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Eval Exam 3 STP

Circulation/Neurological/ROM

QuestionAnswer
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
Created by: 1166629465