Study Knee (PTA 201) Flash Cards

 
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Knee (PTA 201)

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Closed chain isometric exercises are done to facilitate?
CO CONTRACTION OF THE QUADRICEPS AND HAMSTRINGS
The VMO primarily effects what?
PATELLAR ALIGNMENT
When and how long does the moderate protection phase last in a meniscal repair?
4-6 WEEKS TO ABOUT 12 WEEKS POST OP
Open chain training exercise precautions of ACL reconstruction?
-DURING PRE TO STRENGTHEN HIP MUSCULATURE, INITIALLY PLACE THE RESISTANCE ABOVE THE KNEE UNTIL KNEE CONTROL IS ESTABLISHED

-AVOID RESISTED, OPEN CHAIN KNEE EXTENSION BETWEEN 45 AND 15 DEGREES

-AVOID APPLYING RESISTANCE TO THE DISTAL TIBIA DURING QUADRICEPS STRENGTHENING
What are the closed chain training exercise precautions for ACL reconstruction?
-WHEN SQUATTING IN AN UPRIGHT POSITION BE SURE THT THE KNEES DO NOT MOVE ANTERIOR TO THE TOES AS THE HIPS DESCEND BECAUSE THIS INCREASES SHEAR FORCES ON THE TIBIA AND COULD POTENTIALLY PLACE EXCESS STRESS ON THE AUTOGRAFT

-AVOID CLOSED CHAIN STRENGTHENING OF THE QUADRICEPS BETWEEN 60 AND 90 DEGREES OF KNEE FLEXION
Resistance training-exercise precautions after acl reconstruction?
-PROGRESS EXERCISES MORE GRADUALLY FOR RECONSTRUCTION WITH HAMSTRING TENDON GRAFT THAN BONE PATELLAR TENDON BONE GRAFT

-PROGRESS KNEE FLEXOR STRENGTHENING EXERCISES CAUTIOUSLY IF A HAMSTRING TENDON GRAFT WAS HARVESTED AND KNEE EXTENSOR STRENGTHENING IF A PATELLAR TENDON GRAFT WAS HARVESTED.
An increased valgus at the knee might indicate what weak muscle group?
WEAK HIP ABDUCTORS
Why do we want to laterally rotate the femur during SLR's?
BECAUSE MANY FIBERS OF THE VMO ORIGINATE ON THE ADDUCTOR TENDONS AND MEDIAL INTRAMUSCULAR SEPTUM.
Greatest patellar stress is at ______ and compression loads at _____, so pain may be provoked in these ranges whe nmaximum torque from the resistance force is applied in these ranges?
60 DEGREES
75 DEGREES
There is little or no contact of the patella with the trochlear groove from ______ to ______ of _______.
0-15 DEGREES OF FLEXION
Results from prolonged kneeling or recurrent minor trauma to the anterior knee?
PREPATELLA BURSITIS
Prepatellar bursitis is AKA?
HOUSEMAIDS KNEE
Describes a condition related to irritation of remnants of embryological synovla tissue around teh patella?
PLICA SYNDROME
What activities are highly recommended after a TKA?
-STATIONARY CYCLING
-SWIMMING, WATER AEROBICS
-WALKING
-GOLF
-BALLROOM OR SQUARE DANCING
-TABLE TENNIS
What are the goals of intervention in the mod protection phase of a TKA?
-INCREASE STRENGTH AND MUSCULAR ENDURANCE OF KNEE AND HIP
-CONTINUE TO INCREASE KNEE ROM
-IMPROVE STANDING BALANCE
When does the moderate protection phase begin/end?
BEGINS AT 4 WEEKS
ENDS AT 8-12 WEEKS
Why should you avoid placing a pillow under the knee while lying supine after a TKA?
TO AVOID A KNEE FLEIXON CONTRACTURE
What is the risk of a TKR?
-WOUND HEALING PROBLEMS
-DEEP VEIN THROMBOSIS
Significant congruency of compotion of motion?
FULLY CONSTRAINED
Provides some degree of stability with little compromise of mobility; most common design used for TKA?
SEMICONSTRAINED
No adherent stability in the implant design; used primarily with unicompartmental arthroplasty?
UNCONSTRAINED
What degree is a normal Q angle?
10-15 DEGREES
What kind of bone is the patella?
SESMOID
True/False

