Knee 3 - tests and measures Flashcards
what are the two tests for ACL injuries
anterior drawer test
lachmans
what is the number one test for ACL
lachmans
what is the position of the knee for lachmans test
30-deg of flexion
what kind of end feel should the patient have a negative lachmans
hard firm stop
firm end feel
what is a positive lachmans test
anteriorn translation of the tibia beyond the femur with a mushy soft end feel
what is the position of the patient for anterior drawer
knee in 90-deg of flexion
for the anterior drawer where should the thumbs be placed
in the joint line
what is a negative anterior drawer
clear firm stop
what is a postive anterior drawer test
increased anterior translation of the tibia and soft end feel
the anterior drawer primary test what bundle of the ACL
Primarily tests anteromedial bundle
what are the test for PCL
posterior drawer test
posterior stag sign
quad active
what is a positive test for the posterior drawer test
excessive posterior translation and/or a soft end-feel
what is the procedure for the posteior sag sign
the patients knees are supported and flexed to 90-deg
you have to make sure that the quads are relaxed
what is the a positive test for a posterior sag sign
the anterior aspect of the tibia appear to sag
what is the procedure for the qaud active test
- Patient will lie supine
- Hip flexed to 45°
- Knee flexed to 90°
PT sit on the patient foor
ask the patient to perform an isometric quad contraction
what is a positive test for the quad active test
the tibia should sag posteriorly
what is a negative test for the quad active test
clear stop
what is a test for the posterior lateral corner
the dial test
what is the position for the dial test
pt prone
knee flexed to 90 and 30
what is the procedure for the dial test
knee 30 - both
knee 90 - just posterior lateral corner
ER the foot
dial test - what is just isolated posterior lateral corner
ER difference of 15-deg at 30 but not 90
dial test - what is both PCL and posterior lateral corner
ER difference of 15-deg seen at both 30 and 90
what are the tests for MCL
palpation
valgus test
what is the procedure for the valgus test test
pt supine
knee is flexed 20-30
valgus stress is a applied at the joint line
what is the open packed position of the tib femoral
30-deg of felxion
what is a positive valgus test
the presence of laxity or pain
what are we expectiving with palpation of the MCL
tenderness of the tendon
what are the tests for OA
palpation
ROM
strength testing
functional testing
apley’s
mcmurty’s
OA what do we expect to with palpation
bony enlargement
joint line tenderness
OA what do we expect with ROM
capsular pattern
Flex > ext
what strength deficts do we expect to see with OA
quads
hamstrings
hip - compensations
what functional activites do those with OA present with
stairs
transfers
lifting
kneeling
what is the rule to rule in or out a men tear
- report of catching or locking
- joint line tenderness
- pain with forced hyperextension
- pain with max flexion
- pain or audible click with McMurray’s
what is the precentage for 3 positive test my the men cluster
> /= 3 90.2
what are all of the test for men injury
ROM
functional
palpation - joint line
strengthing
McMurty’s
apley’s comprssion and distraction
extension/flexion overpressure
thessaly’s test
what ROM impairment do we expect with Men injury
flex or ext present with limited ROM
functional issues with men
deep squatting and pain with hyper flexion
what should you palpate for an men injury
palpate the joint line when the patient is supine with their knee bent to 90-deg
what should we see with palaption of the joint line with men issue
presence of pain or tenderness
what strength testing can you do to test the men
quad inhibition
has for a qua set:
uninvolved side is fine
involved side - delayed with not much of a contraction
what is the procedure for McMurty’s
patient is supine with knee fully flexed
grasp the ankle of the knee
thumb over the lateral joint line
middle finger over the medial joint line
knee is maximally flexed and IR/ER and then is slowly extended
for McMurty’s why do you turn the leg in for IR and ER
ER - medial men
IR - lateral men
what is a positive McMurty’s test
a click or an audible snap
usually accompanied by pain
what is the procedure for apley’s compression/ distraction
pt is prone
knee is flexed to 90-deg
examiner applies a compressive force through the tibia
medialy and laterally rotates the tibia (compression)
applies a distractive force through the tibia
medialy and laterally rotates the tibia
(distraction)
what is a postive apley’s compression test
pain
what is a postive apley’s distraction test
pain reduction
if there is pain this indicates capsuloligamentous structures
what is the procedure for extension over pressure
pt supine
the examiner grasps the femur superior to the patella and provides a postereior directed force into ext
PT graspsthe great toe of the same limb and pulls the heel off the table
what is a positive test for extension overpressure
Pain
or
Differences in range of motion.
what is the procedure for the flexion over pressure test
the patient is supine
bring the knee into full flexion and notes the patient pain status
what is a positive over pressure test
pain
what is the procedure for thessly test
the patient stands on the involved leg 5-deg and 20 deg of knee flex
hold the PT hands for support
pt rotates there body medially and laterally causing rotation of the knee
what is the tests for PFPS
pain with functional activities
patella tilt test
assessment for the need for tapping
what is the type of tapping we can do for PFPS
medial glide
medial tilt
medial rotation
what are some test for patellar instability
bruising and swelling
patellar apprehension
moving patellar apprehension
sitting - need for patella taping procedure
pt is sitting
MMT the quads at different angles
looking for pain
medially glide the patella and reset - trying to see if the glide reduces the pt’s symtoms
step down - taping procedure
pt standing on a 8’ block
standing on the involved leg
opposite limb in front of them
pain on the first rep - note the angle of the knee that the pain is present
no pain on the first rep - have then perform additional reps until there is pain reproduced
apply tape or manually glide the patella and re-try - medial glide
medial glide of tape is for what
correction of later displacement
what is medial tilt with tape for
correction of lateral compression
what is medial rot taping for
correction of excessive lateral rot
what is the procedure for the patellar apprehension test
pt knee in 30-deg of flex
PT apply pressure to the medial patella forcing a lateral glide of the patella
what is a positive patellar apprehension test
quad activation and/or signs of apprehension
empty endfeel
quad activation - flex the knee and try to get it away
what is the procedure for the moving patellar test
pt is supine with their knee off of the table
1 - knee in full ext and the patella is moved laterally, flexed to 90 and brought back to full extension
2- the same procedure is performed but with a medial glide
what is a positive test for a mobing patellar test
sign of apprehension
and/or
quad contraction during part 1 and not part 2
what tests can we do for IT band syndrome
nobels
TTP of gerbys of the femoral condyle
what is the procedure for noble
pt supine with knee flexed to 90
apply pressure over the lateral femoral condyle and
passivly extend the knee
what is a postive noble test
- Lateral knee pain, usually around 30°
what is the procedure for the royal london hospital test
short sitting
- Knee fully extended – palpate to find the most tender location
- Flex the knee to 90° and palpate again
what is a positive test for royal london hosipital test
decrease or absence of pain with the knee flexed
what is the single-leg decline sqaut test for
patellar tendinopathy
what is the procedure for the single-leg decline sqaut test for
Standing on a 25-30° slant board on a single-leg, trunk upright
the PT instructs the patient to squat down to 60-deg or as low as the pain will allow and then return to the starting position
