Knee 4 - triage Flashcards
do you palpate if there is an open injury
No
what are the ottowa knee rules
55+
isloated tenderness of the patella
or
tenderness over the fibular head
unable to flex the knee past 90
unable to weight bear immediatly or four steps in the ED
how do the ottowa knee rule work
if any of these are present after an acute injury then send the patient to the ED
what are the pittsburgh knee rules
blunt trauma or fall is the MOI
+ (one)
age under 12
age over 50
unable to wieght bear in the ED
if a patient has dimished or absent distal pulses or absent sensation what are you as a PTs next steps
send the pt to the ED - do not finish your exam
what to do if someone has low index of suspicion ottwa knee rule
finish examination and the refer out
what to do if someone has a high index of suspicion and has a high index for ottawa knee rule
stop and refer to the ED
if someone has a gross misalignment of the limb what do we do
stop and refer to the ED
includes:
dislocation without reduction
if someone presents with dislocation without reduction can we fix this ourselves
no, unless this is a long time to get to the ED
what are the two pulse that we find in out feet
dorsalis pedis
post tib art
is the post tib art on the medial or later part of our ankle
medial ankle
how do we find the dorsalis pedis pulse
he first intermetatarsal space just lateral to the extensor tendon of the great toe.
distal to the navicular
what is the most common knee fracture
patella (40%)
tib plateau (32%)
are knee fracture common injuries
no only 6% of knee injuries
when rehabing a knee fracture is strengthing allowed
yes - just no pain reproduction
what is the most common knee dislocation
tib ant on the femur
why is knee dislocation serious
becasue of the neruvscular structure in the popliteal fossa
peroneal and tibial nerve
popliteal art and vien
what is the treatment for dislocation
immobilization
surgerical reconstruction
what distal pulse do you check if there is a post dislocation
post tib art
if there is a posteriolat dislocation which pulse will we evaluate
that dorsalis pedis
- because of the impact on the anterior tibial art
when are DVT common
after surgery
what age does the risk of DVT increase
after the age of 60
lifestyle factors that contribute to DVT
sitting or inactivity for a long time - car, plane (without the muscles the blood sits stagnant)
obesity
birth control
smoking
what are the signs and symptoms of a DVT
swelling in one or both legs
pain or tenderness …
warmth of skin in the affected leg
red/pruple discoloration of the skin
leg fatgue
visible pain
what causes caudication
little blood flow to the limbs
what is caudication often caused by
PAD
what is PAD
narrowing of the peri art that causes reduced blood flow to the limbs
do all DVT cause signs and symptoms
no
what criteria do we use for DVT
wells criteria
what indicates high risk on the wells
3 or higher
what is the motor function of the freat peroneal nerve
great toe ext
toe ext
ankle DF
what is the sensory function of the common peroneal nerve
web space of the 2nd and 1st toe
dorsal surface of the toes
