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Musculoskeletal Exam 4 > Knee Anatomy and Biomechanics > Flashcards

Knee Anatomy and Biomechanics Flashcards

1
Q

What are the 3 types of common injuries in the knee joint?

A
  • Unspecified sprains, strains, or overuse injuries
  • Contusions
  • Meniscal or ligamentous injuries
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2
Q

What is the largest joint in the body?

A

Tibiofemoral joint

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3
Q

What type of joint is the tibiofemoral joint?

A

Modified hinge joint

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4
Q

What originates at the lateral condyle of the femur?

A
  • Popliteus
  • Lateral head of the gastrocnemius
  • Lateral collateral ligament (LCL)
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5
Q

What originates at the medial condyle of the femur?

A
  • Adductor magnus
  • Medial head of the gastrocnemius
  • Medial collateral ligament (MCL)
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6
Q

How are the tibial plateaus oriented?

A

They are both concave in the mediolateral direction
The medial plateau is concave in the A/P direction
The lateral plateau is convex in the A/P direction

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7
Q

The ______ plateau has a surface area that is approximately _____% greater than that of the ______ plateau.

A

Medial 50% greater than lateral

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8
Q

The _______ pleateau’s articular surface is _____x thicker.

A

Medial, 3

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9
Q

What is the resting position of the tibiofemoral joint?

A

25 degrees flexion

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10
Q

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

A

Full extension, external rotation of the tibia

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11
Q

What is the capsular pattern of the tibiofemoral joint?

A

Flexion, Extension

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12
Q

What type of joint is the patellofemoral joint?

A

Modified plane joint

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13
Q

The patellofemoral joint has a wider ______ surface.

A

Lateral

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14
Q

What has the thickest layer of cartilage in the body?

A

Patellofemoral joint

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15
Q

What are the 5 facets of the patellofemoral joint?

A

Odd, Superior, Inferior, Medial, Lateral

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16
Q

What facet is most affected with chondromalacia patella?

A

Odd facet

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17
Q

The patellofemoral joint functions to:

A
  • Provide articulation with low friction
  • Protect distal femur from trauma and quads from wear
  • Improve cosmetic appearance of the knee
  • Improve moment arm of the quads
  • Decrease amount of A/P tibiofemoral shear stress
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18
Q

The knee joint capsule ascends superiorly/anteriorly above the patella to form the _________.

A

Suprapatellar pouch

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19
Q

The cruciates are ________, yet ________.

A

Extrasynovial, Intra-Articular

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20
Q

What type of joint is the proximal tibiofibular joint?

A

Plane synovial joint

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21
Q

The proximal tibiofibular joint has a slight _____ on the oval tibial facet. and a slight _______ on the fibular head.

A

Convexity, Concavity

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22
Q

The tibial articulating facet faces ______, _____, and _____.

A

Laterally, Posteriorly, and Inferiorly

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23
Q

The _______ tibiofibular joint has more motion than the ______.

A

Proximal has more motion than the distal

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24
Q

What are the two glides that can be done on the proximal tibiofibular joint?

