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Procedures & Analysis > KNEE PROC. > Flashcards

KNEE PROC. Flashcards

1
Q

_______ - KNEE JOINT, between 2 condyles of the femur
TYPE:
What else articulates with knee joint? AKA:_____-

A

Femorotibial joint
- synvoial, diathrotic joint, bicondylar type
patella
- patellofemoral joint

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2
Q

DISTAL FEMUR ANATOMY:
_____ - Located posterior view of femur, large & round
________ femoral condyle is ___* than lateral
__________ - sperates medial & lateral condyle posteriorly
_______ - rough prominences on outermost tips of condyle
________ - Superior part of medial epicondyle
_____ - Area posterior femur, right above intercond. fossa

A

-Condyles
-5-7* lower than lateral (this is why you angle on lateral)
-Intercondylar Fossa
- Epicondyles
-Adductor Tubercle
- Popliteal Surface

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3
Q

PROXIMAL TIBIA ANATOMY
____ & ______ - Large processes that make up medial & lateral aspects of tibia
_____ - Tibial spine, medial & lateral intercondylar tubricles
_____ - Tibial Plateau, Slopes _____, @ ______ *
Tibial Tuberocity can be affected by what disease?

A
  • Medial & lateral condyle
    -Intercondylar Eminence
  • Articular facets = tibial plateau, 10-20* posterior angle
    -Osgood-Schlatter Disease
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4
Q

Ligaments in Knee:
1. _______, 2.________, 3. ________, 4. __________

Knee Joints contain 2 fibrocartilage disks called ______, provide ________.

A
  1. Anterior Cruciate Ligament (ACL), 2. Posterior Cruciate Ligament (PCL) 3. Tibial Collateral Ligament (MCL) 4. Fibular Collateral Ligament (LCL)

lateral & medial meniscus = stability & shock absorbers

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5
Q

LABEL THE IMAGE

A

A. Patella
B. Lateral epicondyle
C. Lateral condyle
D. Intercondylar eminence
E. Fibular head
F. Tibia
G. Femorotibial joint
H. Medial epicondyle
I. Femur

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6
Q

PROJECTIONS OF KNEE
ROUTINE:
ADVANCED:
TECHNICAL FACTORS:
SID:
IR SIZE:
GRID?

A

R: AP, AP OBLIQUE (MEDIAL &/OR LATERAL ROTATION), LATERAL

A: CAMP-CONVETRY METHOD, HOLMBLAD METHOD, BECLERE METHOD (TUNNEL VIEWS) & AP WEIGHT BEARING

T: TT = 60-65 @ 4-6 BUCKEY =. 70-75 @ 8-10

SID = 40
IR = 8X12
GRID: ONLY IF ANATOMY MORE THAN 10CM

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7
Q

AP KNEE
CR:
ANGLE?
ANATOMY:

A

CR: 1/2 IN DISTAL TO APEX PATELLA
ANGLE: BASED ON ASIS TO TABLETOP
- <19CM = 3-5 CAUDAD (THIN)
- 19-24 CM = 0* (AVERAGE)
- >24 CM = 3-5* CEPHALAD (THICKER)
ANATOMY: FIB HEAD SUPERIMP. BY TIBIA
- INTERCONDYLAR EMINENCE IN CENTER OF INTERCONDYLAR FOSSA
- FEMOROTIBIAL JOINT SPACE OPEN
- SYMMETRIC APPEARANCE OF FEMORAL & TIBIAL CONDYLES

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8
Q

AP OBLIQUE KNEE
CR:
POSITION:
ANGLE?
ANATOMY:

A

CR: 1/2 IN DISTAL TO APEX PATELLA
POSITION: 45* OBLIQUE MEDIAL OR LATERAL
ANGLE: BASED ON ASIS TO TABLETOP
- <19CM = 3-5 CAUDAD (THIN)
- 19-24 CM = 0* (AVERAGE)
- >24 CM = 3-5* CEPHALAD (THICKER)
ANATOMY:
MEDIAL = PATELLA SUPERIMP. MEDIAL FEMORAL CONDYLE, HALF PATELLA FREE OF FEMORAL SUPERIMP. & TIBIOFUBULAR JOINT OPEN

LATERAL = PATELLA SUPERIMP. LATERAL FEMORAL CONDYLE, HALF PATELLA FREE FEMORAL SUPERMP. & PROXIMAL FIBULA SUPERIMP. BY TIBIA

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9
Q

LATERAL KNEE
CR:
POSITION?
ANGLE:
ANATOMY:

A

CR: 1 IN DISTAL TO MEDIAL EPICONDYLE
POSITION: 20-30* KNEE FLEXION, EPICONDYLES PERP TO IR, PATELLA PERP TO IR
ANGLE: 5-7* CEPHALAD ALWAYS
ANATOMY: PATELLOFEMORAL & KNEE JOINT OPEN
- FEMORAL CONDYLES SUPERIMPOSED
- FIBULAR HEAD SLIGHT SUPERIMP. TIBIA
- PATELLA IN PROFILE

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10
Q

IF YOU FLEX KNEE TOO MUCH, WHAT CAN OCCUR?
WHAT ARE THE TUNNEL VIEWS?
WHAT IS THE CLINICAL INDICATION FOR THEM?

