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MSKII > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

T or F: The lateral tibial plateau is much larger than the medial tibial plateau

A

False

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2
Q

T or F: When it comes to the meniscus, debridement surgery (removing part of a torn meniscus) is not recommended due to the role it plays in the knee.

A

True

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3
Q

Which of the following statements is the most accurate about the MCL?
A. It attaches to the joint capsule, attaches to part of the medial meniscus, it is somewhat pencil-like in shape
B. It attaches to the joint capsule, attaches to part of the medial meniscus, it is somewhat fan shaped
C. It does not attach to the joint capsule or medial meniscus, it is somewhat fan shaped

A

B. Attaches to joint capsule and meniscus, it is fan shaped

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4
Q

T or F: The role of the popliteus is to laterally or externally rotate the tibia on the femur in open chain.

A

False; it unlocks the knee so it rotates it medially/internally

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5
Q

T or F: If you increase the Q angle (causing genu valgum), the patella will become more lateral than normal.

A

True; since it’s encased in the RF and the tibiofemoral joint moves medial, the patella will move more laterally causing patella-femoral pain

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6
Q 
Patient presents with pain, swelling, warmth, and redness in the leg. No recent surgery, infection, or trauma. However, they had a recent abrasion. What do you suspect?
A. Septic arthritis
B. Lumbar radiculopathy
C. Compartment syndrome
D. Cellulitis
A

D. Cellulitis

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7
Q

T or F: To test for popliteus tendinopathy, you will externally/laterally rotate the tibia on the femur to stretch the tendon, and resist internal/medial rotation of the tibia, along with palpating the tendon.

A

False

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8
Q

What can you do to differentiate a medial meniscus versus MCL injury using tests?

A

You would want to put tension on the MCL but then use compression while taking the joint through flex/ext ROM to see if it is painful or catches

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9
Q

What is likely the most distinguishing factor between gout and a tibial plateau fracture?

A

Whether there was a MOI or not

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10
Q 
Which of the following is NOT one of the subgrouping categories discussed regarding anterior knee pain?
A. Weak and Loose
B. Weak and pronated
C. Weak and tight
D. Strong
A

A. Weak and loose

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11
Q 
Dr. U mentioned patella alta and said quads stretching is likely needed to help. Based on this, what position do you think the patella is in with this condition?
A. More inferior than normal
B. More superior than normal
C. More medial than normal
D. More lateral than normal
A

B. More superior than normal; flexing the knee brings the patella more inferior

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12
Q

T or F: Patella fractures are the most common fractures in the knee, accounting for 40% of knee area fractures. However only 6% of knee injuries consist of fractures.

A

True

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13
Q

Which of the following, combined with an acute injury, warrants the need for imaging of the knee (per Ottawa Knee Rules)?
A. 60 year old able to take 4 steps
B. 45 year old with painful knee flexion of 85 degrees
C. 65 year old patient with painful knee flexion of 105 degrees
D. 40 year old patient with tenderness of medial tibial plateau

A

B. Due to inability to flex knee enough

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14
Q

Which of the following is true about Salter-Harris fractures?
A. Type I is partway through the physis and extends into metaphysis
B. Type II is part way through the physis and extends to the metaphysis
C. Type III is through the physis (resulting in widened physis)
D. Type IV is a crush injury to the physis

A

B

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15
Q

T or F: Once a fracture is healed, pain that is present should be ignored, as their pushing through it won’t harm the patient.

A

False

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16
Q

T or F: It is recommended to avoid open reduction internal fixation (ORIF), which is the surgical repair of patellar fractures due to surgery delaying the ability of the patient to start moving their knee.

A

False

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17
Q

Which of the following is accurate when it comes to patellar dislocations?
A. Most commonly result of a twisting injury, valgus load, or direct blow
B. More common in boys than girls
C. They never reduce spontaneously
D. They are always accompanied by an osteochondral fracture

A

A. common from twisting, valgus load and direct blows

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18
Q 
When documenting knee ROM, which of the following would be considered a 'normal' measurement?
A. 15-0-105
B. 5-0-140
C. 15-120
D. None
A

B; need at least 90 degrees of flexion for functional activities

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19
Q 
During open chain motion, which of the following does NOT happen to the tibia as we fully extend our knee?
A. Slides anterior
B. Rolls anterior
C. Rotates externally
D. Rotates internally
A

D. Does NOT rotate internally

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20
Q

What muscle helps to UNLOCK the screw-home mechanism of the knee?

A

Popliteus!

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21
Q

Which of the menisci is more likely to be torn due to being attached to the collateral ligament that it is adjacent to?

A

Medial!

22
Q 
A person is involved in a car accident that results in the car stopping suddenly. She is not wearing a seat belt and her shins hit the dashboard while the rest of her body continued forward. Which ligament is most likely injured?
A. LCL
B. MCL
C. ACL
D. PCL
A

D. PCL (posterior translation of the tibia)

23
Q

Which way do the quads pull the patella? Why do we have a patella?

A

Superior and lateral; increased the moment arm so the quads are able to generate more force

24
Q

T or F: After injuring a ligament, it is very important to maintain immobilization until the ligament is fully healed as it allows it to regain full strength.

A

False

25
Q 
What do you call a fracture where a fragment of bone is displaced due to being pulled off by the ligament or tendon that attaches to the bone?
A. Avulsion
B. Spiral
C. Greenstick
D. Compound
A

A. Avulsion

26
Q

T or F: The anterior portion of the MCL is more taut than the posterior portion of the MCL in knee flexion.

