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Extremity Biomechanics > Second Midterm - Week 6 knee > Flashcards

Second Midterm - Week 6 knee Flashcards

1
Q

What three joints make up the knee complex?

A
  • tibiofemoral joint (posterior)
  • tibiofibular joint
  • patellofemoral joint (anterior)
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2
Q

The femoral condyles are separated by a fossa and are egg shaped. It has a larger (anterior/posterior) radius and a smaller (anterior/posterior) radius

A

Larger anterior radius

Small posterior radius

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3
Q

The femoral condyles have a divergent axes of motion which creates conjoint rotation. What is the screw home mechanism?

A

The tibiofemoral joint rotates around the lateral condyles

(Tibia externally rotates and femur internally rotates to lock the knee into extension and visa versa. This maximally stabilizes the knee)

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4
Q

Which femoral condyle has a larger and longer articular surface?

A

Medial condyle

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5
Q

Which femoral condyle has a smaller epicondyle?

A

Lateral condyle

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6
Q

Which femoral condyle is more obliquely orientated?

A

Medial condyle

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7
Q

Which femoral condyle extends more distally?

A

Medial condyle

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8
Q

When the knees are anatomically touching but the ankles are not (knock-knees), this is called genu _____

A

Valgum

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9
Q

When the knees are anatomically distant but the ankles are touching (bow-legged), this is called genu ______

A

Varum

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10
Q

A normal medial twist of the knee is _____ degrees

A

10-20

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11
Q

Anteverted femur is _____ degrees. This correlates with genu ______ and a (medial/lateral) orientation

A

> 20
Genu valgum
Medial orientation

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12
Q

Retroverted femur is _____ degrees. This correlates with genu ______ and a (medial/lateral) orientation

A

<10
Genu varum
Lateral orientation

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13
Q

The tibial condyles are the flat superior surface. The tibial spine provide attachment points for WHAT THREE STRUCTURES and what is their FUNCTION

A
  • ACL/PCL and meniscus

- help stabilize the knee

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14
Q

Which tibial condyle is larger?

A

Medial tibial condyle

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15
Q

T/F the tibial condyles are concave

A

F they are flat

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16
Q

The medial and lateral articular surfaces of tibial condyles are separated by ________

A

Intercondylar eminence

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17
Q

What are the fibrocartilage shock absorbers that sit on the surface of tibial condyles and what are their functions (4)

A
  • medial and lateral menisci
  1. deepen the articular surface to increase stability
  2. Makes a flexible socket to condyles
  3. Accommodate slide and decrease shear stress
  4. Reduce wear and tear
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18
Q

The slight posterior ngulation of the condyles helps to ________

A

Prevent hyperextension

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19
Q

External tibial torsion may be responsible for foot _____

A

Foot flare

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20
Q

What type of cartilage lines the patellar surface of the femur?

A

Hyaline cartilage

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21
Q

T/F the patellar surface of the femur is anterior to the condyles

A

T

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22
Q

On the patellar surface of the femur the lateral facet is (smaller/larger) and the lateral lip is (shorter/taller) than the medial?

A

Larger

Taller

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23
Q

What is the main function of the patella?

A

Increase the angular pull of the quads

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24
Q

The lateral facet on the patella is (smaller/larger) than the medial?

A

Larger

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25
Q

The patella has the (thinnest/thickest) cartilage in the body?

A

Thickest

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26
Q

Patella Baja is when the patellofemoral ratio is _____

A

<0.8 and the patella is too distal to the knee

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27
Q

Patella Alta is when the patellofemoral ratio is ______

A

> 1.2 and the patella is too proximal to the knee

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28
Q

What makes up the patellofemoral ratio X:Y or X/Y?

A 
X = length of the infrapatellar tendon
Y = S-I diameter of patella
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29
Q

During flexion, the patella glides _________ and __________ in the patellar sulcus.

