Knee Exam Flashcards
what is the first thing you do in a knee examination?
Gait
look for antalgia waddleor broad-based gait
what do you look for on inspection
Scarsfrom previous surgery or trauma. Swellings, asymmetry, leg length discrepancy, Valgus or varus deformity, quadriceps wasting. Posteriorly scars and popliteal swellings
in what position do you palpate the knee joint?
knee flexed at 90°
in what order do you palpate the knee joint?
patella, tibial tuberosity, head of the fibula, tibial and femoral joint lines, collateral ligament, popliteal fossa
how do you perform a patellar tap?
empty the suprapatellar pouch by sliding hand down the thigh to the patella. Keep the hand in position and use the other to press downwards on the patella with your fingertips. If fluid is presentyou will feel a distinct tap as the patella bumps against the femur
how do you perform a sweep test?
empty the suprapatellar pouch with one hand while also emptying the medial side of the joint using an upward wiping motion. It really is your hands and do a similar swiping motion downwards on the lateral side of the joint. Watch for a bulge a report on the medial side of the joint the appearance of will suggest an effusion
what do you ask to look at active new movement.
move your heel as close to your bottom as you can manage. Straighten your leg out as best as you are able to
what is the normal range of movement for knee flexion and extension?
0 to 140°, less than 10°
what do you look for on passive knee flexion and extension?
crepitus, reduced rom
what are the two special tests for examining the knee joint
IIIc collateral cruciate and cartilage. Anterior and posterior draw, collateral ligament, and McMurrays test
how do you perform an anterior draw?
flex need to 90°, hands around proximal tibia with fingers around the back of the knee, rest forearm down patients lower leg to fix its position. position thumbs over tibial tuberosity, ask patient to relax, pull tibia anteriorly (movement suggests anterior cruciate laxity or rupture), push tibia posteriorly (movement suggest posterior cruciate laxity or rupture)
how do you test the collateral ligament’s?
extended patients need fully, hold patients ankle between your elbow inside, place your right hand along the medial aspect of the knee, place your left hand on the lower limb or ankle, push steadily outward with your right hand whilst applying and opposite force with the left do you opposite for lateral and medial collateral ligament.
how do you perform McMurrays test?
with meniscal injury is usually patient complains of knee pain localised to lateral or medial side of joint. McMurrays test shows pain or painful clinic as neat as bought from flexion to extension with either internal or external rotation. Patient lies supine with knee flexed, examiner grasps patients heal with one hand and places other hand over the knee joint. To test medial meniscus examiner passively externally rotate the tibia then places a valgus force. The knee is then extended to test the medial meniscus. To test lateral meniscus tibia is internally rotated and a virus force is placed, the knee is then extended