A
  • WILL DRAW PATELLA INTO INTERCONDYLAR SULCUS
  • CAMP COVENTRY METHOD, HOLMBLAD METHOD.
    & BECLERE METHOD
  • BONY CARTILAGINOUS PATHOLOGY OR NARROWING JOINT SPACE
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11
Q

PA AXIAL PROJECTION - INTERCONDYLAR FOSSA
AKA: CAMP COVENTRY METHOD
ANGLE?
PATIEINT POSITION:
CR:
ANATOMY:

A

CR: PERP TO LOWER LEG @ MIDPOPLITEAL CREASE
ANGLE: 40-50* CAUDAD TO MATCH FLEXION
POSITION: PRONE, FLEX KNEE 40-50*, IR TO KNEE JOINT
ANATOMY: INTERCONDYLAR FOSSA OPEN
-Medial & lateral intercondylar tubercles of intercondylar eminence
- Open femorotibial joint space
- Symmetric femoral condyles
- Part of fibular head superimposed by tibia

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12
Q

PA AXIAL PROJECTION - INTERCONDYLAR FOSSA
AKA: HOLMBLAD METHOD
ANGLE?
PATIEINT POSITION:
CR:
ANATOMY:

A

CR: PERP TO IR & LOWER LEG @ MIDPOPLITEAL CREASE
ANGLE: NO ANGLE
POSITION: KNEELING OR PARTIALLY STANDING
- LEAN FORWARD 20-30* = 60-70* KNEE FLEXION
ANATOMY: INTERCONDYLAR FOSSA OPEN
-Medial & lateral intercondylar tubercles of intercondylar eminence
- Open femorotibial joint space
- Symmetric femoral condyles
- Part of fibular head superimposed by tibia

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13
Q

PA AXIAL PROJECTION - INTERCONDYLAR FOSSA
AKA: BECLERE METHOD
CR:
ANGLE?
PATIEINT POSITION:
ANATOMY:

A

CR: PERP TO LONG AXIS OF LOWER LEG @ 1/2 IN DISTAL
TO APEX PATELLA
ANGLE: (~40-45* CEPHALAD)
POSITION: SUPINE & FLEX KNEE 40-45*
ANATOMY: INTERCONDYLAR FOSSA OPEN
-Medial & lateral intercondylar tubercles of intercondylar eminence
- Open femorotibial joint space
- Symmetric femoral condyles
- Part of fibular head superimposed by tibia
- REVERSE CAMP METHOD

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14
Q

AP WEIGHT-BEARING KNEE
CLINICAL INDICATION:
CR:
POSITION:
ANATOMY:

A

EVALUATE FEMOROTIBIAL JOINT SPACE OF KNEES FOR NARROWING & POSSIBLE DEGENERATION / PATHOLOGY
CR: 1/2 IN BELOW APEX PATELLA
POSITION: BILATERAL, WEIGHT EVENLY DISTRIBUTED
ANATOMY: FEFMOROTIBIAL JOINT SPACE OPEN
- SYMMETRIC APPEARANCE OF FEMORAL & TIBIAL CONDYLES
- PART OF FIBULAR HEAD SUPERIMPOSED BY TIBIA

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15
Q

LARGEST SESAMOID IN THE BODY? LOCATION?

DISTAL PORTION:
SUPERIOR PORTION:
__________ - POSTERIOR SURFACE OF DISTAL FEMUR, ABOVE INTERCONDYLAR FOSSA

A

PATELLA, LOCATED OVER DISTAL ANTERIOR SURFACE OF FEMUR

APEX
BASE
POPLITEAL SURFACE

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16
Q

PATELLAR SURFACE AKA _____ OR ________ LOCATED AT DISTAL PORTION OF ANTERIOR FEMUR

WHEN EXTENDED, PATELLA MOVES:
WHEN LEG IS FLEXED, PATELLA MOVES:

A

INTERCONDYLAR SULCUS OR TROCHLEAR GROOVE

EXTENDED = UP & SUPERIOR TO PATELLAR SURFACE
FLEXED: DOWNWARD & OVER PATELLA SURFACE (INTO SULCUS)

17
Q

JOINT INVOLVING PATELLA CALLED: ____________
ALSO INCLUDES: _____________

PATELLA ATTACHMENTS INCLUDE ___________ & __________

A

PATELLOFEMORAL JOINT
INLOVES PATELLA & DISTAL FEMUR

QUAD TENDON & PATELLA LIGAMENT

18
Q

TENDON ATTACHMENT IS ______ TO _______
LIGAMENT ATTACHMENT IS ______ TO _________

WHY PA PATELLA?
WHY DONT YOU FLEX KNEE MORE THAN 5-10* IN LATERAL PATELLA?

