Lower Extremity: Knee

Question 1

What are the four main ligaments of the knee?

Answer 1

ACL, PCL, LCL, MCL

Question 2

What are the purposes of the lateral and medial meniscus?

Answer 2

cushioning and preventing bone on bone contact

Question 3

Which meniscus is bigger?

Answer 3

Medial because of orientation of Tibia

Question 4

How do we divide the meniscus?

Answer 4

Front- anterior, posterior - back

Depends on vascularity of area for injury length

Question 5

What are the four quad muscles?

Answer 5

Quadricep Fermoris Vastus

Rectus Fermoris (important for hip and knee extension)

Question 6

What are the hamstring muscles?

Answer 6

Bicep Fermoris (most important for flexion and hip extension)

Question 7

What muscle plays a big part in ACL tears?

Answer 7

Calves because valgus collapse of the knee

When landing, knees cave inward

Tight calves prevent dorsiflexion which is important for absorption

Question 8

How to prevent knee injuries?

Answer 8

good conditioning, be well-rounded in terms of strength, flexibility, cardiovascular and muscular endurance

muscles around the hip and knee must be strengthened to maximize stability

shoe type (cleats on turf)

Question 9

What are Prophylactic Knee Braces?

Answer 9

prevent and reduce severity

provide degree of support but should only be temporary

Question 10

What are the stress tests for the knees? Which is more commonly injured between the two?

Answer 10

Valgus (push inside for MCL)

Vargus (push outside for LCL)

MCL is more common because of getting hit on the outside of the knee

Question 11

How to test ACL? How does ACL tear

Answer 11

Lachman Drawer test

trying to pull tibia, should feel stop

rotational forces from cutting or stopping

Question 12

How to test meniscus tear?

Answer 12

Apley’s compression test - hard downward pressure is applied with rotation (not great because its painful regardless of injury)

Question 13

Percentage of ACL tears?

Answer 13

80% of ACL injury are not contact

Question 14

What do you call injuring all ligaments? Why?

Answer 14

Unhappy Triad

Injuries to one is usually associated with another ligament injury because of compromise (ACL and MCL)

Question 15

Why are females more likely to tear ACL?

Answer 15

Bigger pelvis means a sharper femoral angle leading to

Question 16

How do MCL’s get injured?

Answer 16

results of severe blow or outward twist (valgus force)

Question 17

How does an LCL get injured?

Answer 17

results of a vargus force, tibia is internally rotated

Question 18

What is an anterior Cruciate Ligament sprain? How is it caused

Answer 18

deceleration with foot planted and turns in direction of planted foot forcing rapid internal rotation

Question 19

How is meniscus injured? What are the signs?

Answer 19

Rotary force with knee flexed or extended while weight bearing

rotation + valgus force + rotation of calf

Question 20

What to consider when assessing meniscus tear?

Answer 20

pain in knee line, locking, or pain when squatting

Question 21

What is a joint contusion? What are the signs? Treatment?

Answer 21

blow to the muscles crossing the joint

present as knee sprain, severe pain, loss of movement, signs of inflammation and swelling

rice initially and swelling persists

Question 22

what is a knee plica? What are the signs?

Answer 22

Folding of synovial tissue. Twisting of knee with foot fixed, sitting for prolonged periods

knee locking, pain with stars

usually medial patellar plica

Question 23

What are the importances of Bursitis in the knee?

Answer 23

Prepatellar = continued kneeling
Infrapatellar = overuse of patellar tendon

localized swelling above knee, inflammation

Question 24

What is Iliotibial Band Friction Syndrome? The signs?

How to treat?

Answer 24

Runner’s Knee

repeated/overuse from poor mechanics and repeated knee flexion and extension

irritation at band’s insertion (lateral femoral condyle), tenderness, swelling, and redness

correct misalignments, ice before and after activity, avoidance of aggravating activities