Knee Joint Flashcards

1
Q

what is the collateral ligament stability test?

A
  1. Patient lying supine – support the lower leg or ankle and apply a valgus
    stress (lateral to medial) to the knee = test MCL
  2. Switch hands and apply a varus stress (medial to lateral) to the knee = test
    LCL
  3. Do tests first in full extension then in 20-30 degrees of flexion

Positive => excess movement or pain to the medial or lateral knee

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is the findings of collateral ligament stability

A

Damage to the MCL (upon valgus
stress) or LCL (upon varus stress)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is the anterior and posterior drawer test?

A
  1. Patient lying supine with flexed knee and hip
  2. Sit on patients’ foot and place hands around knee with thumbs in the eyes
    of the knee (medial and lateral to the patellar tendon)
  3. Apply anterior force to test for ACL – repeat 2-3 times
  4. Apply posterior force to the tibia on the femur to test for PCL – repeat 2-3
    times

Positive => excessive movement of the tibia on the femur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are the findings for anterior and posterior drawer test

A

Anterior drawer
+ pain – ACL strain
+ excessive motion – ACL rupture

Posterior drawer
+ pain – PCL strain
+ excessive motion – PCL rupture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is the Lachman test

A
  1. Patient lying supine with involved leg beside examiner
  2. Examiner holds patient’s knee between full extension and 30 flexion and
    femur are stabilized with one of examiner’s hand
  3. Move proximal aspect of the tibia forward using the other hand

Positive => mushy or soft end feel when tibia is moved forward on the femur and
the infrapatellar tendon slope disappears

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are the findings of the lachman test

A

Anterior
+ pain – ACL sprain
+ excessive motion – ACL rupture

Posterior
+ pain – PCL sprain
+ excessive motion – PCL rupture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is the McMurray’s test

A
  1. Patient lying supine
  2. With one hand supporting the knee, other hand externally rotates the tibia
    while taking patient out of knee flexion (into knee extension)
  3. Repeat but with internal rotation of the knee

Positive => snap, click or pain to the lateral or medial kne

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are the findings of the McMurray’s test?

A

Medial (external rotation) or lateral
(internal rotation) meniscus
damage/tear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is the Apley’s distraction test

A
  1. Patient lying prone and one leg flexed 90 degree
  2. Stabilize patient’s thigh by placing your knee on it
  3. Pull upwards on tibia while stabilizing thigh
  4. Rotate tibia internally then externally

Positive => pain in collateral ligaments or excessive motion or decreased
pain/crepitus with knee distraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are the findings of Apley’s Distraction test

A

Collateral ligament sprain
Meniscus tear (with decreased
pain)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is the Apley’s Compression Test

A
  1. Patient lying prone and knee is flexed 90 degree
  2. Laterally rotate tibia and push down
  3. Then medially rotate tibia and push down

Positive => pain on medial side with lateral rotation or pain on lateral side with
medial rotation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what are the findings of Apley’s compression test

A

Medial or lateral meniscus
pathology (lesion)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is the Ober’s Test (modified)

A
  1. Patient lying on their side with involved leg up
  2. Abduct and extend thigh while keeping the hip joint in neutral
  3. Slowly lower leg towards the table
  4. If IT band is normal, thigh should drop to the adducted position

Positive => thigh remains abducted when the leg is released

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is the finding of the Ober’s Test (modified)

A

Contracture of the IT band (more
than gluteus medius)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is the Ober’s test (original)

A
  1. Patient lying on their side with involved leg up
  2. Abduct the leg and flex the knee to 90 while keeping hip joint in neutral
    to relax IT band
  3. If IT band is normal, the thigh should drop to the adducted position

Positive => thigh remains abducted when the leg is released

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is the findings of Ober’s Test (original)

A

Contracture of gluteus medius
(more than IT band)

17
Q

what is the apprehension test

A
  1. Patient stands on affected knee
  2. Examiner pushes anteriorly and medially on the anterolateral part of the
    lateral femoral condyle crossing the knee joint
  3. Patient asked to slightly flex knee while examiner pushes with thumb

Positive => condylar movement and a “giving way” sensation

18
Q

what is the finding of Apprehension test?

A

Posterolateral instability

19
Q

what is the bounce home test?

A
  1. Patient lying supine
  2. Cup the heel of the patient’s foot
  3. Patient’s knee is completely flexed, and the knee is passively allowed to
    extend

Positive => if extension is not complete or has a rubbery end feel (springy block)

20
Q

what is the findings for bounce home test

A

torn meniscus

21
Q

what is the Clarks patellar grind test

A
  1. Patient lying supine
  2. Examiner presses down slightly proximal to the base of the patella with
    the web of the hand
  3. Patient asked to contract quad muscles while examiner pushes down

Positive => pain or grinding sensation

22
Q

what is the findings for the Clarks patellar grind test

A

Patellofemoral dysfunction

23
Q

what is the thessaly test

A
  1. Patient stands flat footed on the affected leg – examiner provides hand for
    balance
  2. Patient flexes the knee to 20
  3. While maintaining flexion, patient rotates medially and laterally 3 times

Positive => pain or grinding sensation

24
Q

what is the findings for the thessaly test

A

patellofemoral dysfunction

25
Q

what are the special test for ACL sprain or tear

A
  • Anterior drawer
    + pain – ACL strain
    + excessive motion –
    ACL rupture
  • Lachman’s test
    (anterior)
    + pain w/anterior
    translation – ACL
    sprain
    + excessive motion –
    ACL rupture
26
Q

what are the special test for PCL sprain or tear

A
  • Posterior drawer test
    + pain – PCL strain
    + excessive motion –
    PCL rupture
  • Lachman’s test
    (posterior)
    + pain w/posterior
    translation – PCL
    sprain
    + excessive motion –
    PCL rupture
27
Q

what are the special test for MCL sprain or tear

A

Valgus stress test
(lateral to medial)
+ pain – MCL sprain
+ excessive motion or
gapping – MCL
rupture

28
Q

what are the special test for LCL sprain or tear

A

Varus stress test
(medial to lateral)
+ pain – LCL strain
+ increased motion or
gapping – LCL rupture

29
Q

what are the special test for meniscus tear

A

Apley’s compression
+ pain or crepitus with
compression/rotation –
meniscal lesion

Apley’s distraction
+ decreased pain or
crepitus with knee
distraction

McMurray’s test
+ pain or crepitus –
meniscal lesion
Valgus with external
rotation – lateral men.
Varus with internal
rotation – medial men.

30
Q

what are the special test for Iliotibial band syndrome

A

OBERS (modified)
+ hip pain – hip joint
pathology
+ trochanteric pain –
trochanteric bursitis
+ decreased ROM –
ITB contracture

31
Q

what are the special test for patellar dislocation

A

Patellar apprehension
test

32
Q

what are the special test for Chondromalacia patella

A

Clark’s Patellar Grind
test
+ grinding sensation or
pain

33
Q

what is the terrible or unhappy triad?

A

medial meniscus, ACL, and MCL and they are commonly affected together