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SCS > SCS Study Guide-Knee > Flashcards

SCS Study Guide-Knee Flashcards

1
Q

sartorius innervation

A

femoral

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2
Q

quad group innervation

A

femoral

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3
Q

biceps femoris innervation

A

sciatic

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4
Q

semitend/semimemb poploteus gasctoc and plantaris innervation

A

tibial

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5
Q

gracilis innervation

A

obtruator

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6
Q

what does a postiive valgus stress test mean

A

at 0 degrees: Torn MCL, possible ACL/PCLPMC
at 30 deg: torn MCL (check others too)

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7
Q

whta does a positive varus stress test mean

A

at 0 deg: torn LCL and possible ACL/PCL
at 30 deg: Torn LCL ( check others too for grade III)

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8
Q

positive anterior drawer meaning

A

at 0 deg: torn ACL
at 15 deg ER: torn PMC, ACL possible MCL
at 30 deg IR: Torn PLC and ACL

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9
Q

Lelli’s test or lever sign

A

torn ACL

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10
Q

pivot shift

A

torn ACL, ALC

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11
Q

solcum’s

A

torn ACL ALC

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12
Q

Jerk (Hughston) Torn

A

ACL, ALC

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13
Q

losee test

A

torn ACL, ALC

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14
Q

postrior drawer

A

torn pcl

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15
Q

ER recurvatum (tibial ER)

A

torn PCL, PLC

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16
Q

posterior sag sign

A

torn PCL

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17
Q

reverse pivot shift test

A

torn PCL

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18
Q

Mc Murrays’ in IR vs ER

A

IR: torn LM
ER: torn MM

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19
Q

Apelys’

A

torn MM

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20
Q

thessaly’s

A

torn MM and or LM

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21
Q

over ____% ACL tears are non contact

A

70

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22
Q

cause of ACL tear

A

deceleration, hyperextension, rotational movement
landing from a jump with minimally flexed knee, inc quad relative to HS can lead to excessive translation

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23
Q

signs for the best prognosis of an ACL-R

A

full ROM, decreased swelling, good leg control and excellent mental state

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24
Q

signs that a non-op/conservative will do well

A

single/crossovertriple or timed jumping 80% of affected
number of giving way during test less than 1
knee outcome survey of 80%
subjective global rating 60%

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25
Q

allograft advantages

A

decreased morbidity
preservation of knee ext/flex
decreased operation time
availability of larger grafts
decreased incidence of fibrosis

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26
Q

disadvantages of allografts

A

infection, slow healing/incomplete grafts
increased cost
tunnel enlargement
alteration of structural properties with steralization/storage

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27
Q

female ACL tears _____ x more likely

A

2.4-9.7

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28
Q

intrinsic factors that risk ACL tear

A

intercondylar notch size, ACL size, physcioloical laxity and hormonal fluctuations

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29
Q

extrinsic factors

A

kinematics, kinetics, muscle strength and activaiton

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30
Q

post op ACL-R when can you add gait training and bike

A

week 1-2

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31
Q

post op ACL-R when can you get ROM to 120, then full ROM

A

120 at 3 weeks, full by 4 weeks

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32
Q

post op ACL-R when can you partial squat to 30 adn when can you partial squat to 60

A

30: weeks 1-2
60: week 4-8

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33
Q

when is the graft state weakest

A

at 4-8 weeks

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34
Q

weeks 8-12 is when more intenser things start to happen such as….
what is a side effect of this stage

A

SLS to 60 degrees, SLS 60 sec, nearly equal quad girth,
PATELLAR TENDINOPAHTY HERE

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35
Q

hopping and jogging/running can start when, assuming what

A

at 12-16 weeks assuming hop testing was 80% uninvolved side

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36
Q

when can cutting and plyo start post op ACL-R

A

20 weeks

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37
Q

what are the criteria to begin plyo training post op ACL-R and what time

A

12 weeks, with normal gait, ROM, SLR, min swelling, SLS over 60 sec, SLS at 45 with no valgus

