knee and related structures Flashcards
why would someone not be able to reach the normal knee ROM?
- one reason why an athlete could not reach full ROM would be that they have shortened hamstring, and tight quads, therefore restricting their full ROM of 140.
what are the functions of the patella? MT
- aids knee w/ extension.
- protects patella tendon against friction
- when moving from extension to flexion of the knee, the patella glides laterally, further into the trochlear groove.
what structures are associated with the kinetic chain?
- foot, ankle, hip, lower leg, thigh, pelvis, spine.
what is the kinetic chain?
- the kinetic chain is if the body in unable to manage forces then breakdown to the systems occur, because one part of the body is/has not been managed and therefore it affects the rest of the body.
what is patella Alta and Baja?
- alta is the patella sits high
- baja is the patella sits low.
what things would you observe of someones knee?
- walking, squatting
- swelling, ecchymosis
- leg alinement
- genu valgum & genu varum.
- hyperextension & flexion
- patella alta & baja
- patella rotates in or outward
what is tibial torsion (TT) and (FA & FR) femoral anteversion &retroeversion
TT
- an angle that measures less than 15 degrees
- pigeon toed.
(interna tibial torsionl)
- an angle that measures greater than 15 degrees is (external tibial torsion.)
- duck feet (angle out)
FA
- total rotation of the hip is -100 degrees
FR
- if the hip is more externally rotated outwards.
what is leg length discrepancy?
- there is functional and anatomical and it is where one bone is longer than the other.
what is the difference between functional and anatomical leg length discrepancy?
func.
- the muscles are pulling on the bone and it can make it appear that one bone is longer or shorter than the others.
- caused by pelvic or spinal mechanical faults
anatom.
- this can potentially cause problems in all weight bearing joints.
- the person is usually born with this where one bone is longer or shorter than the other. normally person will have some support in their shoe to help with this.
what is the Q angle? MT
- the Q angle is the angle that is measured between the ASIS and the tibial tubercle. the patella is bisect (split in half)
what is the A angle? MT
- this is the angle that is measured between the patellar orientation to the tibial tubercle.
what is knee plica?
- plica are folds in tissues that line the joint. medial folds are the most common in the knee.
irritation of the plica
what are s/s of knee plica?
- possible knee injury or pain
- painful pseudo locking
- possible snapping and popping.
- pain w/ stairs and squatting
- little or no swelling.
management of knee plica?
- RICE
- may require surgery
what are osteochondral knee fracture? MT
- same MOI as (X)CL injuries or meniscus
- twisting, sudden cutting or direct bow
- fracture of the cartilage and the underlying bone.
what are s/s of osteochondrial knee #? MT
- hear a snap and feeling of giving way.
- immediate swelling and considerable pain
- diffuse pain along joint line,
what is management of osteochondrial knee #? MT
- diagnosed through CT and MRI
- stabilize fracture
- if there are fragments that have detached then surgery is required.
- 3-6 month return to activity.
partial or complete seperation of articular cartilage and the subchondral bone, is known as what?
- osteochondritis dessecans
what are s/s of joint contusions?
- severe pain, loss of movement, acute inflammation
- swelling
- discolouration
what is a perineal nerve contusion? MT
- compression the peroneal nerve due to a direct blow.
s/s of peroneal nerve contusion? MT
- local & possible shooting pain
- numbness & pins and needles in the nerve
- normally resolves quickly.
how do you manage someone with peroneal contusion?
- rice and RTP happens once symptoms have stopped.
- padding for the fibular head is necessary for a few weeks.
what are the different bursitis in the knee? MT
- suprapatellar bursa
- prepatellar bursa
- deep infrapatellar bursa
- subcutaneous infrapatellar bursa
- popliteal bursa
- subsartorial bursa
what are s/s of bursitis? MT
- prepatellar bur. localized swelling above the knee.
- swelling in popliteal fossa may indicate bakers cyst (fluid filled sac)
- recurrent swelling.
what is acute patella subluxation or dislocation?
- quad pulls the patella out of alignment.
- repetitive subluxation will impose stress to medial restraints
- disco. patella comes fully out of the groove and stays out.
- Sublux. patella comes out and goes back in.
what is the difference between a patella dislocation and subluxation?
dislo.
- total loss of function
Sublux
- pain, swelling
- restricted ROM
- palpable tenderness over adductor tubercle
what is a injury to infrapatellar fat pad? MT
- the fat pad becomes wedged between the tibia and patella
- irritation by chronic kneeling, pressure or trauma.
s/s of infrapatellar pad? MT
- capillary hemorrhaging and swelling.
- chronic irritation may lead to scarring and calcification.
how do you manage a infrapatellar fat pad injury?
- rest until inflammation reduces.
- heel lift to prevent irritation during extention
- hyperextentionn tape to prevent full extension.
what is chondromalacia patella?
- softening or deterioration of the articular cartilage
- often associated with abnormal tracking.
what are the 3 stages of chondromalacia patellar? MT
- swelling and softening of cartilage
- fissure of softened cartilage
- deformation of cartilage surface
s/s of chondromalacia? MT
- pain at inferior border during palpation.
- patella not gliding into the groovee correctly.
- possible recurrent swelling, grating sensation w/ flexion and extension.
what is patellofemoral stress syndrome? MT
- lateral deviation of patella while tracking in the femoral groove.
s/s of patellofemoral stress syndrome? MT
- tenderness of lateral facet of pallets and swelling associated w/ irritation of synovium.
- dull ache in centre of the knee
- apprehension when patella is forced laterally.
