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MSK: LQ > lecture 7a: anatomy and biomechanis reviews of the knee > Flashcards

lecture 7a: anatomy and biomechanis reviews of the knee Flashcards

1
Q

knee joint complex is elaborate and includes ___ articulation surfaces ? what do they include

A

3

femur , tibia and patella

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2
Q

in the knee , the joint share 1 joint capsule what are the 2 joints

A

tibio femoral
patella femoral

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3
Q

for the tibio femoral joint the __- and ___ femoral condyle articulate w ___ plateaus

A

medial and lateral
tibial

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4
Q

in the tibio femoral joint is the medial condyle or lateral condyle longer ? adn what does it create

A

medial condyle is longer

creates slight valgus at the knee joint

(valgus is normal for the knee to a certain point)

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5
Q

which tibial plateau is smaller and more mobile

A

lateral tibial plateau

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6
Q

Menisci accentuates___ of tibial
plateaus

A

concavity

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7
Q

the patello femoral joint is dependent on both ___ and ___ ___ for function anf stability

A

dynamic and static restraints

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8
Q

what are the 4 functions of the patella femoral joint

A
  • provide articulation w low friction
  • protect distal demur and quad tendon from damage
  • improve movement arm of quad mm to increase efficiency
  • decrease amount of AP shear stress
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9
Q

which meniscii is most “C” shapes and more tightly bound , covers about 50% of medial tibia surface and is an attachment for muscular and ligamentous structures

A

medial meniscus

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10
Q

which meniscus’s is more “O” shaped and less tightly bound , more coverage of the lateral tibial surface and is an attachment for muscular and ligamentous structures

A

lateral mencius

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11
Q

the medial mencius is ..

• More “__” shaped and more tightly bound
• Covers about 50% of ___ tibial surface
• Attachments: Muscular, ligamentous

A

C

medial

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12
Q

the lateral meniscus is..

• More “____” shaped, and less tightly bound
• More coverage of —- tibial surface
• Attachments: Muscular, ligamentous

A

O

lateral

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13
Q

what are the 3 purposes of the meniscii

A

stability
shock absorption
lubrication

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14
Q

what is the secondary restraint to anterior tibial translation in the ACL deficient knee

A

meniscii

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15
Q

what does the meniscii enchance stability for

A

under A/P , varus/ valgus and IR/ ER loads

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16
Q

how much axial load does the meniscii take in extension vs flexion

A

• 50 - 70% of the load in extension
• 85 - 90% of the load in flexion

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17
Q

how does the meniscii move with flexion and extension

A

postieror with flexion (semimembranosis , popliteus)

anterior with extension

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18
Q

what parts of the meniscii is innervation and has nutrition

A

outer 1/3 and anterior and posterior horns

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19
Q

what are the 4 mina ligaments of the knee

A

ACL
PCL
MCL (medial collateral lig)
LCL (lateral collateral lig)

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20
Q

pertaining to the ligaments in the knee how are the fibers aligned ? how much vascularity is there? how is the collagen ? and what does it contain

A

fibers aer parallel

little vascularity

thick and dense

mechanorecptors and proprioception

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21
Q

what is the orientation of the ALC

A

anterior/medial tibial spine

posteromedial aspect of lateral femorla condyle

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22
Q

what are the 2 bundles in the ACL and when are they taut

A

anteromedail (taut in flexion)

posterolateral (taut in extension) larger

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23
Q

what are the main motions checked (limited) by the ACL

A

• Anterior tibial translation
• Posterior femoral translation
• Internal tibial rotation

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24
Q

what is the orientation of the posteior cruiate ligament

A

posterior/lateral tibial spine

anterolateral aspect of medial femorla condyle

ACL and PCL cross each other

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25
Q

when is the PCL more taut

A

in flexion

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26
Q

what are the main motions that are checked (limited) for the PCL ? and what is it a secondary restatin to

A
  • Posterior tibial translation
  • Anterior femoral translation
  • Internal tibial rotation

Secondary restraint to varus/valgus forces

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27
Q

what is the orientation of the medial collateral ligament

A

femoral medial epicondyle to medial condyle of tibia

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28
Q

the superficial and deep layers of the MCL is separated by ___ … the deep layers are continuous with th enjoin capsule and attaches to the __- meniscus

A

bursa
medial

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29
Q

does the MCL have good or poor blood supply

A

good

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30
Q

what motions does the MCL check (limit)

A

valgus strss
tibial ER
anterio tibial translation

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31
Q

what valgus stress does the MCL resist

A

in 25-30° of knee flexion

32
Q

what is the orientation of the lateral collateral ligament

A

lateral femorla epicondyle to lateral fibular head

33
Q

the extra capsular ligaments of the LCL does not blend with ___ or ___ but it does blend with ___ ___

A

meniscus or capsule

biceps femoris

34
Q

what motions do the LCL check/resist

A

varus stress , especially at 35° of flexion

resists tibial external rotation

35
Q

what does the joint capsule encase

A

medial and lateral tibiofemoral joints

patellofemoral joint

36
Q

which layers of the joint capsule do these things

• ___: fibrous connective tissue to
hold the joint in place
• ___: synovial membrane which
secretes synovial fluid and provides
lubrication

