Care and Prevention Worksheets 20 & 21
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City Colleges of Chicago, Malcolm X *
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Course
MISC
Subject
Medicine
Date
Jan 9, 2024
Type
Pages
5
Uploaded by DoctorWaterBuffalo19034
NAME ______________Ryan LaClair________________
SECTION__________
CHAPTER 20 WORKSHEET
THE KNEE AND
RELATED
STRUCTURES
MATCHING:
Match the
structure with the
appropriate name.
____H____ 1. Anterior
cruciate
____A____ 2. Femur
_____E___ 3. Fibula
____D____ 4. Lateral
collateral
_____B___ 5. Lateral
condyle
____C____ 6. Lateral
meniscus
_____M___ 7. Ligament of
Wrisberg
_ _ _ _ J _ _ _ _ 8 . M e d i a l
collateral
______F__ 9. Medial condyle
_____I___10. Medial meniscus
___G_____11. Posterior cruciate
___L_____12. Tibia
____K____13. Tibial tuberosity
MATCHING:
Match the condition with the correct response.
_____D__ 14. Anterior cruciate tear
A. Cutting motion while running
___F____ 15. Baker's cyst
B. Apophysitis of tibial tubercle
__H_____ 16. Chondromalacia
C. Cyclist's knee
___E____ 17. Iliotibial band syndrome
D. "Pop" with immediate disability
__I_____ 18. Knee plica
E. Runner's knee
___A____ 19. Longitudinal meniscal tear
F. Semimembranous bursa
___B____ 20. Osgood-Schlatter disease
G. Central axis for rotation of knee
___C____ 21. Pes anserinus tendinitis
H. Abnormal patellar tracking
___G____ 22. Posterior cruciate ligament
I. Infrapatellar synovial fold
SHORT ANSWER
: Answer the follow questions with a brief response.
23. What is the main artery carrying blood to the knee? What two nerves carry impulses to the knee?
Popliteal artery; tibial and common peroneal nerves
23.
When inspecting the knee for joint effusion, explain the different types of effusions you might encounter and the
different fluids which could be present?
Swelling
intracapsular; inside the joint capsule. Swelling extracapsular; outside the joint capsule. Synovial fluid
and blood can be present. Blood in the joint is known as hemarthrosis
25. If a positive anterior drawer test occurs at 0 degrees of tibial rotation, the test should be repeated at. . .
30 degrees internal rotation, 15 degrees external rotation
26. Why has the Lachman test become the preferred test by many over the drawer test at 90 degrees of flexion?
It does not force the knee into the 90 degree angle, which minimizes pain, and it also reduces risk of hamstring
contraction that can potentially mask the extent of injury
27. In performing the McMurray stress test, if the tibia is placed in internal rotation the __lateral tears _of the
meniscus_ is being tested. If the tibia is placed in external rotation during the McMurray test, the _medial tears
of the meniscus_ is being tested.
28. How is the patellar apprehension test performed?
With the knee and patella relaxed, the examiner pushes patella laterally, there will be sudden apprehension from the
patient at the point when the patella begins to dislocate.
29. The anterior cruciate ligament is most vulnerable to injury when the. . .
When the tibia is externally rotated and the knee is in a valgus position
30. In meniscal tears close to the periphery, what might you expect for the chances of complete healing? Why?
The injury can heal completely if the stress to the area is kept to a minimum. This is because the periphery is close
to the coronary ligament and a blood supply.
31. How can one injure their infrapatellar fat pad?
Direct blows, it can become wedged between knee articulations, and irritated by chronic kneeling presssures.
LISTING
Of the following stress tests, indicate what structures are tested.
32. Valgus test- medial collateral ligament
33. Varus test- Lateral collateral ligament
34. Anterior drawer test- anterior cruciate ligament
35. McMurray test- menisci and loose bodies within the knee
36. Apley compression test- menisci
37. Apley distraction test-collateral ligamentous tears from capsular and menisci tears
38. Patellar apprehension test-tendency for subluxation and dislocation of patella
39. Pivot-shift test-anterior cruciate ligament ; anterolateral rotary instability of ACL
40. Flexion-rotation test-anterior cruciate ligament
41. Posterior "sag" test- posterior cruciate ligament
ESSAY
42-44.
What is the mechanism of a medial meniscal injury, and why is the medial meniscus more likely to be
injured?
The medial meniscus is more likely to be injured than the lateral meniscus because the lateral meniscus does
not attach to the capsular ligament and is therefore more mobile during knee movement. The medial
meniscus peripherally to the tibia and the capsular ligament by the coronary ligament, and these
attachments subject the medial meniscus to disruption from valves and torsional forces.
INJURY ASSESSMENT
45-47.
A football player was carrying the ball up the field when he set his right foot in the sod and turned to his
left to avoid an oncoming tackler. The defensive player tackled him hitting his right leg. The player went down
with a knee injury. Do an on-the-field evaluation for this mechanism.
