Term
| Which femoral condyle is flatter, projects more anteriorly, and shorter? |
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Definition
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Term
| What is a normal valgus/varus angle for the knee? |
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Definition
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Term
| Which menisci is C-shaped? |
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Definition
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Term
| What attaches the menisci to the tibia? |
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Definition
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Term
| True/False: The Synovial Membrane and Joint Capsule ARE the same thing. |
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Definition
| False: They divide the knee joint into Intrasynovial and Extrasynovial spaces |
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Term
| Normal Open Pack Position is? |
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Definition
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Term
| The cruciate ligaments are extrasynovial or intrasynovial? |
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Definition
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Term
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Definition
| Synovial tissue thickenings or folds |
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Term
| What are the 4 main ligaments of the knee? |
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Definition
| Anterior Cruciate, Posterior Cruciate, Medial Collateral, and Lateral Collateral |
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Term
| Limiting of posterior translation of femur on tibia is due to what structure? |
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Definition
| ACL...also limits anterior translation of tibia on femur |
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Term
| What structure is the limiting structure for posterior translation of tibia on the femur? |
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Definition
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Term
| Which ligament is flat, thin, and fan shaped? |
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Definition
| MCL...also limits valgus angulation |
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Term
| What five muscles help perform the same role as the MCL? |
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Definition
| Vastus Medialus, Sartorius, Gracilis, Semimembranosus, and Semitendonosus |
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Term
| The LCL lies underneath what? |
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Definition
| The Biceps Femoris Tendon |
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Term
| What extensive structure helps stabilize with the LCL? |
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Definition
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Term
| What muscle is responsible for unlocking the knee? |
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Definition
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Term
| What Myotome does Ankle Dorsiflexion? |
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Definition
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Term
| What Myotome does Hip Flexion |
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Definition
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Term
| What Myotome does Extension of the Big Toe? |
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Definition
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Term
| What Myotome does Knee Extension? |
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Definition
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Term
| What is the L4 Dermatome? |
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Definition
| Lateral Knee to Medial Malleolus |
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Term
| What is the S1 Dermatome? |
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Definition
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Term
| What is the L3 dermatome? |
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Definition
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Term
| The medial genicular artery supplies what structure of the knee? |
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Definition
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Term
| What is close-packed postition of tibio-femoral joint? |
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Definition
| Full extension with lateral rotation of tibia on femur |
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Term
| At 130 degrees of knee flexion where on the patella is/are the contact area(s) with the femur? |
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Definition
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Term
| At 20 degrees of knee flexion where is the contact area on the patella with the femur? |
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Definition
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Term
| What is normal q-angle for males and females? |
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Definition
| 13 for males and 18 for females |
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Term
| If the patella is removed, how much more force is required from the quadriceps? |
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Definition
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Term
| Which meniscus moves the most? |
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Definition
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Term
| During extension, which direction does the menisci move? |
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Definition
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Term
| What is the patellafemoral JRF during climbing stairs? |
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Definition
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Term
| What is the patellafemoral JRF during a full squat? |
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Definition
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Term
| During normal walking what is the tibiofemoral JRF at push-off and heel strike? |
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Definition
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Term
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Definition
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Term
| Normal ROM for sitting down? |
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Definition
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Term
| Normal ROM for descending stairs? |
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Definition
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Term
| Normal ROM for tying a shoe? |
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Definition
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Term
| What are the 3 parts of miserable malalignment syndrome? |
