Knee - rotator cuff muscles - elbow - wrist Flashcards
ACL
anterior cruciate ligament
PCL
Posterior cruciate ligament
Anterior drawer sign
With patient supine, bending knee at 90 degree angle, increased anterior of tidia due to anterior cruciate ligament injury –> Lachman test is similar, but at 30 angle
Knee exams - tests?
- Anterior drawer sign
- Posterior drawer sign
- Abnormal passive abduction
- Abnormal passive adduction
- McMurray test
- Lachman sign
Posterior drawer sign
With patient supine, bending knee at 90 degree angle, increased posterior gliding of tidia due to posterior cruciate ligament
Abnormal passive abduction
With patient supine and knee either extended or at 30 degree angle, lateral (varus) force –> medial space widening of tidia –> MCL injury
Abnormal passive adduction
With patient supine and knee either extended or at 30 degree angle, medial (varus) force –> lateral space widening of tidia –> LCL injury
McMurray test
With the patient supine and knee internally and externally rotated during range of motion
- pain, pooping on external rotation –> medial meniscal tear
- pain, pooping on internal rotation –> lateral meniscal tear
anterior and posterior in anterior and posterior cruciate ligament refer to
sites of tibial attachment (superior surface)
ligaments of the knee
- anterior cruciate ligament
- posterior cruciate ligament
- lateral meniscus
- medial meniscus
- Lateral collateral ligament
- Medial collateral ligament
Lateral collateral ligament injury - test
abnormal passive adduction
posterior cruciate ligament - test
posterior drawer sign
meniscal tear test
McMurray test
abnormal passive adduction –> injury of
Lateral collateral ligament
lateral meniscal tear - test
McMurray test with internal rotation
common knee conditions
- Unhappy triad
- Prepatellar bursitis
- Baker cyst
Baker cyst?
popliteal fluid collection in gastrocnemius-semimembranosus bursa commonly communicating with synovial space and related to chronic joint disease
Baker cyst is commonly related to
chronic joint disease
prepateral bursitis is also called / definition
Housemaid’s Knee
inflammation of Knee’s largest sac of synovial fluid
prepateral bursitis - can be caused by
- repeated trauma
2. pressure from extensive kneeling
Unhappy triad - presents with
acute knee pain and signs of joint injury / instability
Unhappy triad - common in (why)
contact sports due to lateral force applied to a planted leg
Unhappy triad - problem?
classically consists of damage to
- anterior cruciate ligament
- Medial collateral ligament
- medial meniscus
most common injury - ligament?
medial meniscus
extensive kneeling can cause –> … (at the knee)
prepatellar bursitis
chronic joint disease can cause –> … (at the knee)
Baker cyst
common injury of the knee at contact sports –>
Unhappy triad
Rotator cuff muscles?
shoulder cuff muscles that form the rotator cuff
rotator cuff muscles - muscles?
- supraspinatus
- infraspinatus
- teres minor
- subscapularis
rotator cuff muscles are innervated primary by
C5-C6
supraspinatus muscle is innervated by
suprascapular nerve
supraspinatus muscle - function
- abducts arm initially (before the action of deltoid)
- laterally rotates arm
infraspinatus muscle is innervated by
suprascapular nerve
infraspinatus muscle - function
laterally rotates arm
teres minor is innervated by
axillary nerve
teres minor - function
adducts and laterally rotates arm
subscapularis is innervated by
upper and lower subscapsular nerve
subscapularis muscle - function
medeally rotates and adducts arm
most common rotator cuff muscle injury (and explain)
supraspinatus muscle – trauma or degeneration and impingement –> tenindopathy or tera
supraspinatus muscle injury is assessed by
empty full/can test
empty full/can test - process
The patient is tested at 90° elevation in the scapula plane and full internal rotation (empty can) or 45°external rotation (full can). Patient resists downward pressure exerted by examiner at patients elbow or wrist.
empty full/can test to assess
supraspinatus muscle injury
infraspinatus injury –>
pitching injury
overuse injuries of the elbow
- Medial epicondylitis (golfer’s elbow)
2. Lateral epicondylitis (tennis elbow)
causes of medial epicondylitis (golfer’s elbow)
- repetitive flexion (forehand shots)
2. idiopathic
causes of lateral epicondylitis (tennis elbow)
- repetitive extension (backhand shots)
2. idiopathic
golfer’s elbow - area of pain
near medial epicondyle
tennis elbow - area of pain
near lateral epicondyle
abduction in greek
απαγωγή
adduction in greek
προσαγωγή
Wrist bones - names
- scaphoid 2. lunate 3. Triquetrum 4. Pisiform
5. Hamate 6. Capitate 7. Trapezoid 8. Trapezium
Wrist bones - 1st series (lateral to medial)
Scaphoid - lunate - Triquentrum - pisiform
Wrist bones - 2nd series (lateral to medial)
trapezium - trapezoid - capitate - hamate
radius is attached to (wrist)
scaphoid and lunate
scaphoid is palpated in (area)
anatomic snuff box
most commonly fractured of the carpal bone (typically how)
scaphoid - typically from a foll on an outstretched hand
scaphoid fracture is prone to (why)
avascular necrosis owing to retrograde blood supply
dislocation of lunate may cause
acute carpal tunnel syndrome
a fall on an outstretched hand that damages the hook of the hamate can cause
ulnar nerve injury
Carpal tunnel syndrome - nerve?
median nerve
Carpal tunnel syndrome - mechanism
entrapment of median nerve in carpal tunnel –> nerve compression
Carpal tunnel syndrome - symptoms
- pain 2. paresthesia 3. numbness
(in distribution of median nerve)
Carpal tunnel syndrome is associated with
- pregnancy 2. RA 3. hypothyroidism 4. repetitive use
- dislocation of lunate (acute Carpal tunnel syndrome)
- diabetes 7. dialysis related amyloidosis
Guyon canal syndrome?
Compression of ulnar nerve at wrist or hand
Guyon canal syndrome is classically seen in (why)
cyclists due to pressure from handlebars
ACL - anatomy
extends from lateral femoral condyle to anterior tibia
PCL - anatomy
extends from medial femoral condyle to posterior tibia
Carpal tunnel syndrome - thenar
- atrophy
- sensation spared, because palmar cutaneous branches enters the hand external to carpal tunel