The medial condyle is longer than the lateral condyle
TRUE
What kind of joint is the knee?
MODIFIED HINGE JOINT
What muscle SPECIFICALLY is the primary focus of quadriceps strengthening?
VASTUS MEDIALIS OBLIQUES (VMO)
What muscle group would you want to strengthen in order to help resolve patellofemoral pain?
QUADRICEPS
Tightness of what muscle can lead to patellofemoral compression?
TIGHTNESS OF THE HAMSTRINGS
A patella posture that is more inferior than normal is referred to as?
PATELLA BAJA
A patella posture that is more superior than normal is referred to as?
PATELLA ALTA
What is typically the underlying cause of anterior knee pain?
MECHANICAL DEVIATION OF PATELLAR TRACKING DURING KNEE FLEXION AND EXTENSION
When can patients begin CKC exercises after a meniscal repair?
8 WEEKS
What can you expect with a positive McMurray's test?
PAIN AND AN AUDIBLE OR PALPABLE SNAP OR POP
How do you test for a lateral meniscus tear when performing McMurray's test?
APPLY A VARUS FORCE WITH INTERNAL TIBIAL ROTATION
McMurray test?
A TEST USED TO REPRODUCE THE SYMPTOMS OF A TORN MENISCUS
Apley's compression/distraction test?
USED TO DIAGNOSE A MENISCAL/LIGAMENTOUS INJURY
Noncontact WB injuries of the menisci usually involve?
COMBINED FORCES OF KNEE FLEXION, ROTATION, COMPRESSION, AND SHEAR
What are the five main types of meniscal tears?
-HORIZONTAL TEARS
-LONGITUDINAL TEARS
-DEGENERATIVE TEARS
-FLAP TEARS
-RADIAL TEARS
The medial and lateral menisci serve as?
"EXTENSIONS OF THE TIBIA"

PROVIDE FOR RECEPTION OF THE FEMORAL CONDYLES ONTO THE SURFACE OF THE TIBIA
Functions of the meniscus?
-STABILITY
-SHOCK ABSORPTION
-LOAD TRANSMISSION
-NUTRITION
-LUBRICATION
-CONTROL OF MOTION
Bracing for knee support generally is organized into three distinct categories known as?
-PROPHYLACTIC
-REHABILITATIVE
-FUNCTIONAL
What is the most common ligament injury seen in the knee?
MCL SPAINS
Generally, full knee flexion can be achieved how long after PCL surgery?
2 MONTHS POST OP
What are common graft choices for reconstructing the PCL?
-MEDIAL GASTROCNEMIUS TENDON
-CENTRAL ONE-THIRD BONE-PATELLAR TENDON-BONE AUTOGRAFTS
-ACHILLES TENDON ALLOGRAFTS
What muscle group needs to be strengthened after a PCL injury?
QUADRICEPS
True/False

Isolated PCL injuries occur less often than isolated ACL injuries?
TRUE
True/False

After an ACL tear, conservative nonoperative Tx progresses at a faster pace.
TRUE
Generally, isokinetic examinations are reserved for what phase of recovery?
MODERATE AND MINIMUM PROTECTION PHASES
How should the tibia be positioned during a standing wall squat?
COMPLETELY VERTICLE TO PREVENT ANY ANTERIOR TRANSLATION OF THE TIBIA WHICH WILL STRESS THE NEW GRAFT
CKC exercises and progressive proprioceptive tasks are designed to stimulate the?
AFFERENT NEURAL INPUT SYSTEM
After an ACL reconstruction, when is immobilization usually discontinued?
5TH OR 6TH WEEK POST OP
After post op ACL reconstruction, when is a good time in the healing process to start propioceptive activities?
IN THE MODERATE PROTECTION PHASE
What muscle group would you want to focus on after an ACL reconstruction?
STRENGTHENING THE HAMSTRINGS AND HAVE CONTROL OF THE QUADRICEPS
True/False

Passive terminal knee extension is allowed after an ACL autograft reconstruction.
TRUE
True/False

Active open chain terminal knee extension is allowed after an ACL reconstruction.
FALSE

NOT ALLOWED BECAUSE THIS WILL CAUSE AN ANTERIOR TRANSLATION OF THE TIBIA WHICH WILL FURTHER STRESS THE NEW GRAFT.

