Knee lab Flashcards
1
Q
Special tests for the knee
A
- Bounce home
- Patella ballottement test (AKA patella tap test)
- Patella mobility (Glide)
- Q-angle
- Fairbank’s Apprehension test
- Zohler & Clarke (Grind) test
2
Q
Special tests for ACL
A
- Anterior drawer
- Lachman’s
- Pivot shift
3
Q
Special tests for PCL
A
- Posterior lag sign
- Posterior drawer
4
Q
Special tests for meniscus
A
- McMurray
- Thessaly’s
- Apley’s
5
Q
Describe the bounce home test
A
- Test for meniscal tear
- Patient Supine: Holding the LE under the distal leg or foot
- Allow the involved knee to gradually “bounce” into full extension
- Positive: block of full extension and/or pain at end range extension
- Low clinical value possibly due to multiple false positives: muscle guarding & pain
6
Q
Describe the Patella ballottement test (AKA patella tap test)
A
- Test for knee effusion
- Clinician pushes the fluid to the knee
- Tap (thumb or fingers) on the patella pushing it posteriorly
- POS = floating patella that taps the femoral condyle
7
Q
Describe the posterior sag sign (Godfrey)
A
- Test for PCL
- Have pt supine with legs at 90-90
- Looks for dip where tibial tuberosity should be
- Ask for isometric hamstring contraction
8
Q
Describe Lachman’s test
A
- Similar position to anterior/posterior drawer test but knee is in more extension
9
Q
What is the advantage of a prone Lachman’s test
A
- Able to grasp a larger leg
10
Q
Describe a pivot shift test
A
- Lateral Pivot Shift Test: Begin in Extension & Grasp the Heel adding IR of the Tibia. With the proximal hand induce a valgus force while flexing the knee to 90; at around 30-40 degrees the shift should occur (Reduction of the Tibia). Flex & Extend knee multiple times.
- Reduction (L) above: Start in Full Flex to 90 and IR the Tibia – any reduction = the pivot shift
- Pivot Shift Subluxation (R) above: Begin in knee flexion and IR the Tibia; apply valgus stress with proximal hand and slowly extend the knee – near full Ext the tibia plateau will relocate
11
Q
Describe Thessaly test
A
- Test the uninvolved side 1st
- Begin at 5 degrees knee flexion, Rotate 3x IR & ER
- Repeat at 20 degree knee flexion
- The test is positive if there is a sense of locking, catching, or pain at either the medial or lateral joint line.
12
Q
Describe Apley’s test
A
- Prone & Flex knee to 90
- Distraction and Compression with rotation (Both IR and ER)
- Possibly useful for meniscus tear with compression
13
Q
Describe Renne test
A
- For ITB Friction
- Apply pressure along the lateral femoral condyle
- Patient stands on involved side and flexes and extends knee
- POS for pain or crepitus around 30 degrees knee flexion
14
Q
Lists the functional optimization tests for the knee
A
- Chair rise test: 5xSTS vs 30sec STS
- Bilateral squat till pain/unilateral squat till pain
- Step down test
- Y-Balance test
- Single leg hop (for distance)
- Triple hop (3 hops for distance)
- Vertical Jump
- Side to side hop test (5-6’ apart)
15
Q
Open/closed packed position for the tibiofemoral joint
A
- Open: 25º flexion
- Closed: extension + tibial ER
16
Q
Open/closed packed position for the hip joint
A
- Open: 30º flexion, 30º ABD, and slight ER
- Closed: max extension, IR + ABD
17
Q
Open/closed packed position for the talocural joint
A
- Open: 10º PF
- Closed: max DF
18
Q
Which patella glides help with flexion and extension
A
- Inferior glide = flexion
- Superior glide = extension
19
Q
What motion does an anterior tibial glide help with
A
- Extension
