knee Flashcards
varus
valgus
accesory movement: flexion
- laying prone position physio grabs patients leg to bed knee
- stabilizes femur
- AP glide on tibio
pain = stiff joint, ACL, PCL
accessory movement extension
- laying on back
- physio rests the patients leg on the physios thigh
- physio puts both hands on the back of the calf
- physio lifts the tibia
tibio-femoral joint origin AP test
AP:
1. patient supine
2. one hand on femur applying pressure down
3. one hand on the tibia applying pressure, on the bottom of knee cap
pain = stiff tibio-femoral joint or ACL
tibio-femoral joint origin PA
- patient in supine
- fix foot by sitting on it
- one hand blocking femur by top of kneecap
- other hand on the back side of the knee (calf)
- do transversal force
pain increases = tibio-femoral stiff joint or PCL
tibio-femoral joint origin medial- lateral sliding in flexion
medial: R hand on the outside of the knee by femur, L on the inside of the knee by tibia and push
lateral: R hand on the outside of knee by tibia, L on the inside of the knee by femur
pain:
medial –> valgus force: MCL
lateral –> varus force: LCL
tibio-femoral joint origin medial- lateral sliding in extension
medial:
1. physio stands with leg of patient on the outside hip
2. R hand on the outside of knee by femur, L on inside knee by tibia
3. lateral force
lateral:
1. physio stands with leg of patient on the outside hip
2. R hand on the outside of knee by tibia, L on inside knee by femur
3. medial force
fibular origin AP, PA with overpressure
AP:
1. patient lying on their side
2. locate head of fibular
3. L on back of knee, R on front of knee
PA:
1. patient lying on their side
2. locate head of fibular
3. L on front of knee, R on back
patella origin
Steps:
1. Make patient stand up and observe their hip, patella and feet
a. Internal rotation, external rotation, how they stand
b. Important not to speak about observations in front of patient because then they will
2. Make patient lay down and move their patella up and down, side to side
a. If there is cracking it is cartilage that is degenerating
b. Should be no pain
3. Splash test: hold patella with one hand and with the other hand press on patella very hard, if you feel water inside it means the knee is not working well
nerve origin tests
- slump test sciatic (L4-S1)
1. Patient lays in lateral position
1. Grab top leg and raise it and move it outwards in extension
1. Then grab top leg and bend it to the back- if it hurts it is femoral nerve - slump test femoral (L2-L4)
1. Make patient sit on the table with their legs hanging off
1. Check if knee hurts in flexion by putting knee straight up
1. Make them curve their neck and back to check if there is neural pain
1. Make them bend their knee and apply a little bit of pressure by pushing to see if there is pain
ACL tear origin lachman test
- 30 deg of flexion –> knee of PT under patients knee
- one hand on femur other on tibia
- external rotation of tibia
- PA on tibia & AP on femur
ACL tear origin pivot shift
- Patient lays on their back
- Grab foot and turn into internal rotation
- And turn it backwards
anterior drawer test
- for ACL
- If patient has a torn ACL they will be able to do this but the pain will be very extreme
- Fix 90 degrees of flexion in relax position
- Grab with both hands the back of knee and both thumbs in the middle of the plates of the patella
- Do quick pulling motions towards you - fast traction. This checks the mobility in the anterior sliding
posterior drawer test
- for PCL
- If patient has a torn ACL they will be able to do this but the pain will be very extreme
- Test cruciate: patient lays on their back and bends one knee with foot on table
- Fix 90 degrees of flexion in relax position
- Grab with both hands the back of knee and both thumbs in the middle of the plates of the patella
- Do quick pushing motions towards patients - fast traction. This checks the mobility in the posterior sliding
appley test
- for meniscus
steps:
1. Patient prone & 90 deg flex knee
2. IR = external meniscus, R hand on hamstring, L on anterior ankle, L hand does rotation R hand does AP on tibia
3. Then do EX to check internal meniscus, R hand on hamstring, L on anterior ankle, L hand does rotation R hand does AP on tibia
5. put forarm on foot and push down with body weight
mc murray test
- for meniscus
- patient in supine position
- hold the heel and the patella
- full flexion of the knee
- IR of the tibia/knee –> lateral meniscus
- ER of the tibia/knee –> medial meniscus
- extension by femur pressing down
