Leg/Knee Flashcards by Tyler Paras

3 functions of the patella

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

How well did you know this?

Not at all

Perfectly

What inserts on head of fibula?

LCL, Biceps femoris

How well did you know this?

Not at all

Perfectly

What goes in groove of tibial head

Peroneal nerve

How well did you know this?

Not at all

Perfectly

Mechanical axis of tibia?

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

How well did you know this?

Not at all

Perfectly

Rosenberg view?

PA weight-bearing, knees at 45°

How well did you know this?

Not at all

Perfectly

Complications of knee dx

Popliteal artery, stiffness

How well did you know this?

Not at all

Perfectly

Schatzker classification

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

How well did you know this?

Not at all

Perfectly

What increases nonunion rate in tibial plateau fx?

Periosteal stripping

How well did you know this?

Not at all

Perfectly

Associated injury in tibial plateau fx?

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

How well did you know this?

Not at all

Perfectly

5 P’s of compartment syndrome

Pallor
Pulseless
Pain (with passive stretch)
Paralyzed
Parasthesias

How well did you know this?

Not at all

Perfectly

Maisonneuve fracture?

Complete syndesmosis disruption with diastasis and proximal fibula fx

How well did you know this?

Not at all

Perfectly

Ruedi/Allgower classification

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

How well did you know this?

Not at all

Perfectly

Distal tibial fracture complications?

Posttraumatic DJD

How well did you know this?

Not at all

Perfectly

Bundles of ACL

AM bundle - tight in flexion, loose in extension

PL bundle - Tight in extension, loose in flexion

How well did you know this?

Not at all

Perfectly

Bundles of PCL

AL bundle - tight in flexion, loose in extension

PM bundle - tight in extension, loose in flexion

How well did you know this?

Not at all

Perfectly

Ligament of Wrisberg

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

How well did you know this?

Not at all

Perfectly

Popliteus insertion in relation to LCL origin

Anterior and distal

How well did you know this?

Not at all

Perfectly

Insall ratio?

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

How well did you know this?

Not at all

Perfectly

Q angle?

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

How well did you know this?

Not at all

Perfectly

Patella displacement test

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

How well did you know this?

Not at all

Perfectly

Patella apprehension

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

How well did you know this?

Not at all

Perfectly

J sign

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

How well did you know this?

Not at all

Perfectly

Patella compression/grind

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

How well did you know this?

Not at all

Perfectly

Joint line tenderness knee

Pain in joint line most sensitive test for meniscal tear

How well did you know this?

Not at all

Perfectly

McMurray test

Flex/varus/ER knee, extend - medial meniscal tear | Flex/Valgus/IR knee, extend - lateral meniscal

Apley's compression

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

Lachman test

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

Anterior drawer test knee

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

Pivot shift knee

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

Posterior drawer test knee

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

Posterior sag sig

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

Quadriceps active

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

Reverse pivot shift

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

Valgus/varus stress

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

Prone ER at 30 and 90° (dial)

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

ER recurvatum

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

Slocum

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)

PL drawer test

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

PM drawer test

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

Innervation of muscles in anterior compartment?

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

Innervation of muscles in lateral compartment?

Superficial peroneal (peroneus L and B)

Test L4 motor fxn with?

Dorsiflex

Test L5 motor fxn with?

Extend great toe

Test S1 motor fxn with?

Plantar flex foot

Innervation of superficial and deep posterior compartments of foot?

Tibial n

Acquired flat foot with injury of which muscle

Tibialis posterior

Which artery does the deep peroneal nerve run with

Anterior tibial a

What a supplies ACL and PCL?

Middle geniculate

Which artery does the tibial nerve run with?

Posterior tibial a

Most commonly affected compartment of the knee in OA?

Medial

Young female athlete with knee pain?

Think patellofemoral syndrome

Terrible triad knee

MCL, ACL, Medial meniscus

Segond fx? Association?

lateral tibial plateau bone avulsion, associated with ACL tear

Pelligrini-Steida?

Calcified medial epicondyle lesion

#1 tumor in adolescents?

osteosarcoma

#1 tumor in adults?

Chondrosarcoma

Blount's disease

Genu varum, either infantile or adolescent.

Anterolateral bowing of tibia association

Osgood-Schlatter disease

Traction apophysitis/osteochondrosis of the tibial tubercle

Tibial torsion

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

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

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

Harmon approach IN planes Dangers

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

Knee arthroscopy ports (6)

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