- hyperextension of the knee - higher among females - & individuals with longer or lax ligs.

Lecture: The Knee Complex Flashcards by Sonny D

3 articulating surfaces, form 2 distinct joints contained w/in a single joint capsule: (2 joints)

patellofemoral joint

- tibiofemoral joint

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2 types of swelling of the knee occur:

localized swelling (i.e. bursal)

- generalized swelling (i.e. intra-articular; synovitis)

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normally tibia has slight __ angulation in comparison to femur.
bowlegged=?
knock-kneed=?

valgus
(coxa)valga
(coxa)vera

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genu recurvatum=

hyperextension of the knee
higher among females
& individuals with longer or “lax” ligs.

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the tibiofemoral joint= __ end of femur & __ end of tibia.
the __ aspect of the femur= __ femoral __, separated by:
the anterior & posterior intercondylar areas serve as attachment sites for:

distal; proximal
distal; 2; condyles; intercondylar eminence
ACL & PCL

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the tibiofemoral joint is a __, or modified hinge joint.
joint stability is therefore dependent upon:
-static restraints:
-& dynamic restraints:

ginglymoid
(static)=joint capsule, ligaments & menisci
(dynamic)=quadriceps, hamstrings & gastrocnemius

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the femoral condyles project __ from the femoral shaft.
the __ lateral femoral condyle is __-__ & faces __.
the __-__ medial femoral condyle faces __.

posterioly
smaller; ball-shaped; outward
elliptical-shaped; inward

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the lateral epicondyle (of the femur) = origin for: (2)

the medial epicondyle (of the femur) = insertion for: (2)

lateral head of gastrocnemius & lat. collateral lig.

- adductor magnus & medial collateral ligament

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the __-__ width of the medial femoral condyle is greater than its lateral by __ cm.
the length of the articular surface of the medial femoral condyle is __ than the length of the lat. fem. condyle.

anterior-posterior
1.7cm
longer

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proximal tibia is composed of __ plateaus, separated by the __ eminence, including the med. & lat. __ __.
the tibial plateaus are __ in the __ to __ direction.
in the ant. to post. direction, the medial tibial plateau is concave, while the lateral is __, producing an __ in lateral __.

2
intercondylar
tibial tubercles
concave
medial to lateral
convex
increase
mobility

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patellofemoral joint is a __ articulation.
dependent on both __ & __ restraints for its fxn & __.
the post. surface of patella can include up to _ facets, w/ _ on the med. & lat. surfaces.

complex
static & dynamic
stability
7; 3

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the patella is a very __, __-shaped bone.
situated in the __ notch.
& embedded in the __ of the __ __ muscle above & the __ tendon below.
it is fixed in the __ groove in __ & mobile in __.

hard; triangular
intercondylar
tendon; quadriceps femoris
patella
trochlear; flexion; extension

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the patellofemoral joint fxns to:
provide an __ w/ __ friction.
protect the __ aspect of the femur from __ & the quads from __ wear.
improve the __ appearance of the knee.
improve the moment(?) arm of the __.
DECREASES the amount of __-__ tibiofemoral __ stress placed on the knee joint.

articulation; low
distal; trauma; attritional
cosmetic
quads
anterior-posterior; shear

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the Quadriceps angle:
aka?
2 lines drawn:
male avg.=
female avg.=
>\_\_deg. are considered \_\_ & may be indicative of potential \_\_ of the patella.

“Q” angle
(1)=from ASIS to center of patella
(2)=center of patella to tibial tubercle
8-14deg.
15-17deg.
20; abnormal; displacement

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(increased Q-angle)
Bayonet Sign=
common in pts. w/ patellofemoral arthralgia=

quads, patellar tendon & tibial shaft resemble french bayonet
w/ the knee flexed 30deg., there is a failure of the tibia to derotate normally & failure of the patellar tendon to line up w/ the ant. crest of the tibia

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patella stability is dependent on 2 factors:
purists (anatomists) classify the patella tendon as a __, b/c it serves as the connection b/w 2 bones (tibia & patella), but b/c it attaches the quads to the tibia, it fxns as a __.

static & dynamic restraints
ligament
tendon

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in a normal knee, the patella glides in a path: __-__ during flexion & extension respectively.
covering a distance of - cm w/ respect to the femur.

inferiorly-superiorly

- 5-7cm

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normal patellar posture w/ knee at 45deg. of flex.=
inf/lower patellar posture=
sup/higher patellar posture=

-patellar articular surface is squarely against the ant. femur
-represents patella BAJA
-represents patella ALTA (ALTitude is high in the sky!/sup.)
(*patella alta makes the patella less efficient in exerting normal forces)

