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BPK 241 Injury Scenario > Knee > Flashcards

Knee Flashcards

1
Q

Observation for the knee

A
  • Gait analysis –> knee valgus or varus
  • Squat –> depth
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2
Q

AROM/PROM for knee

A
  • Knee flexion (laying on stomach)
  • Knee extension
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3
Q

Strength Testing for knee

A
  • Knee flexion (hamstrings)
  • Knee extension (quad)
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4
Q

Ligament stress tests for knee

A
  • Posterior sag –> PCL
  • Posterior drawer –> PCL
  • Lachman test –> ACL
  • Anterior drawer –> ACL
  • Valgus stress test –> MCL
  • Varus stress test –> LCL
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5
Q

Posterior Sag

A
  • Knee flexed 90 degrees
  • Looking if PCL stays intact
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6
Q

Posterior drawer

A
  • Hip flexed 45 degress knee flexed 90 degrees
  • Hands resting on the depression in the knee
  • Push forward
  • Observe posterior translation
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7
Q

Lachman Test

A
  • 30 degree flexion of knee
  • Bring tibia into slight external rotation
  • One hand on femur other hand below the knee
  • Hand on femur pushes down while hand below the knee pulls up
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8
Q

Anterior drawer test

A
  • Hip flexed 45 degress knee flexed 90 degrees
  • Hands resting on the depression in the knee
  • Pull
  • Observe anterior translation
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9
Q

Valgus stress test

A
  • 30 degree knee flexion
  • One hand grabbing end of lower leg other hand grabbing femur
  • External rotate the tibia
  • Hand on lower leg outwards (laterally) while hand on knee is inwards (medially)
  • Observe for laxity for MCL
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10
Q

Varus stress test

A
  • 30 degree knee flexion
  • One hand grabbing end of lower leg other hand grabbing femur
  • External rotate the tibia
  • Lower leg is pulled (medially) while knee is outwards (laterally)
  • Observe for laxity for LCL
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11
Q

Special test for the knee

A
  • Intracapsular swelling test
  • McMurray’s test for meniscus
  • Apley’s compression test for meniscus
  • Lateral patellar glide
  • Patellar grind
  • VMO contraction
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12
Q

Intracapsular swelling test

A
  • Patellar compression –> push down on the top of patellar
  • Swipe Test –> swipe up on medial side, down on lateral side
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13
Q

McMurray test

A
  • Knee flexed 90 degrees
  • One arm on lower leg, other one femur
  • Internally rotate knee for lateral meniscus, externally rotate knee for medial meniscus
  • Bring knee to flexion and extension
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14
Q

Apley’s compression test

A
  • Lay on stomach with knee flexed 90 degrees
  • One hand on heel other hand on ankle
  • Push down on leg while turning
  • Internal rotation of knee for lateral meniscus, external rotation of knee for medial meniscus
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15
Q

Lateral patellar glide

A
  • Stand on opposite side of knee
  • Use both hands to apply a lateral force to patella
  • Examine for laxity
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16
Q

Patellar grind test

A
  • Press down on the top of the patella
  • Patient contracts quadriceps
  • Observe for pain, clicking or grinding
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17
Q

VMO contraction

A
  • Have patient contract quad
  • Observe if contraction is weak or absent
18
Q

Palpation for knee

A
  • Medial meniscus
  • Lateral meniscus
  • MCL
  • LCL
  • Medial retinaculum
  • Underside of patella
19
Q

Injuries for the knee

A
  • ACL sprain
  • PCL sprain
  • MCL sprain
  • LCL sprain
  • Meniscus tears
  • Patellar dislocation
  • Patellofemoral Pain Syndrome
20
Q

History for ACL sprain

A
  • Impact from the lateral side
  • Athlete will report a pop
  • Knee buckles into valgus
  • Sometimes pain sometimes no pain
  • Instability
21
Q

Assessment for ACL sprain

A
  • Laxity or pain with anterior drawer and Lachman
  • Positive swipe test
  • Positive patellar compression test for swelling
  • Restricted knee flexion and extension
22
Q

