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Osce Prep > Special Test of the Knee > Flashcards

Special Test of the Knee Flashcards

1
Q

What are all the Special test for the knee?

A

Apley’s Compression, Apley’s Distraction, Bragard’s Sign, Clarke’s, Helfet’s, Lachman’s, Major Effusion, McConnell’s, McMurray’s, Minor Effusion, Noble’s, Posterior Sag, True Tibia / Femur length test, Valgus / Varus Stress test, Waldron’s.

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2
Q

What is Apley’s Compression used to Assess for?

A

Used to assess for Meniscal injury.

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3
Q

How is Apley’s Compression performed?

A

Client prone, with affected knees flexed to 90*.
Compress the flexed knees by pushing the client’s foot and tibia down into the table, followed by int / ext rot of the tibia.

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4
Q

What is a positive result for Apley’s Compression?

A

If the client reports pain in the medial aspect of the joint.
Positive foe medial meniscal injury.
Pain on lateral aspect of the knee is positive for lateral meniscal injury.

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5
Q

What is Apley’s Distraction Used to Assess for?

A

Assess the integrity of the Collateral ligaments of the knee joint.

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6
Q

How is Apley’s Distraction performed?

A

Client prone with knees flexed to 90*.
Stabilize the client’s leg by placing your knee on the posterior thigh.
Apply a traction of the tibia, and internal / External rot.

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7
Q

What is a Positive result for Apley’s Distraction?

A

If the client reports pain on the medial side of the joint the test is positive for MCL damage.
If the pain is on the Lateral Aspect of the Joint, the test is positive for LCL damage.

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8
Q

What is Bragard’s Sign used to assess for?

A

Used to assess for Meniscal Tearing.

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9
Q

How is Bragard’s Sign performed?

A

Client Supine with Hip and Knee flexed,
Externally Rot the Tibia with one hand while extending the knee,
With the other hand stabilize proximal to the knee.

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10
Q

What is a positive result for a Bragard’s Sign test?

A

Pain / Tenderness along the Medial aspect of the joint line.

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11
Q

What is Clarke’s Test used to assess for?

A

Used for assessing Patellofemoral Syndrome.

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12
Q

How is Clarke’s Test performed?

A

Client supine with knees Extended,
Compress patella posteriorly onto the femoral condyles and then, with moderate pressure move the patella distally.
Get client to contract Quads on affected leg.

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13
Q

What is a positive result of a Clarke’s Test?

A

If the client presents with Apprehension, pain or crepitus, the test is positive.
The test may make clients present with these symptoms of apprehension anyway so the test should be performed several times, using gradually increased pressure.

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14
Q

What is Helfet’s Test used to assess for?

A

Used to Assess the Dynamic rotary function of the Tibia.

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15
Q

How is Helfet’s Test performed?

A

Client is seated with legs over edge of table,
Slowly ext knee,
Observe the tibial tuberosity in relation of the midline of the patella.
Look for the slight lateral rot of the tibial tuberosity at the last part of knee ext.

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16
Q

What is a positive result for Helfet’s test?

A

If there is no slight lateral rot of the tibia, this indicates a positive test for possible damaged Cruciate ligament or Meniscal damage.

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17
Q

What is Lachman’s used to assess for?

A

This test is considered to be the most accurate for assessing the integrity of the ACL.

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18
Q

How is Lachman’s test performed?

A

Client supine, with affected knee in 30* of flexion.
Stabilize the distal femur with one hand and grasp the proximal tibia in the other hand, apply anterior directed stress to the Tibia.

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19
Q

What is a positive result of a Lachman’s test?

A

A positive test indicating damage to the ACL, when there is pain or excessive movement of the tibia.

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20
Q

What is a Major Effusion test used to assess for?

A

Used to assess for major increase in synovial fluid within the knee joint capsule following an acute knee injury.

21
Q

How would you perform a Major Effusion test?

A

Client supine with affected knee in as much ext as possible,
When there is swelling in the knee the client may hold the knee in slight flexion,
Gently but firmly ext the knee, compress the patella down on the femoral condyles and then release it.

22
Q

What is a positive result for a Major Effusion test?

A

If the patella clicks onto the condyles then rebounds to the floating position, the test is positive for swelling.
Meniscal tearing, torn cruciate ligaments or Fracture may be the causes.

23
Q

What is McConnell’s test used to assess for?

A

Used to assess for Patellofemoral Tracking problems.

24
Q

How is McConnell’s test performed?