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the knee joint capsule is composed of a __, strong fibrous membrane.
the KJ is the __ synovial capsule in the body.
a __ membrane lines the inner portion of the KJC.
by lining the JC, the __ membrane excludes the __ ligs. from the interior portion of the knee joint, making them __ yet __-articular.

thin
largest
synovial
synovial
cruciate
extrasynovial; intra-articular

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proximal tibiofibular joint:
an __ plane w/ a slight __ on the oval tibial facet &
slight __ of the fibular head.
has __ motion that its distal partner, the __.

almost
convexity
concavity
more; tail

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Osgood-Schlatter’s Syndrome/Disease
aka?
partial disruption at the __ ligament-tuberosity __.
creating __ inflammatory changes.
__ stress on the knee causing __ at the tibial tuberosity.
commonly in __ usually during a “__ __”.
predisposing factors:

osteochondritis of tibial tubercle
patellar; attachment
localized
repetitive; traction
adolescents; “growth-spurt”
tight hamstrings, tight heel cord (achilles tendon) & tight quad m.’s

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Osgood-Schlatter's Syndrome/Disease
more in which gender?
ages?
\_\_, \_\_ & \_\_ over the tibial tubercle.
pain on \_\_ or \_\_ stairs.
Hx:

males
10-15
pain, swelling & tenderness
ascending or descending
single violent injury OR repetitive FLEX/EXT. movement

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the STATIC stability of the KJC depends on 4 major knee ligaments:
(which provide a __ restraint to __ knee motion)

anterior cruciate
posterior cruciate
medial collateral
lateral collateral
primary; abnormal

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Primary Restraints of the Knee:
anterior translation=
posterior translation=
valgus rotation=
varus rotation=
LATERAL rotation=
MEDIAL rotation=

ACL
PCL
MCL
LCL
MCL & LCL
ACL & PCL

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cruciate ligaments are different from those of other joints, in that they __ normal motion, rather than __ abnormal motion.

- restrict | - restrict

anterior cruciate ligament: one of the most __ ligaments to knee __. serves as a __ restraint to ant. __ of the tibia relative to the femur. & a __ restraint to both __ & __ rotation in the __-weight bearing knee.

- important; stability - primary; translation - secondary; internal & external; non-weight

anterior cruciate ligament: most common MOI= __ kinetic chain, b/c?

- sudden deceleration w/ an abrupt change of direction/speed and or velocity & a fixed foot - closed; b/c of foot on the ground

posterior cruciate ligament: provides __-__% of the total __ to posterior translation of the tibia on the femur. with the remaining _-__% being provided by:

- 90-95%; restraint - 5-10% - collateral ligs, post. portion of the med. & lat. capsules, & the popliteus tendon

posterior cruciate ligament: | MOI where the PCL can tear include:

- excessive hyperflexion (forced bending; i.e. falling not the shin w/ a ben knee and foot pointed) - OR hyperextension (leg bent backwards)

dashboard injury=

- (i.e. in a car) | - where the knee is bent to a right angle and a sudden force drives the tibia backwards

the Medial Collateral Ligament: aka? the __ fibers of the ligament are __ in __, broad & fan shaped & can be __ palpated in this position. the __ fibers are __ in __, & blend in with the capsule & the medial meniscus, making them __ to palpate.

- TIBIAL collateral ligament - anterior; taut; flexion; easily - posterior; taut; extension; difficult

the Lateral Collateral Ligament: aka? main fxn? offers the majority of the __ restraint at __deg. of knee flexion & in full extension.

- FIBULAR collateral ligament - resist varus forces - varus; 25deg.

secondary restraints of the collateral ligaments include: (3)

- the structures in the post.-lateral & post.-medial corners of the knee - the hamstrings & quads. - the patellar ligament, oblique popliteal ligaments & the fibula

menisci: __-shaped lateral & medial menisci. attached on __ of the tibial __. they are pieces of __ material that lie b/w the __ cartilage of the __ & the __.

- crescent - top; plateaus - fibrocartilage; articular; femur & the tibia

``` medial meniscus: semi-lunar or __-__. __ & __ than its lateral counterpart. sits in the __ medial tibial plateau. __ posteriorly than anteriorly. ```

- C-shaped - larger & thicker - concave - wider

lateral meniscus: rounder or __-__. sits atop the __ lateral tibial plateau. attached by __ ligaments. __ & __ than its medial counterpart. more __ than its medial counterpart. __ menischofemoral ligaments attach to the lat. meniscus.

- O-shaped - convex - coronary - smaller & thinner - mobile - two

``` menisci fxn: __ transmission. __ absorption. __ lubrication. __ stability. & __ of movements. ```

- load - shock - joint - joint - guiding

you are __ times more likely to hurt the __ meniscus.

