The Knee Part 2: Exam 3 Flashcards Preview

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Flashcards in The Knee Part 2: Exam 3 Deck (63):
1

Where can knee injuries occur?

-ligament
-muscles
-tendons
-cartilage (meniscus and articular)

2

What does a MCL sprain result from?

Severe blow from the lateral side or a valgus force

3

Symptoms of a grade 1 MCL sprain

-stability valgus stress test (no laxity)
-little or no swelling
-some joint stiffness and point tenderness on medial aspect
-relatively normal ROM

4

Grade 1 MCL sprain

Ligament stretching but no tear

5

Management of grade 1 MCL sprain

-RICE for at least 24 hours
-crutches if necessary
-relatively quick strengthening progression

6

Limiting factor in strength progression of grade 1 MCL sprain

Pain

7

How long is the recovery time for grade 1 MCL sprain?

About 2-3 weeks

8

Grade 2 MCL sprain

Partial tear

9

Symptoms of grade 2 MCL sprain

-no gross instability (slight laxity)
-slight swelling
-joint tenderness with decreased ROM
-pain along medial side of the knee

10

Management of Grade 2 MCL sprain

-RICE and modified weight bearing in acute phase
-hinged knee brace
-modalities for pain
-gradual strength progression

11

What type of strength progression should be used in a grade 2 MCL sprain?

Close chain activities

12

Grade 3 MCL sprain

Complete tear of supporting ligaments

13

Symptoms of grade 3 MCL sprain

-complete loss of medial stability
-minimum to moderate swelling
-immediate pain followed by ache
-loss of motion due to effusion and hamstring guarding
-positive valgus stress test

14

management of grade 3 MCL sprain

-RICE
-Conservative non-operative vs surgical approach
-limited immobilization
-rehab similar to grade 1 and 2 but slower

15

How long should progressive weight bearing and increased ROM take in grade 3 MCL sprain?

Over 4-6 week period

16

What causes LCL sprain?

Varus force

17

Symptoms of LCL sprain

-pain and tenderness over LCL
-Swelling over LCL
Joint laxity with varus testing

18

Management of LCL sprain

Similar to MCL

19

What causes a contact ACL sprain?

valgus force with externally rotated tibia or hyperextension

20

What causes a non-contact ACL sprain?

Deceleration with rotational component
-jump landing strategies

21

What has there been extensive research on regarding the ACL?

Impact of femoral notch, ACL size and baseline laxity, malalignments, and faulty biomechanics

22

do males or females have a valgus angle more often?

Female

23

Symptoms of ACL sprain

-pop with severe pain and disability
-positive anterior drawer and Lachmans
-rapid swelling at the joint line

24

Management of ACL sprain

-RICE
-crutches
-could lead to major instability

25

How long is rehab for ACL sprain?

4-6 months

26

What does ACL surgery involve?

Joint reconstruction with grafts (tendon) transplantation of external structures

27

What can lack of stability in ACL lead to if not corrected?

Degeneration of cartilage and arthritic changes

28

When are you most at risk for a PCL sprain?

During 90 degrees of flexion

29

What causes a PCL sprain?

Fall on bent knee, result of rotational force, car crash

30

Symptoms or PCL sprain

-feel a pop in back of knee
-tenderness and relatively little swelling in the popliteal fossa
-laxity with posterior sag test

31

Management of PCL sprain

-RICE

32

What should non-operative grade 1 and 2 PCL sprain rehab focus on?

Quad strength

33

Surgical PCL time frame

-6 week immobilization in extension with full weight bearing on crutch
-ROM after 6 weeks
-progressive resistance exercises at 4 months

34

What is the most common MOI in meniscal lesions?

Rotary force

35

Symptoms of meniscus tear

-swelling over 48-72 hours
-joint line pain and loss of motion
-intermittent locking and instability
-pain with squatting
-portions may become detached causing locking giving way or catching within the joint

36

Meniscal lesions management

-diagnostic testing
-preserve the meniscus
-full healing dependent on location

37

Menisectomy rehab

-partial weight bearing and quick return to activity

38

How long will rehab be for repaired meniscus?

Immobilization and gradual return to activity over 12 weeks

39

Osteochondral Knee fractures

Fractures of cartilage and underlying bone varying in size and depth

40

What causes osteochondral knee fractures?

Twisting, sudden cutting or direct blow

41

Symptoms of O knee fracture

-immediate swelling and considerable pain
-diffuse pain along the joint line

42

What can happen with swelling of O knee fracture?

Can turn chronic that increases following strenuous activity

43

What causes a patellar fracture?

Direct or indirect trauma
-semi flexed position with forcible contraction

44

Symptoms of patellar fracture

-swelling
-possible deformity
-little bone separation with direct injury

45

Management of patellar fracture

-x-ray for confirmation
-RICE and splinting
-refer and immobilize for 2-3 months

46

What causes patella subluxation or dislocation?

Deceleration with simultaneous cutting in opposite direction (valgus force at knee)

47

Acute patella subluxation or dislocation

Quad pulls patella out of alignment

48

Can people be predisposed to patella dislocation?

Yes

49

Symptoms of patella subluxation

Pain and swelling with restricted ROM and palpable tenderness

50

Symptoms of patella dislocation

-total loss of function until relocated
-potential articular surface damage to both bony surfaces

51

What is another name for patellar tendinitis?

Jumper or kickers knee

52

What causes patellar tendinitis?

Jumping or kicking
-sudden or repetitive extension

53

Symptoms of patellar tendinitis

-pain and tenderness at inferior pole of patella or insertion of tendon on tibia

54

What causes patellar tendon rupture?

Sudden, powerful quad contraction

55

Where does patellar tendon rupture occur?

Point of attachment

56

When does patellar tendon rupture occur?

-chronic inflammatory condition persists resulting in tissue degeneration

57

Symptoms of patellar tendon rupture

-palatable defect
-lack of knee extension
-considerable swelling and initial pain

58

Management of patellar tendon rupture

-surgery

59

What can minimize chances of patellar tendon rupture?

Proper and conservative care of jumpers knee

60

What causes knee dislocation?

Extreme force involved including contact or non contact

61

Why is knee dislocation a medical emergency?

Risk to neurovascualr structures

62

What structures are involved in knee dislocation?

-ligaments
-cartilage
-soft tissue

63

management of knee dislocation

-activate EMS
-check neurovascular status distall
-splint and transport