A

Superioinferior, Anteroposterior

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25
The Anterior Cruciate Ligament (ACL) is the primary restraint for which motions?
Anterior translation and medial rotation of the tibia on the femur
26
The Posterior Cruciate Ligament (PCL) is the primary restraint for which motions?
Posterior translation and medial rotation of the tibia on the femur
27
The ACL and PCL are both secondary restraints for which motions?
Valgus and varus rotation of the tibia
28
The Medial Collateral Ligament (MCL) is the primary restraint for which motions?
Valgus and lateral rotation of the tibia
29
The Lateral Collateral Ligament (LCL) is the primary restraint for which motions?
Varus and lateral rotation of the tibia
30
The MCL and LCL are both secondary restraints for which motions?
Anterior and posterior translation of the tibia on the femur
31
The ACL and PCL both contain __________. What can disruption of these structures cause?
Mechanoreceptors | Interruption or elimination of sensory nerve fibers of the joint
32
A normal ACL is capable of microscopic adjustments to internal stresses. What do these adjustments influence?
- Laxity - Stresses - Kinematics
33
Tensile strength of the ACL is equal to which other ligament(s)? Tensile strength of the _____ is half of that of the _____.
MCL and LCL ACL is 1/2 of the PCL
34
Forcing the ACL more than _____% beyond its resting length may result in rupture.
5%
35
The PCL is _______% thicker and has _______x the tensile strength of the ACL.
50% thicker | Twice the tensile strength of the ACL
36
The PCL provides _______% of the total restraint to posterior translation of the tibia on the femur.
90-95%
37
The MCL and LCL are both considered to be ________ ligaments.
extra-articular.
38
Which of the collateral ligaments develops as a thickening of its meniscus?
MCL
39
The MCL is subdivided into _______ and ______.
Superficial band and deep band.
40
What are the characteristics of the MCL's superficial band?
Thick, flat band Fan-like attachment proximally on the medial femoral condyle Blends with the posteromedial corner of the capsule Typically, the first ligament injured with valgus stress
41
What are the characteristics of the deep band of the MCL?
Continuation of the capsule | Blends with the medial meniscus
42
The LCL arises from the ________ and runs ________ and _______ to insert into the _________.
Arises from the lateral femoral condyle and runs distally and posteriorly to insert into the head of the fibula.
43
What are the secondary restraints of the knee and what purpose do they serve?
They include the structures in the posterolateral and posteromedial corners of the knee and they serve to control anterior tibial translation relative to the femur.
44
What provides dynamic stability to the knee?
Unopposed contraction of the quadriceps complex, increasing anterior tibial translation (synergistic to the PCL) Isolated contraction of the hamstrings resulting in a posterior translation of the tibia (synergistic to the ACL)
45
What other structures provide support to the knee joint?
- Popliteus - Patellar Tendon - Oblique Popliteal Ligament - Fabella: a small sesamoid bone embedded in the lateral gastrocnemius tendon
46
How are the menisci shaped?
Like a race track: - Outer edges are thicker - Inner edges are thinner and more subject to tear with trauma
47
The outer _______% of the lateral meniscus is vascularized.
25%
48
The outer _______% of the medial meniscus is vascularized.
30%
49
The remaining inner portions of the menisci are considered what?
avascular
50
What are the characteristics of the medial meniscus?
- Semilunar - Wider separation of its anterior and poster horns - Larger and thicker than the lateral meniscus - Sits in the concave medial plateau - Attached to the anterior and posterior tibial plateau - Coronary ligament connect the outer meniscal border with the tibial edge and restrict movement of the meniscus - Medial meniscus also has attachment to the deeper portion of the MCL and the knee joint capsule.
51
What are the characteristics of the lateral meniscus?
- C-shaped - Sits on the convex lateral tibial plateau - Smaller, thinner, more mobile than the medial meniscus - Lateral meniscus excursion approx 10 mm (2mm for medial) - Attaches to tibia, capsule, and coronary ligament - Does not attach to the LCL
52
What are the functions of the MM and LM?
- Load transmission - Shock absorption - Joint lubrication - Nutrition - Secondary mechanical stability - Guiding of movements
53
What is plica?
Remnant of the 3 cavities in the synovial mesenchyme of the developing knee
54
What is the retinacula?
formed from structures in the first and second layers of the knee joint
55
How many degrees of freedom does the tibiofemoral joint have?
3
56
Joint stability is reliant on the restraints of:
- Joint capsule - Ligaments - Menisci - Musculature
57
During knee flexion the femur rolls ______ and glides _____.
rolls posteriorly, slides anteriorly
58
During knee extension the femur rolls ______ and glides ______.
rolls anteriorly, slides posteriorly
59
The screw-home mechanism occurs during the last ____ degrees of extension. Is is a complex function of what?
5 - surface geometry - tension in the ligamentous structures - action of the muscles
60
What are the static and dynamic restraints of the patellofemoral joint?
- medial retinaculum - bony configuration of the trochlea - medial patellomeniscal ligament - lateral retinaculum - quadriceps muscles (esp VMO)
61
What is the Q angle formed by? What does it measure?
Biisection of two lines: 1. ASIS to patella 2. Center of patella to the tibial tubercle It measures the tendency of the patella to move laterally when the quadriceps muscles are contracted
62
What is the normal Q angle for males? Females? What is considered abnormal?
Males= 8-14 degrees Females= 15-17 degrees Angles >20 are considered abnormal and may be indicative of potential displacement of the patella
63
Patellofemoral joint reaction force is a function of:
- Quadriceps and patellar tendon tension | - Angle formed between the quadriceps and patellar tendon
64
During OKC exercise, going from 90-full extension results in what?
Increased quad/PT tension, increasing PJRFs
65
OKC exercises ar 90-40 degrees provide what?
The lowest PJRF while producing the greatest amount og PF contact
66
During CKC exercises, at what angle is the maximum force in the Quad/PT generated?
60 degrees
67
What position are CKC exercises typically prescribed at? What should you progress to?
0-16 degrees | 0-30 degrees where the PJRFs are lower
68
The patella covers a distance of ______ with respect to the femur during tracking.
5-7 cm
69
A lateral C-shaped curve is produced by the patella as it moves in ROM from about _____ to _____ degrees.
120-30 degrees
70
Between 45 degrees and 15 degrees patellar tracking, the lateral curve produces:
- gradual medial glide of the patella | - medial tilt of the patella
71
Between 15 degrees and 0 degrees patellar tracking, the lateral curve produces:
- lateral glide of the patella | - lateral tilt of the patella

Musculoskeletal Exam 4 (6 decks)

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