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EEO Final > 11. Knee > Flashcards

11. Knee Flashcards

1
Q

What are the self-report measures for the knee?

A

AIMS
WOMAC
LEAP
LEFS
LEAS
Lysholm Knee Scale
Tegner Activity Scale
Knee OA Outcome Scale (KOOS)

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2
Q

Which 2 Self-Report Measures are for ACL?

A

Lysholm Knee Scale
Tegner Activity Scale

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3
Q

What are the performance measures for Knee patients?

A

Wall Sit Test
8” step down test
LE agility test
Hop Tests (4)
Vertical Jump
LQ Y-balance test

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4
Q

What type of joint is the knee? How many DoF in the knee?

A

Hinge Joint
2 DoF
- flexion/extension
- IR/ER

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5
Q

The knee is strongly affected by mechanics of ___ and ______

A

Hip
Foot/Ankle

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6
Q

4 important nerves at knee?

A

Femoral –> Saphenous
Fibular x 3
Sural Nerve
Tibial Nerve

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7
Q

T/F: Tibial Nerve runs posterolateral and Sural Nerve runs posteromedial.

A

False

Tibial N. runs along tibia which is posteromedial and Sural runs posterolateral

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8
Q

What plane is the Tibiofemoral angle measured in?

A

Frontal plane

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9
Q

How do you measure the Tibiofemoral Angle?

A

Angle between longitudinal axes of femoral shaft and tibial shaft

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10
Q

Normal Tibiofemoral Angle?

A

165-175 degrees

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11
Q

Genu Valgum Angle

A

<165 degrees

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12
Q

Genu Varum Angle

A

> 175 degrees

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13
Q

Do you measure Tibiofemoral angle medially or laterally?

A

Laterally

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14
Q

How do you measure Q-Angle?

A

Line from ASIS to midpatella, line from central patella to tibial tuberosity

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15
Q

Flexed knee: what is tight?

A

Hamstrings
Hip flexors

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16
Q

What is normal Q Angle?

A

10-15 degrees
(females > males)

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17
Q

What is the malignant Q angle?

A

> 20 degrees

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18
Q

Increased Q angle increases risk for _________

A

Lateral Patellar subluxation

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19
Q

Possible causes of > Q angle?

A

Genu valgum
Excessive femoral anteversion
Tibial ER

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20
Q

What does Genu Valgum lead to?

A

Overpronation of foot
Longer Leg
ER of tibia
OA of Lateral knee compartment

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21
Q

Who might you see Genu Valgum for a period of time?

A

Children

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22
Q

What does Genu Varum lead to?

A

Supination of foot
Shorter Leg
IR of tibia
OA of Medial Knee

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23
Q

Who is your classic TKA Patient?

A

Genu Varum

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24
Q

What defines Genu Recurvatum?

A

Knee Hyperextension past 5 degrees

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25
Q

What are possible causes of Genu Recurvatum?

A
  • Anterior Pelvic Tilt
  • Quad weakness
  • Gastroc/soleus weakness
  • Ankle PF contracture OR DF restriction
  • Global ligamentous laxity
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26
Q

What does Genu Recurvatum result in?

A
  • Anterior tibiofemoral compression
  • Posterior knee laxity
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27
Q

What are knee flexion contracture causes?

A
  • Immobilization
  • Prolonged wheelchair use
  • sleeping with pillows under knees
  • Capsular adhesions
  • Abnormal hamstring tone
28
Q

What do knee flexion contracture result in?

A
  • excessive patellofemoral compression
  • over-worked quads and triceps surae
  • Loss of hip extension
  • Abnormal gait pattern
29
Q

What are hip flexion contracture causes?

A
  • Immobilization
  • prolonged wheelchair use
  • sleeping with LEs elevated
  • Capsular adhesions
  • Transtibial or transfemoral amputation
  • Abnormal hip flexor tone
30
Q

What do hip flexion contractures result in?

A
  • Excessive lumbar compression
  • Overactive erector spinae
  • Loss of hip extension
  • Abnormal gait pattern
31
Q

You are evaluating a 63-year-old female patient and she only has 93 degrees of knee flexion. Which of the following activities will she be limited from doing?

