PBL 42 Flashcards
What are the the big 5 CAMs?
- Acupuncture
- Chiropractic
3 Herbal medicine - Homeopathy
- Osteopathy
Which CAMs have evidence in favour of them?
- Acupuncture
- Osteopathy
- Chiropractic
The knee joint is what type of joint?
- Hinge-type
- Synovial
What are the different articulations of the knee joint?
- Tibiofemoral
- Patellofemoral
Function of the patella?
Increase power of the knee extensor and serves as a stabilising structure that reduces frictional forces placed on femoral condyles
Neurovascular supply to the knee joint?
Genicular branches of the femoral and popliteal arteries
Femoral, tibial and common fibular nerves
The medial and lateral menisci are made of?
Fibrocartilage
2 functions of menisci?
- Deepen the articular surface of the tibia, increasing stability of the joint
- Act as shock absorbers by increasing the surface area to further dissipate forces
What are the shapes of the medial and lateral menisci?
- Medial = C
- Lateral = O
Where do both of the menisci attach?
To both ends of the intercondylar area of the tibia
Which of the two menisci are mobile and which is fixed?
Medial is fixed
Lateral is mobile
What makes the medial meniscus fixed?
It is attached to the tibial/medial collateral ligament and the joint capsule
Damage to the tibial collateral ligament usually results in a….
Medial meniscal tear
What is a bursa?
A synovial fluid filled sac
What is the function of bursae?
It is found between moving structures in a joint and it reduces the wear and tear on those structures
What are the 4 bursae of the knee joint?
Suprapatella
Infrapatella
Prepatella
Semimembranosus
What are the major ligaments of the knee joint?
Patellar ligament
Medial and lateral collateral ligaments
Anterior and posterior cruciate ligaments
What is the patellar ligament a continuation of?
The quadriceps femoris tendon distal to the patella
Where does the patellar ligament attach?
The tibial tuberosity
The collateral ligaments are …-… ligaments
Strap-like
What is the function of the collateral ligaments?
Stabilise the hinge motion of the knee, preventing excessive medial or lateral movement
Which of the medial and lateral collateral ligaments are thin and round, and which is wide and flat?
Thin and round = lateral
Wide and flat = medial
Where does the medial collateral ligament attach proximally and distally?
Proximally = medial epicondyle of femur Distally = medial condyle of the tibia
Where does the lateral collateral ligament attach proximally and distally?
Proximally = lateral epicondyle of femur Distally = lateral surface of fibular head
The cruciate ligaments connect the … and the …
Femur and the tibia
The anterior cruciate ligament attaches at the … region of the … where it blends in with the … … It then ascends posteriorly to attach to the … in the … …
Intercondylar region of the tibia where it blends in with the medial meniscus. It then ascends posteriorly to attach to the femur in the intercondylar fossa
The anterior cruciate ligament prevents?
Anterior dislocation of the tibia onto the femur
The posterior cruciate ligament attaches at the … … … of the … and ascends anteriorly to attach at the … … …
Attaches at the anterior intercondylar region of the tibia and ascends anteriorly to attach at the anteromedial femoral condyle
The posterior cruciate ligament prevents … … of the … onto the …
Posterior dislocation of the tibia onto the femur
What are the 4 movements of the knee joint?
Extension
Flexion
Lateral rotation
Medial rotation
How can you tear your meniscus?
Suddenly twist knee while bearing weight on it
- Any activity that causes you to forcefully twist or rotate your knee, esp when putting full weight on it, can lead to a torn meniscus
When does collateral ligament injury occur?
MOST COMMON PATHOLOGY AFFECTING KNEE JOINT
- When force is applied to the side of the knee when the foot is placed on the ground
How do you know if a patient has a medial or lateral collateral ligament injury?
When asked to medially rotate and laterally rotate leg, pain on the medial rotation indicated medial ligament damage and pain on the lateral rotation indicates damage to the lateral ligament
If the medial collateral ligament is damaged, which other structure is likely to be damaged also?
The medial meniscus, due to their attachment
The anterior cruciate ligament can be torn by what?
Hyperextension of the knee, or by application of a large force to the back of the knee with the joint partly flexed
What is the test for an ACL injury?
Anterior drawer test
Lachman’s test
What is the most common mechanism of posterior cruciate ligament damage?
Dashboard injury
- When the knee is flexed, and a large force is applied to the shins, pushing the tibia posteriorly
