the knee Flashcards

1
Q

the tibiofemoral joint is the articulation between

This is part of the knee joint!

A

articulation of the femur with the tibia

specifically, the medial and lateral condyles of the tibia and the medial and lateral condyles of the femur

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2
Q

what kind of joint is the tibiofemoral (TF) joint?

This is part of the knee joint

A

a modified hinge joint (aka synovial condlylar)

- the tibia glides under the femur, but some rotation occurs as we move from flexion to extension

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3
Q

the patellofemoral joint is the articulation between

This is also part of the knee joint!

A

the patella and the intercondyler notch of the femur behind it

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4
Q

what kind of joint is the patellofemoral joint?

This is also part of the knee joint!

A

it’s a gliding joint

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5
Q

the proximal tibiofibular joint is the articulation between

A

the proximal fibula and the lateral condyle of the tibia

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6
Q

The femur and fibula don’t actually attach. But there is a ligament that connects them called the

A

lateral collateral ligament

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7
Q

In terms of the tibiofemoral joint, the bottom of the femur has what between that and the tibia?

A

the bottom of the femur has femoral condyles. There is a lot of hyaline cartilage at the end of these bones (helps with blood supply).

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8
Q

Does the tibia or fibula support our body weight?

A

the tibia

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9
Q

What is the most injured joint in the body?

A

the tibiafemoral joint bc of degenerative joint disease

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10
Q

the intercondylar eminence

A

the top of the tibia (looks like Rocky Mountains) that goes into the condylar notch of the femur and help directs motion

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11
Q

range of motion of the knee

A

0-160 degrees (more than 0 = flexion)

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12
Q

flexion of knee

A

bend towards your tush

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13
Q

extension of knee

A

straightening knee - up to 0

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14
Q

Both articular facet surfaces of the tibia have a corresponding _____

A

meniscus (a lateral and a medial meniscus)

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15
Q

ontop of flexion and extension the knee also has

A

“the screw home mechanism”
flexion has 25 degrees of medial rotation (turns inward)
extension has 25 degrees of lateral rotation (turns outward)

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16
Q

fibula and tibia- which is lateral which is medial?

A

fibula is lateral to the tibia

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17
Q

the screw home mechanism of the knee is due to which muscle?

A

the poplitius muscle. When it contracts, it will medially rotates the tibia.

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18
Q

What kind of bone is the patella and why?

A

Its the largest sesamoid bone and its sesamoid because it is embedded in tendons (quad tendons to be exact)

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19
Q

the quadricep tendon

A

envelops the patella (it’s a line straight down over it)

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20
Q

the patellar ligament

A

a continuation of the quadricep tendon that takes it to the tibial tuberosity

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21
Q

if quadricep tendon contracts what will happen?

A

your leg will kick out into knee extension

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22
Q

the base of the patella vs the apex of the patella

A

the base is the broad top of the patella

the apex is the pointy bottom of the patella

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23
Q

On the posterior aspect of the patella, there is an articular surface. This allows it to articulate with the condylar notch. How is the articular surface of the patellar divided?

A

It is divided into medial and lateral facets. The facets are separated by a median vertical ridge

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24
Q

What is patellar tracking?

A

It is the patella moving in the intercondylar notch of the femur

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25
Q

When your leg is extended, what happens to the patella?

A

It is pulled up

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26
Q

If you flex your knee (aka hamstrings contract) what happens to the patella?

A

It is pulled down

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27
Q

The patella is thought to ___ the pull of the quadriceps

A

increase

28
Q

chondromalacia patella

A

patellar shift and damage to the articular cartilage
(think of the pic where it moved laterally and Mcgowan said to think of the wear and tear every time its flexed and extended)

29
Q

The fibrous capsule of the knee joint is, in general, quite thick. However, it is deficient _____ and is replaced by the fused tendons of the ____ musculature and its expansion

A

ANTERIORLY

replaced by the fused tendons of the QUADRICEPS

30
Q

The articularis genu muscle, which consists of deep fibers of the vastus intermedius that attach into the capsule and innervated by the femoral nerve, DO WHAT?

A

pulls the fibrous knee capsule and bursa out of the joint when we extend the knee to prevent injury

31
Q

what lines the fibrous knee capsule?

A

a synovial membrane

it does not cover articular surfaces

32
Q

oblique popliteal:

A

extension of semimembranosus- attached above the lateral condyle of femur to the medial tibial condyle - forms the floor of popliteal fossa and is in contact with popliteal artery.
supports posterior knee

33
Q

ACL and PCL are in or out of synovial membrane?

