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MSK > Knee Functional/Special Tests > Flashcards

Knee Functional/Special Tests Flashcards

1
Q

Subjective Hx

A

-MOI
-pain/location/changes/time of day
-Swelling
-Noise
-Locking
-Giving out
-length of symptoms

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2
Q

Rule out Non-MSK

A

PAD: claudication, cook extremities, decrease filling time
DVT: pain, warmth, swelling
Compartment Syn: swelling, absent pulses, neuro
Septic Arthritis: pain, swelling, infection signs
Cellulitis: skin warmth, redness, rash

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3
Q

Ottawa Knee Decision Rule

A
  1. > 55
  2. Tenderness at head of fib
  3. Tenderness at Patella
  4. Inability to flex knee 90
  5. Inability to WB 4 steps

(+) 2/5= need imaging

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4
Q

Pittsburgh Knee Decision Rule

A
  1. Hx Trauma
  2. Inability to WB 4 steps
  3. <12 or >50

(+) 2/3: imaging

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5
Q

Knee Decision Rule of Bauer

A
  1. Inability to WB 4 steps
  2. Knee swelling
  3. Ecchymosis

(+) 1/3: imaging

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6
Q

Observations

A

-abrasion, bruising, atrophy, swelling
-LE rotation
-knee position
-flx or hyperextensionon
-tibial torsion
-foot position

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7
Q

Knee Joint ROM

A

-Flex (0-140) then Ext (0-15)
-AROM > Over > PROM

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8
Q

Knee MMT

A

-knee flx/ext
-Hip ROM
-Ankle DF and PF

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9
Q

Flexibility Tests

A

-Ober’s
-Modified Thomas
-Prone Rectus (ELy)
-Gastroc Length
-Hamstring Length

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10
Q

Joint Play/Mobilization: Knee Extension

A

Ext: ant roll AND glide (concave on concex)

  1. Pt supine (prone if dec ext)
  2. Towel under tibia
  3. Push femur posteriorly (push ant if in prone)

Mob:
-ad ER

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11
Q

Joint Play/Mobilization: Knee Flexion

A

Flex: Post roll and glide

  1. Pt supine (sitting if distracting or dec)
  2. Push tibia posteriorly

Mob:
-Ad IR

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12
Q

Joint Play/Mobilization: Patellar Sup/Inf Glide

A

Crab hand: tiny
Bear Claw: big

  1. Pt in supine, full ext
  2. Move patella up and down
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13
Q

Joint Play: Patellar Medial/Lateral Glide

A

Claw hand

  1. Pt in Supine, full ext
  2. Move patella side to side
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14
Q

Joint Play: Proximal Tibiofibular Joint

A

-use if lacking last bit of flexion and has pain at fib head
-or frequent ankle sprains

AP Glide:
1. Pt supine in hooklying
2. Push posteriorly

PA Glide: treat in this position
1. Pt in quadruped
2. Push anteriorly

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15
Q

Menisci Palpation

A

-open packed position
-find joint line

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16
Q

Patellar Tendon Palpation

A

-tib tub to patella

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17
Q

Collaterals Palpation

A

LCL:
-fib head in FABER position

MCL:
-medial knee

18
Q

Plicae Palpation

A

-superiomedial corner of patella

19
Q

Knee Exam Order

A
  1. Subjective Hx (MOI and pain description)
  2. Observation
  3. ROM (knee, hip, ankle)
  4. MMT (knee, hip, ankle)
  5. Joint Play
  6. Palpation
  7. Special Tests
20
Q

Ligament Special Tests

A

ACL: Lachman, anterior drawer, pivot shift

PCL: Posterior Drawer, Posterior sag, valgus at 0

MCL: valgus stress test at 20

LCL: Varus stress test at 20

21
Q

Instability Special Tests

A

AMRI: Anterior drawer + ER
ALRI: anterior drawer + IR, pivot shift
PMRI: Posterior drawer + IR
PLRI: Posterior drawer + ER, reverse pivot shift, dial test

