Term
| What is the important job of the quadriceps group? |
|
Definition
| Extends the knee, important stabilizer of knee during the gait |
|
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Term
| What is the job of the hamstring group? |
|
Definition
| Flexes the knee, arrests knee extension during the gait |
|
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Term
|
Definition
| tibia (distal knee) goes away from midline ("knocked knee") |
|
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Term
|
Definition
| tibia (distal knee) goes towards midline ("bowed leg") |
|
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Term
| What are the flexors (hamstrings) innervated by? |
|
Definition
|
|
Term
| What are the extensors (quadriceps) innervated by? |
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Definition
|
|
Term
| What is the ACL responsible for? |
|
Definition
| Responsible for limiting forward translation of the tibia and prevents hyperextension |
|
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Term
| What is the MOI (Mechanism of Injury)? |
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Definition
| Planted foot with twisting motion of body |
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Term
| If a pt presents with pain in the knee, hemarthrosis, hx of a "POP" with trauma, and on physical exam there is a + Lachman's test, what condition should you suspect? |
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Definition
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Term
| What is the appropriate work-up for an ACL tear? |
|
Definition
Eval for other injuries (PCL, Meniscal, CL)
Exam
MRI
Arthrocentesis (If hemarthrosis present) |
|
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Term
| What are the causes of a chronic ACL tear? |
|
Definition
Missed dx
Failed non-operative treatment |
|
|
Term
| What are the complications of a chronic ACL tear? |
|
Definition
Increased knee instability/laxity
Meniscal tears |
|
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Term
| What is the positioning of the ACL in the knee joint? |
|
Definition
| Connects the posterior femur to the anterior tibia |
|
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Term
| What is the BEST physical exam test for an ACL tear? |
|
Definition
|
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Term
| Which ACL test is described as Pt supine, w/ knee flexed at 30 degrees, Femur stabilized w/ one hand and tibia is pulled anterior w/ the other hand? |
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Definition
|
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Term
| Which ACL stability test is described as Pt supine, hip flexed, knee flexed at 45 degrees, Pt foot stabilized by examiner sitting on foot, Examiner “pulls” tibia forward/anterior? |
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Definition
|
|
Term
| What is the treatment for an ACL tear? |
|
Definition
|
|
Term
| Which injury is more common, ACL tear or PCL tear? |
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Definition
|
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Term
| Why is a PCL injury much less common than an ACL tear? |
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Definition
Much stronger than ACL
Other structures aid in the PCLs function |
|
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Term
| What is the MOI for a PCL? |
|
Definition
| MOI usually direct force if isolated injury |
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Term
| If you have a PCL tear, what other conditions should you suspect? |
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Definition
| ACL, CL (Knee Dislocation) |
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Term
| If a pt presents with knee pain, history of direct knee injury, an on exam you observe a posteriorly subluxed resting tibia, what condition should you suspect? |
|
Definition
|
|
Term
| What is the treatment for a isolated PCL? |
|
Definition
|
|
Term
| When does an PCL tear get surgically corrected? |
|
Definition
| With COMPLETE Knee dislocation |
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Term
| What knee stability test is described as Pt supine, hip flexed, knee flexed at 45 degrees, Pt foot stabilized by examiner sitting on foot, Examiner “pushes” tibia posterior? |
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Definition
|
|
Term
| What type of stress does the MCL resist against? |
|
Definition
|
|
Term
| What type of stress does the LCL resist against? |
|
Definition
|
|
