Ch 6 Eval of the Knee
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| 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
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| Collateral Ligament, Anteriomedial capsule, Anteriolateral pain would describe what? | Pain directly at the area of trauma
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| ACL pain usually feels like what? | Pain beneath the kneecap or inside the knee
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| PCL pain can be reported as what kind of pain? | Mimics a gastroc strain
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| Location of vascular meniscal pain would be where? | Joint line pain
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| Symptoms of avascular meniscal pain would be what? | Popping, clicking or locking
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| 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
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| 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
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| 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
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| 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
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| Posterior tibial displacment force can affect what 3 structures of the knee? | 1. PCL 2. Popliteus 3. Medial/Lateral joint capsule
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| 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
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| External tibail rotation force can affect what five structures of the knee? | 1. posterlateral joint cap 2. mcl 3. pcl 4. lcl 5. acl
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| Hyperextension forces can affect what 3 structures of the knee? | 1. ACL 2. Posterior joint cap 3. pcl
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| Hyperflexion forces can affect what 2 structures of the knee? | ACL, PCL
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| 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
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| Collateral Ligament, Anteriomedial capsule, Anteriolateral pain would describe what? | Pain directly at the area of trauma
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| ACL pain usually feels like what? | Pain beneath the kneecap or inside the knee
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| PCL pain can be reported as what kind of pain? | Mimics a gastroc strain
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| Location of vascular meniscal pain would be where? | Joint line pain
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| Symptoms of avascular meniscal pain would be what? | Popping, clicking or locking
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| 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
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| 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
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| 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
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| 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
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| Posterior tibial displacment force can affect what 3 structures of the knee? | 1. PCL 2. Popliteus 3. Medial/Lateral joint capsule
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| 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
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| External tibail rotation force can affect what five structures of the knee? | 1. posterlateral joint cap 2. mcl 3. pcl 4. lcl 5. acl
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| Hyperextension forces can affect what 3 structures of the knee? | 1. ACL 2. Posterior joint cap 3. pcl
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| Hyperflexion forces can affect what 2 structures of the knee? | ACL, PCL
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| Valgus stress compressive forces affect what tissue in the knee? | lateral meniscus
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| Varus stress compressive forces affect what tissue in the knee? | medial meniscus
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| Anterior tibial displacment compressive forces affect what tissue in the knee? | posterior portion of med/lat meniscus
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| Posterior tibial displacment compressive forces affect what tissue in the knee? | anterior portion of med/lat meniscus
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| Internal tibial rotation compressive forces affect what tissue in the knee? | anterior horn of medial meniscus/ posterior horn of the lateral meniscus
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| External tibial rotation compressive forces affect what tissue in the knee? | anterior horn of the lat. meniscus/ posterior horn of medial meniscus
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| Hyperextension compressive forces affect what tissue in the knee? | anterior portion of medial /lat meniscus
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| Hyperflexion compressive forces affect what tissue in the knee? | posterior portion of medial/ lat meniscus
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| 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
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| When doing girth measurments where should it start? | Joint line and superiorally in 2-3 inch increments.
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| During girth measurment at the joint line what should be noticed? | presenc of swelling
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| When moving up the knee during girth measurments what should be noticed? | presence of muscle atrophy
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| Girth measurments should always be what? | compared bilaterally
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| 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
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| 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
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| 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
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| What should be looked at when inspecting the quad muscle group? | mass and tone/ discoloration/ swelling/ loss of continuity
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| What should be looked at when inspecting the aligment of the femur on the tibia? | angle of articulation ie: genu valgum, genu varum
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| What should be looked at when inspecting the tibial tuberosity? | Osgood-Schlatter disease
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| 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
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| What should be looked at when inspecting the medial aspect? | swelling/ discoloration of joint line, tibia, femur, or pes anserine tendon
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| 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)
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| 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
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| What should be looked at when inspecting the lateral aspect? | swelling, discoloration to tibial joint line and femur
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| What should be looked at when inspecting the fibular head? | equal height bilaterally, Bicep femoris tendon and LCL in knee flexion
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| What should be looked at when inspecting the Posterior sag of the tibia? | 90-90 observing position of the tibial tuburostiy bilaterally (PCL)
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| What should be looked at when inspecting the amount of hyperextension of the knee joint? | Genu recurvatum
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| What are the two things that should be taken note of when doing your inspection of the posterior structures? | Hamstring muscle group, popliteal fossa
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| What should be look at when inspecting the hamstring muscle group? | Contusions(blow), Signs of ecchymosis(strain)
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| What are we looking for when inspecting the popliteal fossa? | Swelling or discoloration(capsular trauma or tears of ham tendons or gastrocs)
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| 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
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| 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
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| 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
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| 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
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| What test is used to determine intracapsular swelling ? | sweep test
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| Positive sweep tests implies what ? | Possible acl trauma, osteochndral fx, synovitis, meniscal lesion, patellar dislocation
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| Normal ROM degree's for knee extension and flexion? | extension: 0' flexion: 135' to 145'
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| ROM for recurvatum? | -10'
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| 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.
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| What ligamentous tests would you perform to rule out ACL instability? | Anterior drawer, Lachmans, Modified Lachmans
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| What ligamentous tests would you perform to rule out PCL instability? | Posterior drawer, Godfreys test (90'-90')
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| What ligamentous tests would you perform to rule out MCL instability? | Valgus stress test
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| What ligamentous tests would you perform to rule out LCL instability? | Varus stress test
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| What special tests would you do for possible meniscal injury? | McMurray's, Apleys comp and distraction
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| 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
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| What special tests help you determine ITB Friction syndrome pathologies? | Nobles compression, Obers test
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| MOI MCL sprain | Valgus force/ external rot of tibia
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| MOI LCL sprain | Varus force/ excess internal rot of tibia
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| MOI ACL sprain | Rot. with knee planted/ Blow to tibia causing tibial translation/ blow to femur driving femur posteriorly/ hyperextension
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| MOI PCL sprain | Posterior translation of the tibia(esp foot plantarflexed)/ hyperextension/ hyperflexion
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| MOI Posterolateral rotatory instibility | direct blow to the posterolateral aspect of knee/ rotational force
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| MOI meniscal tear | tibial rotation with flexion and varus or valgus stress
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| MOI IT Band Syndrome | repeated knee flexion and extension
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| MOI popliteus tendinitis | overuse
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