Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
211 exam 2
Knee
| Question | Answer |
|---|---|
| knee extensors in closed chain vs open chain | quads in open chain, HS and soleus in closed chain |
| knee extensors innervation | femoral, L3 |
| knee flexors innervation | sciatic, S1 |
| knee flexors | Hamstrings Gastrocnemius |
| innervation of popliteus | tibial - unlocks the knee |
| pes anserinus group functions | provide medial stability; affects rotation of tibia in closed-chain |
| pes anserinus mm groups | Gracilis, semitendinosus, sartorius |
| ACL function | Prevents hyperextension; prevents anterior glide of tibia on femur |
| PCL function | Prevents posterior glide of tibia on femur |
| MCL function | resists valgus force to knee Also directly connected to medial meniscus |
| LCL function | resists carus force to knee |
| closed pack position of knee | full extension and tibial ER |
| ope pack position of knee | 25 deg flexion |
| capsular pattern of the knee | flexion, extension |
| screwholm mechanism | with closed chain knee extension, femur internally rotates with open chain, tibia externally rotates |
| how to measure genu varus/ valgus | Draw a line from the center of the hip to the knee down and toward the center of the ankle The line projected beyond the knee and the tibial shaft represents the angle of deformity. |
| normal Q angle | 12-20 |
| Q angle | the angle formed by two intersecting lines |
| landmarks for Q angle | Anterior Superior Iliac crest Mid patella Tibial Tubercle through mid patella |
| important information for eval | Mechanism of Injury (MOI) Patient Medical History How was the injury initially managed Medical Diagnosis Imaging (MRI, X-Rays etc.) Patient WB Precautions/ Surgical Precautions |
| subjective info for eval | Patient Reports of Pain (Location, Description, Intensity) Description of Issues with ADL's and Functional Tasks Specific Concerns from the Patient Date of Injury Social/Home situation |
| what should be included in pt history? | If traumatic: Exact mechanism of injury, Does knee click, pop, give way? Non traumatic pain vs traumatic pain. Medical tests – x-ray, MRI Prior level of function Pain Level Level of function with ADL’s Social/Home situation Equipment |
| eval objective info | Gait Observable Joint Effusions, MM Atrophy, Joint Alignment AROM/PROM Girth Measurement on both palpation (Joint Line) MMT (Quads testing may be inappropriate for post injury or post operative) Patellar Tracking Flexibility |
| objective eval info cont. | ROM – Passive and Active, Hip, knee, ankle Joint Play – Distraction, inf. Glide, etc. Sensation – Light touch, Proprio. Palpation – crepitus, end feel, tightness, discomfort, temp, mobility of tissues, swelling, fat pad tenderness, alignment of patella |
| functional assessment for knee eval | Bed mobility, Transfers, Sit <> stand, Gait, Squat- full, ½, Stairs, One leg standing, Running – back/forth, jumping, Twisting |
| Lachman's test | Stabilize the femur and pull forward on the tibia, Recognized as the universal test for the ACL, +=Instability, soft end feel |
| anterior drawer test | Knee flexed to 90 Degrees making an anterior force on the tibia. Tests the Laxity of the ACL, += Instability and pain. |
| posterior drawer test | Pull Tibia backwards with posterior force to test for Hyperextension Injury and PCL Tear, += Instability, Lack of end feel |
| McMurray's test | Extends and Rotates the lower leg. Testing for Meniscal Tear += Clicking at 90 degrees |
| Apley compression test | Pt. Prone Flex knee to 90 degrees, Apply force to the bottom of the foot and Internally and Externally rotate the lower leg. Tests for Meniscal Tear += Pain Provocation |
| valgus stress test | Put knee from extension to 30 degrees of flexion and put stress on the above the knee and on the Lateral Side. Testing for MCL +=Pain Provocation and laxity of the joint |
| varus stress test | Put knee in same position as Valgus except we are putting Stress on the Medial Side Testing for LCL += Pain Provocation and laxity of the joint |
