Knee, Ankle, and Foot Exam

How many bursae are located at the knee?

13

What is injured more: ACL or PCL?

ACL

What do the medial and lateral meniscuses do?

Absorb shock Deepen the flat joint surface

What tightens during extension preventing excessive hyperextension of the knee?

Anterior cruciate ligament

What type of Chain is sitting to standing and standing to sitting?

Closed

What become tight during extension and contribute to stability of the knee and slack during flexion?

Collateral ligaments

What are the main sets of ligaments for holding the knee?

Cruciate and collateral

What does the fourth and fifth metatarsal articulate with?

Cuboid

What is involved with poorly coordinated gait and due to decreased weight bearing on affected side?

Hemiplegic gait

What muscle groups are acting as prime movers at the hip while moving from standing to sitting and what type of contraction is occurring?

Hip extensors: Gluteus Maximus (Inferior Gluteal)- Eccentric Contraction Gravity flexes the hip; therefore, hip extensors are active eccentrically to overcome the effect of gravity and to control the movement into flexion.

What is the patellas main function?

Increase mechanical advantage of quad joint Protect knee joint

What is achilles tendonitis?

Inflammation of the gastrocnemius/soleus tendon Lose ability to plantar flex Squeeze belly of gastroc to test and if they can't plantar flex then tendon is ruptured

What muscle groups are acting as prime movers at the ankle while moving from standing to sitting and what type of contraction is occurring?

Initial: Ankle is neutral Final: Ankle moves into slight dorsiflexion with the plantar flexors (Tibial) completing an eccentric contraction to control the movement into dorsiflexion. Once relaxed ankle back to neutral.

What muscle groups are acting as prime movers at the ankle joint only while moving from sitting to standing and what type of contraction is occurring?

Initial: Ankle moves into slight dorsiflexion due to the plantar flexors (Tibial) completing a concentric contraction when moving feet back. Final: Ankle returns to neutral when standing.

What muscle groups are acting as prime movers at the knee joint only while moving from sitting to standing and what type of contraction is occurring?

Initial: Knee flexors (hamstrings) (Sciatic) concentrically contract to bring feet back. Final: Knee extensors (quadriceps) (Femoral) concentrically contract to extend knees to a standing position.

What muscle groups are acting as prime movers at the hip joint only while moving from sitting to standing and what type of contraction is occurring?

Initiate with hip flexion: Hip Flexors - iliopsoas - Concentric Contraction (Femoral/Sciatic); Hip Extensors: Gluteus Maximus (Inferior Gluteal)- Concentric Contraction

What is the action of the gastrocnemius?

Knee flexion Ankle plantar flexion

What protects joint from stresses to medial side of the knee?

Lateral collateral lig

What does the third metatarsal articulate with?

Lateral cuneiform

If the common peroneal nerve were injured, what would happen?

Loss of ankle dorsiflexion (foot drop), loss of toe extension, loss of ankle eversion

If the tibial nerve was damaged, what would happen?

Loss of ankle plantar flexion Weakened ankle inversion Loss of toe flexion

If the obturator nerve were injured, what would happen?

Loss of hip adduction Weakened hip lateral rotation

If the sciatic nerve were injured, what would happen?

Loss of knee flexion Weakened hip extension

What is more commonly injured, medial collateral lig or lateral collateral lig?

Medial collateral lig

What prevents excessive motion from a blow to the lateral side of the knee?

Medial collateral ligament

What does the first metatarsal articulate with?

Medial cuneiform

What are the three arches in the foot?

Medial longitudinal Lateral longitudinal Transverse arch (side to side)

What meniscus is more frequently torn?

Medial meniscus

What is caused by anterior leg pain not associated with a stress fracture?

Medial tibial stress syndrome

What does the popliteal surface contain?

Nerves and muscles

What is the starting position of the ankle and what is the ending position of the ankle?

Neutral to dorsiflexion to neutral

What is the starting position of the ankles and what is the ending position of the ankles?

Neutral to dorsiflexion to neutral

What is caused by tenderness over patellar region from jumping too much?

Patellar tendonitis (jumpers knee)

What degrees is plantar flexion and dorsi flexion?

Plantar - 30-50 Dorsi - 20

What supports both longitudinal arches?

Plantar fascia

What is caused by pain in the heel?

Plantar fasciitus

What unlocks the knee to initiate knee flexion?

Popliteus

What is caused by too much pressure between skin and patella?

Prepatellar bursitis (housemaids knee)

What muscle groups are acting as prime movers at the knee while moving from standing to sitting and what type of contraction is occurring? - identify the innervation for each muscle.

Quadriceps (Femoral) would eccentrically contract to control the movement into knee flexion when sitting.

What is Genu recurvatum?

ROM goes beyond 0 degrees of extension

The cruciate ligaments hold stability in what plane?

Saggital

What muscles are in the Pes Anserine Muscle Group?

Sartorius Gracilis Semitendinosus (surgeons can alter attachment site to make the knee more stable)

What is caused by running on hard surfaces causing pain along the medial edge of the tibia?

Shin splints

What transfers is most affected by foot-drop?

Sit-to-stand

What does the deltoid ligament do?

Strengthens medial side of ankle, holds calacaneous and navicular against talus, helps maintain medial longitudinal arch

What two joints can't be separated?

Subtalar joint Transverse tarsal joint

What is the largest, only true weight-bearing bone of the leg?

Tibia

Hyperextension is very important in what?

Toe-off phase during walking

What kind of joint is the ankle joint?

Uniaxial hinge joint

If the femoral nerve was injured, what would happen?

Weakened hip flexion Loss of knee extension

If patient cannot swing arm, will it affect gait?

Yes

What are the purpose of arches?

absorb shock adjust to changes in terrain propel body forward

What is Genu Valgum?

ankles are more lateral than normal knees tend to touch while ankles are apart

What is Genu Varum?

ankles are positioned more medially ankles touch while knee is apart

What does the second metatarsals articulate with?

middle cuneiform