Acute Knee Flashcards
1
Q
ACL injury
1. aggravates
2. ACL test
3. occurance
A
- ext of knee, int rot of knee (can also be ext rot)
- Lachman’s test: laying supine, leg abducted off table with thigh on but leg off, bend knee 20-30 deg flexion with foot between examiner’s leg, use one hand to steady femur and other hand compresses gastroc and put thumb on tibial tuberosity and pull ant in parallel dir of femur; working ACL should stop motion forward and feel firm
- Anterior drawer: laying supine, 90 deg knee flexion, hold femur down with one hand, other hand compresses gastroc and put thumb on tibial tuberosity and pull ant in parallel dir of femur; working ACL should stop motion forward and feel firm
- RR of females vs. males is 1.5, immediate family history of primary ACL injury OR is 2.53
2
Q
PCL injury
1. aggravates
2. PCL test
A
- flex knee, ext rot of knee (can also be int rot)
- posterior drawer: laying supine, 90 deg knee flexion, place the thenar eminences of both hands against the anterior tibia, and push post in parallel dir of femur, on either side
of the patellar tendon; working PCL should stop motion inward and feel firm
3
Q
menisci injury
1. aggravates
2. menisci test
A
- compression, internal rot (lat meniscus), external rot (med meniscus)
- McMurrays test: patient lying supine, bring knee into deep flexion to compress meniscus, externally rotate (medial) or internally rotate (lateral) to bias a side; feel for the meniscus as you extend the leg; a pop, jump or squishy feeling may indicate injury
4
Q
MCL injury
1. aggravates
2. MCL test
A
- valgus
- valgus test: abduct the hip so that the leg is hanging off the bed with the thigh on it, stand on lateral side of the leg with hip perpendicular to the femur at the knee and hold thigh in 20-30 deg flexion with hand at distal end of tibia and pull the tibia toward you, hold down the femur with the other hand and rotate the femur towards the medial side to apply valgus stress
5
Q
LCL injury
1. aggravates
2. LCL test
A
- varus
- varus test: abduct the hip so that the leg is hanging off the bed with the thigh on it, stand on the medial side of the leg with hip perpendicular to the femur at the knee and hold thigh in 20-30 deg flexion with hand at distal end of tibia, pull the tibia toward you, hold down the femur with the other hand and rotate the femur towards the lateral side to apply varus stress
6
Q
hamstring strength and injury tests
A
- medial side: semimembranosus and semitendinosus; patient in prone; knee flexed 90 deg, rotate tibia internally to bias medial side, one hand on the thigh, ask patient to resist as you try to ext their leg with other; test bilat strength
- lateral side: biceps femoris; patient in prone; knee flexed 90 deg, rotate tibia externally to bias medial side, one hand on the thigh, ask patient to resist as you try to ext their leg with other; test bilat strength
- popliteal angle test: laying supine, one hand holding femur 90 hip flexion, hold distal tibia with other hand and ext their leg to max; measure popliteal angle (normal is around 145 deg; if less could be injury or stiffness)
7
Q
hamstring injury
1. prevalent demographic
2. mechanism of injury
3. recurrence
A
- more common in females, older than 23 y/o, sprinters, previous ACL injury and family history, sports involving kicking, high stretch and contraction (dance, gymnastics, martial arts)
- loss of type II fibres responsible for acceleration and propulsion, easily strain muscle with newly synthesized weak fibres; can have bruise on one or both sides depending on which hamstring(s) strained
- high recurrence up to 63% in 2 years, and high recency effect in the first 2 months
8
Q
FADIR
A
test for hip impingement by flexing, abducting, and internally rotation hip; ask for pain or limited motion
9
Q
neuromuscular training programs in prevention of lower body injury
A
- decrease incidence of knee injuries, incidence of it occurring in program comp no program is 47% (IRR 0.47); decrease incidence of ACL injury, incidence occurring in program is 73% comp no program (IRR 0.73)
- program consists of plyometics, strength, aglity, balance, and give feedback on land (less valgus, hip in neutral rotation, increase knee flexion to land soft, land mid and fore foot, no over pronation or supination of foot)
