KNee

Question 1

What are the two main goals in the evaluation of the joint evaluation?

Answer 1

1. Determine if pain is caused by the joint, or if it is referred?
2. To find the specific tissue that may be generating the pain

Question 2

Vague symptoms of the knee may indication what sort of etiology?

Answer 2

Referred pain

Question 3

Pain that radiates from the hip or lower back suggests what etiology?

Answer 3

Referred pain

Question 4

Normal strength and ROM of the knee, but with pain, may indicate what sort of etiology?

Answer 4

Referred pain

Question 5

What is the dermatome of the anterior knee?

Answer 5

L3, L4, and L5

Question 6

The back of the knee is what dermatome?

Answer 6

S1 and S2

Question 7

Knee effusion is indicative of what?

Answer 7

Intra-articular pathology

Question 8

Locking of the knee is indicative of what?

Answer 8

Meniscal lesions or loose body

Question 9

Pain with going downstairs indicates what?

Answer 9

Loads the extensor mechanism

Question 10

A knee that “gives way” indicates what?

Answer 10

Ligamentous or meniscal injury

Question 11

Grinding/popping/clicking indicates what?

Answer 11

Painful = damaged cartilage or menisci

Painless = ligamentous laxity

Question 12

What is eccentric contraction?

Answer 12

When contraction brings about increased distance between O and I

Question 13

Multiple joints affected indicates what?

Answer 13

either polytrauma or systemic issue

Question 14

What are the six principles of joint physical exam?

Answer 14

1. Inspect
2. ROM
3. Resistance/strength
4. Ligaments
5. joint surfaces and menisci
6. Palpate

Question 15

PROM evaluates what?

Answer 15

Ligaments and contractile tissues

Question 16

When should palpation for tenderness be done?

Answer 16

After functional exam has identified potential locations of pain

Question 17

Diffuse swelling of a joint usually indicates what?

Answer 17

Fluid within the joint

Question 18

Diffuse swelling + muscle wasting = what?

Answer 18

longstanding OA

Question 19

Diffuse swelling + redness or heat suggests what etiology?

Answer 19

Gout

Inflammatory arthropathy

Question 20

Localized swelling of a joint is indicative of what?

Answer 20

Baker’s cyst

Inflamed bursa

Question 21

What is considered normal ROM of the knee?

Answer 21

heel touching buttocks

Question 22

What is the normal end feel of knee flexion?

Answer 22

Tissue approximation

Question 23

Passive hyperflexion tests what structure?

Answer 23

Meniscus

Question 24

What limits the extension of the knee?

Answer 24

PCL and posterior capsule

Question 25

What is the capsular pattern of knee pain?/

Answer 25

Gross limitation of flexion and slight limitation of extension

Question 26

What is a non-capsular pattern of the knee?

Answer 26

Lesion does NOT affect the entire joint

Question 27

Problems with resisted flexion of the knee is suspicious for what? (wwo pain)

Answer 27

Hamstring pain or S1/S2 root (depends on if painful or not)

Question 28

Weakness with extension of the knee is suspicious for what? (wwo pain)

Answer 28

Quad problem L3 root lesion if painless

Question 29

What are the two factors that we assess with ligaments?

Answer 29

Pain | Laxity

Question 30

How do you perform the Lachman's test? What does this test for?

Answer 30

Flex knee to 30, anteriorly move the tibia while stabilizing the femur. Tests for ACL damage

Question 31

How do you perform the anterior drawer test? What does this test for?

Answer 31

Flex knee to 90, add pressure from behind the knee, directed anteriorly, to assess for laxity Assess the ACL

Question 32

What are the three components of the unhappy triad?

Answer 32

MCL ACL Medial meniscus

Question 33

Which meniscus is attached to the associated ligament?

Answer 33

Medial meniscus to the medial collateral ligament

Question 34

What is the usual injury that causes the (unhappy) terrible triad?

Answer 34

Valgus force

Question 35

What is the test for a PCL tear?

Answer 35

Posterior drawer test

Question 36

What does the valgus stress test assess?

Answer 36

MCL

Question 37

What does the varus stress test assess?

Answer 37

LCL

Question 38

What does the McMurray's test assess?

Answer 38

Lateral meniscus

Question 39

How do you perform McMurray's test?

Answer 39

Flex hip and knee, externally rotate the foot, and apply valgus stress. Then bring into extension

Question 40

What indicates a positive McMurray's test?

Answer 40

Pain or clicking with movement

Question 41

What does the patellar tap (ballottement) assess?

Answer 41

Patellar effusion secondary to meniscal tear, infection, or other

Question 42

What indicates a positive patellar tap test?

Answer 42

the patella will "tap" onto the femur

Question 43

How do you perform the patellar tap test?

Answer 43

compress inferior and superior portions of the knee, to push fluid behind the patella

Question 44

How do you perform the patellofemoral compression test? What does this assess?

Answer 44

Directly compress that patella posteriorly into the trochlear groove onto the femoral condyles PFPS or chondromalacia patella

Question 45

What is the Apley distraction test? What does this assess for?

Answer 45

Pt is prone. Flex knee to 90. Internal and external rotation of the tibia while applying traction Assess for medial/lateral collateral ligaments

Question 46

What is the Apley compression test?

Answer 46

Pt is prone. Flex knee to 90. Internal and external rotation of the tibia while applying compression Assess for medial/lateral collateral ligaments

Question 47

Why is palpation for tenderness assessed last?

Answer 47

Difficult to determine what it means