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MSK LQ > Lab 7 > Flashcards

Lab 7 Flashcards

1
Q

Pt thinks they sprained a ligament, theyre sore for a while but have no instability

A

possible that they strained their joint capsule, not a ligament

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2
Q

delayed swelling is likely due to

A

synovitis (swollen capsules)

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3
Q

Immediate swelling/ hemarthrosis is more likely with

A

ligament tears

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4
Q

whats the most important thing in the history to ask for knee injuries

A

mechanism

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5
Q

Why is it important to screen if patients are 50+ or under 17 in knee cases

A

Osteosarcoma in distal femur

atrophy of quad, oddly shaped knee, s/s of cancer

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6
Q

What can we do to help rule out DVTs in the knee?

A

take vitals

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7
Q

History of blunt trauma or unaccustomed exercise

severe pain

hardness, paresthesia

no pulse in leg

A

compartment syndrome

URGENT! call the ambulance!

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8
Q

Ottawa knee decision rule:

A

Age 55+

Tenderness at head of fibula

isolated tenderness at patella

inability to flex knee to 90

inability to WB 4 steps

2+ findings need an xray

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9
Q

pittsburgh knee decision rule

A

Hx of blunt trauma or fall

inability to WB 4 steps

age under 12 or over 50

2+ gets an xray

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10
Q

Knee decision rule of bauer

A

inability to WB 4 steps
Presence of knee effusion
presence of ecchymosis

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11
Q

what do the 3 knee decision rules have in common?

A

Inability to WB 4 steps

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12
Q

what unique things do you need to look at in observation for knee

A

abrasions

lacerations

contusions

can cause infection!

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13
Q

You must have tibial ________ for full ext and tibial ________ for full flex

A

External rotation

internal rotation

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14
Q

how much hyperext is normal in the knee

A

15

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15
Q

what does 3-125 mean when writing knee ROM

A

Missing 3 ext, 125 degrees of flexion

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16
Q

What direction does the roll/glide happen for knee flexion?

A

posterior roll posterior glide

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17
Q

What direction does the roll and glide occur for ext of the knee

A

anterior roll, anterior glide

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18
Q

what are we mobilizing here?

A

ext

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19
Q

what motion is being mobilized here

A

ext

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20
Q

.

A
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21
Q

what movement is being mobilized

A

technically all of them, but mainly used for flexion

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22
Q

this glide helps with what motion

A

ext

23
Q

this glide helps with what motion

A

flexion

24
Q

When do we use PA and AP glides for the proximal tibiofibular joint

A

usually when the patient has chronic problems at the distal tibio-fibular joint

ex= chronic lateral ankle sprains

25
Q

Where do you palpate to feel meniscus?

A

Squishy area behind femoral condyles

26
Q

which collateral ligament is easier to palpate?

A

Lateral- is easier, shaped like cord

medial-harder to palpate, shaped like band

27
Q

Subjective -> Observation _> ROM -> MMT -> ____________

A

Joint play

28
Q

Where do we palpate the plicae (if present)

A

medial and superior under patella

29
Q

When would you do ligamentous testing for the knee vs not

A

only do ligamentous testing when there’s a MOI

30
Q

When would you do instability testing on he knee vs not

A

only do this testing if there’s a current or past MOI

31
Q

how to do lachmans

A

bend knee to 30 degrees and provide strong anterior shear with one hand while stabilizing thigh

32
Q

When do you preform a lachmans vs an anterior drawer

A

lachmans- immediately after injury b4 it swells

33
Q

What is the disadvantage of the anterior drawer vs the lachmans

A

knee is in 60 degrees of flexion and there is more hamstring activation guarding the knee

34
Q

injury to what structure is the most common cause of Anterio-lateral rotary instability

A

ACL

35
Q

what is the pivot shift test for

A

ACL, ALRI

36
Q

When we suspect ligamentous instability what tests should we do

A

test all 4 ligaments of the knee

37
Q

How do we know if a posterior sag sign is positive

A

Look for a big divot, compare to other side

38
Q

A valgus stress test at 0 tests the….

A

PCL

39
Q

A valgus stress test at 20 tests what

A

MCL

40
Q

A varus stress test at 0 is for…

A

ACL and PCL

41
Q

A varus stress test at 20 is for what

A

LCL

42
Q

Anteriomedial instability test direction:

A

Anterior drawer with ER

43
Q

Anterolateral instability test direction

A

IR with anterior drawer

44
Q

Posterio-lateral instability test

A

posterior drawer with ER

45
Q

Posterio-medial instability test direction

A

posterior drawer with IR

46
Q

how do you preform the mcmurray for the medial meniscus

A

passively rotate tibia into full ER while passively extending knee

47
Q

how do you preform mcmurrays for a lateral meniscus

A

Fully IR the tibia then extend the knee

48
Q

if you suspect someone has a lateral meniscus tear what part of mcmurray test should you do

A

BOTH tests

49
Q

T or F: Apley’s test can identify which side the meniscus is torn

A

F, it doesn’t discriminate between sides

50
Q

How to preform the apleys test

A

compress/ distract knee joint from lower leg and rotate leg into IR and ER

distraction- makes meniscus better compression- makes menicus worse/ligament worse

distraction- makes ligamentous injuries worse

51
Q

How do you preform Thessaly’s test

A

Preform at 20 and 5 degrees knee flex

pt twists side to side and positive is pop, click, or pain

positive test = mensicus problem

52
Q

What does the lateral patellar aprehension test test for?

A

tests for lateral patellar subluxation

53
Q

how do you preform clarke’s sign/ patellar grind test and what does it test for

A

pt is supine w/ knee straight

push the patella inferior and have patient isometricly contract quad

positive- reproduces their pain

means chondromalacia patella or any Pf dysfunction

MSK LQ (26 decks)

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