A. Safely climb stairs
B. Safely descend stairs
C. Riding a bike
D. Walking

A

C. Riding a bike

Note: Requires 115 degrees knee flexion

32
Q

Full knee flexion = ____ degrees (KF= knee flexion)

A

140 degrees

33
Q

Ride a bike = ____ degrees KF

A

115

34
Q

Get up from a chair = _____ degrees KF

A

105

35
Q

Safely descend stairs = ____ degrees KF

A

90

36
Q

Safely climb stairs = ____ degrees KF

A

83

37
Q

Walking = ___ degrees KF

A

60-70

38
Q

Normal documentation of knee flexion –> hypertextension

A

5-0-140
5 hyper extension
0 normal
140 flexion

39
Q

knee end feels

A

flex=soft
extend=firm

40
Q

capsular end feel of knee

A

ext > flex

41
Q

causes of Patellofemoral Pain syndrome (PFPS/PFS)

A
  • Trauma: excessive compression to anterior knee
  • Microtrauma: patellar maltracking
42
Q

Patellofemoral Pain syndrome pt presentation

A
  • Anterior knee pain
  • Grinding clicking
  • Peripatellar swelling
  • Pain with patellar compression & quad activation
  • Anterior knee pain with squatting
  • Pain with descending stairs!
43
Q

PFPS Outcome measures

A

Kujala Anterior Knee pain scale (AKPS)
SLB
SLS
8” step down test

44
Q

PFPS Tests and Measures

A

Posture - standing
Gait
ROM: knee flex/ext - pain!
MMT
Ober/Thomas
Foot - posture/arch

45
Q

Patellar Tendonitis “Jumper’s Knee” Causes

A
  • Overuse/overload of patellar tendon
  • Repetitive landing on hard surfaces with poor mechanics
46
Q

Patellar Tendonitis “Jumper’s Knee” pt presentation

A
  • Anterior knee pain
  • Infrapatellar pain
  • Possible delayed swelling in knee
  • Tenderness at patellar tendon, “gritty”
  • Pain with ascending stairs!
47
Q

IT Band Syndrome Causes

A
  • Overuse/overtraining of lateral knee
  • postural deviations
  • biomechanical issues from prox/distal jts
48
Q

IT Band Syndrome pt presentation

A
  • Tight TFL, IT Band, piriformis
  • Weak Glute max/med
  • Positive Obers Test
49
Q

IT Band Syndrome Outcome measures

A

LEFS
LEAS
LEAP

50
Q

Meniscal Tears Causes

A
  • Trauma: torsional, particularly in WB
  • Microtrauma: anything –> degenerative changes
51
Q

Meniscal Tears pt presentation

A
  • Popping, clicking, locking * Delayed swelling in the knee
  • Tenderness at the joint line
52
Q

ACL Tear Causes

A
  • Rapid direction change on planted foot or sudden stop
  • Incorrect biomechanics with landing from jump
  • Medially directed blow to knee
  • Non-contact/contact
53
Q

ACL Tear pt presentation

A
  • rapid swelling in knee joint
  • decreased quad activation
  • feeling of knee “giving way”
54
Q

ACL Outcome measures

A
  • Tegner Activity scale
  • Lysholm Scale
  • 8” step down
  • YBT
  • Hop Test
55
Q

PCL Tear Causes

A
  • MVA/dashboard injuries
  • athletic hyperextension injuries
56
Q

PCL Tear pt presentation

A
  • immediate knee swelling
  • feeling of instability
  • usually not injured in isolation cuz of forceful trauma
57
Q

MCL tear causes

A
  • VALGUS hit to knee
  • forceful tibial ER
58
Q

MCL tear pt presentation

A
  • swelling
  • pain
  • knee giving way medially
59
Q

MCL fun fact!

A

MCL can heal on its own in 6 weeks

60
Q

LCL tear causes

rare injury in isolation

A
  • forceful VARUS force to knee
  • forceful tibial ER
61
Q

LCL tear pt presentation

A
  • swelling
  • pain
  • feeling unstable
  • may have numbness/tingling due to stretch of fibular nerve
62
Q

Knee OA causes

A
  • genu varum/valgum
  • obesity
  • female >male
  • repetitive microtrauma at work
  • prior knee injuries
  • age
  • weak hip musculature
  • hereditary
63
Q

Knee OA findings

A
  • loss of knee ROM
  • knee flexion during stance
  • loss of hip ROM/strength
64
Q

TKA reasons

A
  • advanced OA
  • severe trauma
65
Q

TKA post op considerations

A
  • avoid knee twisting or crossing legs
  • priority: FULL EXT
  • WB restrictions
  • don’t allow gait deviations
66
Q

TKA Outcome measures

A

LEFS
KOOS
TUG w/ AD
10 MWT
Gait

EEO Final (14 decks)

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