Week 4 Flashcards
What are the three joints of the knee?
Tibiofemoral
Patellofemoral
Superior Tibiofibular
What is the TFJ?
The articulation between the tibia and the femur
What type of joint is the TFJ?
Modified Hinge Joint
flexion-extension
medial lateral rotation
abduction/adduction
What is the PFJ?
The articulation between the patella and the femur
What type of joint is the PFJ
Modified plane joint
What Is the patella used for
to improve the leverage of the quadriceps muscles
What is the Superior tibialfibular joint?
articulation between the tibia and fibula
What type of joint is the superior tibiafibular joint?
Plane Joint
What muscles flex the knee?
Hamstrings
Gastrocnemius
Gracilis
Sartorius
Which muscles extend the knee?
quadriceps
Which muscles medially rotate the knee?
semitendinosus and semimembranosus
gracilis
Sartorius
popliteus
Which muscles laterally rotate the knee?
Biceps femoris
Name the 6 ligaments at the knee?
Anterior cruciate ligament (ACL) Posterior Cruciate Ligament (PCL) Lateral meniscus Medial meniscus Lateral collateral ligament (LCL) Medial collateral ligament (MCL)
When does the locking mechanism at the tibiofemoral joint occur?
Between 20 degrees of flexion and full extension (0 degrees)
When is the locking mechanism most prominent?
at the last 5 degrees
3 reasons for knee locking
for stability
reduction In friction
improved efficiency
8 steps of the knee locking
1 Full extension
2 Taut anterior cruciate
3 No further symmetrical extension
4 medial femoral condyles moves back - lateral condyle moves forward
5. femur internally rotates on tibia on axis of anterior cruciate ligament
6. Medial/lateral collateral & oblique popliteal ligaments tighten
7. Tensor fascia latae & gluteus maximus tighten iliotibial tract
8. knee hyperextends and locks
3 Steps of knee unlocking
- Popliteus externally rotates femur on tibia
- locked ligaments loosen
- hamstrings can then flex knee
What are the two types of observation
Formal and informal
What does informal observation include?
walking from the waiting room
watching how they stand up from seated position
observing their gate
What should be included in an after P/E plan
Problem list
goals
treatment plan
prognosis
9 causes of acute knee pain
Trauma - fractures (patella, femoral condyles, tibial plateau, avulsion fractures) Patella dislocation Ligament damage (ACL, PCL, MCL, LCL, Meniscus) Haemarthrosis Muscle strain/contusion meniscal damage fat pad damage bursitis tendon rupture
Which ligament is most commonly injured
ACL
Which sex has most ACL injuries?
Males
Top 5 sports that have ACL injuries in order
- Skiing
- AFL
- Rugby
- Netball
- Soccer
Define a grade 1 ligament injury
ligaments stretched or slightly torn
define a grade 2 ligament injury
ligaments partially torn
define a grade 3 ligament injury
ligaments completely torn
3 special tests to test for ACL injury
Lachmann’s test
Anterior Draw test
pivot shift test
Phase 1 goals for ACL treatment
Control pain and swelling, Restore pain free ROM, Improve flexibility, Normalize gait mechanics (WBAT w crutches), Establish good quadriceps activation
Phase 2 goals for ACL treatment
Avoid patella femoral pain, Maintain ROM and flexibility, Restore muscle strength, Improve neuromuscular control
Phase 3 goals for ACL treatment
Avoid patella femoral pain, Maintain ROM and flexibility, Progress with single leg strengthening to maximize strength, Progress dynamic proprioception exercises to maximize neuromuscular control, Initiate plyometrics* and light jogging*
