Term
| Mnemonic to help remember knee eval |
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Definition
HIPROT:
History, inspection, palpation, ROM, other tests |
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Term
| How to take history of MS injury |
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Definition
| Always try to get the mechanism of the injury first. A chronological description of symptoms up to the point of evaluation. |
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Term
What kind of MS injury is often acute?
What kinds of injuries are young active people likely to get? |
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Definition
Ligament injuries
Meniscus or tendon injuries |
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Term
Injuries associated with pain in anterior knee (3)
Injuries associated with pain in posterior knee (2) |
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Definition
Patellofemoral syndrome
Patellar or quadriceps tendonitis
Bursitis
Meniscus tear
Posterior cruciate ligament injury |
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Term
Injuries associated with lateral knee pain (3)
Injuries associated with medial knee pain (4) |
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Definition
Meniscus tear
Ligament injury
Iliotibial band syndrome
Meniscus tear
Arthritis
Ligament injury
Pes anserine bursitis |
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Term
What is pain from going up and down steps often r/t?
Which knee bursa is most likely to be painful?
Where are knee bursae mostly located? |
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Definition
Patellofemoral problems
Pes anserine
Mostly anterior |
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Term
What locking or catching knee injuries usually are
Two kinds of injuries that can cause knee swelling, with three examples for each |
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Definition
Meniscal
Intraarticular issue, as with trauma: meniscus tear, ACL/PCL, fracture
Extraarticular: bursitis, contusion, sprain |
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Term
| Two kinds of knee instabilities there are, with what each can mean |
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Definition
True giving way--often means ligament injury
Giving way because of pain--often patellar subluxation/ disclocation |
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Term
One way to distinguish true from referred knee pain
Why going by xrays to diagnose can be difficult |
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Definition
True MS pain should get worse with activity and better without. Nerve pain will hurt all the time.
Xrays on soft tissue are often normal |
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Term
| Where hip pain in kids often refers to |
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Definition
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Term
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Definition
| The menisci of the knee joint are two pads of cartilaginous tissue which serve to disperse friction in the knee joint between the lower leg (tibia) and the thigh (femur). They are shaped concave on the top and flat on the bottom, articulating with the tibia. They are attached to the small depressions (fossae) between the condyles of the tibia (intercondyloid fossa), and towards the center they are unattached and their shape narrows to a thin shelf. |
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Term
| Where is fibula in r/t the knee? |
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Definition
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Term
| Major ligaments of knee and what they connect |
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Definition
Mentioned above, the anterior cruciate ligament (ACL) is one of the two major ligaments in the knee. It connects the thigh bone to the shin bone in the knee. ACL injuries are a common cause of disability in the knee.
The posterior cruciate ligament (PCL) is the second major ligament in the knee connecting the thigh bone to the shin bone in the knee.
The lateral collateral ligament (LCL) connects the thigh bone to the fibula, the smaller bone of the lower leg on the lateral or outer side of the knee.
The medial collateral ligament (MCL) also connects the thigh bone to the shin bone on the medial or in side of the knee |
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Term
Describe genu valgum
Describe genu varum |
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Definition
Knock knees--inward rotation
Bowlegs--outward rotation |
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Term
| Which direction does the patella usually dislocate toward? |
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Definition
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Term
How does Osgood Schlatter appear?
Years in appears
Describe path |
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Definition
Very prominent knee tubercle
10-14 yoa
Patellar ligament is stronger than the bone and the tibia tubercle gets pulled up |
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Term
4 bony knee landmarks you should be able to feel with knee flexed 90 degrees
What you should feel on knee with leg extended |
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Definition
Tibial plateau
Tibial tubercle
Femoral condyles
Fibular head
Patella: medial and lateral facets |
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Term
| How to check for interarticular knee effusion |
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Definition
Put pt supine and in a position that he can't see knee.
