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KNPE 331 > Lecture 6 > Flashcards

Lecture 6 Flashcards

1
Q

Joints of the knee

A

-tibiofemoral
-patellofemoral
-superior tibiofibular

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2
Q

Compartments of the lower leg

A

-lateral
-anterior
-posterior

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2
Q

What is the lateral compartment of leg

A

-peroneal group

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3
Q

What is the anterior compartment of the leg

A

-extensor group

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4
Q

What is the posterior compartment of the leg

A

-flexor group

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5
Q

What muscles are in the anterior compartment of leg

A

-tibialis anterior
-extensor hallucis longus
-extensor digitorum longus
-fibularis tertius

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6
Q

What muscles are in the lateral compartment of leg

A

-peroneus longus
-peroneus brevis

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7
Q

What muscles are in the deep posterior compartment of the leg

A

-Tom, dick and harry
-tibialis posterior
-flexor digitorum longus
-flexor hallucis loongus

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8
Q

What muscles are in the superficial posterior compartment of the leg

A

-gastrocnemius
-soleus
-achilles tendon

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9
Q

Intracapsular structures of knee (inside capsule)

A

-ACL
-PCL
-meniscus
-cartilage
-joint surface

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10
Q

Why is it important to know which structures are intracapsular vs extracapsular

A

-inflammation may be trapped within capsule

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11
Q

What is the special test to determine if there is something intracapsular that is injured

A

-wipe test

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12
Q

Wipe test

A

-swipe up on medial side of knee to get inflammation away
-then swipe down on lateral side of knee
-see if fluid shifts onto media l side

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13
Q

What shape is medial meniscus

A

-c shaped

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14
Q

What shape is lateral meniscus

A

-o shaped

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15
Q

Components of the quadriceps muscle

A

-rectus femoris
-vastus lateralis
-vastus intermedius
-vastus medialis

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16
Q

What components of the quadriceps have a lateral pull on patella

A

-rectus femoris
-vastus lateralis
-vastus intermedius

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17
Q

What components of the quadriceps have a medial pull on patella

A

-vastus medialis

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18
Q

Divisions of the hamstrings

A

-medial
-lateral

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19
Q

Medial hamstrings

A

-semimembranosus
-semitendinosis

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20
Q

Lateral hamstrings

A

-biceps femoris

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21
Q

Muscles that attach on pes anserine

A

-semitendinosus
-gracilis
-sartorius

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22
Q

What is the main action of gluteus medius

A

-hip abduction
-eccentrically controls internal rotation of femur in weight bearing

