Knee CPA Flashcards
Genu Valgum
Posture with knee close together and feet farther apart (knock-kneed)
Genu Vargas
Posture where the legs appear bowed with feet together (bow-legged)
Genu recurvatum
Posture seen from a lateral view, where the knee has a backward curvature (hyperextension)
Q-angle
Normal = 15°
- Measured by creating a straight line from the ASIS to the center of patella another line through the tibial tuberosity and the same point of the patella. This difference between these two lines forms the “Q-angle”
- Females typically have increased Q-angle.
Flexion —> Hamstrings; muscle?
145-150°
Biceps femoris
Extension —> Quadriceps; muscles?
0°
Rectus Femoris, Vastus Lateralis, Vastus Medialis, and Vastus Intermediate.
Internal /external rotation
10°
Accessory motion of the tibia/fibula as articulates with femur.
Sensation Testing:
Dermatomes
Patellar Reflex
Dermatomes: L3-5, S1, and S2
Patellar reflex: L2-L4, primarily L4
Valgus stress test (collateral ligaments)
Pt. supine, examiner supports patients lower leg, with knee flexed to 30°. Hands on medial and lateral aspects of pt. leg. Providing lateral resistance of the knee, move the lower leg so that ankle shifts laterally while holding the distal femur in place.
Positive: increases laxity, soft or absent endpoint, and pain
Indicated: MCL disruption
*If positive at 0° with knee fully extended, indicated more serious injury, possible joint capsule.
Varus stress test (collateral ligaments)
Examiner and pt same position as valgus ST. Provide medial resistance, and move the lower leg so that ankle shifts medially. Test is done at 30° flexion and neutral (0°).
Positive: Increased laxity, soft or absent endpoint, and pain
Indicates: LCL disruption
*If positive at 0° with knee fully extended, indicated more serious injury, possibly joint capsule.
Anterior Drawer Test (Anterior Cruciate Ligament)
Pt supine with knee flexed to 90°. Examiner sits on the patients foot and grasps the proximal tibia with both hands, pulling the tibia anteriorly.
Positive: Excessive translation when compared to the other knee
Indicated: ACL insufficiency
Lachman’s Test (Anterior Cruciate Ligament)
Pt supine, examiner places cephalad hand on the distal thigh, superior to patella. Caudad hand grasps the proximal tibia. Flexing the knee to 15-30°, examiner used his caudad hand to pull the tibia anteriorly while the cephalad hand stabilized the thigh.
Positive: Increased laxity, soft or absent end point
Indicates: ACL insufficiency
Posterior Drawer Test (Posterior Cruciate Ligament)
Pt supine with knee flexed to 90°. Examiner sits on patient’s foot and grasps the proximal tibia with both hands, translating the tibia posteriorly.
Positive: Excessive translation, particularly when compared to the opposite side.
Indicates: PCL deficiency, posterior capsular injury or disruption.
McMurray’s Test, applying varus vs. valgus tests for?
- Examiner rotates the tibia into internal rotation, apply varus stress (pushes ankle toward middle w/ counterforce to femur), while continuing leg into extension, tests Lateral meniscus
- Examiner rotates the tibia into external rotation, apply valgus stress, while continuing leg into extension, tests Medial Meniscus.
Apley’s Grind Test - Compression test
Pt prone with knee flexed to 90°. Use downward force on the foot to provide a compressive force on the meniscus, while rotating foot internally and externally.
Positive: Pain with rotation and/or compression
Indicates: Possible meniscal injury, collateral ligament injury, or both
