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Management of MS Disorders > Exam 1: Soft Tissue Pathologies of the Knee > Flashcards

Exam 1: Soft Tissue Pathologies of the Knee Flashcards

1
Q

What are the three types of patellar bursitis

A

prepatellar, suprapatellar, and infrapatellar

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2
Q

Patellar bursitis is typically inflamed secondary to (acute/chronic) trauma, but may be (acute/chronic) or associated with infection

A

acute; chronic

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3
Q

(prepatellar/suprapatellar/infrapatellar) bursitis presents with significant anterior swelling

A

prepatellar

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4
Q

True or False:

Although there are risks with draining, patellar bursitis usually responds to conservative management

A

true

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5
Q

Pre-patellar bursitis may be a result of _____ or repetitive _____. Commonly seen in carpet and tile workers

A

trauma or compression

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6
Q

With pre-patellar bursitis, AROM and PROM (flexion/extension) may be limited because in this motion the bursa is compressed

A

flexion

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7
Q

With pre-patellar bursitis, resistive testing is usually (positive/negative) and mobility testing/joint play is (normal/abnormal)

A

negative; abnormal

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8
Q

True or False:

If a patient presents with pre-patellar bursitis, it is normal for the knee to be very swollen, red, and warm to the touch

A

true

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9
Q

If a patient has pre-patellar bursitis, they should avoid the _____ position.

A

kneeling

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10
Q

What does PT management include for a patient presenting with pre-patellar bursitis

A

modalities for pain and swelling, anti-inflammatory meds, and start ROM/strengthening when swelling subsides

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11
Q

Which occupation population is likely to present with pre-patellar bursitis

A

Tile workers and carpenters

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12
Q

What type of bursitis can be described as inflammation of bursa between pes anserine insertion and MCL

A

pes anserine bursitis

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13
Q

How is pes anserine bursitis usually caused

A

repetitive motions or overuse

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14
Q

If a patient has Pes Anserine Bursitis, which motions will be painful

A

AROM and PROM with knee extension

Resisted hamstring, sartorius, or gracilis may also be painful

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15
Q

Pes Anserine Bursitis is typically common in patients after what type of surgery

A

TKA

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16
Q

Patient’s with Pes anserine bursitis may have tightness of the (quadriceps/hamstrings) or the (adductors/abductors)

A

hamstrings and adductors

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17
Q

What does PT management of pes anserine bursitis look like

A

modalities for pain and swelling, gentle stretching, avoid repetitive knee flexion and extension, and isometric strengthening

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18
Q

Excessive foot (supination/pronation) might also influence pes anserine bursitis

A

pronation

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19
Q

(tendinitis/tendinosis) is reserved for tendon injuries that involve acute injuries accompanied by inflammation

A

tendinitis

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20
Q

(tendinitis/tendinosis) implies a pathology of chronic degeneration without inflammation

A

tendinosis

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21
Q

True or False:

Anti-inflammatory medicine can help relieve tendinitis

A

true

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22
Q

True or False:

Anti-inflammatory medicine can help relieve tendinosis

A

false

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23
Q

What is another name for patellar tendinitis

A

jumpers knee

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24
Q

What are the three phases of tendinitis or tendonosis

A
  1. Pain after activity
  2. Pain during and after activity
  3. Pain leading to functional disability
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25
Q

What activities/motions can cause patellar tendinitis or tendinosis

A

running, jumping, overuse, eccentric activities

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26
Q

If a patient has patellar tendinitis or tendinosis, what landmarks might be irritated

A

inferior patella
tibial insertion
superior patella
the tendon in mid-stance

27
Q

If a patient has patellar tendinitis or tendinosis, what motions would be painful

A

AROM and resisted knee extension

28
Q

What would PT management for patellar tendinitis or tendinosis look like

A

modalities for pain/inflammation, activity modification, cho-pat straps, cross friction massage, gentle stretching, eccentrics when there is no pain and progress into plyometrics

29
Q

If a PT were to perform cross friction massage, how long should the massage be performed in order to stimulate the inflammatory phase

A

20 minutes

30
Q

Tendons need (concentric/isometric/eccentric) contractions to heal properly

A

eccentric

31
Q

Treating patellar tendinitis or tendinosis with injections can be (helpful/harmful). _______ medications are (better/worse).