A

MUSCLE TO BONE
BONE TO BONE (L FOR LIKE)

SHARPER DETAIL B/C DECREASED OID

decreases the patellofemoral joint space and may separate fracture fragments if present*

19
Q

PROJECTIONS OF THE PATELLA
ROUTINE:
ADVANCED:

TECHNIQUE:
SID:

A

R: PA & LATERAL
A: MERCHANTS, SETTEGAST & HUGHSTON “SUNRISE”

60-65 & 4-6 && 70-75 @ 8-10 (BUCKY)
40 SID

20
Q

PA PATELLA
CR:
POSITION:
ANATOMY:

A

CR: MIDPATELLA AREA (MIDPOPLITEAL CREASE)
POSITION: ROTATE ANTERIOR KNEE 5-10* INTERNALLY (HEEL 5-10* LATERALLY)

ANAT: PATELLA COMPLETELY SUPERIMPOSED BY FEMUR
- SHARP DETAIL B/C DECREASED OID IN PA

21
Q

LATERAL PATELLA
CR:
POSITION:
ANATOMY:

A

CR: MID-PATELLOFEMORAL JOINT
PST: EPICONDYLES SUOERIMOISED & PERP TO IR, PATELLA PER TO IR
- FLEX KNEE 5-10*
ANAT: PATELLA IN LATERAL PROFILE
- PATELLOFEMORAL JOINT OPEN

22
Q

3 ADVANCED PROJECTIONS OF PATELLA:

CLINICAL INDICATION FOR THEM:

ANATOMY FOR THEM:

A

MERCHANTS, SETTEGAST & HUGHSTON METHODS

CLIN IND: SUBLUXATION OF PATELLA, PATELLAR FXS,
- PATELLOFEMORAL JOINT ANATOMY & ASSES
- FEMORAL CONDYLES

ANAT: OPEN PATELLOFEMORAL JOINT
- PATELLA IN PROFILE
- INTERCONDYLAR SULCUS
- SYMMETRIC FEMORAL CONDYLES

23
Q

PATELLA TANGENTIAL - MERCHANT METHOD:
CR:
POSITION:
CLINICAL INDICATION:
ANATOMY:

A

CR: PERP TO IR, THROUGH PATELLOFEMORAL JOINT
- ANGLE CR 30* CAUDAD (FROM HORIZONTAL)

PST: SUPINE, KNEES FLEXED 40* @ END OF TABLE
- USE MERCHANT BOARD

CLIN IND: SUBLUXATION OF PATELLA, PATELLAR FXS,
- PATELLOFEMORAL JOINT ANATOMY & ASSES
- FEMORAL CONDYLES

ANAT: OPEN PATELLOFEMORAL JOINT
- PATELLA IN PROFILE
- INTERCONDYLAR SULCUS
- SYMMETRIC FEMORAL CONDYLES

24
Q

PATELLA TANGENTIAL - SETTEGAST METHOD:
CR:
POSITION:
CLINICAL INDICATION:
ANATOMY:

A

CR: TANGENTIAL TO PATELLOFEMORAL JOINT
- CR ANFLE 15-20* IF NEEDED

PST: PRONE OR SEATED, FLEX KNEE AT LEAST 90*
- PRP TO IR OR FLEX KNEE MUCH AS POSSIBLE

CLIN IND: SUBLUXATION OF PATELLA, PATELLAR FXS,
- PATELLOFEMORAL JOINT ANATOMY & ASSES
- FEMORAL CONDYLES

ANAT: OPEN PATELLOFEMORAL JOINT
- PATELLA IN PROFILE
- INTERCONDYLAR SULCUS
- SYMMETRIC FEMORAL CONDYLES

25
Q

PATELLA TANGENTIAL - HUGHSTON METHOD:
CR:
POSITION:
CLINICAL INDICATION:
ANATOMY:

A

CR: 45& CEPHALAD ENTERING PATELLOFEMORAL JOINT

PST: PRONE, FLEX KNEE SO TIB-FIB FORMS 50-60* ANGLE WITH TABLE
- PATIENT HOLD FOOR W GAUZE OR SUPPORT DVCE

CLIN IND: SUBLUXATION OF PATELLA, PATELLAR FXS,
- PATELLOFEMORAL JOINT ANATOMY & ASSES
- FEMORAL CONDYLES

ANAT: OPEN PATELLOFEMORAL JOINT
- PATELLA IN PROFILE
- INTERCONDYLAR SULCUS

Procedures & Analysis (14 decks)

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