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Semester 2 PM Exam 8 > Knee Exam and Eval > Flashcards

Knee Exam and Eval Flashcards

1
Q

History

A 
Specifics regarding mechanism
Direction of force
If twisting was involved
Overuse?
All other normal hx questions
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2
Q

If history says valgus force - ACL or PCL

A

ACL

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3
Q

If history says varus force - ACL or PCL

A

PCL

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4
Q

If history involves twisting

A

Menisci, ACL, PCL

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5
Q

If history involves noise, clicking, locking

A

very often meniscus or patella

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6
Q

If history invovles instability or giving way

A

often ACL or meniscus

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7
Q

If history involves child or growth spurt

A

common with patellafemoral pain or osgood schatters

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8
Q

CHECK VITAL SIGNS

A

:)

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9
Q

Lumbar scan

A

Observe and palpate
Gait
Neurological testing

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10
Q

Lumbar scan

A 
Observation/palpation
Gait
AROM with overpressure
Neuro exam
Dermatomes/Myotomes/Reflexes
PA testing
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11
Q

Lumbar Scan - Observation and Palpation

A 
gait
antalgia
position of knee
gross patella position 
effusion
leg length discrepancy
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12
Q

Lumbar Scan - Gait

A

what is knee doing

Hip/foot position

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13
Q

Lumbar Scan - Neurological testing

A

scan for nerve root problem vs peripheral

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14
Q

Observation

A 
Edema 
Patella position 
Muscle atrophy
Femoral anteversion or retroversion (squinting patella, duck feet)
Knee hyperextension or flexion
Tibial torsion, position of ankle/foot
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15
Q

AROM/PROM with overpressure

A

Assesses willingness to move
Goniometry can be done actively and passively
Overpressure with eval of end feel

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16
Q

Knee AROM

A

flexion
extension
tibial IR and ER

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17
Q

What are you listening for with AROM

A

crepitus - very often patella femoral - look at tracking of patella

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18
Q

Must have ___ degrees of ROM to complete all functional motion
___ for stairs

A

120

110

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19
Q

Normal end feel of the knee - flexion

A

soft tissue approximation

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20
Q

Normal end feel of the knee - extension

A

capsular or springy if have tight hamstrings

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21
Q

Specific muscles to test

A 
quads
hams
adductors
gastroc
soleus
TFL
glut med and max
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22
Q

Purpose of resisted motion

A

to determine if contractile or noncontracile problem/large or small lesion

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23
Q

Strong and painless resisted motion

A

normal or minor lesion

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24
Q

Strong and painful resisted motion

A

subacute or small lesion

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25
Q

Weak and painless resisted motion

A

serious lesion like neurological tumor, complete tear

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26
Q

Weak and painful resisted motion

A

major lesion, tear of mm all tendon

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27
Q

Special tests for effusion

A

Patella ballottement
Fluctuation test - test for moderate effusion
Stroking
Tape measure

28
Q

Grade 0 - effusion

A

No wave produced on downstroke

29
Q

Grade trace (effusion)

A

small wave on medial side with downstroke

30
Q

Grade 1+ (effusion)

A

large bulge on medial side with downstroke

31
Q

Grade 2+ (effusion)

A

Effusion spontaneously returns to medial side after upstroke

32
Q

Grade 3+ (effusion)

A

so much fluid that is not possible to move the effusion out of the medial aspect of the knee

33
Q

Clinical decisions related to effusion - 2+ effusion or more

A

exercises not progressed

34
Q

Clinical decisions related to effusion - 2+ effusion persists after ice, elevation, compression

A

contact physician regarding NSAIDS or aspiration

35
Q

Clinical decisions related to effusion - Effusion inc 2 graces

A

Activity decreased to level prior to the change in effusion

36
Q

Clinical decisions related to effusion - trace or less effusion

A

Consider high level activity for return to sport

37
Q

Special tests for ligaments - MCL

A

Valgus force at 0 and 30 degrees
0 should be no movement
at 30 for MCL laxity

38
Q

With valgus force at 0 degrees if movement think…

A

MCL
ACL
PCL
medial knee capsule

39
Q

Ligaments LCL

A

Varus force at 0 and 10-30 degrees
0 degrees no movement
30 degrees - LCL laxity

40
Q

With varus force at 0 degrees if movement think…

A 
LCL
Lateral capsule
Arcuate-popliteus complex
ACL
PCL
41
Q 
ACL - lachman's grades
0
1+
2+
3+
A

no anterior displacement
5mm translation
5-10mm translation
>10mm translation

42
Q

ACL - lachman - watch out for

A

Hamstrings are protectors of ACL so be careful of false negative with hamstrings relaxed

43
Q

Special tests for ACL

A

lachman

anterior drawer

44
Q

Anterior drawer

A

grading same as lachmans

avoid false negative

45
Q

Pivot shift

A

ACL deficient, patient complains of giving way, instability in WB
Determines if patient has dynamic instability of the knee

46
Q

Special tests for PCL

A

Godfreys
Posterior drawer
Reverse lachmans

47
Q

Special test for meniscus

A

joint line palpation
mcmurreys
apleys

48
Q

McMurreys

A

you are trying to click, pop, or pain

49
Q

Apleys

A

for meniscus

50
Q

Functional test for meniscus

A

full knee squat

51
Q

Some common thing with meniscal tear

A
  1. joint line tenderness
  2. hyperflexion with painful endfeel
  3. pos mcmurreys
  4. hx that relates to it
  5. swelling (sometimes dont have this)
52
Q

Normal Q angle

A

15 degrees

53
Q

Abnormal Q angle

A

greater than 20 degrees

54
Q

Q angle measurement

A

ASIS to midpatella and tibial tuberosity and mid patella

55
Q

Patella position - medial/lateral tilt

A

usually lateral

56
Q

Patellafemoral articulating surfaces

A

looking at the articulating surfaces of the patella and see if they are irritated in pulling them close together

57
Q

Apprehension test

A

patella
good for determining subluxation or dislocation
you are moving the patella into the position of how they sublux (mostly laterally)

58
Q

Patella joint mobility - patellafemoral

A

assess all directions of motion, include compression and distraction
Medial and lateral translation should occur at 1/3 of surface of patella

59
Q

Tibiofemoral - joint mobility

A

AP glide

60
Q

Resting position

A

30 degrees flexion

61
Q

Closed packed position

A

full extension with tibial ER

62
Q

Capsular pattern

A

flexion > extension

63
Q

Superior tibia-fibula joint =

A

AP glide

64
Q

Flexibility

A 
hamstrings 
obers
rectus femoris 
gastrocnemius 
adductor
65
Q

Functional hop tests - distance

A

single leg hop for distance
timed hop for dsitance
crossover hop

66
Q

Lysholm knee scoring sclae

A

ACL or knee injury outcome measurement

67
Q

Pittsurgh knee rules

A

blunt trauma or fall
Age less than 12 yo and greater than 50 yo
Cant WB for 4 steps

Semester 2 PM Exam 8 (5 decks)

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