Kns 335 final exam - Study hard. Exams are definition based. This study guide I made will help. If PDF

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Study hard. Exams are definition based. This study guide I made will help. If you do not study there is no way you will pass this class. ...

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flexion, extension, rotation, and the Movement of the knee requires arthrokinematic motions of rolling and gliding

As the knee extends, it externally rotates because the medial femoral condyle is _________

Larger

than the lateral condyleTerm

prevents excessive internal rotation limits anterior Posterior cruciate ligament (PCL)Term

ACL

translation when the tibia is fixed and limits posterior translation of the tibia in non– weight bearing

stops excessive internal rotation, stabilizes the knee in full extension, and prevents hyperextension

Patella aids knee during _______ thus providing a mechanical advantage

When moving from extension to flexion, the patella glides ______ and further into

extension

laterally

trochlear groove

Kinetic chain

Directly affected by motions and forces occurring at the foot, ankle, lower leg, thigh, hip, pelvis, and spineDefinition

With the kinetic chain, forces must be

absorbed and distributed

Intracapsular may be referred to as joint

effusion

Swelling within the joint that is caused by hemarthrosis synovial fluid and blood is called a

Ballotable patella -

Sign of joint effusion

• Knee laxity includes both

straight and rotary instability

Translation (tibial translation)

refers to the glide of tibial plateau relative to the femoral condyles

As the damage to stabilization structures increases, laxity and translation

also increase

A positive Lachman drawer test

indicates damage to the ACL

Variations of lachmans test

• Rolled towel under the femur • Leg off the table approach with athlete supine • Athlete prone on table with knee and lower leg just off tableDefinition

McMurray’s meniscal test

Used to determine displaceable meniscal tear

-Hard downward pressure is applied with Apley compression test

Medial collateral ligament sprain-etiology

rotation – Pain indicates a meniscal injury

Result of severe blow from lateral side

(valgus force)

Little fiber tearing or stretching • Stable valgus test Medial collateral ligament sprain-signs and • Little or no joint effusion symptoms (GRADE 1) • Some joint stiffness and point tenderness on lateral aspect • Relatively normal ROM

• Complete tear of deep capsular ligament and partial tear of superficial layer of MCL Signs and symptoms (Grade II)

• No gross instability; laxity at 30 degrees of flexion • Slight swelling • Moderate to severe joint tightness with decreased ROM • Pain along medial aspect of knee

• Complete loss of medial stability • Minimum to moderate swelling Signs and symptoms (Grade III)

Lateral collateral ligament sprain – Etiology

Lateral collateral ligament sprain – Signs and symptoms

• Immediate pain followed by ache • Loss of motion due to effusion and hamstring guarding • Positive valgus stress test

Result of a varus force, generally with the tibia internally rotated

• Pain and tenderness over LCL • Swelling and effusion around the LCL • Joint laxity with varus testing • May cause irritation of the peroneal nerve

Anterior cruciate ligament (ACL) Caused by direct contact or by a noncontact sprain – Etiology mechanism

– Noncontact mechanisms are 80% more likely to cause an ACL injury

– Experience a pop with severe pain and ACL tear signs and symptoms

disability – Positive anterior drawer and Lachman’s sign – Rapid swelling at the joint line – Other ACL tests may also be positive

Most at risk during 90 degrees of flexion • Fall on bent knee is a most common way to get a PCL Posterior cruciate ligament (PCL) sprain-Etiology

Posterior cruciate ligament (PCL) sprain-signs and symptoms

sprain • Can also be damaged as a result of a rotational force • Sometimes referred to as a “dashboard injury” – May result when flexed knee of car driver or passenger hits the dashboard

• Feel a pop in the back of the knee • Tenderness and relatively little swelling in the popliteal fossa • Laxity with posterior sag test

• Most common MOI is rotary force with knee Meniscal lesions – Etiology flexed or extended

Bursitis – Etiology

• Acute, chronic, or recurrent swelling • Prepatellar = Continued kneeling • Infrapatellar = Overuse of patellar tendon

Bursitis -signs and symptoms -Prepatellar bursitis may be localized swelling above knee that is ballotable

• Swelling in popliteal fossa may indicate a Baker’s cyst – Associated with semimembranosus bursa or medial head of gastrocnemius – Commonly painless and causing little disability – May progress and should be treated accordinglyDefinition

• Hemorrhaging and joint effusion with generalized swelling Patellar fracture-signs and symptoms

• Indirect fractures may cause capsular tearing, separation of bone fragments, and possible quadriceps tendon tearing • Little bone separation with direct injury

Chondromalacia patella – Etiology

Softening and deterioration of the articular cartilage

Osgood-Schlatter disease

is an apophysitis occurring at the tibial tubercle

Larsen-Johansson

is the result of excessive pulling on the inferior pole of the patella

Iliotibial band friction syndrome (Runner’s knee or Cyclist’s knee)

General expression for repetitive and overuse conditions attributed to malalignment and structural

