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KNPE331 > Week 6 > Flashcards

Week 6 Flashcards

(124 cards)

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1
Q

Anatomy of the knee joint

A
  • tibiofemoral joint
  • patellofemoral joint
  • superior tibiofibular joint
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2
Q

Compartments of the lower leg

A
  • lateral
  • anterior
  • posterior
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3
Q

Lateral compartment of the leg

A
  • peroneal group
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4
Q

Anterior compartment of the leg

A
  • extensor group
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5
Q

Posterior compartment of the leg

A
  • flexor group
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6
Q

What muscles make up anterior compartment of the leg?

A
  • tib anterior
  • extensor hallucis longus
  • extensor digitorum longus
  • fibularis tertius
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7
Q

Anatomy of the lower leg lateral compartment

A
  • peroneus (fibularis) longus
  • peroneus (fibularis) brevis
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8
Q

What muscles make up the deep posterior compartment of the lower leg- “deep plantarflexors”

A

Tom, Dick and Harry
- tib posterior
- flexor digitorum longus
- flexor hallucis longus

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9
Q

Role of the deep plantarflexors

A
  • dynamically help stabilize medial ankle
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10
Q

Superficial posterior compartment of the lower leg

A
  • gastrocnemius
  • soleus
  • achilles tendon
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11
Q

Intracapsular structures of the knee

A
  • anterior cruciate ligament
  • posterior cruciate ligament
  • lateral and medial meniscus
  • cartilage
  • joint surface
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12
Q

Why is it important to know which structres are intracapsular vs extracapsular?

A
  • inflammation caught under joint capsule
  • can help identify which structures are intracapsular
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13
Q

Special test for intracapsular swelling

A
  • wipe/swipe/sweep/brush test
  • swipe up on medial side of knee and then down on lateral side
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14
Q

How do you know if the wipe test is positive?

A
  • if fluid moving towards knee is visible
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15
Q

Medial meniscus

A
  • c shaped
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16
Q

Lateral meniscus

A
  • o shaped
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17
Q

What are the muscles of the quadriceps?

A
  • rectus femoris
  • vastus lateralis
  • vastus intermedius
  • vastus medialis
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18
Q

Functional anatomy and biomechanics of quads

A
  • 3 pull laterally
  • 1 pulls medially
  • natural imbalance
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19
Q
A
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20
Q

Which quad muscles have a lateral pull on the patella?

A
  • rectus fem
  • vastus lateralis
  • vastus intermedius
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21
Q

Which quad muscles have a medial pull on the patella?

A
  • vastus medialis
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22
Q

Medial hamstrings

A
  • semimembranosus
  • semiteninosus
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23
Q

