Injuries to the Knee Flashcards
1
Q
Sprain of MCL
Valgus instability
A
Medial Collateral Ligament (MCL)
2
Q
MCL MOI
A
blow to the lateral side of the knee producing valgus stress
foot fixed w/ internal femoral rotation at the knee
overuse as w breast stroke in swimming
3
Q
- a few ligamentous fibers are torn & stretched
- no instability
- little or no joint swelling
- joint stiffness/point tenderness below the joint line
- almost full active and passive ROM
- Return in 1-3 weeks
A
Grade I: SS of MCL
4
Q
- partial tear
- some laxity
- some swelling with loss of passive ROM
- moderate to severe joint tightness w inability to actively extend knee
- pain & point tenderness (at or below joint line)
- return in 2-4 weeks
A
Grade II: S/S of MCL
5
Q
- total rupture of ligament
- gross laxity
- minimum to moderate swelling
- loss of ROM
- pain & point tenderness
- return in 4-6 weeks
A
Grade III: S/S of MCL
6
Q
MCL TX
A
- PRICEMM
- Crutches & Brace (for grades 2 & 3)
- proper rehab (ROM work and strengthening to the quadriceps)
- no surgery recommended (grade 3)
7
Q
MCL DIAG
A
Valgus Stress Test
8
Q
Sprain of LCL
Varus instability
A
Lateral Collateral Ligament (LCL)
9
Q
LCL MOI
A
direct blow to the medial side of the knee
ER of femur & fixed foot
10
Q
LCL S/S
A
pain
point tenderness along the joint line
joint instability depending upon degree
minimum swelling
11
Q
LCL TX
A
similar to that of a MCL
12
Q
LCL DIAG
A
Varus Stress Test
13
Q
Sprain of ACL
most commonly disrupted ligament in the knee
A
Anterior Cruciate Ligament (ACL)
14
Q
ACL MOI
A
Direct blow (hyperextension of valgus)
Rotational force
15
Q
ACL S/S
A
audible “pop”
rapid swelling
pain initially that may diminish
instability
16
Q
O’Donaghue’s version (OLD) of Unhappy Triad
A
combination of ACL, MCL, & MEDIAL meniscus
17
Q
Recent version of Unhappy Triad
A
combination of ACL, MCL, & LATERAL meniscus
18
Q
ACL TX
A
PRICEMM
Refer to MD
Crutches
Brace
19
Q
ACL Anterior Drawer Test
A
- w/ foot point straight: ACL only
- w/ leg internally rotated 20 degrees: ACL & posteroLATERAL aspect of joint capsule
- w/ leg externally rotated 15 degrees: ACL & posteroMEDIAL aspect of joint capsule
20
Q
ACL Lachment Test
A
ACL & PCL tear
21
Q
ACL Pivot Shift Test
A
anterolateral rotary instability
22
Q
ACL DIAG(S)
A
- Anterior Drawer Test
- Lachman Test
- Pivot Shift Test
23
Q
ACL Surgery
A
Patellar Tendon Graft
24
Q
Patellar Tendon Graft
A
middle of 3rd of the patellar tendon
25
Sprain of PCL
Posterior instability
not a v common injury
Posterior Cruciate Ligament
26
PCL MOI
force applied to the front of a bent knee; hyperextension; rotational force
27
tightest at 90 degrees = more susceptible to injury = automobile accidents
Posterior Cruciate Ligament (PCL)
28
S/S of PCL
pain
swelling
instability
29
TX of PCL
PRICEMM
refer to MD
crutches
brace
30
PCL DIAG(s)
Lachman Test
Posterior Drawer Test
Gravity (Sag) Drawer Test
31
Posterior Drawer Test
PCL tear
v easy test
32
PCL
Gravity (Sag) Drawer Test
33
T/F: You can damage PCL & never know it
True
34
tearing ligaments = worry about bld vessels = losing limb
Bad Injury
Dislocated Knee
35
Torn Cartilage
Meniscal Injuries
36
Meniscal Injuries MOI
rotational force
valgus/varus force
squatting hyperextension
cutting motion
forceful knee extension
37
S/S of Meniscal Injuries
Severe Pain
Loss of Function
Locking up of Knee
Clicking Sensation
38
TX of Meniscal Injuries
PRICEMM
refer to MD
Surgery possible
39
2 surgeries possible for Meniscal Injuries
1. Meniscectomy
2. Repair
40
surgery that treats the damaged piece; not the whole meniscus
meniscectomy
41
Meniscal Injuries DIAG(s)
McMurray's Test
Apley's compression Test
Apley's Distraction Test
42
torn cartilage test for Meniscal Injuries
Prof's fav
McMurray's Test
43
meniscal tears test of meniscal injuries
Apley's Compression Test
44
Distinguishes between collateral ligamentous tears from capsular & meniscal tear test of meniscal Injuries
Apley's Distraction Test
45
"joint mice"; condition in which a fragment of cartilage & underlying bone are detached from the articular surface
Osteochondritis Dissecans DEF
46
Outdated term for osteochondritis Dissecans
Joint mice
47
Not always a fragment
Damage to the articular surface of the bone
Osteochondritis Dissecans
48
Osteochondritis Dissecans MOI
unknown
Degeneration of articular cartilage
49
Osteochondritis Dissecans S/S
pain
swelling
intermittent locking
possible palpation of loose bodies
50
Osteochondritis Dissecans TX
PRICEMM
refer to MD
x-ray
51
Catch all term for knee pain
Pain at the patellofemoral joint