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38
Q

what are special considerations if a patient had a HS graft ACL-R

A

no active HS for 2 weeks, no OKC HS exercises for 4 weeks, delay HS ressitance to 12 weeks

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39
Q

in a normal PCL, the popliteus helps to do what

A

control ER, varus and posterior translation

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40
Q

MOI for PCL injury

A

trauma to prox tibia, fall on knee with PF foot, excessive hyperextension

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41
Q

what grades PCL are non-op and op

A

grades I and II are non op and grades III are op

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42
Q

PCL non-op protocol ROM first 3 weeks

A

initially, just 0-60, and in a brace with crutches, and squatting only to 45 (first week) than 60 weeks 2-3

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43
Q

when can you start running post PCL no op treatment

A

around 8-12 weeks if no pain, swelling, laxity and quad testing over 85%

44
Q

post op PCL general guidelines (4)

A
  1. no OCK exercises to start
  2. avoid posterior tibial translation
  3. resistance of hip resistance ABOVE KNEE
  4. more conservative protocol than ACL
45
Q

isolated PCL injury grade I or II management

A

protective WB and return in 2-4 weeks

46
Q

isloated grade III PCL injury treatment

A

splint in extension 2-4 weeks for non op

op: active and young folks, (older are non-op)

47
Q

how soon after combined PCL injury should you have surgery

A

2 weeks

48
Q

first week of PCL-R rehab considerations

A

locked in 0, with pillow behind tibia to reduce sag

49
Q

____ degress of extension is allowed to lack for ___ months following PCL-R

A

1o degrees

50
Q

jumping, running and RTS can happen when post op PCL-R

A

6 months

51
Q

post op PCL-R when can brace be unlocked for everything

A

6-8 weeks

52
Q

MCL and LCL fibers are tight in what

A

extension (lax in flexion)

53
Q

exam and imaging of MCL/PCL injury

A

tenderness joint line, laxity, rotational injury check ACL/PCL
varus/valgus testing and AP, lat, merchant views and a t2 MRI

54
Q

grades of MCL/LCL injuries

A

grade 1: tenderness at ligament, no opening, RTP 2 weeks

grade 2: 5-10mm opening at joint line, firm end point: 3-4 week RTP

grade 3: over 10 mm opening vague endpoint and 6+ weeks to return to

55
Q

when does an MCL/LCL injury need surgery

A

bony avulsion, tibial plateau fracture, crutiate ligament issues, or intra articular entrapment of a ligament

56
Q

is lateral or medial meniscus more mobile

A

laterali

57
Q

is anterior or postreior horn more mobile

A

anterior

58
Q

why are the posterior horn and medial meniscus more vulnerable

A

they are less mobile

59
Q

MOI/exam and treat of meniscus injury

A

contact, rotational movement, cut/pivot or degeneration
pin and stiffness, locking and catching, giving way
treatment: rehab, meiscectomy, meniscus repair

60
Q

what precautions does a meniscus repair have

A

limited WB and flexion

61
Q

first 3 weeks post op meniscus repair

A

brace locked at 0, ROM 0-90 and WBAT

62
Q

post op meniscus repair, strengthening and plyo can start when

A

6-10 weeks

63
Q

runing progression can start when post op meniscus repair

A

11-15 weeks

64
Q

if the postreior horn was repaired, what must you wait to do

A

HS exercises for 6 weeks

65
Q

patellar fracture cause, exam and treatment

A

indirect pull of patellar tendon when partially flexed knee, or a direct blow or fall
swelling, bone separation, x-ray, immob 2-3 months

66
Q

articular cartilage procedures of the knee, WB is begun when (unless what condition)

A

6 weeks (unless debridement )

67
Q

when can you add ROM and CKC post op articualr cartilage procedure

A

ROM ASAP and CKC at 6 weeks

68
Q

what is an OCD

A

partial or complete separation of articular cartilage from subchondral bone due to lack of blood flow

69
Q

where are OCD lesions more common, medial or lateral condyle

A

medial

70
Q

what view for knee OCD lesion

A

tunnel view

71
Q

signs and sxs of OCD lesion

A

clicking, locking, swelling

72
Q

what imaging view and special tests for dislocation

A

view: sunrise view
tessts: patellar apprehension and lateral glide test

73
Q

treatment for patella dislocation

A

relocation (with knee ext!) , then braced/splinted 6 weeks.

