04 Knee Special Tests: Patellofemoral Flashcards Preview

7232 Ortho > 04 Knee Special Tests: Patellofemoral > Flashcards

Flashcards in 04 Knee Special Tests: Patellofemoral Deck (51):
1

Who do you use PF tests on?

all patients

2

What does the medial glide test?

superficial fibers of the lateral retinaculum

3

medial glide procedure

- both thumbs on lateral patella
- push medially 3x

4

medial glides: normal

- 2 quadrants
- thumb should end up where middle of patella started

5

medial glides: hypermobile/hypomobile

- more than 2 quadrants = hypermobile
- less than 2 quadrants = hypomobile

6

What does the lateral glide test?

superficial fibers of the medial retinaculum

7

lateral glide procedure

- using fingers on medial side, push laterally

8

Why do you need to be careful with lateral glides?

99% of patellas dislocate/subluxate laterally

9

What are the other names for lateral glide?

- apprehension test
- Fairbanks test

10

What do caudal glides test?

quad tendon

11

caudal glide procedure

- web space of hand on superior pole
- forearm down
- 3 caudal glides

12

Why does the forearm need to be down for caudal glides?

If you don't, you're pushing down on the suprapatellar synovium, which is painful

13

What are you feeling for with caudal glides?

- mobility
- bilateral comparison
- comparing to other knees you've felt

14

caudal glide rhythm

down-relax, down-relax, down-relax

15

For caudal glides, what do you need to make sure the pt doesn't do?

push caudally while contracting the quads
- passive test
- that would hurt

16

norms for caudal glides

none

17

What do cephalic glides test?

infrapatellar tendon

18

cephalic glides: procedure

- web space on inferior pole above fat pad
- forearm down
- same as caudal glide, but push to the head

19

cephalic glides: Why do you keep the forearm down?

- If you don't you'll push on the infrapatellar fat pad
- aggravate Hoffa's syndrome

20

norms for cephalic glides

10 mm movement

21

Why do you remove the bolster to test the deep fibers of the retinaculum?

- need to loosen deeper structures so you can tilt the patella
- knee is in most lax position

22

What do lateral tilts test?

deep fibers of medial retinaculum

23

lateral tilt procedure

- thumbs on lateral anterior border of patella
- slight medial glide
- use thumb to push toward the floor
- fingers pull to ceiling
- repeat 3x

24

Why do you do a medial glide for lateral tilts?

to get the fingers under the odd facet

25

How are patellar tilts named?

for the position of the part of the patella that's going toward the femur

26

Normal movement for lateral tilts

15˚

27

What does the medial tilt test?

deep fibers of lateral retinaculum

28

medial tilt procedure

- fingers on medial anterior patella
- slight lateral glide
- pull up with thumbs, push down with fingers

29

Why do you do a slight lateral glide for medial tilts?

to get thumbs under lateral facet

30

normal movement for medial tilts

15˚

31

moving patellar apprehension test: part 1

- leg off the table
- lateral glide to patella
- flex knee to 90˚ and repeat 3x

32

What are you looking for on the moving patellar apprehension test?

- pain or apprehension
- if negative, don't need to do part 2

33

moving patellar apprehension test: part 2

- same as part 1
- give medial glide to patella
- flex and extend
- repeat 3x

34

moving patellar apprehension test: part 2

Why do you use a medial glide?

manually reduces patella and allows it to track properly on the femur

35

What does it tell you if part 2 of the moving patellar apprehension test reduces their pain?

- patellar subluxation
- good sign for treatment interventions (taping, bracing, exercise, will probably help)

36

passive tracking test position

- sitting
- tripod

37

Why tripod position for passive tracking test?

- most motion occurs when you assess the patella from the last 30˚
- tight hamstrings can prevent terminal extension

38

passive tracking test: PT position

- directly in front
- looking at patella

39

passive tracking test procedure

- passively raise the knee 3x
- patella should move in a C (left) or reverse C (right) shape

40

What is the passive tracking test assessing?

- noncontractile tissue
- femoral trochlea for potential dysplasia

41

In the passive tracking test, what would it mean if the patella moved and straight laterally?

- tight lateral superficial retinaculum or
- weaker/stretched medial structures

**may require manual therapy, taping, and/or bracing

42

active tracking OKC: position

- same as for passive tracking
- have them actively extend 3x
- observe tracking pattern

43

What is the active tracking OKC test assessing?

- contractile tissue
- patellar groove

44

What does it mean if the patella moves normally passively but laterally during active movement?

- muscle imbalance
- will need a combo of manual therapy and exercise

45

active tracking CKC: 3 parts

1. squat and observe patellar movement
2. squat with 3 fingers over patella
3. squat while palpating soft tissue (diamond shape with hands)

46

In the active tracking CKC test, what are you checking for when you put 3 fingers over the patella? Why?

- grating or crepitus
- If there's chondral damage, want to avoid in rehab by doing short arc exercises

47

What are you palpating for on the third step of the active tracking CKC test?

soft tissue around the knee
- tendonitis
- plica syndrome
- ITB syndrome
- retinacular tear
- Hoffa's syndrome

48

What is the superior hand palpating in the active tracking CKC test?

plica and quad tendon near the ITB

49

What is the inferior hand palpating in the active tracking CKC test?

- plica
- retinaculum
- infrapatellar area

50

Where are the thumbs during the active tracking CKC test (part 3)?

over ITB and retinaculum

51

What types of tissue are you assessing in the active tracking CKC test?

both contractile and noncontractile tissue