Written Flashcards
What is knee extension rom actively?
0
What is the knee extension prom?
5-10
What is knee flexion rom?
130-140
What is knee internal rotation rom?
0-30
What is knee external rom?
0-40
When is knee rotation the greatest?
90 flexion
What are the femoral condyles separated by?
Intercondlyar fossa posteriorly
What do the femoral condlye bend to for?
Concave trochlear groove
What plane has the greatest surface area for the femoral condlyes?
Sagittal plane
Which femoral condlye lip is longer?
Lateral condlye
Which femoral condlye is larger and longer?
Medial
What is the tibial plateau in the frontal plane?
Concave
What is the medial femoral condlye in the sagittal plane?
Concave
What is the lateral femoral condlye in the sagittal plane?
Convex
Why is the femoral condlye axis oblique?
Femoral condlyes are larger than tibial plateaus
Medial condlye is larger than lateral condlye
What is the medial tibiofemoral angle?
Femoral head hangs over femoral shaft
Femoral shaft doesn’t coincide with the leg
Creates an obtuse angle
What is normal for middle tibiofemoral angle?
185-190
Physiologic valgus
What is an increased medial tibiofemoral angle?
Greater than 195
What is genu valgum?
Knock knee
Coxa vara of knee
What is lower than normal medial tibiofemoral angle?
Less than 180
What is genu varum?
Bow legged
Coxa valga
What is the q angle?
Line from Asis to midline intersecting with mid patella
What is a normal q angle?
15
Open chain knee flexion arthrokinematics?
Concave tibia on convex femur
First 25 minimal movement
After posterior bone motion roll and glide
Open kinetic knee extension arthokinematics?
Concave tibia on convex femur
Anterior
Close chain arthokinematics for knee flexion?
Sit to stand
Bone motion roll posterior glide anterior
25 minimal gliding
What is the arthrokinematics for closed kinetic chain knee extension?
Sit to stand
Bone motion roll anterior glide is posterior
What is the screw home mechanism closed kinetic chain?
Internal rotation of femur on tibia
What is the screw home mechanism open kinetic chain?
External rotation of tibia on femur
When does the 20 of rotation occur in the screw home mechanism?
During the last 30 of extension
In the open kinetic chain the medial plateau is bigger so it moves_______ causing __________ rotation.
Anterior, external rotation
In the closed kinetic chain the medial femoral condlye moves ________ causing ___________ rotation.
Posterior,internal rotation.
Unlocking the knee from full extension starts with?
Log posterior to knee
Popliteaus muslce
In closed kinetic chain unlocking cause?
External rotation of femur
In open kinetic chain unlocking knee causes?
Internal rotation of femur
Limits knee extension
Varus and valgus stress
Anterior posteior transition of tibia on femur
Medial and lateral rotation of tibia on femur
General ligament function
This ligament attaches to the joint capsule and medial meniscus
Tight in knee extension
Resist valgus stress
Lateral rotation of tibia
Medial femoral condlye slope ant to medio prox tib
Mcl
No joint or menisci attachment
Tight in knee extension
Resist varus stress
Medial rotation of tibia
Lcl
Postlat- tight knee extension
Antmed- tight knee flexion
Extra synovial
Resist ant transition, prevent hyperextension
Limit internal rot of tibia
Ant tib to med and lateral menisci to post lat prox knee
ACL
Postlat tight in extension Antmed tight in flexion Extra synovial Resist post displacement of tibia Post tib to sup and ant inner knee
PCL
Acruate ligament y shaped
Tight in full knee extension
Prevent hyperextension
Run post to med tibial plAteau
Posterior capsular ligament
Lax and allow great amount of motion
Vertical fibers that Attach above margins of femoral condlye
Joint capsule
Affects patellar tracking
Cylinder invaginated post
Innervated by mechano receptors
Extensor retinaculae
Synovial fluid that is not re absorbed when an adult?
Police
Biconcave fibrocartilagious tissue between femur and tibia
Menisci
Medial menisci is_____ compared to lateral menisci
Wider
Menisci attaches to tibia by
Coronal lig
Menisci attach to patella by
Patellamensici lig
Attach to
Pcl
Popliteaus
Medial femoral condlye
Lateral menisci
Attach to
Mcl
Semimembranous
Medial menisci
Increase stability by increasing
Congruency
Concavity of plateaus
Surface area
Menisci increased stability by
What does the menisci follow?
Femoral condlyes
In closed kinetic chain knee flexion the menisci move?
Posterior bc femur moves anterior
In open kinetic chain knee extension menisci moves?
Anterior bc femur moves posterior
What are the components of the patella femoral joint?
Patella bi convex on concave trochlear notch of femur
What is the medial condlye covered in?
Hyaline cartilage
The lateral condyle is ________ then the medial condlye
Higher
Patellofemoral joint capsule is continuous with
Tibiofemoral joint capsule
What is the function of the patellofemoral joint.
Extensor mechanism
Inc lever for quads
Inc pulley for quads
In flexion the patella slides ___________ seating Btwn femoral condlyes
Distally
In full flexion the patella______ into the intercondylar notch
Sinks
In knee extension the patella slides _________ to ant surface of distal femur
Ant
In early flexion distal patella is with ________ trochlea
Prox
In continued flexion the patella is in_________ contact, more ________ on __________ portion of patella
More, prox, superior
The patellas medial facet is ________ intercondylar notch and ________ facet makes first contact during flexion past 90
In, odd
The _______ and ________ facet are ________ in the notch during 130 of flexion.
