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Clinical Medicine > Knee > Flashcards

Knee Flashcards

1
Q

what is the source of common muscular injury in lower extremity?

A

hamstring & quads

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2
Q

what is common MOI of muscular knee pathology?

A

eccentric contraction
most likely at musculotendinous junction

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3
Q

where are come common location of muscular knee injuries?

A

Origin of muscle
Musculotendinous Junction
Muscle Belly
Insertion of muscle

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4
Q

what is a 1st degree strain?

A

stretching of musculotendionous unit & involves tearing a few muscle fibers

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5
Q

what is a 2nd degree strain?

A

more sever tear w/o complete disruption of musculotendinous junction

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6
Q

what is a 3rd degree strain?

A

complete tear of musculotendinous unit

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7
Q

what are some risk factors to knee pathology?

A

Inadequate flexibility
Inadequate strength or endurance
Muscle Fatigue
Poor running technique
premature return to sport

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8
Q

what is the clinical picture of muscular knee pathology?

A

Pain in posterior or anterior thigh
Tenderness over injury site
Ecchymosis
Palpable mass
Pain w/ movement & resistance

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9
Q

how is muscular knee pathology diagnosed?

A

Clinical picture
May require x-rays if avulsion injury is suspected

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10
Q

what is a differential diagnosis for muscular knee pathology?

A

lumbar radiculopathy

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11
Q

what are some treatment options for muscular knee pathology?

A

PT
NSAIDs
Surgical intervention

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12
Q

what is a grade 1 sprain of ligament?

A

few fibers torn

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13
Q

what is a grade 2 sprain of ligament?

A

apron 1/2 fibers torn

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14
Q

what is a grade 3 ligament sprain?

A

all fibers torn

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15
Q

where does the ACL originate and go to?

A

tibial plateau (just ant & medial to tibial eminence) then extends from tibia superiorly, laterally & posteriorly to posterior aspect of medial wall of lateral femoral condyle

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16
Q

where does the PCL originate & go to?

A

tibial plateau posteriorly & laterally
extend from tibia superiorly & medially to attach on medial femoral condyle

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17
Q

true or false both PCL & ACL are intra-articular but extra synovial?

A

true

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18
Q

what population is more likely to experience ACL pathology?

A

Females 2-8x more than males
14-29 yr old

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19
Q

what is entailed in an autograft ACL?

A

Middle 1/3 patellar tendon
Semitendinosus/gracilis tendon graft (hamstring)
Quads tendon graft

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20
Q

what is an entailed in an autograft for ACL?

A

cadaveric graft
patellar tendon or achilles

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21
Q

when is PT indicated for PCL injury?

A

partial tears or complete tears w/ no other damage

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22
Q

when is a PCL repair indicated?

A

Injury is avulsion of ligament
When other structures are involved

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23
Q

what are the rotary instabilities at the knee?

A

Anteromedial, Anterolateral, Posteromedial, posterolateral

24
Q

where does the MCL attach?

A

proximally to medial femoral condyle & distally to medial aspect of tibia

Deep fiber originate from medial joint capsule & attach to medial meniscus

Ligament taut throughout range

25
Q

when is the MCL taut?

A

through knee range

26
Q

when is the LCL taut?

A

in extension

27
Q

when is LCL loose?

A

flexion

28
Q

what may also result from LCL moi?

A

traction injury to fibular nerve

29
Q

when are PT/rehab regimens effective for bakers cyst?

A

pts w/ minimal sxm & setting of smaller degenerative meniscal tears

30
Q

what does PT entail for treatment of plica syndrome?

A
  • Taping, exercise therapy, activity modification
  • Intra-articular steroid injection
  • Surgical excision
31
Q

which is dangerous: Chronic or acute compartment syndrome?

A

acute - Require immediate medical attention

32
Q

what can happen in acute compartment syndrome is left unattended?

A

permanent muscle damage

33
Q

what does patella Alta mean?

A

high patella

34
Q

what does patella Baja mean?

A

low patella

35
Q

what is chondromalacia?

A

softening & subsequent tearing, fissure & erosion of hyaline cartilage on underside of patella

36
Q

what are the risk factors for chondromalcia?

A

Previous patellar injury
-Patellar position
- Q-angle

37
Q

what are the normal values of Q angle in males & females?

A

18 females
13 males

38
Q

what does a larger Q angle indicate?

A

higher likelihood of lateral patellar tracking

39
Q

when exercising someone w/ chrondromalcia what should you focus on?

A

hip & quad strength & flexibility

40
Q

what is the recurrence rate of PFPS and why?

A

70-90% b/c they stop their exercises eventually

41
Q

what kind of outcomes are associated w/ PFPS?

A

poor w/ longer duration of sxm, higher baseline pain severity

42
Q

what is patellar tendinopathy?

A
  • Anterior knee pain localized at inferior pole of patella
43
Q

what is the prognosis of osgood schlatters?

A

resolution of sxm w/ decreased activity in 2-3 wks to 2-3 months

44
Q

what do we use to screen for fractures?

A

Ottawa knee rules & Pittsburg decision rule

45
Q

what do the Ottawa knee rules say?

A

Refer in injury was traumatic and any of the following pt presents:
- >55
-Tenderness to fibula head
-isolated tenderness of patella
-Inability to flex knee to 90
-Inability to walk 4 WB steps

46
Q

what does the Pittsburgh Decision rules say?

A
  • MOI was blunt trauma or fall & one one the following
    • Age <12 or >50
      - Inability to walk 4 WB steps
47
Q

what is a distal femoral shaft fracture?

A

Disruption of distal femoral shaft
Often displaced fx and/or comminuted

48
Q

what may a distal femoral shaft Fx lead to/

A

massive internal hemorrhage then shock

49
Q

what are some distal femoral Fx complications?

A

Mal-Union (rotated or shortened limb)
Joint and/or soft tissue adhesions
Post traumatic DJD

50
Q

what are some complication of proximal tibia fx?

A

Intra-articular & peri-articular adhesions
DJD

51
Q

where is a proximal tibia fx common in adults?

A

medial & lateral tibial plateau

52
Q

where is proximal tibia fx common in children?

A

Epiphyseal growth plate & metaphysical region

53
Q

what is the pathophysiology of a proximal tibial plateau?

A

-Split (younger) or Depression Fx (older)
-Common lateral plateau
-May contribute to ACL tear

54
Q

which way does the patellar normally dislocate?

A

Lateral

55
Q

what are the risk factors for patellar dislocation?

A
  • Increase Q angle
  • Weak VMO
56
Q

what is the joint progression of OA?

A
  • Loss of cartilage
  • Bony sclerosis, increased subchondral bone growth
  • Bone cysts
  • Osteophyte formation

Clinical Medicine (12 decks)

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