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NMS 670 > Knee Joint > Flashcards

Knee Joint Flashcards

1
Q

What are the 2 joints of the knee?

A

tibiofemoral joint

•patellofemoral joint

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2
Q

Patellofemoral articulation have what type of biomechanics?

A

7x body weight w/squats
2-3x body weight descending stairs
Reaction force

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3
Q

Motion of the knee is a _____ articulation allowing patella to move __ cm causally in full flexion.

A

Sliding
7
Note: max contact b/t femur/patella 45 degree of flexion

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4
Q

An increased Q angle can result in

A

Patella instability characterized by patella subluxation/dislocation

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5
Q

Name the 3 characteristics that lead to an increased Q angle.

A

Femoral anteversion
Genu Valgum
External tibial torsion/pronated foot

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6
Q

What are the biomechanics of the tibiofemoral articulation?

What is its motion?

A

Joint reaction force
3x body weight walking
4x body wight climbing

3 degrees of hyper extension to 155 degrees of Flexion in Sagittal plane. Thigh-calf limiting factor to full flexion
Norm gait ROM 0-70 degree

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7
Q

What is the relevance of of Tibiofemoral articulation rotates instant center, points at direct contact?

A

Rolls posterior
Knee flex: instant center of rotation on femur moves posteriorly
Allows: inc knee flexion by avoids impingement

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8
Q

Which side is the longest on Tibial plateau and what is the cause of screw home mechanism?

A

Medial

Tibial Externally rotates 5 degrees in 15 degrees of extension

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9
Q

What is is the relevance of rotation in TF articulation?

A

Locks knee decreasing the work performed by quads while standing

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10
Q

The tibia is subject to ——— w/knee flexion. External rotates on femur as the knee performs what action?

A

Internal rotation

Extends

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11
Q

The lateral condyle shifts in what direction on the axis of rotation when the knee is in flexion?

A

Posterior

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12
Q

Tibial internal rotation occurs with what movement?

A

Knee flexion

Note: 120 degrees to full flexion both condyle participate in Roll Back

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13
Q

Which ligament has a varus stress at the knee?

A

Lateral collateral ligament

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14
Q

Which collateral ligament experiences a valgus stress?

A

Superficial portion of the medial collateral ligament

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15
Q

What is the function of the stability of the knee?

A

Primary: static restraint to anterior translation

Also, play a role in axial rotation

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16
Q

What are the stabilizing components for the anterior cruciate liagment of the knee?

A

Anteromedial bundle tight in Flexion

Posterolateral bundle tight in Extension

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17
Q

What is the primary function of the posterior cruciate ligament?

A

Primary static restraint to posterior translation

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18
Q

What is the primary stabilizer of external tibial rotation of the knee?

A

Posterolateral corner

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19
Q

Knee and joint pain must b distinguished b/t what?

A

Radiating or referred pain and local knee problems

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20
Q

The knee joint can receive Refetred pain from where else in the body?

A 
Low back
Hip
Ankle
Foot 
Note: frequently the knee joint is injured b/c of position exposure to outside trauma
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21
Q

What is the most commonly injuries joint of the body?

A

Knee joint

Note: the knee relies mainly on ligaments and muscles for its stability

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22
Q 
True or Fail:
Joint effusion (swelling) provides stability to the knee.
A

True

Note: all ortho exams will be painful

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23
Q

True or False:

Reactive muscle spasms and swelling will make testing unreliable to an acute knee injury.

A

True

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24
Q

Are soft tissue injuries usually the result of overuse, disuse or both?

A

both

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25
Q

Knee pain d/t pronation, supination, lower leg torsion, patellar tracking problems and an increased Q-angle are the result of overuse or disuse?

A

Disuse

Notes: disuse is the biomechanics predisposition of knee joint and pain

26
Q

The history concerning activities d/t overuse are what?

A

W/repetitive movements or prolonged awkward positing of the knee

27
Q

Patellofemoeral arthralgia, patellar instability and tracking disorders are all common presentations for what group of people? ID the specific are of knee pain.

A

Athlete w/anterior knee pain

28
Q

Elderly pt’s commonly presents w/knee pain and stiffness as a result of what condition?

A

OA

29
Q

Osgood-Schlatter dz is a condition that ___ experience pain around or directly on the tibial tuberosity.

A

Young athlete

30
Q

Chronic ACL damage is a common presentation for pt’s with what condition?

A

Instability

31
Q

A pt presents with painful locking of the knee. This likely is a common presentation for what condition?

