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Ch 6

Ch 6 Eval of the Knee

QuestionAnswer
When assessing Knee pain what are the six structures that could be involved? 1. Collateral Ligaments 2. Anteromedial capsule 3. Anterolateral capsule 4. ACL 5. PCL 6. Meniscus
Collateral Ligament, Anteriomedial capsule, Anteriolateral pain would describe what? Pain directly at the area of trauma
ACL pain usually feels like what? Pain beneath the kneecap or inside the knee
PCL pain can be reported as what kind of pain? Mimics a gastroc strain
Location of vascular meniscal pain would be where? Joint line pain
Symptoms of avascular meniscal pain would be what? Popping, clicking or locking
What are the eight tensile forces that can be place on the knee when talking about MOI? 1. Valgus 2. Varus 3. Anterior Tibial displacment 4. Posterior Tibial displacment 5. Internal tibial rot. 6. external tibial rot. 7. hyperextension 8. hyperflexion
Valgus stress on the knee can affect what 4 structures of the knee? 1. MCL 2. Medial Joint Capsule 3. Pes Anserine muscle group 4. Medial meniscus
Varus stress on the knee can affect what 4 structures of the knee? 1. LCL 2. Lateral joint capsule 3. IT band 4. Biceps femoris
Anterior tibial displacment force can affect what 5 structures of the knee? 1. ACL 2. IT band 3. LCL 4. MCL 5 Medial/Lateral joint capsules
Posterior tibial displacment force can affect what 3 structures of the knee? 1. PCL 2. Popliteus 3. Medial/Lateral joint capsule
Internal tibial rotation force can affect what 5 structures of the knee? 1. ACL 2. anteriolateral joint capsule 3. posteromedial joint cap 4. posterolateral joint cap 5. lcl
External tibail rotation force can affect what five structures of the knee? 1. posterlateral joint cap 2. mcl 3. pcl 4. lcl 5. acl
Hyperextension forces can affect what 3 structures of the knee? 1. ACL 2. Posterior joint cap 3. pcl
Hyperflexion forces can affect what 2 structures of the knee? ACL, PCL
When assessing Knee pain what are the six structures that could be involved? 1. Collateral Ligaments 2. Anteromedial capsule 3. Anterolateral capsule 4. ACL 5. PCL 6. Meniscus
Collateral Ligament, Anteriomedial capsule, Anteriolateral pain would describe what? Pain directly at the area of trauma
ACL pain usually feels like what? Pain beneath the kneecap or inside the knee
PCL pain can be reported as what kind of pain? Mimics a gastroc strain
Location of vascular meniscal pain would be where? Joint line pain
Symptoms of avascular meniscal pain would be what? Popping, clicking or locking
What are the eight tensile forces that can be place on the knee when talking about MOI? 1. Valgus 2. Varus 3. Anterior Tibial displacment 4. Posterior Tibial displacment 5. Internal tibial rot. 6. external tibial rot. 7. hyperextension 8. hyperflexion
Valgus stress on the knee can affect what 4 structures of the knee? 1. MCL 2. Medial Joint Capsule 3. Pes Anserine muscle group 4. Medial meniscus
Varus stress on the knee can affect what 4 structures of the knee? 1. LCL 2. Lateral joint capsule 3. IT band 4. Biceps femoris
Anterior tibial displacment force can affect what 5 structures of the knee? 1. ACL 2. IT band 3. LCL 4. MCL 5 Medial/Lateral joint capsules
Posterior tibial displacment force can affect what 3 structures of the knee? 1. PCL 2. Popliteus 3. Medial/Lateral joint capsule
Internal tibial rotation force can affect what 5 structures of the knee? 1. ACL 2. anteriolateral joint capsule 3. posteromedial joint cap 4. posterolateral joint cap 5. lcl
External tibail rotation force can affect what five structures of the knee? 1. posterlateral joint cap 2. mcl 3. pcl 4. lcl 5. acl
Hyperextension forces can affect what 3 structures of the knee? 1. ACL 2. Posterior joint cap 3. pcl
Hyperflexion forces can affect what 2 structures of the knee? ACL, PCL
Valgus stress compressive forces affect what tissue in the knee? lateral meniscus
Varus stress compressive forces affect what tissue in the knee? medial meniscus
Anterior tibial displacment compressive forces affect what tissue in the knee? posterior portion of med/lat meniscus
Posterior tibial displacment compressive forces affect what tissue in the knee? anterior portion of med/lat meniscus
Internal tibial rotation compressive forces affect what tissue in the knee? anterior horn of medial meniscus/ posterior horn of the lateral meniscus
External tibial rotation compressive forces affect what tissue in the knee? anterior horn of the lat. meniscus/ posterior horn of medial meniscus
Hyperextension compressive forces affect what tissue in the knee? anterior portion of medial /lat meniscus
Hyperflexion compressive forces affect what tissue in the knee? posterior portion of medial/ lat meniscus
When gathering history on the knee what are the four main things you want to take note of? WB status, sounds or sensations, onset of injury, previous injury
When doing girth measurments where should it start? Joint line and superiorally in 2-3 inch increments.
