The knee
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
|
|
||||
|---|---|---|---|---|---|
| Which aspect of the tibeofemoral joint is larger? | medial!
🗑
|
||||
| C shaped cartilage? | medial meniscus
🗑
|
||||
| O shaped cartilage? | lateral meniscus
🗑
|
||||
| How are the ACL and PCL angled? | oblique
🗑
|
||||
| True or false: Pressure in the joint capsule may interfere with normal arthrokinematics | true! need to find out what is causing the fluid!
🗑
|
||||
| How is the knee cap most easily dislocated? | full extension
🗑
|
||||
| how can you replace a dislocated knee cap? | place it back into extension
🗑
|
||||
| What can we fix if the pt has an excessive Q angle? | work on the hip abductors
🗑
|
||||
| how is the patella pulled laterally into the condyle? | by a tight IT band.
🗑
|
||||
| patellofemoral pain is typically from? | IT band, kinetic chain problems
🗑
|
||||
| Tight IT band + patella? | 'frog eye look', patella goes lateral
🗑
|
||||
| dislocation of the patella is caused by? | medial p-f ligament rupture, potential for success: lig intact= good, not intact=bad=surgery
🗑
|
||||
| Osgood Schlatters | bad hip, bad foot/ankle, if in pronation/lock all the time= quads are CONSTANTLY used
🗑
|
||||
| What happens to the quads in osgood schlatters? | the quads are always used bc all else is weak!
🗑
|
||||
| WB at the time of injury is how sensitive for meniscus? | 85% SN....NOT WB at the time of injury= NOT meniscus
🗑
|
||||
| cut, pivot, or twist injuries may be indicative for? | men. or instability
🗑
|
||||
| stairs may be painful for who? | patellofemoral patients, places higher compression on the patella
🗑
|
||||
| Acceleration and deceleration may cause: | ACL/PCL through instability
🗑
|
||||
| LPP for the patella? | full extension
🗑
|
||||
| 20* flexion for the patella? | tibfem= LPP
🗑
|
||||
| why is pain worse in full ext? | tibfem= closed pack
🗑
|
||||
| when is patellofemoral pain worse? | AT 30*!!! less than 30=fine, over 30= fine
🗑
|
||||
| Why/when does the knee give way? | all muscles relax= the knee gives out
🗑
|
||||
| which joint sounds at the knee are okay, which are not? | patella= okay, tibiofemoral= more concerning
🗑
|
||||
| Swelling in the knee is how SN and for what? | 80% SN for MCL and Meniscal.. DO NOT HAVE!
🗑
|
||||
| True or false: if you have swelling you want to rule OUT MCL/MENIS: | TRUE!
🗑
|
||||
| True or false: if you dont have swelling you do not have a menis. or mcl injury: | TRUE!
🗑
|
||||
| With what type of knee injury will you typically see swelling and why? | ACL tear= has vascular structure with it
🗑
|
||||
| how soon after an ACL tear will swelling occur? | 1 hour, fluid containing blood begins to accumulate
🗑
|
||||
| What is the Fick angle? | angle feet are at when standing or walking
🗑
|
||||
| What does ER do to the knee? | places more MEDIAL force on the patella
🗑
|
||||
| What does IR do to the knee? | places more LATERAL force on the patella...PIGEON TOED= MANY more probs!
🗑
|
||||
| What are the two different types of patellar position? | patella alta, patella baja
🗑
|
||||
| What happens if you rupture your quad or hammys? | lots of blood, wasting =weaker and weaker
🗑
|
||||
| what is the patella position in a 'frog eye' position? | laterally displaced
🗑
|
||||
| What do we need to consider in the screw home mechanism? | why it wont screw home aka, go into full extension
🗑
|
||||
| dif. reasons why it wont 'screw home' | lig(wont make it tight), excessive fluid, tib. wont ER at end range
🗑
|
||||
| what does a pronated foot cause? | ^ valgus at knee, navicular drop, talus IR, tibia= into flexion,
🗑
|
||||
| is the knee more stable or less stable when the foot is pronated? | LESS stable
🗑
|
||||
| What may be the cause of a backward knee appearance? | LAX ACL
🗑
|
||||
| What is the position of the tibia when the ACL is more lax? | the tibia is placed more forward, more likely to rupture ACL
🗑
|
||||
| What happens in Patella baja? | bone does not function as a pulley, more patellofemoral, more compressive force
🗑
|
||||
| What happens in patella alta? | patella= out of groove= no bone stability, lig. check in, GREATER likelihood to dislocate
🗑
|
||||
| is the ACL taut or lax in flexion and extension? | Taut!
🗑
|
||||
| what is the position of the knee in the stance phase? | knee is flexed
🗑
|
||||
| what should the position of the knee be in swing phase? | flexed
🗑
|
||||
| if the knee is not flexed in swing what may this be indicative of? | stiffness=pain
🗑
|
||||
| What limits knee flexion? | tissue approx. from the gastroc:hams.
🗑
|
||||
| what is normal ROM for flex/ext? | 0 to 135* (AROM)
🗑
|
||||
| normal end feel for knee extension, medial rotation, lateral rotation, patella? | tissue stretch
🗑
|
||||
| what happens during econcentric actions? | one= concentric(shorten), the other= eccentric(lengthen)
🗑
|
||||
| What LE muscle groups need to perform ecc and conc? | quads/hammys
🗑
|
||||
| true or false: isokinetic training is very controlled motion with 3 dimensions? | true!
🗑
|
||||
| is isokinetic testing without speed very functional to the knee? | no, it is not essential that is done rapidly, therefore it does not affect the knee function to a great extent
🗑
|
||||
| true or false: isokinetic testing is nice to test as an individual part, but it needs to be integrated as a whole? | true!