A

out, but they’re still inside the joint

34
Q

infrapatellar fold

A

fold of synnovial membrane between the femoral condyles (intercondylar notch)

35
Q

There are about 16 or so bursae around the knee. Name the 4 important ones

A
  1. suprapatellar- above the patellar. it lies on top of the distal portion of femur.
  2. prepatellar- “before the patella”. between the skin and over top of patella
  3. deep infrapatellar- a little below the prepatellar. Kind of over the patellar ligament
  4. superficial infrapatellar - lies between tibial tubercle and the overlying skin
36
Q

housemaids knee

A

prepatellar bursitis

37
Q

clergymans knee

A

infrapatellar bursitis (deep and superficial bursa)

38
Q

bakers cyst

A

benign swelling of semimembranous bursa
- a synovial cyst being filled with fluid due to irritation. It tells us that there is some other derangement going on in body

39
Q

ligamentum patellae

A

this is the patellar ligament.

It’s the continuation of quadriceps tendon, so it goes from inferior border of patella to tibial tuberosity;

40
Q

the lateral (fibular) collateral ligament (LCL)

A

round cord ligament that goes from the lateral epicondyle of femur down to the head of the fibula. It doesn’t directly touch the joint, it leaves space for the tendon of popliteus. It is important for stability

41
Q

Deep to the lateral collateral ligament is the

A

lateral meniscus

42
Q

If the LCL is strained is the lateral meniscus?

A

no, because there is space between

43
Q

The medial(tibial) collateral ligament (MCL)

A

MCL goes from the medial epicondyle of the femur and attaches to the medial condyle of the tibia.

44
Q

If the MCL is strained will the medial meniscus be strained?

A

It likely will be because the MCL is attached to the meniscus

45
Q

The MCL is crossed by which tendons? These tendons attach to the medial meniscus

A

the sartorius, gracilis and semitendinosus tendons

46
Q

arcuate popliteal:

A

Y-shaped - from the posterior border of the intercondylar area of the tibia and the lateral epicondyle of femur to the area below the head of fibula.

form the floor of popliteal fossa
supports posterior knee

47
Q

The cruciate ligaments are called cruciate because they

A

cross each other

48
Q

anterior cruciate:

A

anterior intercondylar area of tibia, runs superiorly, posteriorly and laterally to the posterior part of the medial surface of the lateral femoral condyle.
stability for rotary

49
Q

posterior cruciate:

A

posterior intercondylar area of tibia, runs superiorly, anteriorly and medially to the lateral surface of the medial condyle of the femur.
stability

50
Q

what are the Intracapsular Ligaments?

A

the anterior cruciate, the posterior cruciate and the menisci

51
Q

The cruciate ligaments: are tight both in ____ and ____but are most relaxed at about 30 degrees of flexion, whereas the collateral ligaments are tight in ______ and relaxed in ____

A

cruciate- tight in BOTH flexion and extension

collateral- tight in extension but relaxed in flexion

52
Q

the cruciate ligaments prevent

A

anterior and posterior displacement of tibia

53
Q

the collateral ligaments prevent

A

abduction/adduction of the knee-joint

54
Q

There is an anterior meniscofemoral ligament (Humphrey) and posterior meniscofemoral ligament (Wrisberg). What do they cushion?
also they are only present in 70% of knees

A

The PCL

I don’t really know what their purpose is

55
Q

The medial meniscus is C shaped and bigger. Anteriorly, it attaches to the tibia by the _____ _____ ____ and posteriormedially it attaches to the fibrous capsule and deep surface of the tibial collateral ligament.

A

transverse genicular ligament

menisci work to deepen the surface and to direct motion

56
Q

The lateral meniscus is more round and nearly a complete
ring. Anteriorly, it attaches to the tibia via the ____ ____ ____, and posteriomedially it attaches to the tendon of the
_______

A

Transverse genicular ligament

popliteus

menisci work to deepen the surface and to direct motion

57
Q

ACL tear

A

hyperextension of knee
rotational injury
relaxed in 30 degrees flexion
-weaker than PCL, have poor blood supply,

58
Q

anterior drawer test

A

test to see if there is ACL or PCL injury
if practitioner pulls tibia forward, it should have a stopping point. if it doesn’t, ACL tear.
If practitioner pulls tibia backwards, it should have a stopping point. If not PCL tear

59
Q

transverse genicular ligament

A

attaches the lateral and medial menisci of the knee

60
Q

menisci are ___ on the outside and ____ on the inside

A

bigger on the outside, smaller on inside, create a triangle shape

61
Q

coronary ligaments of knee

A

pieces of the outer menisci that attach to the tibia

62
Q

both MCL and PCL are ___ in extension

A

taught

63
Q

unhappy triad of O’donohue

A

injury to ACL, medial meniscus, and medial collateral ligament

64
Q

Hiltons law

A

know the nerves that innervate a joint, and then you should know the sensory innervation of the joint

65
Q

On the femoral condyles there is a ____ _____- this is where the patella attaches

A

trochlear groove

66
Q

On the back of the femur, there is a ____ _____/ fossa. Some parts of tibia fit nicely in this notch

A

intercondylar notch/ fossa