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PCM > Knee, Ankle, Foot > Flashcards

Knee, Ankle, Foot Flashcards

1
Q

What are the two pulses to know on the foot?

A

Dorsalis Pedis

Posterior Tibialis

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2
Q

When would you check pulses on the foot especially?

A

Diabetics (Diabetic Neuropathy)

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3
Q

What are the grades for edema?

A 
2mm = grade 1
4mm = grade 2
6mm = grade 3
8mm = grade 4
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4
Q

What is the Valgus test for the knee?

Positive sign?

A

Contact on the medial aspect of the ankle and the lateral aspect of the knee and push the leg outwards

Positive would be increased laxity or pain on the medial aspect = medial collateral ligament torn

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5
Q

What is the Varus test for the knee?

Positive sign?

A

Contact on the lateral aspect of the ankle and medial aspect of the knee and put the leg closer to the body “making the R”

Positive would be increased pain or laxity on the lateral aspect = LCL torn

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6
Q

Anterior Drawer Test?

A

Flex the knee and the hip to 90 and sit on their foot

Contact with your fingers the proximal tib/fib

You grasp and pull towards you

positive would be that it comes right out and you see a severe change.

ACL would have been torn

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7
Q

What is the Posterior Drawer Test

A

Same as ACL but you’re pushing, so this is testing the posterior collateral ligament (PCL).

You’d feel it give

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8
Q

Lachman’s Test?

Reverse Lachman’s?

A

Take your Caudad Hand and contact the Proximal Tib/fib

Cephalad hand contact the distal femur

You pull up on the Tib fib and simultaneously push down on the distal femur

You’re testing the ACL on this one!

If you reverse the motion you’re testing PCL. Pushing down on Tib fib and pushing up on the distal femur

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9
Q

What’s important to know about the Lachman’s Test with the angle?

A

10-30 degrees. slight flexion

Remember that anterior drawer is 90 90

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10
Q

Apley Grind Compression Test?

Apley Grind Distraction Test?

A

Flex knee up to 90 (pt prone)

You hold onto the distal tibfib and push down on the knee

if pain = positive finding (possible meniscal injury, collateral ligament injury, or both)

Apley grind distraction = cephalad hand on distal femur, caudal on distal tib/fib. pull up on tib fib

if pain goes away = positive finding for medial meniscus tear

if pain there = collateral ligaments might be torn (MCL, LCL)

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11
Q

Patellar Laxity and Apprehension

A

Take thumbs on medial aspect of the patella and push laterally

If this is extremely laxxed or pain = something going on with patellar dislocation or severe instability

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12
Q

What is the patellar compression (grind) test?

A

Take your thenar eminence and contact top of patella and push down and move it back and forth medial and lateral

pain would be positive finding for possible inflammation, chondromalacia, injury to patellofemoral articular surfaces

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13
Q

What’s the patella-femoral grinding test?

A

Same idea as the patellar compression grind test but instead you push the patella down towards their foot and they tighten the quads

if you feel a popping feeling or pain its a positive test for chondromalacia or roughness of articulating surfaces

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14
Q

What is the Patellar Glide Test?

A

caudal at proximal tib fib, cephalad hand at distal femur

pt flexes and extends the knee

you’re feeling for the glide

if there’s pain or crepitus that’s for possible damage to articular surfaces

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15
Q

Anterior Drawer Test of the Ankle?

A

Cephalad hand on the distal tib/fib (first MCP on the talus)

caudad on the posterior calcaneus

pull forward.. increased laxity and pain is the ATFL torn

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16
Q

Talar Tilt Test?

A

Same hand placement as the anterior drawer test but you’r inverting it

laxity or pain = ATF or calcaneofibular ligament

17
Q

Eversion Test

A

Same hand placement as the anterior drawer test but you evert the foot

increased laxity or pain = deltoid ligament

18
Q

Squeeze Test

A

Take hands and one on either side of the distal tib fib, put fingers together and compress for 2-3 seconds.

syndesmosis if pain (high ankle sprain)

19
Q

Cross Leg Test

A

Cross your leg and the person says ankle hurts = syndesmosis = high ankle sprain

20
Q

Thompson Test

A

Grab the calves and squeeze. see plantar flexion.

if not it’s an achilles tendon rupture

21
Q

Homan’s Sign

A

Patient Laying or seated. dorsiflex the foot. can also apply lateral compression to calf

+ test is pain with dorsiflexion

indicates thrombophlebitis or acute deep vein thrombosis

22
Q

Moses Sign

A

Anterior compression on he gastrocnemius when the knee is slightly flexed or extended.

+ test is pain with anterior compression

Indicates DVT

23
Q

What are you going to do for the Knee exam? (not specialty test)

A

Introduce yourself

inspect knee

palpate patella, tibial tuberosity, popliteal fossa

Assessed for ROM (flexion, extension, internal / external rotation

Strength Testing (flexion/extension)

Patella / Achilles reflexes

Sensation (dermatome)

24
Q

What are you going to do for the ankle/foot exam (not specialty test)

A

Introduce

Inspect ankle, foot, dorsal and plantar aspects

palpate medial and lateral malleolus, deltoid ligament, MTP, PIP, DIP Tarsal bones

Palpate dorsalis pedis artery and posterior tibial artery

ROM of ankle (plantar flexion, dorsiflexion, inversion, eversion

ROM of toes (flexion, extension, abduction, adduction, circumduction

Strength testing of plantar flexion, dorsiflexion, eversion, inversion

patella and achilles reflexes

sensation dermatome

25
Q

What dermatome are you going to do?

A

L5 - Big toe

L4 - Patella

S1 - pinky toe

26
Q

Explain the McMurray test

A

Hip and Knee flexed.

Examiner uses caudal hand to control the ankle and cephalad hand on the distal femur

Medial Meniscus - Rotate the tibia into INTERNAL rotation and a VARUS stress, then continue the leg into extension.

Lateral meniscus - Rotate the tibia into EXTERNAL rotation and a VALGUS stress, then continue the leg into extension

+ test is pain / palpable click during extension

Indication = Medial/lateral meniscal tear

27
Q

What is the ROM for the knee?

A

Flexion: 145-150
Extension: 0
Internal and External Rotation: 10

28
Q

What is the ROM for the ankle/foot?

A

Plantarflexion: 55-65
Dorsiflexion: 15-20
Ankle Inversion: 20
Ankle Eversion: 10-20

29
Q

What nerve root is the patella?

A

L4

30
Q

What nerve root is the Achilles Tendon?

A

S1

PCM (8 decks)

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