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ATR2010C > knee > Flashcards

knee Flashcards

1
Q

where are the femoral condyles and epicondyles?

A

on the top of the femur on both the medial and lateral side

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2
Q

what are the two major structures of the patella?

A
  1. femoral sulcus
  2. patellar tendon
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3
Q

what are the 3 main joints in the knee

A
  1. tibio-femoral
  2. patello-femoral
  3. proximal tibio-fibular
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4
Q

what are the extra-articular ligaments?

A

MCL and LCL

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5
Q

which are the intra-articular ligaments?

A

ACL/PCL

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6
Q

what is the physiologic movement of the knee?

A

flexion and extension

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7
Q

how does the knee flex and extend (with respect to the condyles)

A

the femoral condyles roll on tibial plateaus

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8
Q

what is the accessory movement of the knee?

A

the tibial plateau spins and glides on the femoral condyles

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9
Q

what is the normal degree range of a Q-angle?

A

15-20

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10
Q

how is the Q-angle computed?

A

a line drawn from the center of the patella up to the ASIS is compared to a line from the patella to the tibial tubercle

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11
Q

what does a Q-angle of greater than 20 degrees indicate?

A

knock knees (genu valgum)

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12
Q

what does a Q-angle of less than 15 degrees indicate?

A

low legs (genu varum)

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13
Q

what are three conditions that could result in anterior knee pain?

A
  1. patellar tendinopathy
  2. chondromalacia patellae
  3. patellar dislocation/subluxation
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14
Q

what is the MOI of patellar tendinopathy?

A

eccentric loading through jumping/landing activities

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15
Q

what are signs and symptoms patellar tendionpathy?

A

-quad weakness
-pain when loading the quads
-point tender

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16
Q

what are 3 risk factors to patellar tendon-related injuries?

A

-limited dorsiflexion (ankle)
-muscle weakness of the glutes
-muscle tightness

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17
Q

how many stages are there when examining patellar tendon related injuries?

A

4

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18
Q

what is the first stage of symptoms with patellar tendon related injuries?

A

pain after activity without functional limitation

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19
Q

what is the second stage of symptoms with patellar tendon related injuries?

A

pain during and after activity without functional limitation

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20
Q

what is the third stage of symptoms with patellar tendon related injuries?

A

prolonged pain during and after activity with functional limitations

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21
Q

what is the fourth stage of symptoms with patellar tendon related injuries?

A

complete tendon tear or rupture that will require surgical repair

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22
Q

what does the “opathy” ending mean?

A

symptomatic

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23
Q

what does the “osis” ending mean?

A

degenerative changes

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24
Q

what do degenerative changes lead to?

A

a loss of tensile strength, mucoid present, and the tendon thickening

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25
Q

how to manage patellar tendon related injuries?

A

strengthen the quadriceps and strapping

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26
Q

what is osgood-schlatter’s disease?

A

a growth disorder that is common in adolescents

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27
Q

what occurs during osgood-schlatter’s disease?

A

an outgrow of bone from the tibial tuberosity; there could be an avulsion fracture (separation form the TT)

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28
Q

what is chondromalacia patellae?

A

degenerative softening or wearing away of the articular cartilage.

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29
Q

What forces cause chondromalacia patellae?

A

compression and shear forces

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30
Q

what is the MOI for chondromalacia patellae?

A

an excessive Q-angle, and abnormal tracking of the patella

31
Q

what are signs and symptoms of chondromalacia patellae?

A

pain during quad activities and patellar motion

32
Q

what occurs to the nerve endings with chondromalacia patellae?

A

there is irritation and exposure of the nerve endings on the undersurface of the patella

33
Q

what are risk factors of a dislocation/subluxation of the patella?

A

excessive Q-angle, weakness of the quads, and loose ligaments

34
Q

what are some MOIs of a dislocation/subluxation?

A

a direct blow to the knee and/or a quick start or cutting motion

35
Q

what could occur as a secondary injury due to a dislocation/subluxation?