A

harmful, anti-inflammatory meds are better

32
Q

How would a patient acquire hamstring tendinitis

A

eccentric deceleration with running

33
Q

Hamstring tendinitis has a similar history as _____ tendinitis and so it is treated the same way

A

patellar

34
Q

What is the difference between a contusion and a strain

A

A contusion is a result of a direct blow and a strain occurs via indirect trauma like a pulled muscle

35
Q

What secondary medical condition can contusion lead to if its not taken care of properly

A

Compartment syndrome or myositis ossificans

36
Q

what is a quad contusion

A

a direct trauma to the quadriceps

37
Q

If your patient presents with swelling, a palpable hematoma, and a warm quadricep what would be your initial hypothesis

A

quad contusion

38
Q

If a patient presents with a quad contusion, which motions are going to be painful

A

AROM and PROM knee flexion as well as resistive knee extension

39
Q

A patient with a quad contusion will have painful knee flexion. List the degrees that will cause mild, moderate, and severe pain

A

greater than 90 results in mild pain
45-90 results in moderate pain
less than 45 results in severe pain

40
Q

What does the PT management for a quad contusion look like

A

Lots of ice, e-stim, sometimes crutches, gentle stretching after 24 hours, vigorous stretching after 7-10 days, strengthening when 120 degrees of flexion is pain free

41
Q

What term means inflammation of muscle leading to bone formation

A

myositis ossificans

42
Q

What percentage of quad contusions end up with myositis ossificans

A

9-20%

43
Q

What causes myositis ossificans

A

cellular responses while a muscle, like the quad, is bleeding

44
Q

What is a common site for myositis ossifications in football players

A

the gastroc or the deltoid

45
Q

What are the risk factors for myositis ossificans

A

previous quad contusion
delayed treatment for quad contusion more than 72 hours
knee effusion
injury sustained in a contact sport

46
Q

What are the three main treatment goals of myositis ossificans

A
  1. Limit swelling and bleeding which will
  2. Minimize scar formation
  3. Preserve elasticity, contractility, and strength of the injured and uninjured tissue
47
Q

Which knee soft tissue pathology results from friction between the IT band and lateral femoral condyle during repetitive knee flexion/extension activities

A

Iliotibial band syndrome

48
Q

You are seeing a patient with knee pain. Upon examination you find that the patient has experiences popping, pain over the lateral knee and condyle, and has just increased her workouts to involve hill running. What is your initial hypothesis

A

IT band syndrome

49
Q

What are some contributing factors that may play a role in acquiring iliotibial band syndrome

A

tibial varum, genu varum, overtraining, running downhill or on uneven surfaces, and high or low arches,

50
Q

If a patient has IT band syndrome, what would you find during an examination

A

Painful AROM knee flexion
Tender lateral condyle with palpation
Positive Noble compression test
Positive Ober test and weak gluteus medius

51
Q

What does PT management for IT band syndrome look like

A

Correct imbalances and mechanics, strengthen weak hips, patellar mobs, iontophoresis, NSAID

52
Q

How do hamstring strains happen

A

With an eccentric load to the muscle

53
Q

Untreated hamstring strains can create adverse ____ ____ that will lead to further injury

A

neural tension

54
Q

Are static or ballistic warm ups better for the body and why

A

Ballistic is better because static decreases blood flow in a tissue which is bad

55
Q

Which types of athletes usually acquire hamstring strains

A

runners or baseball players reaching for first base

56
Q

What is the MOI of a hamstring strain

A

quick, explosive contraction usually eccentrically

57
Q

What are some contributing factors that might lead to a hamstring strain

A

muscle imbalances, fatigue, gait, leg length, ROM, muscle innervations

58
Q

If a patient has a hamstring strain, what would a PT find upon inspection

A

possible defect, swelling, ecchymosis

59
Q

If a patient has a hamstring strain, what motions would be painful

A

AROM and resistive knee flexion
PROM for knee extension
Palpation of the muscle belly/tendon

60
Q

If a patient has a hamstring strain, which nerve might have neurodynamic abnormalities

A

tibial nerve unless its way up high then sciatic nerve

61
Q

What is the rehab progression of a hamstring strain

A

re-establish normal gait
RICE
Gentle AROM to light stretching
Isometrics to PRE’s to eccentrics

62
Q

A hamstring strain of grade (1/2/3) may result in no lost time

A

1

63
Q

A hamstring strain of grade (1/2/3) may result in 5-12 days of no participation

A

2

64
Q

A hamstring strain of grade (1/2/3) may result of 3-12 weeks of no participation

A

3

Management of MS Disorders (18 decks)

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