Q
Genu valgum of the knee is anything over what degree?
A
185 degrees
5
Q
genu varum of the knee is anything under….
A
175 degrees
note: the angle is measured medially
6
Q
Genu valgum has _____ forces laterally and ______ forces medially
A
compressive forces laterally
tensile forces medially
7
Q
Genu Varum has ______ forces medially and __________ forces laterally
A
compressive forces medially
tensile forces laterally
8
Q
The line of weightbearing forces through the knee should shift ______ during single leg stance
A
medially
9
Q
A
10
Q
Which meniscus is C shaped?
A
medial
11
Q
Which meniscus is four-fifths of a circle shaped
A
Lateral
12
Q
Which meniscus covers more tibial surface (larger)
A
lateral
13
Q
Mensicus are thicker ______
A
peripherally
14
Q
Which mensicus is more restricted
A
medial
15
Q
Which mensicus attaches to the popliteus muscle?
A
Lateral
16
Q
What meniscus attaches to the semimembranosus muscle?
A
medial
17
Q
Which meniscus attaches to the ACL, PCL, and MCL
A
Medial
18
Q
Which meniscus attaches indirectly to the ACL and PCL
A
Lateral
19
Q
which meniscus has more motion?
A
lateral
20
Q
What part of the mensicus is well vascularized?
A
Horns and peripheral portion (good healing potential)
note: central portion relies on synovial fluid to deliver nutrients (poor healing potential)
21
Q
What is the close packed position of the knee?
A
full extension
22
Q
Both the ACL and PCL are ______capsular and _____synovial
A
intracapsular
extrasynovial
23
Q
Which Plica is found less often in people (not alwys present), but is often a source of pain (plica syndrome)
A
medial plica (25-30% of knees)
24
Q
What is the thickest band in the medial retinaculum?
A
Medial patellofemoral ligament
note: clinically important stabilizer to keep patela in femoral sulcus
25
The lateral patellofemorall ligament connects _____ to the lateral patella
ITB
26
The medial knee joint capsule blends with the ______
the lateral portion blends with the _____
The **posterior joint** capsule blends with the *arcuate* and *posterior oblique* ligaments
MCL
ITB
27
Knee varus is ______ of the tibia
knee valgus is ______ of the tibia
Adduction
Abduction
28
What ligament is the primary restraint to excessive valgus and medial tibial rotation
MCL
29
Other functions of MCL include....
**Taut** in *extension*, plays key role in **flexion**
secondary role to preventing anterior translation of femur on tibia
30
Which ligament is the primary restrain to varus stress and limits excessive lateral rotation
LCL
note: also helps prevent posterio-lateral rotary instability (PLRI)
31
T or F: both MCL and LCL are taut in extension but also play role in flexion
True
32
The MCL goes from the femur to the ______
The LCL goes from the femur to the ______
MCL- tibia plateau
LCL - fibular head
33
The ACL extends from the ______ aspect of the lateral femoral condyle to the ___________ of the medial tibial spine
Postero-medial (aspect of lateral femoral condyle)
Anterio-lateral (aspect of medial tibia)
34
The ACL runs in what direction?
Inferior
Medial
Anterior
35
Which bundle of the ACL is most taut near full extension?
**Posterolateral** bundle (note this means that the PLB resists hyper ext)
note: anterio-medial bundle becomes taut beyond 15 degree knee flexion
36
The ACL becomes tight with knee _______, and medial, and lateral rotation
Flexion
37
The ________ bundle of the ACL becomes taut in **flexion**
the _____ bundle of the ACL becomes taut in **extension**
Anteromedial
Posterolateral
38
Most ACL injuries occur in what position?
Knee slightly **flexed**, **valgus** position combined with **anterior** tibial translation
39
What muscles act to translate the tibia anteriorly relative to the femur
Quad and gastroc
40
What muscles act to translate the tibia posteriorly on the femur
hamstring and soleus
note: soleus can only resist if foot is on the ground
41
co-contraction of hamstring and _______ allows the hamstring to counteract the anterior translation imposed by the quadricep
quadricep
42
How big is the PCL compared to the ACL?
120-150% greater cross sectional area
43
The posteromedial bundle of the PCL is taut in __________
near full extension
44
the anteriolateral bundle of the PCL is taut in ______________
80-90 degrees of knee flexion
45
The PM bundle of the PCL is taut in _______
The AM bundle of the PCL is taut in __________
extension
flexion
46
The PCL runs from the ______ femoral condyle to the ________ tibial surface between posterior horns of both meniscus
medial
posterior
47
What muscles share the **same role** as the PCL?
Popliteus and Quad
48
The posterior oblique ligament of the knee is taut in ________ and it resists both varus and valgus
extension
49
What is PLRI (Posteriolateral rotational instability)
Damage at LCL, popliteus, arcuate ligament, and popliteofibular ligament
50
The IT band attaches to the ______
It covers what 2 muscles?
it increases ________ stability
gerdy's tubercle
TFL and Gluteus Maximus
Lateral stability
51
What bursa are inside of the joint capsule (inside the synovium)?
