ATH503 Exam 2

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What are s&s of an mcl sprain?

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1

What are s&s of an mcl sprain?

Pn, swelling, stiffness
limited flex & ext
+ valgus
joint line pn

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2

What is the ROM for an MCL sprain?

Flexion & extension

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3

What is the MOI for an mcl sprain?

Valgus contact or non-contact valgus &/or rotation

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4

What is the MOI for an lcl sprain?

— & tibial internal rotation

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5

What are S&S for an lcl sprain?

Hearing “pop” or tear
Swelling
Point tenderness

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6

What is the ROM for an LCL sprain?

Flexion & Extension

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7

What is the MOI for an ACL sprain?

Anterior tibial translation or
posterior femoral translation, Noncontact rotational injuries, or Hyperextension

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8

What are S&S of an ACL sprain?

hearing or feeling “Pop”, immediate function loss & swelling within 4-6 hours

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9

What is the ROM for an ACL sprain?

As swelling sets in, theres a decrease in ROM

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10

What are the extrinsic predisposing factors of an ACL sprain?

Muscle strength & fatigue
Muscle activation & coordination
Q angle
Female
Anterior pelvic tilt
Menstrual cycle

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11

What are the intrinsic predisposing factors of an ACL sprain?

Small ACL size
Narrow intercondylar notch width
Joint laxity

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12

What is the MOI for a PCL sprain?

posterior tibial translation, landing on anterior tibia with knee flexed, or landing on dorsiflexed ankle

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13

What are the S&S for a PCL sprain?

may be asymptomatic, popliteal fossa pain & tenderness, & effusion develops over time

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14

What is the ROM for a PCL sprain?


MMT: Quad strength decrease in chronic patients

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15

What is the MOI for a posterolateral corner injury?

Hyperextension w/ varus, & Hyperextension w/ external tibial rotation

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16

What are S&S of a posterolateral corner injury?

“Knee instability”, localized pain, giving way, rapid non-contained edema

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17

What is the MOI for a meniscal tear?

rotation with flexion &/or valgus/varus stress

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18

What are S&S of a meniscal tear?

“clicking” or “locking”
Joint line pain
Decreased motion
Swelling

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19

What are the classifications of a tibiofemoral dislocation?

Tibial Displacement
Complete
Partial
Open
Closed
High or Low velocity

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20

What is the MOI for a tibiofemoral dislocation?

Hyperextension
Hyperextension w tibial rotation
Posterior tibial displacement w flexed knee

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21

What are S&S of a tibiofemoral dislocation?

Severe pain
Spasm
Deformity
“Dimple sign”
Suspect w impaired neuro symptoms

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22

What are predisposing factors to IT Band friction syndrome?

Genu varum
Foot pronation
Leg length
Lateral heel strike

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23

What is the MOI for IT Band friction syndrome?

Repeated flexion & extension

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24

What are the S&S for IT Band friction syndrome?

“Burning”
Point tenderness
MMT pain, none with AROM

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25

What is disrupted with Anterolateral Rotatory Instability?

ACL
Anterolateral & Posterolateral capsule
Biceps femoris
Lateral meniscus

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26

What do patients complain of with rotary instability?

“giving out or giving way”
Decreased strength
Decreased performance
Lack of confidence

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27

What are the special tests for IT Band syndrome?

Nobel’s & Ober’s

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28

What is the Unhappy triad in anteriomedial rotary instabillity?

ACL
MCL
Medial meniscus

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29

What are the special tests for anteriomedial rotary instability?

Crossover
Isolated ACL & MCL
Solcum drawer

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30

What is a discoid menisucus?

Increased thickness & overs a larger area of the tibia
Size, shape & stability causes instability, clicking or locking

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31

What is a meniscal cyst?

Associated w longitudinal tears
Often painless
Breaches joint capsule and fills with synovial fluid

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32

What is an osteochondral lesion?

damage to the bone and cartilage

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33

What are S&S of an osteochondral lesion?

Diffuse pain
Locking or clunking
Increased pain & decreased strength when WB

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34

What are the special tests for uniplanar anterior instability?

Anterior drawer
Lachmans
Prone lachmans

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35

What are the special tests for uniplanar posterior instability?

Posterior drawer
Godfrey’s
quad activation
Dynamic posterior shift
External rotation recurvatum

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36

What are the special tests for uniplanar medial instability?

Valgus test

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37

What are the special tests for uniplanar lateral instability?

Varus test

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38

What are the special tests for multiplanar anteriolateral instability?

Slocum drawer
Crossover
Flexion/rotation drawer
Pivot shift

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39

What are the special tests for multiplanar anteriormedial instability?

Crossover
Anterior drawer
Slocum drawer w/ ER to 15°

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40

What is the MOI for an ACL sprain?

Anterior tibial translation or
posterior femoral translation, Noncontact rotational injuries, or Hyperextension

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41

What are S&S of an ACL sprain?

hearing or feeling “Pop”, immediate function loss & swelling within 4-6 hours

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42

What is the special test for a osteochondral lesion?

Wilsons

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43

What are special tests for meniscal tears?

McMurrays
Apley’s
Thessaly

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44

What are the purposes of the patella?

Increase mechanical efficiency
Anterior protection
Absorption & transmission of joint foreces

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45

What are the planes of the patella?

Frontal & sagittal: Triangular
Frontal: superior portion is wider
Sagittal: Anterior, non-articulating, narrower posterior surface

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46

What are the patella articulations?

Medial, lateral, odd
Medial & lateral have superior, middle & inferior facts
Odd facet has no articulation support

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47

What is the patella ROM?

