B6-073 Joint Injury Flashcards
fibers run posterior lateral
ACL
fibers run anterior medial
PCL
prevents anterior translocation of the tibia and provides rotational stability
ACL
prevents posterior translocation of the tibia and helps provide varus/valgus stability
PCL
restrains valgus stress
MCL
restrains varus stress of knee
LCL
the medical meniscus attaches to
MCL
optimizes force transmission by increasing contact area
meniscii
what structures make up the posterior lateral corner?
popliteus tendon
LCL
popliteo-femoral ligament
controls external rotation, varus, and posterior translation of leg
posterior lateral corner
most sensitive test for ACL tear
lachmans
patient knee bent at 20-30 degrees
pull tibia anterior
what test is this describing?
lachmans
laxity at 30 in valgus stress indicates injury to
MCL
laxity at 0 in valgus stress indicates injury to
MCL and ACL/PCL
laxity at 30 in varus stress indicates injury to
LCL
laxity at 0 in varus stress indicates injury to
LCL and ACL/PCL
LCL injury is commonly accompanied by injury to the
posterior lateral corner
test to evaluate PLC
dial test
positive is greater than 10 degrees of asymmetry
asymmetry at 30 degrees in Dial test indicates
PLC injury
asymmetry at 30 and 90 in Dial test indicated injury to
PLC and PCL
most sensitive exam finding for meniscus tear
joint line tenderness
tests for meniscal tears [3]
mcmurrays
apleys
thessaly
unhappy triad
MCL
ACL
medial mensicus tear
caused by valgus force with tibial anterior translocation and external rotation
unhappy triad
unhappy triad causes a kissing contusion between [..] and […]
lateral femoral condyle
posterior lateral tibial plateu
ATFL is being stretched when the ankle is […] flexed
plantar flexed
**relaxed with dorsiflexion
achilles is being stretched when the ankle is […] flexed
dorsiflexed
**relaxed with plantar flexion
plantar/dorsiflexion of the ankle occurs at what joint?
tibiotalar
inversion/eversion of the foot occurs at what joint
subtalar (talocalcaneal)
what two joints make up the transverse tarsal joint?
talonavicular
talocuboid
restrains inversion while in plantar flexion
ATFL
weakest ligament of the lateral ankle
ATFL
restrains inversion when neutral or dorsiflexion
calcaneofibular ligament
prevents subtalar inversion
calcaneofibular ligament
prevents posterior talar displacement
posterior talofibular
ankle anterior drawer test assesses the integrity of
ATFL
talar tilt (inversion stress) assesses the ingetrity of
calcaneofibular ligament
resists eversion of the hindfoot
deltoid ligament
restrains valgus tilting of talus
deltoid ligament
ligaments of ankle syndesmosis [4]
AITFL
PITFL
TTFL
interosseous membrane
maintains the integrity of the mortise
ankle syndesmosis
tests to assess ankle syndesomosis [3]
Bonus points: what ligament are they stressing?
eversion stress- deltoid
squeeze test- pain at syndesmosis
external rotation stress- AITFL
eversion stress tests assesses function of
deltoid
squeeze test assesses function of
syndesmosis
**pain eillicited is positive
external rotation stress test of ankle assesses function of
AITFL
indications for ankle imaging according to Ottawa ankle rules:
if tenderness is felt at
-posterior edge of lateral mal
-base of 5 MTP
-navicular
-posterior edge of medial mal
get Xrays, more likely for fx
getting weight bearing X rays is crucial for evaluation of
syndesmosis
ACL tear is diagnosed on exam with what tests?
anterior drawer
Lachman’s (more sensitive)
ACL functions to
prevent anterior translation of the tibia relative to the femur
a blow to the anterior tibia with a flexed knee can cause a tear in
PCL
**like knee against dashboard in MVC
the PCL functions to
prevent posterior translation of the tibia
the PCL originates from the
medial femoral condyle
what tests would you expect to be positive when evaluating a high ankle sprain?
eversion stress test
external rotation stress test
squeeze test
pain illicited from the squeeze test indicates
injury to syndesmotic complex
LCL injuries can be associated with injuries to the
PLC
structures of PLC
popliteus tendon
popliteofibular ligament
positive Dial test at 30 degrees suggests injury to
PLC
positive Dial at 90 degrees suggests injury to
PLC and PCL
pain and increased laxity of valgus stress at 30 degrees indicates
isolated MCL tear
pain and increased laxity of valgus stress at both 0 and 30 degrees indicates
MCL + ACL/PCL tear
lateral translation of the talus on Xray indicates damage of what structure?
deltoid
