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6 Orthopedics > L6 Knee > Flashcards

L6 Knee Flashcards

1
Q

Knee Anatomy

A

-hinge joint
-largest in the body
-patella slides superior during extension and inferior in flexion
-screw home mechanisms is necessary for stability

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2
Q

Capsular pattern of knee

A

Flexion > Extension
Open packed = 25° flexion
Closed packed = full extension

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3
Q

Intra-articular problems of knee

A

ACL/PCL
meniscus
chrondral surface of tibiofemoral and patellofemoral

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4
Q

Extra-articular problems of knee

A

contractile
non-contractile = lcl, mcl, MPFL

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5
Q

Referred problems of knee

A

L3
peripheral nerve
systemic

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6
Q

Younger children

A

more likely to be developmental, epiphyseal, fractureT

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7
Q

Teen to middle aged

A

more. likely to be soft tissue

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8
Q

Older adults

A

more likely to be degenerative or fracutre

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9
Q

Peak incidence of knee trauma is at age

A

15 to 19

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10
Q

Prevalence of Knee pain

A

25% of population will have significant episode of knee pain

400,000 ACL reconstructions a year

790,000 TKA a year

patellar dislocations is the least common

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11
Q

Most common injured ligament in isolation

A

ACL

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12
Q

ACL MOI

A

valgus force with foot firmly planted

axial rotation torque

severe hyperextension of knee

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13
Q

ACL History

A

usually non-contact
landed awkwardly
felt pop
immediate effusion

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14
Q

PCL MOI

A

fallin flexed knee w/ankle in PF
dashboard contact
severe hyperextension of knee

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15
Q

PCL History

A

often posterior pain
immediate effusion

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16
Q

MCL MOI

A

valgus force with foot planted
severe hyperextension of knee

17
Q

MCL History

A

contact or non-contact
medial pain and tenderness

18
Q

LCL MOI

A

varus producing force with foot planted
severe hyperextension of knee

19
Q

LCL History

A

contact or non-contact
lateral pain and tenderness

20
Q

How common of injury of ligament?

A

ACL > MCL > medial meniscus > lateral meniscus > LCL > PCL

21
Q

Patient history questions to ask

A

were they weight bearing when the injury occurred

was there twisting/pivoting occurring at the time of injury

were they immediately able to bear weight, feel stable

did the knee swell up rapidly

22
Q

____ chain injuries tend to be less severe than ____ chain injuries

A

Open
Closed

23
Q

For a patient with an acute knee injury, a knee radiograph is indicated if

A

Patient is 55 years old or greater
OR
isolated tenderness of patella
OR
tenderness of the head of fibula
OR
inability to flex knee to 90°
OR
Inability to bear weight both immediately and in the ED for 4 steps

24
Q

Ottawa knee rules

A

useful in ruling out a fracture when negative but not good at ruling in a fracture

only valid for injuries < 7 days
limping counts as WB
cost effective

high sensitivity, low specificity

25
Q

Observation of Knee

A

genu valgus/varus
LE rotation/foot position
supination/pronation
symmetric WB
muscle atrophy/symmetry
swelling
surgical scars
skin color

26
Q

Flexion Norm

A

135°
can vary due to soft tissue girth

27
Q

Extension norm

A

0-15°
15° can be normal, depends on other side

28
Q

Knee flexion end feel

A

tissue approximation

29
Q

Knee Extension end feel

A

tissue stretch

30
Q

Extensor Lag

A

they have to have 0° of extension passively before making this observation

inability to maintain a mobile knee. in full extension during active SLR

31
Q

Implications of Extensor Lag

A

won’t be able to WB
need to address ASAP and use an AD

usually caused by pain, inhibition, weakness, limited patellar glide

32
Q

Patellar Glides M/L

A

medial anshould be <2 quadrants in either direction

33
Q

Patellar Glides S/I

A

smaller amplitude than M/L
should be occurring in passive and active movements

34
Q
A

6 Orthopedics (17 decks)

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