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Netters Orthopedic TP > Leg/Knee > Flashcards

Leg/Knee Flashcards

1
Q

3 functions of the patella

A

1) Enhances quadriceps pull (as fulcrum)
2) Protects knee
3) Enhances knee lubrication

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2
Q

What inserts on head of fibula?

A

LCL, Biceps femoris

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3
Q

What goes in groove of tibial head

A

Peroneal nerve

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4
Q

Mechanical axis of tibia?

A

Line drawn between the center of the knee and center of ankle mortise

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5
Q

Rosenberg view?

A

PA weight-bearing, knees at 45°

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6
Q

Complications of knee dx

A

Popliteal artery, stiffness

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7
Q

Schatzker classification

A 
Tibial plateau fx
I: lateral plateau split fx
II: lat split/depression fx
III: lat plateau depression
IV: Medial plat. split fx
V: Bicondylar plateau fx
VI: Fx w/ metaphysial/diahyseal separation
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8
Q

What increases nonunion rate in tibial plateau fx?

A

Periosteal stripping

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9
Q

Associated injury in tibial plateau fx?

A

Meniscal (50%) and ligament (MCL>ACL) tears

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10
Q

5 P’s of compartment syndrome

A 
Pallor
Pulseless
Pain (with passive stretch)
Paralyzed
Parasthesias
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11
Q

Maisonneuve fracture?

A

Complete syndesmosis disruption with diastasis and proximal fibula fx

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12
Q

Ruedi/Allgower classification

A

Pilon (distal tibial fx)
I) non/minimally displaced
II) displaced: articular surface incongruous
III) comminuted articular surface

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13
Q

Distal tibial fracture complications?

A

Posttraumatic DJD

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14
Q

Bundles of ACL

A

AM bundle - tight in flexion, loose in extension

PL bundle - Tight in extension, loose in flexion

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15
Q

Bundles of PCL

A

AL bundle - tight in flexion, loose in extension

PM bundle - tight in extension, loose in flexion

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16
Q

Ligament of Wrisberg

A

Posterior meniscofemoral ligament, Posterior to PCL, continuation of lateral meniscus

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17
Q

Popliteus insertion in relation to LCL origin

A

Anterior and distal

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18
Q

Insall ratio?

A

Patella [diagonal] length/patellar tendon length. >1.2= patella baja, >0.8= patella alta

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19
Q

Q angle?

A

Angle from ASIS to mid-patella to tibial tubercle. Nl male

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20
Q

Patella displacement test

A

Translate patella medially and laterally. Should translate 2 quadrants. Otherwise tight retinaculum.

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21
Q

Patella apprehension

A

Relax knee, push patella laterally. Pain/apprehension, patellar instability or MPFL injury

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22
Q

J sign

A

Actively extend knee from flexed position. Lateral displacement of patella in full extension=maltracking

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23
Q

Patella compression/grind

A

Extend knee, fire quads, compress patella. Pain=chondromalacia, OCD, PF arthritis, DJD

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24
Q

Joint line tenderness knee

A

Pain in joint line most sensitive test for meniscal tear

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25
Q

McMurray test

A

Flex/varus/ER knee, extend - medial meniscal tear

Flex/Valgus/IR knee, extend - lateral meniscal

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26
Q

Apley’s compression

A

Prone, knee 90°, compress and rotate. Pain or pop = meniscal tear

27
Q

Lachman test

A

Flex knee 20-30°, anterior force on tibia. Laxity = ACL tear. Most sensitive ACL exam. Grade 1 0-5mm, grade 2 6-10mm, grade 3 >10mm. A=good endpoint, B= no endpoint

28
Q

Anterior drawer test knee

A

Flex knee 90°, anterior force on tibia, laxity/anterior translation: ACL injury

29
Q

Pivot shift knee

A

Supine, extend knee, IR, valgus force on proximal tibia, then flex knee. Clunk with knee flexion indicates ACL injury.

