MSK System Flashcards
What does wasting of the muscle suggest?
due to:
- disuse, due to chronic pain movement (arthritis)
What does muscle atrophy suggest?
Lower Motor Nuerones
What is the term for ‘knock knees’?
- valgus
- valgum
What is the term for ‘bow-legged’?
- varus
- varum
How do assess for the temperature?
- use the back of your hands
- above, on, and below the patellar
- comparing both legs at the same time
What does warm knees suggest?
Inflammatory conditions
- osteoarthritis
- septic arthritis
What is the impact of septic arthritis?
irreparable damage to the joint
Where do you palpate when assessing the knee?
- around the patella
- medial and lateral joint lines
Where should you palpate in order to assess for meniscal damage?
- tibial tuberosity and the head of the fibula
- popliteal fossa
What does swelling in the popliteal fossa?
Baker’s Cyst
What is an effusion?
excess of synovial fluid
What can cause an effusion?
- arthritis
- damage to the internal structures of the knee (eg meniscus)
Where does the synovial capsule of the knee extend to?
deep into the quadriceps muscles
supratellar pouch
What is the tap method?
- ensure the knee is extended
- slide hand down the thigh to empty the suprapatellar pouch
- press over the patella
What will you feel in an effusion with the tap method?
feel a tap as the patella hits the femur
When do you use the tap method?
moderate to severe effusions
When do you use the sweep method?
small effusions
What the sweep method?
- ensure the knee is extended
- sweep upward on the medial side to empty the medial compartment
- sweep downward on lateral side to empty the lateral compartment
What will you see if an effusion is present with the sweep method?
a ripple or bulge of fluid on the medial side of the knee from the lateral compartment
What muscles are involved in knee flexion?
Hamstring muscles:
- biceps femoris
- semitendinosis
- semimembranosus and gracilis
What muscles are involved in knee extension?
Quadriceps muscles:
- Vastus medius
- Vastus lateralis
- Vastus intermedius
- Rectus femoris
What is the result of the damage to the muscles involved in knee extension?
inability to straight leg raise
How do you assess the active movement of the knee?
- ask patient to flex and extend
- assess for pain and ROM
What does pain on active movement suggest?
damage to the structures, fracture of the meniscus
What does reduced ROM on active movement suggest?
arthritis
How do you assess the extensor compartment?
- lifting the foot with the patients leg relaxed
- look for hyperextension
- up to 10 degrees of hypertension is normal
How do you perform the anterior draw for the ACL?
- knee at 90 degrees
- ensure that the hamstring is relaxed and look for posterior sag
- hands behind the upper tibia and both thumbs over the tibial tuberosity
- pull the tibia anteriorly
What can cause a false-positive anterior drawer sign?
posterior sag, can be mistaked for ACL laxity
What movement during the ACL drawer test suggests a rupture?
> 1.5cm, suggests a:
- ACL pathology
- often associated with a medial ligament injury
What do medial and collateral ligaments do?
the resist valgus and valrus stresses
How do you assess the integrity of the Lateral Collateral Ligament?
- 30 degrees leg flexion
- place hand on the medial aspect of the lower thigh
- place hand on the lateral aspect of the upper calf with fingers over the lateral joint line
- apply valgus (inward) stress
How do you assess the integrity of the Medial Collateral Ligament?
30 degrees leg flexion
- place hand on the lateral aspect of the lower thigh
- place hand on the medial aspect of the upper calf with fingers over the lateral joint line
- apply varus (outward) stress