- 20X | - medial

``` a meniscectomy (define:) can __ the shock-absorbing capacity of the knee by up to __%. ```

- surgical removal of part of torn meniscus | - reduce; 20%

triad of O'Donoghue: 2 aka's? =rupture of the __, __ & __.

- "terrible triad" & "unhappy triad" | - MCL, ACL & medial mensicus

the __ margins of the menisci are __ than the __ margins & taper __ the center.

- outer - thicker - inner - toward

the menisci are __ attached at their ends to the __area of the tibia.

- firmly | - intercondylar

the __ fibers which attach the menisci to the __ condyles, are called the medial & lateral __ ligaments.

- capsular - tibial - coronary

the middle genicular branch of the __ artery sends branches around the __ of the meniscus under the capsule. small tortuous nonanastomotic vessels enter the __ fibrous zone of the meniscus.

- popliteal - periphery - outer

the __ third of the meniscus is __ & __ (won't heal well).

- inner - cartilaginous - & avascular

the medial meniscus is attached to the=

-medial collateral ligament

the lateral meniscus is __ & more __ moveable than the medial.

- smaller | - freely

the lateral meniscus is attached to the=

-popliteus muscle

the bursae serve to reduce __ & to __ the movement of one body part over another.

- friction | - cushion

Prepatellar Bursitis=

- a fluid swelling occurs subcutaneously over the lower 1/2 of the patella and the upper 1/2 of the patellar lig. which is the distribution of the prepatellar bursa. - the cause is any occupation that causes chronic trauma to the tissue overlying the patella, such as excessive kneeling or leaning forward.

``` Prepatellar Bursitis aka? MOI? a __ blow to the area. __ friction, such as from frequent kneeling. pt. symptoms= pain when? ```

- Housemaid's Knee - overuse - direct - chronic - pain & swelling over the front of the knee - bending or straightening the leg

Infrapatellar Bursitis: aka? __ occurs on both sides of the __ ligament, near the __ __. the cause is repeated __ to the region of the __ __, including a variety of occupations such as:

- Clergyman's Knee - swelling - patellar - tibial tuberosity - trauma - tibial tuberosity - roofers, painters & floor layers

``` popliteal fossa: superior lateral border= superior medial border= inferior borders= contents= ```

- biceps femoris tendon - semitendinosous & semimembranosus - medial & lateral head of the gastrocnemius - posterior tibial nerve, popliteal artery & popliteal nerve

``` Morrant Baker's Cyst=? location at= protrudes when? sometimes dull pain when? may compress? often associated with? __ joint disorder. __ common. ```

- escaped synovial fluid in an enclosed membrane sac which is protruding thru the joint capsule of the knee - midline of popliteal fossa - when knee is extended & is not visible when knee is flex. - when walking is produced - popliteal vessels - RA - femorotibial - very

Plica: __ plica represents a remnant of the _ separate cavities in the synovial __ of the __ knee. pain when __, closely resembles __ injury.

- synovial - 3 - membrane - developing - irritated; meniscal

Retinacula: formed from structures in the __ & __ layers of the KJ. can be subdivided into __ & __ retinacula for __ examination & __ purposes.

- first & second - medial & lateral - clinical - intervention

the major muscles that act on the knee joint complex=

- quadriceps - hamstrings (semi-mem./semi-tend. & biceps femoris) - gastrocnemius - popliteus - & hip adductors

extension lag=

- pt. may be unable to extend the knee thru the last 10deg. of motion, may only be able to w/ a great amount of effort - occurs w/ quadriceps weakness

Helfet's Helix=

- the knee cannot fully extend w/o some amount of external tibial rotation on the femur - b/c of physical configuration of the knee joint & its cruciate ligaments - ACL & PCL cause this rotation

major blood supply of the knee area= (3)

- femoral - popliteal - genicular arteries

neurology of the knee area=

- femoral (saphenous) nerve - sciatic nerve (common peroneal palpable @ neck of fibula) - tibial nerve

the position of the joint at the time of the traumatic force dictates=

-which anatomic structures are at risk for injury

the primary MOI in the knee are= (6)

- direct trauma - varus or valgus force - hyperextension - flexion w/ post. translation - twisting force - overuse

Lecture: The Knee Complex Flashcards

(63 cards)