Knee exam and eval lab

Question 1

Checking for tibial torsion

Answer 1

patient sitting, palpate femoral condyles and then position them so that they are parallel to the edge of the table
One thumb on ant aspect of lateral malleolus and one thumb at mid point of medial malleolus - thumbs should be parallel to edge of table

Question 2

Strength - always test

Answer 2

quads
hams
plantarflexion
hip abductors

Question 3

Palpate semitendinosis

Answer 3

large tendon with knee flexion and IR

Question 4

Palpate gracilis

Answer 4

medial to the semitendinosis

Question 5

Semimembranosis palpation

Answer 5

lateral mm of the semitend

Question 6

Palpate pes anserine - what inserts here

Answer 6

Sartorius
Semitendinosis
Gracilis

Question 7

Palpate plica -

Answer 7

anterior aspect of medial femoral condyle

Question 8

Palpate meniscus

Answer 8

medial joint space with tibia ER

Question 9

Gerdys tubercle - palpation

Answer 9

palpate with knee flexed to 90 degrees just under the lateral aspect of the tibial plateau and lateral to the tibial tub

Question 10

Adductor tubercle - palpate

Answer 10

just superior to the medial epicondyle, patella retinaculum attaches and medial patellofemoral ligament and adductor magnus

Question 11

Patella Ballottement

Answer 11

Tap two fingers on the knee cap and see if it moves?

Question 12

Fluctuation test

Answer 12

Pace hand above the patella and sweep down - edema will be noticeable

Question 13

Sweep test

Answer 13

Sweep along medial joint space to superior to patella - not colelction of fluid at alteral patella and sweep along lateral joint space to superior patella and note collection of fluid at medial patella
J stroke

Question 14

Circumferential measurements

Answer 14

Place tape measure around superior border of patella, mid patells, and patella tendon on R and L leg
You would only use this one when comparing two legs or when comparing against itself over different treatments sessions

Question 15

Special Test to LCL

Answer 15

Varus 0 and 30

Question 16

Varus 0 and 30

Answer 16

testing lateral structures
Place thigh over your on table to get 30 degrees of flexion - stabilize at the joint line and apply force at proximal tibia in varus direction
Same in extension

Question 17

Special test to MCL

Answer 17

Valgus 0 and 30

Question 18

Valgus 0 and 30

Answer 18

Testing medial structures
Place thigh over your leg on the table to get 30 degrees of flexion - stabilize the joint line and apply force at proximal tibia in valgus direction
Same in extension

Question 19

Lachmans

Answer 19

testing the ACL
place your leg on table again with their thigh over
Palpate the joint line and keep thumb on tibial tuberosity
Cup other hand under the leg and apply a quick jerk with the shoulder to feel the ant translation of the tibia

Question 20

Anterior drawer

Answer 20

Testing the ACL
flex their knee up - apply pressure onto their foot to prevent it from moving
Put your thumbs on their tibial plateau, pick up slack from behind and make sure the hamstrings are relaxed
Keep your arms and forearms in the direction you want the force to go and pull quickly towards you
Looking at how much motion you have R to L

Question 21

Godfreys

Answer 21

PCL
Bring leg up into 90 degrees of knee flexion
Look for the tibial tuberosity - it wont be there if there is a PCL tear because it will drop down

Question 22

Posterior Drawer

Answer 22

Like the anterior drawer but opp direction

PCL

Question 23

Reverse Lachmans

Answer 23

PCL
Same as lachmans but in the other direction
Need to compare R to L

Question 24

Pivot shift

Answer 24

Testing anterior rotary instability
You are subluxing the tibia and relocating it
Place hand under fibula and push in an ant med direction with your other hand at the heel - hold these forces and then quickly flex the knee
Positive if there is slippage with the flexion

Question 25

McMurrays

Answer 25

Meniscus
Need to put it with other tests
Take knee into hyperflexion - ER the tibia (gets the post/medial meniscus) and add varus force then quickly extend the knee
Take knee into hyperflexion - IR of the tibia (gets the post/lateral meniscus) and add valgus force then quickly extend the knee
Positive is clicking, pain, catching the meniscus

Question 26

Q angle

Answer 26

Axis = mid patella
ASIS
Tibial tuberosity

Question 27

Patella apprehension

Answer 27

Screening for patellafemoral pain
Apply force down pushing the patella into the femur and then ask for a contraction of the quad
Apprehension positive if pain

Question 28

Flexibility

Answer 28

Gastroc
90/90
Elis
Obers
Others..

Question 29

Functional Tests

Answer 29

Measurement for distance (about 10m) - patient starts at one end and have to hop while being timed
Look at ratio of injured to noninjured side
Usually for return to sport