Download Knee examination

Clinical Objectives
Hip examination
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Gait abnormalities
Trendlenberg test
Look
Feel
o ASIS
o PSIS
o G trochanter
o Gluteis medius
o Sciatic nerve
o Femoral artery
 Move
flexion, extension, abduction, adduction, Internal and
external rotation
o Active
o Passive
o Resistence
o Steinfeild test
o Yoman's test
 Measurements
o LLD (Leg Length Discrepancy)
 Block test
 Visual test
 Direct measurements
 Special test
o Thomas test
o Ober's test
o Ely's test
o Phillip's test
o Piriformis syndrome
 Fair
 Pace
 Beauty Maneauver
o Sacroiliac joint
 Patrick (FABER)
 Geanslen test
 Pelvic rock
Knee examination
 Gait abnormalities
o Varus thrust
o Valgus thrust
o Varus recurvatum thrust
 Alignment
o Knee
o Foot
 Look
 Feel
o Bursae
o MCL and LCL
o Synovial thickening
o Common peroneal nerve
o Popliteal and posterior tibial artery
 Move
Flexion, Extension Internal and external rotation
o Active
o Passive
o Resistence
o Extension lag and fixed flexion deformity of the knee (FFD)
 Measurements
o Muscle wasting
o Q angle
o Sulcus tubercle angle
 Special tests
o Knee effusion
 Milking test
 Wave test
 Patellar Tap test
o Patellar dislocation
 Patellar apprehension test
o Patellofemoral chondromalacia and OA
 Patellar grind test
 Classic
 Step up step down
o
o
o
o
o
 Active
 Patellar glide test
MCL
 Valgus stress test at 0 and 30 degrees
LCL
 Valgus stress test at 0 and 30 degrees
ACL
 Anterior drawer test
 Lachmen's test
 Lateral pivot shift test
PCL
 Posterior drawer test
 Posterior sag sign
 Varus recurvatum test
Meniscal injury
 Childress test
 McMurray's test standing and supine
 Apley's test
 Apley's compression test for meniscal tear
 Apley's distraction test for ligament tear
Spine examination
 Gait abnormalities
 Standing examination
o Look for scoliosis
 Plump Line test
 Adam's leaning forward test
 Skin mark test
o Look for ankylosing spondylitis
 Chest expansion measurements
 Occiput wall distance
 Move
o flexion, extension,
 Shober's test
 Finger – Floor distance
 Finger spinous process test
o right and left lateral bending and
o rotation
 By fixing the pelvis and sitting
 Nerve root tension signs
o Sciatic nerve
 Straight Leg Raising test
 Bragard's test
 Bowstring test
 Laseague test
 Well-leg test
 Sitting SLR
 Hoover's test
o Femoral nerve
 Femoral stretch test
 Neurological examination
o Sensation
 Superficial sensation
Temp, Touch (fine
and crude touch)
 Two-point discrimination
 Deep sensation
 Position
 Pressure
 Vibration
o Reflexes
 Superficial
 Abdominal
 Cremastric
 Anal
 Babiniski
 Beevor's sign
 Deep
 Knee
 Ankle
 Tibialis posterior
 Medial hamstring
o Power
 Foot
 Extensor & Flexor halluces
 Extensor & Flexor digitorum
 Ankle
 Tibialis anterior & posterior
 Peronei
 Knee
 Hip
o Meningeal irritation
Kering's sign
o Space occupying lesion
 Milgram's test
 Naffzigger's test
 Valsalva maneauver
o Waddle's signs
 Superficial tenderness
 Non-anatomical tenderness
 Axial loading
 Pain on simulated rotation
 Distracted sitting SLR
 Regional sensory changes
 Regional weakness
 overreaction
Cervical spine examination
 Head Position
 Look
o Anterior and posterior landmarks
 Feel
o Anterior and posterior landmarks
o Muscles
 Sternomastoid, Trapizius, Romboidus,
Pectoralis Major, Latismus Dorsi,Supra and
Infraspinatus and teres minor
o Cervical Lymph nodes
o Carotid artery and carotid tubercle
 Move
o Active
o Passive
o Resistence
o Examine the serratus anterior muscle
 Special tests
o Cervical compression test
o Cervical distraction test
o Spurling’s test
o Valsalva maneuover
o Hoffmann’s reflex
o Lhermitte’s sign (Barber chair phenomenon)
o Thoracic outlet syndrome
 Adeson test
 Right test
 Rose test
Shoulder examination
 Look
 Feel
o Coracoid process
o Long head of biceps
o Supraspinatus tendon
o Infraspinatus and teres minor tendon
 Move
Flexion, Extension, Abduction, Adduction, Internal
and external rotation
o Active
o Passive
o Resistence
 Special tests
o Impingement syndrome
 Neer’s sign
 Hawkin’s sign
 Empty can sign
 Impingement test
 Drop arm test
o Biciptal tendenitis
 Internal and external rotation
 Speed’s test
 Yargeson’s test
o Biciptal Instability
 Resisted external rotation
o Shoulder instability
 Anterior
 Anterior apprehension test
 Anterior drawer test
 Posterior
 posterior apprehension test
 posterior drawer test
 inferior
 sulcus sign
o SLAP (superior lateral anteroposterior lesion)
 Obrien’s test
o Signs of generalized laxity
 Elbow recurvatum more than 10 degrees
 Thumb forearm distance less than 1 cm
 MCP extension more than 60 degrees
 DIP extension more than 30 degrees
Hand examination
 Look
 Feel
o Flexor zones
o Dorsal compartment
o Pisiform bone and hook of hamate
o Tubercle of scaphoid and trapezium
o Palmaris longus
 Move
o Flexion, extension, radial and ulnar deviation of the wrist
o Movement of the MCP joint, all nails must be directed to the
scaphoid tubercle
o Movement of the PIP and DIP
 Special tests
o Fincklestien test for DeQuirvann’s disease
o Median nerve
 Muscle wasting thenar muscle
 Sensation
 Compression test
o
o
o
o
o
o
 Tinel’s sign
 Phalen test
Anterior interosseous nerve
 OK sign
 Oschner’s test
 Froment’s sign
Ulnar nerve
 Muscle wasting hypothenar & 1st dorsal
interosseous muscle
 Sensation
 Card test
 Book test
 Middle finger movement
Radial nerve
 Sensation
 Wrist extension
 Posterior interosseous nerve
finger extension
Gamekeeper’s thumb
 Valgus stress test
Examine FDS and FDP
Allen’s test
 Patency of the radial and ulnar artery
Foot examination
 Look
o
o
o
o
o
o
 Feel
o
o
o
o
o
Skin
Deformity of the ankle
Deformity of the forefoot
Deformity of the toes
Arches
Tendoachilles
Bony landmarks
Ankle ligaments
Dorsalis pedis artery
Posterior tibial artery
Tendons
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Tibialis anterior
Tibialis posterior
Extensor halluces
Flexor halluces
Extensor digitorum
Flexor degitorum
peronii
 move
o ankle flexion and extension
o subtalar inversion and eversion
o foot supination and pronation
o toes movements
 special tests
o ligaments integrity
 ATF
anterior drawer test
 PTF
rarely injuried
 CFL
talar tilt test
 Syndosmotic ligamnets
Squeeze test
o Tarsal tunnel syndrome
 Compression test
 Tinel’s sign
 Dorsiflexion eversion test
o Achillis tendon
 Tap test
 Gap sign
 Thompson test
o Planter fascia
 Big toe dorsiflexion
o Subtalar movement (Arch test)
 Colemann’s block test
o Morton’s neuroma
 Mulder’s test