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NPTE > Knee > Flashcards

Knee Flashcards

1
Q

Patellar & Quad Tendinopathy: MOI & risks

A

-Change in training load.
-Inadequate recovery btwn training.
-Improper shoes or surface.
-Quad/Ham tightness.

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2
Q

Patellar & Quad Tendinopathy: presentation

A

Pain at inferior (patellar) or superior (quad) pole of patella.
Gradual onset.
Agg: increased load.

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3
Q

Patellar & Quad Tendon Rupture: MOI & risks

A

High tensile force on a weak tendon.
Sudden quad contraction on a flexed knee.
Patellar usually sport.
Quad usually fall.

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4
Q

Patellar & Quad Tendon Rupture: presentation

A

Unable to extend.
Acute onset.
Palpable gap.

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5
Q

Patellar & Quad Tendon Rupture: post-op treatment

A

Progress knee flexion slowly.
Focus on quad function (risk of long-term quad weakness or inability to contract).

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6
Q

Ligaments associated with medial stability

A

MCL
Posterior Oblique

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7
Q

Ligaments associated with lateral stability

A

LCL
Arcuate

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8
Q

Ligaments associated with anterior stability

A

ACL

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9
Q

Ligaments associated with posterior stability

A

PCL

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10
Q

Ligaments associated with patellofemoral stability

A

MPFL

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11
Q

Grade 1 Ligament Sprain

A

Mild, a few fibers torn.
Integrity maintained.
Pain w/ stretch.
Solid end feel.

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12
Q

Grade 2 Ligament Sprain

A

Moderate, half fibers torn.
Integrity partially lost.
Pain w/ stretch.
Mushy end feel.

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13
Q

Grade 3 Ligament Sprain

A

Severe, complete tear.
No pain.
Empty end feel.
Excessive joint movement.

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14
Q

ACL: MOI

A

Hyperextension + valgus on planted foot

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15
Q

PCL: MOI

A

Hyperflexion (dashboard MVC)

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16
Q

MCL: MOI

A

Valgus on planted leg

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17
Q

LCL: MOI

A

Varus on planted leg

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18
Q

ACL: key sxs

A

Loud pop heard/felt.
Instability w/ stair descend.

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19
Q

PCL: key sxs

A

Mild pop heard/felt.
Instability.
P! with decelerating.

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20
Q

MCL: key sxs & special tests

A

Tenderness over MCL.
(+) Valgus Stress Test.

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21
Q

LCL: key sxs & special tests

A

Tenderness over LCL.
(+) Varus Stress Test.

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22
Q

Anterior Drawer Test

A

ACL instability.
(+) excessive anterior translation.

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23
Q

Lachman’s Test

A

ACL instability.
Knee 20-30 flex.
Stabilize femur laterally.
Move tibia anteriorly (grip medial).
(+) excessive translation.

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24
Q

Posterior Drawer Test

A

PCL instability.
Anterior Drawer procedure, but pushing tibia posteriorly.
(+) excessive posteriior translatoin.

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25
Q

Posterior Sag Test

A

PCL instability.
Observe joint line for posterior sag with knee at 90 flex.

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26
Q

ACL: post-op timeline

A

4-6mo for functional.
9-12mo for return to sport.

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27
Q

ACL: return to sport criteria

A

> 90% quad symmetry.
90% SL hop symmetry.

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28
Q

ACL: treatment focus

A

Quad strength!
OKC knee ext good bc isolates quads.
CKC too early may lead to compensations with other mm.

29
Q

PCL: when is reconstruction indicated?

A

Grade 3.
Most others do well non-op.

30
Q

PCL: potential complication if instability persists?

A

Meniscus tears

31
Q

MCL: treatment focus

A

Quad activity.
Stabilization (bracing, exercises).
Medial immobilization for grades 2-3.

32
Q

MCL: when is reconstruction indicated?

A

Rarely; good blood supply so usually heals w/ conservative.

33
Q

LCL: when is reconstruction indicated?

A

Grade 3 + avulsion.
Grade 3 midsubstance tear.

34
Q

Common combined ligament injuries

A
  1. Posterolateral Corner: LCL + Popliteus tendon + Popliteo-fibular ligament.
  2. Posterolateral Corner + ACL or PCL.
  3. ACL + MCL.
  4. Unhappy Triad: ACL + MCL + Med Meniscus.
35
Q

Grade 1 Muscle Strain

A

Pain = none or mild.
ROM deficit = mild.

36
Q

Grade 2 Muscle Strain

A

Pain = moderate.
ROM deficit = moderate.

37
Q

Grade 3 Muscle Strain

A

Pain = none (if complete rupture) or severe.
ROM deficit = severe.
Palpable defect.

38
Q

HS Strain: MOIs for mid-substance & proximal

A

Mid-Substance: high speed running, strong eccentric contraction @ terminal swing.
Proximal: high hip flex with knee ext (high kick).

39
Q

HS Strain (Mid-Substance): key sxs

A

Pain: moderate
SLR: 40% decreased compared to good side.
Knee flex strength: 60% decreased compared to good side.

40
Q

HS Strain (Proximal): key sxs

A

Pain: minor.
SLR: 20% decreased compared to good side.
Knee flex strength: 20% decreased compared to good side.

