Knee

Question 1

Circumferential measurement of muscle bulk – thigh

Answer 1

Half lying

Picture muscles are relaxed

Measure 10 cm and 15 cm above the base of the patella and measure the circumference of these areas

Measure both legs

Question 2

Circumferential measurement of muscle bulk – calf

Answer 2

Half line

Measure 5 cm below tibial tuberosity measure circumference

Measure both legs

Question 3

Integrity of knee ligaments

Valgus MCL ligament

Answer 3

Supine

Unaffected leg measured 1st to determine what normal laxity is

Position Knee nearly in full extension then repeat and 30°

Support leg under arm hand should be positioned under calf other arm hand is placed on thigh apply equal and opposite pressure

Palpate medial joint line

Question 4

Integrity of knee ligaments

Valgus MCL ligament

Explained

Answer 4

Excessive valgus movement suggests MCL damage

Repeating in 30° improve sensitivity by reducing compensation by other knee ligaments

Question 5

Integrity of knee ligaments

Varus LCL

Answer 5

Supine

Sit in between patient legs

Leg in near full extension repeat in 30° flexion

Apply equal and opposite pressure palpate lateral joint line

Question 6

Integrity of knee ligaments

Varus LCL

Answer 6

Gaping excessive varous movement

Repeated in 30° flexion increases sensitivity by reducing potential compensation of other knee ligament

Question 7

Lachmann test for ACL

Answer 7

Supine

Are unaffected like 1st to determine on mate

Please towel underneath knee anteriorly grip femur just above patella posteriorly grip tibia just below patella apply equal and opposite forces

Look for excessive movement of tibia upwards= positive test

Question 8

PA PCL

Answer 8

Supine

Sit on models foot with leg bent 70° flexion

From side check position of tibial plateau look for an obvious step

Using both hands grip behind the knee and thumbs on tibial tubercle push backwards

Excessive posterior displacement i.e. 1 cm =positive test

Question 9

Integrity of meniscus

McMurrays test - Tear in the posterior horn of the medial/lateral meniscus

Answer 9

Medial meniscus

One hand under heel of foot other under the knee then on top of knee Bring into flexion Bringing heel to Bum laterally rotate and evert foot palpate medial joint line and bring into extension

Click - femoral condyles across damaged area

apprehension - pain femoral condyles squeezing meniscus