Knee exam Flashcards
Go over the surface anatomy of the knee
What do you inspect the knees for?
With patient standing
1)bony allignment
- valgus, varus or hyperextension deformity
- line drawn from iliac crest to middle toe
2)Swelling or masses
3)Gait
4)squatting and assessing patellofemoral compartment –> crepitus…
with patient sitting
1)patellar tracking
2)prominence of the tibial tuberosity
with patient lying
1)assymetry between knees
2)masses
3)Scars/ lesions
4)muscle atrophy and hypertrophy
What do you palpate the knees for?
1)Temperature above and below the patella
2)Tenderness
- joint line
- collateral ligaments (MCL, LCL)
- patellar edges
- pre-patellar bursa and suprapatellar bursa
- pes anserine bursa
3)Crepitation
4)Effusion
bulge sign–>best for small effusions
–> milk medially and sweep down lateral
Ballotement–> best for large effusions
–> press down on suprapatellar pouch and then try to move fluid around
Patellar tap-
–> milk fluid into suprapatellar pouch and then press down of pattella –> listen for clunk
How do you test active ROM
Patient displays on their own
How do you test passive ROM on the knee?
Flexion
Extension
Isolation of that joint alone
look for crepitus
How do you test the ligaments, meniscus and patella?
ligaments
1) MCL–> create valgus deformity
2) LCL–> create varus deformity
3) ACL –> anterior drawer test
–> lachmans test with knee fixed in 20-30 degrees of flexion
4)PCL–>posterior drawer test
meniscus’s
McMurrays test for medial meniscus–> fingers on medial joint line, valgus deformity ( ankle inward) + internal rotation
McMurrays test for lateral meniscus–> fingers on lateral joint line, varus deformity (ankly outward + external rotation)
Thessaly test