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Extremities 2 > 6 - Knee > Flashcards

6 - Knee Flashcards

1
Q

Anterior Drawer Sign…excessive motion indicates what?

A

-Anterior cruciate ligament tear.

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2
Q

Most common tear of the knee ligaments?

A
  • Medial menisci…
  • (2nd) Medial collateral…
  • (3rd) Anterior cruciate
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3
Q

How do you stabilize for anterior drawer sign?

A

-Sit on patient’s anterior foot with your posterior thigh while patient’s knee is flexed.

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4
Q

No motion on anterior drawer (A-P) sign indicates what?

A

-Posterior tibia

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5
Q

Posterior Drawer sign

-Excessive (P-A) motion indicates

A

posterior cruciate ligament tear. Not as common as Anterior tears.

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6
Q

Lachman’s test

A

-Same procedure as Anterior draw sign except knee is bent only up to 30 degrees.

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7
Q

What is the orthopedic test of choice for anterior cruciate ligament?

A

–Lachman’s

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8
Q

What follow up test to Anterior Drawer verifies cruciate ligament damage and laxity?

A

–Lachman’s

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9
Q

What test would you run if you suspected a false negative on anterior drawer sign of the knee?

A

–Lachman’s

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10
Q

Why is Lachman’s preferred over anterior drawer for anterior cruciate ligament testing?

A

-The lower angle of flexion does not stretch the quadriceps as much, and the condyles are not as deeply seated into the menisci.

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11
Q

Tibia Posterior…what are some indications?

A
  • Aching behind the knee,
  • Loss of fluid motion on anterior drawer (pulling P-A)
  • Full flexion ROM is lost (pulls anterior ligaments tight)
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12
Q

Apley’s Compression (menisci)

A
  • Positive is pain
  • Indicates Meniscal damage on side of pain finding when compressed
  • Is a subjective test
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13
Q

If Apley’s compression causes a decrease in pain what test would you run next?

A

-Apley’s Distraction suspecting collateral ligament damage.

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14
Q

What would you do to verify pain on the medial side with Apley’s compression?

A

-McMurray’s test.

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15
Q

Apley’s Distraction Test Postive is what?

A
  • Positive report is pain
  • Indicates collateral ligament damage on side of pain
  • It’s a subjective test
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16
Q

If pain were decreased on Apley’s distraction what test would you run?

A

-Apley’s compression suspecting a meniscal tear.

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17
Q

What if Apley’s distraction relieves the pain?

A

-It’s probably meniscal

18
Q

What does Apley’s compression test indicate?

A

-Medial or lateral meniscal damage,….. pain helps determine the side.

19
Q

McMurray’s test ..Describe the order of procedure.

A

. Pt. supine, knee bent, Dr. palpates medial joint.

-Externally rotate foot,…Varus medial stress,…extend leg while palpating the medial joint line.

20
Q

What is a positive finding for McMurray’s?

A

-Palpable or audible click, with or without pain.

21
Q

Positive McMurray’s indicates what?

A

-Tear in the medial meniscus, most likely a horizontal/bucket handle tear

22
Q

Pain alone (no click) in McMurray’s may indicate what?

A

-Medial collateral ligament tear,….-medial meniscal tear,….-anterior cruciate tear,…-Tibia AM

23
Q

What’s the most common cause of a joint mouse of the knee?

A

Medial meniscus tear.

24
Q

What orthopedic tests should be run if McMurray’s has pain only?

A
  • Valgus stress,…-Appley’s compression,…Appley’s distraction…
  • Anterior drawer sign…-Lachman’s,…
25
Q

Valgus stress (Pushing from lateral to medial) What is a positive?

A

-Excessive movement at the medial joint space.

26
Q

What test would you run to verify a Valgus stress test?…

A

Apley’s distraction with medial side pai

27
Q

The best way to check an Anterior-Medial Tibia for fluid motion?

A

-If there’s no motion on Valgus stress, it may be due to the tibia rotating anterior which in turn pulls the medial ligaments tight that attach to the femur. Thus restricting motion.

28
Q

Is it normal to have a little bit of movement during valgus stress?

A

-Yes! (no motion=A-M tibia;……Excess motion=Ligament tear)

29
Q

What other ligament(s) might be torn if the medial collateral is torn?

A

-Medial meniscus,…..-maybe anterior cruciate or (ligament crossing the joint space)

30
Q

With Abduction/Valgus Stress:…-Excess motion indicates medial collateral ligament tear.

A

-If pain is exacerbated during this procedure it indicates a partial tear.
–If pain stays the same it indicates a complete tear.

31
Q

Should you compare valgus to varus stress on the same knee?

A
  • No, the two don’t always have the same laxity.

- Compare right knee valgus to the left knee valgus,……-and right knee varus to left knee varus.

32
Q

What is the direction of pull for patella grind

A

S-I, try to not get A-P force….-A more humane way is to have supine patient lift foot off table which tightens quads & elevates patella superior

33
Q

What is the positive for Patella Femoral Grinding Test

A

Pain or crep

34
Q

What does a positive Patella Femoral Grinding Test indicate

A

Chondromalacia patella

35
Q

What is positive patella femoral grinding most likely indicative of in an adult

A

DJD or plica.

36
Q

Which direction is pressure applied for patellar apprehension test?

A

-M-L against the medial border of the patella…..-then L-M against the lateral border of the patella.

37
Q

Patella Apprehension Test What is a positive?

A

-Patient has a look of apprehension indicating a propensity to dislocate. (Look at patient’s face.)

38
Q

Most common direction of patellar dislocation?

A

?……-Superior & lateral because of quad muscle.

39
Q

How would patient present for needing patellar traction?

A

-flexed knee,…-history of impact on kneecap causing pain. (Remember baseball video?)

40
Q

What are the findings to indicate the need for patellar traction?……

A

1) Dislocation.
-(2) Patient is unable to extend knee because the quadriceps become flexors.
-(3) On visualization Patella is superior and lateral to knee joint
Name (4) Post checks for patellar traction.
-(1.) Visualization,….-(2.) Light palpation,….-(3.) Active ROM (extension)….-(4.) X-ray

41
Q

What procedures would you not use for post checking patellar traction?

A
  • Fluid motion (not on a hypermobile area),
  • Patellar Apprehension,
  • Patella femoral grinding test.
42
Q

Is the tibial tuberosity medial or lateral compared to inferior tip of the patella

A

slightly lateral.

Extremities 2 (7 decks)

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