Knee exam

Question 1

ROM for flexion

Answer 1

145-150

-using Tibial branch of sciatic N. L4-5 and S1-3

Question 2

ROM for extension

Answer 2

0

Question 3

Internal and external rotation

Answer 3

both 10 degrees

Question 4

What dermatome is being hit with the patellar reflex?

Answer 4

L4

Question 5

valgus varus stress tests

Answer 5

testing collateral ligaments

• flex knee to 30
• • if laxity, more sever if still there when knee is fully extended

Question 6

Lachman’s test

Answer 6

cephalad hand on distal thigh, caudad hand proximal tibia,

• flex knee to 30 degrees and pull the tibia out while pushing the femur away
• • if increase laxity, soft or absent end point
• indicates ACL insufficiency
• reverse lachman’s is just the opposite of all this

Question 7

Anterior drawer

Answer 7

flex knee to 90 degrees, sit on foot, grab prox tibia with both hands, pull tibia anteriorly

• • if excessive translation when compared to the other knee
• indicates ACL insufficiency
• posterior drawer is the opposite of all this

Question 8

Patellar compression (grind) test

Answer 8

patient supine and knee extended. compress patella while moving it side to side

• • if pain
• indicates inflammation, chondromalacia, or injury to the patellofemoral articular surfaces

Question 9

McMurray’s test

Answer 9

Patient supine, hip and knee flexed, doc uses caudad hand to control the ankle and cephalad hand placed on distal femur

• test medial meniscus by internally rotating the tibia as knee is extended while adding a varus load
• test lateral meniscus by externally rotating tibia as knee is extended while adding a valgus load
• • if pain or click
• indicates possible meniscus tear

Question 10

Apley compression (grind) test

Answer 10

Patient prone with knee flexed to 90 degrees. Doc usued downward force on the foot to provide a compressive force on the meniscus while rotating the foot internally and externally

• • if pain with rotation and/or compression
• indicates meniscal injury, collateral ligament injury, or both

Question 11

Apley distraction test

Answer 11

Patient prone with knee flexed to 90 degrees. Doc pulls on the foot and rotates internally and externally

• • if pain with distraction and rotation
• indicates collateral ligament damage