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PT 521 Patient Management > Knee Lecture > Flashcards

Knee Lecture Flashcards

1
Q

Screw Home Mechanism

A

As knee extends the tibia ER, as the knee flexes the tibia IR

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2
Q

Which muscle will help unlock the knee?

A

Popliteus

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3
Q

Structures for extension:

A 
Rectus femoris
Vastus intermedius
Vastus lateralis
Vastus medialis
Patellar ligament
Quadriceps tendon
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4
Q

Structures for flexion:

A 
Biceps femoris
SM
ST
Popliteus
Gastroc
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5
Q

Structures stabilizing the knee:

A 
LCL
MCL
ACL
PCL
Medial/Lateral meniscus
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6
Q

Chief complaint:

A 
pain
click
instability
stiffness
locking
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7
Q

History:

A

MOI
SINS
Functional Status

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8
Q

Differential Dx:

A

Anatomy

Biomechanics

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9
Q

Location

A

Superficial
Anterior/Posterior
Medial/Lateral

Deep

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10
Q

Possible injured structures/pathology

A 
Ligament
Articular
Bone
Bursitis
Nerve
Musculo-tendinous
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11
Q

Health Condition

A 
Articular Defects
Meniscal Tears
Ligament
Extensor Mechanism
ITB
Osgood-Schlatter
Fx
Fat pad/bursa
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12
Q

Differential Dx:

A 
Infection
RA
DVT
Neurogenic Claudication
PVD
Cancer
Med Side Effects
Lumbosacral Pathology
Thyroid Disorder
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13
Q

Knee Questionnaires:

A

WOMAC
LEFS
KOOS

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14
Q

Subjective

A 
Current Hx
CC (SINS)
Social/Environmental
PMH
Activity Restrictions
Participation Limitations
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15
Q

Objective

A

Anatomical components
Source of pain
Impairments/movements/posture

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16
Q

Examination

A 
Posture
Gait
Palpation
AROM
PROM
MMT
Accessory
Flexibility
Special Tests
Clearing Exam
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17
Q

Postural Analysis:

A 
Tibio-femoral valgus/varum
Genu recurvatum
Tibial varus
Patella alta
Patella laterally tilted
Edema/swelling
Eccymosis
Atrophy
Skin Callous
18
Q

Gait Analysis:

A

Antalgic?
Step length?
Trendelenburg?
Decreased knee extension at TSt

19
Q

Functional Activities:

A

SLB, squat (SINS)
Pain?
Movement faults?
ROM limited?

20
Q

Palpation

A 
Joint line
Musculo-tendinous inserts
Bursa
Ligament
Popliteal Cyst
Fat Pad
21
Q

Normal knee ROM

A

0-150

22
Q

PROM

A

Endfeel?

Pain?

23
Q

Accessory motion (knee)

A

Tibiofemoral: AP & PA

Patellar glides

24
Q

ACL special tests

A

Anterior Drawer @ 90
Lachman’s @ 30

HS tightness, false negative

25
Q

PCL special tests

A

Godfrey’s

Posterior Drawer

26
Q

MCL special tests

A

Valgus

27
Q

LCL special tests

A

Varus

28
Q

Meniscus special tests

A

McMurray
Thessaly (gold standard)

pain, audible or palpable catching sensation

29
Q

MCL

A

Valgus test
Worst if positive in 0 extension than testing in 30
Why? Joint capsule now compromised

30
Q

Patellofemoral Compression (LongAQ)

A

Provocative

(+) pain

31
Q

What is OA?

A

Articular cartilage degeneration
Bony hypertrophy & osteophyte formation
*special test

32
Q

OA: Findings

A 
Joint hypomobility, limited ROM
Pain w/ motion & worse w/ compression
Mornign stiffness & after being in a static position
Muscle weakness
Crepitus/grinding
Deep, achy pain
Insidious onset (hx of prior trauma)
c/o knee gives during WB
33
Q

Meniscal Lesions

A 
c/o pain, clicking, catching, locking
MOI: can be traumatic or insidious (degenerative)
joint line is tender to palpate
McMurray & Thessaly
Presentation depends on the tear
34
Q

ACL: MOI

A 
valgus knee position
hyperextension, rotation
70% non-contact
deceleration phase
cutting, landing
"pop"
Acute: swelling, laxity, pain
Chronic: unstable joint, loss of function
35
Q

MCL: MOI

A

valgus force, knee collapse inward
football, soccer, slip, direct blow to lateral knee
injured with medial meniscus/ACL

36
Q

PCL: MOI

A 
traumatic, hyperflexion injury
football, falling onto knees, dashboard
excessive tibial post translation
c/o weakness, instability
HS testing will aggravate
37
Q

Patellofemoral Pain

A

tenderness along facets
crepitus
passive patellar compression (QS/LAQ) –> CC
squatting, kneeling, stretch to qudas/ITB may reproduce sx

38
Q

ITBS

A

MOI: tightness elicits increase rubbing, athletes with repetitive knee flexion/extension
hip muscle imbalances

39
Q

Fractures

A

Patellar & Tibial Plateau most common

MOI: traumatic

40
Q

ACL: ICF

A 
HC: ACL tear
Body function & structure: decreased knee ext
Activities: impaired walking tolerance
Participation: can't play soccer
Environmental: school has stairs
Personal: very motivated

PT 521 Patient Management (25 decks)

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