Knee and Patella Flashcards

1
Q

When the femur is vertical, the medial condyle is ______ than the lateral condyle.

A

Lower

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2
Q

About a __ to __ degree difference exists between the two condyles.

A

5 to 7

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3
Q

Adductor tubercle is located

A

above the medial epicondyle

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4
Q

Patella Structures

A

Superior edge is called the base.

Pointed inferior surface is the apex.

Posterior surface has 2 articular facets

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5
Q

When the leg is straightened the patella can move slightly over the…

A

Patellar surface

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6
Q

When the knee is flexed the patella is locked in front of the _____ _______ by the ________ ________

A

Knee joint; quadriceps tendon

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7
Q

Knee Articulations(joints)

A

Femorotibial Joint
•Synovial Hinge

Patellofemoral Joint
•Synovial Gliding

Proximal Tibiofibular Joint
•Synovial Gliding

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8
Q

Stabilizing structures of the knee

A

Collateral Ligaments
•Medial
•Lateral

Cruciate Ligaments
•Anterior (ACL)
•Posterior (PCL)

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9
Q

Lateral and Medial menisci provide…

A

stability and shock absorption

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10
Q

Knee IR size and SID

A

IR: 10x12 LW
SID: 40 inches

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11
Q

Knee AP: IR, Position, CR, Collimation

A

IR: 10x12 LW

Position: Supine
•Femoral condyles parallel to IR

CR:
•Entering 1/2” inferior to patellar apex
Angle variable (ASIS to TT)
-If <19 cm: 3-5º caudal
-If 19-24 cm: perpendicular
-If >24 cm: 3-5º cephalic

Collimation: 1” on sides

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12
Q

Knee AP Evaluation Criteria

A

-Knee fully extended
-Entire knee without rotation
•Femoral condyles symmetric and tibia intercondylar eminence centered
•Slight superimposition of the fibular head if the tibia is normal
•Patella completely superimposed on the femur
-Open femorotibial joint space, interspaces of equal width on both sides if the knee is normal

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13
Q

Knee AP Oblique Medial Rotation IR, Position, CR, Collimation

A

IR: 10x12 LW

Position: Medial rotation
•Rotate affected side 45º

CR:
•Entering 1/2” inferior to patellar apex
•Angle variable (ASIS to TT)
-If <19 cm: 3-5º caudal
-If 19-24 cm: perpendicular
-If >24 cm: 3-5º cephalic

Collimation: 1” on sides

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14
Q

Knee AP Oblique Medial Rotation Evaluation Criteria

A

-Tibia/Fibula separated
-Lateral condyles of femur and tibia
-Both tibial plateaus
-Patella projecting beyond medial side of femoral condyle
-Open knee joint

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15
Q

Knee AP Oblique Lateral Rotation IR, Position, CR, Collimation

A

IR: 10x12 LW

Position: Lateral rotation
•Rotate affected side 45º

CR:
•Entering 1/2” inferior to patellar apex
•Angle variable (ASIS to TT)
-If <19 cm: 3-5º caudal
-If 19-24 cm: perpendicular
-If >24 cm: 3-5º cephalic

Collimation: 1” on sides

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16
Q

Knee AP Oblique Lateral Rotation Evaluation Criteria

A

-Medial femoral and tibial condyles
-Both tibial plateaus
-Fibula superimposed over the lateral half of the tibia
-Patella projecting beyond lateral side of femoral condyle
-Open knee joint

17
Q

Knee Lateral IR, Position, CR, Collimation

A

IR: 10x12 LW

Position: Mediolateral
•Turn on affected side
•Knee flexed 20-30º
•Epicondyles and patella ⟂ to IR

CR:
•Entering 1” distal to medial epicondyle
•Angle: 5-7º cephalic

Collimation: 1” anterior to patella

18
Q

For Knee Lateral why is CR entering 1” distal to medial epicondyle?

A

Prevents joint space from being obscured by magnified medial condyle

19
Q

Knee Lateral Evaluation Criteria

A

-Knee flexed 20 to 30º in true lateral
-Femoral condyles superimposed
-Fibular head and tibia slightly superimposed
-Patella in a lateral profile
-Open patellofemoral joint
-Open joint space between femoral condyles and tibia

20
Q

If the anterior surface of medial condyle is closer to the patella there is…

A

Over-rotation toward the IR

21
Q

If the anterior surface of medial condyle is farther from the patella there is…

A

Under-rotation away from the IR

22
Q

Patella Tangential (Settegast method) Cr and Collimation

A

CR: depends on degree of flexion (Typically 15 to 20 degrees Perpendicular to the joint space between the patella and femur)
Collimation: 4x4

23
Q

What if patient can’t bend knee that much for the tangential(settegast) view?

A

Do the Hughston method

24
Q

Patella Tangential (Merchant Method) IR, Position, CR

A

-IR: 14x17 CW
-SID: 72”
-Position:
•Supine with both knees flexed off table
•Elevate knees 2” to place femurs parallel with table
•Knees flexed 40º
•IR placed 1 foot distal to patella
-CR: perpendicular to IR at 30º caudal angle midway between patellae at patellofemoral joint

25
Patella Tangential Hughston Method
Position: *Prone *Flex knee 50-60º from table *Rest foot against collimator CR: *45º cephalic through patellofemoral joint
26
What if patient can’t lie prone for the Hughston method?
Do the Merchant method
27
Patella Tangential Evaluation Criteria
-Patella in profile -Femoral condyles and intercondylar sulcus -Open patellofemoral articulation
28
Knee AP Weight Bearing IR, Position, CR, Collimation
-IR: 14x17 CW | Wall Bucky -Position: •Upright, Center knees to IR •Toes straight ahead, feet apart •Weight equally distributed -CR: •Entering 1/2” below apices of patellae •Horizontal and Perpendicular -Collimation: 14x17
29
Knee AP Weight Bearing Evaluation Criteria
-Both knees without rotation -Knee joint spaces centered to the exposure area
30
What does Knee AP Weight Bearing show/demonstrate?
Narrowing of joint space; Arthritic knees
31
Which femoral condyle is larger
Medial is larger than lateral
32
What is the Patellar surface?
Shallow triangular depression
33
Tangential view is for the…
Patella
34
The Patella tangential demonstrates…
Fracture, Bipartite patella, Dislocation