Knee Flashcards
how many articulating surfaces are in the knee?
three
how many joints in the knee and their names?
Two. Patellofemoral and tibiofemoral
what are the 2 types of swelling in the knee?
- localized - bursal
2. generalized - intra-articular (synovitis)
Varus aka? (in the knee)
bowlegged
Valgus aka for knees
knock knees
Hyperextension in the knees is known as?
genu recurvatum
genu recurvatum is higher among men or women?
women
what makes up the tibiofemoral joint?
distal end of femur + proximal end of tibia
the two femoral condyles are separated by?
an intercondylar eminence
What serve as the attachment sites for ACL and PCL?
anterior and posterior intercondylar areas
the knee joint is a ______ or modified ____ joint.
ginglymoid. hinge.
where does the stability in the knee come from?
static restraints (so non-bony anything!)
static restraints of the knee? (3)
- joint capsule
- ligaments
- menisci
dynamic restraints of the knee? (3)
- quadriceps
- hamstrings
- gastrocnemius
the femoral condyles project _____ from the femoral shaft.
posteriorly
the smaller _____ femoral condyle is ____ shaped and faces ____
lateral. ball. outward.
the medial femoral condyle is _____ shaped and faces _____.
elliptical shaped. inward.
Lateral epicondyle is the origin for the lateral head of the _____ and ______
gastrocnemius and LCL
Medial condyle is the insertion site for the ___ ____ and the _____
adductor magnus and MCL.
the _____-_____ width of the medial condyle is greater than its lateral by about ____ cm
anterior-posterior. 1.7 cm
the length of the articular surface of the medial femoral condyle is _____ than the length of the _____
longer. lateral
proximal tibia is composed of ___ plateaus and separated by the _______ _____.
- intercondylar eminence.
the tibial plateaus are ___ in a medial-lateral direction.
concave
in the anterior-posterior direction, the medial tibial plateau is also _____, while the _____ is _____.
concave. lateral. convex.
the medial plateau has ____ % greater surface area than the _____ plateau.
- lateral
which plateau has an articular surface 3 times thicker than the other?
medial
attachment site for medial meniscus
medial plateau
the posterior surface of the patellofemoral joint can have up to ____ facets. ____ on the medial and lateral suffaces.
- 3.
the patella is fixed in the ____ groove in _____ and mobile in _____.
trochlear. flexion. extension.
The patella decreases the amount of ____ - _____ tibiofemoral shear stress placed on the knee joint.
anterior-posterior
To make the “Q” angle of the knee. where are the two lines drawn from?
- ASIS to center of patella
2. center of patella to the tibial tubercle
the most common ranges for Q angle are ___ - ____ for males and ____ - ____ for females.
8-14, 15-17.
angles above ___ degrees are considered abnormal.
20
Increased “Q” angle aka?
French Bayonet
With the knee flexed at 30 degrees, there is failure of the ____ to derotate normally and failure of the ____ tendon to line up with the ___ ___ of the tibia.
tibia
patellar
anterior crest
The amount of contact between the patella and femur varies according to a number of factors. (4)
- the angle of knee flexion
- the location of contact
- the surface area of contact
- the patellofemoral joint reaction force.
during normal knee motions. the patella glides ____ and ____ during flexion. It covers a distance of ____.
inferiorly and superiorly . 5-7 cm.
Low patella = ?
patella baja **
High patella = ?
patella alta **
a _____ membrane lines the ____ portion of the knee joint capsule.
synovial. inner
the synovial membrane excludes the ______ ligaments from the interior portion of the knee.
cruciate.
cruciate ligaments are _______ yet _______.
extrasynovial.
intra-articular **
the proximal tibiofibular joint is an almost plane joint with a slight ______ on the oval tibial facet and slight ______ of the fibular head.
convexity.
concavity.
which end of the tibia has more motion?
the proximal head.
partial disruption at the patellar ligament-tuberosity attachment creating localized inflammatory changes. = ?
osgood-schlatter’s syndrome.
osgood-schlatter’s syndrome is common in ______ usually during a “______”
preadolescent.
growth-spurt
predisposing factors for osgood-schlatters syndrome? (3)
- tight hamstring
- tight achilles tendon
- tight quadriceps muscles.
Osgood-schlatter is more common in ____. Ages ___ - ____. Pain, swelling and tenderness over the ___ ____.
men.
10-15
tibial tubercle.
Osgood-schlatter syndrome has pain on _____ or _____ stairs. Usually have a history of _____ injury or ______ ______ - _____ movement.
ascending or descending.
single violent injury.
repetative flexion - extension.
static stability of the knee depends on which 4 ligaments?
- anterior cruciate
- posterior cruciate
- medial collateral
- lateral collateral
static stability provides ____ restraint to _____ knee motion.
primary.
abnormal.