Treatment for ACL sprain

A
  • POLICE
  • Strengthening specific to hamstring –> hamstring curl bodyweight then machine
  • Bracing
  • Possible surgery if ACL ruptured
23
Q

History for PCL sprain

A
  • Impact with dashboard in car accident
  • Falling on another athlete
  • Tibia translating posteriorly
  • Direct impact, may report pop
24
Q

Assessment for PCL sprain

A
  • Positive posterior sag
  • Laxity with posterior drawer test
  • Positive intracapsular swelling tests
  • Possible limitation into knee flexion and extension
25
Q

Treatment for PCL sprain

A
  • POLICE
  • Strengthening specific to quad –> step ups on an elevated platform, body weight then can carry weighted items
  • Bracing
  • No surgery
26
Q

History for MCL sprain

A
  • Lateral impact from side
  • Reports a pop
  • Valgus force applied to knee
27
Q

Assessment for MCL sprain

A
  • Swelling
  • Laxity with either or both valgus stress
  • Limited ROM KF/KE
  • Pain over MCL
28
Q

Treatment for MCL sprain

A
  • Avoid valgus forces during daily activities
  • ROM exercises –> heel slides
  • Deep transverse friction massage
  • Brace
  • Surgery very rare
29
Q

History for LCL sprain

A
  • Impact from medial side
  • Might report pop
  • Varus force applied
  • Often from a fall, not common injury
30
Q

Assessment for LCL sprain

A
  • Swelling
  • Laxity with either or both varus stress tests
  • Limited ROM KF/KE
  • Pain over LCL
31
Q

Treatment for LCL sprain

A
  • Avoid varus forces during daily activities
  • ROM exercises –> heel slides
  • Deep transverse friction massage
  • Brace
  • Surgery very rare
32
Q

History for meniscus tears

A
  • Planted foot with rotary force
  • Clicking, popping
  • Present as chronic in older athletes
  • Knee can feel unstable
33
Q

Assessment for meniscus tears

A
  • Positive apley’s and mcmurray’s test
  • Internal rotation stresses later meniscus
  • External rotation stresses medial meniscus
  • Positive intra-capsular swelling
  • Pain over medial or later joint line
34
Q

Treatment for meniscus tears

A
  • POLICE
  • AROM –> heel slide
  • Strengthening exercises –> step ups on an elevated platform, body weight then can carry, hamstring curl bodyweight then machine
  • Possible surgery
35
Q

History for patellar dislocation/subluxation

A
  • Dislocation –> kneecap completely comes out of groove
  • Subluxation –> patellae slipped out of groove
  • Patellae dislocates almost exclusively laterally
  • Can be impact or non-contact
  • Extremely painful
36
Q

Assessment for patellar dislocation/subluxation

A
  • Limited ROM KF/KE
  • Weakness KE
  • Swelling
  • Positive lateral apprehension test
  • Pain over medial retinaculum
37
Q

Treatment for patellar dislocation/subluxation

A
  • If dislocated immobilize, don’t move athlete call 911
  • Strengthen quads –> Lie on back and extend knee and raise affected leg while keeping leg straight
  • Use a brace
  • Restore squat pattern
38
Q

History for Patellofemoral Pain Syndrome

A
  • Chronic injury
  • Repetitive KF/KE
  • Common in running
  • Pain behind knee cap
  • Pain worse with sitting knee bent or exercising
  • Getting progressively worse
39
Q

Assessment for Patellofemoral Pain Syndrome

A
  • Poor squat pattern
  • VMO contraction test positive
  • Positive patellofemoral grind test
  • Pain over dorsal patellae
40
Q

Treatment for Patellofemoral Pain Syndrome

A
  • Rest, ice
  • Biomechanical correction
  • Squat pattern education
  • Patellar taping or strap
  • Stretch and strengthen quads –> straight leg raises, hip flexors –> high kicks , hip abductors –> open the gate

BPK 241 Injury Scenario (11 decks)

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