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Eval Exam 3 STP
Circulation/Neurological/ROM
| Question | Answer |
|---|---|
| Medial Collateral Ligament prevents | a valgus and external rotation force |
| Deep portion of Medial Collateral Ligament inserts | Into the edge of the medial tibial plateau and medial meniscus |
| Superficial portion of Medial Collateral Ligament inserts | on the flare of the tibia |
| Pes Anserine Muscles | Sartorius, Gracilis, & Semitendonosis |
| Where Lateral Meniscus Palpated | along the lateral joint line |
| What is the Lateral meniscus made out of | fibrocartilage |
| Shape of lateral meniscus | o-shaped |
| What does the lateral meniscus attach to | the tibial plateau by coronary ligaments and popliteal muscles |
| WHy is the lateral meniscus more mobile then the medial | The longer coronary ligaments and it is lateral collateral ligaments does not attach to it. |
| why is the lateral meniscus less prone to injury | its mobility and lack of attachments |
| What does the lateral collateral ligament joins | the lateral femoral epicondyle to the fibular head |
| How do you palpate the lateral collateral ligament | have athlete sit with ankle resting on the opposite knee, this relaxes the IT band and allows easier palpation of the LCL |
| Round fibrous cord shaped like a pencil | Lateral collateral ligament |
| Separated from the joint capsule, unlike the MCL | Lateral collateral ligament |
| LCL | Lateral Collateral ligament |
| LCL is | tight during extension but relaxed in flexion |
| LCL lies | lateral and posterior to the joint line |
| helps stabilize the knee laterally against varus stresses | LCL |
| anterior superior tibiofibular ligament lies | in the space between the fibular head and the tibia |
| Where do you palpate the anterior superior tibiofibular ligament | anteriorly and medially from the fibular head as he ligament crosses the tibia/fibula articulation |
| palpate the tendon as it crosses the knee joint before its insertion onto the fibular head | bicep femoris tendon |
| rarely injured but upon sever trauma it could avulse from the fibular head | bicep femoris tendoon |
| Illiotibial tract (IT Band) becomes prominent during | resisted knee flexion |
| Location of IT Band | anteriorly on the lateral side |
| IT band is made of | a think band of fascia |
| Where do you palpate the IT Band | lateral to the superior pole of the patella |
| Where do you palpate the peroneal nerve | where it crosses the fibular kneck |
| location of the peroneal nerve | slightly below the biceps femoris insertion |
| WHy do you have to palpate the peroneal nerve carefully | because excess pressure can impinge it and cause drop foot |
| STP: Lateral Aspect | LAteral meniscus, lateral collateral ligament (LCL), Anterior Superior Tibiofibular ligament, Bicep Femoris, Illiotibial Tract (IT Band), Peroneal Nerve |
| STP: Posterior Aspect | Popliteal Fosa, Posterior Tibial Nerve, Popliteal Vein, Popliteal Artery, Baker's Cyst, Gastrocnemius, Hamstring muscles, Cruciate Ligaments (anterior and Posterior) |
| Most Superficial structure in the fossa | posterior tibial nerve |
| Superior lateral border of the popliteal fosa is defined by | the biceps femoris |
| Superior medial border of the popliteal fosa is defined by | the semimembranoses and semitendonosis muscles |
| inferior borders of the popliteal fosa consist of | the gasrtocnemius heads |
| the popliteal vein lies | directly under nerve |
| deepest structs in the fossa | popliteal artery |
| why is the popliteal artery difficult to palpate | overlying structures |
| how is the popliteal artery best palpated | in flexion |
| What does swelling in the popliteal fossa indicate | a bakers cyst |
| what is the bakers cyst a distention of | the gastrocnemius and semimembranosis burse |
| painless, mobile swelling located more medially | bakers cyst |
| when is bakers cyst palpable | during knee extension |
| Hamstring muscles | semitendonosis, semimembranosis, and biceps femoris |
| STP: Lateral Aspect | LAteral meniscus, lateral collateral ligament (LCL), Anterior Superior Tibiofibular ligament, Bicep Femoris, Illiotibial Tract (IT Band), Peroneal Nerve |
| STP: Posterior Aspect | Popliteal Fosa, Posterior Tibial Nerve, Popliteal Vein, Popliteal Artery, Baker's Cyst, Gastrocnemius, Hamstring muscles, Cruciate Ligaments (anterior and Posterior) |
| Most Superficial structure in the fossa | posterior tibial nerve |
| Superior lateral border of the popliteal fosa is defined by | the biceps femoris |
| Superior medial border of the popliteal fosa is defined by | the semimembranoses and semitendonosis muscles |
| inferior borders of the popliteal fosa consist of | the gasrtocnemius heads |
| the popliteal vein lies | directly under nerve |
| deepest structs in the fossa | popliteal artery |
| why is the popliteal artery difficult to palpate | overlying structures |
| how is the popliteal artery best palpated | in flexion |
| What does swelling in the popliteal fossa indicate | a bakers cyst |
| what is the bakers cyst a distention of | the gastrocnemius and semimembranosis burse |
| painless, mobile swelling located more medially | bakers cyst |
| when is bakers cyst palpable | during knee extension |
| Hamstring muscles | semitendonosis, semimembranosis, and biceps femoris |
| Gastrocnemious palpation | palpated the two heads of the muscle feeling for any abnormalities especially muscle spasm, step-off deformities, and point tenderness |
| Hamstring palpation | palpate the muscle bellies of each muscle for any step-off deformity, point tenderness, or spasm |
| Cruciate ligaments | two ligaments that cross one another within the joint cavity of the knee and are accountable for joint stability. |
| the two cruciate ligaments are | anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) |
