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PCM_MIDTERM 01 > OSCE: Knee > Flashcards

OSCE: Knee Flashcards

1
Q

What is a Q angle?

What is the normal Q angle for the knee?

A
  • Q Angle: Difference creating one straight line from ASIS to center of patella and another straight line through tibial tuberosity and center of patella.
  • Typically 15o but for females it can be increased
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2
Q

What is the normal ROM for knee flexion?

What muscles are involved?

A

145-150o

  • Biceps Femoris (long head and short head)
  • Semimembranosis
  • Semitendinosis
  • Gracilis
  • Gastrocnemius
  • Plantaris
  • Sartorius
  • Popliteus
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3
Q

What is the normal ROM for knee extension?

What muscles are involved?

A

0o

Quadriceps Muscles

  • Rectus Femoris
  • Vastus Lateralis, Medialis, Intermedius
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4
Q

ROMS for internal and extenral rotation of tiba on femur

A

10

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5
Q

What does the L4 deep tendon reflex test?

A

Patella

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6
Q

Valgus Test

How do you peform this test?

What does a positive test indicate?

A
  1. Patient supine with the knee flexed to 30°.
  2. Physician supports the lower leg with one and other hand placed on the lateral aspect of the patient’s knee.
  3. Apply a medial force to the proximal tibia while abducting the lower leg.
  • This test is done at 30° flexion and neutral 0.
  • Knee toward body and leg goes away*

Positive Test (increased laxity/pain) indicates Medial Collateral Ligament (MCL) Disruption.

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7
Q

Varus Test

How do you peform this test?

What does a positive test indicate?

A
  1. Patient supine with the knee flexed to 30°.
  2. Physician supports the lower leg with one and other hand placed on the medial aspect of the patient’s knee.
  3. Apply a lateral force to the proximal tibia while adducting the lower leg.
  • This test is done at 30° flexion and neutral.
  • Knee away from body and leg goes toward*

Positive Test (increased laxity/pain) indicates Lateral Collateral Ligament (LCL) Disruption.

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8
Q

Anterior Drawer Test

How do you peform this test?

What does a positive test indicate?

A
  1. Patient supine with knee flexed to 90°.
  2. Examiner sits on the patient’s foot
  3. Examiner grasps the proximal tibia with both hands, pulling the tibia anteriorly.

Positive Test (excessive translation) indicates ACL Insufficiency.

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9
Q

Lachman’s Test

How do you peform this test?

What does a positive test indicate?

A
  1. Patient supine.
  2. Examiner places one hand on the distal thigh, superior to patella.
  3. other hand grasps the proximal tibia.
  4. Flexing the knee to 10-30°, the examiner uses his caudad
    hand to pull the tibia anteriorly while the cephalad hand
    stabilizes the thigh.

Positive Test (increased laxity) indicates ACL Insufficiency.

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10
Q

Posterior Drawer Test

How do you peform this test?

What does a positive test indicate?

A
  1. Patient supine with knee flexed to 90°.
  2. Examiner sits on the patient’s foot.
  3. Examiner grasps the proximal tibia with both hands, pulling the tibia posteriorly (just push it in).

Positive Test (excessive translation) indicates PCL Insufficiency.

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11
Q

McMurray’s Test

How do you peform this test?

What does a positive test indicate?

A
  1. Patient supine with knee flexed to 90°.
  2. Examiner uses caudad hand to control the ankle and cephalad hand placed on distal femur.
  • Lateral Meniscus: Examiner rotates the tibia into
    internal rotation and applies a varus stress, then
    continues the leg into extension
  • Medial Meniscus: Examiner rotates the tibia into
    external rotation and applies a valgus stress, then
    continues the leg into extension

Positive Test (pain) indicates Medial or Lateral Meniscus Tear.

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12
Q

Apley’s Grind Test: Compression

How do you peform this test?

What does a positive test indicate?

A
  1. Patient prone with knee flexed to 90°.
  2. Examiner uses downward force on the foot to provide a compressive force on the meniscus, while rotating the foot internally and externally.

Positive Test (pain) indicates possible meniscal injury, collateral ligament injury, or both.

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13
Q

Apley’s Grind Test: Distraction

How do you peform this test?

What does a positive test indicate?

A
  1. Patient prone with knee flexed to 90°.
  2. Examiner stabilizes the thigh, then applies upward traction to the leg while rotating it.

Positive Test (pain) indicates collateral ligament injury.

Positive Test (relief of pain) indicates possible meniscal injury.

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14
Q

Patella-Femoral Grinding Test

How do you peform this test?

What does a positive test indicate?

A
  1. Compress patella caudally into trochlear groove
  2. Instruct patient to tighten quadriceps against resistance

Positive Test (pain) indicates roughness of articulating surfaces

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PCM_MIDTERM 01 (13 decks)

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