Lab 7

Question 1

Pt thinks they sprained a ligament, theyre sore for a while but have no instability

Answer 1

possible that they strained their joint capsule, not a ligament

Question 2

delayed swelling is likely due to

Answer 2

synovitis (swollen capsules)

Question 3

Immediate swelling/ hemarthrosis is more likely with

Answer 3

ligament tears

Question 4

whats the most important thing in the history to ask for knee injuries

Answer 4

mechanism

Question 5

Why is it important to screen if patients are 50+ or under 17 in knee cases

Answer 5

Osteosarcoma in distal femur

atrophy of quad, oddly shaped knee, s/s of cancer

Question 6

What can we do to help rule out DVTs in the knee?

Answer 6

take vitals

Question 7

History of blunt trauma or unaccustomed exercise

severe pain

hardness, paresthesia

no pulse in leg

Answer 7

compartment syndrome

URGENT! call the ambulance!

Question 8

Ottawa knee decision rule:

Answer 8

Age 55+

Tenderness at head of fibula

isolated tenderness at patella

inability to flex knee to 90

inability to WB 4 steps

2+ findings need an xray

Question 9

pittsburgh knee decision rule

Answer 9

Hx of blunt trauma or fall

inability to WB 4 steps

age under 12 or over 50

2+ gets an xray

Question 10

Knee decision rule of bauer

Answer 10

inability to WB 4 steps
Presence of knee effusion
presence of ecchymosis

Question 11

what do the 3 knee decision rules have in common?

Answer 11

Inability to WB 4 steps

Question 12

what unique things do you need to look at in observation for knee

Answer 12

abrasions

lacerations

contusions

can cause infection!

Question 13

You must have tibial ________ for full ext and tibial ________ for full flex

Answer 13

External rotation

internal rotation

Question 14

how much hyperext is normal in the knee

Answer 14

15

Question 15

what does 3-125 mean when writing knee ROM

Answer 15

Missing 3 ext, 125 degrees of flexion

Question 16

What direction does the roll/glide happen for knee flexion in open chain?

Answer 16

posterior roll posterior glide

Question 17

What direction does the roll and glide occur for ext of the knee in open chain?

Answer 17

anterior roll, anterior glide

Question 18

what are we mobilizing here?

Answer 18

ext

Question 19

what motion is being mobilized here

Answer 19

ext

Question 20

what movement is being mobilized

Answer 20

technically all of them, but mainly used for flexion

Question 21

this glide helps with what motion

Answer 21

ext

Question 22

this glide helps with what motion

Answer 22

flexion

Question 23

When do we use PA and AP glides for the proximal tibiofibular joint

Answer 23

usually when the patient has chronic problems at the distal tibio-fibular joint

ex= chronic lateral ankle sprains

Question 24

Where do you palpate to feel meniscus?

Answer 24

Squishy area behind femoral condyles

Question 25

which collateral ligament is easier to palpate?

Answer 25

Lateral- is easier, shaped like cord medial-harder to palpate, shaped like band

Question 26

Subjective -> Observation _> ROM -> MMT -> ____________

Answer 26

Joint play

Question 27

Where do we palpate the plicae (if present)

Answer 27

medial and superior under patella

Question 28

When would you do ligamentous testing for the knee vs not

Answer 28

only do ligamentous testing when there's a MOI

Question 29

When would you do instability testing on he knee vs not

Answer 29

only do this testing if there's a current or past MOI

Question 30

how to do lachmans

Answer 30

bend knee to 30 degrees and provide strong anterior shear with one hand while stabilizing thigh

Question 31

When do you preform a lachmans vs an anterior drawer

Answer 31

lachmans- immediately after injury b4 it swells

Question 32

What is the disadvantage of the anterior drawer vs the lachmans

Answer 32

knee is in 90 degrees of flexion and there is more hamstring activation guarding the knee

Question 33

injury to what structure is the most common cause of Anterio-lateral rotary instability

Answer 33

ACL

Question 34

what is the pivot shift test for

Answer 34

ACL, ALRI

Question 35

When we suspect ligamentous instability what tests should we do

Answer 35

test all 4 ligaments of the knee

Question 36

How do we know if a posterior sag sign is positive

Answer 36

Look for a big divot, compare to other side

Question 37

A valgus stress test at 0 tests the....

Answer 37

PCL

Question 38

A valgus stress test at 20-30 tests what

Answer 38

MCL

Question 39

A varus stress test at 0 is for...

Answer 39

PLC and LCL

Question 40

A varus stress test at 20-30 is for what

Answer 40

LCL

Question 41

Anteriomedial instability test direction:

Answer 41

Anterior drawer with ER

Question 42

Anterolateral instability test direction

Answer 42

IR with anterior drawer

Question 43

Posterio-lateral instability test

Answer 43

posterior drawer with ER

Question 44

Posterio-medial instability test direction

Answer 44

posterior drawer with IR

Question 45

how do you preform the mcmurray for the medial meniscus

Answer 45

passively rotate tibia into full ER while passively extending knee

Question 46

how do you preform mcmurrays for a lateral meniscus

Answer 46

Fully IR the tibia then extend the knee

Question 47

if you suspect someone has a lateral meniscus tear what part of mcmurray test should you do

Answer 47

BOTH tests

Question 48

T or F: Apley's test can identify which side the meniscus is torn

Answer 48

F, it doesn't discriminate between sides

Question 49

How to preform the apleys test

Answer 49

compress/ distract knee joint from lower leg and rotate leg into IR and ER compression- makes menicus worse/ligament worse distraction- makes meniscus better distraction- makes ligamentous injuries worse

Question 50

How do you preform Thessaly's test

Answer 50

Preform at 20 and 5 degrees knee flex pt twists side to side and positive is pop, click, or pain positive test = mensicus problem

Question 51

What does the lateral patellar aprehension test test for?

Answer 51

tests for lateral patellar subluxation

Question 52

how do you preform clarke's sign/ patellar grind test and what does it test for

Answer 52

pt is supine w/ knee straight push the patella inferior and have patient isometricly contract quad positive- reproduces their pain means chondromalacia patella or any Pf dysfunction