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MSK LQ > Lecture 7B > Flashcards

Lecture 7B Flashcards

1
Q

What kind of force causes:

Injury to MCL

A

Valgus Force

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2
Q

What kind of force causes:

Unhappy triad : ACL/MCL/Medial meniscus

and the posteromedial capsule

A

Valgus force

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3
Q

What movement commonly causes injury to ACL and sometimes PCL

can be accompanied by meniscus injuries

A

hyperextension

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4
Q

What are the common mechanisms of injury to the PCL?

A

Flexion w/ posterior translation

Classic dashboard injury

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5
Q

What kind of force causes injury to the LCL and postero-lateral capsule

A

Varus force

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6
Q

Hear a pop

Rapid swelling (0-2 hours)

hx of knee giving way

loss of end range ext

MOI: deceleration/acceleration w/ valgus force near extension

A

acl tear

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7
Q

What clinical tests are best to do IN THE CLINIC for ACL injuries

A

Lachman’s

Anterior drawer

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8
Q

cruciate ligaments limit __________

Collateral ligaments limit __________

A

IR

ER

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9
Q

What is a segond fracture

A

ACL tear causes avulsion of the lateral tibial plateau due to excessive internal rotation

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10
Q

concurrent bone bruising is most common over the ___________ condyle

heals slowily

usually accompanies what injury

A

lateral femoral

ACL tear

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11
Q

How do you decide whether or not someone can cope without an ACL or whether they require surgery

A

Use multiple outcome measures, no single outcome measure is sufficient

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12
Q

post-ACL tear: Individuals with highest pre-injury activity level have a ___________ probability of returning to their preinjury activity level

A

lower

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13
Q

what % of ACL injuries can compensate well without surgery

A

1/3

1/3 could return to activity with bracing, strengthening, and activity modification

1/3 would not return to sport without surgery

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14
Q

Inclusion criteria for people who don’t need ACL surgery

A

isolated ACL injury

Non-repairable meniscal injury

no other ligamentous damage

full and pain free ROM

no knee joint effusion

MVIC of quad is 70% of uninvolved

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15
Q

What criteria is used to identify people who will benefit from no surgery and just rehab after an ACL tear

A

Single hop test of 80% equivelant to other side

No more than 1 episode of giving way since time of injury

KOS ADL scale and sports activity scale of 80%+

Global Rating scale 60%+

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16
Q

patients are more likely to receive a surgery for ACL if they have

a ____ level of activity

more episodes of giving way

_______ KOS-ADL score

__________ score on the international knee documentation committee Subjective knee form 2000

_____ limb symmetric index on the 6m timed hop test and on quadricep strength index

A

Higher

Lower

Lower

Lower

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17
Q

fall with hyperflexed knee and ankle plantarflexion

loss of knee ext with ROM testing or gait

A

PCL injury

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18
Q

What are the 3 clinical tests for PCL tear

A

Posterior Drawer

Posterior sag sign

positive valgus stress test at 0 degrees

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19
Q

What special test is best for MCL

A

Valgus stress test at 20-30 knee flexion

grade 1- 2mm joint space opens on CONTRALATERAL SIDE

grade 2- 3-5mm

grade 3- 5-10mm

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20
Q

T or F, the MCL does well non-operatively

A

T

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21
Q

Pt has MCL injury with boney avulsion, ACL tear

3 months of no progress and still has instability with varus force

A

operative MCL injury

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21
Q

What clinical test is best for LCL injuries

A

Varus Stress test at 30 degrees knee flexion

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22
Q

Anteriomedial stability resists what direction of force?

A

anterior and ER

23
Q

anterolateral stability resists what direction

A

anterior and IR

24
Q

Posteriomedial stability resists what force

A

posterior and IR force

25
Q

posterolateral stability resists what force?

A

posterior and ER force

26
Q

Excessive valgus force with tibial ER motion causes what injury

A

anteromedial rotary instability

27
Q

Excessive valgus force with tibial IR motion will cause what kind of injury

A

Anterolateral rotary instability

28
Q

What kind of drawer test is best for anterolateral instability?

What about anteromedial?

