Knee Osce

Question 1

How do we create a Q angle?

Answer 1

Draw a straight line from the ASIS to the center of the patella
line from patella to tibial tuberosity

Question 2

Normal Q angle of the knee is ___ degrees.

Answer 2

15

Question 3

With genu valgum, will you have a increased or decreased Q angle?

Answer 3

increased

Question 4

With genu varus, will you have a increased or decreased Q angle?

Answer 4

decreased

Question 5

What is genus recurvatum?

Answer 5

Our knees have a backwards curvature. They are hyper-extended.

Question 6

What is the nerve root of the patella?

Answer 6

L4

Question 7

What is the nerve root of the achilles tendon?

Answer 7

S1

Question 8

What muscle strength number does active movement with gravity eliminated indicate?

Answer 8

+2/5

Question 9

A +1/5 muscle strength will indicate what?

Answer 9

Barely detectable/trace of contraction

Question 10

Dermatomes for anteromedial thigh?

Answer 10

L1-L3

Question 11

Dermatomes for patella and big toe?

Answer 11

L4

Question 12

Dermatomes for anterior leg, ankle and big toe?

Answer 12

L5

Question 13

A strong, full and increased pulse would be what?

Answer 13

+3/4

Question 14

Valgus test

Answer 14

Pt lay down
Flex leg to 30 degrees; push into the tibia and abduct lower leg.
Conduct at 30 degrees and neutral

+ test: Pain
Indication: MCL

Question 15

Varus test

Answer 15

Pt lay down
Flex leg to 30 degrees; push into the tibia and abduct lower leg.
Conduct at 30 degrees and neutral

+: Pain
LCL

Question 16

Anterior drawer test

Answer 16

Have patient knee flexed to 90 and sit on it, pull the tibia up
.
+: excessive translation
Indication: ACL injury

Question 17

Lachmans test

Answer 17

Flex knee to 10-30 degrees,
Stabilize thigh w one hand
Pull the tibia upwards with other

+: Increased laxity
Indicate: ACL injury

Question 18

Reverse Lachman’s Test

Answer 18

Flex knee to 10-30 degrees

One hand stabilizes thigh
Other hand pushes the tibia posterior

+: increased laxity,
Indicate: PCL injury

Question 19

McMurray

Answer 19

Lay down with knee and hip flexed.
One hand on the ankle and other on distal femur

To test the lateral meniscus–> internal rotation and varus stress, then extend the leg
To test the medial meniscus–>externally rotate and VALGUS stress, then extend the elg

+: pain or click while extending

Question 20

Apley Grind Compression

Answer 20

Patient is laying down on stomach with knee at 90 degrees
Apply a downward force and rotate

+: pain
Indicate: meniscul or collateral ligament tear

Question 21

Apley Grind Distraction Test

Answer 21

Patient is laying down on stomach with knee at 90
Apply upward traction and rotate leg

+: Pain–> ligament tear
Relief of main–> meniscual tear

Question 22

Patellar laxity and apprehension test

Answer 22

Put thumbs on medial side of patella and push medial –> laterally and ask if there is any pain

+: Apprehension
Indicate: previous patellar dislocation

Question 23

Patellar compression (grind) test

Answer 23

Compress the patella and move it with one hand

+: pain
Indicate: inflammation

Question 24

Patella-femoral grinding test

Answer 24

Compress the patella caudally into trochlear groove and tell pt to tighten quads

+: pain
Indicate: roughness of articular surface

Question 25

Patellar glide test

Answer 25

Pt slowly flex and extend the knee while looks at the glide of the patella. If you place hand lightly, it can increase sensitivity. + test: pain Indicate: possible damage to articular surface

Question 26

Anterior Drawer test (foot)

Answer 26

Put one hand on distal fibula Put other hand on posterior calcaneus and pull anteriorly Calcaneous should come back to neutral. + test: pain and no springing Indicated ATF pathology (lateral ankle sprain

Question 27

Talar tilt test

Answer 27

- Grab distal fibula - grab inferior calcaneous, blocking motion of calcaneuous - invert talas +: Laxity Indicates: calcaneofibular ligament pathology, ATL

Question 28

Eversion test

Answer 28

Evert foot +: laxity indicates: deltoid ligament

Question 29

Squeeze test

Answer 29

Squeeze the right above the ankle for 2-3 seconds with both hands. pain at syndesmosis syndesmosis pathology

Question 30

Cross leg test

Answer 30

Tell patient to cross leg and apply pressure over distal fibula + pain at distal ankle syndesmosis pathology

Question 31

Thomas test

Answer 31

Pt lay down and squeeze calf and look for plantarflexion + no plantar flexion indicates: rupture of achilles tendon

Question 32

Homans sign

Answer 32

Pt lay down with knee extended. force dorsiflexion + pain Indicates DVT

Question 33

To look for DVT, what else can you look at?

Answer 33

edema erythema warmth

Question 34

How can we rule out a blood clot?

Answer 34

venus doppler

Question 35

Moses sign

Answer 35

Pt lay down and extend leg. Lift up a little and apply anterior compression on gastroc muscles on the back of tibia + pain with anterior compression indications: DVT of posterior tibial vein

Question 36

Inversion ankle sprain MOI

Answer 36

inversion with plantar flexion

Question 37

High ankle sprain

Answer 37

eversion with ROTATION

Question 38

ligaments high ankle sprain

Answer 38

anterior inferior tibiofibular | syndesosis

Question 39

plantar fasciatis

Answer 39

inflammation of plantar aponeurosis | worse in AM, calcaneus, dorsiflexion

Question 40

how to test morton neuroma

Answer 40

Mulders sign--> clicking sensation when palpating third web space and other hand compressing the transverse arch together

Question 41

Turfs toe

Answer 41

inflammation and pain at the 1st MTP of big toe Due to hyperextension

Question 42

how to test for DB neuropathy

Answer 42

Monofilament test

Question 43

gout most likely affects what?

Answer 43

1st MTP joint