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23 Cards in this Set
- Front
- Back
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List four types of chronic knee conditions
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Tumor
Infection Arthritis Overuse syndrome |
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List three examples of overuse syndrome
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Tendonitis
Anterior knee pain (chondromalacia) Bursitis |
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List three types of bursitis
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Prepatellar bursitis
Iliotibial bursitis Pes anserine bursitis |
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Knee pain is mimed by what other pains? x5
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Hip pain
Lumbar pain Vascular pain Radiculopathy pain Sympathetically mediated pain |
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What are the components to a knee exam? x6
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Ligament test
Inspection during stance/gait Meniscus test Patellar femoral test ROM Effusion |
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List the five types of ligament tests and include which ligament is being tested.
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Lachman's (ACL)
Anterior Drawer test (ACL) Posterior Drawer test (PCL) Medial (Valgus) Lateral (Varum) |
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Knee effusion
- normal amount - increased by what? - what causes hemarthrosis (blood in effusion) |
2-5 cc's
OA and Infection Trauma |
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What is the an IMPORTANT basic principle to apply during a knee exam?
Why apply this? |
Always examine the OPPOSITE knee before the symptomatic one.
This will give a better idea of what you expect would be normal. |
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Anterior Cruciate injury
- how common - population group most affected - associated with what other injury? |
Very common especially in sports
Female athletes Meniscus and ligament damage |
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Posterior Cruciate injury
- how common - most common mechanism - associated with what |
not as much as ACL injuries
direct blow to knee injury to popliteal artery |
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ACL and PCL workup:
- for surgical planning - if vascular injury |
MRI
Doppler Arteriogram Vascular consult |
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Meniscus tests x2
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McMurray's (standard)
Appley's Grinding test (uncommon) |
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Describe the Biophysical process associated with cartilage compromise.
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Collagen network fracture
Unraveling of PG |
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Describe the Biochemical process associated with cartilage compromise.
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Reduction of Inhibitors
Proteolytic Enzymes increase |
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An osteoarthritic joint would show an increase of what? x2
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Collagen turnover
Water |
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An osteoarthritic joint would show a decrease in what?
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PG
HA size HA concentration Aggrecan's lost |
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Hyaluronan's Role
- primary role - Increases x2 - inhibits x3 - additional roles x2 |
Viscoelasticity in synovial fluid
Condroitin sulfate + ECM PG loss Invasion of inflammatory cells Nociceptors Antioxidant Alters immune cells (slows down lymphocytes) |
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How does the synovial fluid respond to a fast hard impact?
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Slight unraveling makes it act as a shock absorber.
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How does the synovial fluid respond to slow, constant impact?
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Completely unravels becoming a lubricant
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OA:
- Associated with what in knee |
Genu Varum
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Treatment for OA in order
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Non-pharmacological
(excersize, stretch, diet) Acetominophen Viscosupplementation COX-2 inhibitors Steroid shots? + If GI risk, NSAIDs + GI agent IF no risk, low dose NSAIDS Surgery |
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What are the surgery options for OA in the knee?
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Knee effusion
Unilateral Arthroplasty TKR |
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Total knee replacement
- what is sacrificed - what makes it a constrained type |
ACL
If there is ligament damage |