| Anterior cruciate ligament (ACL) attaches | in front of and on top of the tibial plateau, then crossing up and backwards, it attaches to the inner surface of the later condyle of the femur |
| Three twisted bands the ACL is composed of | anteromedial, intermedial, and posterolateral bands |
| the acl prevents | anterior movements of the tibia from the femur |
| acl stabilizes | the tibia against excessive internal rotation and helps the coliateral ligaments with varus and valgus stress |
| acl in extension the | posterolateral and anteomedial bands are tight |
| acl in flexion the | posterolateral is loose and the anteromedial band is still tight. |
| PCL attaches | on the posterior top of the tibia, then crossing forrward and upward medially, it attached to the anterior, lateral surface fo the medial condyle of the femur. |
| strongest ligament in the knee | posterior cruciate ligament (PCL) |
| PCL prevents | posterior movement of the tibia from the femur and hyperextension |
| 2 bands in the pcl | posteriolateral and anteriomedial |
| bands are tight in 3 degree of flexion | posteriolateral and anteriomedial |
| loose in early flexion | posterolateral band |
| Range of motion | active and passive |
| how many degrees is knee flexion | 135 degrees |
| muscles involved in knee flexion | bicep femoris, semitendonosis, semimembranosis, gracilis, sartorius, gastrocnemius and popliteal. |
| how many degrees is knee extension | 0-(-) degrees |
| muscles involved in knee extension | rectum femoris, vastus medialis, lateralis, and intermedialis, |
| external roatation-10degress | have the athlete sitting w/ their legs hanging off the table and instruct them to actively externally rotate their tibia. |
| Internal roatation- 10degress | have the athlete sitting w/ legs hanging off the table and instruct them to actively internally rotate their tibia. the passively internaly rotate the knee, place on hand on top of the knee and grasp the ankle w. the other hand and rotate medially. |
| Muscles involved in internal rotation | popliteal, semimebranosis, semitendonosis sartorius, and gracilis |
| internal roation can only occur when | When the knee is in a flexed position |
| L2 Dermatome | Anterior middle portion of the thigh |
| L3 Dermatome | Anterior thigh just above the patella |
| L4 Dermatome | Anterior, medial portion of the knee cap, medial side of the lower leg and foot |
| S2 Dermatome | Consists of a strip down the middle of the posterior thigh and popliteal fossa |
| L2 Myotome | Quadriceps muscle test- sitting with legs of the table, stabilize above and below the knee joint and the athlete extends their knee resisting a flexion force. |
| L3 Myotome | Quadriceps muscle test-sitting with legs off the table, stabilize above and below the knee joint and the athlete extends their knee resisting a flexion force |
| L4 Myotome | Tibialis anterior muscle test-sitting with legs off the table. Place the athletes foot into dorsiflexion and inversion and try to bring them into plantarflexion and eversion while they resist |
| S2 Myotome | MMT of the hamstrings |
| L2, L3, L4 reflex | Patellar reflex-sitting with legs off the table. Palpate the quadriceps to relax and find the patellar tendon and strike it with the reflex hammer. |
| Vastus medialis | visible bulge of muscle on the medial side of femur |
| vastus lateralis | visible bulge of muscle on the medial side of femur |
| vastus intermedialis | not easily palpated lies deep between the laterlis and medialis |
| Only quadricep muscle that crosses both the hip and knee joint. Easily palpate. Lies over the middle of the thigh | Rectus Femoris |
| Patellar Tendon | Starts at the inferior border of the patella and runs distally to the tibial tubercle. |
| Superficial Infrapatellar Bursa | lies in front of the patellar tendon. Becomes palpable if inflamed, excessive kneeling is often the cause |
| Deep Infrapatellar Bursa | behind patellar tendon, not palpable. |
| Prepatellar Bursa | Located over anterior portion of the patella. helps the skin glide over the patella with ease. Palpated in inflamed |
| Pes Anserine Bursa | located just medial to the tibial tubercle. Palpable if inflamed. |
| What the lateral and medial menisci do | -Aid in lubrication and nutrition of the joint -act as shock absorbers -spread stress over the articular cartilage, preventing degeneration -make the joint surfaces more congruent and improve weight distribution |
| Lateral and medial menisci cont. | -inner 2/3 are avascular a while the outer 1/3 is vascular -reduce friction during movement -aid the ligaments in preventing hyperextension |
| C-Shaped | Medial Meniscus |
| Medial meniscus is made out of | fibrocartilage |
| STP:Medial Aspect | medial meniscus medial collateral ligament pes anserine muscles |
| Injured more because of the firm attachment of the tibia | Medial meniscus |
| thicker posteriorly then anteriorly | medial meniscus |
| where do you palpate the medial meniscus | palpate medially along the medial tibial plateau, while internally rotating the tibia, the meniscus will pop out. |
| Main blood supply to the knee | popliteal artery |
| THe popliteal artery branches into 5 arteries | medial superior genicular lateral superior genicular middle genicular medial inferior genicular lateral inferior genicular |
| where do you palpate the popliteal artery | in the middle of the popliteal fossa |
| STP: Anterior aspect | superficial infrapatellar bursa deep infrapatellar bursa prepatellar bursa pes anserine bursa menisci |
| Teardrop muscles is called the | vastus medialis oblique |
| What makes up the two humps of camel sign | patella and infrapatellar fat pad |
| Which tendon is easiest to feel | Pes Anserine Tendon |
| Tendon most difficult to feel | Sartorious |
| Externally roatates the tibia | biceps femoris |
| Plica | flap of cartilage on patella |
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