30
Q

Posterior drawer test knee

A

Flex knee 90°, posterior force on tibia. Posterior translation: PCL injury

31
Q

Posterior sag sig

A

Supine, hip 45°, knee 90°, view laterally. Posterior translation of tibia indicated PCL tear

32
Q

Quadriceps active

A

Supine, flex 90°, fire quads. Posterior subluxed tibia translates anteriorly if PCL is deficient.

33
Q

Reverse pivot shift

A

Supine, flex knee 45°, ER, valgus force on proximal tibia then extend knee. Clunk w/ extension indicated PCl injury

34
Q

Valgus/varus stress

A

Lateral/medial force to knee at 30° and 0°. Laxity at 30° indicates LCL/MCL tear. Laxity at both indicates additonal cruciate ligament injury

35
Q

Prone ER at 30 and 90° (dial)

A

Increased ER at 30°: PLC injury, at 90°, both PLC and PCL

36
Q

ER recurvatum

A

Supine, legs straight, raise legs by toes, recurvatum, varus, and IR of knee indicates PLC (+/-PCL) injury

37
Q

Slocum

A

Knee 90°, IR tibia 30°, anterior force - Displacement: anterior and lateral injury (ACL+PLC)
Knee 90·, ER tibia 30°, anterior force - Displacement: anterior and medial injury (ACL, MCL, POL)

38
Q

PL drawer test

A

Knee 90°, ER tibia 15°, posterior force. Laxity indicates PLC and or PCL injury

39
Q

PM drawer test

A

Knee 90°, IR tibia 30°, posterior force. Laxity indicates PCL and medial ligament (POL, MCL) injury.

40
Q

Innervation of muscles in anterior compartment?

A

Deep peroneal (TA, EHL, EDL, peroneus T)

41
Q

Innervation of muscles in lateral compartment?

A

Superficial peroneal (peroneus L and B)

42
Q

Test L4 motor fxn with?

A

Dorsiflex

43
Q

Test L5 motor fxn with?

A

Extend great toe

44
Q

Test S1 motor fxn with?

A

Plantar flex foot

45
Q

Innervation of superficial and deep posterior compartments of foot?

A

Tibial n

46
Q

Acquired flat foot with injury of which muscle

A

Tibialis posterior

47
Q

Which artery does the deep peroneal nerve run with

A

Anterior tibial a

48
Q

What a supplies ACL and PCL?

A

Middle geniculate

49
Q

Which artery does the tibial nerve run with?

A

Posterior tibial a

50
Q

Most commonly affected compartment of the knee in OA?

A

Medial

51
Q

Young female athlete with knee pain?

A

Think patellofemoral syndrome

52
Q

Terrible triad knee

A

MCL, ACL, Medial meniscus

53
Q

Segond fx? Association?

A

lateral tibial plateau bone avulsion, associated with ACL tear

54
Q

Pelligrini-Steida?

A

Calcified medial epicondyle lesion

55
Q

1 tumor in adolescents?

A

osteosarcoma

56
Q

1 tumor in adults?

A

Chondrosarcoma

57
Q

Blount’s disease

A

Genu varum, either infantile or adolescent.

58
Q

Anterolateral bowing of tibia association

A

NF

59
Q

Osgood-Schlatter disease

A

Traction apophysitis/osteochondrosis of the tibial tubercle

60
Q

Tibial torsion

A

Congenital internal rotation of the tibia. Intoeing gait. Measure the transmalleolar axis IR/medial

61
Q

Medial parapatellar approach to knee
IN planes?
Dangers?
Complication?

A

No IN plane
Infrapatella branch of saphenous nerve.
Complication= neuroma from cut nerve

62
Q

Harmon approach
IN planes
Dangers

A

Posterolateral approach to knee
IN planes: Gastroc/soleus (tibial), peroneus longus/brevis (superficial peroneal)
Lesser saphenous vein, posterior tibial artery

63
Q

Knee arthroscopy ports (6)

A

Anteromedial - watch anterior horn of medial meniscus
Anterolateral - anterior horn of lateral meniscus
Superolateral
Posteromedial - saphenous nerve
Posterolateral - peroneal nerve
Transpatellar - patellar tendon

Netters Orthopedic TP (7 decks)

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