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msk 3rd shift > tuhod ni daddy nermy > Flashcards

tuhod ni daddy nermy Flashcards

1
Q

exp why the knee is highly predisposed to injuries

A

bcs the ligaments not intact

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2
Q

what is the effect on the knee if dorsiflexors are weak

A

weak dorsiflexors = inc anterior pressure on the knee during a squat

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3
Q

compare medial and lateral meniscus in terms of shape

A

medial meniscus - C-shaped

lat meniscus - circular

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4
Q

which meniscus is more injured and why

A

medial meniscus d/t it being less movable or has more attachments

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5
Q

motion of patellar during knee ext

A

superior tracking

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6
Q

motion of patellar during knee flex

A

inferior tracking

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7
Q

which motions does ACL check

A

hyperextension, ant translation of tibia, valgus stress and IR of tibia

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8
Q

which motions does PCL check

A

flexion, post translation of tibia, varus stress and ER of tibia

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9
Q

if pt complains of aching what should you consider

A

more of degenerative changes

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10
Q

if pt complains of sharp pain or catching what should you consider

A

meniscal or plica

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11
Q

if pt complains of stiffness in the morning that improves with activity

A

more of arthritic in nature - RA or OA

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12
Q

if pt complains of pain in anterior knee what should you consider

A

PFPS
bursitis
fat pad irritation
OSD

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13
Q

if pt complains of pain during activity what should you consider

A

structural deformity - subluxation or patellar tracking disorders

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14
Q

if pt complains of pain after activity what should you consider

A

overuse, tendinosis, paratenonitis, inflammatory disorders - jumper’s knee/SLJ

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15
Q

if pt complains of generalized pain what should you consider

A

contusions of partial tear

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16
Q

why does joint swelling cause pain

A

inc fluid in synovium = inc psi = inc pain

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17
Q

ligament involved if MOI is valgus force c or s rotation

A

MCL

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18
Q

ligament involved if MOI is hyperextension and ant translation of tibia

A

ACL

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19
Q

ligament involved if MOI is flexion c posterior translation of tibia

A

PCL

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20
Q

ligament involved if MOI is varus force

A

LCL

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21
Q

what could the affectation be if it is sudden in onset

A

ligamental - cruciates and collateral

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22
Q

what could the affectation be if it is traumatic in onset

A

avulsion or tear ng muscle

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23
Q

what could the affectation be if it is slow in onset

A

more of arthritic or wear and tear

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24
Q

if pt complains of difficulty in stairs what do we consider

A

patella problem or PFPS

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25
Q

if MOI is twisting or pivoting while WB what can we consider

A

meniscal injury

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26
Q

if pt hears a click or pop

A

ACL or osteochondral fx

if lateral - popliteus

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27
Q

if injury occurred during acceleration + twist

A

consider meniscus

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28
Q

in injury occurred during deceleration

A

consider cruciate

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29
Q

what to look for in PMHx

A

check for hip or ankle injury history bcs usually compounded na injuries

30
Q

knee gives away during uphill or downhill

A

retropatellar lesion - ACL, PCL or hamd

31
Q

knee gives away bcs patella slips out of place

A

subluxation or plica

32
Q

how to compare locking vs catching

A

locking - cant fully extend knee with flexion normal

catching - momentary locking or giving way

33
Q

causes of locking

A

loose bodies, meniscus pathology or hamstring spasm; spasm locking

34
Q

causes of catching

A

reflex inhibition or pain

35
Q

discuss grating or clicking

A

d/t degeneration or structure snapping over another

36
Q

what to look for in OI

A

deformities, abnormal protrusions, dislocations, subluxations or bony enlargements

contusions, ecchymosis and swelling

37
Q

differentiate contusion vs strain

A

contusion - direct blow or trauma to area

strain - over stretch or fast eccentric

both will present as ecchymosis

38
Q

discuss baker’s cyst

A

fluid part of the bursa goes out d/t excessive flex-ext

39
Q

what to consider if painful c resistance and active motion

A

active structures

40
Q

what to consider if painful c passive motion and joint play

A

passive structures

41
Q

what is the reverse J sign

A

seen in PFPS - patella moves superolaterally; normal is superomedial

42
Q

possible causes of reverse J sign

A

weak VMOs or tight ITB

43
Q

normal lateral movement of patella

A

1/2

44
Q

normal medial movement of patella

A

1/4

45
Q

capsular pattern of knee

A

flex > ext

46
Q

possible causes of extension lag

A

reduced force production of quads

excessive resistance from connective tissues

faulty arthrokinematics

47
Q

discuss heel height difference

A

if may mas mataas = extension lag

highest point of calcaneus as reference

48
Q

at what position can you palpate meniscal cysts

A

45deg flexion

49
Q

at what position can you palpate joint line

A

90deg flexion

50
Q

possible diagnosis if pain is felt or there are palpation findings on apex of patella

A

jumper’s knee

51
Q

possible diagnosis if pain is felt or there are palpation findings on patellar tendon

A

paratenonitis or tendinosis

52
Q

possible diagnosis if pain is felt or there are palpation findings on infrapatellar bursa

A

parson’s or vicar’s knee

53
Q

possible diagnosis if pain is felt or there are palpation findings on over the patella

A

prepatellar bursitis or housemaid’s knee

54
Q

possible diagnosis if pain is felt or there are palpation findings on articular facets of patella

A

chondromalacia patellae

55
Q

possible diagnosis if pain is felt or there are palpation findings on suprapatellar pouch

A

effusion, pathology

56
Q

possible palpation findings on quadriceps

A

tenderness, atonia, myositis ossificans, tightness

57
Q

possible palpation findings on MCL

A

sprain, pellegrini-steida syndrome

58
Q

possible palpation findings on pes anserine

A

strain/bursitis

59
Q

possible palpation findings on distal TFL or ITB

A

strain or tenderness

60
Q

what is myositis ossificans

A

calcification of quads d/t to contusions

61
Q

what is pellegrini-steida

A

calcification of MCL

62
Q

possible palpation findings on medial joint line c tibia IR

A

medial meniscus lesion/cyst

63
Q

possible palpation findings on lateral joint line c tibia ER

A

lateral meniscus lesion/cyst

64
Q

possible palpation findings on tibial plateau

A

coronary ligament sprain

65
Q

possible palpation findings on femoral condyles

A

osteochondritis dissecans and adductor insertions

66
Q

how to palpate for LCL

A

figure 4

67
Q

possible palpation findings on post knee

A

baker’s cyst

68
Q

possible palpation findings on popliteus core or arcuate lig

A

strain/sprain

69
Q

possible palpation findings on semimebranosus corner

A

strain/sprain

70
Q

possible palpation findings on hamstrings and gastrocsoleus

A

tenderness, swelling and patholgy

71
Q

what are the ottawa knee rules

A

younger than 55 or older than 18

fibular head tenderness

patellar tenderness

inability to flex knee at 90°

inability to WB and walk 4 steps when examined and at time of injury

msk 3rd shift (7 decks)

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