The Knee Lecture Powerpoint Flashcards

1
Q

Patellar reflex tests ___ nerve root, achilles tendon is ___

A

L4, S1

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2
Q

Sunrise view x ray

A

Knee x ray view that should be very frequently done as it is the only x ray that can see the patellofemoral joint

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3
Q

Tunnel notch x ray

A

Allows for view of femoral tunnel at the patella to assess for avulsion or fracture, cannot assess ACL or PCL integrity

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4
Q

Gradual onset of swelling around knee after falling indicates ___ type injury, while immediate is more likely___

A

meniscal tear, ACL

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5
Q

Meniscal tears signs and symptoms (3)

A
  • pain usually well localized
  • pain with full flexion (inability to duck walk)
  • may have knee locking (inability to fully extend knee)
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6
Q

Best special test to evaluate meniscal tear

A

Mcmuray’s test

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7
Q

Meniscal tear treatment options (3)

A
  • compression, dressing, ice, elevation, crutches, ROM therapy
  • aspirate if tense painful effusion only
  • remove, debride, repair meniscus
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8
Q

Aspiration of fluid from knee joint analysis (3)***

A
  • mostly blood indicative of ACL tear
  • clear yellowish fluid without fat cells or significant blood is meniscal tear
  • blood and globules of fat is intra-articular fracture of the bone
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9
Q

Baker’s (popliteal) cyst definition and management***

A

Normal variant enlargement of semimembranous bursae in medial popliteal space, may be found incidentally, may cause pain/paresthesias if nerve impingement if very inflamed and large, typically imaged on ultrasound or MRI, does NOT need to be excised often unless significantly problematic, often erroneously referred to ortho, can consider aspiration, rarely removed, may recur, treat any underlying cause

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10
Q

MCL injury

A
  • due to valgus stress applied to weight bearing knee
  • more common than LCL injury, association with other tears
  • unable to bear weight
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11
Q

MCL diagnostic studies (2)

A
  • plain films to rule out derangement or growth plate injury

- MRI

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12
Q

MCL treatment options (2)

A
  • knee immobilization, crutches, progress to ROM

- surgical repair results same as non-op

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13
Q

LCL injury

A
  • less common

- caused by varus stress on weight bearing knee

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14
Q

LCL treatment options (2)

A
  • sprain ROM brace and progress to ROM, crutches

- tears need surgical treatment

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15
Q

ACL tear signs and symptoms (3)

A
  • often audible pop after noncontact injury
  • immediate effusion/hemearthrosis
  • may be able to ambulate
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16
Q

ACL tear diagnostic studies (2)

A
  • x ray

- MRI shows torn ligaments

17
Q

ACL tear treatment options (2)

A
  • young active athletes need reconstruction

- for those with limited activity or not surgical candidate, bracing may be possibility

18
Q

Chondromalacia patella (CMP) (runner’s knee) (patellofemoral syndrome)

A

Anterior knee pain syndrome very common cause of knee pain in young adult, present with peripatellar pain, snapping, catching, crepitus, aggravated by stairs, squats, sitting, may be due to tracking problems (can be treated with tibial tubercle transfer) and may be overuse injury

19
Q

Q angle

A

Angle from knee to ASIS compared to tibial tubercle, widened in females creating greater likelihood of knee pathology

20
Q

Diagnostic studies for Chondromalacia patella (CMP) (runner’s knee) (patellofemoral syndrome) (1)

A

-x rays, sunrise view important

21
Q

Chondromalacia patella (CMP) (runner’s knee) (patellofemoral syndrome) treatment options (4)

A
  • stretch strengthen
  • tracking brace
  • NSAIDS
  • footwear mod
22
Q

Patellar sublaxation/dislocation definition/diagnostic studies (1)/treatment options (2)

A
  • Patellar malalignment usually lateral that can occur with repeating episodes, due to retinacular instability, can see significant pain around kneecap and lateral condyle but relocating it manually relieves
  • x ray including sunrise and lateral
  • rehab*** surgery for repeated episodes including lateral retinacular release or patellar realignment
23
Q

Plica syndrome definition

A

Synovitis of the folds of the knee, most often medial and may be due to trauma, overuse, treated with rest, activity restriction

24
Q

Osteochondritis dissecans definition

A

Localized subcondral necrosis of the lateral aspect of the medial femoral condyle most commonly, possibly from trauma

25
Q

Osteonecrosis of the femoral condyle

A

Avascular necrosis of the femoral condyle possibly caused by steroid use, alcoholism, etc.

26
Q

Prepatellar bursitis (housemaid’s knee)

A

Pain anterior and inferior well localized to the patella, have to rule out septic cause before treating conservatively

27
Q

Patellar tendonitis (jumper’s knee) treatment options (4)

A
  • DO NOT INJECT
  • rest, rehab, NSAIDS
  • x ray for calcium deposits
  • surgery for tendon debridement
28
Q

Tibial plateau fractures definition, diagnostic study (1), treatment (2),

A
  • very common fracture most often on the lateral plateau
  • oblique x ray***
  • immobilize and splint or ORIF