41
Q

HS Strain (Mid-Substance): which muscle typically involved?

A

Biceps Femoris

42
Q

HS Strain (Proximal): which muscle typically involved?

A

Semimembranosus tendon

43
Q

Prevention of HS strains

A

Eccentrics!

44
Q

Meniscus Tear: which is more common in different populations?

A

Degeneration (older) = medial.
Traumatic = either.

45
Q

Meniscus Tear (traumatic): MOI

A

Medial: valgus, tibial lateral rotation.
Lateral: varus, tibial medial rotation.

46
Q

Meniscus Tear: key sxs & presentation

A

Joint line tenderness.
P! with passive max knee flex.
P! with hyperext.
Delayed swelling (6-24hr post-injury).

47
Q

Meniscus Tear: special tests

A

-McMurray
-Thessaly
-Ege
-Apley Compression/ Distraction

48
Q

McMurray Test: procedure, purpose, (+)

A

Meniscus.
Max knee flex, then ER/IR.
(+) P! w/ ER = medial.
(+) P! w/ IR = lateral.

49
Q

Thessaly Test: procedure, purpose, (+)

A

Meniscus.
Twist side to side with knee at 5deg flex, then again at 20 flex.
(+) more P! at 20deg; catching, locking.

50
Q

Ege Test: procedure, purpose, (+)

A

Medial Meniscus: hips ER (feet out), squat then stand.
Lateral Meniscus: hips IR (knock-knee position), squat then stand.
(+) = P! and clicking.

51
Q

Apley Compression/ Distraction Test: procedure, purpose, (+)

A

Meniscus.
Prone, knee 90 flex.
1. Axial force thru foot while ER/IR.
2. Distract while ER/IR.
(+) = P! with compression & relief w/ distraction.

52
Q

Osgood Schlatter: definition & MOI/risks

A

-apophysis of tibial tub
-repetitive loading (running, jumping) in adolescence
-male>female

53
Q

Osgood Schlatter: key sxs

A

-Tender tibial tub.
-P! with quad activation.
-Agg: squat.
-Tight quads, HS, gastroc.

54
Q

Osteochondritis Dessicans: definition & common location

A

Bone & cartilage detach from underlying bone d/t lack of blood flow.
Bone & cartilage fragments float in joint space.
Medial epicondyle most common.

55
Q

Osteochondritis Dessicans: treatment

A

Surgical removal of loose bodies.
Focus of post-op PT: muscle recruitment & gradually progress WB.

56
Q

PF Instability: definition

A

patella subluxes or dislocates out of trochlear groove

57
Q

PF Instability: MOI & risks

A

-Patella alta
-Trochlea shallow/flat
-Insufficient medial stabilizers (MPFL & VMO).
-Tight lateral retinaculum.
-Traumatic MOI = forceful quad contraction.

58
Q

PF Instability: treatment & considerations

A

Taping, strengthening mm.
Recurrence high.
Risk of PF OA.

59
Q

Apprehension Test: procedure, purpose, (+)

A

Patellar subluxation or dislocation.
Knee slightly flexed, apply force medial to lateral on patella.
(+) = apprehension, palpable subluxation or dislocation.

60
Q

PFPS: key sxs

A

-Anterior knee P!
-Lateral patella tracking.
-Movie Goer’s Sign (agg by prolonged sitting).
-P! with end-range flexion.
(+) Clarke’s Test
(+) Step Down Test
(+) Patellar Apprehension Test

61
Q

Clarke’s Test: procedure, purpose, (+)

A

PFPS
Place web-space over superior patella, apply pressure downward + inferiorly.
Pt contracts quads.
(+) = P!

62
Q

Step Down Test: procedure, purpose, (+), and variations

A

PFPS
Step down (mimics stair descend).
Variations: lateral step down, decline step down.
(+) = P!

63
Q

Patellar Apprehension Test: procedure, purpose, (+)

A

PFPS
Medial to lateral glide over patella.
(+) = P! and excessive lateral displacement.

64
Q

Tibiofemoral Arthrokinematics (open chain)

A

Concave tibia moving on fixed femur.
Flex = tib roll & glide posteriorly.
Ext = tib roll & glide anteriorly.

65
Q

Tibiofemoral Arthrokinematics (closed chain)

A

Convex femur moving on tibia.
Flex = posterior roll, anterior glide.
Ext = anterior roll, posterior glide.

66
Q

Screw Home mechanism

A

Describes rotation at end range extension.
Lateral side of tibial plateau smaller, so stops first.
Open Chain: tibial ER.
Closed Chain: femoral IR.

67
Q

Tibial Posterior Glide: procedure & promotes what motion?

A

Flexion.
Push posteriorly while pt digs heel into table.
*Variation = add angulation (slightly ER or IR tibia).
-ER = relief laterally.
-IR = relief medially.

68
Q

Tibial Anterior Glide: procedure & promotes what motion?

A

Extension.
Slightly IR femur & ER tibia.
Posterior glide to femur + anterior glide to tibia.

69
Q

Patella Superior & Inferior Glides: promote what motions?

A

Superior = ext.
Inferior = flex.

NPTE (28 decks)

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