BELIEVE IN YOURSELF Flashcards
Meniscus - vascular vs. not
Inner third of medial is AVASCULAR
Outer third of medial is vascular
Apleys
Differentiates meniscal and ligament
Pt prone with knee flexed to 90; stabilize their thigh then passively distract the knww and slowly IR and ER tibia
Apply compressive load to knee joint and rotate tibia again
Pain or dec motion with the added compression = meniscal!
Pain or inc motion with distraction = ligament!
Hughston;s plica
Pt supine with flexed knee and IR tibia, passive glide patella medially while palpatng medial femoral condyle, feel for popping as passively extend and flex the knww
Patellar apprehension
Hx of dislocation
Pt supine with patella passively glided laterally
Clarke’s sign
Patellofemoral dysfunction
Pt supine with knee ext, push post on superior pole of patella, then ask pt to perform quad contraction
Q angle measurement - how and norms
Normal is 13 for men, 18 for women
ASIS, mid patella, tibial tubercle
Angle btw quads and patellar tendon
Noble compression
IT band friction syndrome
Pt supine with hip flexed 45 and knee flexed 90, apply pressure to lateral femoral epicondyle and then extend the knee
Pt will complain of pain over lateral epicondyle at about 30 deg flex
Wilson’s test is for
Osteochondritis dissecans
Pt sit on EOT, actively extend knee with IR of tibia
Pos if pain present at 30 deg with IR but no pain at 30 deg with ER
Max varum at what age
6 to 12 months
Straight by 18-24 months
Max valgus at what age
3 to 4 yrs
Valgum corrects by what age
7
Norms for valgus angle
8 for F
7 for M
ACL - graft
Most common are semitendinosus and gracilis
Osteonecrosis of femoral condyles - most common =
Medial! Due to inc weight bearing forces caused by COG being medial to knee
More common in F - esp over 60
Lachman is performed with what
20-30 deg of knee flexion
Normal angle of anteversion
8 to 15 degrees
Less than 8 is retro
More than 15 is anteverted
Test = Craigs
Pavlik harness maintains in
Hip flex, abd to keep head in acetabulum
THA - posterolateral approach
Keeps hip abd intact!!! Hip instability after is due to post capsule damage
NO hip flex past 90, add, IR
THA - posterolateral approach - most damage to what mm
Glut max!
THA - anterolateral approach - which mm get impact
Hip abd
Wounds - serous
Clear
Wounds - serosanguinous
Pink
Wounds - Sanguineous
Red
Wounds - purulent
Yellow
Wounds - primary intention
Surgically closed
Wounds - secondary intention
Let the body heal it
Wounds - Tertiary
Secondary intention first, and then primary to get it closed
Wound healing stages
Inflammation
Proliferation/Fibroblastic
Maturation/Remodeling
Arterial insufficiency wound
Lateral malleoli, dorsum of foot, toes
Dec hair, dry skin, cool temp
Painful wound/legs
Dec pulses, pallor on elevation, rubor with dep
Venous insufficiency wound
More common
Swelling releived with elevation in early stages
Itch, fatigue, ache, heavy
Hemosiderin staining, lipodermatosclerosis
Inc skin temp
Medial malleolus
Usually wet with exudate
Layers of the epidermis
Corneum
Granulosum
Spinosum
Basale
Layers of skn
Epidermis
Papillary dermis
Reticular dermis
SubQ
Epidermal burn = think
SUNBURN! No blisters!
Superficial partial thickness burn
Through epidermis and into papillary dermis
BLISTERS!!!
PAINFUL!
Heals wo surgery
Deep partial thickness burn
Through epidermis, papillary, and into reticular
Full thickness burn
Through all epidermis and all dermis
INSENSATE!