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Gabe's Metabolism > Knee Joint > Flashcards

Knee Joint Flashcards

1
Q

Which two joints sit within the knee joint capsule?

A

Femur with tibia (tibiofemoral)

femur with patella (patellofemoral)

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2
Q

Which movements occur at the knee joint?

A

Flexion/extension

Rotation (during flexion)

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3
Q

When is the knee joint most stable?

A

In extension (close packed position)

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4
Q

What does the patellofemoral joint share the joint cavity with?

A

The knee

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5
Q

Do the articular surfaces of the knee joint provide much support?

A

No

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6
Q

Which 3 structures provide primary support to the knee joint?

A

Cruciate ligaments (ant & post)

Collateral ligaments (med & lat)

Menisci (med & lat)

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7
Q

When is the knee joint susceptible to injury?

A

In flexion and rotation

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8
Q

Which condyles of the knee joint are longer?

A

Medial condyles of both tibia and femur are longer than the lateral

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9
Q

How does rotation occur at the knee joint

A

Femur rotates medially on fixed (weight bearing) tibia

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10
Q

When does rotation occur in the knee joint? Around which ligament?

A

In last 15-20 degrees

Occurs about tight ACL

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11
Q

When are all knee ligaments tight?

A

In full extension

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12
Q

Which muscle unlocks the knee joint?

A

Popliteus

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13
Q

Does popliteus have an intracapsular origin?

A

Yes

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14
Q

Where is the knee joint capsule attached?

A

Around articular margins

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15
Q

What are the anterior reinforcements of the knee joint?

A

Patellar tendon

Retinacular fibres

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16
Q

What are the lateral reinforcements of the knee joint?

A

Popliteus, biceps femoris, iliotibial tract

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17
Q

What are the medial reinforcements of the knee joint?

A

Pes anserinus’ tendons

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18
Q

What are the posterior reinforcements of the knee joint?

A

Oblique popliteal ligament - from semimembranosus

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19
Q

Where are the deficiencies in the knee joint?

A

Above patella for suprapatellar bursa

Posteriorly, for popliteus tendon & semimembranosus bursa

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20
Q

What is pes anserinus?

A

From anterior to posterior, the tendons are:

Sartorius, gracilis, (bursa) and semitendinosus

“Say grace before tea”

21
Q

What are the bursae around the knee joint?

A

Suprapatellar bursa above patella

popliteus/semimembranosus bursa posteriorly

prepatellar, superficial infrapatellar, deep infrapatellar

22
Q

Which bursae communicate with the knee joint?

A

Suprapatellar and popliteus/semimembranosus bursa

23
Q

Which bursae of the knee joint are non-communicating?

A

Prepatellar

Superficial infrapatellar

Deep infrapatellar

24
Q

What are the cruciate ligaments of the knee joint named according to?

A

Tibial attachments

Cross within joint

25
Q

True or false: anterior and posterior cruciate ligaments are intrasynovial?

A

False

Extrasynovial

26
Q

What are the functions of the anterior and posterior cruciate ligaments?

A

Primary stabilisers in A-P direction

27
Q

What happens to the ACL in going from flexion to extension?

A

Hamstrings produce posterior shear force on tibia, reducing strain on ACL and counterbalances anterior shear provided by quadriceps.

28
Q

What does the ACL do?

A

Tightens & untwists prior to extension (last 15-20 deg)

Passively rotates lateral condyle in medial direction

Assists internal rotation of femur & contributes to locking.

29
Q

When does ACL injury occur?

A

When rotation occurs in opposite direction (laterally)

Involves extension on weight-bearing leg.

30
Q

What happens in an ACL graft?

A

ACL graft using hamstrings can take 1-3 years for graft site to repair

New insertion commonly as much as 4cm prox to pes anserinus

31
Q

What does the PCL do?

A

Limits posterior displacement of tibia in knee flexion

32
Q

When is the PCL prone to injury?

A

Fall on flexed knee

Bumper bar impact

33
Q

What are the 2 parts to the medial collateral ligament?

A

Long, flat superficial part

Deep part blends with capsule & attaches to medial meniscus

34
Q

What does the medial collateral ligament do?

A

Resists valgus (abduction) forces & lateral rotation of tibia

because of alignment (not vertical but A-P) also limits anterior displacement of tibia when ACL damaged (2nd restraint)

35
Q

What separates the lateral collateral ligament from the lateral meniscus?

A

Popliteus tendon

36
Q

Which forces does the lateral collateral ligament resist?

A

Varus (adduction) forces

37
Q

Which collateral ligament is injured most often?

A

Medial

38
Q

What are the functions of menisci?

A

Shock absorb

Weight distribution

Wedge-shaped, increase area of contact by ~⅓

39
Q

When do the menisci move?

A

With the femur in rotation

40
Q

Which meniscus is more commonly injured?

A

Medial

41
Q

Why is the medial meniscus more commonly injured?

A

It is longer

Horns are further apart

It is less mobile (due to attachment to MCL)

42
Q

Which parts of the menisci have covering in the synovial cavity?

A

Peripheral parts

43
Q

What does the meniscus contribute to?

A

Locked knee

44
Q

What does meniscus removal lead to?

A

↑ incidence OA

45
Q

What are the articular surfaces in the patello-femoral joint?

A

Patella & patellar surface of femur

46
Q

What 3 structures maintain the normal alignment of the patellofemoral joint?

A

Strong vastus medialis muscle

Medial patellar retinaculum

Raised lip on lateral femoral condyle (arrow)

47
Q

What pulls the patella laterally?

A

Quadriceps

48
Q

What is the mechanical problem of patellofemoral mechanics?

A

Patella pulled laterally by strong quadriceps muscles

tracking of patella in femoral groove → degeneration of cartilage (chondromalacia patella)

Angle (‘Q - quadriceps angle’ between tendon of quads & patellar tendon)

Predisposes to subluxation/dislocation

Gabe's Metabolism (5 decks)

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