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THEREX 2 > Knee > Flashcards

Knee Flashcards

1
Q

The medial mensicus attaches to what ligaments

Lateral meniscus?

A

medial= MCL, ACL, PCL

Lateral = PCL

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2
Q

When the quads activate the mensicus glides ________

A

anteriorly

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3
Q

Which part of the MCL attaches to the medial mensicus?

A

Deeper portion (which is separate from the superficial portion)

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4
Q

In flexion the ___________ bundle of the ACL is tight

A

anteromedial

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5
Q

In extension which bundle of the ACL is tight

A

post-lateral

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6
Q

which portion of the ACL primarily provides restraint to rotational forces

A

postero-lateral

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7
Q

The anteriorlateral bundle of the PCL is tight in __________

the posterio-medial bundle of the PCL is tight in ____________-

A

flexion

extension

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8
Q

What attachs to the medial meniscus?

A

dMCL

Semimembranosus

Quadriceps

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9
Q

What attaches to the lateral mensicus

A

Popliteus

Quadriceps

Arcuate ligament

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10
Q

which mensicus is more mobile

which is C shaped?

A

lateral

medial

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11
Q

which mensicus is more prone to injury

A

medial

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12
Q

how much does the patello-femoral joint normally move

A

7-8 cm

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13
Q

As the knee extends how does the patella move

A

superiorly

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14
Q

Causes of patellar tracing problems

A

Increased Q angle

short IT band (possibly an upslip)

weak hip ABD/ER

foot pronation

lax medial patellar retinaculum

insufficient vmo?

deficits in lateral groove

pelvic dysfunction

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15
Q

what is the open packed position of the knee

A

25

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16
Q

how much flexion is needed to ride a bike

A

110

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17
Q

when is patellar compression greatest in close chain?

What about open chain?