A

Client seated with legs hanging over table,
Client ext rot the femur of affected leg, while performing AR contractions of the quad.

Note the painful ranges.
Passively bring the clients knee into full ext, glide the affected patella medially and hold it in position.

Get client to perform the Painful ranges.

25
Q

What is a positive result for McConnell’s test?

A

If the client can perform the painful ranges with the medially assisted patella, or the pain decreases dramatically.
The test is positive for poor patellar tracking.

26
Q

What is McMurray’s test used to assess for?

A

Used to assess for injury of the menisci.

27
Q

How do you perform a McMurray’s test?

A

Client supine with Hip and knee flexed,
Cup one hand over the client’s knee with palm over the patella and fingers and thumb over the joint line.

Slowly ext the knee while applying stress with valgus / varus stress and ext / int rot of the tibia.
1 direction at a time to test ether the medial or lateral side.

28
Q

What is a positive result for a McMurray’s test?

A

A positive test is indicated by a click or catch in ext of the knee.
A negative does not completely rule out a Meniscal tear.

29
Q

What does a Minor Effusion test Assess for?

A

Used to assess for Lessor amounts of Synovial fluid within the knee joint capsule after an acute injury.

30
Q

How do you perform a Minor Effusion test?

A

Client supine, with knees in as much ext as possible,

Attempt to slowly brush the fluid from the superior lateral aspect of the knee.

31
Q

What is a positive Minor Effusion test?

A

If excess fluid present, it may take 1-2 secs to appear inferior to the patella in a bulge.
if swelling does not move the test is negative.

32
Q

What is Noble’s test used to assess for?

A

Used to assess for the presence of IT band Friction syndrome.

33
Q

How is Noble’s test performed?

A

Client in supine with both affected Hip and knee in flexion 90*.
Firmly but yet tolerably compress the IT band 2 CMs proximal from the lateral condyle of the knee.

Instruct client to ext knee and hip slowly while compression is maintained.

34
Q

What is a positive Noble’s test?

A

If the client presents with pain over the lateral condyle of the Femur at around 30* the test is positive for IT band friction syndrome.

35
Q

What does Posterior Sag test assess for?

A

Used to assess the PCL.

36
Q

How is Posterior Sag test performed?

A

Client Supine with Hips flexed to 45* and knees to 90*.

Observe the profile of both knees from the side of the table.

37
Q

What is a positive result for a Posterior Sag test?

A

If the affected Tibia “Sags” posteriorly compared to the unaffected knee.

38
Q

What does a True Tibia and Femur Length test Assess for?

A

Used to assess Tibia and Femur length.

39
Q

How do you perform a True Tibia and Femur Length test?

A

Client supine, with hips and knees flexed and feet on table.
Knees together and Mallioi even.
Stand at the end of the table, compare the heights of tibial plateaus.

40
Q

What is a positive result for a True Tibia and Femur Length test?

A

Moving side to side comparing the positions of the paellas, looking for a shorter femur.

41
Q

What does a Valgus Stress test Assess for?

A

Used to assess the MCL / medial aspect of the knee.

42
Q

How do you perform a Valgus stress test?

A

Client supine,
Stabilize affected leg in slight ext rot with one hand on the medial malleolus and the other hand on the lateral aspect of the knee with knee in full ext.

Apply a medially directed stress on the knee, when the knee is 20-30* of flexion youre assessing the MLC only.

43
Q

What is a positive result for a Valgus stress test?

A

In ether full ext or the knee is in 20-30* of flexion, it is indicated by pain in the injured tissues and excessive movement or gapping at the medial aspect of the knee.

44
Q

What does a Varus stress test assess?

A

Used to assess the Lateral aspect of the knee / LCL.

45
Q

How would you perform a Varus stress test?

A

Client supine, Stabilize leg in slight ext rot.
One hand on the lateral malleolus and the other hand on the medial aspect of the knee.
Applying a Lateral stress to the joint from the medial knee.

46
Q

What is a positive result for a Varus stress test?

A

Excessive movement at the affected tissue / gapping or pain on ether full ext or in 20-30* of flexion.

47
Q

What does Waldron’s test assess for?

A

Used to assess for Patellofemoral Syndrome.

48
Q

How would you perform Waldron’s test?

A

Client Standing,

Palpate affected patella while the client performs a number of slow deep knee bends / Squats.

49
Q

What is a positive result for a Waldron’s test?

A

Crepitus, pain or poor patellar tracking indicates a positive result.

Osce Prep (34 decks)

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