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CC Sept 2015 Collateral Ligament Injury

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echoecho's version from 2015-10-15 02:43

Section

Question Answer
The knee is a large, weight-bearing joint that derives the majority of its stability from what?muscles and ligaments that surround it
List the 2 ligmanets that provide major support?1) medial collateral ligament (MCL) or tibial collateral ligament on the medial side of joint 2) lateral collateral ligament (LCL) or fibular collateral ligament on the lateral side of the joint
Describe the MCL (medial collateral ligament)?1) extends in 2 layers from the medial femoral condylel to the medial tibial condyle 2) superficially, it is a broad, triangular ligament with its apex extending posteriorly over the posterior aspect of the medial femoral condyle and joint line 3) more deeply, it is a thick structure that blends with the capsule and has an attachment to the medial meniscus
Describe the LCL (lateral collateral ligament)?the LCL is a cordlike structure with its main attachments stretching from the lateral femoral condyle to the fibula 2) unlike the MCL, it does not blend with the capsule
Unlike the MCL, the LCL does not blend with the _____?capsule
While the MCL provides stablization to the knee during ____ (valgus vs. varus) stress, the LCL provides stablization during ______ (valgus vs. varus) stress?valgus; varus
Classify the degree of ligamentous injury categories?1) First degree (fiber disruption with no demonstrable instability or laxity) 2) Second degree (some loss of function but no noticeable laxity) 3) Third degree (obvious laxity)
Third degree injuries may be further divided based upon the amount of opening of the joint surface on examination. List the grades?1) grade 1 (<5 mm) 2) grade II (5-10 mm) 3) grade III (> 10 mm)
Patients with injury will report _____, but activity s typically only affected in patients with ___degree grade II and grade III injuries?pain; third
If effusion is present, damage to the ______ is suggested?capsule
How would one test the integrity of the MCL and LCL?1) valgus and varus stresses are applied to the knee while it is flexed to 30 degrees 2) if there is excessive opening of the knee joint, particularly in pts w/ a hx of trauma to the area and tenderness to palpation over the course of the ligament or at its insertions, disruption of the collateral ligament should be suspected
*** There is no systematic review has addressed the diagnostic accuracy of the ____ _____ findings in patients w/ collateral ligament damage?physical examination
Collateral ligament damage may occur in the setting of other injuries, such as the so-called "unhappy triad"? What is this?unhappy triad is tears of the MCL, medial meniscus and anterior cruciate ligament
Describe how the Thessaly test is performed?with the patient standing flat-footed on the affected leg, while supported by the examiner, the pt rotates internally and externally with the joint flexed at 20 degrees. Joint line pain or a locking sensation may indicated a meniscus tear, not ligamentous injury
MCL injuries usually occur when the foot is planted and ____ (valgus vs. varus) force is applied to the _____ (lateral vs. medial) side of the knee?valgus; lateral
MCL injuries may also occur with a _____ motion of the knee?twisting
What is the treatment of first and second degree injuries?initial immobilization and use of crutches, followed by gradual mobilization by physical therapists
With severe injuries (3rd degree, especially when laxity is present), what is indicated?orthopedic evaluation for repair
LCL injuries may occur when a ____ (valgus vs. varus) force is applied to the ____ (lateral vs. medial) side of the knee?varus; medial
What nerve should be assessed for function in the region of the LCL? What are the physical exam findings?peroneal nerve; weakness in dorsiflexion of the foot and toes
Treastment of LCL injuries is similiar to that of MCL injuries, true or false?true
*** Summary: To test the integrity of the collateral ligaments, valgus and varus stresses are applied to the knee while it is flexed to ____ degrees?30
*** Summary: Medial collateral ligament (MCL) injuries usually occur when the foot is planted and ____ forces are applied to the ____ side of the knee?valgus; lateral
*** Summary: Lateral collateral ligament (LCL) injuries usually occur when a ____ force is applied to the ____ side of the knee?varus; medial
*** Summary: Lateral collateral ligament (LCL) injury may be associated with injury to the _____ nerve?peroneal
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