Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

MSK II > Knee > Flashcards

Knee Flashcards

1
Q

Locking with meniscus

A

Knee gets locked in flexion and cannot be extended

In bucket handle meniscal tear

Does not get fixed until surgeon performs

Why non-elective? Subchondral break down

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Injury?

A

Ligament or meniscal tears

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Non-contact?

A

One ligament (usually ACL)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Pop?

A

ACL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Swelling?

A

Within hours - ACL

Overnight - meniscus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Locking?

A

Meniscus

Bucket handle meniscus tear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Joint line tenderness?

A

Meniscus or arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Stairs?

A

Patellofemoral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Squatting?

A

Meniscus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Pain landing from a jump?

A

Tendinopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Delayed swelling

A

Intra-synovial or extracapsular

Menisci, collateral ligaments, quad/patellar tendon, patella subluxation

EXCEPTION: MCL
Attaches to medial joint capsule, so you might have immediate swelling, might not

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Giving way straight plane walking

A

Patellar instability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Giving way cutting movements

A

ACL
PCL
Capsule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Giving way descending stairs

A

Quadriceps inhibition

Quads eccentric control problem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Stroke Test Grade 0

A

No fluid-wave while performing a downward stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Stroke Test Trace

A

If the downward stroke produces a small bulge on the medial aspect of the knee

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Stroke Test Grade 1+

A

Larger bulge on medial side of the knee

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Stroke Test Grade 2+

A

If the medial fluid returns to its position without performing a downward sweep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Stroke Test Grade 3+

A

The excess of fluid makes it impossible to stroke the medial fluid away

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Hemiarthrosis

A

Collection of blood in joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Fractures

A

Hx of recent trauma, osteoporosis

Unwillingness to bear weight

Hemiarthrosis

Point tenderness to bony structures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Peripheral Arterial Disease

A 
Age > 55 years
Type II DM
Smoking
Sedentary lifestyle
Intermittent claudication
Unilateral cool extremity
Decreased pulses
Increased capillary refill
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

DVT

A

Recent surgery, pregnancy, trauma, immob

Calf pain

Edema

Tenderness

Homan’s sign? 50/50 accuracy

Wells criteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Compartment Syndrome