Medially: 45-18° into ext
Laterally: 18-0° into ext

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48

Where is the lateral retinaculum?

Over the vastus lateralis & IT band

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49

Where is the medial retinaculum?

Over the vastus medialis & adductor magnus

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50

What is the primary patella lateral mover?

Vastus lateralis

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51

What is the vastus lateralis supported by?

IT band

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52

What movement does the vastus medialis oblique produce on the patella?

Medial & proximal gliding

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53

What is the risk of decreased quad vs hamstring strength?

Patellofemoral risk

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54

What do tight calves increase the risk of?

Decreased dorsi = increased pronation → Hip IR & medial patella tracking

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55

What does a medial patella position cause?

Increased q-angle & lateral force

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56

Where are the 4 bursae of the knee?

Suprapatella
Prepatellar
Subcutaneous infrapatellar
Deep infrapatellar

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57

What are acute MOI’s for patellofemoral?

Contusions
FX’s
Strains
Subluxation/dislocation

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58

what is movie goers sign?

After sitting for a while, getting up the anterior knee is swollen

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59

What is the true leg length?

ASIS to medial malleolus

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60

What is a functional leg length?

Belly button to medial malleolus

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61

What is a J-sign?

A superior/lateral glide of the patella during extension

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62

What is the MOI for a PCL sprain?

posterior tibial translation, landing on anterior tibia with knee flexed, or landing on dorsiflexed ankle

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63

What are the S&S for a PCL sprain?

may be asymptomatic, popliteal fossa pain & tenderness, & effusion develops over time

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64

What is the ROM for a PCL sprain?


MMT: Quad strength decrease in chronic patients

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65

What is the MOI for a posterolateral corner injury?

Hyperextension & varus, & Hyperextension & external tibial rotation

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66

What are S&S of a posterolateral corner injury?

“Knee instability”, localized pain, giving way, rapid non-contained edema

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67

What is a positive test for clarkes sign?

Feeling of crunchiness, hurts

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68

What is a positive apprehension test?

Guarding, verbal or non verbal apprehensiopn
Medial patellar retinaculum laxity

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69

What is a positive medial synovial plica test?

Symptom reproduction
Plica palpation on medial femoral condyle from 60-45°

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70

What is a positive stutter test?

Irregular motion between 40-60°
Medial plica syndrome

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71

What are the S&S of patellofemoral pain syndrome?

pain w/ stairs “movie goers”
“giving out” & “clicking:

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72

What are the observations for patellofemoral pain syndrome?

End ranges increase pain
Point tenderness along medial retinaculum
MMT: weak quads, abductors, hip er

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73

What are the special tests for patellofemoral pain syndrome?

Glides

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74

What are the MOI for acute patellar disloctions?

Valgus blow
tensile stress

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75

What are the S&S for acute patellar dislocaions?

Large blood effusion
Deformity
Point tenderness & pain at MPFL, med retinaculum, VMO
cannot perform ROM

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76

What are the special tests for acute patellar dislocations?

Apprehension to R/O major ligament involvement

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77

What are the MOI for patellar subluxation?

Change of direction
Eccentric contraction

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78

What are the S&S of a patellar subluxation?

Medial capsule pain
“giving out”

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79

What are the ROM of a patellar subluxation?

pain between 0-30°
MMT: weak hip abd & Er

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80

What are the special tests for uniplanar medial instability?

Valgus test

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81

What are the special tests for uniplanar lateral instability?

Varus test

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82

What are the special tests for multiplanar anteriolateral instability?

Slocum drawer
Crossover
Flexion/rotation drawer
Pivot shift

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83

What are the special tests for multiplanar anteriormedial instability?

Crossover
Anterior drawer
Slocum drawer w/ ER to 15°

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84

What are the special tests for multiplanar posteriolateral instability?

Posteriolateral drawer
Reverse pivot shift
Dynamic posterior shift
External rotation recurvatum test

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85

What are the special tests for multiplanar posteriomedial instability?

Posteriomedial drawer
Lachman
Pivot shift

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86

What are S&S of “hoffa’s disease”?

Pain on either side of patellar tendon
Symptomatic hamstring spasm
Reduced knee extension
Limited ROM

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87

What is patellofemoral bursitis?

Inflammation of the bursa

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88

What bursae is effect by direct trauma to the knee?

Superficial Prepatellar
Subcutaneous Infrapatellar

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89

What bursae is effect by overuse?

Suprapatellar
Deep Infrapatella

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90

What are S&S of patellofemoral bursitis?

Pn localized to bursa
point tenderness

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91

What is the ROM for patellfemoral bursitis?

Pn at specific points
MMT: quad weakness

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92

What is a plica?

An extra fold in the synovial membrane

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93

What are the MOIs for a synovial plica?

Direct blow
Overuse

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94

What are the S&S of a synovial plica?

Anterior knee pain
“Giving way”
Worse in the morning
Swelling over plica

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95

What is the ROM for a synovial plica?

Pain & “catching”
MMT: quad weakness

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96

What are the MOIs for a patellar fracture?

Rapid flexion
Acute blow

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97

What are the S&S for a patellar fracture?

Edema
Deformity
Point tenderness

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98

What is the ROM for a patellar fracture?

Extension lag
Limited flexion
Decreased quad strength

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99

What are the predisposing factors for a patellar tendon rupture?

Rheumatoid arthritis
Diabetes
Lupus
Steroids

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100

What are the MOIs for a patellar tendon rupture?

Extensor mechanism overload
Hyperflexion

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