Kin 2236 Final Exam 2025 | All Questions and
Correct Answers | Graded A+ | Verified
Answers | Just Released
What could also happen in a subluxed or dislocated patella ---------CORRECT
ANSWER------------------ this is when the patella moves, but a corner of the femur
could also be chipped off
- should still send for xray if you suspect femur has chipped off
When does patellar dislocation occur? ---------CORRECT ANSWER-----------------
occurs when the patella moves out of its groove laterally onto/over the femoral
condyle so its stuck there (medially is very rare)
MOI for acute patellar dislocation ---------CORRECT ANSWER------------------ Forceful
knee rotation (tibia ER/Femur IR) +/- forceful quads contraction bc it pulls patella
up and then twists it
- Knee usually near full extension (out of trochlea)
- +/- laterally directed force
Symptoms and Signs of Patellar Dislocation ---------CORRECT ANSWER-----------------
Symptoms:
- may report feeling knee "shift", "move or "pop-out"
- Pain ++ until reduced
,- fast swelling bc you are tearing out retinaculum
Signs:
- loss of knee function (if still dislocated)
- tenderness over medial border of patella
-- because they tear out
- positive lateral apprehension test
-- slide knee cap laterally to get apprehension because they feel its going to
dislocate
- Need to rule out ACL bc they both have hemarthrosis (75% of the time its ACL)
What do you do if the patella is dislocated? ---------CORRECT ANSWER-----------------
- Slightly flex the hip and slowly extend the knee
- usually the patella relocates
-- if it does not, do not force the patella medial
- there may be some associated fractures (back of the patella, lateral femoral
condyle)
Facts about the LCL ---------CORRECT ANSWER------------------ LCL Injuries are less
common but more complicated secondary to the number of structures
- usually VARUS loading +/- hyperextension
- most contribution at 20-30 degrees of knee flexion
- may include IT band, lateral hamstrings, and/or popliteus
- can be complicated bc usually other tissues tear with it
- injury to the lateral side
,- always check the other side bc it supports that side (see if injured)
Facts about the MCL ---------CORRECT ANSWER------------------ 40% of all severe
knee injuries involve the MCL, making it the most frequently injured knee
structure
-- get hit a lot from outside which open/stretches inert tissues
- VALGUS force with or without rotation
- Often occurs in isolation
Signs and Symptoms of Collateral Ligament Sprains ---------CORRECT ANSWER------
------------ Reports of pain over structure
- Swelling: Timing
(LCL = capsular or non-capsular so it may or may not swell; MCL is probably going
to swell; ACL swells quick)
-- minimal swelling LCL only -- more if soft tissue injury
-- slow localized swelling medial side (Grade 2+)
--- capsular effusion (>8hrs)
-- Stress testing: in the same direction of MOI!
--- valgus stress for MCL, varus stress for LCL
---- grade 1: pain with no laxity
---- grade 2: pain with laxity and distinct end point
---- grade 3: pain variable with gross laxity and no end point
, Stress testing of the knee ---------CORRECT ANSWER------------------ Unlock knee and
assess for stability
-- do it in 20-30 degrees to rule out muscles and test ligaments
-- push in from one side or the other and assess the other side for laxity/blocks
--- varus (LCL)
--- valgus (MCL)
ACL injuries ---------CORRECT ANSWER------------------ The ACL hurts on lateral joint
line (some people think its LCL bc of this but its usually ACL)
- Occurs with either contact or non-contact (60-80%) mechanism
- Usually during cutting or single leg landing
-- may occur in isolation or in combination with injury
--- 75% sustain meniscal injuries
--- 80% have bone bruise on lateral joint line or (segond fracture)
- 2-8x higher injury rate in females due to hip and knee angles
MOI for ACL injuries ---------CORRECT ANSWER------------------ Valgus after MCL -
usually with contact
- Deceleration/Internal Rotation - non-contact
- Protected in box, straight hyperextension should not tear AC:
-- can tear ACL in hyperextension but NOT isolation
--- if torn, there will be other things that injure as well