A

a tear of the medial retinaculum or medial patello-femoral ligament (MPFL)

36
Q

what is the #1 benefit of patellar bracing?

A

it prevents abnormal tracking of the patella

37
Q

what are secondary benefits of patellar bracing?

A

prevents lateral displacement and maintains normal sliding motion

38
Q

what are common tibio-femoral joint injuries?

A

ligament tears and cartilage tears

39
Q

what three ligaments tear the most with tibio-femoral joint injuries?

A

MCL, ACL, and PCL

40
Q

what is the MOI for a MCL injury?

A

valgus loading of the knee in extension

41
Q

true or false: MCL ligament injuries only occur through contact mechanisms?

A

false

42
Q

True of false: the ACL is the primary restraint to valgus loading?

A

false, the MCL is the primary, but the ACL is secondary

43
Q

what is the most frequently injured knee ligament?

A

the MCL

44
Q

do you want to treat the MCL conservatively?

A

yes, PRICE protocol and then crutches to keep them off the knee for a while

45
Q

what is the goal of the valgus stress test?

A

to open the medial compartment of the knee and to evaluate if there is any damage to the MCL or medial capsule

46
Q

how does a prophylactic knee brace prevent injuries?

A

-lateral blows to the knee
-stresses are absorbed and directed away from the joint
-prevents valgus loading and extra strain on the MCL

47
Q

are prophylactic knee braces effective?

A

no, they tend to interfere with performance

48
Q

why is the ACL known as the “watchdog of the knee”

A

it is the major static stabilizer

49
Q

what are the 3 MOIs for ACL injuries?

A
  1. valgus loading with tibial rotation
  2. anterior tibial displacement
  3. hyperextension
50
Q

what is the terrible triad?

A

when 3 structures in the knee are damaged from one event occurring

51
Q

what three things occur and lead to the terrible triad?

A
  1. valgus loading
  2. compression of postern-lateral tibio-femoral compartment
  3. tibial rotation and anterior displacement of the femur
52
Q

does the ACL require surgery?

A

yes

53
Q

Why do you not want a conservative management?

A

the knee would continue to give out and buckle, and this would cause additional damage to the joint.

54
Q

What is the special ACL test to get for issues?

A

The Lachman

55
Q

What is the golden period?

A

the period of time from the moment of rupture until the joint swells

56
Q

how long is the golden period typically?

A

15-20 minutes

57
Q

what is hemarthrosis?

A

joint inflammation followed by muscle guarding

58
Q

true or false: women how higher rates of ACL tears than men

A

true

59
Q

what are theories for why women show higher rates of ACL tears?

A
  • excessive Q-angle
    -progesterone decreases tensile strength of c-tissue
    -they have slower muscle activation patterns
    -genetic predispositions (weaker collagen)
60
Q

what are the functions of the menisci?

A

they absorb and distribute loads, stabilize the joint, and are involved in proprioception

61
Q

which meniscus is larger?

A

the medial one

62
Q

Which medial meniscus is less mobile and torn more often?

A

the medial one

63
Q

what is the MOI of a meniscus tear?

A

the knee is flexed and rotated

64
Q

where is the location of most meniscus tears?

A

the posterior horn of meniscus

65
Q

does the red zone or the white have the capacity to heal?

A

the red zone

66
Q

what do meniscus tears tend to start as?

A

radial.

67
Q

can the white zone heal?

A

no, it would start to degenerate

68
Q

what is a meniscectomy?

A

a surgery used to remove loos fragments. They trim around the torn section

69
Q

what is a repair when looking at a meniscus tear?

A

then the meniscus is sutured down to the tibial plateau

70
Q

what are the two tests used for meniscus tears?

A
  1. Appley’s compression test
  2. McMurray’s test
71
Q

does the PCL provide rotary stability for the knee

A

no

72
Q

what gets inflamed for ITBFS?

A

the lateral synovial recess (bursae)

73
Q

what is a bursae?

A

a fluid filled sac

ATR2010C (19 decks)

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