Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MUSC 206 > Physical Examination of Overuse/ Chronic Knee Conditions > Flashcards

Physical Examination of Overuse/ Chronic Knee Conditions Flashcards

1
Q

What is the order of the P/E for knee conditions?

A
  1. observation
  2. Fx tests
  3. palpation
  4. active movements
  5. passive physiological movements
  6. passive accessory movements
  7. special tests
  8. other jt assessment
  9. neurodynamic tests
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What do you observe with knee conditions? (3)

A
  • standing
  • gait
  • supine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What functional tests can you do for the knee?

A
  • squat (DL & SL)
  • lunge
  • jump/hop
  • stairs
  • running
  • drop down
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What to palpate with the knee?

A
  • Patella: med and lat facets
  • Med and Lat retinaculum
  • patella tendon (prox, mid, belly, distal)
  • quadriceps tendon
  • Hoffas fat pads
  • lat femoral condyle
  • superior tib-fib jt
  • biceps tendon
  • med and lat TF lines
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What active movements are done with knee conditions?

A
  • knee flexion
  • knee extension
  • repeated knee flexion
  • muscle length testing of quads, hammys, gastrocnemius and soleus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What passive physiological movements are used for knee conditions?

A
  • knee flexion
  • knee extension
  • tibial IR/ ER
  • hip all ranges
  • Lsp all ranges
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Passive accessory movements for knee conditions?

A
  • PF jt: med and lat glides
  • PF jt: ceph and caud glides
  • TF jt: AP/ PA glides
  • TF jt: med/lat glides
  • sup tib-fib jt: AP/PA glides
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What special tests for the knee

A
  • knee examination as per acute knee lecture
  • over pressure +/- knee flex/ect
  • McConnell resisted ext test
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Other jt assessments (clearing)

A
  • examination of lumbar spine
  • examination of hip jt
  • examination of ankle jt
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Neurodynamic tests for knee conditions

A
  • SLR
  • slump test
  • prone knee bend
  • neural thomas test
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

ANTERIOR KNEE PAIN
What are the most common anterior knee pain conditions? (2)

A
  1. Patellofemoral Pain Syndrome (PFPS)
  2. Patellar tendinopathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the less common anterior knee pain conditions (3)?

A
  1. Hoffas Fat Pad impingement
  2. Sinding - Larsen - Johansen lesion in adolescents
  3. Osgood- Schlatter lesion in adolescents
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the conditions NOT TO BE MISSED in anterior knee pain (3)?

A
  1. osteochondritis dessicans
  2. slipped capital femoral epiphysis
  3. perthes’ disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Definition of PFPS:

A

all peripatellar / retropatellar pain in the absence of other pathologies (no mensical/ ACL etc.)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are some synonyms for PFPS?

A
  • PFJP (patellofemoral joint pain)
  • PFPS
  • anterior/ retropatellar pain
  • chondromalacia patellae (death of patella cartilage)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Chondromalacia Patellae

A

refers to the state of the patellar articular cartilage –> poor correlation between articular cartilage damage and PFP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What can a cartilage lesion lead to?

A

chemical/ mechanical synovial irritation, oedema / erosion which contain nociceptors –> = pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What else could PFP be due to?

A

patella maltracking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is patella maltracking due to?

A

VL & VMO imbalance
ITB tightness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What type of factors contribute to PFPS?

A

extrinsic & intrinsic risk factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the definition of extrinsic risk factors?

A

increased/ unaccustomed PFJ load

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

extrinsic risk factors e.g.s

A

body mass, surfaces, footwear, volume of work, increase in amount of knee flexion required for task, eccentric work

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What do intrinsic risk factors refer to?

A

patella alignment in femoral trochlea (patella tracking)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Local factors relating to patella tracking (intrinsic risk factors) (2)

A
  • patella position
  • quadriceps (strength/ imbalance)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Remote factors relating to patella tracking (intrinsic factors) (6)

A
  • increased femoral internal rotation
  • increased hip adduction
  • increased knee valgus/ external tibial rotation
  • poor trunk & pelvic control
  • pronated foot type
  • increased knee flexion
26
Q

How can the patella be maltracked? – different patella positions (5)

A
  1. lateral displacement – closer to lateral femoral trochlea groove
  2. lateral tilt - high medial border
  3. posterior tilt - inferior pole moves posteriorly
  4. patella alta - high riding patella
  5. patella baja - low riding patella
27
Q

What happens to the quadriceps muscles that contributes to patella maltracking & PFP? (5)

A
  1. reduced peak knee extension torque
  2. quadriceps atrophy
  3. reduced quads flexibility
  4. delayed VMO onset compared to VL - they should come on together
  5. reduced hammy flexibility
28
Q

How does the Q angle effect PFP?

