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Semester 2 PM Exam 8 > Knee Exam and Eval > Flashcards

Knee Exam and Eval Flashcards

(67 cards)

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1
Q

History

A 
Specifics regarding mechanism
Direction of force
If twisting was involved
Overuse?
All other normal hx questions
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2
Q

If history says valgus force - ACL or PCL

A

ACL

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3
Q

If history says varus force - ACL or PCL

A

PCL

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4
Q

If history involves twisting

A

Menisci, ACL, PCL

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5
Q

If history involves noise, clicking, locking

A

very often meniscus or patella

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6
Q

If history invovles instability or giving way

A

often ACL or meniscus

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7
Q

If history involves child or growth spurt

A

common with patellafemoral pain or osgood schatters

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8
Q

CHECK VITAL SIGNS

A

:)

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9
Q

Lumbar scan

A

Observe and palpate
Gait
Neurological testing

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10
Q

Lumbar scan

A 
Observation/palpation
Gait
AROM with overpressure
Neuro exam
Dermatomes/Myotomes/Reflexes
PA testing
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11
Q

Lumbar Scan - Observation and Palpation

A 
gait
antalgia
position of knee
gross patella position 
effusion
leg length discrepancy
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12
Q

Lumbar Scan - Gait

A

what is knee doing

Hip/foot position

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13
Q

Lumbar Scan - Neurological testing

A

scan for nerve root problem vs peripheral

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14
Q

Observation

A 
Edema 
Patella position 
Muscle atrophy
Femoral anteversion or retroversion (squinting patella, duck feet)
Knee hyperextension or flexion
Tibial torsion, position of ankle/foot
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15
Q

AROM/PROM with overpressure

A

Assesses willingness to move
Goniometry can be done actively and passively
Overpressure with eval of end feel

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16
Q

Knee AROM

A

flexion
extension
tibial IR and ER

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17
Q

What are you listening for with AROM

A

crepitus - very often patella femoral - look at tracking of patella

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18
Q

Must have ___ degrees of ROM to complete all functional motion
___ for stairs

A

120

110

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19
Q

Normal end feel of the knee - flexion

A

soft tissue approximation

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20
Q

Normal end feel of the knee - extension

A

capsular or springy if have tight hamstrings

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21
Q

Specific muscles to test

A 
quads
hams
adductors
gastroc
soleus
TFL
glut med and max
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22
Q

Purpose of resisted motion

A

to determine if contractile or noncontracile problem/large or small lesion

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23
Q

Strong and painless resisted motion

A

normal or minor lesion

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24
Q

Strong and painful resisted motion

A

subacute or small lesion

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25
Weak and painless resisted motion
serious lesion like neurological tumor, complete tear
26
Weak and painful resisted motion
major lesion, tear of mm all tendon
27
Special tests for effusion
Patella ballottement Fluctuation test - test for moderate effusion Stroking Tape measure
28
Grade 0 - effusion
No wave produced on downstroke
29
Grade trace (effusion)
small wave on medial side with downstroke
30
Grade 1+ (effusion)
large bulge on medial side with downstroke
31
Grade 2+ (effusion)
Effusion spontaneously returns to medial side after upstroke
32
Grade 3+ (effusion)
so much fluid that is not possible to move the effusion out of the medial aspect of the knee
33
Clinical decisions related to effusion - 2+ effusion or more
exercises not progressed
34
Clinical decisions related to effusion - 2+ effusion persists after ice, elevation, compression
contact physician regarding NSAIDS or aspiration
35
Clinical decisions related to effusion - Effusion inc 2 graces
Activity decreased to level prior to the change in effusion
36
Clinical decisions related to effusion - trace or less effusion
Consider high level activity for return to sport
37
Special tests for ligaments - MCL
Valgus force at 0 and 30 degrees 0 should be no movement at 30 for MCL laxity
38
With valgus force at 0 degrees if movement think...
MCL ACL PCL medial knee capsule
39
Ligaments LCL
Varus force at 0 and 10-30 degrees 0 degrees no movement 30 degrees - LCL laxity
40
With varus force at 0 degrees if movement think...
``` LCL Lateral capsule Arcuate-popliteus complex ACL PCL ```
41
``` ACL - lachman's grades 0 1+ 2+ 3+ ```
no anterior displacement 5mm translation 5-10mm translation >10mm translation
42
ACL - lachman - watch out for
Hamstrings are protectors of ACL so be careful of false negative with hamstrings relaxed
43
Special tests for ACL
lachman | anterior drawer
44
Anterior drawer
grading same as lachmans | avoid false negative
45
Pivot shift
ACL deficient, patient complains of giving way, instability in WB Determines if patient has dynamic instability of the knee
46
Special tests for PCL
Godfreys Posterior drawer Reverse lachmans
47
Special test for meniscus
joint line palpation mcmurreys apleys
48
McMurreys
you are trying to click, pop, or pain
49
Apleys
for meniscus
50
Functional test for meniscus
full knee squat
51
Some common thing with meniscal tear
1. joint line tenderness 2. hyperflexion with painful endfeel 3. pos mcmurreys 4. hx that relates to it 5. swelling (sometimes dont have this)
52
Normal Q angle
15 degrees
53
Abnormal Q angle
greater than 20 degrees
54
Q angle measurement
ASIS to midpatella and tibial tuberosity and mid patella
55
Patella position - medial/lateral tilt
usually lateral
56
Patellafemoral articulating surfaces
looking at the articulating surfaces of the patella and see if they are irritated in pulling them close together
57
Apprehension test
patella good for determining subluxation or dislocation you are moving the patella into the position of how they sublux (mostly laterally)
58
Patella joint mobility - patellafemoral
assess all directions of motion, include compression and distraction Medial and lateral translation should occur at 1/3 of surface of patella
59
Tibiofemoral - joint mobility
AP glide
60
Resting position
30 degrees flexion
61
Closed packed position
full extension with tibial ER
62
Capsular pattern
flexion > extension
63
Superior tibia-fibula joint =
AP glide
64
Flexibility
``` hamstrings obers rectus femoris gastrocnemius adductor ```
65
Functional hop tests - distance
single leg hop for distance timed hop for dsitance crossover hop
66
Lysholm knee scoring sclae
ACL or knee injury outcome measurement
67
Pittsurgh knee rules
blunt trauma or fall Age less than 12 yo and greater than 50 yo Cant WB for 4 steps

Semester 2 PM Exam 8 (5 decks)

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