acute soft tissue injury- knee Flashcards

0
Q

second degree lig injury

A

joint opens on stress

definite palpable endpoint

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1
Q

first degree ligament classification

A

local tenderness

no instability on stress

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2
Q

third degree ligament injury

A

joint opens on stress

no endpoint

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3
Q

what is the most common lateral injury

A

MCL injury

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4
Q

how does MCL injury happy

A

direct blow to lateral aspect of knee

valgus stress

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5
Q

physical exam with MCL injury

A

plain on valgus

laxity of medial structures

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6
Q

Tx of 3 grades for LCL and MCL

A

1- symptoms- stay off 2 weeks
2- knee brace- 4 weeks off
3- nonoperative brace or surgery- 6 weeks off

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7
Q

pe of LCL injury

A

pain on vargus

lateral laxity

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8
Q

what do you have to check for with LCL injury

A

peroneal nerve dysfunction (runs under biceps femoris and wraps around head of fibula)

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9
Q

ACL mech of injury

A

rapid deceleration, hyperextension with rotation on a planted foot

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10
Q

gender in ACL tears

A

m>f in tear risk, but F>m x4 of rupture risk

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11
Q

hx of ACL injury

A

audible pop followed by immediate pain and swelling after injury

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12
Q

PE of ACL injury

A

hemarthrosis (bleeding into joint) and limited ROM

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13
Q

tests to exam ACL

A

Lachman (hard to do but most sensitive)
anterior drawer
pivot shift tests

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14
Q

tx of acl injury depends on the

A

pathogenesis

ACl tear–>instability–>stress on secondary restrainign structures–>meniscal tears–>arthritis

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15
Q

osteoarthritis risk with ACL tear

A

surgery does not decrease the risk; remains high after the tear

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16
Q

decision whether or not to operate on ACL depends on

A

age, athletciism, rehab, motivation, ass injuries, failed no op tx

17
Q

what are PCL injuries usually from

A

vehicular injuries

18
Q

dx PCL injury

A

difficult and often missed

-hyperextension, + drawer test, MRI

19
Q

tx PCL injury

A

non-operative if isolated (need to avoid popiteal artery)

operative if complex

20
Q

knee dislocation

A

grossly unstable knee that has disruption of both cruciate ligaments and at least one collateral ligaments

21
Q

natural history of knee dislocation

A

usually decreases spontaneously by patient or caregiver

22
Q

what is always recommended for a knee dislocation?

A

arteriogram –>popiteal artery or peroneal nerve injury–>if disrupted emergency surgery necessary

23
Q

knee dislocation tx options

A

cast immobilization for 6-8 weeks

surgical ligament reconstruction and early motion

24
Q

vasculization and menisci

A

peripheral 1/3 is vascularized

25
Q

job of menisci

A

shock absorbers
increase stability by cupping femoral condyles
decrease chrondral stress

26
Q

dx of menisci injury

A

joint line tenderness, effusion, incomplete extension, positive mcmurray sign

27
Q

how do you really dx an menisci tear

A

mRI

28
Q

tx of menisci

A

usually just observe (not everyone needs a surgery)p

you can also do arthroscopic partial excision/repair

29
Q

paterallar femoral disorder vascular supply

A

geniculate arteries

30
Q

what is fx of patella

A

increase force of extension

31
Q

contact stresses of patella increase with

A

flexion

32
Q

hx of patellar-gemoral disorder

A
knee "giving way"
pain on inclines
pain associated with prolonged flexion
crepitation
swelling
33
Q

PE of patello femoral dx

A

peri-patellar tenderness, pain w/ compression (quadriceps atrophy, exam aprehension)

34
Q

patello0femoral syndrome is commonly seen in

A

adolescent females

35
Q

signs of patelllo-femoral syndrome

A

pain or crepitation in knee at PF joint
positive effusion
positive patellar compression test

36
Q

tx of patello-femoral syndrome

A

non-operative quadriceps strengthing

37
Q

patellar dislocation often presents as

A

ACL tear

38
Q

patellar dislocation occurs from

A

direct or indirect trauma–>patella dislocated laterally

39
Q

inital tx of patellar dislocation

A

decrease dislocation acutely if locked by applying gental medial pressure with knee extended
if dislocation reduced spontaenously, check for signs of medial tenderness, effusion and apprehension

40
Q

later tx of patellar dislocation

A

if first time an dno fx, immobilze

if recurrent, operative repair

41
Q

patellar tendininitis

A

jumper’s knee

stress at insertion site of patellar tendon