Intermediate Knee

Question 1

Muscle wasting

Answer 1

Arthritis
Muscle atrophy - LMN lesion

Question 2

Valgus

Answer 2

Knock knees

Question 3

Varus

Answer 3

Bow-legged

Question 4

Feeling for temp?

Answer 4

Use back of hands on patellar, above and below

Warmth - inflammatory conditions (osteoarthritis or septic arthritis)

Question 5

Swelling in popliteal fossa?

Answer 5

Bakers cyst

Question 6

Effusion?

Answer 6

Excess of synovial fluid
Caused by arthritis or damage to internal structures of the knee such as the meniscus

Question 7

Tap method?

Answer 7

Ensure patient knee extended
Slide non-dominant hand down thigh to empty suprapatellar pouch
Keeping non-dominant hand in place, press firmly over patella with dominant hand
in moderate effusion, will feel a tap as patella hits the femur

Question 8

Sweep methods?

Answer 8

FOR SMALL EFFUSIONS
Ensure patients knee is extended
With non-dominant hand, sweep upward on the medial side of the knee to empty medial compartment
Keeping non-dominant hand in place, sweep downward on lateral side of knee to empty lateral compartment with dominant hand
if there is small effusion, will see a ripple or bulge of fluid appears on medial side of the knee from the lateral side

Question 9

Flexion of knee joint?

Answer 9

hamstring muscles

Biceps femoris
Semitendinosus
Semi membranosus
(and gracilis)

Question 10

Extension of knee joint?

Answer 10

quadriceps muscles

Vastas medius
Vastus lateralis
Vastus intermedius
Rectus femoris

Question 11

Active movement?

Answer 11

Ask patient to flex and extend knee as much as possible
Look for pain or reduced ROM

Question 12

Passive movement

Answer 12

Ask patient to relax legs
Flex and extend each leg to maximum extent
Look at pain and ROM

Question 13

Anterior draw for ACL

Answer 13

Flex patients knee to 90 degrees
With hands behind tibia and both thumbs over the tibial tuberosity, pull the tibia anteriorly

movement of >1.5 cm suggests an ACL pathology - often associated with a medial ligament injury

Question 14

Posterior sag for PCL

Question 15

Medial collateral ligament test?

Answer 15

Instruct patient to flex legs up to 30 degrees towards their glutes
Place hand on medial aspect of upper calf with fingers over medial joint line
Place hand on lateral aspect of lower thigh

Apply valgus stress with hand over thigh whilst feeling for joint opening in the medial joint line

Question 16

Lateral colateral ligament test?

Answer 16

Instruct patient to flex leg to 30 degrees towards glutes
Place one hand on medial aspect of lower thigh
Place other hand on lateral aspect of upper calf with fingers over lateral joint line

Provide varus stress with hand over the thigh whilst feeling for a joint opening in the lateral line

Question 17

Structures to palpate?

Answer 17

Patella
Medial and lateral joint lines
Tibial tuberosity and head of fibular
Popliteal fossa

Question 18

How much hyperextension between thigh and lower leg is normal?

Answer 18

Up to 10 degrees

Question 19

ACL function?

Answer 19

Prevents anterior subluxation

Question 20

PCL function?

Answer 20

Prevents posterior subluxation

Question 21

Posterior sag?

Answer 21

Posterior subluxation of the tibia on the femur
Causes a false-positive anterior drawer sign that should not be interpreted as ACL laxity

Question 22

Normal range of motion of knee flexion?

Answer 22

0-140 degrees