A

Inferior and posterior

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30
Q

How much contact between the patella and femur exists when the knee is in flexion at

  • 0 degrees
  • 30 degrees
  • 60-90 degrees
  • 135 degrees
A
  • no contact
  • Inferior pole of patella contacting superior part of condyles
  • max contact
  • superior pole of patella contacting inferior aspect of condyles. And the odd medial facet contact
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31
Q

At what degree of flexion is the max contact between the patella and femur?

A

60-90 degrees

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32
Q

At what degree of flexion is the odd medial facet in contact with the femur

A

135

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33
Q

At what degree of flexion is the inferior pole of the patella in contact with the femur? What about the superior pole?

A

30

135

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34
Q

What two intersecting lines create the patellofemoral Q-angle?

A
  • ASIS -> center of patella

- center of patella -> tibial tuberosity

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35
Q

What is the normal range of patellofemoral Q-angle? For women? For men?

A

5-15
Women = 10-12
Men = 8-10

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36
Q

The patellofemoral Q-angle represents the pull of the ______

A

Quads

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37
Q

Genu varus (increases/decreases) the Q angle? Genu Valgum (increases/ decreases) the Q angle?

A

Decreases

Increases

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38
Q

The patella is less stable when

  1. knee is (flexed/extended)
  2. VMO is (weak/strong)
  3. Genu _______
  4. vastus lateralis is (too loose/too tight)
  5. patella is (too small/too large)
  6. patellar facet angle is (too flat/too angled)
  7. (small/large) lateral lip or (deep/shallow) groove
  8. patella (baja/alta)
  9. (internally/externally) rotated tibia
  10. (decreased/increased) foot flare
  11. excessive foot (pronation/supination)
A
  1. Knee EXTENDED
  2. VMO WEAK
  3. Genu VALGUM
  4. VL too TIGHT
  5. Patella too SMALL
  6. Patellar facet angle too FLAT
  7. SMALL lateral lip or SHALLOW groove
  8. Patella ALTA
  9. EXTERNALLY rotated tibia
  10. INCREASED foot flare
  11. Excessive foot PRONATION
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39
Q

What type of cartilage is the meniscus?

A

Fibrocartilagenous

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40
Q

A partial meniscectomy creates ______% increase in wear and tear. A full meniscectomy creates _____%

A

50-60

100+

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41
Q

The shape of the medial menisci is (C/O)? The lateral menisci is (C/O) shaped?

A 
Medial = C
Lateral = O
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42
Q

Which menisci is thinner and more fixed? Which is stronger and more mobile?

A

Medial

Lateral

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43
Q

Which menisci is more often injured?

A

Medial

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44
Q

The lateral menisci makes up ____% of menisci tears?

A

25

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45
Q

The MCL and semimbranosus tendon attach to the ____ menisci

A

Medial

46
Q

The popliteus attached to the ____ meniscus

A

Lateral

47
Q

Which ligament arises form the posterior horn of the lateral meniscus travels anterior to the PCL and attaches to the lateral surface of the medial condyle of the femur?

A

Anterior meniscofemoral ligament (Humphrey)

*The posterior meniscofemoral ligament (Wrisberg) travels posterior to the PCL

48
Q

During flexion, the menisci slide (anterior, posterior). Which moves more, the lateral or medial?

A

Posterior

Lateral moves more

49
Q

During flexion, there is more focal weight on the (anterior/posterior) horns of the menisci ?

A

Posterior

50
Q

Deep squats increase stress on the (anterior/posterior) horns of the menisci?

A

Posterior

51
Q

During flexion, synovial fluid is squeezed (anterior, posterior) in the menisci?

A

Posterior

52
Q

During extension the menisci slide (anterior/posterior)? Which moves more, the lateral or medial

A

Anterior

Lateral moves more

53
Q

During extension the (medial/lateral) menisci deforms more?

A

He medial deforms more

**attached to the MCL

54
Q

At full extension, there is (more/less) total pressure on the menisci and (more/less) focal pressure?

