Knee

Question 1

Knee

Bony Palpation

Answer 1

1) Patella
2) Medial tibial plateau
3) Tibial tubercle
4) Medial femoral condyle
5) Lateral tibial plateau
6) Lateral femoral condyle
7) Fibula head

Question 2

Knee

Soft Tissue Palpation

Answer 2

1) Quadriceps muscles (palpate as a unit and Individually)
• Vastus Lateralis
• Vastus Medialis
• Vastus Intermedius
• Rectus Femoris
2) Infrapatellar Tendon
3) Bursae
• Prepatellar
• Superficial infrapatellar
4) Medial meniscus
5) Lareal meniscus 7) Popliteal fossa
6) Pes anserine area 8) Lateral collateral ligament
•Sartorius
9) Medial collateral ligament
•Gracilis
10) Gastrocnemius muscle
•Semitendinosus

Question 3

Knee

Ranges of Motion

Answer 3

Active and Passive

1) Flexion 135°
2) Extension 0°
3) Internal rotation “Raise knee to 90° then rotate”
4) External rotation “Raise knee to 90° then rotate”

Question 4

McMurray Sign

Answer 4

Positive:
Clicking sound or pain by knee joint

Indicates:
Tear of medial meniscus if positive on external rotation
Tear of lateral meniscus if positive on internal rotation.
The higher the leg is raised during when positive is elicited, the more posterior the meniscal injury.

Question 5

Medial Collateral Ligament Test
a.k.a
Abduction Stress Test
a.k.a
Valgus Stress Test

Answer 5

Positive:
Gapping and/or elicited pain above/at/or below joint line

Indicates:
Torn medial collateral ligament

Question 6

Lateral Collateral Ligament Test
a.k.a
Adduction Stress Test
a.k.a
Varus Stress Test

Answer 6

Positive:
Gapping and/or elicited pain above/at/or below joint line

Indicates:
Torn lateral collateral ligament

Question 7

Bounce Home Test

Answer 7

Positive:
Knee does not go into full extension (slight flexion remains)

Indicates:
Diffuse swelling of the knee, accumulation of fluid, due to possible torn meniscus

Question 8

Drawer Test

Answer 8

Positive:

1) Gapping > 6mm (tibia moves posterior) when the leg is pushed
2) Gapping > 6mm (tibia moves Anterior) when the leg is pulled

Indicates:

1) Torn posterior cruciate ligament “Push”
2) Torn anterior cruciate ligament “ Pull”

Question 9

Lachman Test

Gold Standard

Answer 9

Positive:
Gapping with tibia moving away from the femur

Indicates:
Anterior cruciate liament or posterior oblique ligament instability

Question 10

Apprehension Test for the Patella

Answer 10

Positive:
Apprehension, disress of facial expression, contraction of quadriceps to bring patella back in line.

Indicates:
Chronic patella dislocation or pre-disposition to dislocation.

Question 11

Patella Femoral Grinding Test
a.k.a
Clarke Sign

Answer 11

Positive:
Retropatellar pain and the patient is unable to hold the quadriceps contraction.

Indicates:
Degenerative changes of the patellar facets and/or within the trochlear groove (chondromalacia patella)

Question 12

Patella Ballottment Test

Answer 12

Positive:
A floating sensation of the patella

Indicates:
A large amount of swelling in the knee

Question 13

Apley Compression Test

Answer 13

Positive:
Patient points to side of pain

Indicates:
Pain on medial side is medial meniscus tear. Pain on the lateral side indicates lateral meniscus tear.

Question 14

Apley Distraction Test

Answer 14

Positve:
Patient will point to side of pain

Indicates:
Pain on the medial side indicates medial collateral ligament tear. Pain on the lateral side indicates lateral collateral ligament tear.