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Functional Anatomy > Knee TIBIOFEMORAL joint > Flashcards

Knee TIBIOFEMORAL joint Flashcards

ppt directives with book details

1
Q

Which femoral condyle is larger and extends more distally?

A

Medial

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2
Q

What is the classification of the tibiofemoral joint and how many DOF?

A

double condyloid joint; 3 DOF

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3
Q

Femoral condyles are ______ while tibial plateau is ______.

A

large

flat

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4
Q

During dynamic gait, the line of force shifts _________ to the knee joint center.

A

medially

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5
Q

During dynamic gait, there is _________ compression and ________ tensile/distraction force.

A

medial

lateral

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6
Q

In bilateral stance, describe the WB stress to the medial and lateral condyles?

A

equal

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7
Q

What important component increases with genu varum?

A

Adduction Moment

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8
Q

What are 4 important properties of the medial and lateral menisci?

A
  1. increase joint congruence
  2. distribute WB forces
  3. reduce friction b/w tibia and femur
  4. shock absorption
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9
Q

Medial meniscus shape and implication?

A

C-shaped

Less surface area coverage than lateral. susceptible to injury, especially because the medial compression

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10
Q

Lateral meniscus shape and implication?

A

4/5 of a circle

covers greater proportion of smaller lateral tibial surface

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11
Q

What is the relationship between thickness and region for the menisci?

A

thicker peripherally

thinner centrally

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12
Q

Translation is limited for medial meniscus due to

A

greater ligamentous and capsular restraints

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13
Q

The relative lack of mobility of the medial meniscus may contribute to

A

greater incidence of injury

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14
Q

What attaches the menisci anteriorly?

A

transverse ligament

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15
Q

What attaches patella to menisci?

A

anterior capsular thickenings called the patellomeniscal ligaments

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16
Q

What are the peripheral attachments of menisci to tibial condyle?

A

coronary ligaments

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17
Q

Which muscle attaches through capsular connections to the medial meniscus?

A

semimembranosus

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18
Q

What is the primary fxn of the MCL?

A

restrict motion of medial meniscus

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19
Q

What structures attach to the medial meniscus?

A

ACL (Anterior and posterior horns)

deep portion of the MCL

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20
Q

Which muscle attaches through capsular connections to the lateral meniscus? Implication?

A

popliteus; it restrains movement of the lateral meniscus

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21
Q

Removal of menisci the contact area in the tibiofemoral joint is ________. Results?

A

decreased contact area
increased joint stress
risk for damage of articular cartilage

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22
Q

Which part of the menisci have vascularity?

A

periphery; central portion is avascular

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23
Q

How does central menisci get nutrition?

A

depends on diffusion of synovial fluid which requires intermittent loading by WB or muscular contractions

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24
Q

Which part of the menisci is well innervated?

A

free nerve endings (nociceptors) and mechanoreceptors loacted in meniscal horns and vascular periphery

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25
Q

What is the close-packed position of the knee?

A

FULL EXTENSION

max bony congruence and ligament tautness

26
Q

Most mobility of the joint when the knee is in what position?

A

FLEXION

periarticular passive structures tend to be lax (relative bony incongruence)

27
Q

The capsule is reinforced posterolaterally by the ________ ligament and posteromedially by the ________ ligament.

A

aruate
posterior oblique ligament
(both restrain hyperextension)

28
Q

MCL best restrains valgus motion when the knee is in which position?

A

extension –> MCL is taut in extension

29
Q

Injury to the ACL most often occurs with which position?

A

WB: slight flexion and and tibia rotated either way

30
Q

Does the anterior or posterior cruciate ligament resist greater loads? Why?

A

posterior can resist greater loads: more extensive attachment, short, wide, less oblique

31
Q

In a deep squat, which component of the PCL is taut?

A

posteromedial bundle; it limits posterior displacement of the tibia

32
Q

Which component of the PCL is taut in 90* flexion?

A

anterolateral bundle

33
Q

Which component of PCL is taut in extension?

A

posteromedial bundle

34
Q

Which ligament best restrains in flexion?

A

PCL: restraint to posterior displacement

35
Q

Which ligament best restrains in extension?

