04 Medial Knee Palpations 2 Flashcards Preview

7232 Ortho > 04 Medial Knee Palpations 2 > Flashcards

Flashcards in 04 Medial Knee Palpations 2 Deck (33):
1

medial meniscus: clinical significance

- most meniscus tears are in the posterior horn (posterior 1/3)
- same spot as joint line and med tibial plateau

2

medial meniscus: what correlates with meniscal tears?

joint line pain

3

Where does pain from medial meniscus tears come from?

- meniscus is aneural
- pain comes from coronary fibers and horns

4

What cause the ttp seen in meniscus tears?

coronary ligament sprains

5

medial meniscus: palpation

- important to palpate through soft tissue in the back
- most common site of meniscus tears

6

coronary ligaments: clinical significance

where most of the pain is from when we get a meniscus tear

7

coronary ligaments: innervation

- highly innervated
- pain from meniscus tears generated from coronary ligament sprain

8

Where are the coronary ligaments?

- at edges of meniscus
- under capsule

9

What do coronary ligaments do?

hold meniscus on the tibia

10

What all are you palpating on the joint line?

- medial tibial plateau
- joint line
- coronary ligaments
- medial meniscus

11

MCL: anterior edge
clinical significance

- 2nd most commonly injured knee ligament
- most commonly sprained at joint line
- second most commonly torn proximal to joint line if bone is avulsed (pellegrini)
- third most commonly torn distal sprain
- tear can be partial or full thickness

12

Which is the most commonly sprained ligament at joint line?

ACL

13

MCL: palpation

- 1 body inch medial from infrapatellar tendon
- palpate meticulously for step-up of MCL

14

Where is the MCL distal attachment?

tibial flare

15

semitendinosus tendon: clinical significance

- itis/osis
- sometimes harvested for ACL reconstructions

16

semitendinosus tendon: palpation

flex and IR the knee

17

gracilis tendon: clinical significance

- itis/osis
- sometimes harvested for ACL reconstruction

18

gracilis: palpation

- flex, IR, and adduct hip
- move finger forward from semitendinosus to feel the second, cord-like structure

19

sartorius tendon: clinical significance

- itis/osis
- most anterior tendon of the pes group

20

sartorius: palpation

- anterior to gracilis on medial tibial flare
- move into MMT position for sartorius

21

semimembranosus tendon: clinical significance

- membranous down almost completely to distal attachment

22

semimembranosus: palpation

- between gracilis and semitendinosus tendons
- almost impossible to feel
- pt into knee flexion and IR

23

distal attachments for semimembranosus

posterior medial tibial plateau

24

pes anserine bursa: clinical significance

- pes bursitis
- can't feel if it's not inflamed
- if inflamed, it will feel squishy or boggy

25

pes anserine bursa: palpation

underneath the pes group on the tibial flare

26

medial superficial retinaculum: clinical significance

- rent tear defect indicative to patellar tear

27

medial superficial retinaculum: palpation

- medial patella toward medial femoral epicondyle
- can't feel distinctly

28

MPFL: clinical significance

- flat ligament deep to superficial retinaculum
- 92% positive finding on palpation alone

29

MPFL: location

superior medial patella to medial femoral epicondyle

30

plica: clinical significance

- 2nd most innervated structure in the knee

31

plica: MOI

- macrotrauma
- repetitive microtrauma
- chronic synovitis

32

plica: palpate

- flex knee to 45˚
- superior medial patella to medial epicondyle, feels like a pencil
- inflammation causes pain

33

If a patient presents with pain on the anterior tibial flare, what structures could be involved?

- pes anserine
- pes bursitis
- MCL sprain
- pes tendonitis