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MS 1 > Knee > Flashcards

Knee Flashcards

1
Q

knee, closed pack pos.

A

full extension

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2
Q

during extension, tibia glides ____ on femur

A

anteriorly

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3
Q

during felxion, tibia glides_____ on femur

A

posteriorly

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4
Q

tibiofemoral joint is a con____ on con____

A

convex on concave

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5
Q

describe screw home mech.

A

> from 30-15 degrees of extension= ER of tibia w/ anterior glide
from 15-5 degrees of ext. =more ER less ant. glide
from 5-0 degrees of ext=pure ER, no glide

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6
Q

patellofemoral joint glides_____with flex and ____ with ext.

A

cuadally/inferior and medially with flexion, superiorly and laterally with extension

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7
Q

with moving into flexion, what parts of the patella contact the femur?

A

inferior (20 deg. flxn) –>medial (60 degrees)–>superior patella (90 degrees flxn)

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8
Q

when does the patella have most play (least contact with condyles) and least play (most contact with condyles)

A

most play= full extension

least play= 60-90 degrees flexion

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9
Q

common causes of anterior knee pain?

A

patellofemoral pain, quadriceps tendonitis, patellar tendonitis, patellar fat pad irritation (FPI)

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10
Q

causes of lateral knee pain?

A

LCL, lateral meniscus, IT band, spine referral?

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11
Q

causes of medial knee pain?

A

MCL, med. meniscus, pes anserine, bursitis, L3 referral, plica

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12
Q

posterior knee pain?

A

bakers cyst, PCL, hamstring strain, spine referral

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13
Q

diff. diagnose “locking” in the knee

A

meniscus flap caught= lacking 20-30 degrees of motion and its not so painful.
> loose bodies/ chondromalacia/ osteophytes= lacking last 5 degrees and will be SUPER PAINFUL

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14
Q

special tests for ACL

A

ant. drawer, lachmans (more sensitive)

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15
Q

how much should knee be bent for lachman’s

A

30 degrees

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16
Q

PCL sp. tests

A

posterior drawer, post. sag

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17
Q

should u do PCL or ACL tests first?

A

PCL, bc if PCL is the prob, u might get false positives on anterior drawer and ACL tests even though ACL is fine

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18
Q

LCL test?

A

varus test

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19
Q

MCL test?

A

valgus stress test

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20
Q

what angles do u test LCL and MCL at?

A

at 5-10 degrees and again at 30 degrees to take cruciates out of it

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21
Q

so if a valgus test is positive at 15 degrees, what does that mean?

A

it may either be the MCL or the ant/post. cruiciate ligaments.

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22
Q

If u then repeat the valgus test at 30 degrees and it is positive again, what does that mean?

A

that the cruciates are not involved and it really is most likely the MCL

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23
Q

tests for meniscus?

A
  • Apley’s compression
  • Apley’s distraction (collaterals)
  • McMurrays
  • single leg squat and rotate (Thessaly’s)
  • toes in/out squatting
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24
Q

patello-femoral tracking tests

A
  • apprehension test (knee at 20 degrees of flexion, go to glide patella laterally), watch for quad contraction and grimace
  • critical test
  • patellar tap test (for effusion)
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25
Q

how to measure knee ?

A

measure 2 cm above and below joint line to measure swelling

*measure 10 cm above and 20 cm above joint line for quad atrophy and measure 10 cm below for gastroc atrophy

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26
Q

involved leg must be ____% of uninvolved leg to go back to sport

A

90 %

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27
Q

back to sport tests for knee

A 
one legged squat
percentage leg press
one leg balance
one leg cycling
one leg triple hop for distance
one leg hop for distance
timmed one leg hop on minitramp
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28
Q

femoral condyle injury- osteochondritis dessicans

A

focal injury to articular cartilage of femoral condyle or on back of patella

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29
Q

symps of femoral condyle injury

A

pain, swelling, catching, pain with palpation

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30
Q

how to treat osteochondritis dessicans

A

carticel transplant surgery, rehab

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31
Q

Bursitis in knee

A

overuse injury, bursa between tendon and bone or skin and tendon

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32
Q

where can u get bursitis in the knee? (6)

A

subcutaneous prepatellar bursa, subcut. infrapatellar bursa, deep infrapatellar bursa, suprapatellar bursa, pes anserine bursa, semimembranosus bursa

33
Q

PT tx for bursitis

A

PRICE, pt education,

34
Q

sx tx for bursitis

A

fluid aspiration

35
Q

s&s of bursitis

A

obvious inflammation, swelling, pain with palpation.

36
Q

fat pad irritation of knee

A

irritation of the infrapatellar fat pad behind the patellar tendon

37
Q

causes of FPI

A

knee hyperextension (fat pad gets pinched between tibia and patella), overuse, or traua/direct blow

38
Q

how do u differentiate patellar tendonitis vs. FPI?

