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75 Cards in this Set
- Front
- Back
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4 bones of the knee joint
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femur, tibia, fibula, patella
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3 joints of the knee
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tibiofemoral, patellofemoral, tibiofibular
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What does the patella articulate with?
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anterior femoral trochlea
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What is a reference for ligamentous atttachments?
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posterior intercondylar notch
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Which tibial plateau is larger than the other?
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Medial - the medial femoral condyle is larger, therefore the medial tibial condyle needs to be larger
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What is the attachment site for the infrapatellar tendon?
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tibial tuberosity/tubercle
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The fibular head serves as an attachment point for what?
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muscles and ligaments
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What attaches to the superior pole of the patella?
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quadriceps
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What attaches to the inferior pole of the patella?
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infrapatellar tendon
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What protects the anterior portion of the patella?
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prepatellar bursa
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Is the intracondylar notch in or outside the capsule, and, is it covered with articular cartilage?
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Inside the capsule - but, not part of articular surface, therefore, not covered with cartilage
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The tibiofibular joint is what kind of joint?
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Fixed - very little motion
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When does motion at the tibiofibular joint occur? (even though subtle)
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with ankle motion - excursion of the mortis joint (important for joint mobs)
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The ACL is the primary restraint for what motion?
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anterior tibial translation
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The ACL is the secondary restraint for what motion?
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internal tibial rotation
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At what degree of flexion does the ACL contribute most?
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30 degrees of flexion
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The ACL also prevents __________ and helps to guide this mechanism?
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knee hyperextension - screw home mechanism during terminal extension
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What are the 2 bundles of the ACL?
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anteriomedial and posterolateral bundles
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The anteromedial bundle is taut in ____________ .
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flexion
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The posterolateral bundle is taut in ______________ .
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extension
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Partial ruptures of the ACL are more likely in what positions?
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flexion and extension - when the two bundles are taut
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The ACL exhibits isometry - meaning what?
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That no matter when during the range of motion - the ACL is at risk during knee injury - always has some tension
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The PCL is the primary restraint to what motion?
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posterior translation of the tibia
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The PCL is the secondary restraint to what motion?
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external rotation of the tibia at 90 degrees of flexion
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Does the PCL fan out like the ACL?
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No - the fibers are almost parallel to the bone
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The MCL is the primary restraint to what motion?
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abduction (valgus) and internal rotation of the tibia
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There are how many functional structures in the MCL?
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Two - deep (medial capsular ligament) and superficial (MCL)
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What is the secondary role of the MCL?
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provide anterior knee stability (enhanced by external rotation of the tibia) - in an ACL deficient knee, MCL is it!
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The LCL is the primary restraint for what motion?
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adduction (varus) of the knee
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The LCL is the secondary restraint for what motion?
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anterior and posterior tibial displacements
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With the other lateral structures of the knee - the LCL also restrains ________ .
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external rotation of the tibia
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When the primary and secondary stabilizers of the knee fail - what is left to support the joint?
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Dynamic Stabilizers
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What are the dynamic stabilizers of the knee?
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patellar tendon, ITB, biceps femoris, gastroc, semitendinosus, gracilis, sartorius, semimenbranosus
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What are the Medial Static stabilizers of the knee?
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MCL - posterior oblique ligament - PM capsule - ACL - PCL - medial patellar retinaculum - semimenbranosus - pes anserine - medial gastroc
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What are the lateral static stabilizers of the knee?
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LCL - PL capsule - popliteus - arcuate ligament - PCL - ACL - lateral gastroc - biceps femoris
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What are the anterior static knee stabilizers?
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ACL - PL capsule - PM capsule - MCL - ITB - posterior oblique ligament - arcuate ligament
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What are the posterior static knee stabilizers?
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PCL - arcuate ligament - posterior oblique ligament - ACL
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Which meniscus is larger in the knee, and what shape is it?
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Medial = "C" shape (lateral = "O" shape)
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Which meniscus has a stronger peripheral attachment?
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Medial - making it more likely to be injured as it is less mobile
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What are the two primary functions of the menisci?
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load bearing
stability |
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What are the three secondary functions of the menisci?
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joint lubrication
prevent capsule/synovial impingement shock absorbers |
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What provides the blood supply to the menisci?
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medial geniculate artery
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What are the two meniscofemoral ligaments?
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anterior: ligament of Humphrey
posterior: ligament of Wrisberg |
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What is the coronary ligament?
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meniscotibial ligament (helps secure meniscus to the tibial plateau)
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Is the lateral meniscus attached to the LCL?
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NO
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Where does the popliteous tendon attach?
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posterolateral corner of the lateral meniscus
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What attaches to the posterolateral corner of the medial meniscus?
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semimenbranosus fascia
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What is the muscular anatomy of the knee? (in sections)
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anterior - quadriceps
posterior - hamstrings medially - pes anserine group laterally - ITB |
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What is inside the popliteal fossa?
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popliteal artery and vein
tibial and common peroneal nerves |
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What are the borders of the popliteal fossa?
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superomedial: semimenbranosus
superolateral: biceps femoris inferomedial: medial gastroc head inferolaterl: lateral gastroc head |
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What type of bone is the patella?
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sesamoid bone
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What is the purpose of the patella?
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to provide mechanical advantage during extension of the knee
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What is primarily responsible for the stability of the patella between 30 degrees or flexion to full flexion?
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Trochlea (the groove!)
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How many patellar facets are there?
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seven
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trochlear dysplasia
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substantial variability in the depth of the trochlear groove - results in a lack of patellar stability = lateral tracking
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What are the PASSIVE soft-tissue restraints of the PFJ?
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(medial)
layer 1: superficial med. retinaculum; med. PT ligament layer 2: med. PT ligament; sup. MCL layer 3: medial patellar meniscal ligament |
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What are the ACTIVE soft-tissue restraints of the PFJ?
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(lateral)
VMO lateral retinaculum (ITB/VL) |
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Walking results in what reaction forces at the PFJ?
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0.5 times body weight
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Stairs result in what reaction forces at the PFJ?
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3-4 times body weight
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Squatting = what reaction forces at PFJ?
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7-8 times body weight
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Running = what reaction forces at PFJ?
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8 times body weight
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the tibial nerves originates from?
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L 4/5 - S1-3
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the sural nerve?
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S 1-2
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the common peroneal nerve?
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L 4-5; S 1-2
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Superficial peroneal nerve?
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L 4-5; S1
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Deep Peroneal nerve?
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L 4-5; S 1-2
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Saphenous nerve?
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L 3-4
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The knee has how many degrees of motion?
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6 - 3 translations and 3 rotations
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What is normal ROM for AP knee translation?
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5- 10 mm
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normal ROM for compression and distraction at the knee?
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2-5 mm
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normal ROM for medial/lateral translation at the knee?
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1-2 mm
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normal ROM for flex/ext at the knee?
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-15-140 degrees
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normal ROM for varus/valgus at the knee?
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6-8 degrees in extension
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normal ROM for internal/external rotation at the knee
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25-30 degrees in flexion
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What drives the screw home mechanism?
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1. shape of femoral condyle
2. passive tension of ACL 3. lateral pull of quadriceps "Q angle" |