A

increased/ decreased Q angle causes pressure through patella

29
Q

PATIENT HISTORY - PFP
What is the type of pain on the body chart?

A

often vague- ill defined –> poorly localised

30
Q

Is PFP bilateral?

A

can be

31
Q

what may the patient report with PFP?

A

giving way, crepitus, swelling, locking, clicking

32
Q

Aggs of PFP

A

Loaded knee flexion activites
- running, stairs, kneeling, squatting, lunging
Prolonged sitting with knee flexed
- can be referred o as “moviegoers” knee

33
Q

How much BW is loaded into the patella with walking

A

0.3 x

34
Q

How much BW is loaded into the patella with climbing stairs

A

2.5 x

35
Q

How much BW is loaded into the patella with descending stairs

A

3.5 x

36
Q

How much BW is loaded into the patella with squat

A

7 x

37
Q

PHYSICAL EXAMINATION OF PFP
what do you observe in PFP? (4)

A
  • swelling present locally / intracapsular
  • quads wasting (inhibition)
  • patella alta / baja
  • patella tilting
38
Q

What do you palpate in P/E of PFP?

A
  1. tenderness medial / lateral aspects of patella
  2. medial / lateral retinaculum
39
Q

Expected ROM for PFP?

A

often full ROM, but can be painful with flexion & muscle contraction in extension

40
Q

What functional assessments can be used for PFP?

A

squat, lunge, step down, running, jumping

41
Q

PATELLA TENDINOPATHY (PT)
What is it?

A

overuse condition causing degeneration & local pathology of patella tendon

42
Q

What is Patella tendinopathy first referred to as?

A

jumpers knee

43
Q

What are the risk factors for Patella Tendinopathy? (7)

A
  1. higher body mass index (BMI)
  2. higher waist - hip ratio
  3. leg length difference >3cm
  4. lower arch height of foot
  5. reduced quads & hammy flexibility
  6. strength
  7. change in load
44
Q

What are other risk factors for Patella Tendinopathy (5)?

A
  1. age – young males
  2. playing at national level
  3. males
  4. volleyball
  5. position playe
45
Q

PT MOI

A
  • repetitive mechanical loading of the tendon
  • linked to sudden spike in load
46
Q

is PT gradual / trauma caused?

A

insidious / gradual onset

47
Q

How do patients usually report subjectively? (6)

A
  1. progressively worsening
  2. decreased functional ability (ADLs)
  3. pain over patella tendon near inferior pole of patella
  4. commonly morning stiffness
  5. pain worsens after activity
  6. “warms up” with movement
48
Q

PT aggs (6)

A
  1. jumping/ power based mvmt
  2. running
  3. change in direction
  4. deceleration
  5. stairs
  6. prolonged sitting
49
Q

PT easing factors?

A
  • movement
  • unloading e.g. tape / bracing
50
Q

PT observations (2)?

A
  1. may have localised swelling / thickening inferior to patella
  2. consider local & remote intrinsic factors
51
Q

PT palpation (3)?

A
  1. tenderness of palpation of patella tendon, inferior pole of patella, tibial tuberosity
  2. associated with thickening of tendon
  3. crepitus if paratendonitis present
52
Q

PT ROM?

A

often full range
- may experience pulling at EOR flexion

53
Q

PT Fx tests?

A

decline squat (30 deg) –> eccentric load
- may reproduce pain on lunge, hop, jump and / or eccentric loading

54
Q

PT other tests?

A
  • MMT
    glutes, hammy, quads, calf
  • Jt ROM
    Lsp, Hip, Knee, Ankle
    Questionnaire –> VISA -P
55
Q

What happens during the healing of PT that you can see on an ultrasound?

A

neovascularisation –> new blood vessels form

56
Q

How to DD between PFP and PT?
Body chart

A

PT = localised pain to inferior pole of patella etc. vs vague ache of PFP

57
Q

How to DD between PFP and PT?
Observation

A

PT = thickening around patella tendon in infrapatella region
- no jt effusion

58
Q

How to DD between PFP and PT?
Palpation

A

PT = localised tenderness to inferior pole of patella, mid belly / tibial tuberosity

59
Q

How to DD between PFP and PT?
ROM

A

PT = tightness/ pulling in EOR knee ext

60
Q

How to DD between PFP and PT?
Fx Tests

A

PT = decline squat - eccentric loads reproduce pain

MUSC 206 (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions