11 Knee And Anckle

Front 1

WHAT TYPE OF JOINT IS A KNEE

Back 1

HINGE

Although is probably more appropriate to call it a double condyloid joint because it can rotate when flexed

Front 2

T/F KNEE IS LARGEST AND MOST SUPERFICIAL JOINT

Back 2

T

Front 3

THREE ARTICULATIONS KNEE

Back 3

Lateral tibiofemoral
Medial tibiofemoral
Patellofemoral

Front 4

KNEE MOVEMENT RANGES

Back 4

Flexion 120-150°
Extension 5-10°
Internal rotation 10°
External rotation 30-40

Front 5

KNEE AXIS FOLLOWS AN

Back 5

ARCH

Front 6

D LOCKING OF KNEE (SCREW HOME MECH)

Back 6

AS WE EXTEND KNEE, FEMUR ROTATES MEDIALLY OF TIBIA AND LOCKS. THIS ALLOWS US TO SUPPORT OUR WEIGHT AS WE STAND.

AS WE STAND, MUSCLES RELAX AND LIGAMENTS ARE TAUT.

Front 7

--------MUSCLE UNLOCKS THE KNEE.

Back 7

POPLITEUS MUSCLE UNLOCKS THE KNEE.

Front 8

PARTS PATELLA

Back 8

ASE APEX,

ARTICULAR SURFACE HAS MADIEAL AND LATERAL FACUETS AND
VERTICAL RIDGE

Front 9

NORMAL ALIGHMENT DEGREES

Back 9

170 TO 175 DEGREES. WE ARE IN A LITTLE OBIT OF A GENU VALGUS NORMAL

Front 10

D GENU VALGUM

Back 10

LESS THAN 170

Front 11

D GENU VARUM

Back 11

GREATER THAN 180 DEGREES

Front 12

D GENU RECURVATUM

Back 12

HYPEREXTENSION OF KNEE. KNEE IS POSTERIOR TO ANKLE.

Front 13

PARTS KNEE JOINT CAPSLE

Back 13

External fibrous layer

Internal synovial membrane

Front 14

D LIG OF KNEE

Back 14

PATELLAR LIGAEMNT

Patellar retinacula support patella alignment

Collateral ligaments
Medial (tibial)
Lateral (Fibular)

POPLITEAL LIGAMENTS

CRUCIATE LIGAMENTS=ACL AND PCL

INTRA ARTICULAR LIGS

Front 15

WHAT'S UNDERNEATH PATELLAR LIG?

Back 15

INFRAPATELLAR FAT PAD
AND INFRAPATELLAR BURSA

Front 16

T/F PATELLAR RETINACULA ARE NOT REALLY LIGAMENTS BUT PART OF JOINT CAPSLE

Back 16

T

Front 17

Medial collateral ligament ATTACHMENTS

Back 17

Proximal attachment: medial femoral condyle

Distal attachments
Superficial layer: proximal medial tibia posterior to pes anserinus

Deep layer: attaches to the medial meniscus and tibial at joint line

Front 18

LAT COLATERAL LIG ATTACHMENTS

Back 18

Proximal attachment: lateral femoral condyle
Inserts head of fibula

Not part of the jt. capsule

Front 19

WHAT ARE THE POPLITIAL LIGAMENTS AND THEIR F

Back 19

Oblique popliteal LIG, strengthens the jt. capsule posteriorly

Arcuate popliteal LIG, “Y” shape and passes over the popliteus muscle

Front 20

LOCATION CUCIATE LIGS ACL AND PCL

Back 20

Located in the central portion of the knee

They are within the capsule of the knee surrounded by synovial sheath that separates them from the synovial space (i.e., synovial fluid does not come in contact with the ligaments)

Front 21

ACL NAMED BY ITS

Back 21

ATTACHMENT ON THE TIBIAL PLATEAU

Front 22

ATTACHMENT ACL

Back 22

LATERAL FEMORAL CONDYLE

ANTERIOR MEDIAL TIBIAL PLATEAU

Front 23

FUNCTION ACL

Back 23

resists anterior translation of tibia on femur (promotes gliding motion)
resists hyperextension
resists internal rotation of tibia

Front 24

PCL ATTACHMENT

Back 24

Medial femoral condyle
Posterior tibial plateau

Front 25

PCL F

Back 25

resists posterior translation of tibia on femur

Front 26

2 INTRA ARTICULAR LIGS AND FUNCTION

Back 26

Coronary ligament
Attach to menisci and tibial condyles

Transverse ligament
Attach to anterior

Front 27

F INTRA ARTICULAR LIGS

Back 27

Stabilizers for the menisci

Front 28

D MEDIAL MENISCUS

Back 28

C shaped
Anterior and posterior horns attach to tibia
MCL attaches to it

Front 29

D LATERAL MENISCUS

Back 29

O shaped (almost)
It has horns too!
Posterior meniscofemoral ligament

Front 30

BURSA KNEE

Back 30

THERE ARE 12

Just know the Suprapatellar, Prepatellar, infrapatellar and semimembranosus bursa