A

with patellar tendonitis it is painful with palpation to the tendon itself, with FPI, all around the tendon will be painful but not the tendon itself

39
Q

acute treatment of, FPI?

A

no quads, modalities (ionto) and NSAIDS, tape superior pole to relieve pressure on inferior pole, mm lengthening of quads

40
Q

knee instability

A

when the knee translates out of its ligamentous and muscular boundaries and the articular cartilages are partially or completely disengaged

41
Q

test for knee instability

A

ACL, PCL, MCL< LCL, tests. MMT, mm length tests

42
Q

Rehab goals for knee instability

A

strengthen surrounding musculature, stretch areas that need it without stressing the ligature to create balanced ROM

43
Q

what results from a dashboard injury?

A

PCL injury

44
Q

what results from excessive valgus force?

A

MCL injury

45
Q

What results from excessive varus forces?

A

LCL injury

46
Q

what results from blow to a planted foot while cutting,

A

ACL injury

47
Q

Placement of ACL in knee

A

medial lateral femoral condyle to the lateral medial tibia

48
Q

MOI for ACL injury

A

cutting, decelerating quickly, hyperextension, valgus force, axial rotation with foot planted

49
Q

S&S ACL injury

A

popping, giving out, pain, swelling, instability, inability to walk, quad atrophy, hemarthrosis (bleeding into the joint spaces)

50
Q

PCL placement in knee

A

medial condyle of femur to lateral tibia

51
Q

MOI PCL injury

A

fall on hyperflexed knee, hyperextension, varus/valgus forces with planted foot, dashboard injury

52
Q

S&S PCL injury

A

pain, pain with kneeling, squatting, running, slowing down, walking up or down stairs, minimal swelling/tenderness (bc its so deep), instability, popping, giving out, anterior tibia contusion, post. knee pain especially past 90 degrees of flexion

53
Q

S&S MCL injury

A

pain over ligament, swelling, bruising, instability

54
Q

MOI MCL

A

valgus force, hyperextension

55
Q

which is described as a “clipping injury”

A

MCL

56
Q

LCL S&S

A

pain, swelling, stiffness, catching/locking,Numbness/weakness in foot if peroneal nerve is stretched or compressed

57
Q

MOI LCL

A

varus force, hyperextension

58
Q

Meniscal injury

A

sharp pain, pop, giving way, locking/catching, clicking/snapping

59
Q

aggrivating factors of meniscal injuries

A

stairs, squatting, sit to stand, WBing in general, joint line tenderness with palpation, swelling

60
Q

MOI meniscus tear

A

flexion, compression, rotation

61
Q

patellofemoral pain syndrome

A

anterior knee pain, under patella, imbalance of forces pulling patella

62
Q

Tests for patellar femoral pain syndrome?

A

Q angle
mod. obers for IT band tightness,
pes planus?
critical test

63
Q

tx for PFPS

A

patellar mobs, mm strengthening to correct imbalances,

IT band flexibility

64
Q

gold standard tests for meniscal tears?

A

joint line pain and thessaly’s

65
Q

Knee OA tests

A 
compression test
mcmurrays
joint girth
crepitus?
MMT
Knee CPR? (flex>ext)
66
Q

Tx knee OA

A 
distraction
glides to inc. ROM
ice 
ultrasound
mobility (50 reps) and unweighted exercise (aquatics, bike)
67
Q

pain behavior for knee OA

A

intermittent stiffness <30 mins in morning

68
Q

IT band syndrome tests

A

lat. knee pain with flex/ext.
weak abductor on MMT
trendelenburg?
palpate band-tender,tight

69
Q

IT Band syndrome tx

A 
ice
med patellar mob to stretch?
massage
foam roller
doorway stretch
clams
SLS
monster walks
70
Q

Osgood schlatter’s: test

A

palpate tibial tub.
pain with kneeling
obvious deformity

71
Q

osgood schlatters: tx

A

ice
ultrasound to inc. flexibility of tissues?
sup. patellar glide to lengthen tendon, massage
strengthen hammys, change up routine, lengthen quads

72
Q

Baker’s cysts

A

obvious deformity in post. knee that is tender to palpation, measure knee girth, restricted flexion with goni

73
Q

Tx for baker’s cyst

A

ice, ROM, treat underlying cause (most likely meniscus)

bike, low resistance high reps

74
Q

Plica syndrome: tests

A

palpation
limited flex/ext due to swelling
grind test

75
Q

plica Tx

A 
mobs for area of restriction
ice
ultrasound
ionto
bike
 low load high reps
76
Q

patellar tendinosis: tests

A

pain with resisted knee extension

pain reproduced with squatting, lunging, jumping

77
Q

treatments for patellar tendinosis

A

mobs to inc. extension in tendon, lengthen quads, eccentric strengthening

78
Q

4 stages of patellar tendinosis

A

1) pain after activity
2) pain before and after activity
3) pain before,after and during activity but performance still ok
4) pain before, after, during and performance not ok

MS 1 (11 decks)

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