Asses nuerovascular function, preform valgus stress test, try and get patient up and to athletic training table.
48-50.
An athlete had received arthroscopic surgery for an anterior cruciate injury. The immobilization is
removed, swelling has been controlled, and pain is minimal. What exercises can be started, and what goals will
you want to attain before you allow this athlete back into practice?
NAME ______Ryan LaClair________________________
SECTION__________
CHAPTER 21 WORKSHEET
THE THIGH, HIP, GROIN, AND PELVIS
MATCHING:
Match the structure with the
a p p r o p r i a t e
name.
____I____ 1. Acetabulum
____H____ 2. Anterior-superior spine
____G____ 3. Iliac crest
___E_____ 4. Ischial tuberosity
____F____ 5. Obturator foramen
____B____ 6. Posterior-inferior spine
____A____ 7. Posterior-superior spine
__K______ 8. Pubic crest
____L____ 9. Ramus of ischium
____C____ 10. Sciatic notch
___D_____ 11. Spine of ischium
___J_____ 12. Superior ramus of pubis
MATCHING
:
Match the letter of the condition with
t h e c o r r e c t
response.
_____B__ 13. Hip pointer
A. Hip contractures
____E___ 14. Legg-Calvé-Perthes disease
B. Caused by blow to iliac crest
__D_____ 15. Myositis ossificans
C. Caused by repetitive stress to pubic
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____C___ 16. Osteitis pubis
symphysis
____F___ 17. Renne's test
D. Cartilage tissue formed in muscle
____A___ 18. Thomas test
E. Avascular necrosis of femoral head
F. Iliotibial band tightness
SHORT ANSWER:
Answer the following questions with a brief response.
19. What is the function of the quadriceps femoris muscle groups?
They all extend the knee; rectis femoris also flexes the hip
20. What two nerves innervate the quadriceps and hamstrings
Femoral and Sciatic
21. How would you manage myositis ossificans?
The bony formation must be fully ossified before it is removed after one year
22. Why do most fractures occur at the middle third of the femur instead of at the ends?
The anatomical curve is in the midsection which is the weakest section; area receives more blows.
24. What are the functions of the pelvis?
The supports the spine and truck and transfers the weight to the lower limb; it also serves to protect the pelvic
viscera and is a point for muscular attachments
24. Name the capsular ligaments holding the femoral head into the hip socket.
The iliofemoral, pubocapsular, and ischiocapsular ligaments
25. What are some symptoms of Legg-Calvé-Perthes disease?
Limping, Pain in the groin that is sometimes referred to the abdomen or knee.
26. How would you treat osteitis pubis?
Rest; anti-inflammatory (oral medication), gradual return to play
27. What usually accompanies a fracture of the femur as a result of the pathology and pain?
Shock
LISTING
List the four classes of muscles in the thigh.
28. Quadriceps
29. Hamstrings
30. Abductors
31. Adductors
List three things one can do to aggravate a thigh contusion.
32. Massage directly over contusion
33. Use superficial heat or ultrasound on the are
34. “run-off” the contusion
List the five classic signs of a fractured femur.
35. Deformity; thigh rotated outward
36. Loss of function
37. Pain and point tenderness
38. Shortened thigh; bone displacement
39. Swelling of soft tissue
ESSAY
40-41. Describe how to determine true leg-length discrepancy in an athlete.
Anatomically- shortening may be equal throughout the limb or localized with the femur or lower leg.
Apparent/Outwardly- lateral pelvic tilt, for a flexion or adduction abnormality/defomrity
Functionally- Different in leg length due to deformity that cant be fixed.
42-44. How would you evaluate and examine an athlete for Femoral Anteversion and Retroversion?
Femoral Retroversion is a condition characterized by the femoral neck being less than 8 degrees posterior to the long
axis of the femur, this condition is commonly seen with individuals who walk in a pronounced toe-out style.
Craigs test is used to evaluate for femoral retroversion; the patient will be lying prone with their affected leg 90
degrees flexion; from here the examiner will locate the posterior aspect of the greater trochanter and passively
rotate the hip laterally and medially until it is in its most later position, once here
the examiner will use a
goniometer to measure the angle between the vertical axis of the treatment table to and longitudinal axis of the
lower leg. If the angle is less than 8 degrees, the conclusion is positive for femoral retroversion. Similarily,
femoral anteversion ic characterized by individuals who walk toe-in style. When the same test is repeated, a
positive for femoral anteversion will be greater than 15 degrees.
INJURY ASSESSMENT
44-47. A lacrosse player has received a severe blow to the quadriceps by an opponent's knee. There is marked pain
and swelling, and the athlete is having difficulty walking without a limp. How would you manage this acute
condition and what follow-up care would you do?
48-50. A female distance runner has come into the training room complaining of pain on the lateral side of her hip
just above the greater trochanter. Identify the evaluation steps and tests that you would do to determine what her
condition may be.