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Musculoskeletal Exam 4 > Knee > Flashcards

Knee Flashcards

1
Q

What are the 3 most common types of injuries seen in the clinics for the knee?

A
  • unspecified sprains, strains, or overuse injuries
  • contusions
  • meniscal or ligamentous injuries
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2
Q

What type of joint is the tibiofemoral joint?

A

Hinge joint

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3
Q

What are the degrees of freedom for the tibiofemoral joint?

A

Flex/ext
IR/ER (minute)
ABD/ADD (minute)

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4
Q

What structures originate on the lateral condyle?

A

Popliteus, lateral head of the gastrocnemius, LCL

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5
Q

What structure originate/insert on the medial condyle?

A

Adductor magnus, medial head of the gastrocnemius, MCL

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6
Q

What are the two tibial plateaus separated by?

A

Intercondylar eminence

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7
Q

The medial tibial plateau is ______ in the ML direction and ______ in the AP direction.

A

concave, concave

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8
Q

The lateral tibial plateau is ______ in the ML direction and ______ in the AP direction.

A

concave, convex

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9
Q

The medial plateau surface area is ___% greater than the lateral plateau, and the articular surface is ___ times thicker.

A

50% greater, 3 times thicker

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10
Q

What helps to accentuate the concavity of the tibial plateau?

A

The mensici

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11
Q

What is the resting position of the tibiofemoral joint?

A

25 flexion

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12
Q

What is the closed-packed position of the tibiofemoral joint?

A

full extension, ER of the tibia

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13
Q

What is the capsular pattern of the tibiofemoral joint?

A

flexion, extension

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14
Q

What type of joint is the patellofemoral joint?

A

Modified plane joint

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15
Q

Which surface of the patellofemoral joint is widest?

A

Lateral

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16
Q

What are the 5 facets of the patella? Which is associated with chondromalacia?

A

Odd, Superior, Inferior, Medial, Lateral

Odd is most frequently associated

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17
Q

What are the functions of the patellofemoral joint?

A

Provide the articulation with low friction
Protect the distal aspect of the femur from trauma and the quadriceps from attritional wear
Improve the cosmetic appearance of the knee
Improve the moment arm of the quadriceps
Decrease the amount of AP tibiofemoral shear stress placed on the joint

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18
Q

Where does the tibial articulating facet face?

A

laterally, posteriorly, inferiorly

19
Q

Which joint has more motion: proximal or distal tibiofibular joint?

A

Proximal

20
Q

What are the two directions that you can glide the tibiofibular joint?

A

Superior-Inferior

Anterior-Posterior

21
Q

What is the concavity/convexity of the proximal tibiofibular joint?

A

Slight convexity of the tibial facet and slight concavity of the fibular head

22
Q

What is the ACL a primary and secondary restraint for?

A 
Primary = anterior translation and medial rotation of the tibia on the femur
Secondary = restraint to valgus and varus rotation of tibia
23
Q

What is the PCL a primary and secondary restraint for?

A 
Primary = posterior translation and medial rotation of the tibia on the femur
Secondary = restraint to valgus and varus rotation of tibia
24
Q

What is the MCL a primary and secondary restraint for?

A 
Primary = restraint for valgus and lateral rotation of the tibia
Secondary = anterior and posterior translation of the tibia on the femur
25
Q

What is the LCL a primary and secondary restraint for?

A 
Primary = restraint for varus and lateral rotation of the tibia
Secondary = anterior and posterior translation of the tibia on the femur
26
Q

ACL and PCL contain ________ that if disrupted, can eliminate sensory nerve fibers to the joint.

A

mechanoreceptors

27
Q

What can the ACL do while under internal stress?

A

Microscopic adjustments to the laxity, stresses and kinematics of the joint

28
Q

Which of the cruciates is strongest?

A

PCL > ACL > MCL,LCL

29
Q

Forcing the ACL more than ___ beyond its resting length may cause a rupture.

A

5%

30
Q

How much thicker is the PCL than the ACL? How much stronger?

A

50% thicker, twice as strong

31
Q

How much total restraint does the PCL provide to posterior translation of the tibia on the femur?

A

90-95%

32
Q

Are MCL and LCL intra or extra-articular ligaments?

A

extra

33
Q

Where does the MCL superficial band originate and attach?

A

Thick, flat band. Attaches proximally on the medial femoral condyle, blends with the posteromedial corner of the capsule

34
Q

Which ligament is the first to be injured with a valgus force?

A

MCL Superficial Band

35
Q

What is the MCL deep band a continuation of? Where does it attach?

A

Continuation of the joint capsule, blends into the medial meniscus

36
Q

Where does the LCL originate and attach?

A

Arises from lateral femoral condyle, runs distally and posteriorly to insert on the head of the fibula

37
Q

Is the LCL a part of the joint capsule?

A

No, the cord-like LCL develops independently, completely free from the joint capsule and lateral meniscus

38
Q

Where are the secondary restraints located?

A

Posterolateral and posteromedial corners of the knee

39
Q

What do the secondary restraints assist with?

A

Control anterior tibial translation relative to the femur

40
Q

What are the secondary restraints?

A

Hamstrings, popliteus, patellar tendon, oblique popliteal tendon, fabella

41
Q

Which region of the menisci are most susceptible to injury?

A

Inner regions

42
Q

Which portions of the medial and lateral menisci are vascularized?

A

Lateral = outer 25%
Medial = outer 30%
(the remaining inner portions are considered avascular)

43
Q

What shape is the medial meniscus?

A

Semilunar

Musculoskeletal Exam 4 (3 decks)

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