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COMP ORTHO > Knee > Flashcards

Knee Flashcards

1
Q

Femur - mechanical axis

A

connects hip joint to knee joint

3 degrees from vertical

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2
Q

Femur - anatomical axis

A

along shaft of femur

6 degrees from vertical

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3
Q

Femur - trabecular system

A

weak zone at neck

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4
Q

Medial femoral condyle

A

Thinner

Longer

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5
Q

Lateral femoral condyle

A

sticks out more - more in line with femoral shaft

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6
Q

Femoral shaft obliquity

A

femur tilts towards lateral side

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7
Q

Patella surface

A

longer on lateral side

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8
Q

Tibia - condyles

A

medial is 50% larger and 3x thicker

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9
Q

Tibial condyles - concave/convex

A

Convexity is greater posteriorly so the joint is more congruent in extension

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10
Q

Transverse ligament

A

holds menisci from getting farther apart

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11
Q

Coronary ligament

A

connection btw menisci and rim of tibia

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12
Q

Medial meniscus attached to what

A

MCL and semimembranosus

More C shaped

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13
Q

Lateral meniscus attached to what

A

PCL and popliteal

More O shaped

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14
Q

Bowstring effect draws patella what direction

A

laterally

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15
Q

Genu valgum

A 
knock knees
abnormal angulation of tibia away from midline
mechanical axis is displaced laterally 
medial structures = tensile
lateral structures = compressive
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16
Q

Genu varum

A

bow legged
mechanical axis displaced medially
medial = compression
lateral = tensile

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17
Q

Genu recurvatum

A

mechanical axis displaced anteriorly
Ant = compression
Post = tensile
Excessive strain on ACL

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18
Q

Q angle

A

line between patellar tendon and patellar tendon tubercle

usually 14 degrees

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19
Q

Flexion - synovial flow

A

posteriorly

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20
Q

Extension - synovial flow

A

anteriorly

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21
Q

LCL
Resists what
Tight and slack in what

A

Resists varus stress and tibial ER
tight in ext, slack in flex
first resistance to force from medial side

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22
Q

MCL

A

Resists valgus stress, ER, and ant translation of tibis
Connects capsule and medial meniscus
tight in ext, slack in flex

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23
Q

ACL

A

resists ant tibial translation and tibial IR

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24
Q

PCL

A

resists post tibial translation and tibial IR

protects knee with flex

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25
Q

Arcuate popliteal ligeamnt

A

Reinforces posterolateral capsule

resists varus stress

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26
Q

Oblique popliteal ligament

A

reinforces posteromed capsule
resists valgua stress
limits ER
resists hyperextension

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27
Q

Parapatellar ligament (retinaculums)

A

helps hold patella in groove

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28
Q

Flexion

A

130

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29
Q

Extension

A

0?

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30
Q

IR

A

30

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31
Q

ER

A

40

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32
Q

Open chain arthrokinematics

A

Tibia on femur

concave on convex = SAME

33
Q

Close chain arthrokinematics

A

Femur on tibia

convex on concave = OPP

34
Q

screw home mechanism

A

flexion = tibia IR
extension = fbular ER
Most of rotation occurs over last 30 degrees of extension

35
Q

Close packed

A

ext

36
Q

Loose packed

A

flex 25 degrees

37
Q

Lateral tibial torsion

A

knee is forward but foot goes out in lateral direction

38
Q

Miserable mal alignment syndrome

A

femoral anteversion throws you into IR

Will have genu valgum, VMO weak, lateral tibial torsion, forefoot pronation

39
Q

Camel sige

A

patellar tendon torn - secondary to patella alta

40
Q

Squinting patella

A

Patella comes out too far medially

look for flat feet

41
Q

Classification for articular cartilage damage

A

stage 1 - softening
stage 2 - fibrillation
stage 3 - deeper fissuring
stage 4 - exposed bone

42
Q

Gout

A

elevated serum uric acid and deposition of urate crystals in joint soft tissues and kidneys

43
Q

Pseudogout

A

deposit of calcium pyroophosphate crystals

44
Q

Gout - epidemiology

A

Males more than females

most common over age 40

45
Q

Hemophillic arthritis

A

Medical emergency!!!

blood in joint leads to cartialge degeneration

46
Q

OA - where most vulnerable

A

medial side

47
Q

OA - nonsurgical treatment - when open vs. closed chain

A

Acute = open chain

Subacute - closed

48
Q

Pyogenic arthritis

A

medical emergency!