Lateral, odd, sitting in
Knee extensor muscle
Quad
Articularis genu
Knee flexor muscles
Hamstring Sartorious Gracilis Popliteaus Gastroc
Internal rotator of tibia on femur
Semimembranous Semitendious Gracilis Sartorious Popliteaus
External rotators of tibia on femur
Biceps femoris
TFL
Talus and calcaneous
Hind foot
Navicular, cuboid and cunieforms
Mid foot
Metatarasals and phalanges
Fore foot
Talus, distal fib, tib
Talocruaral joint
Talocrural joint component
Wedge talus on concave mortis ( distal tib, fib, fib malleoli)
Proximal tib fib joint is
Plane joint
Distal tib fib joint is
Syndesmosis
Concave tib on convex fib.
Control valgus motion, check extreme motion
Very strong lig
Medial collateral lig of talocrural joint
Control lateral and varus stress
Weak lig
Lateral collateral lig of talocrural joint
Open kinetic chain arthokinematics of talocrural joint
Convex talus on concave mortis
Motions of talocrural joint
Dorsiflexion
Plantarfleixo.
Closed kinetic chain arthokinematics of talocrural joint
Concave mortise on convex talus
With dorsiflexion__________ rotation occurs in the talocrural joint
Internal
With plantar flexion ___________ rotation occurs in the talocrural joint
External
Dampens rotational forces imposed by body weight while maintaining contact of foot with the floor
Prevent unwanted rotational forces
Subtalar joint
Interosseous talocalcaneal
Ligamentum cervics
Posterior and lateral talocalcaneal
Ligaments of subtalar joint
Posterior facet arthrokinematics for subtalar joint
Concave talus on convex calcanleous
Anterior and medial facet arthokinematics for subtalar joint
Convex talus on concave calcaneous facets
Subtalar joint arthokinematics go opposite ways so have ________ motion
Scewlike
Motions at subtalar joint t
Pronation and supination
Adduction
Inversion
Plantar flexion
Supination
Abducton
Eversion
Dorsiflexion
Pronation
Calcaneous will invert two times as many degrees as evertong
Subtalar neutral
Closed kinetic chain of subtalar supination.
Dorsiflexion
Abduction
Inversion
Closed kinetic chain of subtalar joint pronation
Plantar flexion
Adduction
Eversion.
Talocalcaneal joint is made up of
Talonsvicular and subtalar joint together
Key to foot function
Joint distal to TCN form a single elastic unit moves in response to talus and calcaneous
Talocalcaneonavicular joint functions
Made up of talonavicular joint and calcaneocubodial joint
Transverse tarsal joint
Midtarsal joint
Cuboid and navicular are _____– in weight bearing of transverse tarsal joint.
Immobile
Lateral band of bifurcate lig
Dorsal calcomedocuboid lig
Plantar calcomedocuboid lig
Long plantar lig
Lig of midtarsal joint
Link between hind foot and forefoot
Add to increase supination and prontation
Rom compensates for forefoot for hind foot postion
Midtarsal joint function
Distal tarsal row and base of metatarsals
TarsometatarsAl joint
Tmt
Continuous with midtarsal joint
Regulate position of metatarsals and phalanges and weight bearing surfaces
Adjust for rear foot motion
Hollowing of foot
Tarsometarsal joint
Functional unit formed by metatarsal and associated cuneiforms
Rays
Allow foot to hinge at toes
Function of metarsophalangeal joint
45 flexion
1 mcp rom flexio
70 extension
1 mtp rom
40 flexion and extension
2-5 mtp
Toes extend fascia tighten draw heel towards toes increase stability of foot
More efficient for pushing off
Windlass mechanism
Smooth weight bearing shift to opposite foot
Maintain stability
Interphalangeal joint
Calcaneous to toes
On both side of the foot
Longitudinal arch
Tarsals with middle cuneiforms
Transverse tarsal arch
Metatarsal
Second apex of arch
Transverse metatarsal arch
Spring lig
Long plantar log
Plantar aponeurosis
Short plantar lig
Lig of arches of foto
Gastroc and soleus Plantaris Tibialis posteior Flexor hallicus longus Flexor digitorium longus Fibularis longus and brevis
Plantar flexor muscles
Tibialis anterior
Extensor hallicus longus
Extensor digitorium longus
Perneous Fibularis
Dorsiflexors
Tibialis posterior in open kinetic chains
Supinator
Closed kinetic chain posterior tibialis
Pronation eccentrically
Attributes of gait
Foot clearance Pre positioning of foot for hs Stability Adequate step length Energy conservation
Momentum initiated during push off
Swimg phase
Toe off and continue until midswing
Acceleration
Reference leg pass directly beneath body
Midswing
Tibia pass beyond perpendicular and knee extending
Deceleration
Low point of cog
Hs–> ff at push off
Double support
High point of cog
Mid stance to mid swing
Single support
Lateral pelvic tilt
During midstance knee flexes, giving _______ in cog is limited
Rise
Movement of foot ankle knee when cog goes down ( hs) then up (ff)
Knee flexes
Plantar flexion
Pronation
Movement of foot ankle knee when cog falls after midstance
Plantarlflexion
Supination
Extension
What is the primary function of the knee?
Lengthen and shorten the lower limb