MSK System

Question 1

What does wasting of the muscle suggest?

Answer 1

due to:

- disuse, due to chronic pain movement (arthritis)

Question 2

What does muscle atrophy suggest?

Answer 2

Lower Motor Nuerones

Question 3

What is the term for ‘knock knees’?

Answer 3

• valgus

- valgum

Question 4

What is the term for ‘bow-legged’?

Answer 4

• varus

- varum

Question 5

How do assess for the temperature?

Answer 5

• use the back of your hands
• above, on, and below the patellar
• comparing both legs at the same time

Question 6

What does warm knees suggest?

Answer 6

Inflammatory conditions

• osteoarthritis
• septic arthritis

Question 7

What is the impact of septic arthritis?

Answer 7

irreparable damage to the joint

Question 8

Where do you palpate when assessing the knee?

Answer 8

• around the patella

- medial and lateral joint lines

Question 9

Where should you palpate in order to assess for meniscal damage?

Answer 9

• tibial tuberosity and the head of the fibula

- popliteal fossa

Question 10

What does swelling in the popliteal fossa?

Answer 10

Baker’s Cyst

Question 11

What is an effusion?

Answer 11

excess of synovial fluid

Question 12

What can cause an effusion?

Answer 12

• arthritis

- damage to the internal structures of the knee (eg meniscus)

Question 13

Where does the synovial capsule of the knee extend to?

Answer 13

deep into the quadriceps muscles

supratellar pouch

Question 14

What is the tap method?

Answer 14

• ensure the knee is extended
• slide hand down the thigh to empty the suprapatellar pouch
• press over the patella

Question 15

What will you feel in an effusion with the tap method?

Answer 15

feel a tap as the patella hits the femur

Question 16

When do you use the tap method?

Answer 16

moderate to severe effusions

Question 17

When do you use the sweep method?

Answer 17

small effusions

Question 18

What the sweep method?

Answer 18

• ensure the knee is extended
• sweep upward on the medial side to empty the medial compartment
• sweep downward on lateral side to empty the lateral compartment

Question 19

What will you see if an effusion is present with the sweep method?

Answer 19

a ripple or bulge of fluid on the medial side of the knee from the lateral compartment

Question 20

What muscles are involved in knee flexion?

Answer 20

Hamstring muscles:

• biceps femoris
• semitendinosis
• semimembranosus and gracilis

Question 21

What muscles are involved in knee extension?

Answer 21

Quadriceps muscles:

• Vastus medius
• Vastus lateralis
• Vastus intermedius
• Rectus femoris

Question 22

What is the result of the damage to the muscles involved in knee extension?

Answer 22

inability to straight leg raise

Question 23

How do you assess the active movement of the knee?

Answer 23

• ask patient to flex and extend

- assess for pain and ROM

Question 24

What does pain on active movement suggest?

Answer 24

damage to the structures, fracture of the meniscus

Question 25

What does reduced ROM on active movement suggest?

Answer 25

arthritis

Question 26

How do you assess the extensor compartment?

Answer 26

- lifting the foot with the patients leg relaxed - look for hyperextension - up to 10 degrees of hypertension is normal

Question 27

How do you perform the anterior draw for the ACL?

Answer 27

- knee at 90 degrees - ensure that the hamstring is relaxed and look for posterior sag - hands behind the upper tibia and both thumbs over the tibial tuberosity - pull the tibia anteriorly

Question 28

What can cause a false-positive anterior drawer sign?

Answer 28

posterior sag, can be mistaked for ACL laxity

Question 29

What movement during the ACL drawer test suggests a rupture?

Answer 29

>1.5cm, suggests a: - ACL pathology - often associated with a medial ligament injury

Question 30

What do medial and collateral ligaments do?

Answer 30

the resist valgus and valrus stresses

Question 31

How do you assess the integrity of the Lateral Collateral Ligament?

Answer 31

- 30 degrees leg flexion - place hand on the medial aspect of the lower thigh - place hand on the lateral aspect of the upper calf with fingers over the lateral joint line - apply valgus (inward) stress

Question 32

How do you assess the integrity of the Medial Collateral Ligament?

Answer 32

30 degrees leg flexion - place hand on the lateral aspect of the lower thigh - place hand on the medial aspect of the upper calf with fingers over the lateral joint line - apply varus (outward) stress