Knee Exam Tests

Question 1

Genu Valgum vs genu varus vs genu recurvatum

Answer 1

• Valgum= knees close together, feet father apart (knock-kneed)
• Varus= legs appear bowed, felt close together (bow legged)
• recurvatum= lateral view, knee has backward curvature (hyperextension)

Question 2

What si the Q angle

Answer 2

• normal= 15 degrees
• increased in females
• straight line from ASIS–>patella and tibial tuberosity–> patella

Question 3

ROM strength testing: flexion/extension/internal/external rotation

Answer 3

• flexion= 145-150 degrees (hamstrings)
• extension= 0 degrees (quads)
• internal and external rotation= 10 degrees

Question 4

Sensation/reflex testing knee exam

Answer 4

• dermatomes L3, L4, L5, S1, S2

- patellar reflex (primarily L4) femoral n.

Question 5

Tests for collateral ligaments?

Answer 5

-valgus and varus stress test for medial and lateral collateral ligaments

Question 6

What is valgus stress test?

Answer 6

• pt supine with knee flexed 30 degrees, lateral resistance at knee move lower leg, ankle shift lateral while holding femur in place
• asses for laxity, quality of motion, pain
• positive= increased laxity, soft end point, pain
• indicates MCL disruption

Question 7

What is varus stress knee exam?

Answer 7

• pt supine knee flexed to 30 degrees
• appply medial resistance at knee over leg ankle shifts medially and hold femur
• positive= increased laxity soft end point, pain
• indicates= LCL disruption

Question 8

What are the tests for anterior and posterior cruciate ligament?

Answer 8

• anterior drawer test
• lachmans test
• posterior drawer test
• reverse lachmans test

Question 9

What is the anterior drawer test?

Answer 9

• pt supine knee flexed to 90 degrees
• sit on pts. Foot and grasp proximal tibia w/both hands pulling tibia anteriorly
• positive= excessive translation when compared with other knee
• indicates ACL insufficiency

Question 10

What is the lachmans test?

Answer 10

• pt supine
• cephalad hand on distal thigh (superior patella)
• caudad hand grasp proximal tibia
• flex knee 15-30
• caudad hand pull tibia anterior and cephalad stabilizes thigh
• positive= increased laxity, soft/absent end point
• indicates= ACL insufficiency

Question 11

What is the posterior drawer test?

Answer 11

• pt supine w/knee flexed to 90
• sit on pt foot and grasp proximal tibia w/both hands and push translating tibia posteriorly
• positive= excessive translation
• indicates= PCL insufficiency

Question 12

What is the reverse lachmans test?

Answer 12

• pt supine
• cephalad hand distal thigh superior patella
• caudad hand proximal tibia
• flex knee 15-30 with cephalad hand stabilizes femur and caudad hand pushes tibia posterior
• positive= increase laxity, soft/absent end feel
• indicates PCL insufficiency

Question 13

What are test for meniscus cartilage?

Answer 13

• Mcmurrays test
• apley grind compression
• apley grind distraction

Question 14

What is mcmurrays test?

Answer 14

• pt supine, hip and knee flexed
• caudad hand control ankle cephalad hand on distal femur
• rotate tibia into internal rotation and varus stress, continue until extension of knee
• rotate tibia into external rotation and valgus stress, continue until extension of knee
• positive= pain or click during extension
• indicates= medial or lateral meniscus tear

Question 15

What is the apley grind- compression test?

Answer 15

• pt. Prone with knee flexed 90
• downward force on foot (compression on meniscus) while rotating foot internally and externally
• positive= pain with rotation or compression
• indicates= meniscus injury OR collateral ligament injury or BOTH

Question 16

What is the apley grind - distraction test?

Answer 16

• pt prone knee flexed to 90
• stabilize thigh and apply upward traction to leg while rotating in internally and externally
• traction decreases meniscus pressure and increases ligament strain
• positive= pain with distraction/rotation
• indicates= collateral ligament damage (MCL or LCL)

Question 17

What are test used for the patella?

Answer 17

• for ligaments:
  1. Patellar laxity and apprehension test
• for cartilage:
  1. Patellar compression (grind) test
  2. Patella-femoral grinding
  3. Patellar glide test

Question 18

What is the patellar laxity and apprehension test?

Answer 18

• laxity= 1 hand above and 1 hand below joint, thumbas against medial patella–>push patella laterally assessing ROM
• apprehension= when testing laxity to point of restriction ask pt if maneuver provokes any discomfort or sense of instability
• positive= sense of apprehension, instability, increased laxity
• indicates= possible previous patellar dislocation or instability

Question 19

What is the patellar compression (grind) test?

Answer 19

• pt supine w/knee extended
• provide compressive load to patella w/1 hand while moving patella medial/lateral
• positive= pain with compression
• indicates= possible inflammation, chondromalacia, injury to patellofemoral articular surface

Question 20

What is the patella-femoral grinding test?

Answer 20

• compress patella inferiorly into trochlea groove and instruct pt. To tighten quads (flex)–> against resistance b/c quad pull superiorly
• positive= crepitation/pain
• indicates= roughness of articulating surfaces= chondromalacia

Question 21

What is the patellar glide test?

Answer 21

• pt sitting or supine will slowly extend/flex knee
• note quality of articular motion
• place hand lightly over patella to increase sensitivity of test
• positive= palpable or audible crepitus/pain/catching of patella
• indicates= damage to articular surface