Anatomy clinical correlates: Knee

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Anatomy clinical correlates: Knee

Prerequisite basic sciences

Prerequisite basic sciences

Anatomy clinical correlates: Anterior and posterior abdominal wall

Anatomy clinical correlates: Inguinal region

Anatomy clinical correlates: Peritoneum and diaphragm

Anatomy clinical correlates: Viscera of the gastrointestinal tract

Anatomy clinical correlates: Other abdominal organs

Appendicitis: Pathology review

Complications during pregnancy: Pathology review

Diverticular disease: Pathology review

Gallbladder disorders: Pathology review

GERD, peptic ulcers, gastritis, and stomach cancer: Pathology review

Inflammatory bowel disease: Pathology review

Mood disorders: Pathology review

Pancreatitis: Pathology review

Anatomy clinical correlates: Female pelvis and perineum

Cervical cancer: Pathology review

Complications during pregnancy: Pathology review

Uterine disorders: Pathology review

Anatomy clinical correlates: Heart

Anatomy clinical correlates: Mediastinum

Anatomy clinical correlates: Pleura and lungs

Anatomy clinical correlates: Thoracic wall

Aortic dissections and aneurysms: Pathology review

Coronary artery disease: Pathology review

Deep vein thrombosis and pulmonary embolism: Pathology review

GERD, peptic ulcers, gastritis, and stomach cancer: Pathology review

Pleural effusion, pneumothorax, hemothorax and atelectasis: Pathology review

ECG cardiac infarction and ischemia

Pigmentation skin disorders: Pathology review

Skin cancer: Pathology review

Papulosquamous and inflammatory skin disorders: Pathology review

Anatomy clinical correlates: Pleura and lungs

Anatomy clinical correlates: Thoracic wall

GERD, peptic ulcers, gastritis, and stomach cancer: Pathology review

Lung cancer and mesothelioma: Pathology review

Nasal, oral and pharyngeal diseases: Pathology review

Obstructive lung diseases: Pathology review

Pneumonia: Pathology review

Tuberculosis: Pathology review

Chest X-ray interpretation: Clinical sciences

Amnesia, dissociative disorders and delirium: Pathology review

Cerebral vascular disease: Pathology review

Dementia: Pathology review

Electrolyte disturbances: Pathology review

Mood disorders: Pathology review

Hypothyroidism: Pathology review

Mood disorders: Pathology review

Anatomy clinical correlates: Facial (CN VII) and vestibulocochlear (CN VIII) nerves

