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MSK I,II,III > Knee Examination > Flashcards

Knee Examination Flashcards

1
Q

Traumatic onset of knee pain that occurred while jumping. twisting or changing direction with the foot planted

A

ACL, patella subluxation, quad rupture, meniscal tear

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2
Q

Traumatic injury with posterior directed force to the tibia with knee flexed

A

PCL

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3
Q

traumatic injury with varus or valgus force on knee

A

LCL or MCL

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4
Q

Anterior knee pain with jumping with full knee flexion

A

patellar tendonitis

patellofemoral pain syndrome

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5
Q

Swelling in the knee with occasional locking or clickin

A

Mensical Tear

Loose body within knee joint

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6
Q

Pain with prolonged knee flexion, during squats, and while going up and down stairs

A

patellofemoral pain syndrome

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7
Q

pain and stiffness in the morning that diminishes after a few hours

A

OA

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8
Q

Ottawa Knee Rule for Radiography For knee fractures

A

1/5= have to have a radiograph

Age > 55
isolated patellar tenderness without other bone tenderness
Tenderness to fibular head
inability to flex knee to 90
inability to bear weight immediately after injury

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9
Q

Functional Movements to test during exam

A

Sit to stand
gait
Stairs

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10
Q

How to measure Tibiofemoral angle

A 
Normal = 170-175
Less= valgum (165)
More= varum (180)

measure between the axis of femur and tibia

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11
Q

Q- Angle and how to measure it

A

standing with knee extended
align with ASIS, Tibial tuberosity and Patella as axis
Normal = 10-15

Larger the Q angle predisposes to patellar subluxation

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12
Q

If you have a large Q angle what are you predisposed to

A

Patellar Subluxation

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13
Q

Tibial Torsion ( the twist in the tibia itself) And how to measure it

A

Sitting, Knee flexed to 90
fingers of malleoli
then looking down over distal thigh visualize the axes of the knee and ankle
should be 13-18 angle due to lateral tibial rotation

Increased lateral torsion= increases Q angle

Internal torsion= leads to pronation

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14
Q

How to measure the position of the patella

A

Knee flexed to 60 degrees and measure the height of the patella and length of the tendon

Alta= patella tendon is longer by 15-20% than patella height - tight quads

Baja= patellar tendon is 15-20% shorter than patella height

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15
Q

How many measures do you need for edema?

A

3

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16
Q

Rapid onset of edema what could be wrong? ( within 1 hour)

A

patella dislocation, osteochondral fracture, ACL

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17
Q

Intermediate edema (6-12 hours) what could be wrong?

A

Capsular tear, peripheral meniscus tear, ACL

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18
Q

What is the Ballottement test

A

Looks for joint effusion

Pt is supine, pushing from prox and distal knee to center and then push patella posteriorly towards femur

(+)
patella bounces off with distinct impact

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19
Q

What is the Milking Test

A

move fluid to inferior suprapatellar area then to medial area from lat joint line= all fluid will be inferior and medial

Then tap medial area and fluid will then float back to lateral side of joint

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20
Q

Easiest way to palpate the medial mensci

A

Medial rotate Tibia- will disappear with Lat rotation

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21
Q

Easiest way to palpate lat menisci

A

slight knee flexion - will disappear with full extension

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22
Q

What is the joint line tenderness test

A

Looks at meniscal tear

palpate joint line with knee in 90 flexion

(+) reproduces pain

23
Q

Easiest way to palpate the MCL and LCL

A

Lateral- easy to palpate with examined ankle crossed over opp knee

24
Q

What is the pes anserine

A

Insertion for Sartorius, graciliis and semitendinosus

25
Q

What is the closed packed position of Tibiofemoral

A

full extension

26
Q

What is the closed packed position of Prox tibiofibular

A

Full DF

27
Q

What is the closed packed position of patellofemoral

A

Full flexion

28
Q

What is the open packed position of tibiofemoral

A

25 degrees flexion

29
Q

what is the open packed position of prox tibiofibular

A

neutral ankle, 25 degrees knee flexion

30
Q

what is the open packed position of patellofemoral

A

0-5 degrees flexion

31
Q

What is the capsular pattern of the tibiofemoral

A

Flexion > Extension

32
Q

What is the capsular pattern of the prox tibiofibular

A

not reported

33
Q

what is the capsular pattern of the patellofemoral

A

not reported

34
Q

What is the Extensor or Quad lag test

A

Can be due to muscle atrophy, pain, effusion or loss of mechanical advantage

Able to achieve full passive extension of knee and
lack of full active extension

35
Q

What is the tibial rotation ( screw home mechanism)

A

Pt sitting with knee flexed to 90 and palpate the tibial tubercle and point on the patella = so the points make a vertical line
pt then actively extends knee

You should observe tib rotating laterally on femur

Tib rotation can be influenced by subtalar joint motion

36
Q

What position should resisted motion testing be done for the knee?

