Lab 7

Question 1

Pt thinks they sprained a ligament, theyre sore for a while but have no instability

Answer 1

possible that they strained their joint capsule, not a ligament

Question 2

delayed swelling is likely due to

Answer 2

synovitis (swollen capsules)

Question 3

Immediate swelling/ hemarthrosis is more likely with

Answer 3

ligament tears

Question 4

whats the most important thing in the history to ask for knee injuries

Answer 4

mechanism

Question 5

Why is it important to screen if patients are 50+ or under 17 in knee cases

Answer 5

Osteosarcoma in distal femur

atrophy of quad, oddly shaped knee, s/s of cancer

Question 6

What can we do to help rule out DVTs in the knee?

Answer 6

take vitals

Question 7

History of blunt trauma or unaccustomed exercise

severe pain

hardness, paresthesia

no pulse in leg

Answer 7

compartment syndrome

URGENT! call the ambulance!

Question 8

Ottawa knee decision rule:

Answer 8

Age 55+

Tenderness at head of fibula

isolated tenderness at patella

inability to flex knee to 90

inability to WB 4 steps

2+ findings need an xray

Question 9

pittsburgh knee decision rule

Answer 9

Hx of blunt trauma or fall

inability to WB 4 steps

age under 12 or over 50

2+ gets an xray

Question 10

Knee decision rule of bauer

Answer 10

inability to WB 4 steps
Presence of knee effusion
presence of ecchymosis

Question 11

what do the 3 knee decision rules have in common?

Answer 11

Inability to WB 4 steps

Question 12

what unique things do you need to look at in observation for knee

Answer 12

abrasions

lacerations

contusions

can cause infection!

Question 13

You must have tibial ________ for full ext and tibial ________ for full flex

Answer 13

External rotation

internal rotation

Question 14

how much hyperext is normal in the knee

Answer 14

15

Question 15

what does 3-125 mean when writing knee ROM

Answer 15

Missing 3 ext, 125 degrees of flexion

Question 16

What direction does the roll/glide happen for knee flexion?

Answer 16

posterior roll posterior glide

Question 17

What direction does the roll and glide occur for ext of the knee

Answer 17

anterior roll, anterior glide

Question 18

what are we mobilizing here?

Answer 18

ext

Question 19

what motion is being mobilized here

Answer 19

ext

Question 20

.

Question 21

what movement is being mobilized

Answer 21

technically all of them, but mainly used for flexion

Question 22

this glide helps with what motion

Answer 22

ext

Question 23

this glide helps with what motion

Answer 23

flexion

Question 24

When do we use PA and AP glides for the proximal tibiofibular joint

Answer 24

usually when the patient has chronic problems at the distal tibio-fibular joint

ex= chronic lateral ankle sprains

Question 25

Where do you palpate to feel meniscus?

Answer 25

Squishy area behind femoral condyles

Question 26

which collateral ligament is easier to palpate?

Answer 26

Lateral- is easier, shaped like cord medial-harder to palpate, shaped like band

Question 27

Subjective -> Observation _> ROM -> MMT -> ____________

Answer 27

Joint play

Question 28

Where do we palpate the plicae (if present)

Answer 28

medial and superior under patella

Question 29

When would you do ligamentous testing for the knee vs not

Answer 29

only do ligamentous testing when there's a MOI

Question 30

When would you do instability testing on he knee vs not

Answer 30

only do this testing if there's a current or past MOI

Question 31

how to do lachmans

Answer 31

bend knee to 30 degrees and provide strong anterior shear with one hand while stabilizing thigh

Question 32

When do you preform a lachmans vs an anterior drawer

Answer 32

lachmans- immediately after injury b4 it swells

Question 33

What is the disadvantage of the anterior drawer vs the lachmans

Answer 33

knee is in 60 degrees of flexion and there is more hamstring activation guarding the knee

Question 34

injury to what structure is the most common cause of Anterio-lateral rotary instability

Answer 34

ACL

Question 35

what is the pivot shift test for

Answer 35

ACL, ALRI

Question 36

When we suspect ligamentous instability what tests should we do

Answer 36

test all 4 ligaments of the knee

Question 37

How do we know if a posterior sag sign is positive

Answer 37

Look for a big divot, compare to other side

Question 38

A valgus stress test at 0 tests the....

Answer 38

PCL

Question 39

A valgus stress test at 20 tests what

Answer 39

MCL

Question 40

A varus stress test at 0 is for...

Answer 40

ACL and PCL

Question 41

A varus stress test at 20 is for what

Answer 41

LCL

Question 42

Anteriomedial instability test direction:

Answer 42

Anterior drawer with ER

Question 43

Anterolateral instability test direction

Answer 43

IR with anterior drawer

Question 44

Posterio-lateral instability test

Answer 44

posterior drawer with ER

Question 45

Posterio-medial instability test direction

Answer 45

posterior drawer with IR

Question 46

how do you preform the mcmurray for the medial meniscus

Answer 46

passively rotate tibia into full ER while passively extending knee

Question 47

how do you preform mcmurrays for a lateral meniscus

Answer 47

Fully IR the tibia then extend the knee

Question 48

if you suspect someone has a lateral meniscus tear what part of mcmurray test should you do

Answer 48

BOTH tests

Question 49

T or F: Apley's test can identify which side the meniscus is torn

Answer 49

F, it doesn't discriminate between sides

Question 50

How to preform the apleys test

Answer 50

compress/ distract knee joint from lower leg and rotate leg into IR and ER distraction- makes meniscus better compression- makes menicus worse/ligament worse distraction- makes ligamentous injuries worse

Question 51

How do you preform Thessaly's test

Answer 51

Preform at 20 and 5 degrees knee flex pt twists side to side and positive is pop, click, or pain positive test = mensicus problem

Question 52

What does the lateral patellar aprehension test test for?

Answer 52

tests for lateral patellar subluxation

Question 53

how do you preform clarke's sign/ patellar grind test and what does it test for

Answer 53

pt is supine w/ knee straight push the patella inferior and have patient isometricly contract quad positive- reproduces their pain means chondromalacia patella or any Pf dysfunction