During girth measurment at the joint line what should be noticed? presenc of swelling
When moving up the knee during girth measurments what should be noticed? presence of muscle atrophy
Girth measurments should always be what? compared bilaterally
What are the five things that should be taken note of when doing your inspection on the anterior structures? 1. Alignment of the patella 2. Patellar Tendon 3. Quad muscle group 4. Alignment of Femur on the Tibia 5. Tibial tuburosity
What should be looked at when inspecting the alignment of the patella? Resting normally above femoral trochlea/ Evenly alligned with med/lat asepects of knee
What should be looked at when inspecting the Patellar tendon? swelling over tendon due to tendonitis or bursitis/swelling on both sides of tendon due to inflamed fat pad
What should be looked at when inspecting the quad muscle group? mass and tone/ discoloration/ swelling/ loss of continuity
What should be looked at when inspecting the aligment of the femur on the tibia? angle of articulation ie: genu valgum, genu varum
What should be looked at when inspecting the tibial tuberosity? Osgood-Schlatter disease
What are the two things that should be taken note of when doing your inspection of the medial structures? Medial aspect/ Oblique fibers of vastus medialis
What should be looked at when inspecting the medial aspect? swelling/ discoloration of joint line, tibia, femur, or pes anserine tendon
What should be looked at when inspecting the oblique fibers of the vastus medialis? Tone and girth compared bilaterally ( first to go due to injury)
What are the four things that should be taken note of when doing your inspection of the lateral structures? lateral aspect, fibular head, posterior sag of the tibia, hyperextension
What should be looked at when inspecting the lateral aspect? swelling, discoloration to tibial joint line and femur
What should be looked at when inspecting the fibular head? equal height bilaterally, Bicep femoris tendon and LCL in knee flexion
What should be looked at when inspecting the Posterior sag of the tibia? 90-90 observing position of the tibial tuburostiy bilaterally (PCL)
What should be looked at when inspecting the amount of hyperextension of the knee joint? Genu recurvatum
What are the two things that should be taken note of when doing your inspection of the posterior structures? Hamstring muscle group, popliteal fossa
What should be look at when inspecting the hamstring muscle group? Contusions(blow), Signs of ecchymosis(strain)
What are we looking for when inspecting the popliteal fossa? Swelling or discoloration(capsular trauma or tears of ham tendons or gastrocs)
During palpation what six structures need to be palpated in regards to the anterior surface of the knee? 1. patella 2. patellar tendon 3. tib tuburosity 4. quad tendon 5. quad muscles 6. sartorius
During palpation what seven structures need to be palpated in regards to the medial surface of the knee? 1. medial meniscus/joint line 2. mcl 3. medial femoral condyle 4. medial tibial plateau 5. pes anserine tendon/ bursa 6. semitendinosus tendon 7. gracilis
During palpation what six structures need to be palpated in regards to the lateral surface of the knee? 1. joint line 2. fib head 3. lcl 4. popliteus 5. bicep femoris 6. it band
During palpation what three structures need to be palpated in regards to the posterior surface of the knee? 1. popliteal fossa 2. hamstring muscle group 3. head of gastroc
What test is used to determine intracapsular swelling ? sweep test
Positive sweep tests implies what ? Possible acl trauma, osteochndral fx, synovitis, meniscal lesion, patellar dislocation
Normal ROM degree's for knee extension and flexion? extension: 0' flexion: 135' to 145'
ROM for recurvatum? -10'
What to look for when looking at ROM for internal and external rotation? observe rotation of tibial tuburosity bilaterally when doing ER and IR in active knee flexion and extension.
What ligamentous tests would you perform to rule out ACL instability? Anterior drawer, Lachmans, Modified Lachmans
What ligamentous tests would you perform to rule out PCL instability? Posterior drawer, Godfreys test (90'-90')
What ligamentous tests would you perform to rule out MCL instability? Valgus stress test
What ligamentous tests would you perform to rule out LCL instability? Varus stress test
What special tests would you do for possible meniscal injury? McMurray's, Apleys comp and distraction
When dealing with suspected Rotary Knee Instability injuries what five special tests would you do? 1. slocum drawer 2. crossover test 3. lateral pivot shift 4. slocum ALRI 5. FRD test
What special tests help you determine ITB Friction syndrome pathologies? Nobles compression, Obers test
MOI MCL sprain Valgus force/ external rot of tibia
MOI LCL sprain Varus force/ excess internal rot of tibia
MOI ACL sprain Rot. with knee planted/ Blow to tibia causing tibial translation/ blow to femur driving femur posteriorly/ hyperextension
MOI PCL sprain Posterior translation of the tibia(esp foot plantarflexed)/ hyperextension/ hyperflexion
MOI Posterolateral rotatory instibility direct blow to the posterolateral aspect of knee/ rotational force
MOI meniscal tear tibial rotation with flexion and varus or valgus stress
MOI IT Band Syndrome repeated knee flexion and extension
MOI popliteus tendinitis overuse
Created by: shsuman152
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