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545 > acl > Flashcards

acl Flashcards

1
Q

Origin insertion of ACL

A

A
runs Posterioly
inserts in External (lateral) condyle of femur

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2
Q

function of ACL

A

resist anterior translation of tib on femur
resist rotation of femur on tib

resist valgus
assist in screw home mechanism

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3
Q

mechanism of ACL injruy

A

70% non contact

between 0-30 deg flexion

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4
Q

can ACL injury happen from excessive hyper flexion and extention

A

yes

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5
Q

T/f ACL is most frequent totally disrupted ligament in KNEE

A

true

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6
Q

Why higher in females

A

intrinsic

Extrinsic factors

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7
Q

Extrinsic factors

A

ligament dominance,
supporting mm don’t absorb GRF,
quad dominant,
stiff landing posture

leg dominance

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8
Q

intrinsic

A

anatomy
limb posture
joint laxity
size of indracondyal notch

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9
Q

which leg at greater risk for ACL

A

the unfavoured leg

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10
Q

diagnosing ACL

A

history
observation
special tests

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11
Q

what in history makes you think ACL

A

pain
unable to play on
swelling, when and how much
instability

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12
Q

condition that accompany an ACL

A

mensical damage
capsular damage
secondary ligament
fracture

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13
Q

Is surgery best

A

we don’t know whats best long term

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14
Q

first thing after ACL

A

get quad strength pre op
increase load
open chain

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15
Q

name 2 types of ACL surgeries

A

semitendinosus - gracillis

bone-patellar tendon - bone

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16
Q

sequences of events in graft healing

A

avascular necrosis
cellular infiltration
vascular invasion
remodelling (1-3 years)

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17
Q

potential ACL surgery complications

A 
pain/swelling
loss of ROM
laxity
nerve injury
infection
DVT
18
Q

two elements of proprioception

A

joint position sense

sense of limb movement

19
Q

what provides proprioception

A

mechaoreceptors
nociceptors
mm afferents

20
Q

t/F acl has proprioceptive properties and is a mechanical stabilizer

A

t

21
Q

whats a major factor in ACL injury / re injury risk

A

poor control of dynamic movements

22
Q

t/f deficits in uninjured leg post op has similar deficits

A

t

23
Q

goal of ACL patients

A

inc unconscious motor response
improve nervous systems optimal mm firing for stability

unlearn some movements

24
Q

if ACL left untreated what are some deficits

A

mm weakness

impaired neurological control

25
Q

how to increase demand in ACL exercises

A

add internal and external perturbation

26
Q

stages in post op ACL

A 
pre op
immediate post op (1week)
early rehab (2-4)
inter rehab (4-10)
advanced activity (10-16)
Return to activity (16-22)
27
Q

do isometric hamstring exercise >60 degs endanger the graft

A

no

28
Q

which exercise results in more axial orientated forces and mm co contraction

A

closed k chain

29
Q

when is graft week

A

6-12 weeks

30
Q

goals in pre op phase

A

reduce swelling pain
ROM
mm activity
eduation

31
Q

immediate post op goals

A 
extention
swelling / pain
flexion
quad control 
ind ambulating
hamstring strength to 8-%
32
Q

when should ACL have 90 deg flexion by

A

day 5

and 100 by 7

33
Q

goal of early post op

A 
ext 
swelling pain
flexion
proprioception
patellar mobility
hamstring back to full
34
Q

which phase should hamstring be back to full strength

A

early post op week 2-4

35
Q

intermediate post op goals

A 
ROM
LE strength
proprioception, banche, control
mm endurance
limb confidence
36
Q

is there a role for open chain quad strengthening

A

yes - more quad stretch and RTS but no difference in lax

37
Q

how to avoid undue stress on healing graft

A

limit knee rom from 90-45 deg for any NWB exercise

progress to 90-10 deg by week 12

38
Q

advanced activity phase

A 
LE 
prop, balance
power , endruace
sport specific 
hop test
39
Q

where should the hop test bee by week 12

A

> 85%

40
Q

Return to activity phase

A

unrestricted in sport

progress training

41
Q

why do we care if the meniscus was repaired

A

more post op restriction

i.e. limited in ROM in WB

545 (34 decks)

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