22
Q

Meniscus Special Tests

A

McMurray, Thessaly, Apley

23
Q

Patellar Special Tests

A

Patellar Grind Test
Patellar Apprehension

24
Q

Lachman Test

A

ACL
-less flx than Anterior drawer

  1. Pt supine, knee flexed slightly
  2. PT stabilizes femur and pulls tibia ant
  3. 1-2 reps
25
Q

Anterior Drawer Test

A

ACL
-more flx ~ 60

  1. Pt supine with knee flexed 60
  2. PT sits on foot
  3. Pull tibia anteriorly
26
Q

Pivot Shift

A

ACL, ALRI

  1. Pt supine
  2. PT flexes knee to 90 while IR tibia (check for lateral sublux
  3. PT slowly extends knee while maintaining IR (reduction at full extension)
27
Q

Posterior Drawer

A

PCL
-more flx ~ 60

  1. Pt supine with knee flexed 60
  2. PT sits on foot
  3. Find norm of tibia
  4. Push tibia posteriorly
28
Q

Posterior Sag Sign

A

PCL

  1. Pt supine
  2. PT flexes knee and hip ot 90 passively and looks for sag of tibia
29
Q

Valgus Stress Test

A

PCL (0 deg) , MCL (20 deg)

  1. Pt supine w/ leg at 0 then 20 deg flexion
  2. PT outside of leg holding medial tibia and lateral thigh (take up slack)
  3. PT provides valgus stress
30
Q

Varus Stress Test

A

Cruciates (0 deg), LCL (20 deg)

  1. Pt supine w/ leg at 0 then 20 deg flexion
  2. PT inside of leg holding lateral tibia and medial thigh (take up slack)
  3. PT provides varus stress
31
Q

Anterior Medial Rotary Instability Special Test

A

Anterior Drawer w/ ER

32
Q

Anterior Lateral Rotary Instability Special Test

A

anterior drawer + IR

33
Q

Posterior Medial Rotary Instability Special Test

A

Posterior drawer + IR

34
Q

Posterior Lateral Rotary Instability Special Test

A

Posterior drawer + ER

35
Q

Posterorlateral Instability Reverse Pivot Shift

A

PLRI

  1. Pt supine
  2. PT flexes knee to 90 while ER tibia (check for medial sublux
  3. PT slowly extends knee while adding valgus stress (reduction at full extension)
36
Q

McMurrays Test

A

-Meniscus
-NWB
-tells you which one is involved
-provocative

Medial:
1. Pt supine at 90/90
2. PT palpates or watches medial joint line
2. PT passively flexes knee
3. PT puts tibia into ER while extending knee

Lateral:
1. Pt supine at 90/90
2. PT palpates or watches lateral joint line
2. PT passively flexes knee
3. PT puts tibia into IR while extending knee

37
Q

Apley’s Test

A

-Meniscus test
-NWB

Distraction:
1. Pt prone with knee bent
2. PT stabilizes femur with leg
3. PT ER then distracts, IR then distracts

Better: meniscus
Worse: Ligament

Compression:
1. Pt prone with knee bent
2. PT stabilizes femur with leg
3. PT ER then comrpesses, IR then compresses

Worse: Mensicus

38
Q

Thessaly’s Test

A

-meniscus
-WB test
-5 deg of knee flx, then 20 deg

  1. Pt stands on one leg with leg bent 5/20 with PT support
  2. PT askes Pt to twist from side to side

(+): clock, pop, or reproduction of pain

39
Q

Patellar Apprehension

A

-lateral patellar subluxation

  1. Pt supine with leg off of plinth slightly flexed ~15
  2. Pt foot on PT leg
  3. PT lateral mobs patella

(+): Pt feels apprehensive about it subluxing

40
Q

Patellar Grind Test

A

-Chondromalacia, PF dysfunction

  1. Pt supine in full knee ext
  2. PT uses web space to push superir patella down
  3. Pt then contracts quad

(+): reproduction of patients pain

41
Q

Altman’s Criteria for Knee OA

A
  1. Knee Pain
  2. > 50
  3. Knee Crepitus
  4. Palpable bony enlargement
  5. Bony tenderness
  6. Morning stiffness <30mins
  7. No warmth
42
Q

Contraindications to Manual Therapy

A

-infection
-Fever
-Cancer
-Acute Circulatory Condition
-Open Wound
-Fracture
-Hematoma
-Advanced DM
-Hypersensitivity
-Abnormal Endfeel
-RA
-Cellulitis
-Constant, Severe pain
-Extensive radiation of pain
-Condition not evaluated

MSK (34 decks)

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