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100
What are the basic movements of the knee
100
Outline the components of RICE and how each component helps alleviate symptoms.
Rest, Ice, Compression, Elevation
Recovery, reduce swelling, pain, and throbbing sensations.
100
what movements do the ACL and PCL protect the knee from?
ACL - prevents anterior displacement
PCL - prevents posterior displacement
100
What does the LCL connect?
connects lateral epicondyle of femur to fibular head
100
What is the scale for assessing reflexes? (what does each number mean)
200
What are the four main stabilizing ligaments of the knee joint?
Anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL), and lateral collateral ligament (LCL).
200
Is the femur rotated medially/laterally when the knee is locked?
medially
200
What are some of the common physical examination maneuvers used to assess knee injuries?
Lachman test, anterior drawer test, pivot shift test, McMurray test, and joint line tenderness. These tests are used to assess the integrity of the ACL, menisci, and presence of joint effusion.
200
Difference between joint effusion and hemarthrosis in knee swelling
Joint effusion is the term used to describe swelling inside a joint, such as a swollen ankle or knee, caused by the excess production of synovial fluid in response to inflammation or direct injury. It is the most specific sign of joint inflammation. The fluid buildup in joint effusion might contain some blood, but it is not primarily blood.
Hemarthrosis is a condition where there is blood and swelling within a joint, indicating either a ligament injury, such as an ACL tear, or a fracture. It is a type of joint effusion that is primarily composed of blood. Knee swelling within four to six hours of injury is indicative of hemarthrosis. Half of all cases of hemarthrosis in knees are caused by ACL tears and other damage to knee ligaments.
200
What 2 articulations does the knee joint consist of?
tibiofemoral and patellofemoral
300
What are the five questions that must be asked when applying the Ottawa Knee Rules?
- Are you 55 years of age or older?
- Do you have isolated tenderness of the patella?
- Do you have tenderness at the head of the fibula?
- Are you unable to flex the knee to 90 degrees?
- Are you unable to bear weight immediately after the injury and in the emergency department, taking four steps regardless of limping?
300
What are some symptoms of a lateral collateral ligament injury?
- Pain, tenderness, and swelling on the outside of the knee
- Limping or walking with the knee bent
- A feeling of popping, tearing, or pulling at the time of injury
- Feeling like the knee buckles or gives way
- Decreased range of motion, making certain movements, such as bending at the knee, difficult
- Knee catching or locking, where the knee feels like it gets stuck during movement
- Bruising around the outside of the knee, caused by tiny blood vessel tears under the skin
- Trouble bearing weight on the affected leg, such as when standing and walking
- Foot numbness, if the peroneal nerve, located near the LCL, is stretched during the injury or affected by tissue swelling
300
What are the Ottawa knee criteria, and how is it used in determining the need for imaging in patients with acute knee injuries? (Don't list the criteria, explain its purpose)
The Ottawa knee criteria is a set of guidelines used to determine the need for imaging in patients with acute knee injuries.
It includes factors such as age, inability to bear weight, tenderness at the head of the fibula, and isolated tenderness of the patella, among others.
Patients who do not meet the fracture predictor of the Ottawa knee criteria are highly unlikely to have clinically significant fractures and can have knee radiographs safely deferred.
The Ottawa knee criteria have been shown to have a high sensitivity in identifying the need for imaging, and their implementation can lead to a reduction in the number of unnecessary knee radiographs ordered following acute knee injuries
300
What are the different imaging modalities used to diagnose ligamentous knee injuries?
X-Ray, Ultrasounds, MRI, CT, Arthroscopy
Arthroscopy: a minimally invasive surgical procedure that allows direct visualization of the knee joint using a small camera. It can be used for both diagnostic and therapeutic purposes, providing a direct view of the ligaments, cartilage, and other structures in the knee joint
300
What ligaments do the varus and valgus stress tests test for respectively?
Varus - tests for integrity of LCL
Valgus - tests for integrity of MCL
400
Name some surgical interventions used in treating knee injuries.
Meniscus repair, ACL reconstruction, partial/total knee replacements, etc.
400
What is the purpose of the medial and lateral menisci in the knee joint?
The medial and lateral menisci are fibrocartilage structures in the knee joint that serve to improve the compatibility between the femur and tibia, absorb shock, and distribute load.
400
MOA of NSAIDs?
NSAIDs primarily work by inhibiting the enzyme cyclooxygenase, which is required to convert arachidonic acid into prostaglandins, thromboxanes, and prostacyclins. By reducing the synthesis of these eicosanoids, NSAIDs elicit anti-inflammatory, analgesic, and antipyretic effects
400
what are some exercises that can help prevent lateral knee injuries
Squats, lunges, hamstring stretch, hip adduction, etc.
400
what muscle "unlocks" the knee joint?
Bonus 100 pts.: What is its innervation?
Popliteus muscle - tibial n. (L4-S1)
500
What are the different phases of the gait cycle?
- Stance Phase: This phase makes up about 60% of the gait cycle and is divided into five subphases:
- Initial Contact: The moment the foot touches the ground.
- Loading Response: The period of time when the foot is accepting the weight of the body.
- Midstance: The point at which the body weight is directly over the supporting foot.
- Terminal Stance: The period of time when the body is moving forward over the supporting foot.
- Preswing: The period of time when the body is preparing to lift the foot off the ground.
- Swing Phase: This phase makes up about 40% of the gait cycle and is divided into three subphases:
- Initial Swing: The period of time when the foot is lifting off the ground.
- Midswing: The point at which the swinging foot is directly under the body.
- Terminal Swing: The period of time when the swinging foot is preparing to make contact with the ground again.
500
What is the Q-angle's purpose and its normal ranges for males and females?
Bring knees and feet closer to midline, under center of gravity.
Males ~10 degrees
Females ~15 degrees
500
Explain the grading criteria for knee injuries
Grade 1/mild — Some tenderness and minor pain.
Grade 2/moderate — Noticeable looseness in the knee when moved by hand; major pain and tenderness at the inside of the knee; swelling.
Grade 3/severe — Considerable pain and tenderness at the inside of the knee; some swelling and marked joint instability. The knee opens up about 1 centimeter when the doctor moves your leg around. A grade 3 MCL tear often occurs along with a tear of the anterior cruciate ligament.
500
Relative Q angles for Genu Valgum and Genu Varum?
Valgum - increased Q angle
Varum - decreased Q angle
500
What is the Unhappy Triad, and what structures are involved in this injury?
The Unhappy Triad, also known as the Terrible Triad, is an injury to the knee that involves the anterior cruciate ligament (ACL), medial collateral ligament (MCL), and either the medial or lateral meniscus.