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Ortho 1 > The Knee > Flashcards

The Knee Flashcards

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0
Q

flexors of the knee include (5)

A

sartorius, gracilis, hamstrings, popliteus, gastrocnemius

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1
Q

quads contract through ..

A

the patella

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2
Q

popliteus main function:

A

unlocks the knee (laterally rotates the femur on the tibia in CKC)

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3
Q

arcuate ligament is used for ..

A

rotary instability

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4
Q

anterior knee pain could be indicative of.. (7)

A

Patellar subluxation, Osgood-schlatter’s, PFPS, jumper’s knee (patellar tendonitis), Pre-patellar bursitis, patellar arthritis, chondromalacia of the patella

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5
Q

Medial knee pain could be due to.. (5)

A

MCL sprain, pes anserine bursitis, plica syndrome, saphenous neuritis, medial meniscal tear

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6
Q

lateral knee pain could be due to.. (4)

A

LCL sprain, ITB friction syndrome, lateral meniscal tear, peroneal nerve compression

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7
Q

posterior knee pain could be due to.. (2)

A

PCL tear, Baker’s cyst

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8
Q

what is an adverse affect of cortizone injections on joints?

A

weakens the strength of cartilage

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9
Q

which meniscus is MORE MOBILE?

A

lateral

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10
Q

Meniscal functions (Primary -3, secondary - 3)

A

Primary – load distribution, shock absorption, & joint stability
Secondary – joint lubrication, articular cartilage nutrition & proprioceptive feedback

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11
Q

articular cartilage function =?

A

decreases friction at the end of long bones

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12
Q

which type of knee surgery is associated with increased incidence of OA later in life?

A

Menisectomy

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13
Q

Does articular cartilage have a vascular supply or nervous supply?

A

no - avascular & lacks nerve supply

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14
Q

pronation causes ____ stress on the knee

A

valgus stress

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15
Q

Are the ACL/PCL part of the synovium of the knee?

A

NO - intra-articular but EXTRA synovial

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16
Q

When is the anteromedial bundle of the ACL loose/taut?

A

loose in extension/taut in flexion

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17
Q

the ACL’s posterolateral bundle is loose/taut in which motions?

A

loose in flexion/taut in extension

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18
Q

PCL v ACL

A

PCL - 2x as strong & thick

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19
Q

If you have a grade 3 tear of the ACL, what situation would make it feasible for surgery to NOT be required?

A

If the accessory ligaments are intact

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20
Q

AL bundle of PCL

A

65% of ligament; taut in flexion/loose in ext

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21
Q

PM bundle of PCL :

A

35% of ligament; taut in ext/loose in flexion

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22
Q

LCL origin and insertion

A

origin: lateral femoral epicondyle; insertion: head of fibula

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23
Q

the LCL is taut in (ext or flexion?), resists (varus or valgus) stress, & resists what tibial motion? ALSO a secondary restraint to …

A

LCL taut in EXT, resists VARUS stress, resists ER of TIBIA; also SECONDARY restraint to Ant/Post translation

