S3_L3: Knee Flashcards by Mind Med

What is the action of the piriformis muscle beyond 90
degrees of hip flexion?

internal rotation

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What is the arthrokinematics of the knee during OKC knee extension?

glides anteriorly

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What is the direction of tibial rotation during
OKC knee extension?

Tibia goes to ER

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TRUE or FALSE: Foot overpronation will lead to increase in Q-angle

TRUE

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TRUE or FALSE: Weakness of the Hip Abductors does not affect the knee.

FALSE.

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Forcibly rotating medially on a planted foot will injure the what structure?

Femur

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TRUE OR FALSE: During resisted Open-Kinematic Chain (OKC) knee extension, tibial anterior translation increases during the terminal knee extension.

TRUE.

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Which knee motion has a greater amount of LOM in knee OA?

Flexion

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An abnormal Q-angle is also known as ____

knocked knee

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What is the resting position of the knee?

25-30°

Clinical Practice: 20-30°

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What is the unhappy triad?

anterior cruciate ligament (ACL), medial meniscus and tibial (medial) collateral ligament

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the following are problems within the kinetic chain that may result to anterior knee pain, EXCEPT:

A. Femoral Anteversion
B. External Tibial Torsion
C. Foot Hypersupination
D. Genu Valgum
E. None

C. Foot Hypersupination

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TRUE OR FALSE: PTs may use dry needling as an intervention for PFP.

FALSE

Clinicians should not use dry needling for the
treatment of patients with PFP.

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How many weeks until pts with central zone repair can have FWB?

6-8 Weeks

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After meniscal repair, which kind of zone repair does not need protective bracing?

Peripheral Zone Repair

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What is the passive insufficiency of the rectus femoris?

rotate pelvis posterior, extend the hip, and flex the knee

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When the hip internally rotates, what motion will the knee have?

external rotation

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TRUE OR FALSE: MAI may be done in the protection phase of knee OA.

True.

This is allowed as long as patient can tolerate it and has a wide range of movement.

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Scenario: You asked your patient to perform a figure of 4 (dekwatro) position using his (L) leg and you noticed that the (L) leg was going upwards.

Using your knowledge in anatomy, what muscle is tight? Consider the laterality.

(L) Piriformis

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TRUE OR FALSE: Active insufficiency uses the principle of stretching.

False.

Passive insufficiency uses the principle of stretching.

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What is the passive insufficiency of the quadriceps muscle?

Knee Flexion

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TRUE OR FALSE: It is easier to reach passive insufficient for 2-jointed muscles as lesser range is needed, but it can be also weakened because of this.

True

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To maximize force production, do not place a muscle in an _____ position

active insufficiency

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What is the passive insufficiency of the iliopsoas muscle?

posterior tilt of pelvis & extend the hip

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This muscle is the first to become weak or first to atrophy during injury

Vastus Medialis Obliquus (VMO)

TRUE OR FALSE: Transcutaneous electrical stimulation (TENS) is recommended for patients with knee and/or hip OA.

FALSE TENS is strongly recommended against patients with knee and/or hip OA.

This implant design is used in bicompartmental replacement

Semi-constrained

When a pt has ACL tear, what muscle must be strengthened to provide anterior stability?

Hamstring NOTE: In PCL tear, the Quadriceps must be strengthened.

TRUE OR FALSE: When dealing with a knee injury, a PT must also give interventions for the hip, ankle, and foot.

True

This is when one or both trochlea are flat

Dysplastic Trochlea

The bones of the knee joint consist of the (1)______ with its two condyles, the (2)_____ with its two tibial plateaus, and the large sesamoid bone in the quadriceps tendon, the (3)_____.

1. distal femur 2. proximal tibia 3. patella Source: Kisner & Colby 7th ed., page 770

What type of joint is the knee?

biaxial, modified hinge joint Source: Kisner & Colby 7th ed., page 770

In general, anteroposterior stability is provided by the (1)_____ while mediolateral stability is provided by the (2)_____

1. cruciate ligaments 2. collateral ligaments Source: Kisner & Colby 7th ed., page 770

What condyle contributes to the locking mechanism at the knee?

Medial Condyle Source: Kisner & Colby 7th ed., page 770

In OKC movements of the knee, which direction does gliding happen?

Concave plateaus slide in the same direction Source: Kisner & Colby 7th ed., page 771

In non-weight bearing extension the tibia rotates (1)____ on the femur, and with flexion it rotates (2)____.

1. laterally 2. medially Source: Kisner & Colby 7th ed., page 771

This is the axial rotation that occurs between the femoral condyles and the tibia during the final degrees of extension is called the

Locking or screw-home mechanism Source: Kisner & Colby 7th ed., page 771

What muscle unlocks the knee?

Popliteus Source: Kisner & Colby 7th ed., page 771

TRUE OR FALSE: The patella is not associated with extensor lag as the patellofemoral joint is not responsible in extending the knee

False If patellar movement is restricted, it interferes with the range of knee flexion and may contribute to an extensor lag with active knee extension. Source: Kisner & Colby 7th ed., page 771

The primary function of the patella is to increase the moment arm of the _____muscle in its function to extend the knee.

quadriceps Source: Kisner & Colby 7th ed., page 771

The Q-angle is the angle formed by two intersecting lines: one from the (1)____ to the midpatella and the other from the (2)____ through the midpatella

1. anterior superior iliac spine (ASIS) 2. tibial tubercle Source: Kisner & Colby 7th ed., page 771

TRUE OR FALSE: A normal Q-angle which tends to be greater in me and has a value of 15° to 20°.

False A normal Q-angle tends to be greater in women than men and is between 10° to 15°. Source: Kisner & Colby 7th ed., page 771

This is the prime mover for knee extension

quadriceps femoris Source: Kisner & Colby 7th ed., page 773

What are the major nerves subject to knee injury?

1. common fibular (peroneal) nerve (L2–L4) 2. saphenous nerve (L2–L4) Source: Kisner & Colby 7th ed., page 775

TRUE OR FALSE: In the knee, articular cartilage destruction is more often apparent on the medial joint compartment than the lateral compartment.

TRUE Source: Kisner & Colby 7th ed., page 775

What is the deformity commonly seen in the presence of OA?

Genu varum Source: Kisner & Colby 7th ed., page 775

When there is effusion (swelling within the joint), what is often most comfortable for the patient?

near 25° of flexion Source: Kisner & Colby 7th ed., page 776

TRUE OR FALSE: Do not increase ROM unless the patient has sufficient strength to control the motion already available.

True A mobile weight-bearing joint with inadequate muscle control causes impaired stability and makes lower extremity weight-bearing function difficult. Source: Kisner & Colby 7th ed., page 777

A mobile-bearing knee design is recommended for (1)____ patients , younger than (2)____ years of age.

1. active 2. 55 to 65 Source: Kisner & Colby 7th ed., page 783

The position of immobilization after primary TKA is in ____.

extension NOTE: Although uncommon, an alternative approach is to immobilize the knee in a 90° flexion splint immediately after surgery Source: Kisner & Colby 7th ed., page 786

In Post-op TKA, the ROM goal is to attain (1)____ for knee flexion and (2)____ for knee extension by the end of this first phase of rehabilitation.

1. 90° 2. full ROM for Source: Kisner & Colby 7th ed., page 787

TRUE OR FALSE: Full knee extension is not possible until joint swelling has subsided.

TRUE Source: Kisner & Colby 7th ed., page 787

TRUE OR FALSE: Avoid placing a pillow or rolled towel under the knee while lying supine or while seated with the operated leg elevated to reduce the risk of developing a knee flexion contracture.

TRUE Source: Kisner & Colby 7th ed., page 788

Patellar instability is most often in what direction?

lateral Source: Kisner & Colby 7th ed., page 792

This condition is when an embryological synovial tissue remnants or bands around the patella cause joint irritation during motion.

Plica syndrome Source: Kisner & Colby 7th ed., page 793

______, also known as housemaid’s knee, can result from prolonged kneeling or recurrent minor trauma to the anterior knee.

Prepatellar bursitis Source: Kisner & Colby 7th ed., page 793

TRUE OR FALSE: Quadriceps inhibition is common with pain and joint effusion

TRUE Source: Kisner & Colby 7th ed., page 795

Ligament injuries occur most frequently in individuals between ____ years of age during sport participation

20 and 40 Source: Kisner & Colby 7th ed., page 805

The _____ is the most commonly injured knee ligament.

ACL Source: Kisner & Colby 7th ed., page 805

TRUE OR FALSE: More than one knee ligament is often damaged during a single injury episode.

TRUE Source: Kisner & Colby 7th ed., page 805

This knee ligament is usually managed with only a conservative (nonsurgical) approach when injured.

MCL Source: Kisner & Colby 7th ed., page 808

Define auto-graft

It is when the tissue used for intra-articular reconstructions is from the patient’s own tissue Source: Kisner & Colby 7th ed., page 811

TRUE OR FALSE: A semitendinosus-gracilis tendon graft's strength and stiffness are greater than that of the native ACL.

TRUE Source: Kisner & Colby 7th ed., page 811

TRUE OR FALSE: When a pt's ACL is injured or torned, surgery is immediately indicated and performed.

False. Surgery is typically delayed until acute symptoms have subsided. Source: Kisner & Colby 7th ed., page 817

TRUE OR FALSE: Simple squatting may cause a meniscus tear.

TRUE Source: Kisner & Colby 7th ed., page 824

What special test may be positive in meniscal tear?

McMurray test or Apley’s compression/distraction test Source: Kisner & Colby 7th ed., page 824

Determine whether the MOI presented is for what ligament: 1. Dashboard injury 2. Varus force on the knee 3. Kick in the front of the knee 4. Valgus moments 5. Kick on the lateral part of the knee A. Anterior Cruciate Ligament B. Posterior Cruciate Ligament C. Medial Collateral Ligament D. Lateral Collateral Ligament

1. B 2. D 3. B 4. C 5. A

In terms of ROM, what is the criteria to progress from maximum to moderate protection phase?

✔ ~100-110 degrees of flexion ✔ Full active extension (no extensor lag)

TRUE OR FALSE: Clinicians should not prescribe patellofemoral knee orthoses, including braces, sleeves, or straps, for patients with PFP.

True

3 common MOI of PCL injury?

1. Dashboard/ anterior injury mechanism 2. Fall on flexed knee c PF foot 3. Sudden violent hyperflexion