Lateral hamstrings

A
  • biceps femoris
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24
Q

Pes anserine group function

A
  • dynamic stability to medial aspect of knee
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25
Muscles of pes anserine group
- semitendonosis - gracilis - sartorius
26
Functional anatomy and biomechanics of glute medius
- hip abduction - prevents pelvis on stance side from dropping during gait
27
Action of anterior fibres of gluteus medius
- internally rotate - assist with hip flexion
28
Action of posterior fibres of gluteus medius
- extension - external rotation - eccentrically controls internal rotation of femur in weight bearing
29
Trendelenburg gait
- sign of a weak glute medius
30
Quads:hams ideal ratio
3:2
31
Quads:hams ration post ACL injury
1:1
32
Medial tibial stress syndrome (MTSS)
- shin splints - exercise induced pain over the anterior tibia and is early stress injury in the continuum of tibial stress fractures
33
Compartment syndrome
- excessive pressure within a muscle/fascial compartment
34
Acute compartment syndrome
- trauma following a long bone fracture (ex. tibia- most common, distal radius)
35
Overuse compartment syndrome
- often overlooked as shin splints
36
SIgns and symptoms of compartment syndrome
- red - hot - shiny - very painful - numb - weak - faint pulse distal to site - pale skin over damaged tissue
37
Acute management of compartment syndrome
- no pressure - reduce inflam - no RTP - NWB - refer to sport med dr. - fasciotomy to release pressure
38
Where is compartment syndrome most common?
- anterior compartment
39
Gastroc/soleus strains
- overstretch in dorsiflexion with knee extension (gastrocs) especially with forceful contraction
40
Signs and symptoms of gastroc/soleus sprain
- pop or pull - sharp pain - swelling - bruising
41
Special tests for gastroc/soleus sprain
- muscle test for gastrocs, soleus, deep flexors - thompson test to rule out achilles rupture - toe raises
42
Acute management of gastroc/soleus strains
- PIER (pressure, ice, elevation, rest) - pressure pad with wrap - NWB - avoid stretch or contraction
43
RTP post gastroc/soleus strain?
- no, usually self limiting - once rehabbed can tape with heel lift for initial RTP
44
Achilles rupture MOI
- sudden forceful contraction
45
In which sports in an achilles rupture common?
- basketball - tennis - squash
46
Signs and symptoms of achilles rupture
- sudden sharp pain - feeling of being kicked in back of leg - unable to plantarflex - swelling - delayed onset bruising
47
Special tests for achilles rupture
- thompson test - two foot--> 1 ft toe raise
48
Acute management of achilles rupture
- PIER - NWB - pressure pad with tensor - educate - refer for consult with sports med dr.
49
Patellofemoral pain syndrome (PFPS) MOI
- poor tracking of patella in femoral condyle
50
Signs and symptoms of PFPS
- tenderness on palpation of posterior aspect of patella
51
What to check for when looking for PFPS?
- mechanics from bottom up and top down - stable base - quad imbalance (med vs lat pull? static quad contraction) - 1 leg squat (does femur collapse into IR?)
52
Sign that someone has PFPS when they perform a static quad contraction
- patella moves laterally
53
What type of injury is PFPS usually?
- most often overuse - occasional acute onset
54
Patellar dislocation MOI
- valgus force with foot planted, causing IR of femur
55
Who is a patellar dislocation most common in?
- active children ages 10-17
56
Signs and symptoms of patellar dislocation
- patella positioned on lat side of knee - significant pain, usually in knee flexion
57
Patellar dislocation vs subluxation
- dislocation: goes out and stays out - subluxation: goes out and comes back in
58
Special tests for patellar dislocation
- non if dislocated - subluxed= apprehension test
59
What needs to be ruled out if someone has a first time patellar dislocation?
- osteochondral fracture
60
Osteochondral fracture
- can affect patella or femoral condyle - occurs in 25-75% of cases and requires surgical intervention
61
Acute management of patellar dislocation
- r/o fracture - PIER if reduced - refer - braced in full extension for 3 wks - ROM and VMO (vastus medialis oblique) strengthening
62
Patellar tendonitis MOI
- excessive traction on patellar tendon
63
Signs and symptoms of patellar tendonitis
- pain - swelling - heat - pain with jumping, running, quick COD, strong quad contraction - pain with flexion and extension - can often train through the pain
64
Special tests for patellar tendonitis
- thomas test - resisted quads
65
Acute management for patellar tendonitis
- PIER - roll/soft tissue mobility for quads - lower extremity mechanics
66
Tendinopathy rehab for patellar tendonitis
- eccentrics - x-training
67
RTP for patellar tendonitis
- patellar tendonitis tape job
68
Bursas
- fluid filled sacs - lay flat btwn areas of friction
69
Knee bursitis MOI
- direct trauma - friction from tight muscles/tendons
70
Signs and symptoms of knee bursitis
