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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
when is the PCL more taut
in flexion
26
what are the main motions that are checked (limited) for the **PCL** ? and what is it a secondary restatin to
* Posterior tibial translation * Anterior femoral translation * Internal tibial rotation Secondary restraint to varus/valgus forces
27
what is the orientation of the **medial collateral ligament**
femoral medial epicondyle to medial condyle of tibia
28
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
bursa medial
29
does the MCL have good or poor blood supply
good
30
what motions does the MCL check (limit)
valgus strss tibial ER anterio tibial translation
31
what valgus stress does the MCL resist
in 25-30° of knee flexion
32
what is the orientation of the **lateral collateral ligament**
lateral femorla epicondyle to lateral fibular head
33
the extra capsular ligaments of the LCL does not blend with ___ or ___ but it does blend with ___ ___
meniscus or capsule biceps femoris
34
what motions do the **LCL** check/resist
varus stress , especially at 35° of flexion resists tibial external rotation
35
what does the joint capsule encase
medial and lateral tibiofemoral joints patellofemoral joint
36
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
Outer Inner
37
what ist eh joint capsule reinforced by
mm , tendon and ligamentous structures
38
what are the **anterior reinforcements** of the joint capsule
quads patella retinacular fibers
39
what is apart of the **posteior reinforcement** of the joint capsule
- * Oblique popliteal ligament * Popliteus * Gastrocnemius * Hamstrings * posterior lateral arcute complex
40
what is apart of the **posterolateral arcuate complex**
arcuate ligament, LCL and tendon of popliteus
41
what is apart of the **medial reinfomrcemt** of the joint capsule
* MCL * Medial patellar retinacular fibers * Tendon of semimembranosus * Tendons of pes anserinus
42
what is apart of the lateral reinforcement of the joint capsule (6)
• LCL • Lateral patellar retinacular fibers • Iliotibial tract • Biceps femoris • Popliteus • Lateral head of gastrocnemius
43
what bursas in the knee are considered **intracapsular communication bursae**
suprapatellar bursa semimembranousus bursa posterior gastrocnemius bursa
44
what bursae in the knee are considered **non communication bursae**
prepatellar buesa infrapatellar bursa
45
the fat pad (hoffa’s fat pad) … ____ inverted source of ___/____ knee pain
highly anterior/infeiror
46
what is a loose synovial fold from fetal development , presents in 20-60% of the population
plica
47
which **plica** is the **most symptomatic**
medial patellar plica
48
what is the **open** packed position , **closed** pack position and **capsular** pattern of the **tibio femoral joint**
* Open Packed Position: 25° flexion * Closed Packed Position: Extension * Capsular Pattern: Flexion > Extension
49
pertaining to the arthokinematics of the tibio femoral joint what is the open chain and closed chain movement
* 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
how many DOF does the knee have
2
51
what is the screw home mechanism
relative , concurrent external rotation of the tibia ont he femur with end range terminal knee extension
52
what is the screw home mechanism is caused by
• Shape of medial femoral condyle • Passive tension of ACL • Lateral pull of quadriceps
53
what produces relative tibial internal rotation (unlocking) during screw home mechanism
popliteus
54
what is the q angle
angle between the long axis of femur and long lapis of tibia
55
what is the **normla q angle**
13-18*
56
what is increased q angle associated with
• Femoral anteversion • External tibial torsion • Laterally displaced tibial tubercle • Genu valgum
57
genu valgum • ↑ compressive force on the ___ condyle • ↑ ___ force on medial structures • ____ pull of ____ • Patella ___ dislocation
lateral tensile Lateral , quadriceps lateral
58
what does this describe • ↑ compressive force on the lateral condyle • ↑ tensile force on medial structures • Lateral pull of quadriceps • Patella lateral dislocation
genu valgum
59
what is genu valgum associated with
coxa varum and foot pronation
60
genu varum • ↑ compressive force on ___ condyle • ↑ tensile stress on ___ structures
medial lateral
61
what is genu varum associated with
coxa valgum foot supination
62
what is the **open pack position** for the **patello femoral joint** anatomy
full knee extension
63
what is the **close pack position** for the **patello femoral joint** anatomy
full knee flexion
64
what is the articulation of the patello femoral joint
articulation of patella within femoral groove
65
in **closed chain movements** the ___moves under the patella
femur
66
the patello femoral joint is extremely ___ and moves ____ in relation to femoral condyle
mobile 7-8 cm
67
what is the 4 functions of the patello femoral joint
anatomic pulley guides movement of patella/qaud tendon decreases friction of wards mechanism cheadle cartilage of femorla condyle
68
what is the movement of patella tracking as the knee extends and as the knee flexes from extension
as the knee extedns , patella moves superiorly as the knee flexes from extension , patella moves inferiorly
69
what is there an imbalance of during a lateral patellar subluxation
lateral forces
70
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
VL stronger then VMO shortened short
71
during a lateral patellar subluxation there is deficits in the lateral selects of the einercondlar groove and there is what angle there
sulcus angle : greater then 150°
72
what kind of joint is the **proximal tibio fibular joint**
plan synovial joint angled 45° from anterolateral to posteromedial
73
what is the joint movements of the proximal tibio fibular joint during knee flexion and extension
• Knee flexion: Fibula moves anteriorly • Knee extension: Fibula moves posteriorly
74
the Proximal Tibio-fibular Joint also moves during ____ movement
ankle
75
during ankle DF what movements happens at the Proximal Tibio-fibular Joint
proximal fibular externally rotates with a slight upward movemtn

MSK: LQ (22 decks)

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