Knee

Question 1

Function of the knee joint

Answer 1

Hinge

Does flex/ext and int/ext rotation when the knee is flexed

Question 2

Articulations with the femur at the knee

Answer 2

Tibial plateau

Posterior patella

Question 3

What is important to note about the fibula?

Answer 3

Not part of the knee joint
Does not bear any weight
There for attachments of biceps femoris and lateral collateral ligament

Question 4

What type of bone is the patella considered

Answer 4

Sesamoid

Question 5

What is the reason for the patella?

Answer 5

Acts as a pulley for the quadriceps and patellar tendon improving the angle of the pul

Question 6

What is the Q angle?

Answer 6

Angle between:
ant. sup. iliac spine to the middle of the patella
a line straight though the tibial tuberosity

Question 7

What attaches at Gerdy’s tubercle

Answer 7

Iliotibial band (IT band)

Question 8

What is located at the prox ant. medial tibial surface

Answer 8

Pes anserine bursa

Question 9

Why is it important to catch a prox. fibular head fx.

Answer 9

The common peroneal nerve runs just inferior to it

Question 10

Where does the ant. cruciate ligament attach

Answer 10

Post. lat. femoral condyle to the ant. med. tibia

Question 11

Where does the post cruciate ligament attach

Answer 11

med. femoral condyle posteriorly to lat. tibia

Question 12

What do the menisci do and what are the differences between medial and lateral menisci

Answer 12

Cushion between bones for shock absorption
Medial: Bigger and less mobile; also attached to MCL and other structures so injured more often
Lateral: Smaller and more mobile

Question 13

Important knee bursa to know

Answer 13

Suprapatellar
Prepatellar
Deep infrapatellar
Pes anserine bursa

Question 14

What muscles do the femoral nerves innervate

Answer 14

EXTENSORS:
rectus femoris
vastus lateralis, intermedius,. medialis

Question 15

What muscles does the sciatic nerve innervate

Answer 15

FLEXORS:
Tibial nerve: semitendinosus, semimembranosus, biceps femoris
Common peroneal nerve: short head of biceps femoris

Question 16

What is the blood supply to the knee extensors

Answer 16

Lateral circumflex femoral artery which splits to ascending, transverse, and descending

Question 17

What artery shows up as the BIG RED ONE on MRI

Answer 17

Popliteal artery

Question 18

MOI for patellar/quadriceps tendonitis

Answer 18

40 y.o. caused by lifting, increased physical activity, and weight gain

Question 19

Clinical signs/Physical exam for patellar/quadriceps tendonitis

Answer 19

Ant. knee pain following exercise, assoc w/ jumping or squatting
Tenderness at tendon attachment
Normal ROM, pain w/ hyperflexion

Question 20

Tx of patellar/quadriceps tendonitis

Answer 20

rest,NSAIDs, immobilize/support
strengthening of quads/hamstrings
slow return to activity
PT referral if doesn’t get better

Question 21

Patellar dislocation/subluxation Risk factors

Answer 21

Patella alta “high sitting patella”
Laxity of ligaments
Increased Q angle
IT Band tightness

Question 22

Tx of patellar dislocation

Answer 22

Sedation
Reduction
Post reduction xray/immobilize
Refer to PT

Question 23

Clinical signs of septic arthritis

Answer 23

Acute onset of pain, erythema, warmth, swelling, and reduced ROMFebrile

Question 24

Most common organisms for septic arthritis

Answer 24

MRSA, MSSA, gram neg. bacilli

Question 25

Organisms for knee infections of:
Diabetics
Arthroplasty
Tick bourne disease

Answer 25

Diabetics: salmonella
Arthroplasty: s pyogenes, group A B or G strep
Tick: Lymes

Question 26

Organisms for knee infections of:
Sexually active
rheumatoid
endemic tb area

Answer 26

sexually active: n gonorrhoeae
rheumatoid: TB, fungal 2 TNF inhibitor
Endemic TB: TB

Question 27

What labs to order with a knee infection

Answer 27

Synovial fluid aspiration&raquo_space; gram stain and culture
Blood cultures
CBC, CRP, and ESR

Question 28

Ottawa rules for knee xray

Answer 28

MUST HAVE 1 or more
age >55
isolated tenderness of patella
tenderness at the head of the fibula
inability to flex 90 degrees
inability to bear weight both immediately and in the ED for four steps