A

ACL: restraint to anterior displacement

36
Q

Which muscles can decrease strain on PCL when knee is flexed?

A

POPLITEUS and quds

37
Q

Which muscles can decrease strain on ACL?

A

hamstrings and soleus

38
Q

Does ITB resist displacement?

A

Resists anterior displacement with the help of LCL and popliteal tendon when knee is flexed

39
Q

In flexion of femur in WB, the femoral condyles roll in which direction? What ligament “checks”?

A

posterior roll checked by ACL –> results in anterior translational force by ACL on femur

40
Q

In extension of femur in WB, the femoral condyles roll in which direction? What ligament “check”?

A

anterior roll checked by PCL –> results in posterior translational force by PCL on femur

41
Q

The menisci must remain under the femoral condyles to fxn in reducing friction and absorbing forces onto the small tibial plateau. How do menisci react to forces during flex/ext?

A

deformation allows menisci to remain under femoral condyles

42
Q

With posterior deformation of menisci, which muscles contribute?

A

semimembranosus exerts post. pull on medial meniscus

popliteus exerts post. pull on lateral meniscus

43
Q

How do menisci react to forces as knee moves into extension?

A

anterior deformation

44
Q

How do menisci react to forces in flexion?

A

posterior deformation

45
Q

The medial femoral condyle is distal to the lateral femoral condyle in an extended knee. This results in?

A

physiological valgus knee (in extension)

axis for flex/ext is obliquely oriented

46
Q

Coupled motions about the obliquely oriented axis for flex/ext are?

A

valgus+extension

varus+flexion

47
Q

What is the axis for axial rotation (IR/ER)?

A

medial tibial plateau –> the lateral tibial condyle rotates about the medial

48
Q

Axial rotation is maximized in which position? Limited in which position?

A

maximized in 90* flexion

limited in full extension

49
Q

What happens with forceful quad contraction when the knee close to full extension? Why?

A

anterior tibial translation (places stress on both anteromedial and posterolateral ACL bundles)
patella increases the length-tension relationship by increasing MA for quads

50
Q

There is little to no anterior translation in which position? Why?

A

knee flexed >60*

because of influence of patella on quad MA and length-tension relationship

51
Q

What muscles assist with knee extension in WB?

A

soleus and glut max

52
Q

During WB, quads generate greater force as knee ___________ increases to control the increasing MA.

A

flexion

53
Q

During NWB, quads generate greater force as knee __________ increases to overcome the increasing MA.

A

extension

54
Q

What structures limit anterior tibial translation?

A 
ACL
ITB
Hamstring
Soleus (in WB)
Glut max (in WB)
55
Q

What structures limit posterior tibial translation?

A 
PCL
meniscofemoral ligaments
quads
popliteus
medial and lateral heads of gastric
56
Q

What structures limit valgus of tibia?

A 
MCL, ACL, PCL
arcuate ligament
posterior oblique ligament
sartorius, gracilis, semitendonosis (pes anserine)
semimembranosus
medial head of gastroc
57
Q

What structures limit varus of tibia?

A 
LCL, ACL, PCL
ITB
Arcuate ligamanet
posterior oblique ligament
biceps femoris
lateral head of gastroc
58
Q

What structures limit medial rotation of tibia?

A 
ACL
PCL
posterior medial capsule
meniscofemoral ligament
biceps femoris
59
Q

What structures limit lateral rotation of tibia?

A 
posterolateral capsule
popliteus
sartorius, gracilis, semitendonosis (semitendinosus)
semimembranosus
MCL
LCL
60
Q

Posterolateral instability?

A

damage to posterolateral joint capsule, popliteus, acrcute ligament can cause excessive lateral tibial rotation and posterior instability

61
Q

Posteromedial instability?

A

Dame to posterior oblique ligament, medial hamstrings, MCL and posteromedial joint capsule

62
Q

Anteromedial and anterolateral knee has dynamic support from what structure?

A

Extensor retinaculum - composed of fibers from quadriceps femoris muscle and fuses with fibers of joint capsule

Functional Anatomy (13 decks)

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