Cardiomyopathies: Pathology review

Cerebral vascular disease: Pathology review

Heart blocks: Pathology review

Supraventricular arrhythmias: Pathology review

Valvular heart disease: Pathology review

Ventricular arrhythmias: Pathology review

Vertigo: Pathology review

ECG axis

ECG cardiac hypertrophy and enlargement

ECG intervals

ECG normal sinus rhythm

ECG QRS transition

ECG rate and rhythm

Kidney stones: Pathology review

Sexually transmitted infections: Vaginitis and cervicitis: Pathology review

Sexually transmitted infections: Warts and ulcers: Pathology review

Urinary tract infections: Pathology review

Central nervous system infections: Pathology review

Nasal, oral and pharyngeal diseases: Pathology review

Pneumonia: Pathology review

Shock: Pathology review

Urinary tract infections: Pathology review

Anatomy clinical correlates: Anterior blood supply to the brain

Anatomy clinical correlates: Temporal regions, oral cavity and nose

Central nervous system infections: Pathology review

Cerebral vascular disease: Pathology review

Headaches: Pathology review

Traumatic brain injury: Pathology review

Vasculitis: Pathology review

Anatomy clinical correlates: Arm, elbow and forearm

Anatomy clinical correlates: Axilla

Anatomy clinical correlates: Bones, fascia and muscles of the neck

Anatomy clinical correlates: Bones, joints and muscles of the back

Anatomy clinical correlates: Clavicle and shoulder

Anatomy clinical correlates: Foot

Anatomy clinical correlates: Hip, gluteal region and thigh

Anatomy clinical correlates: Knee

Anatomy clinical correlates: Leg and ankle

Anatomy clinical correlates: Median, ulnar and radial nerves

Anatomy clinical correlates: Wrist and hand

Seronegative and septic arthritis: Pathology review

Apnea, hypoventilation and pulmonary hypertension: Pathology review

Deep vein thrombosis and pulmonary embolism: Pathology review

Heart failure: Pathology review

Nephrotic syndromes: Pathology review

Renal failure: Pathology review

Anatomy clinical correlates: Anterior and posterior abdominal wall

Anatomy clinical correlates: Bones, joints and muscles of the back

Anatomy clinical correlates: Vertebral canal

Aortic dissections and aneurysms: Pathology review

Back pain: Pathology review

Anatomy clinical correlates: Inguinal region

Anatomy clinical correlates: Male pelvis and perineum

Penile conditions: Pathology review

Prostate disorders and cancer: Pathology review

Testicular and scrotal conditions: Pathology review

Testicular tumors: Pathology review

Anatomy clinical correlates: Pleura and lungs

Coronary artery disease: Pathology review

Obstructive lung diseases: Pathology review

Pleural effusion, pneumothorax, hemothorax and atelectasis: Pathology review

Bronchodilators: Beta 2-agonists and muscarinic antagonists

Bronchodilators: Leukotriene antagonists and methylxanthines

Pulmonary corticosteroids and mast cell inhibitors

Anatomy clinical correlates: Ear

Anatomy clinical correlates: Temporal regions, oral cavity and nose

Nasal, oral and pharyngeal diseases: Pathology review

Sexually transmitted infections: Vaginitis and cervicitis: Pathology review

Assessments

Anatomy clinical correlates: Knee

USMLE® Step 1 questions

0 / 9 complete

USMLE® Step 2 questions

0 / 10 complete

Questions

USMLE® Step 1 style questions USMLE

of complete

USMLE® Step 2 style questions USMLE

of complete

A 47-year-old man presents to the emergency department with left lower extremity pain and swelling. The patient was outside jogging when he suddenly felt a “pop” with associated pain behind the left knee. The left lower extremity has become progressively more swollen and painful over the past few hours. The patient recently traveled to the United States from London. Past medical history is notable for hypertension. Vital signs are within normal limits. Bilateral lower extremity pulses are normal and equal. Physical examination reveals a swollen and tender calf and ecchymosis at the popliteal region. Anterior and posterior drawer tests are negative. An ultrasound of the left calf is shown below. Which of the following is the most likely diagnosis?
 
Image reproduced from Wikimedia Commons

Transcript

The knee is one of the most complex joints in the human body, and along with the rest of the lower limb there are numerous ligamentous, muscular, and bony structures that are prone to injury. Oftentimes we can injure many of these structures at the same time, but injury to even one of these structures can affect how we walk, dance, or exercise. This video will go over all the relevant anatomy you ‘kneed’ to know in order to understand the clinical conditions affecting the knee.

First up, let’s discuss the Q angle - where “Q” stands for quadriceps. The Q angle is the angle measured between the femur and the tibia.

This angle is created by the femur’s diagonal placement within the thigh and by the tibia’s vertical placement in the leg. This angle is typically below 20 degrees and on average is higher in biologic females, and a normal Q angle allows the weight supported by the knee joint to be centered through the middle of the knee, in the knee’s intercondylar region.

When the Q angle increases over the normal range, it can lead to genu valgum or knock knees. With genu valgum, the increase in Q angle shifts the weight bearing center to the lateral compartment of the knee, which increases the quadriceps lateral pull and causes the medial collateral ligament to overstretch. This can cause joint misalignment and a predisposition for articular degeneration in the lateral compartment of the knee and subsequent gait abnormalities.

To remember the knock knee appearance of genu valgum, think of the ‘g’ as standing for ‘gum’ sticking the knees together!

Alternatively, when the Q angle is below normal range, a genu varum alignment can occur where the legs angulate away from the midline and create a bow legged appearance. This results in the weight bearing center being shifted through the medial compartment of the knee, stretching the lateral capsule lateral collateral ligament. So this time, there’s joint misalignment and a predisposition to articular degeneration in the medial compartment of the knee and subsequent gait abnormalities.

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