Knee joint Exam Flashcards
Normal flexion value for the knee
145-150
Normal extension value for the knee
0
Normal internal and external rotation value for the knee
10
What do you need to palpate on the knee?
Patella, patellar tendon, tibial tuberosity, medial and lateral joint line, popliteal fossa
Anteromedial thigh dermatome
L1-L3
Patella dermatome
L4
Big toe and anterior leg dermatome
L5
What are the specialty tests for knee exams?
Valgus test, varus test, lachman, anterior and posterior drawer test, mcmurrays test, Apley’s grind compression/distraction, bounce home test, patella-femoral grind and bulge sign
What are the specialty tests for testing knee ligaments?
Valgus test, varus test, lachman, anterior and posterior drawer test
What are the specialty tests for testing meniscus?
Mcmurrays, Apley’s Grind compression and distraction, bounce home test
How would you perform a valgus test and what are you testing?
Medial collateral ligament;
pt supine, slightly flex knee to 30 degrees, ABduct lower leg and apply valgus (medial force) at knee
How would you perform a varus test and what are you testing?
Lateral collateral ligament;
pt supine, slightly flex knee to 30 degrees, ADDuct lower leg and apply varus (lateral force) at knee
What are you looking for in the ligament testing of the knee?
Laxity or pain
How would you perform a lachman’s test and what are you testing?
ACL;
pt supine, flex knee 10-30 degrees and stabilize thigh with one hand and then pull tibia anteriorly
How would you perform an anterior drawer test and what are you testing?
ACL;
pt supine, flex knee to 90 degrees and have foot flat on ground, use both hands to pull tibia anteriorly
How would you perform a posterior drawer test and what are you testing?
PCL;
pt supine, knee flexed to 90 degrees and have foot flat on ground, use both hands to push posteriorly on tibia
Describe a mcmurrays test for the medial meniscus
pt supine, flex hip and knee, externally rotate tibia and press inward (valgus) at the knee and then EXTEND
Describe a mcmurrays test for the lateral meniscus
pt supine, flex hip and knee, internally rotate tibia and press outward (varus) at the knee and then EXTEND
What symptoms are you looking for when doing a mcmurray’s test?
Palpable clicking or pain
How would you perform an Apley’s Grind compression test?
pt PRONE, knee flexed, load into heel and then internally and externally rotate
How would you perform an Apley’s Grind distraction test?
pt PRONE, knee flexed, pull up and rotate
What symptoms are you looking for when doing an Apley’s Grind test?
Pain with compression/rotation, distraction OR
Relief of pain with distraction
How would you apply a bounce home test?
pt supine, slightly flex knee and then release and it should bounce back at end point
What would lack of bounce or lack of full extension on a bounce home test suggest?
Meniscus tear or effusion
How would you perform a patella-femoral grind test?
pt supine, leg extended, place hand on kneecap and have them tighten quads - looking for crepitus or pain
What does a positive patella-femoral grind test suggest?
Roughness of articulating surface
How would you perform a Bulge sign test?
pt supine, place hand above knee cap and press downward and then medial/lateral looking for a bulge of fluid