- rebound pain - often painless - visible fluid filled sac
71
Acute management of knee bursitis
- protect with padding to avoid repeat insult - soft tissue mobility of tight muscles
72
What can chronic bursitis develop?
- granular rice-like texture
73
Fractures of knee and lower leg
- stress fractures - patellar fracture - tibial plateau fracture
74
Stress fracture of lower leg
- medial tibial stress syndrome/shin splints
75
Medial tibial stress syndrome/shin splints MOI
- overuse/poor mechanics
76
Patellar fracture MOI
- direct blow - patellar dislocation
77
Tibial plateau fracture MOI
- varus or valgus load - direct blow
78
Function of the meniscus
- cushion joint during loading - poor blood supply (low ability to heal)
79
Types of meniscus tears
- vertical - transverse - peripheral - bucket-handle - parrot break - flap
80
Meniscus tears MOI
- plant and twist - contact - wear and tear/degeneration
81
Signs and symptoms of meniscus tears
- sharp pain at specific ROM, loaded rotation and deep squat - catching/clicking/locking - swelling
82
What are meniscus tears often associated with?
- ACL injuries
83
Special tests for menisicus tears
- mcmurray's - apley's - duck wall
84
Acute management of meniscus tears
- PIER - NWB - educate
85
What is another condition that might present the same as a meniscus tear?
- plica - develops at birth
86
RTP post meniscus tear?
- no, need rehab
87
Is bracing effective for a meniscus tear?
- wont prevent another injury - can be effective to draw awareness to injury
88
When should athlete be referred when they have a meniscus tear?
- if there is locking
89
Which meniscus tear types get in the way of ROM?
- bucket-handle - flap
90
Ligament sprains of the knee
- MCL - LCL - ACL - PCL
91
Where does the ACL run?
- anterior to medial aspect of intercondylar area of tibial plateau - passes up and back to posterior-medial aspect of lateral femoral condyle
92
Two bundles of the ACL
- posterolateral - anteromedial
93
Posterolateral bundle of ACL
- taught in extension with <30 degree rotation
94
Anteromedial bundle of ACL
- taught going into flexion and with rotation
95
Function of the ACL
- prevents anterior translation of tibia on femur - limits IR if tibia - major stabilizer of knee - major proprioceptors
96
ACL MOI
- sudden cut or pivot (rotational force) - added external force from a tackle/collision (valgus, hyperextension)
97
Signs and symptoms of ACL
- swelling - extreme pain - difficulty/unable to WB - delayed onset bruising
98
Incidence of ACL
- higher in females bc females have a larger Q angle (quad angle) - 30% from direct contact - 70% from wrong movement
99
Special tests for ACL
- anterior drawer - lachman's - pivot shift
100
Acute management of ACL
- PIER - NWB - educate
101
Types of ACL surgery
- autograft (person's tissues) vs allograft (cadaver) - bone-tendon-bone graft - hamstring graft - unilateral vs contralateral - BEAR
102
BEAR
- bridge enhanced ACL repair - new technique
103
RTP post ACL?
- no
104
Where does thew PCL run?
- from anterior-lateral aspect of medial femoral condyle within the notch - inserts along posterior aspect of tibial plateau
105
PCL MOI
- hyperflexion - forced post translation of tibia on femur
106
Signs and symptoms of PCL
- swelling -extreme pain - difficulty/unable to WB - delayed onset bruising
107
Special tests for PCL
- posterior drawer - sag sign
108
Acute management of PCL
- PIER - NWB - educate
109
Fibres of MCL
- superficial and deep
110
What injury is MCL injury associated with?
- ACL
111
MOI of MCL
- valgus stress on knee (direct blow on outside of knee) - plant and twist (lat rotation of femur on tibia)
112
Special test for MCL
- valgus stress
113
Acute management of MCL
- PIER - NWB - pressure pad to approx ends
114
LCL MOI
- varus stress to knee
115
Signs and symptoms of LCL
- lateral knee pain and swelling - tenderness on palpation of LCL - stiffness
116
Special test for LCL
- varus stress
117
Acute management of LCL
- PIER - NWB - pressure pad to approx ends
118
Which ligaments are more commonly repaired?
- ACL not collateral ligaments
119
Knee special tests summary
- wipe test--> intracapsular swelling - valgus at 0 degrees (superficial fibres) and 30 degrees (deep fibres)--> MCL - varus at 0 degrees--> LCL - Lauchman's-> ACL - anterior drawer--> ACL - posterior drawer--> PCL - mcmurray's--> meniscus - apley's--> meniscus and ligamentous
120
Indications of resisted muscle testing of tibialis posterior
- medial ankle sprain mechanism - posterior shin splints
121
Indications of resisted muscle testing of tibialis anterior
- anterior shin splints - excessive PF mechanism
122
Indications of resisted muscle testing peroneals
- suspected peroneal strain or tendonitis
123
What does a positive thompson test look like?
- no plantarflexion = complete achilles rupture
124
What does a negative thompson test look like?
- plantarflexion occurs - then do double heel raise in weightbearing - then single heel raise

KNPE331 (12 decks)

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