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The Knee
Ch 6 Evaluation of the Knee
| Question | Answer |
|---|---|
| What Three Muscle Groups make up the Pes Anserine? | The Gracilis, Sartorius, and Semitendinosus |
| What kind of pain will the person complain of the ACL? | Pain beneath the kneecap or inside of the knee |
| Location of pain of the PCL? | Mimics gastrocnemius strain |
| Location of pain of the Meniscus ( vascular)? | Joint line pain |
| Location of pain of the meniscus ( avascular)? | Popping, clicking or locking |
| MOI Varus tensile forces( 4) ? | 1.LCL,2. Lateral joint capsule,3. IT band, 4.Biceps Femoris. |
| MOI Valgus Tensile forces (4)? | 1. MCL, Medical jont capsule, pes anserine mucsle group, and Medial meniscus |
| MOI Anterior tibial Displacement ( 5)Tensile Force? | ACL, IT band, LCL, MCL, medical and lateral joint capsules. |
| MOI Posterior Tibial Displacment(4)Tensile Force)? | PCL, poplitus, medial and lateral joint capsules |
| MOI Internal Tibial Rotation(Tensile Force)? | ACL, Anterolateral joint capsule, posteromedial joint capsule, posterolateral joint capsule, LCL |
| MOI External tibial rotation(Tensile Force)? | Posterlateral joint capsule, MCL, PCL, LCL, ACL |
| MOI hyperextension(Tensile force)? | ACL, posterior joint capsule |
| MOI Hyperflexion( tenseile force)? | ACL, PCL |
| MOI Compressive forces- Valgus? | Lateral Meniscus |
| MON Compressive forces- Varus? | Medical Meniscus |
| MOI Compressive forces- Anterior tibial displacement? | Posterior portion of the medial and lateral meniscus |
| MOI compressive forces- Porterior tibial displacement? | Anterior portion of the medial and lateral meniscus |
| MOI Compressive force to the Interal tibial rotation? | Anterior horn of the medial meniscus, posterior horn of the medial meniscus |
| MOI compressive force of external tibial rotation? | Anterior horn of the lateral meniscus, posterior horn of the lateral meniscus |
| MOI compressive force hyperextenion? | anterior portion of the medial and lateral meniscus |
| MOI Compressive force of Hyperflexion? | Posterior portion of the medial and lateral meniscus |
| When inspecting the alignment of the patella, should you be looking for? | Should rest normally above the femoral trochlea, evenly aligned with the medial and lateral aspects of the knee |
| While inspecting the patellar tendon, you should look for? | Swelling over or directly around the tendon may indicate tendinitis or bursitis, swelling on both sides may indicate inflammation of the underlying fat pad |
| When inspecting the Quadriceps muscles, you should be looking for? | Compare mass and tone bilaterally, note any discoloration, swelling, loss of continuity |
| Inspection of the alignment of the femur on the tibia? | Observe angle of articulation ( genu valgum, Genu varum) |
| Inspection of the Tibial Tuberosity | Note if enlarged( Osgood-Schlatter disease) |
| Inspection of the medical aspect, what should you be looking for? | Any swelling or discoloration of the joint line, tibia, femur, or pes anterine tendon |
| Inspection of the Oblique fiber of the vastus medialis? | Note tone and grith compared bilaterally, first to inhited following injury ( disuse or result of inflammation) |
| Inspection of the lateral aspect? | Notice any swelling or discoloration of the tibia joint line and femur. |
| Inspection of the Fibular head? | Should be aligned equally ht when compared bilaterally. Biceps femoris tendon and LCL may be visble during knee flexion. |
| Inspection of Posterior sag of the tibia? | Patient is supine and knees at 90 degrees, Observe postions of the tibia(PCL- deficient knee) |
| Inspection of hyperextension? | Genu recurvatum |
| Inspection of the hamstring muscles? | Observe Length of the hamstring group for signs of contusions, indicating a blow to this area, ecchymosis, indicating a strain |
| Inspection of the Popliteal Fossa? | Notice any swelling or discoloration, indication of capsular trauma or tear of the distal hamstring tendons or the heads of the gastrocnemius muscle |
| Determining intracapsular swelling, what is the test? | Sweep Test |
| What indicated that a sweep test is postive? | Reformation of the edema on medical aspect of the knee pressure appliesd to lateral aspect |
| What are the implications of a postive Sweep Test? | Joint capsule swelling- indicative of possible ACL trauma, osteochondral fx, synovitis, menisal lesion, or patellar dislocation. |
| ROM testing when during flexion and extension of the knee what are the degrees? | 0( extension)- 135 to 145 (Flexion)degrees |
| ROM testing of recurvatum what are the degrees? | -10 degrees |
| ROM testing of internal and external rotation? | Observer and compare bilaterally the rotation of the tibial tuberosity to estimate the amount of ER and IR occurs during active flexion and extension. |
| What are the three ligamentous test that test of ACL instablitliy | Anterior drawer test, Lachman's Test, Modified lachman's test |
| What are the two ligamentous test for PCL Instability? | Posterior Drawer test, Godfreys test (Sag) |
| What is the test for MCL instability? | Valgus stress test |
| What is the test for LCL instability? | Varus stress test |
| What are the two Special test for Meniscal tears? | McMurrays Test, and Apley's compression and distraction test |
| What are the five special test of rotary knee instabilies? | Slocum Drawer, Crossover test, Lateral pivot shift, Slocum ALRI, FRD test |
| What are the tests for IT band friction Syndrome? | Noble's compressive test, Ober's test |
| What the MOI for an MCL sprain? | A valgus Force to the knee or less commonly, external rotation of the tibia. |
| What is the MOI of a LCL sprain? | Varus force placed on the knee or excess internal tibial rotation. |