A

Meniscus tear

32
Q

An ACL tear or patellar dislocation present in the history indicates a trauma with what motion?

A

Hyperextension

33
Q

The pt has a history of a tear in the PCL. What motion has most likely occurred from this type of trauma?

A

Hyper-flexion

34
Q

A history of a sudden declaration trauma is likely to be due to what type of damage and specifically to what muscle filter?

A

ACL tear

35
Q

Valgus force with no rotation is a tear to what specific ligament?

A

MCL

36
Q

Valgus force w/ration (foot fixed) can lead to trauma on what fibers?

A

ACL, MCL and menisci

37
Q

Which of the following is not d/t valgus force w/rotation to the knee? ACL, MCL, PCL and menisci

A

PCL

38
Q

What structure make up the terrible triad of the knee?

What is the aka of this condition?

A

ACL
MCL
Meniscus
O’Donoghue triad

39
Q

O’Donoghue triad aka is

A

The Terrible Triad

Note:ACL, MCL, meniscus

40
Q

What injury occurs when the foot is planted or fixed and outside force applied in a valgus direction?

A

The terrible triad aka O’Donoghue triad

Made of Anterior Cruciate Ligament, Medial Collateral ligament and Meniscus

41
Q 
Which of the following are included in the “Terrible Triad”? 
Anterior Cruciate Ligament
Posterior Cruciate Ligament  
Medial Collateral ligament 
Lateral Collateral ligament 
Meniscus
A

Anterior Cruciate Ligament, Medial Collateral ligament and Meniscus

42
Q

A pt has a history of feeling a pop and pain deep with immediate swelling (hemarthrosis) to the knee. What fiber has been damaged?

A

Anterior cruciate ligament

43
Q

A pt has generalized knee pain, instability that prevents to return to sports and difficulty weight bearing. These are symptoms involve what ligament?

A

Anterior cruciate ligament (ACL)

44
Q

On physical exam the doc might observe an effusion and what else during inspection?

A

Quadricep avoidance gait (pt will not actively extend the knee).

45
Q

The lack of what motion is secondary to meniscus injury or arthrofibrosis?

A

Full extension

46
Q

The McMurray varus/valgus stress test evaluates the motion of what structures?

A

Meniscus or concomitant ligamentous injuries

47
Q

ACL tears are common athletic injuries leading to what type of instability of the knee?

A

Anterior and lateral rotatory instability

48
Q

The dx of an ACL tear or damage can be supspected clinically with the presence of a dame to the knee. What test is required to confirm dx? What ortho is used to check for damage?

A

Traumatic knee effusion w/increased laxity on Lachman’s test (also any drawers test). This requires a MRI to confirm dx.

49
Q

The treatment of choice for ligamentous reconstruction depends upon what?

A

Pt’s age and activity level

50
Q

Will a chronic ACL issue have a previous acute presentation in the history?

A

Yes

51
Q

A pt complains of instability of the knee and not pain with the occurrence of a non-traumatic joint line swelling and an acute presentation in their history. This pt likely has an issue with what ligament?

A

ACL

52
Q

ACL tears occur from hyperextension and what other actions?

A

Sudden stopping/cutting

Quadriceps contraction

53
Q

ACL tears occur from hyperextension a sudden stop and quadriceps contraction. Contact with rotation can affect what structures?

A

Menisci and MCL

54
Q

What section of the ACL usually tears?

A

Mid-substance

55
Q

What other structure may rupture with the anterior cruciate ligament?

A

Middle Genicular artery

56
Q

True or False

An anterior cruciate ligament causes sudden selling and is Stengel and painful.

A

True

57
Q

A. What visual information can be gathered from taking a MRI of the ACL?

B. Why are x-ray’s taken?

A

A. Integrity of the ACL

B. To rule out a fracture

58
Q

What orthopedic test is used to evaluate a suspected ACL injury? What structure is eliminated with this test?

Note: may need to update this question later.

A

Anterior Drawer Test
Hamstrings functions are considered here

Lachman’s test in the acute setting

59
Q

What injury accounts for half of all knee injuries and has a common incidence?

A

ACL

60
Q

A. ACL injuries are more common among in what demographic?

B. What leg is most subject to injury?

A

A.Female athlete,
Sustained at younger age than males

B. Supporting leg (its kicking leg w/males)

61
Q

What are the risk factors for an ACL injury?

A
  1. Female soccer player,
  2. Male basketball player
  3. Valgus moment at the Knee and Adduction moment at the Hip upon LANDING

NMS 670 (1 decks)

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