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241 > lecture 7- knee > Flashcards

lecture 7- knee Flashcards

1
Q

bones of the knee

A

femur
tibia
patella

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2
Q

2 articulations of the knee

A

Tibiofemoral
- femur and tibia

Patellofemoral
- patella and femur

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3
Q

what 5 things help with stability of the knee?

A

capsule, ligaments, menisci, muscles, tendons

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4
Q

Capsule of the knee

A

the joint capsule on the back is tight

the joint capsule on the back is extensive and redundant (allows joint flexion)

resists hyperextension

provides rotational stability

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5
Q

Extracapsular ligaments of the knee

A

MCL (medial collateral)
LCL

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6
Q

what movement do the collateral ligaments prevent?

A

side to side movements of the knee

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7
Q

Intracapsular ligaments of the knee

A

ACL
- prevents anterior displacement of tibia on fixed femur, hyperextension
PCL
-prevents posterior displacement of tibia on fixed femur

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8
Q

what does the posterior cruciate ligament prevent?

A

prevents tibia from moving forwards, prevents femur from moving backwards

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9
Q

is the medial or lateral meniscus longer?

A

medial (c shaped)= longer!!!
lateral is o shaped= smaller!!!

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10
Q

Menisci

A
  • fibrocartilage
    -medial and lateral
    -attached to tibial plateau
    -attached to capusle by coronary lligaments
    -provides cushioning and stability
    -increases synovial fluid, circulation
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11
Q

what does the quadriceps femoris do?

A

extends the leg at the knee, helps w PCL to prevent tibia from moving backwards

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12
Q

what does the rectus femoris do?

A

helps w hip flexion

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13
Q

Hamstrings: 3

A

semimembranosis
semitendinosis
biceps femoris

=flex lower leg on thigh at knee,
extend thigh on trunk at hip

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14
Q

what does the hamstring do?

A

helps the ACL to prevent tibia moving forwards

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15
Q

the last bit of knee locking comes from

A

tibia externally rotating, femur internally rotating

–> able to do this bc of length difference between medial and lateral tibial plateau
(medial condyle is larger than lateral)

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16
Q

tensor fascia latae function

A

helps flex and abduct thigh on trunk at hip

adds lateral stability to knee

17
Q

gracilis help with

A

knee flexion

(same origin and insertion as semimembranosis, semitendinosis)

18
Q

3 types of bursae

A

prepatellar
suprapatellar (and fat pad)
infrapatellar (and fat pad)

19
Q

how does knee flexion and extension work?

A

gliding of condyles on plateau and menisci

20
Q

Knee Ax

A

pain, tenderness
snap or pop

observation:
limp, instability
swelling= intercapsular injury

ROM:
compare sides
thigh circumference
palpation

21
Q

knee alignment deviations

A

patellar malalignment

Q-angle= line between ASIS through patella and then a line between the patella through the tubercle

Genu valgum, genu varum, genu recurvatum, genu antecurvatum

22
Q

knee contusion (injury)

A

direct blow, worse if muscles relaxed

  • no heat, no deep tissue massages (can increase bleeding)
23
Q

Weight bearing functional assessment

A
  • Gait
  • Squat
  • Single leg squat
  • Thessaly
  • Duck walk
  • 2 legged hop
  • Single leg hop
24
Q

bursitis (injury)

A

direct blow or kneeling, overuse

-inflammation, tenderness
-heat, physio, rehab, police, padding, NSAIDs

25
Q

bursitis– knee extension is painful if it is

A

infrapatellar or suprapatellar

26
Q

knee sprains Hx

A

direct blow (usually medial into valgus position)

27
Q

3 degrees of knee sprains

A

1st degree= mild pain, mild swelling

2nd degree= snap or pop, increased laxity, firm endpoint

3rd degree= snap or pop, swelling, soft endpoint

28
Q

meniscal tears

A

caused by torsion, hyperextension

  • acute= no surgery
  • free floating fragment of meniscus= arthroscopy
29
Q

capsular tears

A

caused by torsion, hyperextension

  • only seen on MRI
  • similar to meniscus tear

SSx: pain, swelling, tenderness, rotary instability
Tx: rest, physio, rehab, surgery

30
Q

patellofemoral pain syndrome

A

= paint around patellofemoral joint

  • overpronation, genu valgum, large Q angle contributes to abnormal patellar tracking
31
Q

chondromalacia patellae

A

= softening and deterioration of cartilage on the back of the patella

tx: conservative!!! (police, decrease activity, activity modification, orthotics, strengthening)

32
Q

Patellofemoral Stress Syndrome

A

= Lateral tracking of patellae in femoral groove

-tight musculature, weak hip abductors/stabilizers

SSx: pain lateral patellae, crepitis with patellar compression

Tx: POLICE, avoid aggravating activities, McConnell taping (keep patella in its groove)

33
Q

name the 3 acute traumatic knee injuries

A
  1. patellar subluxation/dislocation
  2. unhappy triad
  3. osteochondritis dissecans
34
Q

what is the unhappy triad?

A

ACL tear, MCL tear, meniscal tear, capsular tear

Tx: reconstructive surgery, brace, physio, rehab
- more common in females

35
Q

what if you have effusion (collection of fluid) in an unhappy triad?

A

hospital asap!!!!

36
Q

osteochondritis dissecans

A

= damage to the cartilage and subchondral bone

  • cartilage is free floating
  • they drill into the bone which causes bleeding, can increase chondrocytes but also increases risk of osteoarthritis
37
Q

what do do for ACL (post surgical rehab)?

A
  • quad/hamstring activation
  • ROM focusing on full extension
  • caution 3-4 months post-surgery
  • closed kinetic chain before open kinetic chain
  • strengthening (quads and hamstrings balanced)
  • 6 months: increase loads, jogging/running
  • neuromuscular training
  • RTP- technique, education
  • RTP- functional testing
  • brace? depends on athlete
38
Q

how to screen for risk of knee injury?

A

drop vertical jump test

  • are knees in line w toes as they land?
    if yes, good
    “knees kissing”= weak abductors, increased risk of ACL tear
39
Q

Ottawa knee rules

A

X ray for knee surgery if:

  1. age 55+
    OR
  2. isolated patella tenderness
    OR
  3. head of fibula tenderness
    OR
  4. inability to flex 90 degrees
    OR
  5. inability to weight bear for 4 steps (limping doesn’t count)

241 (13 decks)

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