Bacterial infiltration

49
Q

Reiters

A

reactive arthritis from microbial pathogens

most common in males over 30

50
Q

ACL injury

A

Contact or non

Hyperextension, valgus, or rotational force

51
Q

ACL injury - clinical presentation

A

audible pop, rapid onset, unable to WB, instability/giving way
Knee flexion as protection

52
Q

Chondromalacia patellae is what

A

softening of cartilage on undersurface of patella due to overuse

53
Q

Special tests for chrondromalcia patellae

A

Clarke’s

54
Q

Fat pad syndrome is what

A

irritation of infrapatellar fat pad due to impingement between femoral condyles and patella

55
Q

Fat pad syndrome - clinical presentation

A 
Genu recurvatum
patella alta
hypertrophied fat pad
knee cap pain
inferiorly titled patella
56
Q

LCL injury caused by what

A

Varus stress contact
not as common
heals slowly

57
Q

LCL - sprain grades

A

grade 1 = slight

grade 3 = complete tear

58
Q

Special tests for LCL

A

varus stress at 0 and 30

59
Q

MCL injury is caused by what

A

valgus stress contact with rotational force

often get ACL or meniscus issue too

60
Q

Meniscus injury is caused by what

A

trauma with rotation, cutting movement, deep flexion
degeneration (fraying, stable, tears, necrosis, CPPD)
most likely to occur at 30 flexion

61
Q

Meniscus injury is often associated with what

A

ACL and MCL injury if caused by trauma

62
Q

Forced into myperextension can lead to

A

medial meniscus tear

poor blood supply - poor healing

63
Q

Clinical presentation with meniscus tear

A

loacking at 10-30 degrees flexion
instability
click/snap
symptomatic pop with pain at joint line

64
Q

Special tests for meniscus

A 
Apley
joint line palpation
valgus/varus stress
mcmurray 
arthrogram
mri (not easy to meniscus tear though)
65
Q

Patellar dislocation caused by what

A

pivot turn and patella will dislocate

can be direct blow to knee or indirect patellar malalignment

66
Q

Patella subluxation

A

More common than dislocation

F more than M

67
Q

Clinical presentation - sublux

A 
tenderness around patellar border
Q angle more than 20
Instability 
click/slide/lock
atrophy of VMO
hypertrophy of VL
68
Q

Patellar tendon rupture caused by

A

forceful eccentric contraction
defect in inf pole
more common 20-40

69
Q

PCL injury how

A

post tibial translation - MVA with tibia on dash

varus, twisting motion

70
Q

Pre-patella bursitis

A

prolonged kneeling or falling onto knees

71
Q

Ottawa rules

A 
Age 55+
Tender fibular head
Isolated patellar tenderness
Unable to flex knee to 90
Unable to WB for 4 steps immediately post trauma or in ER
72
Q

Pittsburgh rules

A

Age less than 12 or more than 50

Unable to walk 4 WB steps in ER

73
Q

Distal femur fx types

A 
A = extraarticular
B = unicondylar
C = bicondylar
74
Q

Femoral shaft fracute -

A

life threatening because of considerable bleeding and fat embolism
massive force required

75
Q

Intercondylar (tibial spine) fracture

A

direct blow to proximal tibia with knee flexed or in rotation
Hyperextension with varus/valgus stress

76
Q

Bakers cyst

A

herniated synovial lining

77
Q

Osgood Schlatters

A

due to overuse in young athletes

osteochondritis of tibial tubersotiy apophysis

78
Q

Osteochrondritis dissecans

A

trauma causes separation of cartilage and subchondral bone
piece becomes necrotis
loose body in joint space

COMP ORTHO (11 decks)

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