Podcast
Questions and Answers
Which bones articulate to form the knee joint?
Which bones articulate to form the knee joint?
- Tibia, fibula, and patella
- Femur, tibia, patella, and fibula
- Femur, patella, and fibula
- Femur, tibia, and patella (correct)
- Femur, fibula, and tibia
In a lateral radiograph of a normal knee joint, which bone is anterior?
In a lateral radiograph of a normal knee joint, which bone is anterior?
- Patella (correct)
- Tibia
- Calcaneus
- Fibula
- Femur
Which term best describes the type of joint present at the knee?
Which term best describes the type of joint present at the knee?
- Condylar synovial joint (correct)
- Pivot joint
- Saddle joint
- Hinge joint
- Plane joint
What is the primary function of the menisci in the knee joint?
What is the primary function of the menisci in the knee joint?
Which ligament primarily prevents anterior translation of the tibia on the femur?
Which ligament primarily prevents anterior translation of the tibia on the femur?
The 'screw-home' movement of the knee joint involves which motion of the tibia during terminal extension?
The 'screw-home' movement of the knee joint involves which motion of the tibia during terminal extension?
Which arteries primarily supply blood to the outer one-third of the menisci?
Which arteries primarily supply blood to the outer one-third of the menisci?
In an MRI of the knee, normal menisci typically appear:
In an MRI of the knee, normal menisci typically appear:
During the McMurray test for medial meniscus tear, which maneuver is typically performed while extending the knee?
During the McMurray test for medial meniscus tear, which maneuver is typically performed while extending the knee?
Which structure is considered the primary restraint against varus forces at the knee?
Which structure is considered the primary restraint against varus forces at the knee?
Which of the following is a common non-contact mechanism of injury for the anterior cruciate ligament (ACL)?
Which of the following is a common non-contact mechanism of injury for the anterior cruciate ligament (ACL)?
The Lachman test is performed with the knee in approximately how many degrees of flexion?
The Lachman test is performed with the knee in approximately how many degrees of flexion?
A positive 'posterior sag sign' is indicative of injury to which ligament?
A positive 'posterior sag sign' is indicative of injury to which ligament?
The 'unhappy triad' of knee injuries typically involves damage to which three structures?
The 'unhappy triad' of knee injuries typically involves damage to which three structures?
Which nerve provides cutaneous innervation to the lateral aspect of the leg and dorsum of the foot?
Which nerve provides cutaneous innervation to the lateral aspect of the leg and dorsum of the foot?
Which muscle group is located in the anterior compartment of the leg?
Which muscle group is located in the anterior compartment of the leg?
Which of the following muscles is NOT located in the posterior compartment of the leg?
Which of the following muscles is NOT located in the posterior compartment of the leg?
Which nerve innervates the muscles of the anterior compartment of the leg?
Which nerve innervates the muscles of the anterior compartment of the leg?
What is the primary action of the muscles in the lateral compartment of the leg?
What is the primary action of the muscles in the lateral compartment of the leg?
Which of the following bursae is located between the patella and the skin?
Which of the following bursae is located between the patella and the skin?
A Baker's cyst is most commonly associated with:
A Baker's cyst is most commonly associated with:
Which of the following is a radiographic feature of osteoarthritis in the knee joint?
Which of the following is a radiographic feature of osteoarthritis in the knee joint?
Genu varum is a congenital deformity characterized by:
Genu varum is a congenital deformity characterized by:
The tibial tuberosity is an anatomical landmark for the insertion of which structure?
The tibial tuberosity is an anatomical landmark for the insertion of which structure?
The medial collateral ligament (MCL) primarily resists which type of stress on the knee?
The medial collateral ligament (MCL) primarily resists which type of stress on the knee?
During knee flexion, what is the role of the popliteus muscle in the 'screw-home' mechanism?
During knee flexion, what is the role of the popliteus muscle in the 'screw-home' mechanism?
Which of the following statements is TRUE regarding the cruciate ligaments?
Which of the following statements is TRUE regarding the cruciate ligaments?
Which of the following is NOT a muscle that inserts via the pes anserinus?
Which of the following is NOT a muscle that inserts via the pes anserinus?
Which nerve is most likely to be injured with a fracture of the neck of the fibula?
Which nerve is most likely to be injured with a fracture of the neck of the fibula?
In a cross-section of the leg, which compartment is located most anteriorly?
In a cross-section of the leg, which compartment is located most anteriorly?
The tibial nerve is a branch of which larger nerve?
The tibial nerve is a branch of which larger nerve?
What is the primary action of the Tibialis anterior muscle?
What is the primary action of the Tibialis anterior muscle?
Which of the following muscles is a primary plantarflexor of the ankle?
Which of the following muscles is a primary plantarflexor of the ankle?
Which of the following is NOT a function of the menisci?
Which of the following is NOT a function of the menisci?
The anterior intercondylar area of the tibia serves as the tibial attachment site for which ligament?
The anterior intercondylar area of the tibia serves as the tibial attachment site for which ligament?
Which test is specifically designed to assess for pain on compression and distraction to differentiate between meniscal and ligamentous lesions?
Which test is specifically designed to assess for pain on compression and distraction to differentiate between meniscal and ligamentous lesions?
The infrapatellar branch of the saphenous nerve is clinically relevant because it can be injured during:
The infrapatellar branch of the saphenous nerve is clinically relevant because it can be injured during:
Which of the following knee bursae is most likely to be affected in 'Housemaid's knee'?
Which of the following knee bursae is most likely to be affected in 'Housemaid's knee'?
In genu valgum, the distal part of the tibia is displaced in which direction relative to the femur?
In genu valgum, the distal part of the tibia is displaced in which direction relative to the femur?
The medial meniscus is more commonly injured than the lateral meniscus because:
The medial meniscus is more commonly injured than the lateral meniscus because:
Which of the following muscles is NOT involved in knee flexion?
Which of the following muscles is NOT involved in knee flexion?
Which of the listed arteries is NOT a genicular artery contributing to the blood supply around the knee joint?
Which of the listed arteries is NOT a genicular artery contributing to the blood supply around the knee joint?
Which of the following bones does NOT directly participate in forming the knee joint?
Which of the following bones does NOT directly participate in forming the knee joint?
The 'screw-home' mechanism of the knee joint, which provides added stability in full extension, is primarily driven by:
The 'screw-home' mechanism of the knee joint, which provides added stability in full extension, is primarily driven by:
In a normal knee MRI, menisci typically exhibit which signal intensity on T2-weighted images?
In a normal knee MRI, menisci typically exhibit which signal intensity on T2-weighted images?
Which action during the McMurray test is MOST indicative of a medial meniscus tear?
Which action during the McMurray test is MOST indicative of a medial meniscus tear?
The primary stabilizer against valgus stress at the knee is the:
The primary stabilizer against valgus stress at the knee is the:
A positive Lachman test suggests injury to which of the following ligaments?
A positive Lachman test suggests injury to which of the following ligaments?
The 'unhappy triad' of knee injuries classically involves damage to the:
The 'unhappy triad' of knee injuries classically involves damage to the:
Which nerve provides the primary innervation to the muscles of the anterior compartment of the leg?
Which nerve provides the primary innervation to the muscles of the anterior compartment of the leg?
The primary action of the muscles located in the lateral compartment of the leg is:
The primary action of the muscles located in the lateral compartment of the leg is:
Which of the following bursae is commonly affected in 'Housemaid's knee'?
Which of the following bursae is commonly affected in 'Housemaid's knee'?
A Baker's cyst is most accurately described as:
A Baker's cyst is most accurately described as:
Genu varum, a congenital deformity, is characterized by:
Genu varum, a congenital deformity, is characterized by:
The tibial tuberosity serves as the distal attachment site for which tendon?
The tibial tuberosity serves as the distal attachment site for which tendon?
During knee flexion, the popliteus muscle plays a key role in the 'screw-home' mechanism by:
During knee flexion, the popliteus muscle plays a key role in the 'screw-home' mechanism by:
Which of the following muscles is NOT part of the pes anserinus insertion on the proximal tibia?
Which of the following muscles is NOT part of the pes anserinus insertion on the proximal tibia?
Injury to the common fibular nerve is most likely associated with fracture of which anatomical part of the fibula?
Injury to the common fibular nerve is most likely associated with fracture of which anatomical part of the fibula?
The anterior intercondylar area of the tibia serves as the tibial attachment site for which structure?
The anterior intercondylar area of the tibia serves as the tibial attachment site for which structure?
Apley's grind test is designed to assess for pain on compression and distraction at the knee joint. Pain that is WORSE with distraction, compared to compression, is MOST indicative of:
Apley's grind test is designed to assess for pain on compression and distraction at the knee joint. Pain that is WORSE with distraction, compared to compression, is MOST indicative of:
The infrapatellar branch of the saphenous nerve is clinically relevant because it is most vulnerable to injury during:
The infrapatellar branch of the saphenous nerve is clinically relevant because it is most vulnerable to injury during:
Which of the following statements BEST describes the anatomical difference contributing to the higher incidence of medial meniscus tears compared to lateral meniscus tears?
Which of the following statements BEST describes the anatomical difference contributing to the higher incidence of medial meniscus tears compared to lateral meniscus tears?
Flashcards
Name the bones of the knee joint
Name the bones of the knee joint
Femur, Tibia, Patella
Name the functions functions of the menisci
Name the functions functions of the menisci
To deepen the articular surface of the tibia, act as shock absorbers, help in lubricating the joint cavity, give rise to proprioceptive impulses.
What is the blood supply of the menisci?
What is the blood supply of the menisci?
The outer 1/3 of the menisci receive blood supply via the genicular arteries. Nutrition to the inner 1/3 of meniscal tissue primarily occurs by synovial diffusion
How are the cruciate ligaments named?
How are the cruciate ligaments named?
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What movements do the ACL and PCL limit?
What movements do the ACL and PCL limit?
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What injuries make up the unhappy triad?
What injuries make up the unhappy triad?
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Describe the screw home mechanism
Describe the screw home mechanism
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Describe the mechanism of noncontact ACL injuries
Describe the mechanism of noncontact ACL injuries
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What is prepatellar bursitis?
What is prepatellar bursitis?
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When using Apley's Grind test, what do Painful compression and Painful distraction mean?
When using Apley's Grind test, what do Painful compression and Painful distraction mean?
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Which muscles make up the pes anserinus?
Which muscles make up the pes anserinus?
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What is a Baker's cyst?
What is a Baker's cyst?
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Study Notes
Bony Anatomy of the Knee Joint
- Bones forming the knee joint are the femur, tibia, and patella
- Important anatomical landmarks on these bones must be identified
- Recognize the radiographic appearance of normal knee joint structures on X-rays, including the "sunrise" view
Intra-Articular Structures of the Knee
- Intra-articular structures including menisci and ligaments
- The structure and function of the menisci: deepen the articular surface of the tibia, act as shock absorbers, help in lubricating the joint cavity, and give rise to proprioceptive impulses
- Menisci receive blood supply via genicular arteries in the outer 1/3; the inner 1/3 relies on synovial diffusion for nutrition
- Medial meniscus is more commonly injured
- Tibial collateral ligament is more fixed
- Lateral meniscus is more mobile
- Meniscal tears are the second most common knee injury in athletes
- Types of meniscal tears are identifiable on MRIs
- Interpret MRI findings of normal and injured menisci
- The layers are Outer Red, Red-White/Grey, and White.
Cruciate Ligaments
- Differentiate between normal and pathological appearances of the anterior cruciate ligament (ACL) and posterior cruciate ligaments (PCL) on imaging such as MRI
- Anterior Cruciate Ligament (ACL): prevents forward translation of the tibia
- Posterior Cruciate Ligament (PCL): prevents posterior dislocation of tibia on femur, primary restraint on posterior glide
- ACL originates from the anterior intercondylar area and inserts at the lateral condyle of the femur
- PCL originates from the posterior intercondylar area and inserts on the medial condyle of the femur
- ACL and PCL are intracapsular and extrasynovial
- Understand common mechanisms of cruciate ligament injuries
- The cruciate ligaments are named according to their attachment to the tibia
- Cruciate ligaments are assessed via the anterior drawer test and Lachman test (for ACL), and the posterior drawer test (for PCL)
Knee Joint Stability and Diagnostic Tests
- Cruciate ligaments maintain the knee joint stability
- Extracapsular (or within) ligaments: lateral collateral ligament (outside capsule), medial collateral ligament, oblique popliteal ligament
- Intracapsular ligaments: anterior cruciate ligament, posterior cruciate ligament
- Muscles/Iliotibial band provide dynamic and static stability
- Menisci aid in deepening the inferior articular surface
- The lateral stabilizers include the lateral collateral ligament (primary restraint), cruciate ligaments, politeus tendon + capsule, and iliotibial band (secondary restraints) against varus forces
- The medial stabilizers include the medial collateral ligament (primary restraint), cruciate ligaments, semimembranosus, and joint capsule (secondary restraints) against valgus forces
- Demonstrate clinical tests used to diagnose anterior and posterior cruciate ligament injuries
- ACL and PCL limit movements, and are taut during extension.
- Assess for anteroposterior and rotary instability
Knee Bursae, Degenerative Diseases, and Congenital Deformities
- Identify important knee bursae and their associated pathologies such as infectious prepatellar bursitis and infrapatellar bursitis (or clergyman's knee)
- Housemaid's knee or carpenter's knee is prepatellar bursitis caused by kneeling
- Baker's cyst is an enlarged semimembranosus bursa due to accumulation of synovial fluid and can be primary (in children) or secondary (due to joint pathology such as OA)
- Describe common degenerative diseases (osteoarthritis) and congenital deformities (genu varum and genu valgum) affecting the knee joint
- Osteoarthritis (OA) X-ray features: joint space narrowing, osteophyte formation, subchondral sclerosis, and cysts
- Genu varum (bowlegs): knees out lateral
- Genu valgum (knock-knees): knees near each other
Gross and Clinical Anatomy of the Leg
- Identify the compartments of the leg and their associated muscles and explain the nerve supply and clinical relevance of leg anatomy
- Anterior compartment: tibialis anterior, extensor hallucis longus, extensor digitorum longus, and peroneus tertius muscles- the deep fibular nerve provides innervation
- Action: Inversion and Dorsiflexion
- Lateral compartment: peroneus longus and peroneus brevis muscles- the superficial peroneal nerve provides innervation
- Action: Eversion of foot
- Posterior compartment muscles
- Flexerhallucis longus, Flexor digitorum longus, Tibialis posterior, popliteus
- The tibial nerve provides innervation
- Action: Plantarflexion
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