Knee MSK

Question 1

Largest joint in the body

Answer 1

knee

Question 2

Hyaline articular cartilage what type

Answer 2

Type II collagen

Question 3

Collagen types

Answer 3

Type I: Skin and normal tendons
Type II: Hyaline/articular cartilage
Type III: Tendinosis tendons
Type IV: Basement membrane

Question 4

Segond fx

Answer 4

when you tear your ACL and you get a lateral tibial plateau fracture

Question 5

ACL attachment/insertion

Answer 5

starts on femur and runs antero-infero medially to attach onto the tibia

Question 6

ACL tenses with and muscle imbalance for injury

Answer 6

knee extension;; Weak hamstrings and stronger quadriceps causes imbalance forces on the ACL and may increase the risk of a tear in women.

Question 7

With knee flexion wthe tibia will curve under the femur which will cause the ACL to pull the femur ___

Answer 7

anteriorly

Question 8

PCL origin/insertion

Answer 8

starts on femur and runs postero infero laterally to attach onto the tibia

Question 9

PCL tenses with

Answer 9

knee flexion;

Because of increased force in the patellofemoral compartment, patients with a PCL-deficient knee are more prone to patellofemoral arthritis.

Question 10

PCL limits

Answer 10

posterior translation of tibia

Question 11

Conjoint tendon

Answer 11

houses semitendinosus and biceps femoris medially, semimembranosus tendon originates laterally; ultimately going down the thigh the muscles separate out as MTB going medially to laterally

Question 12

Semimembranosus and semitendinosus innervation

Answer 12

L4,L5, S1 sciatic nerve (tibial division)

Question 13

Biceps femoris innervation

Answer 13

L5,S1 sciatic nerve tibial division long head fibular division short head

Question 14

Sartorius

Answer 14

starts at ASIS and attaches at knee, hip flexor and knee flexor

Question 15

Hip flexor and knee flexor

Answer 15

sartorius

Question 16

Gastroc

Answer 16

S1,2 tibial nerve, flexes te knee as well as plantar flexes ankle

Question 17

Quad- rectus fem, vast intermed, vast medialis, v LAT

Answer 17

L2,3,4 femoral nerve

Question 18

Knee internal rotators

Answer 18

semimembranosus, semitendinosus, Sartorius, gracilis , Say grace before tea + semimembranosus

Question 19

knee external rotators

Answer 19

biceps femoris

Question 20

unlocks knee

Answer 20

popliteus muscle

Question 21

risk factors for knee OA

Answer 21

trauma, obesity, weak quad muscles and weak hip muscles

Question 22

popliteal artery entrapment syndrome

Answer 22

young males usually, gastrocs , pop pulse diminishes with plantar flexion, lower limb swelling and discomfort with mild disease otherwise vascular bypassnumb/ting in lower limb or foot, arteriogram, activity modificatoin

Question 23

most comonly injured ligmaent in sports

Answer 23

ACL

Question 24

most commonly injured ligament overall

Answer 24

MCL

Question 25

brace for ACL tear

Answer 25

Lenox Hill derotation orthosis

Question 26

Bakers cyst location

Answer 26

between medial head of gastroc and semimembranosus

Question 27

Tx for patellofemoral pain syndrome

Answer 27

RICE, IT band vastus lateralis stretching and VMO and hip girdle strengthening (quad imbalance, more lateral pull, so want to make it more medial), patellar sleeve, kinesiotape for tracking, surgery if fails after 6 months

Question 28

Chondromalacia Patella

Answer 28

Generally sequela of patellofemoral pain syndrome, patellar cartilage degenerates and becomes soft due to improper tracking, MRI, arthroscopy, XR

Question 29

Jumpers knee location

Answer 29

Inferior pole of patella, proximal patellar tendon

Question 30

tx of patellar tendonitis

Answer 30

quad strengthening and stretching, PRP or tendon scraping (tendonosis)

Question 31

Popliteus tendonitis

Answer 31

pain in lateral knee, often due to downhill skiing or running

Question 32

Snapping knee from what

Answer 32

IT band snapping over lateral femoral condyle

Question 33

Cause of IT band syndrome

Answer 33

Weakness/tightness of TFL/IT band and hip abductors (glut med)...most pain in 30 deg knee flexion, nobles test postive with 90 deg knee flexion

Question 34

Ober test

Answer 34

side lying raise affected leg, abduct leg and let it drop, if it floats for a little bit then IT band tight, tests for IT band syndrome.

Question 35

Patello femoral syndrome caveat

Answer 35

A shallower-than-normal patellofemoral contour would imply that the patella does not “stay in its lane”, and may easily veer off towards the shallow side, since it does not have good bony anatomy keeping it in place. This veering off is the reason for these patients’ knee pain... so if shallow medial patellofemoral contour then you would want to do vastus lateralis Strengthening and vastus medialis stretching!

Question 36

right leg single leg squat while twisting on the right knee.

Answer 36

Thessaly test, meniscal tears

Question 37

deep squatting while pivoting under resistance is a classic mechanism for

Answer 37

lateral meniscus tears.

Question 38

significance of q angle The Q-angle is measured with one line from the ASIS to the central patella. Another line is drawn from the tibial tuberosity through the central patella. The Q angle is typically measured for evaluation of patellofemoral pain syndrome.

Answer 38

``` A larger Q-angle may create a larger lateral vector and potentially a greater predisposition to lateral patellar tracking when compared to a smaller Q-angle;;;; also increased risk for patellar sublux ```

Question 39

Q angle associated with genu **

Answer 39

increased Q-angle is | traditionally associated with a valgus knee

Question 40

Q angle females and males

Answer 40

Normally, Q angle is 14° for males and 17° for females.

Question 41

What things increase q angle

Answer 41

``` increased by genu valgum increased femoral anteversion external tibial torsion a laterally positioned tibial tuberosity or a tight lateral retinaculum. ``` also from Hip adduction and internal rotation Basically, any biomechanical factor that causes the tibial tuberosity to be laterally displaced in relation to the central patella or ASIS will increase the Q-angle.

Question 42

arcuate popliteal ligament complex function

Answer 42

to provide posterior and lateral rotary stability .. posterior horn of the lateral meniscus attaches here

Question 43

Superficial posterior compartment of leg

Answer 43

gastrocnemius plantaris soleus

Question 44

Deep posterior compartment

Answer 44

tibialis posterior flexor hallucis longus flexor digitorum longus popliteus

Question 45

medial and lateral patella facets in contact with the sulcus?

Answer 45

45 deg

Question 46

WB after ACL reconstruction

Answer 46

Immediate weight-bearing should be advised to reduce patellofemoral pain.... want to avoid , open chain exercises and isokinetic quadriceps strengthening

Question 47

Posterolateral corner injury pain in posterior knee

Answer 47

posterolateral corner is a complex of ligaments that brings stability to the posterolateral aspect of the knee. The arcuate ligament, fibular collateral ligament, and popliteus muscle tendon make up this complex. The common peroneal nerve lies between the first and second layers (between the IT band/biceps and LCL) of the outer knee. Test with DIAL test The most likely scenario is popliteal tendonitis considering downhill running and method of palpation. Remember, the posterolateral corner complex is made up of the arcuate ligament, fibular collateral ligament, and popliteus muscle tendon.

Question 48

Fulcrum test

Answer 48

most indicative of a femoral stress fracture (distal)