2. Knee Tests & Disorders Flashcards Preview

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Flashcards in 2. Knee Tests & Disorders Deck (61):
1

Medial mensiscus palpation

Palpable in IR; Pain with ER if injured

2

Lateral Collateral Ligament Palpation

Palpable in Tailor's position

3

(Common) Peroneal/Fibular Nerve

Behind fibular head; posterior & lateral branches

4

Valgus Stress Test of Knee

Tests for instability of MCL; tests for sprain of MCL. Apply Valgus pressure (try to force leg into knock-kneed position)

5

Varus Stress Test of Knee

Tests for instability of LCL. Apply Varus pressure (try to force leg into bow-legged position)

6

Anterior Drawer Test

Tests ACL instability by pulling tibia anteriorly; if tibia can be pulled forward, ACL is not intact

7

Posterior Drawer Test

Tests PCL instability by pushing tibia posteriorly; if tibia can be pushed back, PCL is not intact

8

Lachman Test

Tests ACL instability by pulling tibia anteriorly; if tibia can be pulled forward, ACL is not intact

9

Modifid Lachman Test

Hang lower leg off table; Use table to stabilize upper leg. Tests ACL instability by pulling tibia anteriorly; if tibia can be pulled forward, ACL is not intact

10

Pivot Shift Test

Tests ACL instability; Valgus stress with IR; Perform in ext and at 30; Difficult test used by orthopaedists

11

Apply's Compression (Grind test)

Tests meniscal tears; Place downward pressure on the ankle and IR/ER; Pain w/ IR = Lat mensiscus tear; Pain w/ ER = Med meniscus tear; Also painful with injured capsule & ligaments

12

Apply's Distraction

Tests capsule and ligament sprains; Pull ankle upward and IR/ER; Pressure taken off meniscus; Pain w/ IR = lat side; pain w/ ER = med side

13

McMurray's Test

PRIMARY MENISCUS TEST!!! Passively flex hip & knee and ER, then passively extend hip and knee in IR & pull knee lat; CLICKING & PAIN INDICATIVE OF MENISCUS TEAR

14

Patella Crunch Test (Clarke's)

Tests for Patellofemoral Syndrome; 1) Patient contracts quad; 2) Patient contracts quad while provider applies slight pressure; 3) Patient contracts quad while provider applies more distal pressure

15

Apprehension Test of Knee

Attempt to displace patella laterally; Positive = pain & fear of dislocation

16

Knee Effusion Test

Milk edema to one side and release

17

Ballotable Test

Push down on patella and watch it float up; incative of edema

18

Bounce Home Test

AWEFUL TEST!!! DON'T EVER DO THIS!!! Place patient leg into 30 flex; as s/he relaxes, drop leg into extension and watch for it to bounce back

19

Quadricep Muscle Contusion - Mechanism

Mechanism = Direct blows

20

Quadricep Muscle Contusion - S/Sx

S/Sx = pain, edema, ecchymosis, decreased knee ext

21

Quadricep Muscle Contusion - Complication

Complication = Myositis Ossificans

22

Myositis Ossificans

Development of bone in muscle due to calcification during inflam. process; Develops from blood pooling close to bone; Start massaging quickly to push blood away from area of injury

23

Quadricep Muscle Strain - Mechanism

Mechanism = Forceful overstretch or contraction

24

Quadricep Muscle Strain - S/Sx

S/Sx = point tender; edema; spasm; pain on extreme flex & resistive ext

25

MCL Sprain - Mechanism

Mechanism = DIRECT BLOW TO LAT SIDE OF LEG; QUICK CHANGE OF DIRECTION; IR of femur; ER of tibia;

26

MCL Sprain - S/Sx

S/Sx = Pain at MCL; hemarthrosis; decreased RoM; (+) Valgus stress test; Med meniscus and capsule may also be injured

27

LCL Sprain - Mechanism

Mechanism = IMPROPER LANDING from a jump; DIRECT BLOW TO MEDIAL SIDE OF LEG; IR of tibia; ER of femur;

28

LCL Sprain - S/Sx

S/Sx = Pain at LCL; minimal edema because it is outside of the capsule; (+) Varus stress test

29

ACL Sprain - Mechanism

Mechanism = RAPID DECELERATION COMBINED WITH IR; Hyperextension; POSTERIOR BLOW TO TIBIA (such as at dog parks); Anterior blow to femur;