| what is the MOI of a ACL Sprain? | Rotation of the knee while the foot is planted (tensile force)a blow that drive the tibia anterio relative to the femur or the femur posterior relative to the tibia ( shear force)or hyperextenion |
| What is the MOI of a PCL Sprain? | Posterior displacement of the tibia on the femur, Hyperflextion of the knee, Hypextension of the knee |
| What is the posterolateral rotatory instablitiy? | Most commonly, a direct blow to the posterolateral aspect of the knee, rotational force |
| During RROM of flexion of the knee what muscles are you testing(7)? | Semitendinosus, semimembranosus, biceps formois, sartoris, gactrocnemis, graclis, poplitus |
| During RROm of extersion what muscles are being being tested (4)? | Rectur femoris, vastus lateralis, vastus intermedius, vastus medialis. |
| what are u testing for during a Anterior Drawer test for the ACL? | Increased amount of anterior tibial translation compared with the opposite limb. |
| What does a postive test for a anterior drawer test mean? | a sprain of the anteromedial bundle of the ACL or complete tear of the ACL. |
| What are you testing for during a Lachman's test for the ACL laxity | Increaced amount of anterior tibial translation compared with the opposite side limb or the lack of a firm end feel |
| When performing the posterior drawer test for the PCL instablity, what are you looking for ? | Increased amounts of posterior tibial translation compared with the opposite limb or lack of the firm end feel |
| A postive result from lackmans means? | Sprain to the ACL |
| A postive result from the posterior drawer test means? | Sprain to the PCL |
| Godfreys test for PCL instability, what are you looking for? | unilateral posterior displacement of the tibial tuberosity |
| A postive result from a Godfreys test is? | A sprain to the PCL |
| valgus stress test for the MCL instability is testing for? | Increased laxity, decreased quality of the end point and pain compared with the uninvolved ligament |
| resuls to the valgus stress test for a MCL means? | At 0degrees flexion( sprain to the macl, medial joint capsule and possibly cruciate ligamentsAt 25 degrees ( sprain to the MCL) |
| Varus stree test for LCL ligament instability testing for? | Increased laxity, dreacred quality of the end-point or pain compared with the uninvolved limb |
| Results to a Varus stress test fot the LCL mean? | at 0 degrees of extension- sprain of the LCL,lateral joint capsule cruciate ligaments and related structures indicate rotatary of the joint25 degrees- a sprain to the LCL |
| Anterolateral rotatory instability are a disruption to what 7 structural? | ACL, anterolateral joint capsule, LCL, IT band, biceps femoris, lateral meniscus, posterolateral capsule. |
| Anterolateral rotatory instability involves what kind of trauma? | Trauma to the ACL, and the anterolateral capsule restraints, anterolateral rotary instablity resulting in a greater displacment of the tibia. |
| what are the three test to the anterolateral rotatory instability> | Lateral pivot drawer, the slocum ALRI test, and flexion rotation drawer. |
| When performing the Slocum drawer test at interally rotated at 25 degrees what are the implications? | Test for anterolateral instability: damage to the ACL, anterolateral capsule, lcl, IT band, popliteus tendon, posterolateral capsule |
| When performing the slocum drawer test at externally roated at 15 degrees what are the implications? | test for the anteromedical instablity: damage to the MCL, anteromedical capsule, ACL posteromedical capsule |
| Lateral pivot test for anterolateral knee instablity a postive test would be? | tibia;s postion on the femur reduces as the leg is flexed of 30 degreees or 40 degrees, during extension the anterior subluxation is felt |
| Lateral pivot test for anterolateral knee instalility a implication are? | tear of the ACLm posterolateral capsule, arcuate ligament complex or the IT band |
| Slocum anterolateral rotatory instablilty a postive test means? | appreciable" chuck or instability as the lateral tibial plateau subluxates or pain or instability reported |
| Posteriolateral rotatory instability involves? | anterior displacement of the lateral femoral condyle relative to the tibia ( the tibia externally rotating relative to the femur) |
| Posterolateral structures are of the knee? ( 4) | Arcuate ligament complex, LCL, biceps femoris, posteral capsule |
| Postormedical structues are of the knee? (4) | Posterior oblique ligament, MCl, semimembranosus, anteromedical capsule, |
| Anteromedical structures of the knee?( 6) | ACLm Anteromedical joint capsule, MCL, pes anserine, medial meniscus, postermedial capsule |
| External rotation test for posterolateral knee instability postive test is? | Increased external rotation greater than 10 degrees compared to the opposite limb |
| External rotation test posterolateral knee instablility implicatioin at 30 degrees not at 90? | injury isolated to the arcuate ligament complex and posterolateral structed of the knee |
| External rotation test posterlateral knee instability implication at 30 and 90 degrees? | trauma to the PCL, posterolateral knee structures, and arcuate ligament complex |
| External rotation test posterlateral knee instablility implication at a90 degrees | isolates the PCL |
| The McMurry's test for meniscal lesions, postive test would result in? | Popping or clicking or locking of the knee, pain emanating from the meniscus |
| Nobles compressive test for IT band friction syndrome, postive test results in? | Pain under the thumb most commonly as the knee approaches 30 degrees |
| Ober's test for IT Band tighness postive test results in? | The leg is unable to adduct past parallel |
| Scew Home Mechanism is? | When extension of the Knee the finial degrees, resulting in extenal rotation of the tibia when the lateral meniscus seving as a pivot point. |
Created by:
Msathletic
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