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Kines Exam 1 > Knee > Flashcards

Knee Flashcards

1
Q

What is the osteology of the tibiofemoral joint and the patellofemoral joint?

What type of joint?

A

Femur, Tibia, Patella

Tibiofemoral = modified hinge

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2
Q

What is normal tibiofemoral alignment? What is genu valgum? Genu varum?

A 
Normal = 170-175 femoral shft laterally from tibial shaft
Valgum = (knock knees) <165
Varum = (bow legs) >180
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3
Q

What compartment is compression in genu valgum? Genu varum?

A

Valgum - lateral compression

Varum - medial compression

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4
Q

What factors can lead to genu valgum?

A 
	Previous injury
	Genetic predisposition
	High body mass index
	Laxity of ligaments
	Abnormal alignment &amp; muscle weakness at either end of the lower extremity
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5
Q

What factors can lead to Genu varum?

A
  • Previous injury
  • Genetic predisposition
  • Laxity of ligaments
  • Abnormal alignment & muscle weakness at either end of the lower extremity
  • Thinning of articular cartilage on medial side can result in genu varum (only one different)
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6
Q

What might result from genu valgum?

A

 Increased stress on MCL, increased stress in lateral compartment
 Excessive lateral tracking of the patella
 Increased stress on ACL

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7
Q

What might result from Genu varum?

A

 Increased medial compartment loading
 Greater loss of medial joint space
 Increased strain on LCL

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8
Q

What is genu recurvatum? Where is the stress placed with this posture?

A
  • Hyperextension at the knee when standing

- Overstretched posterior capsule and paralyzed knee flexors

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9
Q

What are the attachments and function of the meniscus?

A

 Distribute weight bearing forces
 Increase joint congruence
 Shock absorption
 Medial meniscus
 Less mobility due to greater ligamentous restraint
Attachments:
 Connections to MCL, ACL, PCL, semimembranosus

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10
Q

What is the lateral meniscus connected to?

A

MCL, PCL popliteus

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11
Q

What part of lateral meniscus is vascularized?

A

Periphery

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12
Q

What motions does the ACL restrict?

A

Primary - restraint to anterior translation of tibia on femur
-Also hyperextension, varus/valgys, tibial rotation medial/laterally

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13
Q

What motions does the PCL restrict?

A

Primary - posterior translation of tibia on femur

-Also varus and valgus stresses, tibial rotation medial

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14
Q

What motions does the MCL restrict?

A

Primary - valgus and lateral tibial rotation

-Also anterior translation of tibia on femur

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15
Q

What motions does the LCL restrict?

A

Primary - varus

-Also tibial rotation laterally

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16
Q

ACL 3 factors associated with non-contact injuries:

A

 Strong activation of quad over moderately flexed or nearly extended knee
 Marked valgus collapse of the knee
 Excessive ER of the knee

17
Q

PCL factors associated with injuries:

A
  • Associated with high-energy trauma: contact sports
  • MOI
    1. Falling on to fully flexed knee with ankle plantar flexed (proximal tibia his ground first)
    2. “Dashboard” injury
  • Posterior sag sign
18
Q

Describe the osteo of the tibiofemoral joint.

A

Flex/Ext
IR/ER (arthro not defined)
Abduction/Adduction (arthro not defined)

19
Q

Describe the arthrokinematics of the tibiofemoral joint.

Flex OKC and CKC=

A 
OKC = posterior roll/glide
CKC = Posterior roll/ant glide
20
Q

Describe the arthrokinematics of the tibiofemoral joint.

Ext OKC and CKC=

A 
OKC = Anterior roll/glide
CKC = Anterior roll/post glide
21
Q

What is terminal extension of the knee?

A

Need 10 degrees of ER to fully extend knee

22
Q

Describe the screw home mechanism at the knee

A

Knee must unlock (popliteus) prior to performing flexion by 1st medially rotation then flexing

23
Q

What is the open pack position and capsular pattern at the tibiofemoral joint?

A

Open pack = 25 flexion

Capsular pattern = flex&raquo_space; ext

24
Q

Describe the joint congruency of the patellofemoral joint and the changes that occur in it with knee flexion.

A

Full ext = patella lies on femoral sulcus so minimal joint congruency here -> greater chance for instability

25
Q

Why is important for us to have a patella?

A
  1. Acts as spacer/pulley between femur and quad

2. Increase internal moment arm of knee extensors

26
Q

What structures help stabilize the patella?

A 
 Reliant on static and dynamic structures for stability secondary to incongruence of PF joint Lateral patellofemoral ligament
 Medial patellofemoral ligament
 Medial patellotibial ligament
 Lateral patellotibial ligament
 Quadriceps
 Trochlear Groove
27
Q

Describe the motions of the patella.

A
  • Inferior/superior glide with flex/ext
  • Medial/lateral glide: frontal plane translation
  • Medial/lateral tilt
  • Medial/lateral rotation
28
Q

Put in order from least to most the compressive forces at the patellofemoral joint during squatting, walking, and climbing stairs.

A
  1. 1.3 body weight with walking on level surface
  2. 3.3x body weight with climbing stairs
  3. 7.8x body weight with deep squats
29
Q

What is the Q angle? What is a normal Q angle? Why do we care?

A

q angle - line connecting ASIS to middle of patella
-estimation of line of pull of quads
Normal - 13-15
-Increased Q angle increases lateral force on the patella

30
Q

Describe local factors that may limit lateral pull of the patella.

A

 Raised lateral facet of trochlear groove
 Quadriceps in particular VMO
 Medial patellar retinacular fibers
 Medial passive structures

31
Q

Describe local factors that may contribute to lateral pull of the patella.

A
  • Tight IT band or excessive tension in lateral patellar retinacular fibers or lateral passive structures may increase lateral pull
  • Decreased fit of patella within trochlear groove of femur
32
Q

Describe global factors that may contribute to lateral pull of the patella.

A
  • Excessive Genu valgum increases Q-angle
  • Weakness of hip abductors/ER, or tightness of adductors/IR
  • Excessive pronation (eversion) of subtalar joint also can create excessive valgus load
33
Q

What are the recommendations for weight bearing and non weight bearing exercises for patellofemoral pain syndrome?

A

-Recommended avoid deep flexion in weight bearing, and avoid final 30 degrees of extension during non-weight bearing

Kines Exam 1 (15 decks)

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