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Ortho > Knee Joint > Flashcards

Knee Joint Flashcards

1
Q

objective exam parts

A 
observation 
movement analysis
ROM assessment
strength assess
flexibility 
neurological 
joint accessory motion 
special test
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2
Q

subjective exam parts

A

MOI
Differencial considerations
Signs and Symptoms

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3
Q

MOI

A

Mechanism of Injury

May not be very specific

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4
Q

differential considerations

A

medial management (surgery vs. conservative rehab)
age, sex, occupation
PMH

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5
Q

Signs and Symptoms

A

Location
SINS
Aggravating and Easing positions

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6
Q

Sings and Symptoms Parts

A
  1. Pain (severity location better/worse)
  2. Laxity (lig injury, carti injury, arthritis/m. weakness)
  3. Locking (menisal lesion/patellofemoral dysfunction)
  4. Effusion (TRUE lesion, Infection)
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7
Q

Observation/Posture

A

Knee stability and movement coordination impair

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8
Q

movement analysis

A

functional movement testing
gait assessment
WHAT MOTION BRINGS OUT PAIN

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9
Q

Knee ROM

A 
Tibiofemoral joint (TFJ)
Normal 135-140 flexion, 0 extension
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10
Q

Closed Pack Position

A

full extension and ER

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11
Q

Resting position

A

25-45 of flexion

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12
Q

strength assessment

A

quad, hamstring, hip, foot/ankle

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13
Q

prox stabilizers

A

glut max/med, TFL, adductors

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14
Q

prime movers

A

quads, hamstrings, popliteus

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15
Q

distal stabilizers

A

gastroc, soleus, posterior tibialis

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16
Q

flexibility assessment

A

important walking, lifting, stepping normally

ROM affected by flexibility (condition joint itself, muscle, CT around joint)

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17
Q

joint accessory testing

A

movement WITHIN joint and surrounding tissue that are necessary for full ROM–performed actively
osteokinematic motion
arthorkine motion

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18
Q

Pediatric Knee Conditions

A

Osteochondritis dissecans
osgood-schlatter
larsen-johansson

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19
Q

Traumatic injuries

A

fracture, lig injury, meniscal lesion, chondral injury

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20
Q

Complication of Fracture

A
  1. loss of knee movment
  2. non-union or failure of fracture to unite
  3. arthritis of knee joint
  4. infection
  5. deep vein thrombosis
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21
Q

Testing Fractures

A
  1. PROM
  2. Percussion
  3. Palpation
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22
Q

ACL Resists

A

Anterior tibial translation
flex/ext
frontal, axial motion

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23
Q

ACL antagonist

A

quads

24
Q

Injury to ACL

A

sudden stop of direction
twist or pivot
hyperextensive movement of knee

25
Q

Sign and symptoms of ACL injury

A
  1. Pop or Snap sound
  2. Unstable in WB over knee
  3. self-limiting activity
  4. Loss of knee motion in WB
  5. Knee feels like its falling apart/ giving way
  6. IMMEDIATE LACK OF FUNCTION
26
Q

PCL Resists

A

posterior tibial translation
extension (ant lateral bundle)
frontal, axial motion

27
Q

PCL antagonist

A

hamstrings

28
Q

PCL injury

A
  1. primary passive external force
  2. force applied to extended knee
  3. extremem hyperextension movement of knee
29
Q

PCL sing and symptoms

A
  1. rarely audible sound at injury
  2. moderate swell and stiff
  3. resume activity after hurting it
  4. decrease knee motion (extension limited)
30
Q

MOI PCL

A

fall with weight to ANT part of knee with knee bent
knee bend and foot plantar flexed
hard blow to anterior lower leg with KNEE FLEXED
Tenderness POP fossa
posterior laxity to functional

31
Q

ACL Special tests

A

Lachman’s

anterior drawer test

32
Q

lachman’s test

A

best for ACL test on field
+ result will have mushy or empty end-feel
- result (tibia is IR, femur not properly stabalized)

33
Q

Anterior drawer

A

+ result increase anteiro tibial tranltion
- only if acl torn, swelling or hamstring spasm
false + result posterior sag sign present

34
Q

Medial Collateral Lig

A

More common
valgus or twisting force (foot in neutral/ER)
HIGH risk for meniscus involvement

35
Q

Lateral Collateral Lig

A

varus or twisting force
unstable knee at risk
less risk for meniscus injury
RISK peroneal nerve involvement

36
Q

MCL ROM

A

both fibers taut in full extension
anterior fibers taut in flexion
posterior fibers taut in mid range

37
Q

Valgus Stress test

A

assess medial instability
0* (MCL super and deep, Post oblique lig, post med capsule)
30* (MCL superficial, post oblique lig, PCL, post med capsule)

38
Q

LCL ROM

A 
taut in extension
loose flexion (especially after 30* of flexion)
39
Q

Injury LCL

A

varus forces (ADDUCTED and tibia IR)

40
Q

Varus Stress Test

A

assess lcl instability
0* (lol, pcl, arcuate complex, pcl/acl)
30* (lcl, post lat capsule, arcuate complex)

41
Q

Meniscal movement

A

extension=anterior movement

flexion=posterior movement

42
Q

meniscal lesions

A

increase medial due to valgus stress attach capsule and MCL
Swelling in POP fossa secondary to injury within joint
Baker’s cyst

43
Q

MOI meniscal

A 
compression
rotational force
valgus force
combination of forces 
degenerative changes (>30, Po PMHX)
44
Q

Cartilage Clinical Presentation

A 
history
pain
CATCHING
giving way/buckling
joint stiffness
antalogic gait
joint line pain
effusion (baker cyst)
clicking during rom
pain with varus/valgus/squating test
45
Q

Meniscal testing

A

IR Tibia=lateral meniscus
ER=Medial meniscus
McMurray
Thessaly’s

46
Q

McMurray’s

A

+ result from pop, clicking, locking of knee

pain/ reproduction of symptoms

47
Q

proceedure mcmurray

A
  1. flex knee
  2. rotate tibia on femur
  3. extend knee
  4. click and compiant
  5. repeat
  6. detect flap from meniscal tear
48
Q

Thessaly’s Test

A

early detection of meniscal tear

  1. parallel bend knee
  2. rotate with support
  3. return to center
  4. repeat other side
49
Q

Overuse syndrome patellofemoral pain

A 
poor patellar tracking 
chondromalacia
fatpad impingement
patellar tendonitis and tendinosis
pes anserinus endinitis/bursitis 
ITB syndrome
50
Q

IRB syndrome

A

chornic irritation

weak gluteal musculature and genu valgrum

51
Q

oseoarthritis

A

most common
increase risk with activities that stress joints
blood test can rule out other diagnosis

52
Q

Imflammatory/Systemic Condition

A 
Arthritis (osteo, rheumatoid, spetic)
bursitis
tendonitis
synovitis
osteomyelitis
pseuedogout
53
Q

knee locking

A

meniscal lesion

54
Q

knee won’t straighten

A

meniscal/lig

55
Q

gives out going down

A

cruciate lig

Ortho (7 decks)

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