Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clin Med II - Ortho > Knee > Flashcards

Knee Flashcards

1
Q

Medical hx

A 
Hx often leads to correct dx
MOI & associated injuries
Pop
Nature & character of pain
Swelling
Instability
Catching or locking
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Meniscus - in general

A

Consists of fibrocartilage
Can’t see on x-ray
Blood supply of peripheral 1/3 only
Peripheral attachment onto capsule at joint line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Meniscus - normal function

A

Takes up space
Disburses synovial fluid
Supports approx. 505 of its compartment weight with posterior horn bearing majority of weight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Meniscus Tear - Clinical feature

A

Medial meniscal injuries most common causes of knee joint pain
Hx of trauma with subsequent knee locking or catching
Pain persists and interferes with weight bearing activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Meniscus Tear - PE

A 
Inspection
- Swelling 
- Loss of extension
Palpation
- Joint line tenderness
- Effusion
ROM
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Meniscus Tear - Tests

A

McMurray’s test

Apley’s test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

McMurray’s test

A

Knee fully flexed, leg externally rotated testing for medial tears and internally rotated for lateral
While maintaining rotation extend knee with a firm controlled movement
Painful click “positive” test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Apley’s test

A

Pt prone, knee flex at 90°, axial load on heel while leg is rotated internally and externally
Pain “positive” test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Meniscus Tear - dx

A

X-rays
MRI
ARthroscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Meniscus Tear - tx

A 
Ice (acute)
Quadriceps exercises
Crutches
NSAIDS
Analgesics
Arthroscopy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Meniscus Tear - when to refer

A

Locked knee or lack of full extension
Persistent pain and/or swelling
Giving way

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Ligamentous injuries

A

Anterior & posterior cruciate

Medial and lateral collateral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Anterior cruciate injury

A

Results from traumatic injury
Torn more commonly than PCL
Primary anterior and rotational stabilizer of knee
May occur with associated injury, meniscal or medial collateral tear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

ACL injury - Clinical feature

A

Hx of significacnt twisting injury
Popping sensation at time of injury
Hemarthrosis found 75% - rapid
Giving way - acute or chronic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

ACL injury - PE

A

Inspection - swelling
Palpation - effusion & pain
ROM - painful

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

ACL injury - Tests

A

Lachman’s Test
Anterior Drawer
Pivot Shift

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Lachman’s Test

A

More sensitive
Knee flexed 30°
Anterior/posterior translation of tibia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Pivot shift

A

Knee fully extended
Valgus and upward force applied to knee
Tibia subluxes anteriorly on femur
Knee flexed produces reduction of tibia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

ACL injury - imaging

A

X-rays - avulsion
Arthrocentesis
MRI - gold standard

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

ACL injury - tx

A 
RICE
Knee immobilizer
Crutches
NSAIDS
Arthrocentesis
Therapy
Sx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

ACL injury - when to refer

A

Acute injury

Presence of effusion secondary to trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Posterior cruciate injury - in general

A

Direct trauma to proximal tibia when flexed knee is decelerated rapidly - dashboard injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

PCL injury - tests

A

Posterior drawer test

Tibia sag test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Posterior drawer test

A

Posterior displacement of tibia on femur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Collateral ligament injury - in general

A 
Medial & lateral stabilizer
Medial collateral (MCL)
Lateral Collateral (LCL)
Traumatic partial or complete tear
May occur with meniscal, ACL, PCL injury
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Collateral ligament injury - clinical features

A 
Able to ambulate 
C/o swelling or stiffness
Pain
Tenderness
Localized ecchymosis
Swelling possible
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

MCL injury - MOI

A

Valgus force

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

LCL injury - MOI

A

Varus force (less common)

29
Q

Collateral ligament injury - PE

A 
Examine normal knee first
Inspection
- swelling 
- ecchymosis
Palpation - tenderness about origin & insertion of ligament
ROM
30
Q

Collateral ligament injury - tests

A

Valgus and varus stress tests

Perform with knee in full extension and 30° flexion

31
Q

Collateral ligament injury - dx

A

Radiographs usually negative - possible avulsion

32
Q

Collateral ligament injury - Grade I

A

Localized tenderness over ligament
Little or no laxity
Tx with RICE & NSAIDs short term

33
Q

Collateral ligament injury - Grade II

A

Significant laxity, but definite end point reached

Tx with hinged brace 4-6w & allow WBAT

34
Q

Collateral ligament injury - Grade III

A

Laxity with no end point
Hinged brace, gradual return to FWB
Rehab - early ROM & quad strengthening
Refer for possible sx

