Knee Flashcards
1
Q
Observation for the knee
A
- Gait analysis –> knee valgus or varus
- Squat –> depth
2
Q
AROM/PROM for knee
A
- Knee flexion (laying on stomach)
- Knee extension
3
Q
Strength Testing for knee
A
- Knee flexion (hamstrings)
- Knee extension (quad)
4
Q
Ligament stress tests for knee
A
- Posterior sag –> PCL
- Posterior drawer –> PCL
- Lachman test –> ACL
- Anterior drawer –> ACL
- Valgus stress test –> MCL
- Varus stress test –> LCL
5
Q
Posterior Sag
A
- Knee flexed 90 degrees
- Looking if PCL stays intact
6
Q
Posterior drawer
A
- Hip flexed 45 degress knee flexed 90 degrees
- Hands resting on the depression in the knee
- Push forward
- Observe posterior translation
7
Q
Lachman Test
A
- 30 degree flexion of knee
- Bring tibia into slight external rotation
- One hand on femur other hand below the knee
- Hand on femur pushes down while hand below the knee pulls up
8
Q
Anterior drawer test
A
- Hip flexed 45 degress knee flexed 90 degrees
- Hands resting on the depression in the knee
- Pull
- Observe anterior translation
9
Q
Valgus stress test
A
- 30 degree knee flexion
- One hand grabbing end of lower leg other hand grabbing femur
- External rotate the tibia
- Hand on lower leg outwards (laterally) while hand on knee is inwards (medially)
- Observe for laxity for MCL
10
Q
Varus stress test
A
- 30 degree knee flexion
- One hand grabbing end of lower leg other hand grabbing femur
- External rotate the tibia
- Lower leg is pulled (medially) while knee is outwards (laterally)
- Observe for laxity for LCL
11
Q
Special test for the knee
A
- Intracapsular swelling test
- McMurray’s test for meniscus
- Apley’s compression test for meniscus
- Lateral patellar glide
- Patellar grind
- VMO contraction
12
Q
Intracapsular swelling test
A
- Patellar compression –> push down on the top of patellar
- Swipe Test –> swipe up on medial side, down on lateral side
13
Q
McMurray test
A
- Knee flexed 90 degrees
- One arm on lower leg, other one femur
- Internally rotate knee for lateral meniscus, externally rotate knee for medial meniscus
- Bring knee to flexion and extension
14
Q
Apley’s compression test
A
- Lay on stomach with knee flexed 90 degrees
- One hand on heel other hand on ankle
- Push down on leg while turning
- Internal rotation of knee for lateral meniscus, external rotation of knee for medial meniscus
15
Q
Lateral patellar glide
A
- Stand on opposite side of knee
- Use both hands to apply a lateral force to patella
- Examine for laxity
16
Q
Patellar grind test
A
- Press down on the top of the patella
- Patient contracts quadriceps
- Observe for pain, clicking or grinding
17
Q
VMO contraction
A
- Have patient contract quad
- Observe if contraction is weak or absent
18
Q
Palpation for knee
A
- Medial meniscus
- Lateral meniscus
- MCL
- LCL
- Medial retinaculum
- Underside of patella
19
Q
Injuries for the knee
A
- ACL sprain
- PCL sprain
- MCL sprain
- LCL sprain
- Meniscus tears
- Patellar dislocation
- Patellofemoral Pain Syndrome
20
Q
History for ACL sprain
A
- Impact from the lateral side
- Athlete will report a pop
- Knee buckles into valgus
- Sometimes pain sometimes no pain
- Instability
21
Q
Assessment for ACL sprain
A
- Laxity or pain with anterior drawer and Lachman
- Positive swipe test
- Positive patellar compression test for swelling
- Restricted knee flexion and extension
22
Q
Treatment for ACL sprain
A
- POLICE
- Strengthening specific to hamstring –> hamstring curl bodyweight then machine
- Bracing
- Possible surgery if ACL ruptured
23
Q
History for PCL sprain
A
- Impact with dashboard in car accident
- Falling on another athlete
- Tibia translating posteriorly
- Direct impact, may report pop
24
Q
Assessment for PCL sprain
A
- Positive posterior sag
- Laxity with posterior drawer test
- Positive intracapsular swelling tests
- Possible limitation into knee flexion and extension
25
Q
Treatment for PCL sprain
A
- POLICE
- Strengthening specific to quad –> step ups on an elevated platform, body weight then can carry weighted items
- Bracing
- No surgery
26
Q
History for MCL sprain
A
- Lateral impact from side
- Reports a pop
- Valgus force applied to knee
27
Q
Assessment for MCL sprain
A
- Swelling
- Laxity with either or both valgus stress
- Limited ROM KF/KE
- Pain over MCL
28
Q
Treatment for MCL sprain
A
- Avoid valgus forces during daily activities
- ROM exercises –> heel slides
- Deep transverse friction massage
- Brace
- Surgery very rare
29
Q
History for LCL sprain
A
- Impact from medial side
- Might report pop
- Varus force applied
- Often from a fall, not common injury
30
Q
Assessment for LCL sprain
A
- Swelling
- Laxity with either or both varus stress tests
- Limited ROM KF/KE
- Pain over LCL
31
Q
Treatment for LCL sprain
A
- Avoid varus forces during daily activities
- ROM exercises –> heel slides
- Deep transverse friction massage
- Brace
- Surgery very rare
32
Q
History for meniscus tears
A
- Planted foot with rotary force
- Clicking, popping
- Present as chronic in older athletes
- Knee can feel unstable
33
Q
Assessment for meniscus tears
A
- Positive apley’s and mcmurray’s test
- Internal rotation stresses later meniscus
- External rotation stresses medial meniscus
- Positive intra-capsular swelling
- Pain over medial or later joint line
34
Q
Treatment for meniscus tears
A
- POLICE
- AROM –> heel slide
- Strengthening exercises –> step ups on an elevated platform, body weight then can carry, hamstring curl bodyweight then machine
- Possible surgery
35
Q
History for patellar dislocation/subluxation
A
- Dislocation –> kneecap completely comes out of groove
- Subluxation –> patellae slipped out of groove
- Patellae dislocates almost exclusively laterally
- Can be impact or non-contact
- Extremely painful
36
Q
Assessment for patellar dislocation/subluxation
A
- Limited ROM KF/KE
- Weakness KE
- Swelling
- Positive lateral apprehension test
- Pain over medial retinaculum
37
Q
Treatment for patellar dislocation/subluxation
A
- If dislocated immobilize, don’t move athlete call 911
- Strengthen quads –> Lie on back and extend knee and raise affected leg while keeping leg straight
- Use a brace
- Restore squat pattern
38
Q
History for Patellofemoral Pain Syndrome
A
- Chronic injury
- Repetitive KF/KE
- Common in running
- Pain behind knee cap
- Pain worse with sitting knee bent or exercising
- Getting progressively worse
39
Q
Assessment for Patellofemoral Pain Syndrome
A
- Poor squat pattern
- VMO contraction test positive
- Positive patellofemoral grind test
- Pain over dorsal patellae
40
Q
Treatment for Patellofemoral Pain Syndrome
A
- Rest, ice
- Biomechanical correction
- Squat pattern education
- Patellar taping or strap
- Stretch and strengthen quads –> straight leg raises, hip flexors –> high kicks , hip abductors –> open the gate
