Session 8 Flashcards

1
Q

What is a common complication of a hamstring strain?

A

Rupture to the surrounding blood vessels leading to a haemotoma contained within the fascia lata

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2
Q

How does an avulsion fracture to the ischial tuberosity commonly occur?

A

In sports that require rapid contraction and relaxation

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3
Q

What are the articulations of the knee joint?

A

Tibiofemoral - between femoral and tibial condyles (main weight bearing)
Patellofemoral

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4
Q

What are the functions of the menisci of the knee?

A

Deepens the articular surface of the tibia, increasing stability
Acts as a shock absorber

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5
Q

What are the connections of the medial and lateral menisci of the knee?

A

Both C shaped and connect to Intercondylar area. Anteriorly connected by transverse ligament of the knee. Medial meniscus is connected to the tibial collateral ligament

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6
Q

What is the function and attachments of the cruciates?

A

Posterior cruciate ligament - passes Anteriorly from posterior tibia and inserts Medially on the femur (PAMs). Prevents posterior dislocation of the tibia. Main stabiliser of a weight bearing flexed knee.
Anterior cruciate ligament - passes Posteriorly from anterior tibia and inserts onto Lateral femur (APpLes). Prevents anterior dislocation of tibia.

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7
Q

Describe the distribution of the joint capsule of the knee

A

Absent anteriorly the allow synovial membrane to extend up beneath patella. Strengthened laterally by inferior fibres of vastus medialis and lateralis. Strengthened posteriorly by the oblique popliteal ligament.

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8
Q

What are the Extracapsular ligaments of the knee and where do they insert?

A

Tibial (medial) collateral ligament - medial femoral epicondyle to tibia
Fibular (lateral) collateral ligament - lateral femoral epicondyle to lateral surface of fibular head

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9
Q

What causes rotation of the flexed knee?

A

Medial - Semitendinosus, Semimembranous

Lateral - biceps femoris

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10
Q

What does the knee do to reduce energy expenditure when standing?

A

Femur rotates internally over tibia to lock knee in place and hold it in position. The popliteus contracts to rotate the femur externally and unlock the knee.

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11
Q

What are the 3 bursa in the knee prone to bursitis?

A

Supra-patellar
Pre-patellar (housemaids knee)
Superficial infra-patellar (clergymans knee)

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12
Q

What is an “unhappy triad”?

A

Damage to the medial collateral ligament can affect the medial meniscus, such as a lateral force to the extended knee. The ACL is also affected, completing the unhappy triad.

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13
Q

How is the ACL injured and tested?

A

Hyperextension of the knee or by a large force to the back of the knee whilst flexed. Tested with an anterior draw test where the tibia is attempted to be pulled forwards.

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14
Q

How is the PCL injured and tested?

A

“Dashboard injury” - force on shins when knee is flexed. Tested by the posterior draw test - knee flexed and shin pushed posteriorly

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15
Q

What are the 3 bursa in the knee prone to bursitis?

A

Supra-patellar
Pre-patellar (housemaids knee)
Superficial infra-patellar (clergymans knee)

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16
Q

What is an “unhappy triad”?

A

Damage to the medial collateral ligament can affect the medial meniscus, such as a lateral force to the extended knee. The ACL is also affected, completing the unhappy triad.

17
Q

How is the ACL injured and tested?

A

Hyperextension of the knee or by a large force to the back of the knee whilst flexed. Tested with an anterior draw test where the tibia is attempted to be pulled forwards.

18
Q

How is the PCL injured and tested?

A

“Dashboard injury” - force on shins when knee is flexed. Tested by the posterior draw test - knee flexed and shin pushed posteriorly

19
Q

How are medial meniscus tears tested and why is the lateral meniscus not normally torn?

A

Pain on medial rotation of the tibia. Lateral meniscus is usually too mobile to tear.

20
Q

What are the borders of the popliteal fossa?

A

Superiomedial - Semimembranous
Superiolateral - biceps femoris
Inferiomedial - medial head of gastrocnemius
Inferiolateral - lateral head of gastrocnemius and plantaris
Floor - posterior surface of the knee joint capsule
Roof - popliteal fascia and skin

21
Q

What are the contents of the popliteal fossa medial to lateral?

A

Popliteal artery
Popliteal vein (with small saphenous vein draining into it)
Tibial nerve
Common fibular nerve

22
Q

What are the causes of a mass in the popliteal fossa?

A

Bakers cyst - inflammation of the Semimembranous bursa, usual arising in conjunction with arthritis. The cyst can rupture and cause symptoms similar to DVT.
Popliteal aneurysm - causes compression of the tibial nerve, leading to leg anaesthesia or loss of motor function because popliteal fascia is strong.
Rarer causes are DVT and various neoplasms.