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Clinical > Joint exam > Flashcards

Joint exam Flashcards

1
Q

What are the steps of a knee exam? (5)

A
  • Gait
  • Inspection
  • Palpate knee
  • Joint effusion
  • Active movement
  • Passive movement
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2
Q

What should be checked for in gait? (5)

A
  • Normal heel strike/toe?
  • Normal step height?
  • Not broad based steps?
  • Normal speed?
  • Symmetrical?
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3
Q

What position should the patient be in to palpate for a knee exam? (2)

A
  • Sit patient with legs in front of them

- Knee flexed to 90 degrees

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4
Q

What should be felt for in the knee? (6)

A
  • Assess temperature and compare both
  • Quadriceps tendon
  • Borders of patella
  • Patella tendon
  • Tibial tuberosity
  • Head of fibula and joint lines
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5
Q

How are large joint effusions assessed?

A

Patellar tap

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6
Q

Explain how to carry out a patellar tap (4)

A
  • Empty suprapatellar pouch
  • Sliding left hand down thigh to patella with fingertips
  • Keep L hand in position, use R hand to press down on patella with fingertips
  • Fluid = tap of patella against femur
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7
Q

How are small joint effusions assessed = bulge test? (4)

A
  • Swipe fluid from medial knee to suprapatellar pouch
  • Hold fluid in suprapatellar pouch with 1 hand on medial side
  • Swipe down from suprapatellar pouch on lateral side with other hand
  • Bulge/ripple on medial side of joint = effusion
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8
Q

What test is used to assess small joint effusions?

A

Bulge test

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9
Q

What is active movement assessment? What should be observed? (2)

A

Patient performing movement

  • Restricted range of movement
  • Signs of discomfort
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10
Q

What movements in the knee should be assessed in active movement? (2)

A
  • Knee flexion

- Knee extension

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11
Q

What is the normal range of movement in active knee flexion?

A

0-140 degrees

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12
Q

What instruction should be given to the patient for knee flexion?

A

“Move your heel as close to your bottom as you can manage”

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13
Q

What instruction should be given to the patient for knee extension?

A

“Straighten your leg out as best as you can”

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14
Q

What is a passive movement test? What is being observed? (2)

A

Patients relaxes, you move joint freely

  • Crepitus
  • Restriction of movement
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15
Q

What deformities should be checked for in a knee exam? And what do they look like? (2)

A
  • Valgus deformity ><

- Varus deformity <>

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16
Q

When palpating the knee what are the main things to check? (3)

A
  • Quadriceps bulk/wasting: chronic knee condition
  • Swelling
  • Pain along joint lines
17
Q

What passive movements in the knee should be tested?

A
  • Knee flexion
  • Knee extension
  • Hyperextension
18
Q

How should hyperextension in the knee be assessed?

A

Elevate both legs by heels

19
Q

What is normal hyperextension in the knee?

A

Less than 10 degrees

20
Q

What are the special tests of a knee exam? (2)

A
  • Anterior/posterior draw test for ACL and PCL

- Medial and lateral collateral ligaments

21
Q

Describe the anterior/posterior draw test for ACL and PCL

A
  • Flex knee to 90 degrees
  • Wrap hands around proximal tibia
  • Fingers around back of knee
  • Thumbs on tibial tuberosity
  • Relax legs
  • Pull tibia anteriorly - feel for anterior movement of tibia on femur
  • Push tibia posteriorly - feel for posterior movement of tibia on femur
22
Q

Why should the legs be relaxed in the anterior/posterior draw test for ACL and PCL?

A

Tense hamstrings can mask pathology

23
Q

What does movement on tibia on femur suggest?

A

ACL/PCL laxity/rupture

24
Q

How is the lateral coollateral ligament assessed for (LCL)? (6)

A
  • Extend patient’s leg
  • Patient’s ankle between inner upper arm and side
  • Hand on knee medial aspect
  • Other hand on calf (so hands on same side of leg)
  • Push hands steadily in opposing directions to stress joint laterally
  • Should be little movement
25
Q

How is the medial coollateral ligament assessed for (MCL)? (6)

A
  • Extend patient’s leg
  • Patient’s ankle between inner upper arm and side
  • Hand on knee lateral aspect
  • Other hand on calf (so hands on opposite sides of leg)
  • Push hands steadily in opposing directions to stress joint laterally
  • Should be little movement
26
Q

What additional exams can be done after a knee exam? (3)

A
  • Contralateral knee
  • Hip exam
  • Ankle exam
27
Q

McMurray’s test

A
  • Left hand, palpate medial joint line + hold thigh in place

- Hold ankle heel with right hand + externally rotate foot

Clinical (21 decks)

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