lab 7: knee joint complex Flashcards
if a paitent has a MOI of a valgus or varus what do we think
collaterals
if a pt has a MOI of a combo of directions what do we think
unhappy triad - ACL , MCL medial mencius
if a pt has a MOI of twisting what do we think
menisci
if a pt has a MOI of hyperextension what do we think
ACL
PCL
meniscus
if a pt has a MOI that is repetitive what do we think
tendons
PFJ
stress sx
menisci
if a pt desrcibes their pain as better in AM and w activity but gets worse by the evening and they are >50 what can we think
OA
if a pt is >60 years old , has a hx of type 2 DM , ischemic heart diease smoking and has a sedentary lifestyle .. they tell u they have concurrent intermittent claudication and u palpate and fell a unilateral cold extermity , a decreased pedal pulse and they have prolonged venous filling time what do u think they have and what do u do
peripheral artieal occlusive disease and refer out
what are 3 red flags w DVT
calf pain , edema, tender , warm
calf pian that increases w standing or wlaking and relived w rest and elevation
recent sx
h istory of blunt trauma, crush injury, or unaccustomed exercise
Severe, persistent leg pain that is intensified with stretch applied to involved muscles
Swelling, exquisite tenderness, and palpable tension (hardness) of involved compartment
Paresthesia, paresis, and pulselessness
if someone has this what do u think they have and what do u do
compartment syndrome and refer out
Constant aching and/or throbbing pain, joint swelling, tenderness, warmth
History of recent infection, surgery, or injection
Coexisting immunosuppressive disorder
what non MSK problem does this sound like
septic arthritis
Pain, skin swelling, warmth, and an advancing, irregular margin of erythema/reddish streaks
Fever, chills, malaise, and weakness
what non MSK problem does this sound like
cellulitis
what is the ottawa knee decisions rule
Criteria:
1. Age > 55 years
2. Tenderness at head of fibula
3. Isolated tenderness of patella
4. Inability to flex knee to
90 degrees
5. Inability to WB and take a
minimum of 4 steps
(+) if 2-5 are positive
what is the pittsburgh knee decision rule
Criteria:
1. History of blunt trauma or fall
2. Inability to weight bear or take
a minimum of 4 steps
3. Age < 12 years or > 50 years
(+) if hx of trauma and 2 or 3 are positive
what is the Knee Decision Rule of Bauer
Criteria:
1. Inability to weight bear and
take a minimum of 4 steps
2. Presence of knee effusion
3. Presence of ecchymosis\
Positive finding is the presence of
any one of the 3 criteria.
what is normla hyperextension
0-15°
which femorla condyle is longer
medial
what is know IR/ER
IR: 20-30°
ER: 30-40°
for the knee what MMT are u testing
knee flex/ext
hip flex/ext
IR/ER
ABD/ADD
what are the.5 flexibility test u could do for the knee
obers test
modified thomas test (if decreased flexion)
elys test
gastroc/soleus length (supine leg straight for gastroc and bend of soleus)
hamstring length (if decreased knee extension)
is the joint play for knee extension
for knee extesnion the the tibia glides anterior sooooo 2 options
can have a fixed tibia and push down on the distal femur which will causes tibia to go anteriorly
or
can have towel under ankle push down on femur and pull up of tibial from underneath the calf
if the patient is lacked full extension by a lot then have them lay prone and grab their ankle and push coward on the distal proximal tibi fib (like a the crest of ur knee)
what is joint play for knee flexion
so for knee flexion the tibila glides posteriorly so u have a few options
can stabilize under the distal thigh and pull anteriorly on the tibia in flight knee flexion
or
have ft foot flat on mat w knee flexion and pull anteriorly on the tibia and other hand under distal thigh
or
if they lack full flexion by a lot have pt sir edge of mat and put a towel under the knee and what ever flexion they have then push anteriorly on the tibia
how does the patella move in extension and flexion
superiorly during extension
inferiorly during flexion
do u rule our meniscus or ligaments first
meniscus
what ligaments are u checking w valgus and varus stress test
VALGUS
-PLC at 0°
- MCL at 20°
varus
LCL check at 0° and 20°
