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Orthopedic Diagnosis > The Knee Complex > Flashcards

The Knee Complex Flashcards

1
Q

The knee joint is made up of:

A

three articulating surfaces, forming two distinct joints contained within a single joint capsule

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2
Q

which joints make up the knee joint

A

patellofemoral and tibiofemoral

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3
Q

Two types of swelling seen in the knee

A

localized (bursal)

generalized (intra-articular or synovitis)

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4
Q

genu recurvatum

A

hyperextension of the knee

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5
Q

The incidence of hyperextension is higher among?

A

females and individuals with longer/lax ligaments

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6
Q

Tibiofemoral joint

A

distal end of the femur and proximal end of the tibia

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7
Q

What type of joint is the tibiofemoral joint?

A

ginglymoid or modified hinge

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8
Q

knee joint stability is dependent on:

A

static restraints of the joint capsule, ligaments, and menisci and the dynamic restraints of the quadriceps, hamstrings, and gastrocnemius

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9
Q

Femoral condyles

A

project posterior from the femoral shaft

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10
Q

Medial femoral condyle

A

elliptical shaped

faces inward

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11
Q

lateral femoral condyle

A

smaller, ball shaped, faces inward

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12
Q

the medial femoral condyle is

A

the insertions for adductor magnus and MCL

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13
Q

the lateral femoral condyle is

A

the origin for the lateral head of the gastrocnemius and LCL

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14
Q

patellofemoral joint

A

a complex articulation, dependent on both dynamic and static restraints for its function and stability

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15
Q

The quadriceps Angle

A

aka the q angle
formed by the bisection of two lines
one from ASIS to center of patella and the other drawn from the center of the patella to the tibial tubercle

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16
Q

Common ranges of the Q angle

A

8-14 in males and 15-17 in females

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17
Q

A q angle greater than what is considered abnormal?

A

angles greater than 20

may be indicative of potential displacement of the patella

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18
Q

Increased Q angle leads to what sign?

A

bayonet sign

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19
Q

patella baja

A

a lower posture of the patella

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20
Q

patella alta

A

a higher posture of the patella

makes the patella less efficient in exerting normal forces

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21
Q

Knee joint capsule

A

composed of a thin, strong fibrous membrane

largest synovial capsule in the body

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22
Q

the synovial mambrane excludes

A

the cruciate ligaments from the interior portion of the knee joint, making them extrasynovial yet intra-articular

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23
Q

Proximal tibiofibular joint

A

an almost plane joint with a slight convexity on the oval tibial facet and a slight concavity of the fibular head

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24
Q

Osgood-Schlatter’s syndrome

A

Partial disruption at the patellar ligament- tuberosity attachment creating localized inflammatory changes

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25
Q

predisposing factors to Osgood-schlatters

A

tight hamstrings, tight heel cord, and tight quadriceps

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26
Q

Who is osgood-schlatters commonly seen in

A

males more than females, ages 10-15

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27
Q

the static stability of the knee joint complex depends on

A

anterior cruciate ligament
posterior cruciate ligament
medial collateral ligament
lateral collateral ligament

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28
Q

What ligament restrains anterior translation

A

ACL

29
Q

What ligament restrains posterior translation

A

PCL

30
Q

What ligament restrains valgas rotation

A

MCL

31
Q

What ligament restrains varus rotation

A

LCL

32
Q

What ligament restrains lateral rotation

A

MCL, LCL

33
Q

What ligament restrains medial rotation

A

ACL, PCL

34
Q

Cruciate Ligaments

A

intra-articular, extra-synovial

different from those of other joints in that they restrict normal motion rather then restrict abnormal motion

35
Q

Which is one of the most important ligaments in knee stability?

A

ACL

36
Q

ACL

A

serve as a primary restraint to anterior translation of the tibia relative to the femus and secondary restraint to both internal and external rotation in the non weight bearing knee

37
Q

Most common MOI in an ACL tear

A

sudden deceleration with an abrupt change of direction/speed and a fixed foot (closed kinetic chain)

38
Q

PCL

A

provides 90-95% of total restraint to posterior translation of the tibia on the femur

39
Q

After the PCL, what provides restraint to posterior translation of the tibia on the femur?

A

the collateral ligaments, posterior portion of the joint capsule, and popliteus tendon

40
Q

Common MOI in a PCL tear

A

excessive hyperflexion

hyperextension

41
Q

Dashboard injury

A

with the knee in 90 degrees of flexion can drive the tibia posterior and cause a PCL tear

42
Q

MCL

A

anterior fibers are taut in flexion, broad and fan shaped

posterior fibers are taut in extension and blend with the capsule

43
Q

LCL

A

main function is to resist varus forces

44
Q

Where does the LCL provide a majority of varus restraint?

A

at 25 degrees knee flexion and full extension

45
Q

Secondary collateral restraints

A

hamstrings and quadriceps

patellar ligament, oblique popliteal ligaments, and the fabella

46
Q

Medial meniscus

A

semi-lunar

larger and thicker than lateral meniscus

47
Q

Lateral Meniscus

A

o-shaped
sits atop the convex lateral tibial plateau attached by coronary ligaments
more mobile than medial meniscus
two meniscofemoral ligaments attach to the lateral meniscus

48
Q

Functions of the Menisci

A

load transmission, shock absorption, joint lubrication, joint stability, and the guiding of movements

49
Q

A meniscectomy can reduce the shock-absorbing capacity of the knee by

A

up to 20%

50
Q

Triad of O’Donoghue

A

Rupture of ACL, MCL and medial meniscus

aka terrible triad

51
Q

Housemaid’s Knee

A

aka prepatellar bursitis

subcutaneous swelling over the lower half of the patella and upper half of the patellar ligament

52
Q

MOI of housemaid’s knee

A

overuse, as with frequent kneeling

direct blow to the area

53
Q

Clergyman’s knee

A

aka infrapatellar bursitis

swelling on both sides of the patellar ligament

54
Q

MOI of clergyman’s knee

A

repeated trauma to the region of the tibial tuberosity

55
Q

Superior lateral border of the popliteal fossa

A

biceps femoris tendon

56
Q

Superior medial border of the popliteal fossa

A

semitendinosus and semimembranosus tendons

57
Q

inferior borders of the popliteal fossa

A

two heads of gastrocnemius

58
Q

Contents of the popliteal fossa

A

posterior tibial nerve, popliteal artery and nerve

59
Q

Baker’s cyst

A

escaped synovial fluid in an enclosed membrane sac which is protruding through the joint capsule of the knee

60
Q

What is baker’s cyst associated with?

A

RA

61
Q

Plica

A

represents a remnant of three separate cavities on the synovial mesenchyme of the developing knee

62
Q

Retinacula

A

formed from structures in the first and second layers of the knee joint
can be subdivided into medial and lateral

63
Q

Major muscles that act on the knee joint complex

A

quadriceps, hamstrings, gastrocnemius, popliteus, and the hip adductors

64
Q

Extension lag

A

the arc of flexion and extension should be smooth, pt may be unable to extend the knee through the last 10 degrees and may only finish with great effort

65
Q

extension lag occurs with

A

quadriceps weakness

66
Q

Helfet’s helix

A

the knee cannot fully extend without some amount of external tibial rotation on the femur because of the physical configuration of the knee joint and its cruciate ligaments

67
Q

the final locked knee extension allows

A

the patient to maintain knee extension for prolonged periods of standing without relying on muscles

68
Q

Major blood supply to the knee comes from

A

femoral, popliteal, and genicular arteries

69
Q

pain can be referred to the knee from

A

L3 through S2 nerve roots

Orthopedic Diagnosis (10 decks)

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