Anterior translation restricted by?
ACL
Posterior translation restricted by?
PCL
valgus rotation restricted by?
MCL
varus rotation restricted by?
LCL
lateral rotation restricted by?
MCL and LCL
medial rotation restricted by?
ACL and PCL
Cruciate ligaments are _____ - ___ and _____ ____ because of the posterior invagination of the synovial membrane.
intra-articular and extra synovial
cruciate ligaments are different because they restrict ______ motion rather than restrict _____ motion.
NORMAL, abnormal .
Cruciate ligaments are named for their ______ ____
attachment sites.
ACL is primary to the ____ and secondary to the ____.
tibia
Femur
ACL is a ____ restraint to both ____ and _____ rotation in the ___ - ____ bearing knee.
secondary.
internal and external.
non-weight
ACL MC MOI? **
sudden deceleration with an abrupt change of direction with a FIXED FOOT
fixed foot = ?
closed kinetic chain
PCL provieds ____ - ___ % of posterior translation
90-95%
MOI where the PCL can tear? (2)
- excessive hyperflextion
2. Hyperextension
PCL most common injury? (at least from lecture)
dashboard injury
MCL: anterior fibers are taut in _____.
flexion (easy to palpate)
MCL: posterior fibers are taut in _____
extension (difficult to palpate)
main function of LCL?
to resist Varus forces.
LCL offers the majority of the varus restraint at ___ degrees of knee ____ and in full ____.
25 degrees.
flexion.
extension.
Secondary restraints of the knee? (3)
- the structures in the posterior-lateral and posterior-medial corners of the knee
- hamstrings and quadriceps.
- patellar ligament, oblique popliteal ligament and fabella.
which menisci is semi - lunar or C shaped?
Medial
Medial menisci is _____ and sits in the ____ medial tibial plateau and is ____ posteriorly than anteriorly.
thicker. concave. wider.
Which menisci is O shaped?
lateral
Lateral menisci sits over the ____ lateral tibial plateau. attached by ____ ligaments.
convex. coronary
Lateral menisci is ____ and more ____ than the medial.
smaller, mobile.
two ________ ligaments attach to the lateral menisci
mensicofemoral.
a meniscectomy can reduce the shock absorbing capacity of the knee by up to ___ %
20%
Terrible triad aka?
triad of O’Donoghue
Terrible triad is composed of?
- MCL
- ACL
- Medial meniscus
prepatellar bursitis aka?
housemaids knee
where does swelling occur for housemaids knee?
lower 1/2 patella and upper 1/2 of patellar ligament.
MOI for prepatellar bursitis?
excessive repetative kneeling or leaning forward. OVERUSE
Other possible MOI for housemaids knee?
direct blow or chronic friction.
Infrapatellar bursitis aka?
Clergyman’s knee
for clergymans knee, swelling occurs on both sides of the ___ ____ near the tibial tuberosity.
patellar ligament
superior lateral border of popliteal fossa
biceps femoris tendon
superior medial border of popliteal fossa
semitendinosus and semimembranosus
inferior borders of popliteal fossa
2 heads of gastrocnemius muscles
contents of popliteal fossa
posterior tibial nerve, poplietar artery and nerve.
escaped synovial fluid in an enclosed membrane sac which is protuding through the joint capsule of the knee
Bakers cyst
Bakers cyst often associated with?
RA
bakers cyst is a ________ joint disorder
femorotibial
Synovial ______ represents a remnant of the three separate cavities in the synovial ______ of the developing knee.
plica. mesenchyme
Retinacula is formed from structures int he ____ and ____ layers of the knee joint
first and second
retinacula can be divided into ____ and ____ retinacula.
medial and lateral
major muscles that act on the knee joint.
quadriceps hamstrings gastrocnemius popliteus hip adductors
The arc of flexion and extension should be smooth - on occasion a patient may be unable to extend the knee through the last ___ of motion and only may be able to finish with great effort. = ?
10 degrees.
= EXTENSION LAG
Extension lag occurs with ?
quadriceps weakness
the knee cannot fully extend without some amount of external tibial rotation of the femur because of the physical configuration of the knee joint and its cruciate ligaments.
Helfets Helix
With screw home motion; the ____ moves onto the femoral condyles in ____
tibia. extension
to reach full extension, the ____ side of the tibia must rotate _____ around the lateral femoral condyle.
medial
laterally
The _____ rotation allows the ____ femoral condyle to complete the extension position
lateral
medial
major blood supply to the knee comes from? (3)
- femoral artery
- popliteal artery
- genicular arteries
Nerves in the knee? (2)
- Femoral/saphneous N
2. Sciatic (common peroneal & tibial)
knee pain can be reffered to the knee from the lumbosacral region ___ to ___ segements, or from the ___.
L3 - S2
Hip