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Download Evaluation-The KNee - Williston.k12.sc.us
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ANATOMY REVIEW-BONES • Femur • Tibia • Patella • Joints • Tibiofemoral Joint • Patellofemoral Joint ANATOMY REVIEW-SOFT TISSUE • Medial Collateral Ligament (MCL) • Lateral Collateral Ligament (LCL) • Anterior Cruciate Ligament (ACL) • Posterior Cruciate Ligament (PCL) • Medial Meniscus • Lateral Meniscus ANATOMY REVIEW-MUSCLES Anterior Muscles• Quadriceps Muscle Group-knee extension • Rectus femoris-and hip flexion • Vastus lateralis • Vastus medialis • Vastus intermedius • Gracilis-knee flexion, internal tibial rotation, hip adduction • Popliteus-knee flexion • Sartorius-knee flexion, interal tibial rotation, hip flexion, hip abduction, hip external rotation • IT Band ANATOMY REVIEW-MUSCLES Posterior Muscles• Gastrocnemius-knee flexion, ankle plantar flexion • Hamstring Muscle Group-knee flexion, hip extension • Biceps femoris-external tibial rotation, hip external rotation • Semimembranosus-internal tibial rotation, hip internal rotation • Semitendinosus-internal tibial roation, hip internal rotation HISTORY • Location of Pain • Tears to MCL and LCL-p! normally directly over ligament • Tear to ACL-p! usually described as being “beneath kneecap” or “inside the knee” • Meniscus tear-p! along joint line • MOI • Direct blows in one plane usually result in isolated ligamentous injury (valgus/varus) • Rotational stresses usually result in injury to multiple ligaments and/or menisci • • Weight-bearing-did patient have his/her foot planted Sounds or sensations • Snap, crackle, pop-more commonly seen with fx or ligament injury • Clicking or snapping-more commonly seen with a meniscus injury • Knee “giving out”-typically seen with meniscal or ligamentous injury INSPECTION • Girth measurements-to determine amount of swelling or atrophy seen • Alignment • Patella • Femur and tibia • Patellar tendon and tibial tuberosity-check for swelling or enlargment • Edema • Discoloration • Deformity • Posterior sag of tibia • Biomechanical abnormalities-genu recurvatum (hyperextension), genu valgum (knock-kneed), genu varum (bow-legged) PALPATION • Patella, patellar tendon, and tibial tuberosity • Joint line • MCL and LCL • Femoral condyles • Tibial plateau • IT Band ROM TESTING • AROM, PROM, and RROM should be assessed as necessary • Knee flexion and extension • Patella mobility should also be examined in eval LIGAMENTOUS TESTING • ACL• Anterior Drawer Test • Lachman’s Test • PCL• Posterior Drawer Test • Godfrey’s Test • MCL • Valgus Stress Test • LCL • Varus Stress Test NEUROLOGICAL TESTING • Lower quarter screen – will learn when we get to the hip SPECIAL TESTS • Slocum Drawer Test • Crossover Test • Lateral Pivot Shift Test • McMurray’s Test • Apley’s Compression and Distraction Test • Noble’s Compression Test • Ober’s Test
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