A

25 flexion with pt supine or prone

37
Q

What liggs are taut and lax with medial rotation

A

Collateral are Lax

cruciates are Taut

38
Q

What liggs are taut and lax with Lateral Rotation

A

Cruciates are Lax

Collateral are Taut

39
Q

What is the lachman test?

A

For ACL tear

pt supine and knee at 30 degrees- then translate tib anteriorly

(+) excessive anterior translation

40
Q

What is the Anterior Drawer Test

A

For ACL tear

Pt supine and knee flexed to 90- then translate tib anteriorly

(+) excessive anterior translation of tibia
or
anterior subluxation of > 5mm

41
Q

what is the Anterolateral ( Slocum) test

A

For rotary instability

Perform after (+) anterior drawer test

Do an anterior drawer test and test with tibia in max ER
If the Tibia moves as much with the ER and Anterior Translation= MCL and Meniscus compromised

Then Do the anterior drawer test with tibia in max IR
If the translation is the same= LCL and meniscus compromised

42
Q

With a (+) Slocum test in External Rotation What structures are compromised?

A

ACL, MCL, Meniscus

43
Q

With a (+) Slocum test in Internal Rotation what structuers are compromised?

A

ACL, LCL, Meniscus

44
Q

What is the pivot Shift Test

A

For ACL Tear

Pt supine. Lift leg in full extension to 45 degrees of hip flexion
Then with top hand hold above the knee and place thumb on Fibular head- Applying superior glide to fibula and a force medial on the knee

Then with bottom hand at ankle apply force into Internal rotation and pull Lateral on the Tibia

(+) If Lateral Tibial plateau subluxes anteriorly

45
Q

What is the Posterior Drawer Test

A

For PCL tear

Pt supine and knee flexed to 90 degrees
Then do a posterior glide of tibia

(+) posterior subluxation of tibia or
excessive posterior translation of tibia

46
Q

What is the Valgus Stress Test

A

For MCL

Place knee joint in max varus and then into Valgus
This is done at
5 degrees of knee flexion and then again at
30 degrees of knee flexion

(+) pain and laxity
or
Laxity of medial joint line

47
Q

What is the Varus Stress Test

A

For LCL

Place joint knee joint in max valgus and then into Varus
This is done at
5 degrees of flexion ( focus more on anterior and posterior fibers) then again
30 degrees of flexion( focus more on anterior fibers)

(+) pain and laxity
or
laxity of lateral joint line

48
Q

To maximize stress on the collateral ligg of the knee what direction should the tibia be placed in?

A

External Rotation

49
Q

What is the McMurray Test

A

For Meniscal Tear
can also test for OA

pt is supine- one hand on heel of foot and one hand stabilizing the knee
Hip and knee are flexed up passively
While flexing up place the tibia in ER and Axially load ( push up on tib and down through femur)
Then take leg into extension

Do test again in Internal Rotation

(+)
(palpable or audible click or pain during rotation)

50
Q

What is the Apley’s compression test

A

For Meniscus

Pt is prone with knee flexed to 90
place downward pressure on foot to compress knee
Then IR and ER rotate Tibia

(+) pain or reproduction of symptoms

51
Q

What is the Thessaly Test

A

For meniscal Tear

Pt stands Wb on symptomatic leg- holding onto examiners hands
then then IR and ER rotates body with knee flexed to 20 degrees
Can clinically have them do more than 20 degrees of flexion

(+) pain/ reproduction of symptoms
or
clicking in the joint line

52
Q

What is the moving patellar apprehension test

A

For patellar instability

pt supine with knee extended and ankle off of exam table
therapist passively flexes knee to 90 degrees and back into extension while the patella is held in a lateral position
then repeated with a medially held patellar position

(+) pt exhibits apprehension or quad contraction during lateral glide and no apprehension during medial glide

53
Q

What is Clarke’s Sign

A

For retropatellar pain syndromes
Especially chondromalacia

pt supine with knee extended
apply distal and posterior compression of patella
have pt then contract quads

(+) pain
this though can be positive for asymptomatic individuals

MSK I,II,III (9 decks)

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