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Flashcards in KNee Deck (47):
1

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

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

2

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

Referred pain

3

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

Referred pain

4

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

Referred pain

5

What is the dermatome of the anterior knee?

L3, L4, and L5

6

The back of the knee is what dermatome?

S1 and S2

7

Knee effusion is indicative of what?

Intra-articular pathology

8

Locking of the knee is indicative of what?

Meniscal lesions or loose body

9

Pain with going downstairs indicates what?

Loads the extensor mechanism

10

A knee that "gives way" indicates what?

Ligamentous or meniscal injury

11

Grinding/popping/clicking indicates what?

Painful = damaged cartilage or menisci

Painless = ligamentous laxity

12

What is eccentric contraction?

When contraction brings about increased distance between O and I

13

Multiple joints affected indicates what?

either polytrauma or systemic issue

14

What are the six principles of joint physical exam?

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

15

PROM evaluates what?

Ligaments and contractile tissues

16

When should palpation for tenderness be done?

After functional exam has identified potential locations of pain

17

Diffuse swelling of a joint usually indicates what?

Fluid within the joint

18

Diffuse swelling + muscle wasting = what?

longstanding OA

19

Diffuse swelling + redness or heat suggests what etiology?

Gout
Inflammatory arthropathy

20

Localized swelling of a joint is indicative of what?

Baker's cyst
Inflamed bursa

21

What is considered normal ROM of the knee?

heel touching buttocks

22

What is the normal end feel of knee flexion?

Tissue approximation

23

Passive hyperflexion tests what structure?

Meniscus

24

What limits the extension of the knee?

PCL and posterior capsule

25

What is the capsular pattern of knee pain?/

Gross limitation of flexion and slight limitation of extension

26

What is a non-capsular pattern of the knee?

Lesion does NOT affect the entire joint

27

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

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

28

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

Quad problem

L3 root lesion if painless

29

What are the two factors that we assess with ligaments?

Pain
Laxity

30

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

Flex knee to 30, anteriorly move the tibia while stabilizing the femur.

Tests for ACL damage

31

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

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

Assess the ACL

32

What are the three components of the unhappy triad?

MCL
ACL
Medial meniscus

33

Which meniscus is attached to the associated ligament?

Medial meniscus to the medial collateral ligament

34

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

Valgus force

35

What is the test for a PCL tear?

Posterior drawer test

36

What does the valgus stress test assess?

MCL

37

What does the varus stress test assess?

LCL

38

What does the McMurray's test assess?

Lateral meniscus

39

How do you perform McMurray's test?

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

40

What indicates a positive McMurray's test?

Pain or clicking with movement

41

What does the patellar tap (ballottement) assess?

Patellar effusion secondary to meniscal tear, infection, or other

42

What indicates a positive patellar tap test?

the patella will "tap" onto the femur

43

How do you perform the patellar tap test?

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

44

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

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

PFPS or chondromalacia patella

45

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

Pt is prone. Flex knee to 90. Internal and external rotation of the tibia while applying traction

Assess for medial/lateral collateral ligaments

46

What is the Apley compression test?

Pt is prone. Flex knee to 90. Internal and external rotation of the tibia while applying compression

Assess for medial/lateral collateral ligaments

47

Why is palpation for tenderness assessed last?

Difficult to determine what it means