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ACL/PCL

ACL and PCL mechanism of injury

QuestionAnswer
What are the classifcation of ligament injury? Grade I (Mild), Grade II (Moderate), Grade III (Severe)
What grade would it be if the ankle had and incomplete stretching of collagen ligament fibers? Grade I (Mild)
In a Grade I of ligament injury is there any other signs of tissue damage? No just minimal pain, no swelling, no loss of joint function, no clincal instability, or functional instability
In a Grade II ligament injury would you see a PT? Yes, pt has partial loss of ligament fiber continuty.
What happens to the ligament fibers in a Grade II injury? A few collagen ligament fibers may be compleely torn, but most of the ligament is intact
What are some of the characteristics in a Grade II injury to the ligaments? Moderate pain, moderate swelling and some loss of function and stabiltiy
What happens in a Grade III ligament injury? The entire collagen ligament fiber bundles are completely torn, no continuity within the body of the ligament, profound pain, intense swelling, loss of joint function and instability
(ANATOMY OF BIOMECHANICS OF CRUCIATE LIGAMENT)What are ligaments considered? Intraarticular
(ANATOMY OF BIOMECHANICS OF CRUCIATE LIGAMENT)What is the purpose of the ligaments? To attach the femur tothe tibia
(ANATOMY OF BIOMECHANICS OF CRUCIATE LIGAMENT)Where are the ligaments located between? The medial and lateral condylar joints
(ANATOMY OF BIOMECHANICS OF CRUCIATE LIGAMENT)What does "Cruciate" mean? Cross = 2 ligaments cross
(ANATOMY OF BIOMECHANICS OF CRUCIATE LIGAMENT)Ligaments are named for what or by what? The strong rounded bands that are named according ot their site of attachment of the tibia
Where does the ACL attach to? Anteriorly o the tibia
Can ACL be injured alone? ACL can be injured alone or with other structures
Is the ACL a weak ligament? It is weaker than the PCL
What is ACL called when it is in the flexed position? The ACL is on SLACK
What is the ACL called when it is fully extended? The ACL is TAUT
What is the purpose of the ACL in body? To prevent forward displacement of the tibia and hyperextenion of the knee
When the Acl is injured or sprained, typically how is it caused? Non contact deceleration, CKC, rather than an external force
How can the ACL be an isolated injury? 1.Tibia is driven anteriory on the femur 2.Femur is driven posteriorly on the tibia 3.Knee is severely hyperextended
When the ACL is injuried by an external force how is it usually injured? When the knee is hit hard from the lateral side when the foot is planted on the ground
What happen in a "Terrible Triad"? ACL, MCL, and Medial Meniscus are injured usually from an external force
What is the resuld of a sprianinthe knee? Hemathorsis, blook within the joint capsule often occurs with ACL injury, requirring arthrocentesis(aspiration of fluid within the joint)
Th procedure called arthrocentesis can tell different things about the injury. What are they? 1.Removal of BLood = ligament tear 2.Blood + Fat droplets = fracture and or ligament sprain Synovial fluid w/out blood = chronic meniscus lesion or synovitis
When will you get the best results when doing the ligament stabilty tests? Either right away or several months later du to swellling
When doing the Lachman Exam, what are you looking for? ACL tear
What position is the pt in for the exam? Pt is supine and knee flexed to 25-30 degrees
What position is the pta in during the Lachman exam? PTA stabilize distal femur with one hand just proximal to knee joint. Grasp proximal tibia with the other hand and try to displase anteriorly
When doing the Lachmans test what direction is the force? anterior and posterior
Anterior Drawer Test looks for what? ACL and PCL tear
What is different about the pt position from the Lachman to the Anterior Drawer tests? The knee position for pt in the Lachmans is at 25-30 degrees in the Anterior Drawer is in approx 90 degrees
What position if the PTA is for the Anterior Drawer Test? Stabilize affected limb by sitting on the foot of affected leg. Grasp the prozimal tibia with both hands, thumbs on the anterior joint line and provide an anterior force. Observe the amount of joint seperation
What are some other Mulitdirectional Rotation Exams done for tears at the knee? AMRI Anteromedial Rotary Instability, PLRI Posteromedial Rotary Instability, Anterolateral Rotary Instability ALRI
What test is done for pivot shift test are commonly used to sublux and reduce the tibia relative to the femur Hughston jerk test
The posterior cruciate ligament attaches where on the tibia? The PCL attaches posteriorly to the tibia
What ligament stronger PCL OR ACL PCL is a stronger ligament than the ACL
When the PCL is in extension what position is it in? When the PCL is in extension the ligament is slack
When the knee is fully flexed what position is the PCL in? When the PCL is fully flexed the ligament is TAUT
What is the main function of the PCL? The main function of the PCL is hyperflexion of the knee, backward displacement of the tibia on the femur
When the PCL is injuried their are 4 specific injury mechanisms that can result in PCL injury, but the most common force of injury is what? Most common PCL injury is posteriorly directed force on the anterior aspect of a flexed knee. MVA
What ligament is injuried when someone falls on a flexed knee making contact with the tibial tuberosity forcing the tibia posteriorly? The PCL is injuried
What is one mechanism of a PCL injury? Hyperflexion without a resultant force of the tibia
When both are the ACL and PCL injuried how is the mechanism of injury? When the ligaments are injuried from the foot planted and knee is hyperextended
Can ligament test be easy or hard to read? Ligament instability tests can be confusing to diagnose
What position is the PTA and pt in for the Drawer Test? Same as the Anterior drawer test
If the PCL is torn way can there be a false positive reading? The tibia is sagging backward and so the tibia is actually just being brough back to neutral with anterior force
Waht test is more senitive test of the ligaments instability tests? Godfrey Posterior tibial sag test
Waht position is the pt in for the Godfrey Posterior tibial sag test? The pt is supine with the hip and knee of the affected leg is at 90 degrees
Doing the Godfrey Posterior tibial sag test the PTA is doing what with the limb? The PTA holds heel of the affected limb and allow tibia to sublux/say posteriory by gravity
What direction of force going while doing theGodfrey Posterior tibial sag test? Palpate and watch at joint line for tibia to sag in relation to distal femur
Created by: demiller243