🗑
|
||||
| what do the machines that perform isokinetic testing control? | speed
🗑
|
||||
| what happens when our muscles fatigue out? | decrease mechanics=increase for injury
🗑
|
||||
| How is avg torque for isokinetics figured? | left/right, quads/hams/ body weight (2:1 ratio [smaller frame vs larger frame]
🗑
|
||||
| what is total work? | how much done in a given time
🗑
|
||||
| when does peak torque occur? | it is generated at its max amount at approx. the middle of range.
🗑
|
||||
| what is the definition of the time to peak? | 0-->60= how long to contract to full force...training is very important!
🗑
|
||||
| what is cutting? | abrupt change in direction (think meniscal tears)
🗑
|
||||
| what type of special test does walking down hill function similarly to? | anterior drawer (ACL)
🗑
|
||||
| functional tests are completed how? | in order of progressive difficulty: walking, stairs, squatting, running(straight, curves, cutting, stopping), then jumping
🗑
|
||||
| what is a jump considered? | 2 feet to 2 feet
🗑
|
||||
| what is a hop considered? | 1 foot--> land on the same foot
🗑
|
||||
| what is a bound considered? | start one foot--> land on opposite foot
🗑
|
||||
| what is the point of the 3 hop test? refer to 12.37- Magee? | compare how much distance is covered in 3 hops
🗑
|
||||
| the crossover test can be examined how? refer to 12.37 | over distance or over time
🗑
|
||||
| what does covering more distance in a shorter amount of time indicate? refer to 12.37 | better function!
🗑
|
||||
| Agility hops are performed how? refer to 12.37 | one-then other- one- then other
🗑
|
||||
| Mini hurdles are completed how? refer to 12.37 | side-> side
up->down
...height matters!
🗑
|
||||
| The MOST USEFUL patellofemoral tests include: | step down test
waldron test
🗑
|
||||
| how is the step down test so useful? | control step down= slow touch heel, bend knee, control eccentric load down
🗑
|
||||
| how is the waldron test so useful? | patellafemoral (lig?), controlled squat, look for patellofemoral pain
🗑
|
||||
| What are Metric tests for the knee? | cincinnati knee rating system, knee outcome survey, knee society, knee score, lysholm
🗑
|
||||
| Medial ligaments: Valgus Test SN | 91% SN with laxity.... NOT lax= NO MCL tear, pain doesnt always indicate tear
🗑
|
||||
| Lateral ligaments are tested how? | varus test
🗑
|
||||
| Lachmans test: SN and SP | does not ALWAYS indicate an ACL tear, SN= 85%, SP= 94%, negative means NEGATIVE!
🗑
|
||||
| Anterior drawer test: SN and SP | positive means positive, low SN= 55%, HIGH SP=92%
🗑
|
||||
| Sag Sign: | weight of tibia can cause tibia to go back on femur "sag on femur"
🗑
|
||||
| Posterior Drawer Test SN: | 100% SN- no laxity= no laxity/tear in PCL
🗑
|
||||
| Pivot Shift Tests SN and SP: | not good to rule out: SN= 24%, SP= 98%....positive test= you know something is wrong!
🗑
|
||||
| Findings for a pivot shift test may be a result of: | tightness, need to look for rotary instabilities
🗑
|
||||
| What is the KT 2000? | it measures lachmans test in mm, how far back the tibia glides on femur. It is used for studies because it is valid, reliable, and quantifiable
🗑
|
||||
| McMurrays test SN and SP: | SN= 55-71%, SP= 71-77%, a POSITIVE means positive a little more. NEGATIVE does not always mean a negative!
🗑
|
||||
| Apley's test SN and SP: | distration:ligaments, compression:meniscus..... SN=22 to 61%...SP= 70-88%
🗑
|
||||
| Thessalys test SN and SP: | SN= 90%, SP= 98%
🗑
|
||||
| what is Thessalys test? | test for meniscus, look for lock or catch in knee, drive knee medially...this is a FUNCTIONAL test!
🗑
|
||||
| brush test: | pt is sitting: tap on one side, other side will bulge from the fluid
🗑
|
||||
| bakers cyst: | palpate and feel a hole- swollen in front= 10 cc fluid, bulging in jt capsule
🗑
|
||||
| Patellofemoral tests: | Clarkes sign, Patellar Apprehension, Q-Angle
🗑
|
||||
| Patellar Apprehension SN and SP: | SN= 100%, SP= 88%....SN= NO APPREHENSION= DONT have it(-)....(+)= good indicator that pt does have it, this is where we then look for dislocation
🗑
|
||||
| which order should be check for dislocation? | run through range, then try to dislocate
🗑
|
||||
| Knee OA: mobilize how? | 4 directions in 1 session
🗑
|
||||
| how do knee OA patients respond to mobilization? | MODERATELY better 2 days later
🗑
|
||||
| how do we 'attack' knee OA? | the hip attacks the knee with limitations
🗑
|
||||
| Patellofemoral pain | Tx: OTC foot orthotics
🗑
|
||||
| how do patellofemoral patients respond to tx? | 50% decrease in pain with orthotics
🗑
|
||||
| how does the foot influence patellofemoral pain? | 2* or more forefoot valgus, 78*/90* 1st MTP ext
🗑
|
Review the information in the table. When you are ready to quiz yourself you can hide individual columns or the entire table. Then you can click on the empty cells to reveal the answer. Try to recall what will be displayed before clicking the empty cell.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
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
Created by:
1158150021
Popular Physical Therapy sets