meniscus - exam 3

Question 1

2nd MOST common knee injury?

Answer 1

meniscal tear

Question 2

True or False:
Medial < Lateral Meniscus
Posterior < Anterior Horn

Answer 2

False:
>
>

Question 3

RF of meniscus tear:
acute:
chronic:

Answer 3

acute- all WB sports

Chronic/Degenerative:
greater the age, especially > 60 yrs. of age
male > female
worked related kneeling/squatting/stair climbing

Question 4

Meniscus: structures involved :
attachment:

Answer 4

nearly circular wedged-shaped fibrocartilage discs on the tibial plateau
attached to the tibia via horizontal coronary ligaments

Question 5

Meniscus Functions:
–outer
–inner

Answer 5

stability>shock absorption
deepen the joint surface for stability

–Outer 1/3
80% type I collagen
<1% of other types

–Inner 1/3
60% type II collagen
40% type I collagen

Question 6

Medial meniscus characteristics: (3)

Answer 6

more “O” shaped
torn more frequently
attachment to MCL

Question 7

Lateral meniscus characteristics: (2)

Answer 7

more “C” shaped
greater mobility without ligamentous attachment

Question 8

There are various portions of the meniscus that can tear. T or F?

Answer 8

True

Question 9

Symptoms of Meniscal Injury?
-______P!, refer _________
-Onset?
-ROM/WB?

Answer 9

Joint P! with possible referral into shin
Onset: if acute, trauma reported likely with WB sport
if chronic, gradual and unknown, typically in. an older individual w/o a prior injury

limited and P!ful motion
WBing limitation with possible catching or locking

Question 10

Signs of Meniscal Injury:
Observation:

Answer 10

possible swelling
potential asymmetrical and antalgic gait

Question 11

Signs of Meniscal Injury:
-ROM:
-Resisted Testing:
-Stress Tests:

Answer 11

limited and P!ful motions
potentially weak and P!full (severity dependent)
possibly P!full w/compression

Question 12

What are the meniscus special tests:

Answer 12

McMurrays
Ege’s
Thesallys’s (lateral ONLY)
Apley’s

Question 13

Which of the following special tests is being described:

pt. in supine palpate menisci at end range flx
–IR then EXT _________menisci
–ER then EXT for _______menisci
–checking for ________________

Answer 13

McMurray’s

Lateral
Medial
audible or palapble clicking/thud: NOT P!**

Question 14

Which of the following special tests is being described:
in B stance w/feet 1-1 1/2 ft. apart
Full hip IR and squat for _______menisci
Full hip ER and squat for ________menisci
–checking for ___________

Answer 14

Ege’s
lateral
medial
P! or click

Question 15

Which of the following special tests is being described:

in U stance twist 3x in each direction testing ________ menisci ONLY
@5º flx
@30º flx
–checking for ________________

Answer 15

Thesally’s
Lateral
locking, catching or P!

Question 16

Which of the following special tests is being described:
pt. in prone flx knee to 90º (stabilize femur)
-apply distx then IR/ER : (+) test Indicates ____________
-apply comp then IR/ER (+) test indicates _________

Answer 16

Apleys
ligamentous injury
meniscal injury

Question 17

Signs of Meniscal Injury:
- m. activity/MMT:
- palpation

Answer 17

inhibited quads
joint line tenderness has minimal to no support

Question 18

PT Rx for meniscal injury:

Answer 18

POLICED
assistive device to minimize/avoid limping
JM - meniscal integrity

Question 19

what are the purposes of MET for a meniscal injury?

Answer 19

meniscal integrity and stabilization
NMES - moderate support for strength

Question 20

what does the research say about surgery for degenerative tears in the meniscus?

Answer 20

strong recommendation AGAINST even in the presence of age related joint changes

Question 21

what is a partial meniscectomy?
- post op aspects?

Answer 21

removal of tear
- no immobilization
- earlier WBing
- return to play in 2-6 weeks

Question 22

what is a meniscal repair?
- post op aspects?

Answer 22

sutured
primarily with tears in outer 1/3
immobilization and/or limited ROM initially
TTWB 4-6 weeks
return to play in 12 weeks - takes this long to become densely healed which you need before running, jumping, etc

Question 23

what is a bakers cyst?

Answer 23

excessive swelling in popliteal space, often due to articular changes i.e., age related joint changes

Question 24

fluid filled cysts can be due to:

Answer 24

persistent inflammation
subsequent weakening of capsule

Question 25

baker’s cysts are asymptomatic until:

Answer 25

significant effusion

Question 26

How do Baker’s cysts differentiate from meniscus tears?

Answer 26

palpable popliteal protrusion just medial to medial gastroc head
No p! With compression like meniscal tear

Question 27

Signs of Baker’s cyst:
- ROM:
- Resisted:

Answer 27

limited and painful with flx/ext
flexion painful

Question 28

PT Rx for Baker’s cyst:
- precaution:

Answer 28

like degenerative meniscal tear (reduce swelling)
- forceful activity

Question 29

prognosis for Baker’s cyst:
- complication

Answer 29

difficult to manage in active individuals
complication: rupture may occur and mimic gastroc tear

Question 30

MD Rx for baker’s cyst:

Answer 30

aspiration and/or surgical repair