The Knee Flashcards
What are palpable ligament and bony structures on the knee
- head of the fibula and shaft
- tibia tuberosity
- tibial plateau and shaft
- patella
- pes anserinus attachment site
- lat/med femoral condyles
- Lateral collateral ligament
- medial collateral ligament
- patella tendon
- sartorius
- quad muscle group
Leg alignment observations
- Genu valgum and genu varum
- hyperextension and hyperflexion
- patella alta and baja
- patella rotated inward or outward
- leg length discrepancy (anatomical/functional)
Tibial torsion
an angle that measures less than 15 degrees is an indication of tibial torsion
should be able to internally and externally rotate leg
Femoral anteversion and Retroversion
total rotation of hip equals ~100 degrees
if the hip rotates >70 degrees internally, anteversion of the hip may exist
The Q angle
bisect the patella from the ASIS and the tibial tubercle
“norm” = 10 M 15 F
- elevated angle over 22 or less than 12 lead to pathological conditions associated w/ improper patella tracking
A-angle
patellar orientation to the tibial tubercle
> 35 degrees often correlated w/ patellofemoral pathomechanics
Knee Plica
irritation of the plica
S/S: history of knee pain/injury
- painful pseudo-locking / snapping or popping
- pain w/ stairs and squatting
- little to no swelling and no ligamentous laxity
Management: RICE, surgery if reoccurring
Osteochondral Knee #
MOI: same as collateral/cruciate ligament or meniscal injuries
- twisting, sudden cutting or direct blow
- # of cartilage and underlying bone varying in size and depth
S/S: snapping, swelling, pain along join line
M: CT/MRI, cast, RTP 3-6 months
Osteochondritis Dissecans
EST: partial/complete separation of articular cartilage and subchondral bone
- unknown MOI
S/S: pain w/ recurrent swelling and possible locking
- possible quad atrophy and point tenderness
MANG: rest immobilization (children)
- surgery ( teenagers and adults)
Peroneal Nerve Contusion
EST: compression on peron. nerve. MOI = direct blow
S/S: local pain (w/ shooting nerve pain)
-numbness and paresthesia in cutanous distrubution of the nerve
- added pressure may exacerbate condition
- can result in drop foot
MANG: RICE, padding for fib. head for a few weeks
Bursitis
acute, chronic or recurrent swelling
prepatellar = continued kneeling
infrapatellar = overuse of patellar tendon
M: RICE, NSAID, eliminate cause
Patellar #
MOI: direct blow or semi-flexed position w/ forcible contraction
S/S: hemorrhaging and joint effusion w/ generalized swelling
- indirect # may cause capsular tearing, separation of bone fragments and possible quad tendon tearing
bone separation w/ direct injury
MANG: x-ray, RICE, refer and immobilize 2-3 months
Acute patella Subluxation or Dislocation
Patella pulled out of alignment due to quads
S/S: pain, swelling, restricted ROM, px over adductor tubercle
M: reduction, surgery, improve posture and biomechanical factors
Infrapatellar Fat Pad injury
MOI: chronic kneeling, pressure or trauma
S/S: cap hemorr. and swelling, px bellow patellar ligament
M: Rest from irritating activities, heel lift, hyperextension taping
Chondromalacia patella
MOI: abnormal tracking, due to biomechanical problems causing deterioration of the articular cartilage
S/S: px w/ walking, squatting, stairs, running
M: RICE NSAID orthotics
Surgical