A

CKC- 90

OKC- 30

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18
Q

how much tibial rotation should there be each direction

A

20-30

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19
Q

what muscles externally rotate the tibia when the knee is flexed

what musces medially rotate

A

TFL and biceps femoris

popliteus medially rotates

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20
Q

Knee effusion leads to ________

A

inhibition of the quadriceps

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21
Q

what is the 1# priority in post-op knee patients

A

restoring ext ROM

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22
Q

Weight loss is shown to decrease load on the knee by

A

1:4 ratio

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23
Q

At what point in the knees motion is the quadricep at a mechanical disadvantage

A

last 15 degrees of knee ext

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24
Q

what muscle controls the amount of knee flexion in closed chain activities

A

quad

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25
what muscle resists hyperextension of the knee and supports the posterior capsule
gastroc
26
50+ Knee crepitus Boney enlargements Morning stiffness under 30 mins no palpable warmth
Knee OA
27
What has strong evidence for treating OA?
Exercise NSAIDs Self management Education
28
For OA, what evidence level?: Unloading Neuro-Rehab Weight Loss Corticosteroid inj
Moderate
29
For OA, what evidence level: Lateral wedge insoles Oral narcotics Hyaluronic acid Arthoscropy w/ lavage or debridement
NOT recommended
30
Indications of TKA
**Severe joint pain** that compromises function extensive destruction of artiuclar cartilage/ advanced **arthritis** Marked deformity of knee such as **genu varum or valgum** gross **instabilty** or limitation of motion failure of non-oporative management
31
What movements are associated with valgus collapse of the knee Foot: Hip: VMO inhibiton?
Foot : ER Hip: Adduction and IR (Hip Abduction and ER weakness)
32
Pain with squatting, getting up from chair, kneeling, prolonged sitting, jumping, walking, running
PFPS
33
PFPS acute treatment
modalities, rest, gentle ROM, muscle setting exercises in pain free position, isometrics
34
PFPS subacute management
look at hip (address contributing mechanical factors) Education: reduce stairs initially, avoid prolonged sitting Address flexibility issues improve muscle strength and endurance of knee extensors and hip extensors, ER, ABD
35
PFPS exercises in close chain: Must exercise caution when.....
squatting past 60 degrees
36
PFPS beginning exercises
Open chain; Quad sets, isometrics CLosed chain: mini squats, leg press
37
# [](http://) Pain localized at inferior pole of patella load related pain that increases with demand on knee extensors rarely pain at rest
patellar tendonopathy
38
39
In what order do you progress exercises for patellar tendinopathy
Isomeetric Isotonic Energy Storage (like jumping) Return to sport
40
What evidence level: Progressive knee flexion and progressive WB for meniscal and articular cartilage legions
Grade B Moderate
41
What’s a major difference between a meniscus and an articular cartilage tear
Meniscus- delayed swelling Articular cartilage- immediate hemarthrosis
42
What is most important for fixing instabilities in the knee joint
Functional stability- sensorymotor control
43
What can injure: Medial meniscus, posteromedial capsule, ACL, and MCL
Valgus force
44
What structures are injured in the unhappy triad
ACL/ MCL/ Medial Mensicus
45
What ligament is injured most common w/ hyperext
ACL and sometimes PCL and menisci
46
What ligament is injured with flexion and posterior translation AKA dashboard injury
PCL
47
Varus force typically injuries what structures
LCL, Posterolateral capsule, PCL
48
Which ligaments often do fine non-operatively
PCL and MCL
49
signs and symptoms of ACL injury: Hx of giving way loss of end range ___________ 6m SL hop test less than ____________________ special tests: ______________ guarding my hamstrings
knee ext less than 80% Lachman, Anterior drawer, pivot shift
50
What is the MOI that can cause the unhappy triad?
Sudden valgus impact with IR or ER of tibia
51
signs and symptoms of unhappy triad:
Swelling, hemorrhage, pain, impaired muscle control/inhibition
52
What is the critera necessary to get out of the acute phase of ACL injury
Minimal swelling and pain Full ROM SLR with NO LAG Normal gait with no AD or brace
53
What is the most important motion to get at the knee in the acute phase
ext
54
What kind of disinhibitory treatment do you do for patients who are less than 3 months post op OR have swelling and pain for ACL/ quad inhibition
TENS (treats arthrogenic muscle inhibiton)
55
What kind of disinhibitory treatment do you do for patients with no swelling/pain who are over 3 months post OP for acl injury
NMES to treat cortical inhibitions
56
When can you start doing single leg strengthening for ACL
around week 6
57
What is the critera for the strengthening phase for post-ACL injury
Squat equal on both sides
58
At what degrees of flexion are OKC exercises safe to preform for ACL injuries when is there the most strain on the ACL?
between 90 and 40 between 40 and 0
59
T or F: There are simular strain values to the ACL when comparing open chain knee ext and closed chain squats
T
60
When can a patient start running, double leg jumping, and going back to gym after an ACL injury
functional phase: 8-16 weeks
61
Return to run criteria
95% knee flexion ROM full knee ext no effusion limb symmetry 80% quad:hamstring LSI >80% eccentric impulse during countermovement jump pain free aqua jogging and alter-G running pain free repeated single leg hopping
62
At how many weeks can post ACL injury begin single leg hopping how many weeks for cutting/changing direction
16 weeks 20 weeks
63
Return to sport critera for ACL
Normal Neuromuscular control Quad/HS/Glute index over 90% or isokinetic testing at 60d/s Hamstring quad ratio over 66% Hop test 90% comparable to contralateral side. Good landing mechancis
64
What are posterolateral corner repair patients not allowed to do at any point in rehab process
Pt is WBAT in brace for 4 weeks, avoid active knee flexion for 4 weeks NO resisted leg ext machine AT ANY TIME IN REHAB no high impact cutting/twisitng activities for 3-4 months post-op
65
IT band syndrome factors Excessive foot ______ Excessive _______ rotation/torsion Genu ___________ Deep hip rotator/abductor weakness innominate positioning
Pronation Internal genu varum
66
Osgood schlatter syndrome happens at the _______ Sinding larsen johansson syndrome happens at the _____________
Tibial Tuberosity Inferior pole of patella

THEREX 2 (12 decks)

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