lecture 6: therapeutic exercsies for the knee

Question 1

what is a large seasamoid bone in the quad tendon

Answer 1

patella

Question 2

in the knee what ligaments provide anterior posterior stability

Answer 2

ACL and PCL

Question 3

in the knee what provides medial lateral stability

Answer 3

MCL and LCL

Question 4

what is the menisci connected it

Answer 4

connected to tibial condyle and capsule by coronary ligaments

Question 5

each menisci are connected by what

Answer 5

trasnverse ligament

Question 6

what is the medial meniscus firmly attached to the

Answer 6

joint capsule and MCL ,ACL , PCL and semimembranosus mm

Question 7

what is the lateral meniscus attached to

Answer 7

PCL and popliteus tendon via capsule capsular connections

Question 8

which ligament resist valgus force

Answer 8

MCL (sMCL primarily)

Question 9

sMCL resists what

Answer 9

tibial ER at 30° flexion

Question 10

when is the sMCL taut

Answer 10

at end range of flexion and extension

Question 11

what are the 2 main bundles of the ACL

Answer 11

 Anteromedial bundle (smaller)
 Posterolateral bundle (larger)
 {Intermediate bundle} (maybe

Question 12

when is each anteromedial bundle and posterolateral bundle taut

Answer 12

anteromedial- flexion
posterolateral - extension

Question 13

what is the function of the ACL

Answer 13

percent anterior translation of tibia
provide stability during tibial rotation
limit hyperextension

Question 14

what becomes taut with IR and ER of tibia with the most notes at 30° flexion

Answer 14

ACL

Question 15

in knee extension when ACL bundle provides restraint to rotational forces

Answer 15

posterolateral is taut
AMB is slack

Question 16

in knee flexion when ACL bundle provides restraint to anterior translation

Answer 16

AMB is taut
PLB is slack

if the AMB is gone then there will be more anterior translation

Question 17

what are the 2 bundles of the PCL

Answer 17

ALB (larger)
PMB

Question 18

when is the ALB of the PCL taut and lax

Answer 18

taut in knee flexion
lax in knees extension

Question 19

when is the PMB of the PCL taut and lax

Answer 19

 Taut in knee extension
 Lax in knee flexion

Question 20

when is the PCL vulnerable to injury

Answer 20

to a posterior force to the proximal tibia when the knee is FLEXED

Question 21

what is the main function of the PCL

Answer 21

resist excessive posterior translation of the tibia

Question 22

what is the medial menisci attached to , what shape is it and is it mobile or not mobile

Answer 22

 dMCL
 Semimembranosus
 Quadriceps

C shaped
not mobile

Question 23

what is the lateral menisci attached to , what shape is it and is it mobile or not mobile

Answer 23

 Popliteus
 Quadriceps
 Arcuate ligament

 Circular Shaped
 Mobile

Question 24

what is the articulation of the patellofemoral joint

Answer 24

patella within femoral groove

Question 25

how does the femur move not he patella in CKC

Answer 25

under the patella

Question 26

how much does the patellofemoral joint more in relation to femorla condyle

Answer 26

7-8 cm

Question 27

pertaining to patella tracking what happens as the knee extends

Answer 27

patella moves superiorly

Question 28

what are some malaligment and tracking problems

Answer 28

 Increased Q-angle  Short ITB  Weak hip abd/ER  Foot pronation  Lax medial patellar retinaculum  Insufficient VMO?  Deficits in lateral aspect of intercondylar groove  Pelvic Dysfunction

Question 29

what is the normal knee ROM for extension and flexion

Answer 29

extensions: 0° flexion: 135°

Question 30

what is open packed and closed pack for the knee

Answer 30

open packed: 25° of flexion closed packed: full knee extension

Question 31

how much ROM is needed to make a full revolution on a bike

Answer 31

~110°

Question 32

in CKC the patellar compression raised between what degrees of flexion

Answer 32

between 30-60°

Question 33

during OKC when is there patellar compression

Answer 33

greatest joint reaction force is at 30°

Question 34

how much tibia rotation is there for IR and ER

Answer 34

IR and ER is 20-30°

Question 35

IR of the tibia causes what ligaments to become taut

Answer 35

AMB of ACL and sMCL

Question 36

what wraps around what during IR of the tibia

Answer 36

ACL wraps around the PCL

Question 37

during ER what stretches over what

Answer 37

ALC stretches over the lateral condyle

Question 38

with the knee flexed what casues the ER of the tibia

Answer 38

TFL and BF

Question 39

what provides a MR (unlock) from a full extension

Answer 39

popliteus

Question 40

what does joint effusion of the knee lead to

Answer 40

inhibiton of the quadriceps

Question 41

what does joint effusion results in during walking

Answer 41

low sustained quadriceps activator and prolonged hamstring activation

Question 42

___ rupture can lead to bruising in the calf with no significant joint effusion

Answer 42

PCL

Question 43

in what position/activity is the patellofemoral join reaction forces the highest

Answer 43

deep squat

Question 44

for every 1 lb of weight loss , there is a __lb reduction in knee load per step

Answer 44

4

Question 45

what is the main knee extensor in the leg

Answer 45

quads

Question 46

what does the quads do in closed chain activities

Answer 46

the quads control the amount of knee flexion , also causes knee extension thru reverse mm pull on th femur

Question 47

in the erect posture , wehn the knee is locked , the quads does not need to function when the gravity line is where a

Answer 47

dallas anterior to the axis of motion

Question 48

what is the qaud function in open chain activities

Answer 48

a strong contraction of the quad mms is required to overcome the physiological and mechanical disadvantages of the mm to complete the final 15° of motion

Question 49

what is the main knee flexor in the knee

Answer 49

hamstrings

Question 50

what does the hamstrings do in closed chain

Answer 50

can assist w knee extension by pulling on the tibia

Question 51

what is the gastrocnemius main function at the knee

Answer 51

during WB is to support the posterior capsule against hyperextension forces (can also assist with knee flexion)

Question 52

what mm supports the posterior capsule adn acts to unlock the knee (screw home mechanism)

Answer 52

popliteus

Question 53

what is in the pes anserinus mm group

Answer 53

sartorius , gracilis , semtendiniosus

Question 54

what is the function of the Pes anserinus muscle group (sartorius, gracilis, semitendinosus)

Answer 54

provides medial stability to the knee , affects rotation of the tibia in a closed chain

Question 55

Lack of hip IR , hip flexion contracture and lack of ankle DF ROM can cause pain where

Answer 55

the knee