knee 1 - exam 3

Question 1

Functional ROM: GAIT
_________ during the swing phase
maximally _____________ up to 10º at heel off

Answer 1

60º flexion
hyper-extended

Question 2

Screw home mechanism:
Tibial_____ with extension
–IF the knee doesn’t reach full ___________ then ankle may become ________
–HIP will not compensate b/c it needs _______ when knee _____ at heel off

Answer 2

ER
extension; hypermobile
IR; ER

Question 3

Functional ROM:
–Stair decent
–Sit to Stand
–Flexion

Answer 3

90º flexion- may need 120º
105º flexion
120º ; goal w/TKA

Question 4

Functional ROM: Kneeling and Deep Squat (arthokinematics)

Generally (CC) for knee flexion is ________roll and ______ slide BUT recent research has shown that w/ DEEP SQUAT and KNEELING you have a ____________roll with _______glide and ______rotation of the femur from 90-150º

Answer 4

full flexion needed (closed chain)

posterior roll and anterior slide ;
posterior roll w/ posterior glide and external rotation

**seems opposite*

Question 5

Flexion creates valgus stress and extensions create varas stress. T or F

Answer 5

True

Question 6

Stretching or tearing of the ligament that may lead to some degree of joint laxity and dysfunction-

Answer 6

Sprain

Question 7

Joint instability:

Answer 7

increased accessory motion and inadequate neuromuscular function

Question 8

Function joint instability:
Mechanical joint instability:

Answer 8

able to offset laxity through neuromuscular function
unable to offset laxity through neuromuscular function and likely requires Sx

Question 9

Types of Strain: Grade I/1st degree-

Answer 9

Mild S&S; activity may continue; fibers are stretched but NOT torn so minimal to no change during ligamentous special tests

Question 10

Strain: Grade II/2 degree -

Answer 10

Moderate S&S: activity stops; fibers stretched and torn so increased laxity with sofer/later end feel during ligamentous testing

Question 11

Strain: Grade III/3rd degree-

Answer 11

Severe S&S; activity stops; fibers torn completely with possibly avulsion; significantly increased in laxity w/emtpty end feels during ligaments testing (NWB)

Question 12

What do you know about Ligaments and Capsules:

Answer 12

dense connective tissue
type I collagen -resists tension
low elastin - better stabilization
fibrocytes

Question 13

Ligaments & Capsuel have more _____________ fibers than tendons
–Mid substance
–Insertional ends:

Answer 13

multi-directional
hypovascular, hyponeural - slower healing
hypervascular, hyperneural- high metabolic activity for greater healing capacity; proprioception

Question 14

Blends with capsule and often heals without Sx:
–why?

Answer 14

extraarticular structures i.e. MCL/TCL
because of attachment; lay down more collagen to heal on its own

Question 15

within joint space
often requires Sx needed for repair due to dilution from synovial fluid

Answer 15

Intrarticular i.e. ACL

Question 16

Healing Phases:
Initial tensile strength @
Dense Connective Tissue @
_____-_____ mths to normal strength postoperatively

Answer 16

3-5 wks
12wks.
10-12 mths.

Question 17

MET: Primary Focus for Knee

Answer 17

primarily for tissue proliferation and integrity and stabilization

Question 18

Distinctive Rx:

Answer 18

POLICED
–assistive device and/or external support
–protecting ligament in a shortened position for better long-term stability