A

Outer

Inner

37
Q

what ist eh joint capsule reinforced by

A

mm , tendon and ligamentous structures

38
Q

what are the anterior reinforcements of the joint capsule

A

quads
patella retinacular fibers

39
Q

what is apart of the posteior reinforcement of the joint capsule

A
    • Oblique popliteal ligament
  • Popliteus
  • Gastrocnemius
  • Hamstrings
  • posterior lateral arcute complex
40
Q

what is apart of the posterolateral arcuate complex

A

arcuate ligament, LCL and tendon of popliteus

41
Q

what is apart of the medial reinfomrcemt of the joint capsule

A
  • MCL
  • Medial patellar retinacular fibers
  • Tendon of semimembranosus
  • Tendons of pes anserinus
42
Q

what is apart of the lateral reinforcement of the joint capsule (6)

A

• LCL
• Lateral patellar retinacular fibers
• Iliotibial tract
• Biceps femoris
• Popliteus
• Lateral head of gastrocnemius

43
Q

what bursas in the knee are considered intracapsular communication bursae

A

suprapatellar bursa
semimembranousus bursa
posterior gastrocnemius bursa

44
Q

what bursae in the knee are considered non communication bursae

A

prepatellar buesa
infrapatellar bursa

45
Q

the fat pad (hoffa’s fat pad) …

____ inverted
source of ___/____ knee pain

A

highly
anterior/infeiror

46
Q

what is a loose synovial fold from fetal development , presents in 20-60% of the population

A

plica

47
Q

which plica is the most symptomatic

A

medial patellar plica

48
Q

what is the open packed position , closed pack position and capsular pattern of the tibio femoral joint

A
  • Open Packed Position: 25° flexion
  • Closed Packed Position: Extension
  • Capsular Pattern: Flexion > Extension
49
Q

pertaining to the arthokinematics of the tibio femoral joint what is the open chain and closed chain movement

A
  • Open Chain: Rolling and gliding same (tibia moving on the femur so concave on convex)
  • flexion: roll and glide anterior
  • extension: roll and glide post
  • Closed Chain: Rolling and gliding
    opposite ( femur moving not he tibia so convex on concave)
  • flexion: roll posterior , glide anteior
  • extension: roll anterior , glide posterior
50
Q

how many DOF does the knee have

A

2

51
Q

what is the screw home mechanism

A

relative , concurrent external rotation of the tibia ont he femur with end range terminal knee extension

52
Q

what is the screw home mechanism is caused by

A

• Shape of medial femoral condyle
• Passive tension of ACL
• Lateral pull of quadriceps

53
Q

what produces relative tibial internal rotation (unlocking) during screw home mechanism

A

popliteus

54
Q

what is the q angle

A

angle between the long axis of femur and long lapis of tibia

55
Q

what is the normla q angle

A

13-18*

56
Q

what is increased q angle associated with

A

• Femoral anteversion
• External tibial torsion
• Laterally displaced tibial tubercle
• Genu valgum

57
Q

genu valgum

• ↑ compressive force on the ___
condyle
• ↑ ___ force on medial structures
• ____ pull of ____
• Patella ___ dislocation

A

lateral

tensile

Lateral , quadriceps

lateral

58
Q

what does this describe

• ↑ compressive force on the lateral
condyle
• ↑ tensile force on medial structures
• Lateral pull of quadriceps
• Patella lateral dislocation

A

genu valgum

59
Q

what is genu valgum associated with

A

coxa varum and foot pronation

60
Q

genu varum

• ↑ compressive force on ___ condyle
• ↑ tensile stress on ___ structures

A

medial
lateral

61
Q

what is genu varum associated with

A

coxa valgum
foot supination

62
Q

what is the open pack position for the patello femoral joint anatomy

A

full knee extension

63
Q

what is the close pack position for the patello femoral joint anatomy

A

full knee flexion

64
Q

what is the articulation of the patello femoral joint

A

articulation of patella within femoral groove

65
Q

in closed chain movements the ___moves under the patella

A

femur

66
Q

the patello femoral joint is extremely ___ and moves ____ in relation to femoral condyle

A

mobile

7-8 cm

67
Q

what is the 4 functions of the patello femoral joint

A

anatomic pulley
guides movement of patella/qaud tendon
decreases friction of wards mechanism
cheadle cartilage of femorla condyle

68
Q

what is the movement of patella tracking as the knee extends and as the knee flexes from extension

A

as the knee extedns , patella moves superiorly

as the knee flexes from extension , patella moves inferiorly

69
Q

what is there an imbalance of during a lateral patellar subluxation

A

lateral forces

70
Q

there is an imbalance of lateral forces with a lateral patellar subluxation .. the ___ is stronger then the ___ , the lateral patellar retinaculum is ___ and there is a ___ ITB

A

VL stronger then VMO
shortened
short

71
Q

during a lateral patellar subluxation there is deficits in the lateral selects of the einercondlar groove and there is what angle there

A

sulcus angle : greater then 150°

72
Q

what kind of joint is the proximal tibio fibular joint

A

plan synovial joint

angled 45° from anterolateral to posteromedial

73
Q

what is the joint movements of the proximal tibio fibular joint during knee flexion and extension

A

• Knee flexion: Fibula moves anteriorly
• Knee extension: Fibula moves posteriorly

74
Q

the Proximal Tibio-fibular Joint also moves during ____ movement

A

ankle

75
Q

during ankle DF what movements happens at the Proximal Tibio-fibular Joint

A

proximal fibular externally rotates with a slight upward movemtn

MSK: LQ (22 decks)

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