Supra-patellar
sub-popliteal
gastrocnemius bursae
Note:Pre-patellar, infrapatellar, and deep infra patellar fat pad are **extrasynovial
**
\
52
During closed flexion, the femur rolls ______ and glides _______
Posteriorly
Anteriorly
Note: convex on concave movement
53
During open chain knee flexion, the tibia rolls _______ and glides __________
Posteriorly, posteriorly
Note: concave on convex movement
54
Walking requires ______ of knee flexion
stairs require:
Sit->stand requires:
60-70
80
90+
55
Tightness in plantarflexors may present as __________ in standing
genu recurvatum
56
In prone, knee flexion may be limited by passive insufficiency of the ___________
rectus femoris
57
closed chain knee flexion causes the ______ to become tight
closed chain knee extension causes the _______ to become tight
ACL (note: why ACL is always damaged with partial flexion)
PCL
58
The meniscus deform _______ with flexion
the meniscus deform ________ with extension
Posterior
Anterior
Note: menisci deform to steer roll/glide, assisted by semimem and popliteus
59
Which side of the knee joint has more rotation, lateral or medial?
Lateral
60
Medial rotation causes deformation of the ______ meniscus on the posterior side
Medial rotation causes deformation of the ______ mensicus anteriorly
medial meniscus
lateral meniscus
61
In what position is there very little tibial rotation at the knee
full ext
62
Varus and valgus of the knee are tested in what two positions?
Full ext usually 8 degrees of movement
30 degrees of flexion 13-20 degrees normal
63
Terminal knee extension is accompanied by _____ rotation (open chain) of the tibia
Lateral rotation (note: screw home mechanism)
63
From full extension, flexion requires unlocking the knee with _________ rotation of the tibia in open chain, or ________ rotation of the femur in closed chain
Medial rotation
Lateral rotation
63
Flexion of the knee occurs with slight ________
whereas extension of the knee occurs with slight ___________
Varus
Valgus
64
In closed chain knee extension, the femur rotates __________ to lock the knee
medial rotation
65
to unlock the knee in open chain, the tibia rotates _______
medially
note: done by popliteus
66
Popliteus only _____ the knee
UNLOCKS
it doesn't lock
67
the sartorius and gracilis can do ___ rotation of the knee
medial
(Basically everything medially rotates except for the biceps femoris which laterally rotates)
68
The medial group of hamstrings produce ______ moments
the lateral group of hamstrings produce _____ moments
Varus
Valgus
69
T or F: Glute max and soleus have no influence of knee extension in weight bearing
F
Glute max and soleus contribute to knee ext in weight bearing
70
The patella increases the torque of the quads how?
lengthens movement arm away from joint line
note: MA is maximal at 45-60 of flexion
MA is decreased in full extension (Postion of extension lag)
71
The quads are typically ________ as strong as the hamstrings
twice
72
In full ext, gravity passes _____ to the knee creating a _____ moment
anterior
extension moment
73
In open chain, quads generate more torque as the knee approaches __________
In closed chain, quads generate more torque as the knee is in ______
full ext
More flexion
(Think of the hardest part of a squat vs the hardest part of a leg extension)
74
In closed chain, the quad generates more force as the knee ________ to control increasing movement arm
flexes
75
Open chain knee extension produces ________ tibial shear force
Close chain knee ext produces ________ tibial shear force
anterior
posterior
76
Which of the following does not limit anterior tibial translation:
ACL
ITB
Popliteus
Hamstrings
Soleus
Glute Max
Popliteus
77
Which of the following does not limit posterior tibial translation
PCL
MCL
Quads
Soleus
Popliteus
Gastroc heads
Soleus
78
The MCL limits knee _______ whereas the LCL limits knee __________
Valgus
Varus
79
Patella alta vs patella baja
alta- high patella
baja - low patella
80
During flexion the patella glides ________
during extension the patella glides __________
Inferior
Superior
81
The patella shifts ______ (medial/lateral) in extension and ____________ in flexion
Lateral
Medial
Note: This is why the patella often gets displaced laterally on some people when they extend their knee forcefully
82
How many motions can the patella do?
Tilt
Shift
Rotate
83
What is the loose pakced position of the patello-femoral joint?
Extension
Flexion is the closepacked position
84
From 30-70 degrees of flexion the forces of the patellofemoral joint are dissipated by the ____ facet
beyond 90 degrees the _____ facet and odd facets are compressed
Medial
Lateral
84
Physiological valgus of tibia/femur causes patella to be pulled ___________ by the quad tendon
laterally
85
Patellofemoral joint stress w/ walking vs running?
Walking 25-50% of bodyweight
running- 5-6x bodyweight
85
Patella is more likely to dislocate in what direction?
Lateral
Note: all of the following can result in lateral patellar forces
weak vmo
tight ITB
genu valgum
femoral anteversion
lateral tibial torsion
foot pronation
stretched medial structures
86
A Q angle of _______ could result in excessive lateral forces on the patella
an increased Q angle will present as genu __________
Over 20
genu valgum
Note: 10-15 normal
87
3 criteria for Patellofemoral pain exercises
Pain free range
may need to avoid last 30 degrees of ext in non-weight bearing exercises
may need to avoid deep squats in weight bearing exercises
88
What muscles increase shear on PCL?
Hamstring and Gastroc
89
The arcuate ligament of the knee is taut in _______ and it resists varus/ valgus and __________
The arcuate ligament of the knee is taut in **Extension** and it resists varus/ valgus and **rotation**
