assessment of the knee Flashcards
flexion ROM
135 deg
extension ROM
0 deg
end feel
flexion can be soft or firm
extension is firm
loose packed position
25 deg flexion
closed packed position
full extension with external rotation of tibia
capsular pattern
flexion > extension
ottawa knee rules
need one of the 5 after knee injury
age 55 or older
isolated tenderness of patella
tenderness of head of fibula
inability to flex to 90 deg
inability to weight bear for 4 steps
pittsburgh knee rules
need one of two after blunt force trauma to knee
age < 12 or > 50
unable to walk 4 steps
patella
prominent in anterior knee
patellar ligament
1 inch wide band
inferior from patella
tibial tuberosity
distal attachment of patellar ligament
medial and lateral meniscus
soft structures in anterior joint space
medial femoral condyle
bony prominence medial to patella
adductor tubercle
distal bony prominence at distal adductors
proximal to medial femoral condyle
medial collateral ligament
attaches to medial femoral condyle and tibial plateau
firm structure that pushes out of medial joint space
pes anserine
proximal, medial slope of tibia
inferior from joint line
lateral femoral condyle
bony prominence lateral to patella
lateral collateral ligament
firm structure that pushes out of lateral joint space
fibular head
distal and posterior to lateral femoral condyle
gerdy’s tubercle
prominent bump halfway between tibial tub and fibular head
biceps femoris tendon
lateral in slightly flexed knee
semitendinosus and semimembranosus tendons
medial in slight knee flexion
medial and lateral heads of gastroc
proximal to articular surface of medial and lateral femoral condyles
popliteal fossa
space between borders
knee flexion ROM
stationary arm: greater trochanter
fulcrum: lateral epicondyle of knee
movement arm: lateral malleolus
normal flexion: 0-135 deg
normal extension: 0 deg
documentation 0 - 0 - 135
knee flexion 3-5
prone
resistance applied near ankle
knee extension 3-5
seated
resistance applied over mid tibia
knee flexion 0-2
side lying with PT in front of pt
test hip on table
PT stabilizes top leg
knee extension 0-2
side lying with PT behind pt
test hip on table
PT stabilizes top leg
tibio femoral joint distraction
client’s leg off side of table, knee bent 25 deg
both hands on proximal tibia
pull parallel to long axis of tibia
tibiofemoral joint anterior glide
pull tibia anterior from femur
tibiofemoral joint posterior glide
push tibia posterior from feumr
patellofemoral superior glide
pt supine
knee flexed 5 - 10 deg
patella in web of hand and push upward
patellofemoral infererior glide
pt supine
knee flexed 5 - 10 deg
patella in web of hand and push downward
patellofemoral medial glide
pt supine
knee flexed 5 - 10 deg
thumbs on lateral patella and push inward
patellofemoral lateral glide
pt supine
knee flexed 5 - 10 deg
thumbs on medial patella and push outward
patellofemoral medial tilt
pt supine
knee flexed 5 - 10 deg
push patella laterally then push down on medial side
q angle
supine and in full knee extension
stationary arm: ASIS
fulcrum: patella
moving arm: tibial tuberosity
angel greater than 10 for men and 15 for women is positive
circumferential measurements
measure where the edema is
measure bilaterally
lateral pull test
pt supine and in full extension
isometric quad contraction
observe movement of patella
positive: more lateral than superior
anterior drawer
supine with knee flexed 90 deg and foot on table
pull tibia anterior
positive: soft end feel
anteromedial instability
supine with knee flexed 90 deg and foot on table
tibia externally rotated 15 deg
pull tibia anterior
positive: soft end feel
anterolateral instability
supine with knee flexed 90 deg and foot on table
tibia internally rotated 30 deg
pull tibia anterior
positive: soft end feel
posterior drawer test
supine with knee flexed 90 deg and foot on table
push tibia posterior
positive: increased posterior translation
valgus stress test at 30 deg knee flexion
supine on table with testing limb over edge and flexed to 30 deg
abduct at the ankle with stabilizing the thigh
varus stress test
supine on table with testing limb over edge and flexed to 30 deg
adduct at the ankle with stabilizing the thigh