PASSIVE TERMINAL KNEE EXTENSION HOWEVER, IS ALLOWED
Strengthening exercises after an ACL reconstruction?
ISOMETRICS OF THE HAMSTRINGS AND QUADS
Why is there less swelling in an MCL sprain (extra articular) over an ACL/PCL sprain (intracapsular)?
BECAUSE THE BLEEDING FROM THE INJURED TISSUES CAN EVACUATE THE AREA AND THE FLUID IS NOT RESTRAINED WITHIN THE JOINT CAPSULE
Removal of synovial fluid will often indicate what?
A CHRONIC MENISCUS LESION OR SYNOVITIS
A hemarthrosis will often require?
ARHTROCENTESIS (ASPIRATION OF FLUID WITHIN A JOINT)
Hemarthrosis?
BLOOD WITHIN A JOINT
How does an ACL sprain typically occur?
NONCONTACT, DECELERATION, CKC MOI.
What is a major risk of an allograft?
DISEASE TRANSMISSION
This procedure refers to using biologic tissue taken from another human body?
ALLOGRAFT
This procedure uses tissues from the body of the patient?
AUTOGRAFT
What motions must be avoided after an ACL autograft?
-ANTERIOR TRANSLATION OF THE TIBIA
-ROTATORY FORCES
How long does the minimum protection phase last for after an autograft?
13 WEEKS POST OP TO RETURN TO ACTIVITY
How long does the moderate-protection phase last for after an autograft?
7-12 WEEKS POST OP
How long does the maximum-protection phase last after an autograft?
APPROX 6 WEEKS POST OP
How long will a graft be most fragile after surgery?
2 MONTHS
Once a graft is harvested and surgically routed within the knee, it begins a gradual process of __________ ____________ over the first _____ to _____ weeks?
-AVASCULAR NECROSIS
-6-8 WEEKS
Chronic overuse injuries/anterior posterior knee pain?
-PF PROBLEMS
-PLICA SYNDROME
-OSGOOD SCHLATTERS
-PATELLAR TENDONITIS
-BAKERS CYST
Two types of patellar Fx's?
-STELLATE
-OSTEOCHONDRAL
Two types of tibial FX's?
-AVULSION OF THE LAT TIBIAL CONDYLE
-AVULSION OF THE INTERCONDYLAR EMINENCE
Diagnosis of DJD?
-PAIN WITH WB
-SWELLING
-PAIN WITH FULL FLEXION
-LIMITED ROM
Etiology of DJD?
-GENETIC COMPONENT
-PREVIOUS MENSCIAL PATHOLOGY
-GENU VARUM/VALGUM
Diagnosis of LCL injuries?
-VARUS STRESS TEST IN EXTENSION
-PALPATION FLEX KNEE TO 90 DEGREES AND ER OF HIP
Etiology of LCL injuries?
-HYPEREXTENSION/VARUS FORCE
-SEVERE INJURIES INCLUDE DAMAGE TO PCL
Function of the LCL?
-PREVENT EXCESSIVE VARUS FORCE AT THE KNEE
-SECONDARY ANTERIOR AND POSTERIOR DRAWER
-PREVENTS ER
Etiology of MCL injuries?
-VALGUS AND ER FORCE
-ACL AND MENISCUS CAN ALSO BE INJURED
Function of the MCL?
-ABDUCTION AND ER OF TIBIA
-SECONDARY ANTERIOR DISPLACEMENT
-FIBERS SLACKEN IN FLEXION
Diagnosis of PCL injuries?
-POSTERIOR DRAW
-POSTERIOR SAG
-REVERSE PIVOT SHIFT
-POSTEROLATERAL DRAWER TEST
Etiology of PCL injuries?
-HYPERFLEXION
-DASHBOARD INJURIES
Function of the PCL?
-PREVENT EXCESSIVE POSTERIOR TRANSLATION OF THE TIBIA ON A FIXED FEMUR
-ER OF THE TIBIA FLEXED TO 90 DEGREES
True/False

ACL injuries are usually associated with meniscal lesions but isolated tears are possible.
TRUE
What are the predisposing factors of ACL injuries?
-NARROW INTERCONDYLAR NOTCH
-TIBIAL ROTATION
-HYPERMOBILITY
-ALIGNMENT OF THE FOOT AND WIDTH OF THE PELVIS IN FEMALES
What is the etiology of ACL injuries?
-DECELERATION AND PIVOTING
-SEVERE ROTARY INJURIES
-HYPEREXTENSION
Function of the ACL?
-PREVENT EXCESSIVE ANTERIOR TRANSLATION OF THE TIBIA
-IR OF TIBIA WITH KNEE FLEXED TO 90 DEGREES
Types of meniscal tears?
-LONGITUDINAL
-VERTICAL LONGITUDINAL
True/False

Medial mensicus tears are commonly seen in stable knees.
TRUE
Why are medial mensicus tears more common than lateral tears?
BECAUSE THE MEDIAL MENISCUS IS ANCHORED MORE SECURELY TO THE MEDIAL TIBIAL PLATEAU
True/False

Lateral meniscus tears are more common than medial meniscus tears?
FALSE

MEDIAL TEARS ARE MORE COMMON
MOI of mensical injuries?
-MICRO TRAUMA
-DEGENERATIVE TEARS
(DUE TO DIMINISHED BLOOD FLOW
VARUS/VALGUS FORCES)
Function of the meniscus?
-IMPROVE THE CONGRUENCY BETWEEN THE TIBIA AND FEMUR
-DECREASE LOAD FORCES ON ARTICULAR CARTILAGE
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