Knee Flashcards
What are the facets of patella?
Superior 90 degree
Inferior 20
medial and lateral 45
odds 135
distinct pop may indicate
an anterior cruciate ligament tear or osteochondral fracture or popliteus tendons snapping (laterally)
acceleration and twisting injury may involve? Deceleration injuries involve? Constant speed cutting?
Acceleration: meniscus
Deceleration: cruciate
Constant: ACL
Anterior knee pain
Tend to be insidious and occurs spontaneously often from overuse Patellofemoral problems (prepatellar, infrapatellar bursa, fat pad, tendinosis, osgood-shlatter
Pain during activity
usually seen in structural abnormalities, such as subluxation or patellar tracking disorders
Pain after activity or with overuse
characteristic of inflammatory disorders such as synovial plica irritation, early tendinosis, paratenonitis, jumper’s knee, sinding-Larsen-Johnsson syndrome
Generalized pain in the area of the knee
contusions, partial tears of muscles or ligaments
pain in the knee on ankle movements may indicates
the superior tibiofibular joint
give way?
instability in the knee, meniscus, patellar subluxation, undisplaced osteochondritis, patellofemoral syndrome, plica, loose body
give way when walking uphill or downhill
retropatellar lesion
knee locked?
Psudo: Loose bodies Locking: meniscus or spasm (hamstring mm)
Synovial swelling may occur how many hours? Blood?
8-24 hours
Hemarthrosis immediately
shoes with negative heels (earth shoes)
Increase the incidence of patellofemoral syndrome
normal tibiofemoral shaft angle
6 degree
Miserable malalignment syndrome
anterior pelvic tilt, increase hip anteversion, decreased tibiofemoral angle, genu recurvatum, navicular drop and increased foot pronation
intracapsular swelling is evident over
entire joint
extracapsular swelling tends to be more…
localized
patella alta what sign may be present?
camel sign
if laterally displaced “frog eyes” or “grasshopper eyes”
Fick angle
5 in baby
18 in adults
Tight hamstrings result in increased knee flexion, which can lead to the need for more….
ankle dorsiflexion, if no further dorsiflexion is possible, the foot pronates to compensate, increasing dynamic q angle
patella normal tracking is from
medially in early flexion then laterally
what is quadriceps lag?
when quad is not strong enough to fully extend the knee.
passive lateral glide test positive
if movement of more than two quadrants is considered hyper mobile
disco test
patient stands on one leg with the knee flexed 10-20. Patient is asked to rotate or twist left and right while holding the flexed position. Apprehension during the test or refusal to do the test is positive for rotatry instability.
what is Merke’s sign?
during Disco test, Pain felt on the joint line it may indicate meniscus pathology
anterior cruciate ligament extends…
to check….
superiorly posteriorly, and laterally
To prevent anterior movement of the tibia on the femur, to check lateral rotation of the tibia in flexion, and to a lesser extent, to check extension and hyperextension at the knee
posterior cruciate ligament extends…
Check….
extends superiorly, anteriorly, and medially from tibia to the femur
Check primary stabilizer of the knee against posterior movement of the tibia on the femur, and it checks extension, and hyperextension and rotary stability and functions as the knee’s central axis of rotation
with lateral rotation of the tibia, both collateral ligaments become more…
cruciate ligaments become more….
Collateral: taut
Cruciate: relaxed
Medial rotation, reverse action occurs
what is dynamic ligament to help stabilize knee
Popliteus in controlling rotation of the tibia on the femur by contributing to lateral rotation stability
Oblique popliteal ligament is expansion of what tendon? and what does it do?
Semiembranosus
Preventing hyperextension of the knee
swain test
patient seated, with knee flexed to 90, passively laterally rotates the tibia on the femur. Positive is pain along the medial side of the joint, indicating injury to the medial collateral ligament complex,
with knee flexed to 90, cruciates are….
collateral ligaments are ….
Cruciates: lax
Collateral ligaments are tight
active drawer test
AKA quadriceps active test
normal drawer test position. Examiner holds the patient’s foot down. Patient is asked to try to straighten the leg, and the examiner prevents patients from doing so. (isometric test). If cruciates are torn, the anterior contour of the knee changes as the tibia is drawn forward. If posterior cruciate ligament is torn, a posterior sag is evident before the patient contracts the quads.
Lachman test is also known as
Ritchie, Trillat, or Lachman-Trillat test
Posterior sag sign is also known as
Gravity drawer test. Hip flexed 45, Knee flexed 90
There is audible snap or palpable jerk during anterior drawer test
Finochietto jumping sign
Ege’s test
Weight bearing McMurry’s test for menisus, standing position knee rotates
what mimics meniscus pathology?
abnormal plica
What is brush stroke test called
bulge test or wipe test to assess minimal effusion
+ accumulates inferior medial knee
Turner’s sign
medial meniscus lesion leads to irritation of the infrapatellar branch of the saphenous nerve, resulting hyperaesthetic area the size of quarter on the medial side of the knee
common peroneal nerve lesion
L4-S2 injured in posteolateral knee and it winds around the head of the fibula.it can be stretched as a result of lateral ankle sprain. Result is weakness or paralysis of muscles supplied by the deep and superficial peroneal nerves, two branches of the common peroneal nerve. Instability to dorsiflex (foot drop) and steppage gait and instability to evert. Dorsal side sensory loss especially between big toe and 2nd toe
saphnous nerve
L2-L4 sensory branch of the femoral nerve that arises near the inguinal ligament and passes down the leg to supply the skin on the medial side of the knee and calf. entrapped between vastus medialis and adductor magnus mm. Entrappement lead to medial knee pain (burning) that is aggravated by walking standing and quad exercises. Sensory loss after surgery is medial knee and calf.
posterolateral corner of the knee is called
Posteromedial corner of the knee is called
Lateral: popliteus corner
Medial: Semimenbranosus corner
what patella improves the efficiency of?
Extension during the last 30 degree of extension because it holds the quadriceps tendon away from the axis of movement and functions as a guide for the quad or patellar tendon decreases friction of the quads
sesamoid bone is found in where and what is called
tendon of the lateral head of the gastrocnemius mm, called febella
