322_CH10

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Author:
itzlinds
ID:
247095
Filename:
322_CH10
Updated:
2013-11-23 18:38:15
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Knee complex
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Knee complex
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  1. list 3 important characteristics of the knee complex:.

    how does the joint contributed to dynamic and static stability
    • largest, most complex joint in the body
    • subject to sever stresses and strains - related to further fxn: many forces/stresses
    • important joint in weight bearing (closed chain (ex: standing up from a chair)) & locomotion (ROM, mobility, open chain motion; swing phase of gait)
    • dynamic stability: provided by extensors and flexors (particulary on the posterior)
    • static stability: provided by strong ligamentous structures
  2. why are there more muscular injuries at the knee and shoulder than other joints?
    • repetitive use
    • breakdown
    • degrade
    • muscles are needed for motion
  3. list the 4 bones of the knee complex:

    list the characteristics of the bone, if known:
    • femur: angled medially (from proximal to distal) benefit: produces smaller base of support while walking, feet are closer together
    • tibia
    • fibula
    • patella: acts as an anatomical pulley (helps to reduece friction)
  4. list the 2 joints of the knee:
    • patellofemoral
    • tibiofemoral
  5. osteology:
    joint type:
    fxn:

    of the patellofemoral joint:
    • osteology: patella and femoral condyles
    • joint type: arthrodial joint (irregular, gliding)

    • fxns:
    • Patella glides over femoral condyles
    • Acts as anatomic pulley
    • Reduces friction between quadriceps tendon and femoral condyles
  6. osteology:
    joint type:
    degrees of freedom:
    flexion ROM:
    Extension ROM:
    internal rotation ROM:
    external rotation ROM:

    ... of the tibiofemoral joint:
    • osteology: femur, tibia (Femoral condyles on tibial plateaus
    • joint type: hinge joint (hinge joints typically have 1 degree of freedom, internal/external rotation is the 2nd degree)
    • degrees of freedom: 2
    • flexion ROM: 1400
    • extension ROM: 100 of hyperextension possible
    • IR ROM: 30
    • ER ROM: 450   (internal/external rotation occurs when knee flexed @ about 300)
  7. compared to other joints, what is different about the proximal end of the tibia?

    what is the benefit of this:
    • the proximal end of the tibia is a flat, plateau others are concave/convex
    • benefit: does not allow for dislocations, less friction
  8. describe the structure of the menisci:

    what are the benefits of this design:
    • structural design
    • circular rims of fibrocartilage
    • thick at the peripheral borders
    • thin within the inner portions
    • (the thick/thin of each portion creates the concave shape)

    • benefits of design
    • provides for a more congruent joint
    • deepens tibial articular facets
    • shock absorption
  9. describe the fxn of the medial and lateral menisci
    • supports the knee
    • cushions actions due to weight bearing

    • lateral menisci
    • incomplete circle
    • less attachment; more movement or stretch

    • medial menisci
    • "C" shaped
    • stronger attachment
    • injured more often
    • more often injured because it has a stronger attachments to the bone
    • attachment of the semitendinosis
  10. the patellar ligament connects lower margin of patella with ____________:

    the patellar ligament is a continuation of _________:

    what is the fxn of the patellar ligament:
    • the patellar ligament connects lower margin of patella with: tuberosity of the tibia
    • the patellar ligament is a continuation of: the central fibers of the quadriceps tendon
    • fxn: provides patellar stability
  11. what is the fxn of the oblique popliteal ligament:
    protects against hyperextension
  12. what are the 2 fxn of the medial (tibial) collateral ligament:

    where does the MCL attach:
    what type of force does the MCL resist:
    which forces tears the MCL:
    • fxn
    • secures the medial condyle of the tibia to the medial epicondyle of the femur
    • checks extension
    • prevents lateral motion

    • where does the MCL attach:  medial menisci
    • what type of forces does the MCL resist: valgus forces (abduction of the tibia)
    • torn: with laterally directed forces
    •  more frequently injured than the LCL
  13. what are the 2 fxn of the lateral (tibial) collateral ligament:

    what type of forces does the LCL resist:
    which forces tears the LCL:
    • fxns
    • secures the lateral side of the head of the fibula to the lateral epicondyle of the femur

