Knee Exam

Question 1

Ligamentous Structures

Answer 1

Posterior cruciate ligament
Anterior cruciate ligament
Medial collateral ligament
Lateral collateral ligament

Question 2

Cartilaginous Structures

Answer 2

Lateral meniscus
Medial meniscus
Posterior horn
Anterior horn
Articular

Question 3

Bursa

Answer 3

Suprapatellar
Prepatellar
Superficial infrapatellar
Infrapatellar

Question 4

Muscles

Answer 4

Adductor Magnus
Articularis genu
Biceps femorus
Peroneus longus
Tibialis anterior
Vastus medialus
Iliotibial tract
Vastus intermedius
Rectus femoris
Semimembranosus
Popliteus
Tibialis posterior
Extensor digitorum longus
Sartorius
Gracilis
Semitendinosus
Vastus lateralis
Plantaris
Soleus
Gastrocnemius

Question 5

ROM

Answer 5

Flexion: 145-150 degrees (hamstrings - biceps femoris, semimembranosis, semitendinosis) (tibial n. L4-5, S1-3; branch of sciatic n.)

Extension: 0 degrees (quadriceps - rectus femoris, vastus lateralis, vastus medialis, vastus intermedius) (femoral n. L2-4)

Internal rotation: 10 degrees

External rotation: 10 degrees

Question 6

Collateral Ligaments

Answer 6

Knee flexed to 30 degrees

Valgus Stress Test (increased laxity, soft or absent endpoint, pain) - MCL disruption, joint capsule injury

Varus Stress Test (increased laxity, soft of absent endpoint, pain) - LCL disruption

Question 7

Anterior Cruciate Ligament

Answer 7

Lachman’s Test - knee flexed 15-30 degrees (increased laxity, soft or absent endpoint) - ACL insufficiency

Anterior Drawer Test - knee flexed 90 degrees (excessive translation when compared to other knee) - ACL insufficiency

Question 8

Posterior Cruciate Ligament

Answer 8

Posterior Drawer Test - knee flexed 90 degrees (excessive translation when compared to their side) - PCL deficiency, posterior capsular injury or disruption

Reverse Lachman’s Test - knee flexed 15-30 degrees (increased laxity, soft or absent endpoint) - PCL deficiency/post capsule deficiency

Question 9

Patellar Ligaments

Answer 9

Laxity Test - assess ROM (graded 1-4; +1 = 0-25%, +2 = 25-50%, etc.)

Apprehension Test - testing laxity to the point or restriction (sense of apprehension or instability)

Possible previous patellar dislocation or severe instability

Question 10

Patellar Cartilage

Answer 10

Compression (Grind) Test ( pain with compression) - possible inflammation, chondromalacia, injury to patellofemoral Articular surfaces

Glide Test (palpable or audible crepitus, pain, or catching of the patella - possible damage to the articular surface

Question 11

Meniscus Cartilage

Answer 11

McMurray’s Test
- medial meniscus: internally rotate tibia as knee is extended while adding varus load
- lateral meniscus: externally rotate tibia as knee is extended while adding valgus load
(Pain or painful click during extension) - possible meniscus tear

Apley Compression (Grind) Test (pain with rotation and/or compression) - meniscus injury, collateral ligament injury, or both

Apley Distraction Test (pain with distraction and rotation) - collateral ligament damage

Question 12

Unhappy Triad

Answer 12

ACL
Medial meniscus
Medial Collateral Ligament (MCL)

Question 13

Hamstring Injury

Answer 13

Sprinting and other fast or twisting motions

Most often in running, jumping, kicking sports

Question 14

Iliotibial Band Syndrome

Answer 14

Overuse problem
Often in bicyclists, runners, long-distance walkers
Bursitis

Question 15

Patellar Tendonitis

Answer 15

Jumper’s Knee - common overuse condition

Associated with running, repeated jumping and landing, kicking

Question 16

Quadriceps Tendonitis

Answer 16

Overuse injury

Soccer, volleyball, or running activities

Question 17

Osgood-Schlatter Disease

Answer 17

Overuse injury
Common in adolescents
Avulsion of secondary ossification center of tibial tubercle

Question 18

Q-angle

Answer 18

Normal = 15 degrees

Females typically have increased Q-angle

Angle measured between straight line created from:

• ASIS to center of patella
• Tibial tuberosity to center of patella