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24
MCL origin & insertion =
``` Origin = medial femoral epicondyle, Insertion = medial tibia ```
25
MCL is taut in (ext/flex), resists (valgus/varus) stress & resists ____ of the tibia; SECONDARY restraint to ____?
MCL taut in EXT, resists VALGUS stress, resists ER of the TIBIA; secondary restraint to ANT/POST TRANSLATION
26
LCL vs MCL:
MCL is thicker, less mobile & MORE OFTEN INJURED
27
4 plica syndromes
1. Mediopatellar 2. Suprapatellar 3. lateral synovial patella 4. Infrapatellar - pinch femoral condyle/patella - INFLAMMATION
28
the SCREW-HOME mechanism of femur on tibial extension is...
LATERAL rotation of the femur on the tibia to lock the knee
29
NORMAL ROM for flexion: | " " ext:
flexion: 135-140 deg ext: 0 (could have 5-10 deg hyperext)
30
CPP of the tibiofemoral jt:
full ext w ER
31
Loose packed position of tibiofemoral jt:
25 deg flexion
32
capsular patter of the tibiofemoral jt:
flexion more limited v ext
33
IF pt has a range of -5 - 105 deg, thinking...
capsular pattern (i.e. OA, etc)
34
IF your patient presents with 5-140 ROM, you're thinking..
NON-capsular pattern (i.e. soft tissue tightness, internal derangement of meniscus, etc)
35
patellar movement with ext/flexion
patella moves superiorly with ext
36
Patellar Jt Rxn force increases with...
ext in OKC, flexion in CKC
37
normal quadriceps angle
males: 8-14 deg females: 15-17 deg
38
when is patellar loading the greatest with WB ADLs? (rank descending stairs, climbing stairs, walking and squatting least to greatest)
LEAST --> GREATEST: walking, climbing stairs, descending stairs, squatting
39
how many deg of flexion do you need from the patella during gait?
21 deg -- stance phase, 67 deg - swing
40
how many deg of flex do you need for stair climbing? sitting & rising?
87/83 deg
41
if a pt complains of clicking/grinding/popping, you're thinking (acute or chronic injury)?
more CHRONIC
42
if a pt c/o knee LOCKING, you may think..
meniscal tear (chronic injury not acute)
43
3 common overuse knee injuries:
tendonitis, bursitis & PF syndrome
44
IF MOI is varus/valgus w/o rotation:
MCL, LCL, patellar dislocation, epiphyseal fx
45
If MOI is varus/valgus WITH rotation:
MCL/LCL & ACL/PCL, Meniscus, MCL/LCL + patellar dislocation
46
IF pt has pain w prolonged sitting OR descending stairs (no traumatic, sudden onset)...
PF jt dysfxn
47
If MOI is AP force w knee flexed OR fall on flexed knee w foot in DF
osteochondral fx
48
if MOI is A/P blow w knee flexed OR fall on flexed knee w foot in PF...
PCL injury most likely
49
If MOI is contact hyperextension
either ACL or PCL are probable but PCL x2 as strong/thick
50
if MOI is NON-contact hyperext, the most likely involved structure is...
ACL
51
if the MOI is non-contact decel, the most likely involved structure is
ACL
52
patellar subluxation has a (sudden or gradual?) onset of pain
sudden/traumatic onset
53
if MOI is non-contact rotational w/ compressive loading, ____ are possibly involved
meniscus, osteochondral fx
54
hyperflexion could involve:
meniscus or ACL (possibly AL bundle of PCL)
55
what are the OTTAWA KNEE RULES (to determine whether or not an x-ray of the knee is needed)?
1. pt. > 55 y.o. 2. fibular head tenderness 3. patella tenderness 4. inability to flex knee >90 deg 5. inability to bear wt and walk 4 steps when examined AND at time of injury
56
ANA profile is a blood test for...
SLE (Lupus)
57
If you are concerned about a systemic infection, you can refer out for a ____ (to check out ____)
Arthrocentesis to check synovial fluid
58
the fxnl outcome scale used for ligamentous & meniscal injuriees is ..
Lysholm Knee scale
59
The fxnl outcome scale used for knee ligamentous injuries is
internat'l knee documentation knee questionnaire
60
Fick angle is a measure of..
tibial torsion
61
if your pt. presents w abnormal swelling posteriorly, suspicious of..
Baker's cyst
62
Hoffa's syndrome is due to..
an enlarged fat pad
63
an enlarged tibial tubercle is most likely due to
Osgood-Schlatter's disease
64
should assess the patellofemoral jt at ____ deg of flexion
0-20 deg of flexion
65
how much play should you expect from the patella?
1/2 width
66
spontaneous healing could be expected in these types of meniscal tears (3)
short vertical, partial thickness & small radial meniscal tears
67
when would you expect to have pain-free gait, fxnl mobility & ADLs for a meniscal tx? what about non-palpable edema? expect full ROM in...
8-12 wks; 4 weeks ; full ROM 4-6 wks
68
with Skippy's, pt. is limited in ... (hip motions)
IR & flexion (refer immed, NWB)

Ortho 1 (3 decks)

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