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Knee
| Question | Answer |
|---|---|
| Muscles of the Quadriceps | Vastus intermedius, rectus femoris, vastus lateralis, vastus medialis oblique |
| Muscles of the Hamstrings | Biceps femoris (long head, short head), semitendinosus, semimembranosus |
| Muscles of the Pes Anserinus | Sartorius, gracilis, semitendinosus |
| Characteristics of Grade I MCL sprain | Little fiber tearing/stretching, stable valgus test, little or no jt effusion, some stiffness & point tenderness on lateral aspect, relatively normal ROM |
| Characteristics of a Grade II MCL sprain | Complete tear of deep capsular lig & partial tear of superficial layer of MCL, no gross instability (laxity at 30° of flexion), slight swelling, mod to severe jt tightness w/ decreased ROM, pain along medial aspect |
| Characteristics of Grade III MCL sprain | Complete tear of supporting ligs, complete loss of med stability, min to mod swelling, immediate pain followed by ache, loss of motion due to effusion & HS guarding, + valgus stress test |
| Etiology of a LCL sprain | Result of VARUS force, generally w/ tibia IR, damage can also occur to the cruciate ligs, ITB, and meniscus |
| Etiology of a MCL sprain | Result of severe blow from lateral side, VALGUS force |
| Signs & symptoms of a LCL sprain | Pain & tenderness over LCL, swelling & effusion around LCL, joint laxity w/ VARUS testing, may cause irritation of the peroneal nerve |
| Etiology of a Non-contact ACL tear | 80% more likely, multiple forces collectively acting on jt, decelerating from jump or running, foot contacts geound with heel or flatfoot, WB creates axial force with knee near full ext & ABD or in knee valgus |
| Etiology of a Contact ACL tear | Decelerating & usually changing directions, foot is planted with knee abducted, contact occurs lat & post forcing knee into valgus & IR with ant shear |
| Signs & Symptoms of an ACL tear | Experience a pop with severe pain & disability, rapid swelling at joint line |
| Etiology of a PCL tear | Most risk at 90° of flexion, fall on bent knee is most common, can also be as a result of a rotational force, âdashboard injuryâ |
| Signs & Symptoms of a PCL tear | Feel a pop in back of the knee, tenderness & relatively little swelling in the popliteal fossa |
| Etiology of Meniscal Lesions | Med meniscus more commonly injured due to ligamentous attachments & decreased mobility (torsional & valgus forces), most common MOI is rotary force with knee flexed/extended, tears may be long, obl, or transverse |
| Sign & Symptoms of Meniscal Lesions | Effusion developing over 48-72 hr period, jt line pain & loss of motion, intermittent locking & giving way, pain w/ squatting, portions may become detached, if chronic recurrent swelling or muscle atrophy may occur |
| Etiology of Knee Plica | Irritation of the plica, mediopatellar plica & often associated w/ chondromalacia |
| Signs & Symptoms of Knee Plica | Possible history of knee pain/injury, recurrent episodes of painful pseudo-locking, possible snapping & popping, pain w/ stairs & squatting, little or no swelling, and no lig laxity |
| Etiology of Osteochondral Fractures | Same MOI as collateral/cruciate ligs or meniscus injuries, twisting, sudden cutting or direct blow, fractures of cartilage & underlying bone varying in size & depth |
| Signs & Symptoms Osteochondral Knee Fractures | Hear a snap & feeling of giving way, immediate swelling & considerable pain, diffuse pain along jt line |
| Etiology of Osteochrondritis Dissecans | Partial or complete separation of articular cartilage & subchondral bone, cause is unknown but may include blunt trauma, endocrine abnormalities, prominent tib spine impinging on fem condyle, or impingement due to patellar facet |
| Signs & Symptoms of Osteochrondritis Dissecans | Aching pain with recurrent swelling & possible locking, possible quad atrophy & point tenderness |
| Etiology of Peroneal Nerve Contusion | Compression of peroneal nerve due to direct blow |
| Signs & Symptoms of Peroneal Nerve Contusion | Local & possible shooting pain, numbness & paresthesia in cutaneous distribution of nerve, added pressure may exacerbate cond, generally resolves quickly but if it does not, can result in foot drop |
| Etiology of Bursitis | Acute, chronic or recurrent swelling, prepatellar = continued kneeling, infrapatellar = overuse of patellar tendon |
