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68 Cards in this Set

  • Front
  • Back
1. What is the patella?
a. Largest sesamoid bone
b. Fulcrum for quadriceps
2. What are the symptoms of a bipartite patella?
a. Usually asymptomatic
a. How far does the joint capsule extend inferiorly? Why is this important?
i. 15 mm distal to joint line
ii. Pin placement
b. Where does the ACL attach to the tibia?
i. Intercondylar tubercles (spines)
c. What attaches on Gerdy’s tubercle?
i. IT band
d. What are the characteristics of the medial tibial plateau?
i. Oval and concave
e. What are the characteristics of the lateral tibial plateau?
i. Circular and convex
f. What tibial plateau is more sensitive to meniscal insufficiency and fracture?
i. Lateral
a. Where is the common peroneal nerve with respect to the fibula?
i. Wraps around neck
a. What does the ACL provide?
i. Stability to anterior and rotational force
b. What are the two bundles of the ACL?
i. Anteromedial
ii. Posterolateral
c. What does the PCL provide?
i. Stability to posterior force
d. What are the two bundles of the PCL?
i. Anterolateral
ii. Posteromedial
e. What does the posterolateral corner provide?
i. Stability to rotational movement
f. What is in the posterolateral corner?
i. Arcuate ligament
ii. Popliteus
iii. Posterolateral capsule
iv. LCL
v. Popliteofibular ligament
vi. Lateral head of gastroc
g. What are the attachments and function of the deep MCL?
i. Medial epicondyle to medial meniscus
ii. Hold medial meniscus to femur
h. What are the attachments and function of the superficial MCL?
i. Medial epicondyle to medial tibia
ii. Resists valgus force
i. What are the attachments and function of the LCL?
i. Lateral epicondyle to fibular head
ii. Resists varus force
j. What are the attachments and function of the ACL?
i. Lateral wall of intercondylar notch to anterior intercondylar tibia
ii. Resist anterior/rotational force
k. What are the attachments and function of the PCL?
i. Medial wall intercondylar notch to posterior tibial sulcus
ii. Resist posterior force
l. What are the attachments and function of the intermeniscal ligaments?
i. Anterolateral meniscus
ii. Stabilizes menisci
m. What are the attachments and function of the coronary ligaments?
i. Meniscus to tibial periphery
ii. Meniscal attachment
a. What is the red-red zone of the menisci?
i. Outer 1/3-- vascular
b. What is the red-white and white-white zone of the menisci?
i. Inner 2/3
c. What is the function of the menisci?
i. Deepen the concavity of tibial facets
d. What type of meniscal tear is most common? Why?
i. Medial
ii. Less mobile
e. When will you most often see a lateral meniscus tear?
i. With ACL tears
a. What are the characteristics of the articular cartilage in the knee?
i. Low coefficient of friction
ii. Alymphatic, aneural, avascular
b. What makes up the articular cartilage of the knee?
i. Water (65-80%)
ii. Chondrocytes
iii. Matrix
c. What increases the water content of articular cartilage?
i. Osteoarthritis
d. What does collagen provide to the articular cartilage?
i. Tensile strength
e. What type of collagen is predominant in articular cartilage?
i. Type II
f. What type of collagen is in hypertrophic chondrocytes during cartilage growth?
i. Type X
g. What provides compressive strength to articular cartilage?
i. Proteoglycans
h. What makes up proteoglycans?
i. GAGs
ii. → Chondroitin sulfate
iii. Keratin sulfate
i. What is an aggrecan molecule?
i. GAGs bound to protein core
j. What makes up an aggregate molecule?
i. Aggrecan bound to HA
k. What type of cartilage injury heals? How does it heal?
i. Deep injury
ii. Fibrocartilage production→ scar
l. What type of cartilage injury does not heal?
i. Superficial
a. What does a good knee exam begin with?
i. Good history
b. Where should you palpate in a knee examination?
i. Joint lines
ii. Patellar tendon
iii. Quadriceps tendon
iv. Pes anserine bursa
v. Fibular head
vi. Popliteal space
vii. Gerdy’s tubercle
c. What is the most accurate dx test for a meniscal tear?
i. Tenderness upon palpation of joint lines
d. How do you measure ROM?
i. Goniometer
e. How do you perform a Lachman test?
i. Flex to 30 degrees
ii. Compare to contralateral side
f. What is a Lachman grade 0?
i. No difference
g. What is a Lachman grade 1?
i. 1-5 mm difference
h. What is a Lachman grade 2?
i. 5-10 mm difference
i. What is a Lachman grade 3?
i. > 10 mm difference
j. What should you feel for in a Lachman test? How do you confirm?
i. Endpoint
ii. KT-1000
k. What is a Lachman test looking for?
i. ACL tear
l. How do you do an anterior drawer test?
i. Flex to 90 degrees
ii. Use Lachman grading
m. What is a posterior drawer grade 0?
i. Normal
n. What is a posterior drawer grade 1?
i. Normal step off
o. What is a posterior drawer grade 2?
i. Flush with tibial plateau
p. What is a posterior drawer grade 3?
i. Sags posterior to plateau
q. How do you perform a pivot shift test?
i. Start extended
ii. Internally rotate
iii. Axial load
iv. Flex slowly
r. What is the sign of a positive pivot shift?
i. Clunk
s. What does the pivot shift test look for?
i. ACL disruption
t. What is valgus and varus stress test used for?
i. Collateral ligament injury
u. How do you perform a valgus/varus stress test?
i. 0 and 30 degrees of flexion
ii. If tibia comes up and the rest of the leg doesn’t, then its positive
v. What is a McMurray’s test? How do you perform it?
i. Meniscal test
ii. Fully flex, internally rotate
iii. Pain and/or click is positive
a. What are the Ottawa knee rules for an x-ray?
i. Age >55
ii. Tenderness at head of fibula
iii. Isolated tenderness at patella
iv. Inability to flex knee 90 degrees
v. Inability to bear weight four steps immediately and in examination room
b. What are T1 MRIs weighted to?
i. Fat
c. What are T2 MRIs weighted to?
i. Water
a. What MRI is best for anatomy?
i. T1
e. What MRI is best for pathology?
i. T2
f. What three cuts should you get in an MRI?
i. Axial
ii. Sagittal
iii. Coronal
g. What will an MRI provide?
i. Accurate for ligament and meniscal tears
ii. Injuries can be assessed sans MRI, but useful for dx