A 
Trauma
Rigorous unaccustomed activity
Severe leg pain with passive stretching
Paresthesias
Decreased pulses
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Ottawa Knee Rules
You DON'T need an xray if... ``` Age 2-55 No fibular head TTP No isolated patellar TTP Able to flex 90 degrees Able to WB for 4 steps after injury AND in ED ```
26
Pittsburgh Knee Rules
No fall or blunt knee trauma Age 12-50 Able to walk 4 WB steps in the ED
27
Tibial and fibular fx
MOI... MVA, sports Tx... Stable = closed reduction and cast or walking cast or functional brace Unstable = ORIF of Illizarov Complications... ``` Ankle stiffness Arterial/nerve injury Malunion Nonunion Compartment syndrome Infection CRPS ```
28
Tibial plateau fx
MOI... Valgus or varus force and axial loading Tx... Undisplaced = hemiarthrosis aspiration, CPM, PWB after 8 weeks Comminuted = slightly depressed c traction Displaced = ORIF Complications... Frequently leads to knee OA PWB for at least 2 mos
29
Patella fx
MOI... Direct blow or the result of a strong quad contraction Tx... Undisplaced = aspiration, plastic cylinder in ext. for 3-4 weeks Comminuted = patellectomy or cast Displaced = ORIF
30
Knee OA Symptoms
Pain with WB | Morning stiffness
31
Knee OA Systemic Risk Factors
``` Age and sex Genetics Decreased estrogen levels Increased bone mineral density Obesity Acute injury Repetitive injury Joint deformity ```
32
CRITERIA FOR CLASSIFICATION OF KNEE OA
``` Age > 50 Knee crepitus Palpable bony enlargement Bony TTP Morning stiffness that improves in 3 variables present ```
33
Knee OA tx
Manual therapy + exercise Gait training for lack of TKE Hip mobilizations
34
Indications for TKA
Can no longer stand the pain Radiographic severity NOT an indicator
35
Contraindications for TKA
``` Major psychiatric disorder Poor soft tissue coverage Infection PVD Poor motivation Alcohol and drug use ```
36
Goal of any TKA
Restore the mechanical axis of the TFJ through bony cuts, soft tissue mobilization, and ideal component implantation with proper patellar tracking
37
3 Steps TKA
Skin incision Arthrotomy Mobilization of the extensor mechanism
38
Medial Parapatellar TKA advantages
Gold standard Protects neurovascular structures Clear visualization of the joint
39
Medial parapatellar TKA disadvantages
Extensive incision through the quadriceps tendon PCL may or may not be spared s/p 1 year have 40-50% deficit in quad strength
40
Common TKA surgical elements
PCL may or may not be removed Femoral component is metal Tibial component is metal Spacer on top of tibia is plastic ***In a year, everyone is pretty much in the same place REGARDLESS of the surgical intervention
41
PCL sparing or sacrificing
Very controversial Based on surgeon's comfort level currently
42
TKA Complications
``` DVT Stiff knee Infection Peripheral nerve injuries Aseptic loosening Extensor Mechanism Rupture ```
43
DVT s/p TKA
Greatest 1st week after surgery First sign can be PE ``` Symptoms... Pain Swelling Redness of the leg Dilation of the surface veins ``` 15% higher risk DVT for every decade after 50
44
Sx/sy PE
Chest pain Respiratory symptoms w/wo hemoptysis Tachycardia (> 100) 10% cases fatal within first hour
45
Stiff knee
Flexion contracture equal to or > 10 degrees Total arc of motion
46
Stiff knee tx
``` Intensive PT Splinting Injections Close manipulation (MUA) Arthroscopic debridement (ONLY AFTER MUA FAILS) Revision surgery (COMPONENTS FAIL) ```
47
Most important predictors of post-op stiff knee?
Pre-op ROM
48
Conservative vs Manipulation for Stiff Knee
Manipulation works best within 3 mos sx Late manipulation can be more risky with complications as quad and patella tendon rupture, femur fracture, and hematoma formation More successful for flexion gains than extension gains
49
Stairs
85 degrees knee flexion
50
Rising from a chair
95 degrees knee flexion
51
Kneeling and squatting
125-135 degrees knee flexion
52
Osgood Schlatter's
Overuse injury of the knee Symptoms BELOW knee cap... Pain Swelling Tenderness Constant/overuse pulling of patella tendon Low of dx if growth plates are closed Don't need to take off from sport
53
Discoid lateral meniscus
More common during puberty in girls Lateral meniscus is much thicker than normally expected Clinical exam - Click, ext block Tx - reshaping or excision if symptomatic
54
Meniscal prevalence
Medial > Lateral
55
Meniscal injuries sx/sy
``` Joint line TTP Knee locking Daily pain Effusion Decreased flexion ROM ```
56
Thessaly test
Meniscal tear Standing + rotation + pain and/or clicking
57
Meniscal tears
MOI... Loading and rotation Lateral more common with ACL tears as the lateral tibial plateau subluxes anteriorly
58
Red red zone
Good blood supply | Repair
59
Red white zone
Controversial | Some surgeons may opp to try and repair
60
White white zone
No blood supply | Menisectomy or conservative tx
61
Apley test
Meniscal tear Patient prone + reproduction of pain or clicking with compression and rotation
62
McMurray test
Meniscal tear Flex knee to end-range with one hand IR/ER into ext and back into flexion + pain and/or clicking
63
Diagnostic accuracy for meniscal tear special tests
Lateral meniscus high LR
64
Combination of meniscal testing
Hx of mechanical catching or locking reported by pt Joint line tenderness Pain with forced knee HYPERext Pain with max passive knee flexion Pain or audible click with McMurray maneuver
65
Conservative treatment for meniscal repairs
Modalities for inflammation Flexibility Quad strengthening Hamstring strengthening * **Semimembranosus attaches to medial meniscus * **Be aware of after meniscal repair Orthotics
66
Menisectomy
WB immediately They don't need a brace 1st or 2nd day lose crutches No swelling with increase in activity level
67
Meniscal repair
``` PROTECT FOR 1 MONTH Passive extension TTWB No flexion > 90 for 4 weeks No CKC exercises > 90 for 4 weeks ``` Hamstrings - for 1 month, especially if it's a medial meniscal repair
68
Meniscal transplantation
C/I - advanced arthrosis No arthritis in either compartment No genu varum or valgum You must have failed menisectomy at least once
69
ACL
Women > men Noncontact most common Pts with these injuries have greater risk of developing OA
70
ACL MOI
HYPERext, valgus, ant tib translation, rotation
71
Sx/sy ACL
``` Inability to continue play Immediate joint effusion Commonly feel/hear pop Instability Limited ROM Quad atrophy ```
72
Lachman test
ACL Gold standard Don't let femur move + laxity or no end feel
73
Anterior drawer
ACL Don't use this Too much flexion and the hamstring will contribute to a false negative + no end feel or excessive motion
74
Pivot shift
ACL Surgeons do this UNDER ANESTHESIA Physically impossible to get a good pivot shift test while someone is awake + tibia will sublux in ant/lat position
75
Non-operative management ACL
``` Improve stability Return to activities Minimize complications Restore ROM Restore strength Normalize gait ```
76
ACL extension
Work on immediate passive extension, then flexion will generally return as swelling subsides
77
OC knee extension
Yes with full blown ACL tear NO with partial tear bc there's more tensile force in OC movement
78
Autographs
Comes from you BPTB Hamstrings Quads ITB
79
Allographs
BPTB TA/TP Achilles tendon
80
Bone to bone healing
Trumps all tissue healing
81
Non-modifiable factors return to sport
Graft Age Sex Sport level
82
Modifiable factors return to sport
Increased motivation confidence Optimism Low fear
83
Avulsion fx of anterior tibial spine
Intra-articular fx, hemiarthrosis Anatomical reduction ORIF or reduction by extending the knee
84
Valgus stress test
MCL + reproduction of pain and/or laxity
85
MCL tears
Pain increases with partial tears Complications... Instability Pellegrini-Stieda lesion Adhesions
86
LCL tears
Better outcomes in pts c valgus alignment Surgical repair in first two weeks (III) Conservative tx (I and II) Complications... Traction injury peroneal nn Instability
87
Varus stress test
LCL + reproduction of pain and/or laxity
88
PCL tears
MOI... Blow to ant tibia (dashboard injury) or hyperflexion Dx... History, posterior drawer, "sag" sign, dial test Commonly other ligaments are also torn Surgical repair is difficult
89
Posterior drawer test
PCL + increase posterior tibial translation
90
Posterior sag sign
PCL Pt supine + increased posterior tibial translation
91
Dial test
PCL Examines ER of tibia + PCL tear increased ER at 90 degrees knee flexion + PLRI increased tibial ER at 30 degrees flexion
92
Patella tracking
SUPERIOR in EXTENSION
93
ITB Friction Syndrome
Risk factors... > 20 miles a week Training on canted surfaces Training on inclined or declined surfaces Second most common injury in runners Occurs at 20-30 degrees knee flexion
94
Bursa
Suprapatellar Pre patellar Infrapatellar Pes anserine

MSK II (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions