Brainscape's Knowledge GenomeTM

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


See full index

Clinical conditions for MSK > Session 4 - Disorders of the Knee > Flashcards

Session 4 - Disorders of the Knee Flashcards

1
Q

Femoral Shaft Fractures

Why may femoral shaft fractures occur in previously healthy children and young adults?

A

High-Velocity trauma

  • falls from height
  • road traffic accident

Child abuse in young children should be considered

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

Femoral Shaft Fractures

Why may femoral shaft fractures occur in the elderly?

A
  • osteoporotic bone
  • bone metastases
  • bone cysts

Occurs following a low-velocity injury
- falling over from a standing position

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

Femoral Shaft Fractures

Why is the proximal fragment abducted?

A

Due to pull of the gluteus medium and minimus on the greater trochanter

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

Femoral Shaft Fractures

Why is the proximal fragment flexed?

A

Due to the action of Iliopsoas on the lesser trochanter

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

Femoral Shaft Fractures

Why is the distal fragment adducted into a varus(medial) deformity?

A

Due to the actions of the adducted muscles (Adductor Magnus, gracilis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Femoral Shaft Fractures

Why is the distal fragment extended?

A

Due to the pull of gastrocnemius on the posterior femur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Femoral Shaft Fractures

What does the patient present with, with this condition?

A

Tense swollen thigh

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Femoral Shaft Fractures

Compare the blood loss in a closed femoral shaft fracture compared to an open one

A

Closed femoral shaft fracture

  • 1000-1500mL
  • may develop hypovolaemic shock

Open femoral shaft fracture

  • Double the amount
  • will develop hypovolemic shock
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Femoral Shaft Fractures

How is this condition treated?

A

Surgical fixation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Distal femoral fractures

Why may this occur in younger patients?

A

High energy sporting injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Distal femoral fractures

What will be seen on an x-ray of distal femoral fractures in younger patients?

A

Significant displacement of the fracture fragments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Distal femoral fractures

Why may this occur in an elderly?

A
  • osteoporotic bine

- fall from standing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Distal femoral fractures

Which vascular structure in the popliteal fossa may be damaged if there is significant displacement of the fracture?

A

Popliteal artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Distal femoral fractures

Careful assessment of what structure in the limb before and after reduction of the fracture is essential?

A

Neurovascular

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

Tibial plateau fractures

In what type of injuries can Tibial plateau fractures occur?

A

High energy injuries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Tibial plateau fractures

What is the usual mechanism in this type of fracture?

A

axial (top to bottom) loading with varus or valgus angulation

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

Tibial plateau fractures

When these fractures are described as either unicondylar or bicondylar, what does it mean?

A

Unicondylar
- affecting one tibial condyle articulating surface within the knee joint

Bicondylar
- affecting both tibial condyles articulating surface within the knee joint

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

Tibial plateau fractures

Fractures affecting which tibial condyle are the most common?

A

Lateral tibial condyle

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

Tibial plateau fractures

Which condition will most patients develop in the affected joint despite careful approximation of the fracture fragments? why?

A
  • Post-traumatic Osteoarthritis

- Articular cartilage is always damaged

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

Tibial plateau fractures

Name 2 other injuries with the ligaments that Tibial plateau fractures can be associated with?

A
  • Meniscal tears

- Anterior cruciate ligaments injuries

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

Patellar fractures

Why may a patellar fracture occur?

A
  • direct impact injury (knee against dashboard)

- eccentric contraction of the quadriceps

22
Q

Patellar fractures

In what age groups are these fractures common in?

A

20-50 years

23
Q

Patellar fractures

What can be seen/felt upon clinical examination?

A
  • palpable defect in the patella

- haemarthrosis (blood in joint)

24
Q

Patellar fractures

Why may the patient be unable to perform a straight leg raise in some instances?

A

The extensor mechanism is disrupted

- fracture completely splits patella distal to the insertion of the quadriceps tendon

25
Q

Patellar fractures

What is the treatment for displaced patellar fractures?

A
  • reduction

- surgical fixation

26
Q

Patellar fractures

What is the treatment for undisplaced patellar fractures?

A
  • do not usually require surgical fixation

- protected via splinting and using crutches whilst healing takes place

27
Q

Patellar fractures

What may be mistaken for a patella fracture on an X-ray?

A

Bipartite (in two parts) patella

28
Q

Patellar fractures

Why does a bipartite patella develop?

A

There is a failure of union of a secondary ossification centre with the main body of patella

29
Q

Patella dislocation

What is the term given to the partial displacement of the patella?

A

Subluxation

30
Q

Patella dislocation

What is the most common direction for the patella to dislocate? Why?

A

Lateral dislocation

  • (the Q angle ) the angle between the line of pull of the quadriceps muscles and patellar ligament means that during extension of the knee, the patella naturally tries to be displaced laterally
31
Q

Patella dislocation

What are the common causes of this condition?

A
  • trauma
  • a twisting injury in a slight flexion
  • direct blow to the knee
32
Q

Patella dislocation

Which age group is most commonly affected?

A

Athletic teenagers

33
Q

Patella dislocation

What is the usual mechanism of injury?

A

internal rotation of the femur on a planted foot whilst flexing the knee (e.g sudden change of direction during sports)

34
Q

Patella dislocation

Give 4 factors that can predispose to a patellar dislocation

A
  • Weakness of the quadriceps muscles, especially the VMO
  • Shallow trochlea(patellofemoral) groove with a flat lateral lip
  • Long patellar ligament
  • Previous dislocations
35
Q

Patella dislocation

What is the treatment for this condition ?

A
  • extending knee then manually reducing patella (put it in correct alignment)
  • immobilisation is used whilst healing takes place
  • physiotherapy to strengthen the VMO
36
Q

Meniscal injuries

When do these injuries occur?

A

Sudden twisting motion on a weight-bearing knee in a high degree of flexion

37
Q

Meniscal injuries

What are the symptoms patients present with?

A
  • intermittent pain, localised to the joint line
  • knee clicking, catching and locking
  • the sensation of the knee giving away
38
Q

Meniscal injuries

Why may swelling occur?

A
  • delayed symptom
  • due to a reactive effusion or not at all
  • menisci are largely avascular (except at peripheries)
39
Q

Meniscal injuries

Why is acute haemarthrosis rare in Meniscal injuries?

A

Menisci are largely avascular

40
Q

Meniscal injuries

What does acute haemarthrosis indicate if present in Meniscal injuries?

A
  • A tear in the peripheral vascular aspect on the meniscus

- an associated injury to the anterior cruciate ligament

41
Q

Meniscal injuries

Why may chronic effusion (increased synovial fluid) occur?

A

Synovitis ( inflammation of the synovial membrane)

42
Q

Meniscal injuries

What can be seen upon examination of the patient?

A
  • joint line tenderness

- restricted motion due to pain or swelling

43
Q

Meniscal injuries

How is acute traumatic meniscal tears treated?

A

Treated surgically by either meniscectomy or meniscal repair

44
Q

Meniscal injuries

How are chronic degenerative meniscal tears treated?

A

Conservative management

45
Q

Collateral ligament injury

Why does this injury occur?

A

They usually result from acute varus or valgus angulation of the knee.
- common sporting injury, particularly in direct
contact sports

46
Q

Collateral ligament injury

In acute valgus strain, which collateral ligament is at risk?

A

medial collateral ligament (MCL)

47
Q

Collateral ligament injury

In acute varus strain, which collateral ligament is at risk?

A

lateral collateral ligament (LCL)

48
Q

Collateral ligament injury

Which collateral ligament is injured more commonly?

A

Medial collateral ligament

49
Q

Collateral ligament injury

Why does the lateral collateral ligament have a higher chance of causing knee instability?

A
  • the medial tibial plateau forms a deeper and more stable socket for the femoral condyle than the lateral tibial plateau.
  • Hence, an intact LCL plays a more critical role in maintaining the stability of the knee
50
Q

Collateral ligament injury

What are the symptoms the patient present?

A
  • pain and swelling of the knee.

- complain of it giving way or not supporting their body weight

51
Q

Collateral ligament injury

What is the unhappy triad?

A

injury to the anterior cruciate ligament, medial collateral ligament and medial meniscus

52
Q

Collateral ligament injury

How does the unhappy triad occur?

A

A strong force applied to the lateral aspect of the knee

Clinical conditions for MSK (6 decks)

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