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Definition
| Inc. femoral anteversion, Patella subluxation, and lateral tibial torsion |
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Term
| Where are the majority of the tears on the ACL? |
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Definition
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Term
| What is Osgood Schlatter's disease? |
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Definition
| A traction injury at the tibial tubercle |
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Term
| What is Sinding-Larsen-Johansson Disease? |
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Definition
| Calcification and ossification within patellar ligament |
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Term
| What is the main diagnostic difference between Osgood-Schlatter's and Sinding-Larsen-Johansson? |
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Definition
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Term
| What is the overall treatment plan for patella disorders? |
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Definition
-Correct predisposing mal-alignments if possible
-Strengthen quadriceps to improve tracking of parella
-Strengthen hamstrings to control tibial rotation
-Control Patellar tracking via taping/bracing
-Exercise specificity while avoiding abnormal tracking or large JRF's |
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Term
| Describe first phase of ACL rehab |
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Definition
-1 month
-Emphasis on ROM, esp. full ext
-Minimize anterior tibial translation
-Emphasize quad sets more than SLR
-Partial controlled WB while performing CKC short arc co-contraction of quadriceps and hamstrings |
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Term
| Describe second phase of ACL rehab |
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Definition
-4 to 8 weeks
-Control Inflammation
-Re-establish proprioception
-No Resistive knee strengthening until knee is "quiet" |
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Term
| Describe last phase of ACL rehab |
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Definition
-8 wks +
-Begin strengthening program; include hips and core muscles
-Progress as tolerated unless patella tendonitis
-Work on sport or activity specific exercises and proprioception |
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Term
| Describe Collateral Ligament rehab for grades 1 and 2 sprain |
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Definition
-NSAIDs and cryotherapy
-Immobilization for 7-14days avoiding rotation
-Early controlled ROM to prevent adhesions
-Controlled WB with crutches |
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Term
| Describe Collateral Ligament rehab for grade 3 sprain |
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Definition
-Surgery to avoid future instability
-Recommend early surgical intervention <14days
-Ligament protection for 6 weeks plus bracing/PWB
-Progressive loading of tensile forces on tendon repair
-Prevent adhesion with ROM
-Exercise muscle, but avoid tension on ligaments |
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Term
| What is the most common MOI for meniscal injuries? |
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Definition
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Term
| Describe rehab for meniscal injuries without surgery |
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Definition
-NSAIDS
-Cryotherapy
-Crutches to control WB
-Immobilization with brace |
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Term
| Describe post-op rehab for meniscal tear |
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Definition
-Immediate PROM; NSAIDS and cryotherapy
-Controlled WB 1-6 weeks with crutches depending on surgery
-Avoid squats, deep knee flexion, twisting, isotonic resistive knee extension, plyometrics, etc |
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Term
| What is Osteochondritis Dissecans (OCD) |
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Definition
-Vascular disorder which leads to osteonecrosis below the AC of a joint
-Bone breaks down which AC vulnerable to injury |
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Term
Describe Valgus Varus Stress Test |
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Definition
[image]
Test in 20-30 degrees of flexion first and then closed pack. Should be less mobility in closed pack. Check Bilaterally. Tests for MCL and LCL instability. Positive test is hypermobility or pain. |
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Term
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Definition
[image]
Check in open pack position. Stabilize femur, and apply P/A translation to proximal tibia. Test for ACL instability. Positive if hypermobile or pain. |
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Term
| Describe Anterior Drawer Test |
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Definition
[image]
Have pt knee bent to 90 degrees of flexion. Sit on patients foot to help stabilize. Apply P/A translation at proximal tibia. Test for ACL instability. Positive with hypermobility or pain. |
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Term
| Describe Posterior Drawer Test |
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Definition
[image]
Have pt knee bent to 90 degrees of flexion. Sit on foot to stabilize. Apply A/P translation to proximal tibia. This tests for PCL instability. Positive if hypermobile or pain. |
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Term
| Describe a Posterior Sag Sign |
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Definition
[image]
When pt knee is bent to 90 degrees of flexion look for a sagging of the proximal tibia in the posterior direction. This is positive for PCL injury. |
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Term
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Definition
[image]
Place pt supine in 90/90 position. Support ankles with arm or bolster. Have pt relax. Look for sagging at proximal tibia in posterior direction. This tests for PCL instability. Positive if sagging. |
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Term
| Describe Lateral Pivot Shift Test |
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Definition
[image]
With pt in supine and involved leg extended apply valgus and internal rotation forces to the knee. Sustaining those forces flex the knee. This test for ACL instability. A positive test will have subluxing of the lateral knee when going into flexion. Often a clunk is heard or felt. |
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Term
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Definition
[image]
With pt supine and knee in 90 degrees of flexion rotate tibia 15 degrees externally or 30 degrees internally. Sit on foot to stabilize. Apply P/A translation at proximal tibia. With foot in 15 degrees ER testing for Anteromedial instability. With foot in 30 degree IR testing for Anterolateral instability. Positive if hypermobile or pain. |
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