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Management of MS Disorders > Exam 1: Knee Evaluation Introduction Lecture > Flashcards

Exam 1: Knee Evaluation Introduction Lecture Flashcards

1
Q

List the order of which you perform a full examination of the knee

A
  1. History
  2. Observation
  3. Palpation
  4. ROM (AROM, PROM, overpressure, and end-feel)
  5. Strength testing
  6. Ligamentous/instability testing
  7. Special testing
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2
Q

When checking ROM during an examination of the knee, which motions are important to test

A

knee extension
knee flexion
tibial internal rotation
tibial external rotation

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3
Q

Is reliability for end feel good or bad

A

it is bad unless you use end feel categories consistently such as (soft, hard, empty)

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4
Q

When checking strength testing during an examination of the knee, what types of strength testing are important

A

isometric testing of knee extension and flexion
Dynamometry testing of knee flexion and extension
Functional testing

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5
Q

(Isometric/dynamometry) strength testing is better because it is more objective

A

dynamometry

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6
Q

When checking ligamentous/instability testing during an examination of the knee, which ligaments are important to test

A

ACL, PCL, MCL, LCL, and rotary instabilities

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7
Q

When performing special tests during an examination of the knee, what are two broad area of special test that are important to cover

A

meniscal pathologies and patellar instability

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8
Q

Yellow and red flags found on the medical screening form and during the history allow the PT to formulate an ______ _____

A

initial hypothesis

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9
Q

If a patient reports a traumatic onset of knee pain during jumping, twisting, or changing direction with the foot planted, what would your initial hypothesis be

A

Possible ACL injury, possible patellar subluxation, possible quadriceps rupture, possible meniscus tear

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10
Q

If a patient reports a traumatic injury from a posteriorly directed force to the tibia with the knee flexed, what would your initial hypothesis be

A

Possible PCL injury

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11
Q

If a patient reports a traumatic injury from a varus or valgus force exerted on the knee, what would your initial hypothesis be

A

Possible MCL or LCL injury

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12
Q

If a patient reports anterior pain with jumping and full knee flexion, what would your initial hypothesis be

A

possible patellar tendonitis, possible patellofemoral pain sydrome

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13
Q

If a patient reports swelling to the knee with occasional locking and clicking, what would your initial hypothesis be

A

possible meniscus tear, possible loose body in the knee joint

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14
Q

If a patient reports pain with prolonged knee flexion, during squats, and while going up and down steps, what would your initial hypothesis be

A

possible patellofemoral pain syndrome

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15
Q

If a patient reports pain and stiffness in the morning that diminishes after a few hours

A

Possible osteoarthritis

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16
Q

When does observation begin and end

A

It begins with the PT first sees the patient and ends as they leave the clinic

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17
Q

As you observe a patient, what are three things you may look at

A

Bony alignment, Q - angle, soft tissue symmetry and atrophy, and articular vs extra-articular swelling

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18
Q

Q-angle measurements have a (poor/good/excellent) reliability

A

poor

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19
Q

Patellar position has poor reliability especially in which four motions

A

medial/lateral position
medial/lateral tilt
anterior/posterior tilt
patellar rotation

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20
Q

True or False:

When palpating the knee, we are comparing our findings to a norm

A

False, we are comparing to the uninvolved side

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21
Q

When palpating the patella, what are four things you would feel for

A
  1. Size, shape, and position
  2. Superior and inferior poles
  3. Medial and lateral excursion
  4. Medial and lateral facets and borders
22
Q

When palpating the femoral condyles, what are two things you would feel for

A
  1. lateral condyle more prominent anteriorly

2. Adductor tubercle

23
Q

Where is Hunter’s canal located and why is it important

A

Hunter’s canal is made of the femoral condyles and adductor tubercle. This is important because the saphenous nerve and femoral vein and artery runs through the canal which later turns into the popliteal artery and vein

24
Q

When palpating the proximal tibia, what structures would you be feeling for

A
  1. Pes anserine
  2. Tibial tubercle
  3. Lateral tibial tubercle (ITB attachment)
25
Q

What is the pathology behind runner’s knee

A

A bursa under the ITB gets inflamed and causes pain when the ITB snaps over the bursa

26
Q

Why would we palpate the pes anserine

A

because the semitendinosus tendon, gracilis tendon, and sartorius tendon attach there

27
Q

Which two special test are performed to test effusion

A

Stroke test and blottman test

28
Q

What is normal ROM for knee flexion

A

0-140

29
Q

What are normal ROM for knee extension

A

0-15

30
Q

What are normal ROM of internal rotation of the tibia on the femur

A

20 to 30

31
Q

What are normal ROM of external rotation of the tibia on the femur

A

30 to 40

32
Q

Check for ____ with overpressure

A

pain

33
Q

What are the five movements a PT will perform to assess end feel of the knee.

A
  1. Flexion for approximation
  2. Extension for stretch
  3. Medial rotation of tibia on femur
  4. lateral rotation of tibia on femur
  5. Patellar movement
34
Q

What are the 6 strength tests a PT would perform to assess the strength of the knee

A
  1. Knee flexion
  2. Knee extension
  3. Hip flexion
  4. Hip Extension
  5. Hip Abduction
  6. Glute medius
35
Q

Assessing the strength of a patient’s hip flexion in sitting (is/is not) functional. Why or Why not?

A

This is not functional because in sitting, the hip flexors are already shortened which causes the muscle to be weaker with a shorter lever arm.

36
Q

Testing hip flexion strength in sitting is not functional especially if the patient has ____ ____ pain due to the psoas attachment on the spine

A

low back

37
Q

Which ligamentous test would a PT perform when testing anterior stability

A

Anterior Drawer and

Lachman’s Test

38
Q

Which ligamentous test would a PT perform when testing posterior instability

A

Posterior Drawer test
Posterior Sag/Godfrey Sign
Quadricep Active Test

39
Q

Which ligamentous test would a PT perform when testing medial instabilty

A

Valgus Stress test

40
Q

Which ligamentous test would a PT perform when testing lateral instability

A

Varus Stress test

41
Q

Which ligamentous test would a PT perform when testing rotary instabilities

A

Pivot Shift

42
Q

What does composite testing mean and what is its significance

A

It is a test cluster which states the LR of two or more tests done together

43
Q

What are the 6 tests to assess meniscal injuries

A 
McMurray's Test
Apley's Compression Test
Thessaly's Test
Ege's Test
Steinmann's Sign
Joint line tenderness
44
Q

Which three outcome measurements are used while examining the knee

A

WOMAC
Timed 6 minute walk test
Lower Extremity Functional Scale (LEFS)

45
Q

True or False:

The WOMAC, Timed 6 minute walk test, and Lower Extremity Functional Scale (LEFS) are all outcome measures that can be used for the hip, knee, and ankle

A

true

46
Q

What does WOMAC stand for

A

Western Ontario and MacMasters Universities Index

47
Q

The WOMAC outcome measure is found to be reliable, validated and responsive for ______ of the hip and knee and has been applied to (ACL/Meniscal) tears as well as general PT.

A

osteoarthritis; meniscal tears

48
Q

Do you need permission to use the WOMAC outcome measure

A

yes and it is expensive

49
Q

Explain what the timed 6 minute walk test is

A

A functional measure that times how far a patient can walk in 6 minutes. This should be compared to a baseline after a re-evaluation

50
Q

True or False:

The LEFS is found to be reliable and valid compared to the SF-36

A

true

51
Q

The LEFS has good (specificity/sensitivity) and is easy to administer and score. This (is/is not) useful for research and clinical decision making

A

Sensitivity; is useful for research

Management of MS Disorders (18 decks)

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