Knee Flashcards
list cruciate ligaments of knee
ACL, PCL
function and location of ACL PCL
Cross each other like an “X”
limit knee hyperextension
ACL - prevents anterior displacement (forward and lateral) of tibia on femur
PCL - prevents anterior displacement of femur on tibia
Cruciate ligament more prone to injury
ACL - due to deceleration, plant & pivot
how is an ACL injury diagnosed
MRI
MOI of ACL injuries
- combo of fixed foot with valgus force and external rotation
- cutting, landing or deceleration
- usually non-impact
-ACL rupture - females more susceptible to injury
S&S of ACL injuries
-Pain (deep, minimal to severe and lasting)
- “pop” heard or felt
- rapid/immediate swelling
- instability “doesn’t feel right”
- partial to no weigh bearing
MOI PCL injuries
tibia goes backward
hyperextension
falling on knee in bent position
direct impact on tibia just below knee
S&S PCL injuries
- pain, tightness behind knee
- feeling of joint instability
- swelling (not always, minimal)
- may be unable to walk, full weight bear (FWB)
name collateral ligaments
MCL, LCL
how does the MCL and LCL get injured
MCL - Resist valgus force at knee
LCL - Resist varus force at knee
Define valgus and varus force
Valgus - force from lateral to medial, MCL MOI
Varus - force from medial to lateral, LCL MOI
what is commonly injured with MCL
medial meniscus
MCL deep fibers attached
“bucket handle” tears on meniscus
MOI of meniscal injuries
- quick sharp twisting movement with planted foot
- possible isolated injury from MCL
- common to tare with ACL and MCL (“terrible triad”)
S&S fo meniscal injuries
medial or lateral joint pain with twisting of knee
symptoms vague/limited - limited nerves, minimal disability or swellinh
pain occurs over joint line
significant tear - clicking/locking, buckling, torn flap of meniscus locks knee
List types of meniscal tears
Bucket handle (hole in meniscus)
Flap tear (“hang nail”)
Transverse tear
Torn horn tear (posterior, at back of “C”)
special test for LCL
Varus stress test - push on inside knee, pull on ankle
Special test for MCL
valgus stress test - push on outside of knee, pull on ankle
bend knee 30-40 degrees for deep fibers
special test for ACL and PCL
Anterior drawer - ACL
posterior drawer - PCL
bend knee, thumbs on front of knee, fingers behind knee
- move forward (ACL)
- Move backward (PCL)
types of knee braces, functions
off the shelf (OTS) - hinges, soft, minimal/moderate support
custom - specific hinges/strapping, de-rotational, max support
rehabilitative - post op, restrict ROM
What should you do with a patellar dislocations
commonly patella goes outward
call AT
what type of bone is the patella
sesamoid - imbedded in quad tendon, travels in femoral groove, patello-femoral syndrome
common cause of patellar tendonitis? special test?
weakness of lower quad muscle (vastus medialis) and glute muscle (gluteus medius)
ask athlete to contract quad or perform straight leg raise
Patellar tendonitis MOI
- repeated, overuse stress on infrapatellar tendon
- running, hills, jumping, over-training
- muscle imbalance ( weak medial quad, tight hamstrings)
- Eccentric forces at various points on patella and extensor (quad)
S&S of patellar tendonitis
- localized tenderness at apex of patella or along tendon
- swelling or deformity
- gradual onset, local soreness, dull aches, stiffness, stair painful
Blood supply of meniscus
Outer 1/3 has supply
Inner 2/3 doesn’t