A

True

27
Q

If you stand and twist your shoulders and trunk to the right, that will create most stress on which ligament in the left knee, medial or lateral?

A

Medial due to valgus stress while twisting

28
Q 
You will 1st perform the valgus stress test at 20-30 degrees of flexion. It is also performed at 0 degrees. What difference do you expect to see with 0 degrees in a normal knee?
A. Less MCL laxity
B. More MCL laxity
C. No difference in MCL laxity
D. Can't be performed at 0 degrees
A

A. Less since in closed packed position

29
Q

Why do ACL injuries result in a large amount of effusion that develops fairly rapidly?

A

Because it is an intra-articular ligament that leads to fluid build-up that will be contained within the joint.

30
Q

T or F: When performing ligamentous stress testing. you should only apply a slow steady force to determine the end-feel. Don’t worry about the amount of available motion of the joint as that doesn’t tell us anything.

A

False; always assess ROM

31
Q 
Which of the following is not something commonly on a differential diagnosis list when concerned about an ACL tear?
A. Chondral defects
B. Fracture/Dislocation
C. Patellar tendionopathy
D. Meniscal teat or ligament involvement
A

C. More of an overuse injury not caused by particular MOI

32
Q 
A patient reports with an excessive Q angle. Over time, this will most likely result in laxity of what ligament?
A. ACL
B. PCL
C. LCL
D. MCL
A

D. Due to genu valgum

33
Q

T or F: The ideal time to have ACL reconstruction surgery is as soon as possible after the injury.

A

False; pre-hab to regain ROM and reduce swelling is super important for outcomes

34
Q 
Which of the following is LEAST important to achieve prior to having ACL reconstruction surgery?
A. Full knee flexion ROM
B. Full knee extention ROM
C. Mild pain and effusion
D. Absent extensor lag and normal gait
A

A. Full flexion; easier to get back after surgery

35
Q

When it comes to ACL grafts, which of the following is true?
A. With patellar BTB grafts, fixation of bone plugs are stronger than mid-portion of the graft during 1st month of surgery
B. With hamstring grafts, the soft tissue attachments into the bone are very strong immediately after surgery
C. The mid-portion of any autograft is often the weakest 8-12 weeks after surgery
D. Surgeon preference does not matter; patellar is the better option

A

C. Weakest around 8-12 weeks

36
Q

T or F: Open chain exercises from 0-30 degrees knee flexion puts less stress on the ACL than closed chain exercises from 0-30 degrees of knee flexion.

A

False; they are about the same

37
Q

T or F: Stability of the knee comes from bony congruency, ligamentous stability, proprioception, and motor control. The first 2 can be helped after an ACL surgery but proprioception can not be improved.

A

True

38
Q

T or F: Just because roughly 40% of 40 year olds have meniscal tears or rotator cuff tears doesn’t mean they have to be painful.

A

True

39
Q 
T or F: What type of meniscal tear is the most common?
A. Flap
B. Longitudinal
C. Horizontal
D. Bucket-handle
A

B Longitudinal

40
Q

T or F: When it comes to meniscal repairs, surgeons will often perform them if the tear is in the white white zone due to poor healing without surgery (due to lack of blood supply).

A

False! They still will not heal well if repaired with surgery so they usually due a meniscectomy.

41
Q

T or F: The patient interview, when appropriately performed, should assist with nearly 80% of our hypothesis generation.

A

True

42
Q

Why should you opt for meniscal repair over debridement?

A

Debridement is a quicker recovery but preserving the mesiscus is more beneficial for the long-term

43
Q

What are the ACL pre-op requirements?

A

Decreased effusion and pain, full knee extension. knee flexion to 110; no extensor lag; normal gait

44
Q

What are the most important activities for the 1st week after ACL surgery?

A

Control swelling, regain knee extension ROM, patella mobility, improve quad activation, and normalize gait

45
Q

What is the most common MOI for meniscal tears?

A

Twisting with a planted foot

46
Q

What is the most common meniscal tear? Most common location?

A

Longitudinal and radial; posterior horn

47
Q

Which of the following would have provided the BEST prognosis for a meniscal tear sustained last year?
A. Injury to the white-white zone
B. Injury involving central damage to meniscus
C. Injury resulting in bloody effusion
D. Injury that also involved the MCL

A

C. Bloody effusion because that makes healing more likely

48
Q

Pros and Cons of Meniscectomy/Debridement?

A

Compromises integrity of the knee resulting in more stress on articular surfaces (no real pros)

49
Q

Pros and Cons of meniscus repair?

A

Pro - saves meniscus for the long term; best for tears >8mm

Con - longer rehab (4-6 weeks no to partial WB and no knee flexion)

50
Q

Pros and Cons of Non surgical meniscal management?

A

Pro- can do as well as meniscectomy 6-12 months out

Con - takes longer but preserves integrity of the knee

51
Q

A patient presents with imaging for right knee pain. While the left knee is pain free, the imaging reveals articular cartilage lesions that extend almost 50% of the depth of the cartilage. What grade lesion would this be?

A

Grade II

52
Q 
Your 33 year old sedentary neighbor calls and lets you know they need surgery for their knee. You learn they have a small (about 2cm) lesion in the articular cartilage of the femur. What type of surgery are you hoping they have?
A. OATs
B. ACI
C. MACI
D. Microfracture
A

D. Microfracture is best for sedentary individuals with a small lesion

MSKII (2 decks)

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