    • what types of forces does the LCL resist: varus forces (adduction of the tibia)
    • torn: with medially directed forces

    LCL infrequently injured
  14. what are the common characteristics of the ACL and PCL:
    • both are strong cordlike ligaments
    • cross (cruicate) within the knee
    • named due to the attachment to the tibia
    • limited extension & prevent rotation in exteneded position of the knee
  15. describe the characteristics of the ACL:
    • passes up and back from the anterior tibia to the posterior femur
    • provides anterior stability
    • checks posterior slide of femur on tibia
    • most injures (from noncontact rotatary forces, and planting or cutting)
  16. describe the characteristics of the PCL:
    • passes up and forward from the posterior tibia to the anterior femur
    • provides posterior stability
    • shorter and stronger than the ACL
    • checks anterior slide of the femur on tibia
    • not often injured (unless hyperextended)
  17. describe the screw home mechanism:
    • WB, closed chain extension (seated to standing up)
    • as knee is extending; at about 300 flexed
    • the lateral femoral condyle (shorter) stops roll glide
    • medial femoral condyle continues posterior roll glide
    • causes interal rotation of the femur on the tibia



    brings the knee into its more stable position:closed packed position
  18. Which portion of the quadriceps is the largest muscle of the quadriceps group?

    A.Rectus femoris
    B.Vastus medialis
    C. Vastus intermedius
    D. Vastus lateralis
    D. vastus lateralis
    (this multiple choice question has been scrambled)
  19. Which of the following is not considered a hamstring muscle?

    A. Biceps femoris
    B. Semitendinosus
    C. Semimembranosus
    D. Rectus femoris
    D. rectus femoris
    (this multiple choice question has been scrambled)
  20. What muscle action is involved in the movement of the knee joints in the power phase of the standing long jump?

    A. Eccentric action of the quadriceps
    B. Eccentric action of the hamstrings
    C.Concentric action of the hamstrings
    D. Concentric action of the quadriceps
    D. concentric action of the quadriceps
    (this multiple choice question has been scrambled)
  21. In performing a deep squat, which of the following is not an active muscle at the knee

    A. Rectus femoris
    B. Biceps femoris
    C. Vastus lateralis
    D. Vastus medialis
    B. biceps femoris
    (this multiple choice question has been scrambled)
  22. External rotation of the knee is produced by which of the following muscles?

    A. Vastus lateralis
    B. Rectus femoris
    C. Biceps femoris
    D. Semitendinosus
    C. biceps femoris
    (this multiple choice question has been scrambled)
  23. Which muscle helps prevent lateral subluxation of the patella?

    A. Vastus medialis
    B. Semimembranosus
    C. Vastus lateralis
    D. Biceps femoris
    A. vastus medialis
    (this multiple choice question has been scrambled)
  24. Which of the following terms is used to describe someone who is bowlegged?

    a. Genu varum
    b. Genu valgum
    a. genu varum
  25. Bowlegged stance stretches which of the following ligaments?

    A. Anterior cruciate ligament
    B. Medial collateral ligament
    C. Lateral collateral ligament
    D. Posterior cruciate ligament
    C. lateral collateral ligament
    (this multiple choice question has been scrambled)
  26. In landing from a vertical jump, what motion is occurring at the knees?

    A. External rotation
    B. Internal rotation
    C. Flexion
    D. Extension
    C. flexion
    (this multiple choice question has been scrambled)
  27. What muscle action is involved in the movement of the knee joints in landing from a vertical jump?