- Quads active - anterior tibial translation
Correct Answers | Graded A+ | Verified
Answers | Just Released
What could also happen in a subluxed or dislocated patella ---------CORRECT
ANSWER------------------ this is when the patella moves, but a corner of the femur
could also be chipped off
- should still send for xray if you suspect femur has chipped off
When does patellar dislocation occur? ---------CORRECT ANSWER-----------------
occurs when the patella moves out of its groove laterally onto/over the femoral
condyle so its stuck there (medially is very rare)
MOI for acute patellar dislocation ---------CORRECT ANSWER------------------ Forceful
knee rotation (tibia ER/Femur IR) +/- forceful quads contraction bc it pulls patella
up and then twists it
- Knee usually near full extension (out of trochlea)
- +/- laterally directed force
Symptoms and Signs of Patellar Dislocation ---------CORRECT ANSWER-----------------
Symptoms:
- may report feeling knee "shift", "move or "pop-out"
- Pain ++ until reduced
,- fast swelling bc you are tearing out retinaculum
Signs:
- loss of knee function (if still dislocated)
- tenderness over medial border of patella
-- because they tear out
- positive lateral apprehension test
-- slide knee cap laterally to get apprehension because they feel its going to
dislocate
- Need to rule out ACL bc they both have hemarthrosis (75% of the time its ACL)
What do you do if the patella is dislocated? ---------CORRECT ANSWER-----------------
- Slightly flex the hip and slowly extend the knee
- usually the patella relocates
-- if it does not, do not force the patella medial
- there may be some associated fractures (back of the patella, lateral femoral
condyle)
Facts about the LCL ---------CORRECT ANSWER------------------ LCL Injuries are less
common but more complicated secondary to the number of structures
- usually VARUS loading +/- hyperextension
- most contribution at 20-30 degrees of knee flexion
- may include IT band, lateral hamstrings, and/or popliteus
- can be complicated bc usually other tissues tear with it
- injury to the lateral side
,- always check the other side bc it supports that side (see if injured)
Facts about the MCL ---------CORRECT ANSWER------------------ 40% of all severe
knee injuries involve the MCL, making it the most frequently injured knee
structure
-- get hit a lot from outside which open/stretches inert tissues
- VALGUS force with or without rotation
- Often occurs in isolation
Signs and Symptoms of Collateral Ligament Sprains ---------CORRECT ANSWER------
------------ Reports of pain over structure
- Swelling: Timing
(LCL = capsular or non-capsular so it may or may not swell; MCL is probably going
to swell; ACL swells quick)
-- minimal swelling LCL only -- more if soft tissue injury
-- slow localized swelling medial side (Grade 2+)
--- capsular effusion (>8hrs)
-- Stress testing: in the same direction of MOI!
--- valgus stress for MCL, varus stress for LCL
---- grade 1: pain with no laxity
---- grade 2: pain with laxity and distinct end point
---- grade 3: pain variable with gross laxity and no end point
, Stress testing of the knee ---------CORRECT ANSWER------------------ Unlock knee and
assess for stability
-- do it in 20-30 degrees to rule out muscles and test ligaments
-- push in from one side or the other and assess the other side for laxity/blocks
--- varus (LCL)
--- valgus (MCL)
ACL injuries ---------CORRECT ANSWER------------------ The ACL hurts on lateral joint
line (some people think its LCL bc of this but its usually ACL)
- Occurs with either contact or non-contact (60-80%) mechanism
- Usually during cutting or single leg landing
-- may occur in isolation or in combination with injury
--- 75% sustain meniscal injuries
--- 80% have bone bruise on lateral joint line or (segond fracture)
- 2-8x higher injury rate in females due to hip and knee angles
MOI for ACL injuries ---------CORRECT ANSWER------------------ Valgus after MCL -
usually with contact
- Deceleration/Internal Rotation - non-contact
- Protected in box, straight hyperextension should not tear AC:
-- can tear ACL in hyperextension but NOT isolation
--- if torn, there will be other things that injure as well
- Quads active - anterior tibial translation
