Ouch!
I saw the sign!
Location, Location, Location
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100
This is the number of main types of knee dislocations.
What is 5?
Knee dislocations occur in 5 main types: anterior, posterior, medial, lateral, and rotary. They are classified based on the position of the tibia in relation to the femur.
Rotary dislocations can further be divided into anteromedial, anterolateral, posteromedial, and posterolateral injuries.
Posterior dislocation: This type of knee (tibiofemoral) dislocation occurs when something strikes the front of the knee and pushes the tibia, or shinbone, back.
» This can happen during falls or in some car accidents—like in our patient, Mrs. Crutchfield.
100
This sign that Bill Nye demonstrates with his hands is called _______.
What is Go Frogs?
100
This location is where Mrs. Crutchfield was brought to right after her car accident.
What is an ED or ER?
100
The knee is this joint type.
What is a hinge joint?
A hinge joint only allows movement in one axis.
https://www.osmosis.org/learn/Fibrous,_cartilage,_and_synovial_joints
200
Posterior knee dislocation poses the highest risk of injury to this artery.
What is popliteal artery?
A knee dislocation is a true surgical emergency because a major artery in the knee (popliteal artery) is likely to be damaged; if it is not treated early, the patient may lose their leg.
To rule out vascular injuries, you can use a blood pressure ratio between ankle and arm (the ankle-brachial index). If the index is low, an angiogram (blood vessel imaging) is typically performed to identify any vascular damage.
Source:
https://usmle-rx.scholarrx.com/rx-bricks/brick/CP_MUS0050
200
A positive Lachman sign indicates ______.
What is ACL tear?
A Lachman test can be used to assess an ACL tear. The patient lies on their back and flexes the knee slightly (20°-30°). You put your hand on the femur to stabilize and move the proximal calf toward you. Increased displacement indicates ACL injury.
200
The pes anserinus inserts into this bone.
What is the anteromedial proximal tibia?
The conjoined tendon lies superficial to the tibial insertion of the medial collateral ligament (MCL) of the knee.
200
Fluid accumulation in the intra-articular space of a joint is called _____.
What is a joint effusion?
The knee contains sac-like structures containing synovial fluid, called bursae, which are located between the skin and bony prominences. Fluid accumulation in the intra-articular space of a joint is called an effusion.
300
Injury to this nerve is usually associated with knee dislocations.
What is Common Fibular (Peroneal) Nerve?
Neurologic damage involving the common peroneal nerve is estimated to occur in approximately 25% of knee dislocations
Source:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4117866/
https://www.orthobullets.com/trauma/1043/knee-dislocation
300
A positive Posterior Drawer Sign indicates a tear in this _____ ligament.
What is PCL?
Anterior and posterior drawer tests are useful when you suspect ACL or PCL damage (Figure 3).
The patient lies on their back and bends the knee by 90°. Then place your hands around the proximal tibia and pull toward you (anterior) or push toward the patient (posterior).
300
This ligament (one of the 4 main ligaments of the knee) is located right above the fibula.
What is lateral cruciate ligament (LCL)?
• aka Fibular collateral ligament
• stabilizes the lateral side of the knee joint
300
They are fibrocartilaginous structures that operate as shock absorbers within the knee joint.
400
At the knee, there are four main ligaments: ACL, PCL, MCL, and LCL.
For an injury to be considered a knee dislocation, ____ is the minimum number of ligaments (out of the 4 mentioned) needed to be torn.
What is at least 3—where 2 have to be cruciate ligament and at least 1 collateral ligament?
Source:
https://www.lecturio.com/magazine/posterior-knee-dislocation/
For our patient, Mrs. Crutchfield, her MRI revealed:
1.) Complete tear anterior cruciate ligament and posterior cruciate ligament.
2) Complete tear of the medial collateral ligament. (Lateral collateral ligament is intact.)
However:
Although the conventional thinking is that both cruciate ligaments and at least 1 collateral ligament must be torn in order for the knee to dislocate, some patients who have suffered a knee dislocation still have 1 cruciate intact.
400
The name of this Stress Test is seen in the video.
What is Varus Stress Test (of the knee)?
Valgus vs Varus: refer to angulation (or bowing) within the shaft of a bone or at a joint in the coronal plane.
If you can move the distal part Laterally, it's vaLgus (there's a problem with MCL). If more medially, it's varus (there's a problem with LCL).
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In our patient Mrs. Crutchfield: L knee is normal with varus stress testing, but extreme laxity to valgus stress test.
Source:
https://radiopaedia.org/articles/valgus-vs-varus-1
400
Clue by Dr. Kunkler:
What is Simulation Room?
• Third Floor IREB room
• Room 379
400
The name of this bone and indicate if it's Left or Right.
What is left femur?