A

More total

Less focal

55
Q

During extension, the synovial fluid in the menisci is pushed (anterior/posterior)

A

Anterior

56
Q

T/F menisci rotate with the femur

A

T

*abnormal motion leads to tears

57
Q

During tibial internal rotation, the medial meniscus rotates (anterior/posterior) which increases the pressure.
The lateral meniscus moves (anterior/posterior)

A

Anterior

Posterior

58
Q

During tibial external rotation, the medial meniscus rotates (anterior/posterior)
The lateral meniscus moves (anterior/posterior) which increases the pressure

A

Anterior

Posterior

59
Q

Genu varus pinches he (medial/lateral) meniscus & tractions the (medial/lateral) meniscus through coronary ligaments

A

Medial

Lateral

60
Q

Genu valgum pinches he (medial/lateral) meniscus & tractions the (medial/lateral) meniscus through coronary ligaments

A

Lateral

Medial (also through the collateral ligament)

61
Q

Which part of the menisci has a blood supply?

A

Outer 1/3 in young and healthy

62
Q

Are the menisci innervated?

A

Yes for pain and proprioception

63
Q

What affect does aging have on the menisci? (3)

A
  • decreased vascularization
  • increased wear and tear
  • increased friability
64
Q

Where does the MCL attach? It resists (valgus/varus) stress

A

Medial femoral condyle & medial tibial condyle

*hence aka tibial collateral ligament

Valgus

65
Q

How is the MCL sprained?

A

Direct blow to the lateral side of the knee

External rotation force (twisting)

66
Q

Where does the LCL attach? It resists (valgus/varus) stress?

A

Lateral femoral epicondyle & fibular head

*hence aka fibular collateral ligament

Varus

67
Q

How is the LCL sprained?

A
  • Direct blow to the medial side of the knee

- hyper extension

68
Q

Medial rotation (increases/decreases) tension on collaterals? Lateral rotation?

A

Decreases

Increases

69
Q

The ACL and PCL are (intra/extra)capsular, (intra/extra)synovial and support vessels for nutrients

A

Intracapsular

Extrasynovial

70
Q

Where does the ACL attack?

A

Anterior tibial plateau and tibial spine & the medial aspect of the lateral femoral condyle

71
Q

The ACL is (larger/smaller) than the PCL

A

Smaller

72
Q

The ACL is always tense because the (anterior/posterior) band is taut in flexion and the (anterior/posterior) band is taut in extension

A

Anterior

Posterior

73
Q

T/F the ACL is not vascularized?

A

False. It is highly vascularized and the knee will fill with blood if it is torn

74
Q

The ACL resists (anterior/posterior) translation of the tibia

A

Anterior

75
Q

What is the most common serious ligament injury to the knee?

A

ACL

76
Q

___ of all knee hemiarthrosis involve the ACL

A

3/4

77
Q

What is the test for ACL

A

Anterior drawer test: anterior tibial translation joint play (anterior glide)

78
Q

Where does the PCL attach?

A

Posterior tibial plateau and posterior tibial spine & lateral aspect of the medial femoral condyle

79
Q

The PCL is ____________ in relation to the ACL

A

Posteromedial

80
Q

The PCL is __ times as strong as the ACL

A

2x

81
Q

The PCL is always tense but is lest tense at ____ degrees of flexion

A

25-40

*it also has two parts like the ACL

82
Q

Which crucial ligament is lest likely to require surgery?

A

PCL

83
Q

The PCL resists (anterior/posterior) translation of the tibia

A

Posterior

84
Q

How can you see if a PCL is torn? (2)

A
  • posterior sag sign

- posterior drawer test: posterior tibial translation join play (posterior glide)

85
Q

The cruciates twist around each other in (internal/external) rotation of the femur?

A

Internal

*helps lock out with screw home mechanisms during extension

86
Q

Which cruciate is weaker and more likely to tear due to internal rotation?