Front 31

BLOOD SUPPLY KNEE

Back 31

Genicular anastomosis

****The middle genicular branches from the popliteal artery supply the cruciate ligaments, synovial membranes, and peripheral margins of the menisci

Front 32

NERVES KNEE

Back 32

EVERY MUSCLE THAT CROSSES KNEE SENDS OFF ARTICULAR BRANCH

Front 33

ANKLE JOINT TYPE

Back 33

Talocrural joint

Uniaxial hinge type synovial joint

Front 34

PARTS TALUS

Back 34

Head
Neck
Body
Trochlea
Talar sulcus

Front 35

MEDIAL LIGAMENT OF ANKLE=

Back 35

DELTOID LIGAMENT (MEDIAL LIG)

Front 36

4 PARTS DELTOID LIGAMENT

Back 36

Posterior tibiotalar
Tibiocalcaneal
Tibionavicular
Anterior tibiotalar

Front 37

3 LATERAL LIGAMENTS OF ANKLE

Back 37

POSTERIOR TALOFIBULAR LIGAMENT

ANTERIOR TALOFIBULAR LIGAMENT

CALCANEOFIBULAR LIGAMENT

Front 38

BLOOD SUPPLY ANKLE

Back 38

Malleolar branches of the fibular, anterior and posterior tibial arteries

Front 39

NERVES ANKLE

Back 39

Nerves from the tibial and, deep fibular

Front 40

RANGE OF MOTION TALOCURARAL JOINT

Back 40

DORSIFLEXTION=20 TO 30 DEG
PLANTARFLEXION= 40 TO 50 DEG

Front 41

DISTAL TIBIOFIBULAR JOINT TYPE

Back 41

SYNDESMOSIS

NEED TO BE STABLE FOR NORMAL NAKLE FUNCTION

Front 42

WHAT STABALIZES DISTAL TIBIOFIBULAR JOINT

Back 42

2 LIGS

Front 43

WHAT STRUCTURES CROSS THE ANKLE

Back 43

LATERAL
BLT-BACON LETTUCE TOMATOE

Medial
Tom, Dick And Very Nervous Harry

LOOK UP

Front 44

D 1ST DEGREE LIG INJURY

Back 44

microtrauma, some pain, minimal swelling, no loss of function

Front 45

D 2ND DEGREE LIG INJURY

Back 45

incomplete macrotrauma, pain, moderate loss of function, swelling, slight, instability

Front 46

D 3RD DEGREE LIG INJURY

Back 46

complete macrotrauma, pain, loss of function, severe instability

Front 47

T/F ACL most prevalent 3rd degree sprain in the knee

Back 47

T

Front 48

T/F PCL most common dashboard injury in auto accident

Back 48

T

Front 49

HOW CAN YOU GET AN ACL INJURTY

Back 49

Most ACL injuries are non-contact

Running and cutting sharply in an erect posture, landing from a jump without bending the knees sufficiently.

Front 50

SIGNS ACL INJURY

Back 50

Hear a “pop”
Immediate swelling
Knee “giving way”

Front 51

FACTORS RELATED TO ACL INJURIES

Back 51

Higher in females
Narrowing of the femoral notch
Q-angle
Hormonal changes
Development of quad and hamstring musculature

Front 52

HOW CAN YOU GET A PCL INJURY?

Back 52

fall on a flexed knee
dashboard injury

Front 53

MENISCAL LESIONS MECH

Back 53

Mech – weight bearing combined w/ rotary force, squatting, cutting

Front 54

MENISCAL LESIONS SX

Back 54

S&S – gradual effusion, joint line point tenderness, locking or giving away, pain on squatting

Medial meniscus has less mobility due to its attachment to the medial collateral ligament and capsule
Medial is injured more often

Front 55

PAPETELLAR BURSITIS MECH, SX, TX

Back 55

Mech – contact to the anterior potion of the knee

S&S – swelling directly over the patella, itching or burning sensation

Manage – compression, NSAIDS, Rest

Front 56

WHAT IS MOST COMMONLY SPRAINED LIG IN BODY

Back 56

The Anterior Talofibular ligament is the most commonly sprained ligament in the body

Front 57

D MEDIAL AVERSION ANKLE SPRAIN. MECH AND SX.

Back 57

5-10% of ankle sprains
Mech – forced eversion – foot pronation more susceptible

S&S – pain on weight bearing, may result in some pronation

Front 58

SYNDESMOTIC/ HIGH PAIN MECH

Back 58

forced dorsiflexion and external rotation of foot

Front 59

SX SYNDESMOTIC/ HIGH PAIN

Back 59

severe pain and loss of function

Point tender over the anterior tibiofibular lig. especially during wt. bearing, and passive external rotation of the foot.

Front 60

TX SYNDESMOTIC/ HIGH PAI

Back 60

BRACING, SCREW, BOOT

LONG HEALING TIME