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

lower extremity - the knee Flashcards

(45 cards)

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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

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A
  • valgus producing force with planted foot

- severe knee hyperextension

20
Q

functions of lateral collateral ligament

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

common injury mechanisms of lateral collateral ligament

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A
  • varus producing force with planted foot

- severe knee hyperextension

22
Q

functions of posterior capsule

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

common injury mechanism of posterior capsule

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A

hyperextension or combined hyperextension with external knee rotation

24
Q

functions of anterior cruciate ligament (ACL)

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A
  • most fibers resist extension

- resists extremes of varus, valgus, & axial rotation

25
common injury mechanisms of anterior cruciate ligament (ACL)
- large valgus-producing force with firmly planted foot - large axial rotation torque applied to knee with firmly planted foot - severe knee hyperextension
26
functions of posterior cruciate ligament (PCL)
- most fibers resist knee extension | - resists extemes of varus, valgus, & axial rotation
27
common injury mechanisms of of posterior cruciate ligament (PCL)
- 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
what does severe knee extension involving posterior cruciate ligament cause?
large gapping of posterior side of the joint
29
how do most fibers resist knee flexion?
- excessive posterior translation of tibia | - excessive anterior translation of femur
30
what kinds of risk factors increase risk of anterior collateral ligament (ACL) rupture?
- environmental factors - anatomical factors - biomechanical factors - physiological factors
31
what environmental factors increase the risk for anterior collateral ligament (ACL) rupture?
- improper footwear - bracing - playing conditions - weather/climate
32
what anatomical factors increase the risk for anterior collateral ligament (ACL) rupture?
- bone & joint alignment involving Q-angle & foot pronation - body mass index - femoral intercondylar notch width - posterior-inferior directed slope of lateral tibial plateau
33
what biomechanical factors increase the risk for anterior collateral ligament (ACL) rupture?
- muscular strength, stiffness, & fatigue - hamstring-quadriceps strength ratio - neuromuscular control of the body during landing & cutting maneuvers - cross sectional area strength of ACL
34
what physiological factors increase the risk for anterior collateral ligament (ACL) rupture?
- physical maturation - hormonal fluctuations - limb dominance - proprioception or kinesthesis - overall joint laxity - genetic predisposition
35
what muscles are involved in for lower extremity muscular strength, stiffness, & fatigue?
- hamstring muscles - gluteus maximus - hip abductor muscles - external rotators
36
functions of menisci
- shock absorption - stabilization of tibiofemoral joint - joint lubrification - proprioception - helps to guide knee motions
37
describe the lateral meniscus
- almost O-shaped with a small opening - covers around 60% of lateral tibial plateau - loosely attached
38
describe the medial meniscus
- C-shaped with greater opening - covers about 50% of medial tibial plateau - firmly attached - medial collateral ligament has fibers attaching to medial meniscus
39
what are the movements that can occur at the knee?
- flexion/extension | - internal/external rotation
40
structural/functional causes of lateral tracking
- 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
specific examples of body dysplasia/other anomaly
- dysplastic lateral facet of trochlear groove of femur | - "high" patella
42
specific examples of excessive laxity in periarticular connective tissue
- 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
specific examples of excessive stiffness in periarticular connective tissue & muscle
- increased tightness in lateral patellar retinacular fibers/iliotibial band - increased tightness of internal rotator/adductor muscles of the hip
44
specific examples of extreme bony/joint alignment
- coxa verus - excessive anteversion of femur - external tibial torsion - large Q-angle - excessive genu valgum
45
specific examples of muscle weakness
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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