Term
| If a pt presents with pain along the medial joint line of the knee and pain with valgus stress, what condition should you suspect? |
|
Definition
|
|
Term
| What imaging should be used for knee ligament injuries? |
|
Definition
|
|
Term
| Which physical exam tests should be used to evaluate a MCL injury? |
|
Definition
Valgus Stress Test
Apley's Distraction Test |
|
|
Term
| What nerve can be injured with a LCL tear? |
|
Definition
|
|
Term
| What is the treatment for a MCL tear? |
|
Definition
|
|
Term
| What is the MC ligament that is injured in the body? |
|
Definition
|
|
Term
| A LCL tear is not usually an isolated injury, what injury is usually associated with it? |
|
Definition
| Usually associated with cruciate and posteriorlateral corner injury |
|
|
Term
| Which physical diagnosis test is used to evaluate an LCL tear? |
|
Definition
Varus Stress Test
Apley's Apprehension test |
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Term
| Which physical diagnosis test is described as Pt supine on the table, leg abducted, Examiner applies force in the lateral direction to the ankle from the medial aspect and force in the medial direction of the knee from the lateral aspect? |
|
Definition
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|
Term
| Which physical diagnosis test is described as Pt supine on the table, leg abducted, Examiner applies force in the medial direction to the ankle from the lateral aspect and force in the lateral direction of the knee from the medial aspect? |
|
Definition
|
|
Term
| What does a MCL or LCL injury usually result in? |
|
Definition
| Usually results in significant stiffness or residual instability |
|
|
Term
| Which part of the Meniscus is the MC to be injured? |
|
Definition
| Medial injuries more frequent than lateral injuries |
|
|
Term
| What is the MOI for Meniscal Tears? |
|
Definition
|
|
Term
| If a pt presents with knee pain, popping, locking or giving way, and on physical exam there is joint line tenderness, a positive McMurray's test and and a positive Apley's compression test, what condition should you suspect? |
|
Definition
|
|
Term
| What is the BEST diagnostic test for Meniscal Injuries? |
|
Definition
|
|
Term
| Which physical diagnosis is described as Pt lies supine w/ knee completely flexed (foot to buttocks), Examiner medially (internally) rotates foot and tibia, and extend leg/knee? |
|
Definition
| McMurray Test – lateral meniscus |
|
|
Term
| Which physical diagnostic test is described as Pt lies supine w/ knee completely flexed (foot to buttocks), Examiner laterally (externally) rotates foot and tibia, and extend leg/knee? |
|
Definition
| McMurray Test – medial meniscus |
|
|
Term
| Which physical diagnostic test is described as Pt in prone position, knee flexed to 90 degrees, Examiner applies pressure to (pushes on) the heel and then medial and laterally rotates the leg/foot? |
|
Definition
|
|
Term
| If the patient has a + Apley's on the medial side, where is the Meniscal tear? |
|
Definition
|
|
Term
| If the patient has a + Apley's on the lateral side, where is the Meniscal tear? |
|
Definition
|
|
Term
| What condition is caused by extrusion of synovial fluid through the meniscal tear, accumulating outside the joint capsule? |
|
Definition
|
|
Term
| What imaging is appropriate for meniscal cysts? |
|
Definition
|
|
Term
| If a pt presents with a mass on the lateral side of their knee that changes size with flexion and extension, and their is a PHx of trauma, what condition should you suspect? |
|
Definition
|
|
Term
| What is the treatment of a Meniscal cyst? |
|
Definition
| Excision/Drainage and repair or removal of meniscus |
|
|
Term
| What is the treatment for Bursitis? |
|
Definition
Ice, Compression, Crutches, NSAIDs
Aspiration (helps in pain) or Injection |
|
|
Term
| What are the signs and symptoms of bursitis? |
|
Definition
| pain and swelling over bursa |
|
|
Term
| Which bursas are MC affected in the knee with bursitis? |
|
Definition
Suprapatellar bursa
Subcutaneous prepatellar bursa |
|
|
Term
| Does bursitis have pain with ROM? Why is this important? |
|
Definition
| No; Differentiates it from septic arthritis b/c with septic arthritis there will be pain with ROM |
|
|
Term
|
Definition
| A bursitis of the semimembranosus bursa that develops calcifications |
|
|
Term
| If there is prepatellar busitis, what should you suspect? |
|
Definition
| Infection (until proven otherwise) |
|
|
Term
| What should you be highly concerned about with femur shaft fractures? What should you do to prevent this concern? |
|