Patellofemoral Arthralgia (PFA)
52
PFA MOI
multiple causes
53
PFA S/S:
pain
point tenderness
crepitus (grinding and/or squeaky door sensation)
Swelling
Inflammation
54
PFA TX
PRICEMM
Proper rehab
55
gradual degenerative process of the underside of the patella; roughening up of the underside of the patella like sand paper
Chondromalacia DEF
56
Chondromalacia MOI
repeated direct trauma
biomechanical problems
57
pain (especially when bending the knee)
swelling
crepitation
joint stiffness
Chondromalacia S/S
58
Chondromalacia TX
PRICEMM
x-ray
possible surgery
59
Chondromalacia DIAG(s)
Patella Compression
Patella Grinding
60
tests for chondromalacia
Patella is pressed downward into femoral groove and moved forward and backward
Patella Compression
Prof has no issue w/ this test
61
tests for both chondromalacia and patellar tendinitis
Patella is forced downward while knee is flexed followed by active extension of the knee
Patella Grinding
Prof wouldn't do this bc this hurts everybody
62
folds in joint lining of knee that are remnants of embryonic tissue
MEDIAL plica more common
Plica DEF
63
Plica MOI
indirect trauma as with torsion; overuse
64
Plica S/S:
pain
popping (usually over the superior/medial aspect of the patella)
65
Plica TX
PRICEMM
refer to MD
possible surgery
66
Broken knee cap
Patella Fracture
67
Patella Fracture S/S:
direct blow to patella
indirect trauma (severe pull of patella tendon)
68
Patella Fracture TX:
PRICEMM
refer to MD
x-ray
possible surgery
69
lateral displacement of the patella
more common in women
Patella Subluxation/Dislocation DEF
70
Broader pelvis
Femoral neck anteversion
excessive Q-angle
Patella Subluxation/Dislocation
"Miserable Malalignment Syndrome"
71
hypermobile patella
external tibial torsion
pronated (flat) feet
lower lateral femoral head, shallow femoral groove
patella high riding, flat and externally pointing
Patella Subluxation/Dislocation
"Miserable Malalignment Syndrome"
72
S/S: Patella Subluxation/Dislocation
Pain
point tenderness
swelling
loss of function
obvious deformity with dislocation
73
TX of Patella Subluxation/Dislocation
PRICE
refer to MD
immobilize
rehab
74
Patella Subluxation/Dislocation DIAG
Apprehension test
75
push patella laterally and watch for fear in athlete’s face
Apprehension test
76
apophysitis of the tibial tubercle
(attachment for patellar tendon); common in kids and often associated with a growth spurt
Osgood-Schlatter Disease
77
Osgood-Schlatter Disease MOI
repetitive stress on the patella tendon
78
Osgood-Schlatter Disease S/S
pain on extension, squatting, or jumping
swelling
prominent tibial apophysis
79
Osgood-Schlatter Disease TX
PRICEMM
Refer to MD
80
pain at the inferior pole of the patella
occurs most often in kids 10-12 (varies)
Sinding-Larsen-Johansson Condition DEF
81
Sinding-Larsen-Johansson Condition MOI
overuse of the patella tendon
82
Sinding-Larsen-Johansson Condition S/S
pain
point tenderness
pain on active movements
swelling
83
Sinding-Larsen-Johansson Condition TX
PRICEMM
refer to MD
84
tear of patellar tendon (may tear quadriceps tendon also)
Patellar Tendon Rupture DEF
85
Patellar Tendon Rupture MOI
sudden eccentric contraction of the quadriceps
86
“pop” with immediate loss of function
pain
swelling
palpable defect
Patellar Tendon Rupture S/S
87
PRICEMM
immobilize
refer to MD
surgery
Patellar Tendon Rupture TX
88
2 types of Prepatellar Bursitis
Acute
Chronic
89
blow to anterior pole of patella
results in rapid
severe swelling
Acute Prepatellar Bursitis
90
Prepatellar Bursitis TX
PRICEMM
may require draining
91
(housemaid’s knee; carpet layer’s knee)
caused by overuse as in continuous kneeling
Chronic Prepatellar Bursitis
92
jumper knee
Infrapatellar Bursitis
93
Cyclist's knee
Pes Anserine Bursitis:
94
water on the knee
Ballotable Patella
Knee Synovitis
95
push patella down and see if it will rebound
Ballotable Patella
96
jumper’s knee; kicker’s knee
most common
Patellar Tendinitis
97
Pes Anserine Tendinitis
no definition
98
irritation of IT band as it crosses over the lateral femoral condyle
(more common in women)
Iliotibial Band Friction Syndrome
99
Iliotibial tract =
Tensor Fascia Latae (TFL) + Gluteus Maximus
100
Iliotibial Band Friction Syndrome MOI
overuse
biomechanical faults
worn shoes
101
Iliotibial Band Friction Syndrome S/S
pain
point tenderness
clicking
102
Iliotibial Band Friction Syndrome TX
PRICEMM
NSAIDs
stretching
103
Iliotibial Band Friction Syndrome DIAG
Ober's Test
Nobel's Test
104
tightness of IT Band test
Ober's Test
105
IT Band Friction Syndrome test
Nobel's Test