Press down onto patella and then release; if feels like floating, may be effusion
Can improve by pushing down on quad with one hand to get all fluid into joint before pressing down |
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Term
First major bursa, with location
Second, with location and two types
Describe pes anserine, and three bursae there |
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Definition
Prepatellar: directly anterior to patella
Infrapatellar: inferior to patella, both superficial and deep
Pes anserine: insertion of muscles just medial to tibial tubercle): Sartorius, gracilis, semitendinosis |
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Term
| 3 major soft tissue structures to palpate on medial knee |
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Definition
Meniscus
Medial collateral ligament
Pes anserine muscles |
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Term
| 4 major soft tissue structures to palpate on lateral knee |
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Definition
Meniscus
LCL (lateral femoral epicondyle to fibular head)
Biceps femoris
Iliotibial tract |
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Term
| Another name for biceps femoris |
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Definition
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Term
2 soft tissue disorders you could find palpating posterior knee
What usually causes the first? |
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Definition
Baker's cyst
Distention of the gastrocnemius-semimembranous bursa
Baker's cyst usually caused by arthritis |
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Term
| 2 knee strength testing types and what they test |
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Definition
Resisted knee extension: quadriceps strength and function of quadriceps and patellar tendons
Resisted knee flexion (w/ pt prone): hamstring strength |
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Term
Major nerves innervating knee area, with additional one for posterior knee
Spinal nerves mediating patellar reflex
Which is mostly knee sensation, which are mostly patellar reflex |
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Definition
L3, L4, L5; S2 posteriorly
L2, L3, L4
L3 mostly anterior knee
L2 to L4 patellar reflex |
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Term
| Describe how to test MCL joint stability |
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Definition
Apply valgus (outside) stress with knee in 0 and 30 degree flexion.
Assess for laxity and endpoint.
Compare to other side for result. |
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Term
| Describe how to test for LCL joint stability |
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Definition
Apply varus (outward) stress with knee in 0 and 30 degrees of flexion
Assess for laxity and endpoint
Compare with other side for result |
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Term
| Other names for testing MCL and LCL joint stability |
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Definition
| Varus and valgus stress tests |
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Term
| 2 tests to evaluate for ACL tear |
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Definition
Anterior drawer test
Lachman test |
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Term
| Describe anterior drawer test |
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Definition
| Pt is supine. Flex hip and knee, with foot flat on table. Wrap hands around tibia and pull; if ACL is torn or injured, it could be very loose |
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Term
Describe Lachman test
What is advantage of this test |
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Definition
Pt is supine and relaxed with knee flexed 20-30 degrees.
Stabilize proximal femur and pull downward on tibia with other hand.
Testing for ACL injury or tear; will be wobbly if so.
This has higher sensitivity and specificity for ACL injuries vs anterior drawer |
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Term
| Disadvantage of anterior drawer test |
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Definition
| Unlike Lachman test, appears to be inconclusive for drawing conclusions about ACL |
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Term
| 2 tests to eval for PCL tear |
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Definition
Posterior drawer test
Posterior sag sign |
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Term
| Describe posterior drawer test |
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Definition
Pt supine; hip flexed, knee flexed 90 degrees
Stabilize foot and push tibia backward
If PCL is injured, will be wobbly or unstable |
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Term
| Describe posterior sag sign |
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Definition
Have pt supine and bend both knees at 90 degree angles
If PCL is injured, tibia below knee will appear to sag down compared to other knee because PCL is injured |
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Term
| Name and describe patella test |
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Definition
| Patella apprehension test: pt supine and knee extended. Apply lateral and medial pressure to patella. Positive if find subluxation or dislocation. |
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Term
What McMurray test tests for
Describe |
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Definition
Meniscal tear
To perform the test, the knee is held by one hand, which is placed along the joint line, and flexed to complete flexion while the foot is held by the sole with the other hand. The examiner then places one hand on the lateral side of the knee to stabilize the joint and provide a valgus stress in order to identify a valgus deformity. The other hand rotates the leg externally while extending the knee. If pain or a "click" is felt, this constitutes a "positive McMurray test" for a tear in the medial meniscus. Likewise the medial knee can be stabilized in a fully flexed position and the leg internally rotated as the leg is extended. A tag, caused by a tear will cause a palpable or even audible click on extension of the knee. A positive test indicates a tear of the lateral meniscus. |
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Term
What does Apley test test for?
Describe
When good to use |
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Definition
Meniscal tear
In order to perform the test, the patient lays prone (face-down) on an examination table and flexes their knee to a ninety degree angle. The examiner then places his or her own knee across the posterior aspect of the patient's thigh. The tibia is then compressed onto the knee joint while being externally rotated. If this maneuver produces pain, this constitutes a "positive Apley test" and damage to the meniscus is likely.
Good to use when pt has limited flexion past 90 degrees |
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