Knee exam Flashcards
Extension
0
Quads (Rectus Femoris, Vastus Lateralis, Vastus Medialis, Vastus Intermedius
Femoral N. L2-4
Internal Rotation
10
External Rotation
10
Valgus stress test
Collateral Ligament
Pt. supine and doc supports lower leg on hip. Knee flexed to 30. Examiners hands are placed on medial and lateral aspects of patient’s knee. Push knee internally.
(+) test= increased laxity, soft or absent endpoint, pain
MCL injury
Varus Stress test
Patient supine. KNee bent to 30. Caudal hand holding distal tib/fib. Cranial hand providing lateral force to knee.
(+) test= increased laxity, soft or absent endpoint, pain
LCL disruption
Lachman’s test
Patient supine. Cephalad hand on distal thigh, superior to patella. Caudad hand grasps proximal tibia. Flexing knee to 15-30, doc uses his caudad hand to pull the tibia anterior while the cephalad hand pushes femur posterior
(+) test= increased laxity, soft or absent end point
ACL insufficiency
Anterior Drawer test
Patient supine with knee flexed to 90. Doc sits on patients foot and grasps proximal tib with both hands. Pull tibia anteriorly
(+) test= excessive translation when compared to other knee
ACL insufficiency
Posterior Drawer
Patient supine with knee flexed to 90. Examiner sits on pt’s foot. Grasp proximal tibia with both hands. Push tibia posteriorly
(+) test= excessive translation, compared to opposite side
PCL deficiency, posterior capsular injury or disruption
Reverse Lachman’s Test
Patient supine. Examiner places cephalad hand on the distal thigh, superior to patella. Caudad hand grasps the proximal tibia. Flexing the knee to 15-30. Proximal hand stabilizes the femur while the distal hand pushes tibia posterior
(+) test= increased laxity, soft or absent end point when compared to other side
PCL deficiency or post capsule deficiency
Laxity Test
Patellar Ligament
One hand above, one hand below joint. Thumbs placed agains side of the patella. Examiner pushes the patella medially and laterally assessing ROM
Laxity is graded 1-4(+1= 0-25%, +2= 25-50%)
Apprehension Test
When testing laxity to the point of restriction, ask the patient if the maneuver provokes any discomfort or instability.
(+) test= sense of apprehension or instability
possible previous patellar dislocation or severe instability
Patellar Compression (Grind) Test
Patellar Cartilage
Patient supine and knee extended. PRovide compressive load to the patella with one hand while moving patella medial and lateral
(+) test= pain with compression
Possible inflammation, chondromalacia, or injury to patellofemoral articular surfaces
Patellar Femoral Grinding variation
Patellar cartilage
Compress patella caudally into trochlear groove and instruct patient to tighten quads against resistance
(+) test= crepitation or pain indicating roughness of articulating surfaces
Patellar Glide test
PT sitting or supine will slowly extend and flex the knee. Doc notes quality of articular motioin. Doc places hand lightly over the patella can increase sensitivity of the test
(+) test= palpable or audivle crepitus, pain, or catching of the patella
Possible damage to the articular surface
McMurray’s Test
Pt supine with hip and knee flexed. Doc uses caudad hand to control the ankle and cephalad on distal femur
Medial meniscus: internally rotate tibia as knee is extended while adding a varus load
Lateral meniscus: Externally rotate tibia as knee is extended while adding a valgus force
Possible meniscus tear
