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APA1313 - Musculoskeletal Anatomy > lower extremity - the knee > Flashcards

lower extremity - the knee Flashcards

1
Q

what is the Q-angle?

A

angle between the line of action of quadriceps & line of action of patellar tendon

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2
Q

what are the joints of the knee?

A
  • tibiofemoral joint
  • patellofemoral joint
  • proximal tibiofibular joint
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3
Q

what kind of joint is the tibiofemoral?

A

biondyloid joint

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4
Q

what kind of joint is the patellofemoral joint?

A

trochlear joint

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5
Q

what kind of joint is the proximal tibiofibular joint?

A

planar joint

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6
Q

what are the roles of the proximal tibiofibular joint?

A
  • very small weight bearing role

- very small role in motion

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7
Q

what are the functions of the patella?

A
  • anterior knee protection

- provides better mechanical advantage for quadricep action on tibia

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8
Q

importance of mechanical advantage in patella function?

A
  • insertion angle would be near 0° in extension

- resulting it in being impossible to produce force

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9
Q

what are the four ligaments in the knee?

A
  1. medial collateral ligament (MCL)
  2. lateral collateral ligament (LCL)
  3. anterior cruciate ligament (ACL)
  4. posterior cruciate ligament (PCL)
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10
Q

what are the extra capsular & extra articular ligaments?

A
  1. medial collateral ligament (MCL)

2. lateral collateral ligament (LCL) `

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11
Q

what are the intra articular & extra synovial ligaments?

A
  1. anterior cruciate ligament (ACL)

2. posterior cruciate ligament (PCL)

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12
Q

general functions of anterior & posterior cruciate ligaments?

A
  • provide multiple planar dynamic knee stability
  • guides natural arthrokinematics
  • contributes to proprioception in knee
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13
Q

what ligament is the primary restraint for valgus force?

A

medial collateral ligament (MCL)

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14
Q

what are the secondary restraints for valgus force?

A
  • posterior medial capsule
  • anterior & posterior cruciate ligaments
  • lateral joint contact
  • lateral meniscus compression
  • medial retinacular fibres
  • medial head of gastrocnemius
  • tendons of sartorius, gracilis, & semitendinosus
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15
Q

what ligament is the primary restraint for varsus force?

A

lateral collateral ligament (LCL)

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16
Q

what are the secondary restraints for varus force?

A
  • posterior-lateral corner of knee
  • iliotibial band
  • biceps femoris tendon
  • medial joint contact
  • medial menisus compression
  • anterior & posterior cruciate ligaments
  • lateral head of gastrocnemius
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17
Q

what is included in the posterior-lateral corner of the knee?

A
  • posterior-lateral capsule
  • arcuate popliteal ligament
  • lateral collateral ligament (LCL)
  • popliteofibular ligament
  • popliteus tendon
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18
Q

functions of medial collateral ligament & posterior-medial capsule

A
  • resists valgus (abduction)
  • resists knee extension
  • resists extremes of axial rotation (especially external knee rotation)
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19
Q

common injury mechanisms of medial collateral ligament & posterior-medial capsule

A
  • valgus producing force with planted foot

- severe knee hyperextension

20
Q

functions of lateral collateral ligament

A
  • resists varus (adduction)
  • resists knee extension
  • resists extremes of axial rotation
21
Q

common injury mechanisms of lateral collateral ligament

A
  • varus producing force with planted foot

- severe knee hyperextension

22
Q

functions of posterior capsule

A
  • resists knee extension
  • oblique popliteal ligament resists knee external rotation
  • posterior-lateral capsule resists varus
23
Q

common injury mechanism of posterior capsule

A

hyperextension or combined hyperextension with external knee rotation

24
Q

functions of anterior cruciate ligament (ACL)

A
  • most fibers resist extension

- resists extremes of varus, valgus, & axial rotation

25
Q

common injury mechanisms of anterior cruciate ligament (ACL)

A
  • large valgus-producing force with firmly planted foot
  • large axial rotation torque applied to knee with firmly planted foot
  • severe knee hyperextension
26
Q

functions of posterior cruciate ligament (PCL)

A
  • most fibers resist knee extension

- resists extemes of varus, valgus, & axial rotation

27
Q

common injury mechanisms of of posterior cruciate ligament (PCL)

A
  • falling on a fully flexed knee resulting in proximal tibia striking the ground first
  • any event causing forceful posterior tibial translation or anterior femoral translation, especially with fully flexed knee
  • large axial rotation or valgus-varus applied torque to knee with firmly planted foot & flexed knee
  • severe knee hyperextension
28
Q

what does severe knee extension involving posterior cruciate ligament cause?