| sag test | PT holds the knee in 90 degrees Looks for Posterior sag of the tibia |
| patella apprehension | Lateral displacement of the patella, Testing Lateral Patella Stability, += Anxiety and resistance. |
| Slocum test | : Essentially a modified anterior drawer test looking for anteromedial instability |
| Steinman's test | Put the knee in 90 degrees of flexion and sudden external rotary force applied to tibia and test for Lateral Meniscus +=Pain provocation |
| Ege's test | Also Known as Weight Bearing McMurray's test, testing for the meniscus |
| thessaly test | Twisting on the knee in IR,ER 3X and is known as the novel test for meniscus. |
| what causes ACL injury? | combination of extension and valgus force to knee with foot planted |
| which motion should you focus on first for ACL rehab? | Early ROM, WBAT; Generally full extension in 2 weeks, full flexion in 8 weeks |
| tx for ACL rehab | Inflammation/edema control Bracing Avoid stress to graft Hamstring strengthening for stability Proprioceptive exercise Progress to sports specific exercise Gait, running, plyometrics |
| precautions with patellar tendon graft ACL | Caution with knee extension strengthening |
| precautions with HS tendon graft ACL | Caution with knee flexion strengthening |
| is medial or lateral meniscus injured more often? | Medial meniscus 5-15x more frequently injured than lateral |
| what motion causes meniscal injury? | Weightbearing injury caused by rotary force to knee in flexion |
| signs and symptoms of meniscal injury | Joint line pain, effusion, sensations of joint crepitus or popping, LOM, joint locking, instability with ambulation and pain when ascending stairs |
| indications for partial meniscectomy | Tear extending to the central, avascular third of the meniscus that is not deemed reparable Tear localized to the avascular inner third of the meniscus |
| indications for meniscal repair | Lesion in the vascular outer third of the meniscus Tear extending to the central, avascular third of the meniscus |
| weight bearing status for meniscus | WBAT > FWB; can use crutches until gait is non-antalgic Often wear braced locked to 0 in initial ~4 weeks post-op |
| therex for meniscus | Quad sets, SLRs in multiple planes AROM, AAROM (possibly avoid active knee flexion first 6 weeks) Progressive strengthening Balance training |
| pain management for meniscus | Use of NSAIDs for pain, inflammation Cryotherapy |
| return to sport criteria for meniscus | near-symmetrical to non-surgical leg |
| TKA acute phase tx | Increase knee ROM of Flexion/ Extension and patellar mobility Decrease Pain and swelling Safe Transfers Improve ambulation with appropriate AD Restore Function Independence with HEP |
| WB protocol for TKA | Up to the Orthopedic Surgeon protocol usually is WBAT |
| exercises for TKA | Quad HS, Glute Sets Isometrics Supine Heel slides, Seated knee AAROM, If there is no quadricep lag SLR may be introduced |
| education for TKA | WB Precautions Not to overstress the new hardware Prolonged Standing Sitting and Walking should be avoided |
| causes for TKA components loosening | High Impact Activities Excessive Body Weight Wear on the plastic spacer |
| WB status 6 weeks post TKA | full WB |
| exercise for TKA 6 weeks post | OKC Exercises SLR in Multiple Planes Proximal Hip Strengthening ( ABD, ADD Flex, Ext) CKC leg press with Bilateral LE Wall Squats SAQ |
| pt education 6 weeks post TKA | Promote Independence with Functional Activity Educate on importance of getting ROM back |
| modalities for patellofemoral dysfunction | Kineseo Taping Cryotherapy NMES for proper quad activation |
| exercises for patellofemoral dysfunction | PROM/AROM Stretching the Gastrocnemius and Soleus, Lawnmowers Maintain Knee ext. With SLR Squats Plyometrics |
| education for patellofemoral dysfunction | Reinforce the importance of stretching and maintaining good knee ROM The Stationary bike is a great way to improve and maintain the ROM in the knee With Everything else work on Proximal realignment |
Created by:
bdavis53102
Popular Physical Therapy sets