A

Anterior drawer with IR

Anterior Drawer with ER

29
Q

Traumatic forcing knee into ext and tibial IR causes….

Ext + ER causes….

A

Posterio-medial instability

Posterio-lateral instability

30
Q

What test is best for posteromedial instability

postero-lateral instability

A

posterior drawer with IR

Dial test/Posterior drawer test with ER of 15

31
Q

MOI for: Posterolateral corner injury

A

direct hit on proximal tibia with extended knee

posterior force on a flexed knee with tibia ER

32
Q

Posterolateral corner injury grades of 1, 2, 3

which requires surgery

A

grade 2 or more

33
Q

What population is ACL tear the most common in

A

young female athletes

34
Q

What interventions have strong evidence for ACL tear?

A

A level - Therex, NMES, NM education

B- Immediate immobilization, cryotherapy, supervised rehab

C- CPM, Knee bracing, early weight bearing

35
Q

What level of evidence: Programs should use ACL injury prevention program prior to athletic training sessions in games, especially female athletes, those under 18, soccer players

A

Grade A

36
Q

What level of evidence: Programs should incorporate multiple components of control, strength, plyometrics in training

A

A

37
Q

History of catching/locking

forceful twist MOI

joint line tenderness

A

Meniscal injury

38
Q

What variables help predict meniscal injuries

A
  • Catching/locking
  • forceful twist, especially medial
  • joint line tenderness
  • forceful hyperextension or max flexion
  • McMurrays test

4+ predict 81%

39
Q

What’s the difference betwen an articular cartilage injury and a meniscus injury

A

Meniscus has delayed effusion, Articular cartilage has immediate hemarthrosis

Articular cartilage injury has pain that is intermittent

40
Q

What interventions have strong evidence for Meniscus and articular cartilage injuries

A

B level: Progressive knee motion

progressive WB

therex

NMES

40
Q

T or F: the diagnosis of Osteoarthritis of the knee should be made by radiographs alone

A

F

41
Q

Altman’s criteria for knee OA

A

50+

Knee crepitus

Boney enlargements

boney tenderness

morning stiffness less than 30 mins

No palpable warmth

42
Q

What is kellgren-lawrence scale for knee OA

A

Ranks radiographs by how bad the osteoarthritic changes look

43
Q

T or F: Manual therapy + exercise was proven to be better for knee OA than exercise alone

A

T

44
Q

How can hip mobs benefit knee OA patients?

A

short term increase in knee ROM and decreased pain

so if they have a hip issue pull on their hip! (after asking contras)

45
Q

CPR for knee OA patients who would benefit from hip mob

A

pain with ipsilateral hip distraction

ipsilateral knee flexion passive ROM is under 122

ipsilateral hip IR is less than 17

pain or paresthesia in ipsilateral hip or groin

ipsilateral anterior thigh pain

46
Q

What relationship does BMI have to OA patients

A

BMI has a strong relationship to pain and function in patients with knee OA

47
Q

What are the 4 components of OA treatment

A

Exercise!

Weight control!

Mob and exercise for knee ROM

Check hip

48
Q

What impairments are associated with PFPS

A

Dc quad strength

dc flexibility

dc coordination

control of femurtibia rotation, overpronation, patellar positions

49
Q

how much increased wb compression does the knee experience with walking?

running?

A

walking +25-50% bodyweight

running 5-6x bodyweight

50
Q

What gender experiences PFPS more

A

women

51
Q

What 3 areas of the body can cause PFPS

A

abnormal femur/tibia motion

controlling hip and pelvic motion

ankle/foot motion

52
Q

Pt has been sitting for over 30 mins and experiences pain after getting up

A

PFPS!!!!!!!!!!!!

53
Q

What test will patients with PFPS have the most pain on?

A

Step down test

54
Q

What are the 5 critera for lumbopelvic manip for Tx of PFPS

A

side to side diff of hip IR 14+

Ankle DF over 16

Navicular drop over 3mm

No self reported stiffness in sitting 20+ mins

Squatting reported as most painfu lactivity

atleast 3/5 gets you a 94% probability

MSK LQ (26 decks)

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