74
Q

segond fracture MOI,

A

avulsion of insertion at LCL, from excesssive IR and varus

75
Q

what are some patellar instabilities

A

patella sublux/disloc (acute or chronic)

76
Q

overuse knee injuries

A

patellar tendinopathy, Osgood Sclatters, SLJ

77
Q

what are some soft tissue lesions

A

ITB, plica, hoffa’disease, bursitis, MPFL

78
Q

hoffa’s disease

A

fat pad inflammation

79
Q

j-sign

A

lateral patella tracking when going from flex to ext

80
Q

patellar glide test

A

hypomobile is glides less than 1/4 patella

hypermobile if glides over 3/4 patella

81
Q

patellar tilt positive finding

A

no upward movement due to tight retinaculum

82
Q

basset sign

A

tenderness over medial epicondyle of femur

83
Q

sulcus sign

A

line down the medial and lateral walls of trochlea, >150 degrees (shallow) may have instability

84
Q

normal Q angle men and women

A

men 13
women 18

85
Q

what are the ottawa knee rules

A

trauma and age over 55, tenderness over patella and fibular head adn unable to flex over 90 degrees and unable to WB 4 steps

86
Q

AP views are best for seeing what at what angles

A

tibial plateau and
at 30 degrees flex: joint space narrowing

87
Q

lateral view with partial flexion can view

A

patella and joint effusion

88
Q

sunrise or merchant view can see

A

relationship between patella and femur

89
Q

tunnel view can see

A

tibial and femoral condyles

90
Q

what can cause a patella rupture

A

strong quad contraction in a fixed LE or a fall onto a partially flexed knee

91
Q

findings on exam of patella tendon rupture

A

inabiltiy to extend knee, inability to WB, effusion and instability

92
Q

first 2 weeks post op patella tendon rupture

A

TTWB in full extension brace, ROM 0-15 degrees and quad iso

93
Q

bracing ROM for post op patella tendon rupture repair

A

0-45 at 3 weeks
0-60 at 4 weeks
0-90 at 5 weeks
all WBAT

94
Q

when does full ROM and WB happen post patella tendon rupture

A

6 weeks

95
Q

when can CKC strengthening not beyond 70 happen

A

7 weeks

96
Q

agilit, plyo, running and sport interval training can start when post op patella tendon rupture repair

A

16-24 weeks

97
Q

oscgood schlatter

A

pain at attahcment of patellar tendon at tibial tuberosity

98
Q

larsen johansson

A

pain at inferior pole of patella

99
Q

exam of overuse in knee OSGS and SLJ

A

swelling, pain and point tenderness, pain with kneeling running and jumping

100
Q

treatment for knee overuse OSGS and SLJ

A

decreased ativity, isometrics strnetghening and ice

101
Q

patellar tendinitis is AKA
cause, exam and treatment

A

jumpers knee: jumping, kick, run will hurt.
pain at patella tendon, after/during/rest
ice patella tendon strap and friction massage

102
Q

runners knee AKA
cause, exam and treat

A

ITB friction syndrome
cause: repetitive overuse, structural abnormalities at foot (genu Varum and over pronated )
pain at lateral knee and (+) Ober’s test
orthotics, address structure, ice, WU and rest

103
Q

what biomechanical structural things at knee and ankle can cause runners/ITB friction syndrome

A

over pronation and varus

104
Q

peroneal nerve contusion
cause, exam and treatment

A

around the back of fibular head, direct contact
pain often radiating down anterior leg into the foot, numbness short time,
RICE, return when sxs go away and no weakness.

105
Q

bursitis in knee cause, exam and treatment

A

cause: prepatellar most common from kneeling
localized swelling (but not intra-articular) and you need to eliminate the cause (such as kneeling)

SCS (26 decks)

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