30

ACL Sprain - S/Sx

S/Sx = Sharp pain, audible pop, then fall; Sensation that "whole knee just moved"; (+) Anterior drawer test; (+) Lachman's test

31

PCL Sprain - Mechanism

Less common than ACL sprains; Mechanism = MVAs; POSTERIOR BLOW TO FEMUR; Anterior blow to tibia; HYPERFLEXION; Severe Hyperextension (ACL then PCL);

32

PCL Sprain - S/Sx

S/Sx = Sharp pain, audible pop, then fall; (+) Posterior drawer test

33

Patellar Tendon Rupture - Mechanism

Mechanism = Forceful contraction of quads (knee extension); Jumping up

34

Patellar Tendon Rupture - S/Sx

S/Sx = Indentation below patella where tendon was; bruising; tenderness; cramping; Patella alta; inability to straighten knee; difficulty walking due to knee buckling or giving way

35

Patellar Tendonitis - Mechanism

Inflammation of patellar tendon; Mechanism = overuse

36

Patellar Tendonitis - S/Sx

S/Sx = Pain, edema, crepitus; tender at inf. Pole of patella

37

Meniscus Sprain - Mechanism

Medial more common than lateral; Mechanism = weight-bearing with rotational stress

38

Meniscus Sprain - S/Sx

S/Sx = Joint line pain, snapping following injury; posterior pain possible; clicking; locking of knee; mild edema day after injury

39

Medial Meniscus Sprain - Mechanism

Mechanism = Weight-bearing with external rotation stress

40

Lateral Mensiscus Sprain - Mechanism

Mechanism = Weight-bearing with internal rotation stress

41

Unhappy Triad

ACL sprain, MCL sprain, & Medial Meniscus Sprain

42

Unhappy Triad - Mechanism

Mechanism = Valgus stress with ER; Direct blow during rotational movement; CUTTING WHILE RUNNING

43

Patellar Fracture - Mechanism

Mechanism = Direct trauma, fall

44

Patellar Fracture - S/Sx

S/Sx = Pain, edema, radiating pain, indirect tenderness; HARD TO DIAGNOSE on Xray

45

Pes Anserine Bursitis

Chronic inflammation of bursa; Gracilis - add; Sartorius - Ext; Semitendinosis - fles

46

Pes Anserine Bursitis - Mechanism

Mechanism = Cyclist's Knee; overuse

47

Osgood Schlatter's Disease - Mechanism

Mechanism = Direct trauma to tibial tuberosity & then over use; COMMON IN TEENAGERS ACTIVE IN SPORTS

48

Osgood Schlatter's Disease - S/Sx

S/Sx = Large bump on tibial tuberosity; tender to palpation; No pain w/ activity

49

Osgood Schlatter's Disease - Complication

Complication = Avulsion (rupture) of tendon from bone; usually happens with rapid growth spurts

50

Osgood Schlatter's Disease - Tx Recommendation

Treatement Recommendation = Should be removed from activity to prevent further damage

51

Patello-femoral Syndrome

Chondromalacia - softening of underneath surface of patella & anterior surface of femur

52

Patello-femoral Syndrome - Mechanism

Mechanism = Overuse

53

Patello-femoral Syndrome - S/Sx

S/Sx = lateral tracking of patella in fossa; Abnormal Q angle - more common in women; pain w/activity, edema, crepitus; stiffness w/ extended sitting (Movie goers knee); AM stiffness; pain with palpation along medial border of knee

54

Osteoarthritis

Chronic disorder; narrowing of joint space

55

Osteoarthritis - S/Sx

S/Sx = Medial pain; stiffness; decreased RoM; Edema

56

Prepatellar Bursitis - Mechanism

Housewife's Knee; Mechanism = extended kneeling; direct blow to knee; overuse

57

Prepatellar Bursitis - S/Sx

S/Sx = Marked local edema; pain on extreme flexion due to pressure on bursa

58

Popliteal Bursitis

Baker's Cyst; affects medial hamstring tendons due to irritation

59

Popliteal Bursitis - Mechanism

Mechanism = overuse

60

Patellar Dislocation - Mechanism

Mechanism = Sudden change of direction while weight-bearing; direct trauma

61

Patellar Dislocation - S/Sx

S/Sx = Pain, edema, deformity; Will often sublux and return to original position