Definition
| hemovascular compromise; Stabilization Device (splint, screw etc) |
|
|
Term
| What is the MOI for femur shaft fracture? |
|
Definition
| high energy trauma - MVA, Gunshot wounds, falls from heights |
|
|
Term
| What is the imaging tool that is used to diagnose a femur shaft fracture? |
|
Definition
|
|
Term
| What is the treatment for femur shaft fracture? |
|
Definition
hemovascular stabilization (Type and cross match)
Stabilization device
Ortho |
|
|
Term
| What is the biggest concern with tibial plateau fractures? How can you prophylactically address these concerns? |
|
Definition
| Compartment syndrome; faciaotomy (spelling?) |
|
|
Term
| What is the treatment for tibial plateau fracture? |
|
Definition
|
|
Term
| What is used to classify a tibial plateau fracture? |
|
Definition
| Schatzker (1 - 6 the higher the # the more difficult the surgical repair) |
|
|
Term
| What imaging is needed for a tibial plateau fracture? |
|
Definition
| Plain film and MUST get CT w/scout views |
|
|
Term
| What is the MOI for a tibial plateau fracture? |
|
Definition
| falls from heights, MVA accidents and MVA/pedestrian accident |
|
|
Term
| What does a small avulsion fracture of the lateral ligament indicate? |
|
Definition
| Usually signals a severe joint injury (LCL and ACL) |
|
|
Term
| What is the MOI of a patellar fracture? |
|
Definition
|
|
Term
| If a pt presents with complaints of trauma, acute knee pain, swelling and an inability to extend the knee, what condition should you suspect? |
|
Definition
|
|
Term
| What imaging should be done to assess a patellar fracture? |
|
Definition
|
|
Term
| What is the treatment for a patellar fracture? |
|
Definition
| Surgery!! (Seen John for the Steel Cable) |
|
|
Term
| What are the risk factors for a patellar dislocation? |
|
Definition
| excessive Q angle, ligament laxity, Pes Planus |
|
|
Term
| Which physical diagnosis test is described as Pt supine, legs flat on table, quadriceps relaxed, Try to dislocate the patella laterally? |
|
Definition
| Patellar Apprehension Test |
|
|
Term
| What is the treatment for a patellar dislocation? |
|
Definition
Reduction (Grab big toe)
Ortho consult (Disrupts the patellar femoral retinaculum)
NSAIDs/Pain Meds |
|
|
Term
| What is the treatment for Tibiofemoral dislocation? |
|
Definition
| Ortho and Vascular surgery Emergency (literally 1 hr before limb death occurs) |
|
|
Term
| What are the imaging studies needed for a tibiofemoral dislocation? |
|
Definition
|
|
Term
| If a pt presents with a severe knee deformity s/p MVA and pulselessness in the ankle, what condition should you suspect? |
|
Definition
|
|
Term
| If the pt presents s/p injury to their knee w/ acute pain and swelling and inability to extend knee, and on physical exam the patella is located proximally over femur head ("riding up"), what condition should you suspect? |
|
Definition
|
|
Term
| What is the treatment for patellar tendon rupture? |
|
Definition
|
|
Term
| If a pt presents with knee pain and stiffness and decreased ROM, what condition should you suspect? |
|
Definition
|
|
Term
| What is the treatment for osteoarthritis? |
|
Definition
PT consult – ROM
Decrease weight
NSAIDS
Ortho – knee replacement |
|
|
Term
| What is the cause of Patellofemoral Syndrome
(Chondromalacia)? |
|
Definition
| overuse or excessive Q angle |
|
|
Term
| If a pt presents with Anterior knee pain worse w/ stair climbing or prolong sitting, and on physical exam you note + patellar tenderness & swelling and + apprehensive test, what condition should you suspect? |
|
Definition
| Patellofemoral Syndrome
(Chondromalacia) |
|
|
Term
| What is the treatment for Patellofemoral Syndrome
(Chondromalacia)? |
|
Definition
PT consult
R.I.C.E & NSAIDS
Ortho consult if needed – diagnose chondromalacia |
|
|
Term
| If there is a knee effusion, what MUST you do diagnostically? |
|
Definition
|
|
Term
| What are the WBC levels for an inflammatory effusion? |
|
Definition
|
|
Term
| What are the WBC levels for an septic effusion? |
|
Definition
|
|
Term
| What is the neutrophil % in an inflammatory effusion? |
|
Definition
|
|
Term
| What is the neutrophil % in a septic effusion? |
|
Definition
|
|
Term
| What is the general protein/glucose ratio in septic effusion? |
|
Definition
| Septic high protein/low glucose |
|
|
Term
| What physical diagnosis test is described as Pt supine, examiner pushes fluid from the suprapatellar pouch toward the foot (“milking the knee”)? |
|
Definition
| Minor effusion test/Patellar Ballotment |
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