| Signs & Symptoms of Bursitis | Prepatellar Bursitis may be localized swelling above knee that is âballotableâ, swelling popliteal fossa may indicate Bakerâs Cyst |
| Signs & Symptoms of Bakerâs Cyst | Swelling in popliteal fossa, associated with semimem bursa or med head of gastroc, commonly painless & causes little disability, may progress & should be treated accordingly |
| Etiology of Patellar Fracture | Direct or indirect trauma (severe pull of trauma), semi-flexed position with forcible contraction (falling, jumping, or running) |
| Signs & Symptoms of Patellar Fracture | Hemorrhaging and joint effusion w/ generalized swelling, indirect fractures may cause capsular tearing, separation of bone fragments, & possible quad tendon tearing, little bone separation w/ direct injury |
| Etiology of Acute Patellar Subluxation or Dislocation | Deceleration w/ simultaneous cutting in opposite direction (valgus force), quad pulls patella out of alignment, some individuals may be predisposed, repetitive subluxation will stress medial restraints |
| Signs & Symptoms of Acute Patellar Subluxation or Dislocation | Pain and swelling, restricted ROM, palpable tenderness over adductor tubercle, results in total loss of function |
| Etiology of Injury to Infrapatellar Fat Pad | Irritated by chronic kneeling, pressure or trauma, capillary hemorrhaging and swelling, chronic irritation may lead to scarring and calcification |
| Signs & Symptoms of Injury to Infrapatellar Fat Pad | Pain below the patellar lig (esp during knee ext), may display weakness, mild swelling and stiffness during mvmt |
| Etiology of Chondromalacia of the Patella | Softening and deterioration of articular cartilage, often associated with abnormal patella tracking |
| Three Stages of Chondromalacia | 1) swelling and softening of cartilage 2) fissure of softened cartilage 2) deformation of cartilage surface |
| Signs & Symptoms of Chondromalacia of the Patella | Pain w/ walking, running, stairs, and squatting, possible recurrent swelling, grating sensation w/ flex & ext, painat inf border during palpation. |
| Etiology of Patellofemoral Stress Syndrome | Result of lat deviation of patella while tracking in femoral groove (tight structures, pronation, increased Q-angle, insufficient medial musculature) |
| Signs & Symptoms of Patellofemoral Stress Syndrome | Tenderness of lat facet of patella & swelling associated w/ irritation if synovium, dull ache in center of knee, patellar compression will elicit pain & crepitus, apprehension when patella is forced laterally |
| An apophysitis occuring at the tibial tubercle (repeated avulsion of patellar tendon), begins cartilaginous & develops a bony callus, enlarging the tubercle, resolves with maturation | Osgood-Schlatter Disease |
| Signs & Symptoms of Larsen-Johansson Disease | Elicits swelling, hemorrhaging, and gradual degeneration of the apophysis due to impaired circulation, pain with running and jumping, pain with sudden ext |
| Etiology of Patellar Tendinitis (Jumperâs or Kickerâs Knee) | Jumping or kicking - placing tremendous stress and strain on patellar or quad tendon, sudden or repetitive ext |
| Signs & Symptoms of Patellar Tendinitis | Pain and tenderness at inf pol of patella |
| Three Phases of Patellar Tendinitis | 1) pain after activity 2) pain during and after 3) pain during and after (possibly prolonged) and may become constant |
| Etiology of PatellarTendon Rupture | Sudden, powerful quad contraction, generally does not occur unless chronic inflam cond persists resulting in Tissue degeneration, occurs primarily at point of attachment |
| Signs & Symptoms of Patellar Tendon Rupture | Palpable defect, lack of knee ext, considerable swelling & pain (initially) |
| General expression for repetitive/overuse cond attributed to malalignment & structural asymmetries, irritation at bandâs insertion, commonly seen in individual that have genu varum or pronated feet | Iliotibial Band Friction Syndrome (Runnerâs or Cyclistâs Knee) |
| Result of genu valgum and weak vastus medialis, often occurs due to running w/ one leg higher than the other (running on a slope or crowned road) | Pes Anserine Tendinitis or Bursitis |
Created by:
natamccl
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