Knee Exam Procedures Flashcards
(38 cards)
What is knee effusion?
fullness or swelling in the suprapatellar pouch of the knee
How can effusion be confirmed?
By ballottement of the patella
How is patellar ballottement performed?
By compressing the patella posteriorly and releasing quickly, observing for rapid rebound indicating increased fluid pressure
What is chondromalacia patellae?
inflammation of the underside of the patella including erosion and irritation to the hyaline cartilage on its undersurface which allows it to effortlessly articulate with the patellar groove of the femur
What types of patients are more prone to chondromalacia patellae?
young individuals engaged in active sports and older adults who overwork their knees
How can chondromalacia patellae be confirmed?
By performing the patellar grind test
How is the patellar grind test performed?
With knee extended, the examiner pushes the patella posteriorly into the trochlear groove of the femur. Pain is a positive test
How is patellarfemoral syndrome confirmed?
By performing the patellar inhibition test
How is the the patellar inhibition test performed?
With knee extended, the examiner pushes the patella distally into the trochlear groove of the femur and then the patient is asked to contract the quads. Pain is a positive test
What test should you perform if you want to assess the possibility that the patient may have sustained a patellar dislocation?
Patellar Apprehension Test
How is the patellar apprehension test performed?
The patient lies supine on the table with the knee in 20-30 degrees of flexion and the quadriceps relaxed. The examiner carefully glides the patella laterally observing for the apprehension sign. A positive test is the presence of this reaction by the patient.
The Q-angle is the measured angle between what 2 lines?
Line 1: ASIS to the Patella Center
Line 2: Tibial Tubercle to the Patella Center
What is the normal Q angle in men? Women?
Men: 11 to 17 degrees
Women: 14 to 20 degrees
7 causes of an increased Q angle
- Knock-Kneed (Genu Valgum)
- Excessive Femoral Anteversion
- Lateral Tibial Torsion
- Laterally positioned tibial tuberosity
- Tight lateral Retinaculum
- Weakness of vastus medialis oblique
- High riding Patella (Patella alta)
What is the associated risk with an increased Q angle?
patellar subluxation
A ____ stress test is performed to determine the stability of the MCL
valgus
Describe 1st, 2nd, and 3rd degree injuries to the MCL and LCL
1st degree injury is represented by significant tenderness to palpation
2nd degree injury is laxity at 30 degrees of flexion
3rd degree injury is laxity at 0 degrees of flexion
What is the definition of a sprain?
an injury in a joint, caused by the ligament being stretched beyond its own capacity
The _____ drawer test assesses the tear of the ACL
anterior
The _____ drawer test assesses the tear of the PCL
posterior
What is another test you could perform to determine if someone has an ACL tear?
Lachman’s test
How is Lachman’s test performed?
The patient lies supine, the examiner flexes the knee slightly (about 20-30 degrees). The examiner then stabilizes the thigh while pulling the tibia forward toward the examiner.
What is another test you could perform to determine if someone has an PCL tear?
Posterior Cruciate Ligament Sag (Gravity Drawer) Test
How is the posterior sag test performed?
With both knees flexed to 90 degrees and feet planted on the table (or held in the air by the clinician), view the knees from the side to compare position of the anterior tibia. If a sag of the tibia is noted on one side, it is considered a positive test.