– Etiology

asymmetries

______ is the only quad muscle Rectus femoris that crosses the hip

Rectus femoris

Extends knee and flexes hip

Hamstrings cross the knee joint____

posteriorly

all except the short head of

Hip

the biceps cross the ___

_______produce forces that depend on position of both knee and hip

“2 joint” muscles

T/F While muscle function is critical to perform dynamic activities, it is also critical in True providing a base of support with pelvis for whole body motion

• Constantly exposed to traumatic blunt blow • Contusions usually develop as a result of severe Quadriceps contusions – Etiology

Quadriceps contusions- signs and symptoms

Heterotrophic ossificans (Myositis ossificans) – Etiology

Quad Grade 1 Strain:

impact • Extent of force and degree of thigh relaxation determine depth and functional disruption that occurs

• Pain, transitory loss of function, and immediate effusion with palpable swollen area • Graded 1–4 = Superficial to deep with increasing loss of function (decreased ROM and strength)

• Formation of ectopic bone following repeated blunt trauma (disruption of muscle fibers, capillaries, fibrous connective tissue, and periosteum) • Gradual deposit of calcium and bone formation • May be the result of improper thigh contusion treatment (too aggressive)

Complain of tightness in front of thigh; near normal ambulation; swelling may be limited; mild discomfort during palpation

Abnormal gait cycle; may be splinted in extension; swelling may be noticeable with Quad grade 2 strain: pain on palpation; possible defect in muscle; resistive knee extension will reproduce pain

Unable to ambulate; pain with palpation; may be unable to perform knee Quad grade 3 strain: extension; isometric contractions may produce defect or bulge in muscle

Hamstring muscle strains

(most common thigh injury)

Hamstring muscle strains grade 1:

Grade 1 - Soreness during movement and point tenderness ( 18° is going to result in knee and hip issues

What the three muscles make up pes anserine

1.) sartorius 2.) gracilis 3.) semitendinosus

Medial meniscus can cause injury to the

semimembranosus

Meniscus tear

clicking and locking sound

must be torn for the knee to dislocate

Minimum of 3 ligaments

Bursitis can be injured a compression force by

Wall sit Closed chain exercise Forward step-ups for the knee Side step-ups Lunges

Closed kinetic chain exercise:

The extremity remains in constant contact with the immobile surface, usually the ground or the base of a machine.

Aid in lubrication and nutrition of the joint Know the functions of meniscus

   

- Reduce friction during movement - Increase area of contact between the condyles, improving weight distribution - Provide shock absorption - Prevent hyperextension

What patella alta is

high riding patella due to long patellar tendon

ACL tear test is

lachman's test

ACL tears happen from

lateral cutting movements and a planted force

ACL swelling can happen

1 – 2 hours after even when you ice and acute phase (won’t swell immediately)

Claw Toe

A claw toe is a toe that is contracted (downward bend) at the PIP and DIP joints (middle and end joints in the toe); hyperextension of the MTP joint and flexion of the PIP joint and DIP joint

Big toe is called

hallux

Your big toe holds the majority of the weight the body’s stabilization during running and walking most of the time and controls...

How to treat lateral vs. medial ankle sprain

the exact same; ice, try to get swelling down immediately

Prolonged pronation

constantly turned in; can cause long-term overuse injuries

To help plantar fascia you should stretch calf (gastrocnemius)

Turf toe

How to treat turf toe

can occur after a very vigorous upward bending of the big toe causing a sprain to the ligaments under base of the big or great toe.

Ice immediately. Applying cold therapy to the injured joint will reduce pain and inflammation speeding up the healing process. Apply a compression bandage to support and protect as well as reduce swelling. Rest, which might include crutches to take the weight off Use a brace to protect the toe or at the very least wear a shoe that has a firm sole that will not allow bending

Mortons neuroma is

a thickening of nerve tissue between the third and fourth toe; tingling and burning, radiating into the toes

4 motions of foot

1.) inversion : pronation 2.) eversion : supination 3.) dorsiflexion 4.) plantar

Mortons toe

a common forefoot disorder where the second toe is longer than the Big Toe (the Hallux). vascular necrosis of the 2nd metatarsal head

If your legs are two different lengths

then cause foot issues

Heel bruise is

painful to palpate

Achille’s tendon tear

happens more in 50-60 year olds

Pes cavus:

high arch

Pes planus

flatfoot

4 muscles of rotator supraspinatus, infraspinatus, teres minor, subscapularis cuff

subacromial bursa is compressed during overhead arm motion

Deceleration

where most injuries happen in rotator cuff when throwing

Deceleration most commonly causes tendonitis in

anterior part of shoulder

S.C. (sternoclavicular joint) injuries happen from

compression

dead arm syndrome he sensation of the arm going “dead” and occurs usually with

chronic shoulder dislocations (aka reoccurence dislocation)

painful arc

between 70 and 120 degrees

Thoracic outlet compression syndrome

nerves and/or vessels become compressed in the proximal neck or axilla.