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23
Q

What extra actions do the anterior fibres of the gluteus medius do

A

-internally rotate hip
-assists with hip flexion

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24
What extra actions to the posterior fibres of the gluteus medius do
-extend hip -externally rotate the hip
25
What action does gluteus medius prevent
-prevents pelvis on stance side from dropping during gait (trendelenburg gait)
26
What is the quads:ham ratio in how it supports the knee
-ideally 3:2
27
What is the quads:ham ration post ACL injury
-1:1
28
What is the full name for shin splints
-medial tibial stress syndrome (MTSS)
29
What is MTSS
-involves exercise-induces pain over the anterior tibia and is an early injury in the continuum of tibial stress fractures
30
What is compartment syndrome
-excessive pressure with a muscle/fascial compartment
31
Acute cause of compartment syndrome
-trauma -following a long bone fracture
32
Overuse cause of compartment syndrome
-often overlooked as shin splints
33
Signs and symptoms of compartment syndrome
-red -hot -shiny -very painful -numb -weak -faint pulse -distal to site
34
Acute management of compartment syndrome
-no pressure -reduce inflammation -no RTP -NWB -refer to sport doc -sometimes fasciotomy to release pressure
35
What causes gastroc/soleus strains
-overstretch in dorsiflexion with knee extension -forceful contraction
36
Signs and symptoms of gastroc/soleus strains
-pop -pull -sharp pain -swelling -bruising
37
Special tests for gastroc/soleus strains
-muscle test for gastroc, soleus, deep flexors -thompson test to rule out achilles rupture (toe raises)
38
Acute management of gastroc/soleus strain
-pressure, ice, elevation, rest (PIER) -pressure pad with wrap -no weight bearing -avoid stretch or contraction
39
Achilles rupture MOI
-sudden forceful contraction
39
Can an athlete play with gastroc/soleus strain
-no -once rehabbed can tape with heel lift
40
What sport is achillles rupture common in
-stop and go sports -basketball -tennis -squash
40
Signs and symptoms of achilles rupture
-sudden sharp pain -feel of being hit in back of leg -unable to go up on toes -swelling -delayed onset bruising
40
Patellofemoral pain (PFPS) syndrome MOI
-poor tracking of patella in femoral condyle
40
Special tests for achilles rupture
-thompson test -1 or 2 foot toe raise
41
Acute management of achilles tendon
-PIER -NWB -pressure pad over injured tissue -educate -refer to sports doc
42
Signs and symptoms of patellofemoral pain syndrome
-TOP post aspect of patella
43
What to check when looking at patellofemoral pain syndrome
-mechanics from bottom up and top down -stable base? -quad imbalance (static quad contraction) -1 leg squat, what happens?
43
What is patellofemoral pain syndrome most often caused from
-overuse
44
Patellar dislocation MOI
-valgus force with foot planted, causing internal rotation. of femur
45
What age is patellar dislocation most common in
-active children ages 10-17 years old
45
Signs and symptoms of patellar dislocation
-patella positioned on lateral side of knee -significant pain -pain with knee flexion
46
Special tests for dislocated patella
-none
47
Special tests for subluxed patella
-apprehension test
48
What do we need to rule out in 1st time patella dislocation
-osteochondral fracture
49
Acute management of patellar dislocation
-rule out fracture -PIER -refer
50
What is a subluxation
-partial dislocation -goes out and comes back in
51
Longer term management of patellar dislocation
-braced in full extension for 3 weeks -ROM and strengthening
52
Patellar tendonitis MOI
-excessive traction on patellar tendon
53
Signs and symptoms of patellar tendonitis
-pain -swelling and heat over patellar tendon -pain with jumping, running, quick change of direction or strong quad contraction -pain with flexion and extension -can often train through pain
54
Special tests for patellar tendonitis
-thomas test -resisted quads
55
Acute management of patellar tendonitis
-PIER -roll/soft tissue mobility for quads -lower extremity mechanics
56
Tendinopathy rehab of patellar tendon
-eccentrics -x-training
57
Return to play taping for patellar tendonitis
-patellar tendonitis tape job
58
What is a bursa
-fluid-filled sacs -lay flat between areas of friction
59
Knee bursitis MOI
-direct trauma -friction from tight muscles/tendons
60
Signs and symptoms of knee bursitis
-rebound pain -often painless -visible fluid filled sac
61
Acute management of knee bursitis
-protect with padding to avoid repeat insult -soft tissue mobility of tight muscles
62
What does the texture of chronic bursitis feel like
-granular, rice-like texture
63
Different types of fractures around knee/lower leg
-stress fractures -patellar fracture -tibial plateau fracture
64
What can stress fractures develop from
-medial tibial stress syndrome -shin splints
65
Patellar fracture MOI
-direct blow -patellar dislocation
66
Tibial plateau fracture (top of tibia) MOI
-varus or valgus load -direct blow
67
Function of meniscus
-cushion the joint during loading
68
Why does meniscus not heal itself well
-poor blood supply
69
Types of meniscus tears
-vertical -transverse -peripheral -bucket-handle -parrot beach -flap
70
What meniscus tears often cause clicking or catching in the knee
-bucket handle -flap
71
Meniscus tear MOI
-plant and twist -contact -wear and tear/degeneration
72
Signs and symptoms of mensicus tears
-sharp pain at specific ROM -pain with loaded rotation and deep squat -catching/clicking/locking -swelling
73
What are meniscus tears typically presented with
-ACL tears
74
Special tests for meniscus tears
-mcmurrays -apleys -duck walk
75
Acute management of meniscus tears
-PIER -NWB -educate -conservative treatment often first choice
76
When would a meniscus tear elicit a trip to emerge
-locking of the knee
77
Can an athlete return to play with meniscus tear
-no
78
Ligaments of the knee
-MCL -LCL -ACL -PCL
79
Where does the ACL run
-ant-med aspect of intercondylar area of tibial plateau -passes up and back to post-med aspect lateral femoral condyle
80
What are the 2 bundles of the ACL
-posterolateral -anteriomedial
81
Posterolateral bundles of ACL
-taught in extension with less than 30 degrees rotation
82
Anteromedial bundles of ACL
-taught going into flexion and with rotation
83
What does the ACL prevent
-prevents anterior translation of the tibia on femur and limits internal rotation of tibia
84
What is the ACL
-major stabilizer of the knee -major proprioceptor
85
ACL tear MOI
-sudden cut or pivot (rotational force) -sometimes from added external force from a tackle/collision
86
Signs and symptoms of ACL tear
-swelling -extreme pain -difficulty/unable to WB -delayed onset bruising
87
Which gender has a higher incidence of ACL tears
-females -larger quadriceps angle
88
What are 30% of ACL tears from
-direct contact
89
What are 70% of ACL tears from
-wrong movement
90
Special tests for ACL tears
-anterior drawer -lachmans -pivot shift
91
Acute management of ACL tears
-PIER -NWB -educate
92
Types of ACL surgery
-autograft (persons tissues) vs allograft (cadaver) -bone-tendon-bone graft -hamstring graft -BEAR (new technique)
93
Where does the PCL run
-ant-lat aspect of med femoral condyle within the notch -inserts along post aspect of tibial plateau
94
PCL tear MOI
-hyperflexion -forced post translation of tibia on femur
95
Signs and symptoms of PCL tear
-swelling -extreme pain -difficulty/unable to WB -delayed onset bruising
96
Special tests for PCL tear
-posterior drawer -sag sign
97
Acute management of PCL tear
-PIER -NWB -educate
98
What are the different types of MCL fibres
-superficial and deep
99
What are MCL commonly associated with
-ACL injuries
100
MCL MOI
-valgus stress on the knee (outside of knee) -plant and twist
101
Treadmill test for MCL tear
-valgus stress
102
Acute management of MCL tear
-PIER -NWB -pressure pad to approx ends
103
LCL tear MOI
-varus stress to knee
104
Signs and symptoms of LCL tear
-lateral knee pain and swelling -TOP -stiffness
105
Special test for LCL tear
-varus stress
106
Acute management for LCL tear
-PIER -NWB -pressure pad to approximate ends

KNPE 331 (12 decks)

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