    A. Concentric action of the quadriceps
    B. Concentric action of the hamstrings
    C. Eccentric action of the quadriceps
    D. Eccentric action of the hamstrings
    C. eccentric actions of the quadriceps
    (this multiple choice question has been scrambled)
  28. how does the concentric action of the extensor muscles contribute to motion:

    how does the eccentric action of the extensor muscles contribute to motion:
    • concentric action
    • important for ...
    • jumping
    • walking
    • running

    • eccentric action
    • work body into slow landing
    • changing direction
  29. list the anterior (quadriceps group) of extensor muscles:
    • rectus femoris
    • vastus intermedius
    • vastus lateralis
    • vastus medialis
  30. what is the fxn of the rectus femoris:

    how can this muscle become inactive:
    • fxn: strong, powerful extension
    • how can this muscle become inactive: when the hip is flexed
  31. what is the fxn of the vastus intermedisu, vastus lateralis, vastus medialis:

    which is the largest of this group:

    which is the most active of this group:
    • fxn: extension
    • largest of the group: vastus lateralis; can cause lateral patellar subluxation
    • most active of the group: vastus medialis; prevents lateral disolcation of the patella
  32. list the muscles of the posterior (hamstring group) of flexors:
    • biceps femoris
    • semimembranosus
    • semitendinosus

    • secondary flexors
    • sartorius
    • gracilis
    • popliteus
    • gastrocnemius

    • the flexors of the knee are also secondary hip extensors
    • the ability to produce effective force at the knee is influenced by the position of other joints
  33. what is the fxn of the biceps femoris:
    • flexion
    • external rotation in NWB

    helps to stabilize posterolateral aspect of the joint
  34. what is the fxn of the semimembranosus and semitendinosus collectively:

    what is the fxn of the semimembranosus independently:
    fxn: flexion, internal rotation in WB

    • semimembranosus
    • dynamic medial stability
    • fibers attach to medial meniscus
    • with popliteus cause posterior motion of menisci during flexion
  35. what is the fxn of the sartorius:
    • flexion
    • internal roation

    • activity more common with the hip
    • relativley impervious to active insuffiency
  36. what is the fxn of the gacilis:
    • flexion (weak)
    • slight internal rotation

    • more primarily a hip flexor and adductor
    • actively insufficient if hip and knee flex together
  37. what is the fx of the popliteus:
    • flexion
    • assists with internal rotation
    • unlocks the knee - to innitiate flexion, creates external rotation of the femur

    with semimembranosus, pulls menisci posteriorly during flexion
  38. what is the fxn of the gastrocnemius:
    • dynamic stabilizer
    • slight force to flexion
    • effective in preventing hyperextension

    becomes actively insufficient easily
  39. list the internal rotator muscles of the knee:

    under what conditions can this motion happen:
    • semitendinosus
    • semimembranosus
    • popliteus
    • gracilis
    • sartorius


    knee flexed at least 300
  40. list the external rotators of the knee:
    • biceps femoris
    • possibly tensor fascia lata
  41. how would you strengthen the quadriceps muscles:
    • resisted knee extension from a seated position
    • fxnal WB activites such as step-ups or squats
  42. how would you strengthen the rectus femoris, vastus lateralis, vastus medialis, and vastus intermedialis (the quadriceps group)?



    knee extension activites against resistance

    • leg extensions
    • dead lifts
    • sumo dead lifts
    • dumbell squats
    • squats
    • front squats
    • angled leg press
    • power squats
    • hack squats
    • lunges
  43. how would you stretch the rectus femoris, vastus lateralis, vastus medials, vastus intermedialis (the quadriceps group):
    • stretching
    • pulling the knee into maximum flexion
    • standing on one leg and pulling the heel of the other leg up to the buttocks
  44. how can you strengthen the biceps femoris, the semimembranosus, and the semitendinosus (the hamstring group) muscles:
    preforming knee or hamstring curls on a knee table against resistance

    • exercises
    • standing leg curls
    • seated leg curls
    • lying leg curls
  45. how can you stretch the biceps femoris, the semimembranosus, and the semitendinosus ( the hamstring group) muscles:
    • slow, static stretching
    • flexing the hip slowly while maintaining knee extension in a long sitting position
  46. how do you strengthen the popliteus muscle:

    how do you stretch the popliteus muscle:
    • strengthen
    • hanging from a bar with legs flexed at the knee
    • walking, running
    • combine knee internal rotation and flexion exercises against resistance

    • sstretch
    • passive full knee extension without flexing the hip
    • passive max external rotation with the knee flexed to 20-30 degrees

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