04 Anterior Knee Palpations Flashcards Preview

7232 Ortho > 04 Anterior Knee Palpations > Flashcards

Flashcards in 04 Anterior Knee Palpations Deck (43):
1

tibial tuberosity: clinical significance

- Osgood-Schlatter disease
- bone plug where they harvest for ACL reconstruction

2

What is Osgood-Schlatter disease?

apophysitis of infrapatellar tendon attaching to the bone

3

inferior pole of the patella: clinical significance (bony)

Sinding-Larsen Johansson Syndrome

4

What is Sinding-Larsen-Johansson Syndrome

- apophysitis of inferior pole of the patella
- where infrapatellar tendon attaches to bone
- open physis so it pulls apart

5

anterior patella: clinical significance (bony)

- patellar fracture
- BTB harvest site for ACL repair (may feel bony divot)

6

When is a patellar fracture on the anterior surface likely to occur?

- falls
- bone plug harvested

7

How many layers of "stuff" over the anterior patella?

8

8

superior pole of patella: clinical significance (bony)

potential chondral problem

9

Pain over the superior lateral aspect of the patella is indicative of what?

bipartite patella

10

inferior aspect of medial trochlear ridge: clinical significance

most common site of OCD due to AVN of the femur

11

palpating for the inferior aspect of the medial trochlear ridge

flex IP joint from SRP, thumb is on it

12

inferior aspect of lateral trochlear ridge: clinical significance

no specific pathology that occurs here other than OA/DJD

13

superior aspect of medial trochlear ridge: clinical significance, palpation

- no clinical significance
- can't feel because it's under the VMO

14

superior aspect of lateral trochlear ridge: clinical significance

OCD
- if dislocation/subluxation occurs, may get OCD from retropatellar surface or from lateral trochlea

15

superior aspect of lateral trochlear ridge: palpation

- above superior pole of patella
- hand on distal end of femur
- easy to feel, prominent

16

trochlear groove: clinical significance

- where patella tracks
- site of arthritis changes

17

trochlear groove: palpation

- can't feel because the quad tendon and rectus femoris is in the way
- between medial and lateral trochlear ridge

18

infrapatellar tendon: clinical significance

- itis/osis
- partial tear
- full tear/rupture
- middle 1/3 harvested for BTB ACL reconstruction

19

infrapatellar tendon width and BTB harvest width

- tendon: 30 mm
- harvest: 8-10 mm

20

What happens to the infrapatellar tendon after ACL reconstruction?

should fill in with scar tissue

21

infrapatellar tendon: palpation

- from tibial tuberosity to inferior pole of patella
- will feel defect if part was harvested

22

How many bursa around the knee?

17

23

anterior surface of patella: clinical significance (soft tissue)

pre-patellar bursitis

24

pre-patellar bursitis

- knee looks huge and swollen, but not really a big deal
- usu a serosanguinous hemorrhagic type of bursa
- common

25

How might a pre-patellar bursitis form and what is done for it?

- fall on knee, swells
- may need to be aspirated

26

superior pole of patella: clinical significance (soft tissue)

- quad tendon insertion point
- tendonitis/osis, rupture
- harvest site for ACL reconstruction

27

largest tendon of the knee

quad tendon

28

Are ruptures of the quad tendon common?

no, because it's one of the strongest tendons in the body

29

Why is a quad tendon ACL reconstruction becoming more common?

because it's the largest tendon of the knee

30

What muscle is deep to the vastus intermedius?

genu articularis

31

rectus femoris: clinical significance

- myositis/osis
- inflammation
- tears (partial or full thickness)
- strains
- reconstructions with imbrication or plication

32

rectus femoris: palpation

have pt extend the knee while you resist

33

Which types of imbrications are most common?

VMO

34

VMO: clinical significance

- myositis/osis
- inflammation
- tears (partial or full thickness)
- strains
- reconstructions with imbrication or plication

35

VMO: palpation

have pt extend the knee while you resist

36

vastus lateralis: clinical significance

- myositis/osis
- inflammation
- tears (partial or full thickness)
- strains
- reconstructions with imbrication or plication

*don't want to cut muscle in VL

37

vastus lateralis: palpation

have pt extend the knee while you resist

38

infrapatellar fat pad: clinical significance

Hoffa's syndrome

39

testing for Hoffa's syndrome

- passively extend the knee and press on the fat pad
- if symptomatic, it's Hoffa's

40

palpate the fat pad in this position

extension (if you do it in flexed, won't be able to palpate and pt won't be symptomatic)

41

odd facet

do a medial glide to palpate the odd facet

42

lateral facet

do a lateral glide to palpate lateral facets

43

synovium: clinical significance

2nd most highly innervated structure in the knee