A

large gapping of posterior side of the joint

29
Q

how do most fibers resist knee flexion?

A
  • excessive posterior translation of tibia

- excessive anterior translation of femur

30
Q

what kinds of risk factors increase risk of anterior collateral ligament (ACL) rupture?

A
  • environmental factors
  • anatomical factors
  • biomechanical factors
  • physiological factors
31
Q

what environmental factors increase the risk for anterior collateral ligament (ACL) rupture?

A
  • improper footwear
  • bracing
  • playing conditions
  • weather/climate
32
Q

what anatomical factors increase the risk for anterior collateral ligament (ACL) rupture?

A
  • bone & joint alignment involving Q-angle & foot pronation
  • body mass index
  • femoral intercondylar notch width
  • posterior-inferior directed slope of lateral tibial plateau
33
Q

what biomechanical factors increase the risk for anterior collateral ligament (ACL) rupture?

A
  • muscular strength, stiffness, & fatigue
  • hamstring-quadriceps strength ratio
  • neuromuscular control of the body during landing & cutting maneuvers
  • cross sectional area strength of ACL
34
Q

what physiological factors increase the risk for anterior collateral ligament (ACL) rupture?

A
  • physical maturation
  • hormonal fluctuations
  • limb dominance
  • proprioception or kinesthesis
  • overall joint laxity
  • genetic predisposition
35
Q

what muscles are involved in for lower extremity muscular strength, stiffness, & fatigue?

A
  • hamstring muscles
  • gluteus maximus
  • hip abductor muscles
  • external rotators
36
Q

functions of menisci

A
  • shock absorption
  • stabilization of tibiofemoral joint
  • joint lubrification
  • proprioception
  • helps to guide knee motions
37
Q

describe the lateral meniscus

A
  • almost O-shaped with a small opening
  • covers around 60% of lateral tibial plateau
  • loosely attached
38
Q

describe the medial meniscus

A
  • C-shaped with greater opening
  • covers about 50% of medial tibial plateau
  • firmly attached
  • medial collateral ligament has fibers attaching to medial meniscus
39
Q

what are the movements that can occur at the knee?

A
  • flexion/extension

- internal/external rotation

40
Q

structural/functional causes of lateral tracking

A
  • body dysplasia/ other anomaly
  • excessive laxity in periarticular connective tissue
  • excessive stiffness in periarticular connective tissue & muscle
  • extremes of bony/joint alignment
  • muscle weakness
41
Q

specific examples of body dysplasia/other anomaly

A
  • dysplastic lateral facet of trochlear groove of femur

- “high” patella

42
Q

specific examples of excessive laxity in periarticular connective tissue

A
  • laxity of medial patellar retinacular fibers (medial patellofemoral ligament)
  • laxity of attrition of medial collateral ligament (MCL)
  • laxity & reduced height of medial longitudinal arch of foot (overpronation of subtalar joint)
43
Q

specific examples of excessive stiffness in periarticular connective tissue & muscle

A
  • increased tightness in lateral patellar retinacular fibers/iliotibial band
  • increased tightness of internal rotator/adductor muscles of the hip
44
Q

specific examples of extreme bony/joint alignment

A
  • coxa verus
  • excessive anteversion of femur
  • external tibial torsion
  • large Q-angle
  • excessive genu valgum
45
Q

specific examples of muscle weakness

A

weakness or poor control over:

  • hip external rotator/abductor muscles
  • vastus medialis (oblique fibers)
  • tibialis posterior muscle (related to foot overpronation)

APA1313 - Musculoskeletal Anatomy (13 decks)

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