knee and vascular LE orthopedic tests Flashcards
How is a Drawer test or sign performed?
Observe for sag sign on the symptomatic leg first
Patient is supine with the knee flexed and the examiner stabilizes the foot or ankle and firmly pulls the tibia forward and then pushes the tibia posteriorly
If a patient reports locking in the knee what should be immediately considered?
Meniscal lesion or joint mice
What ligament holds the menisci in the knee in place?
Coronary ligament
What is the action of articularis genu?
Contracts in knee extension to move the joint capsule out of the way
What is a positive result for a Drawer test or sign?
Excessive motion upon either translation as compared to the opposite side or pain in the central knee joint
A present sag sign is indicative of a(n) ____________________ injury?
PCL
What test should NOT be performed if a sag sign is present?
Drawer Test or Sign
What is indicated by a positive result for a Drawer Test?
Excessive anterior tibial motion = ACL damage
Excessive posterior tibial motion = PCL damage
A drawer test is performed on a patient and there is noted excessive anterior motion of the tibia compared to the opposite leg, how is this recorded and what is indicated?
Positive Drawer Test indicating an ACL injury
A drawer test is performed on a patient and there is noted excessive posterior motion of the tibia compared to the opposite leg, how is this recorded and what is indicated?
Positive Drawer Test indicating a PCL injury
How is a Lachman’s test performed?
The patient is supine with the knee flexed to 30 degrees
The examiner stabilizes the femur with one hand and exerts P to A stress on the tibia
What orthopedic tests for the knee can determine ACL damage?
Drawer Test/Sign
Lachman’s Test
What orthopedic test is specific to ACL damage?
Lachman’s test
What is a positive finding for a Lachman’s test?
Excessive anterior translation of the tibia and or pain in the central knee
What is indicated by a positive fining for a Lachman’s test?
ACL damage
How is an ABduction or Valgus stress test for the knee performed?
Lower leg ABducted with lower femur stabilized opening up the medial knee joint
Perform test in full extension and repeat in slight flexion on the well side first
What is a positive finding for an ABduction or Valgus stress test for the knee?
Pain or excessive motion at the medial knee
What is indicated by a positive finding for an ABduction or Valgus stress test for the knee?
MCL damage
An ABduction or Valgus stress test is testing the integrity of the _____________?
MCL
An ADduction or Varus stress test is testing the integrity of the ______________?
LCL
How is an ADduction or Varus stress test performed for the knee?
Lower leg is ADducted while the lower femur is stabilized opening up the lateral knee joint
Perform test in full extension then repeat in slight flexion on the well side first
What is a positive result for an ADduction or Varus stress test on the knee?
Pain or excessive motion at the lateral knee
What is indicated by a positive result for an ADduction or Varus stress test on the knee?
LCL damage
If a patient has lateral knee pain what can be on your DDx list? What test can be performed for each?
LCL = Varus/ADduction stress test
Lateral meniscus = Apley’s Compression/Grind Test OR McMurray’s Test (INT Rotation)
IT Band = Noble’s Test
Common Peroneal Nerve = MRS over fibular head
Fibular head
How is Noble’s test performed?
Patient in a supine position, the doctor places a thumb over the lateral femoral epicondyle as the patient repeatedly flexes and extends the knee. Pain symptoms are usually most prominent with the knee at 30 degrees of flexion
What is a positive finding for Noble’s test?
Reproduction of pain in the iliotibial band
What is indicated by a positive finding for Noble’s test?
Iliotibial band tendonitis
What orthopedic test is used for determining IT band TENDONITIS?
Nobles test
What motion leads to lateral knee pain and IT tendonitis?
Repetitive knee flexion in runners and cyclists
How is Apley’s Compression/Grinding Test performed?
Patient prone with knee flexed to 90 degrees. Compress the tibia firmly down into the examining table while rotating the tibia internally. Repeat with external rotation
What is a positive result for Apley’s Compression/Grinding Test?
Any report of pain or clicking at the medial or lateral meniscus
What is indicated by a positive result for an Apley’s Compression/Grinding Test?
Pain or click in external rotation = Damage to posterior horn of medial meniscus
Pain or click in internal rotation = Damage to posterior horn of lateral meniscus
An Apley’s Compression/Grinding Test is performed and the patient notes clicking during external rotation of the tibia. How is this recorded and what does it indicate?
Positive Apley’s indicating a medial meniscus injury