A

ACL

87
Q

The cruciates untwist during (internal/external) rotation of the femur?

A

External

*help to unlock during takeoff

88
Q

The IT blends with the __________ and attaches to ______

A

Lateral retinaculum

Gerdy’s tubercle

89
Q

A tight IT band rubs on the lateral femoral condyle and pulls on the ______. This is called ______

A

Patella

ITB syndrome

90
Q

The posteriormedial capsular complex consist of what 3 things?

A
  • posterior part of MCL
  • semimebranosus tendon
  • oblique popliteal ligaments
91
Q

The posteriomedial capsular complex resists:

  • hyper (extension/flexion)
  • (anterior/posterior) translation
  • (varus/valgus) stress
  • extreme rotation: lateral (>/
A
  • hyperextension
  • anterior translation
  • valgus stress
  • extreme rotation (lateral >medial)
92
Q

The posterolateral capsular complex consists of? (6)

A
  • LCL
  • poplitiofibular ligament (PFL)
  • arcuate ligament
  • biceps femoris tendon
  • popliteus
  • ITB
93
Q

The Posterolateral capsular complex resists:

  • hyper (extension/flexion)
  • (anterior/posterior) translation
  • (varus/valgus) stress
  • extreme rotation: lateral (>/
A
  • hyper extension
  • anterior translation
  • varus stress
  • extreme rotation: medial > lateral
94
Q

What does the PFL stand for? It _____ during flexion and helps provide support to the knee

A

Poplitiofibular ligament

- tenses

95
Q

What 4 bursa/cysts is the joint cavity connected to?

A
  • Suprapatellar bursa
  • popliteal bursa
  • bakers cyst (aka popliteal cyst)
  • gastrocnemius bursa
96
Q

What 4 bursa are not connected to the joint cavity?

A
  • pre-patellar
  • infrapatellar
  • pes anserine
  • ITB
97
Q

What ”ligaments” are actually extensions of he quadriceps tendon?

A

Medial and lateral retinaculum

98
Q

Valgus sprain and patellar dislocations tear the (medial/ lateral) retinaculum?

A

Medial

99
Q

Weak or stretched (medial/lateral) retinaculum OR tight (medial/lateral) retinaculum can cause patellar instability

A

Medial

Lateral

100
Q

What is the synovial plica?

A

Remnant embryonic sac

*most are small and asymptomatic

101
Q

Which one has more co-contracted, closed or pen chain?

A

Closed

102
Q

Increased velocity = (increased/decreased) co-contraction of antagonist

A

Increased

103
Q

What is the balance between quads and hamstrings ratio?

A

~60:40

104
Q

VMO is most important to ______ stability

A

Patellar

105
Q

Muscle contraction is _____ stability

A

Dynamic

* they are secondary stabilizers

106
Q

Walking on a stable surface produces _____ BW on quad tension.

  • Jogging = ?BW
  • sprinting = ?BW
  • jumping = ?BW
A

1x

  • 5x
  • ~7x
  • > 10x
107
Q

The patella increases extensor leverage ___% when knee is flexed 90-120

A

13

108
Q

The patella increase extensor leverage ___% when the knee is flexed 0-5

A

31

109
Q

What is PERCENTAGE of BW on quadriceps force during squats at the following degrees:

  • 5
  • 15
  • 30
  • 45
  • 75
A
  • 30% of BW
  • 100% of BW
  • 200% of BW
  • 300% of BW
  • 500% of BW
110
Q

What is the compression force on the patella during

  1. walking?
  2. Jogging?
  3. Stair climbing?
  4. Down a stair?
  5. 90 degree squat?
  6. Knee extension?
  7. Jumping?
A
  1. 0.5x BW
  2. 4x BW
  3. 2.4x BW
  4. 3.5x BW
  5. 7.5x BW
  6. 8x BW
  7. > 10x BW

Extremity Biomechanics (9 decks)

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