Musculoskeletal Flashcards
position for the intermediate knee examination
patient lying flat
exposure for the intermediate knee examination
need to be able to see the knee joint and the quadriceps and calf muscles to evaluate for wasting
inspection for intermediate knee examination
scars (previous surgery or trauma) muscle wasting (disuse > arthritis, or LMN finding) deformities (valgus: knock knees, varus: bow legged)
what should you feel for in the intermediate knee examination?
temperature using the back of your hands, at the patellar, above and below the joint
warmth at the knee joint can be due to?
inflammatory condition such as osteoarthritis or septic arthritis which is an in infection in the joint associated with severe pain
list structures to palpate in the intermediate knee examination
Around the patella
Medial and lateral joint lines
The tibial tuberosity and head of the fibula
Popliteal fossa
what is an effusion?
what can it be caused by?
excess of synovial fluid, which can be caused by arthritis or damage to the internal structures of the knee such as the meniscus
is the tap method for small or large effusions?
large
is the sweep method for small or large effusions?
small
outline the tap method
ensure knee is extended > slide your non-dominant hand down the thigh to empty the suprapatellar pouch > keeping your non-dominant hand in place, press firmly over the patella with your dominant hand > in a moderate effusion you will feel a tap as the patella hits the femur
outline the sweep method
ensure knee is extended > with your non dominant hand sweep upward on the medial side of the knee to empty the medial compartment > keeping your non-dominant hand in place, sweep downward on the lateral side of the knee to empty the lateral compartment with your dominant hand > if there is a small effusion you will see a ripple or bulge of fluid appears on the medial side of the knee from the lateral compartment
flexion of the knee is handled by what muscles?
hamstrings: biceps femoris, semitendinosus, semimembranosus and (gracilis)
extension of the knee involves what structures?
extensor apparatus comprising of the: quadriceps muscles, quadriceps tendon, patella, patellar tendon and tibial tuberosity
damage to the extensor apparatus can cause what?
inability to straight leg raise
how to assess movement of the knee - active
ask the patient to flex and extend each knee as much as possible in turn > look for pain on movement and note the range of motion of each joint