S&S of Thoracic outlet compression syndrome:

aching pain, pins and needle sensation or numbness if neurological syndrome; hand stiffness, edema if vascular syndrome

epiphyseal keeps growing

until 25 for males and females

know what Allens test is and what it test for

thoracic syndrome , rotate humeral head and if radial pulse diminishes test is positive

Shoulder is repeatedly irritated in

an overhead throw

Main function of rotator cuff

important in shoulder movements and in maintaining glenohumeral joint (shoulder joint) stability

Jersey finger, what is Rupture of flexor digitorum profundus from distal phalanx; injured ? mechanism of injury is rapid extension (from active flexion)

What is not in the wrist? I’m assuming S.L.T.P.T.T.C.H (scaphoid, lunate, triquetrum, pisiform, trapezium, know all the carpal trapezoid, capitate, hamate) bones?

What is damaged in Rupture of extensor tendon from distal phalanx; mechanism of mallet finger? injury is forceful flexion of PIP (proximal interphalangeal joint)

What does the thumb not have?

Only has two phalanges instead of three (aka no middle phalanx) doesn't have a distal interphalangeal joint DIP

Why is strength often limited in carpal tunnel syndrome?

B/c the median nerve is compressed, which is responsible for innervating the flexors of the hand

How to check circulatory problems Allen’s test of Adson’s test in hand?

What is a carpal Bones of the wrist; scaphoid, lunate, triquetrum, pisiform, bone, what are they? trapezium, trapezoid, capitate, hamate

DIP?

Distal interphalangeal joint (thumb only has PIP)

Where to be in maximal grip?

Exerted with wrist in ulnar deviation and slight hyperextension

What protective gloves do boxers, rowers, etc use?

Padded gloves?

What is skier’s thumb -

tear of the UCL (ulnar collateral joint) of the MP (metacarpophalangeal) joint on the thumb

The lunate dislocation most commonly affects what finger?

The ring finger is most commonly injured

How long should Mallet finger be splinted

8-12 weeks in splint o Injury at the DIP – extensor digitorum tendon on the fingers

Boutonniere deformity?

Rupture of central slip of extensor tendon at the middle phalanx; mechanism of injury is rapid forceful flexion of PIP

Trigger finger?

Finger flexors contract but are unable to re-extend due to nodule within tendon sheath or sheath too constricted to allow free motion - tendon synosis (swelling)

How to test carpal tunnel syndrome?

grip and pinch strength is minimum; carpal tunnel compression test

Point tenderness in anatomical snuff box?

Symptom of scaphoid fracture

Kienbock’s disease is?

avascular necrosis of the lunate; chronic pain and dysfunction

Know what a boxer's fracture is and tape Occurs at the distal metaphysis or neck of fourth or fifth finger 5th metacarpal?

Tinel’s sign is?

Way to detect carpal tunnel syndrome by lightly tapping on the median nerve eliciting the sensation of pins and needles

Myositis ossificans?

Bone growing into muscle; Contusion that develops from secondary to single significant blow or repetitive blow to same area

What can be damaged in a hip dislocation?

ligaments surrounding femoral head, labrum, femoral artery breaking and pinching of nerve

What causes pain if an abductor muscle is strained?

Point tender with palpable spasm; pain with AROM; pain with PROM (muscles placed on stretch)

Know when avascular necrosis occurs?

Occurs in Legg-Calve-Perthes Disease on proximal femoral epiphysis (head of femur)

What is hip pointer

Mechanism: direct blow to iliac crest. Common—anterior or lateral portion of crest. Often from improperly fitting (or absent) hip pads. Individual prefers slightly forward flexed position to relieve tension of abdominals and iliop ↑ pain with active trunk flexion and active hip flexion

how to test for hamstring strain?

Test the healthy leg to see if there is a strength imbalance between the healthy and injured legs; putting knee in flexion

Legg-Calve-Perthes disease

happens in boys from 3-8 -Avascular necrosis of proximal femoral epiphysis -Seen esp in males ages 3–8 -Osteochondrosis - femoral head

S&S of Legg-CalvePerthes disease

-Gradual onset of limp and mild hip or knee pain of several months in duration -Pain -activity related - Decreased ROM in hip abduction, extension, and external rotation due to spasm in hip flexors and adductors

weakest part of femur?

neck

q angle is off?

Greater trochanter bursitis in hips; normal Q angle: Men 13° | Women 18°

rectus femoris injured?

Typically a quadriceps strain; Rectus femoris is active during hip flexion and knee extension; kicking a ball; most often hurt by kicking a ball

thrombolysis

acute inflammation of a vein; best preventative measure after treatment are compression stockings

Femoral Triangle Borders

inguinal ligament (superior), sartorius (lateral), adductor longus (medial); contains femoral arteries, veins, and nerves so concern

when damaging

Piriformis strain-

strain in butt but pain can sometimes be felt on the lateral side of the leg; mimics IT band syndrome...