35
Q

Collateral ligament injury - when to refer

A

Hemarthrosis

Ligamentous instability

36
Q

Tendinitis

A

Overuse syndrome

37
Q

Quadriceps tendon & Tendinitis

A

At insertion on superior pole of patella

38
Q

Patellar tendon & Tendinitis

A

At inferior pole of patella or insertion at tibial tubercle (jumper’s knee)

39
Q

Tendinitis - clinical symptoms

A

Anterior knee pain
Night pain
Pain with sitting, squatting or kneeling
Increased with climbing stairs

40
Q

Tendinitis - PE

A

Palpation - pain
Quadriceps atrophy
Check straight leg raise to r/o rupture
Check ACL & PCL

41
Q

Tendinitis - Dx

A

MRI is helpful if conservative tx fails

42
Q

Tendinitis - tx

A 
Rest
Knee immobilizer intermittently
NSAIDs - short term
AVOID STEROIDS
Strength and pain free motion
Refer all possible tendon ruptures
43
Q

Osgood-Schlatter dz - in general

A

Seen in adolescents (12-14yo)
Repetitive injury
Occurs at bone tendon junction-patellar tendon & tibia tubercle

44
Q

Osgood-Schlatter dz - clinical features

A 
Pain
Swelling
Tenderness
Relieved by rest
irregular ossifications or fragmentation of tibial tubercle on lateral x-ray
45
Q

Osgood-Schlatter dz - tx

A 
Avoid activity triggering s/s
Ice
Immobilization for severe s/s
Parental reassurance
Sx rare
46
Q

Patellar fx - in general

A

Direct blow while quadriceps is under tension

47
Q

Patellar fx - clinical features

A

Pain

Inability to extend knee

48
Q

Patellar fx - PE

A

Hemarthrosis with swelling
Unable to extend knee
Open fx common due to direct blow

49
Q

Patellar fx - dx

A

AP & lat s-rays

Extensor mechanism usually intact if two main fragments <6mm apart

50
Q

Patellar fx - tx

A

immobilize in extension 6 weeks (3-4 weeks ROM)
- if < 5mm separation & <2 mm displacement
- extension intact
Sx

51
Q

Dislocations - in general

A 
C/o knee giving way or popping out
May occur secondary to acute injury
May spontaneously reduce with gradual extension
Evaluate for other injuries
F>M
52
Q

Patellar Dislocations - tests

A

Positive Apprehension test

53
Q

Patellar Dislocations - Tx

A

Aspirate tens hemarthrosis
Immobilization (2-6 wks)
Full weight bearing
Quadriceps exercises important!!!

54
Q

Patellofemoral Pain Syndrome - in general

A

Chondromalacia pateleae
Most common anterior knee problem
Worse with sitting with knee flexed (theatre sign) or going down stairs

55
Q

Patellofemoral Pain Syndrome - dx

A

X-ray usually show negative, sunrise films may show lateral displacement of patella

56
Q

Patellofemoral Pain Syndrome - tests

A

Positive patellar compression

Entrapment signs

57
Q

Entrapment sign

A

Weak quadriceps

58
Q

Patellofemoral Pain Syndrome - tx

A 
NSAIDs
Ice
Quadriceps exercise
Avoid triggering activities
Sx if conservative tx fails
59
Q

Fx of the knee joint

A 
May are intra-articular
Tibial plateau &amp; femoral condyles
- MOI
Clinical feature
Tx
60
Q

OA - in general

A

Common cause of knee pain
Progressive breakdown of cartilage and joint (synovial fluid)
Breakdown causes a loss of the cushioning and lubrication that cartilage and joint fluid give to the knee joint

61
Q

OA - s/s

A 
Pain
Stiffness
Functional impairment
Swelling
Grating &amp; catching when knee is bent
62
Q

OA - RF

A 
Increasing Age
Excessive weight
Overuse of the knee
Injury to the knee
A FHx of OA
63
Q

Healthy knee

A

Bone ends are protected by healthy cartilage

The space between bones is well lubricated with healthy joint fluid

64
Q

Cartilage

A

A cusiony substance that keeps bones from rubbing together

65
Q

Mild OA

A

Cartilage surface stats to break down

66
Q

Moderate OA

A

Cartilage continues to break down and is more easily damaged by everyday ear and tear or injury
Joint fluid starts to lose its lubrication and shock-absorbing ability

67
Q

Severe OA

A

Large amounts of cartilage have worn away, allowing bones to rub against each other
Bone spurs form on the ends of bones

68
Q

Treating OA knee pain summary

A

Non-drug therapies include - exercise, weight loss, heat & cold & PT
Drug therapies include - acetaminophen, NSAIDs topical therapies, injectable corticosteroids & viscosupplements
Viscosupplements replace dzed joint fluid

Clin Med II - Ortho (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions