knee lab l.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
Knee Lab PowerPoint Presentation
Download Presentation
Knee Lab

Loading in 2 Seconds...

play fullscreen
1 / 84

Knee Lab - PowerPoint PPT Presentation


  • 267 Views
  • Uploaded on

Knee Lab. BONY PALPATION:. Medial Aspect. medial tibial plateau . medial joint line . medial femoral condyle . medial femoral epicondyle . adductor tubercle . Lateral Aspect. lateral tibial plateau . lateral joint line . lateral femoral condyle . lateral femoral epicondyle .

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Knee Lab' - rufin


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
quadriceps
Quadriceps

Rectus femoris

Vastus lateralis

Vastus medialis

Vastus intermedius is below rectus femoris

valgus stress test
Valgus Stress Test

Test Positioning:

The athlete lies supine with the knee in full extension. The examiner stands with the distal hand on the subject’s medial ankle and the proximal hand on the knee (laterally).

Action:

With the ankle stabilized, apply a valgus force at the knee with the proximal hand. (This is performed with the knee in full extension, and repeated with the knee in 20 to 30 degrees of flexion.)

Positive Finding:

Medial knee pain and/or increased valgus movement with a diminished or absent endpoint as compared to the uninvolved knee indicates damage to primarily the MCL, PCL, and posteromedial capsule when found in full extension, and MCL when tested in 20 to 30 degrees of flexion.

valgus stress test54
valgus stress test

Normal

Symptomatic

varus stress test
Varus Stress Test

Test Positioning:

The athlete lies supine with the knee in full extension. The examiner stands with the distal hand on the subject’s lateral ankle and the proximal hand on the knee (medially).

Action:

With the ankle stabilized, apply a varus force at the knee with the proximal hand. (This is performed with the knee in full extension, and repeated with the knee in 20 to 30 degrees of flexion.)

Positive Finding:

Lateral knee pain and/or increased varus movement with a diminished or absent endpoint as compared to the uninvolved knee indicates damage to primarily the LCL, PCL, and arcuate complex when found in full extension, and LCL when tested in 20 to 30 degrees of flexion.

anterior lachman s test
Anterior Lachman’s Test

Test Positioning:

The athlete lies supine with the test knee flexed to 20 to 30 degrees. The examiner stands with the proximal hand on the subject’s distal thigh (laterally) immediately proximal to the patella, and the distal hand on the subject’s proximal tibia (medially) immediately distal to the tubercle.

Alternate Test Positioning:

The examiner places his or her flexed knee under the patient’s test knee, with the proximal hand over the distal thigh (anteriorly) and the distal hand on the subject’s proximal tibia (medially), just distal to the tibial tubercle.

Action:

From a neutral anterior-posterior position, apply an anterior force to the tibia with the distal hand while stabilizing the femur with the proximal hand. The same procedure applies for the alternate test positioning.

Positive Finding:

Excessive anterior translation of the tibia as compared to the uninvolved knee with a diminished or absent endpoint is indicative of a partial or complete tear of the ACL.

lachman s test59
lachman’s test

Normal

Symptomatic

anterior drawer test
Anterior Drawer Test

Test Positioning:

The athlete lies supine with the test hip flexed to 45 degrees, knee flexed to 90 degrees, and foot in neutral position. The examiner sits on the subject’s foot with both hands behind the subject’s proximal tibia and thumbs on the tibial plateau.

Action:

Apply an anterior force to the proximal tibia. The hamstring tendons should be palpated frequently with index fingers to ensure relaxation.

Positive Finding:

Increased anterior tibial displacement as compared to the uninvolved side is indicative of a partial or complete tear of the ACL.

anterior drawer test62
anterior drawer test

Normal

Symptomatic

slocum drawer test
Slocum drawer test

To perform the Hughston test, apply a posterior force

pivot shift test
Pivot Shift Test

Test Positioning:

The athlete lies supine with the test knee in full extension. The examiner stands with the proximal hand on the subject’s anterolateral tibiofemoral joint, with the thumb on or posterior to the fibular head. The distal hand grasps the subject’s midfoot and heel.

Alternate Test Positioning:

Place the athlete’s foot between the examiner’s distal arm and body with the same hand on the tibia. The proximal hand is placed on the posterolateral leg, just distal to the knee, with the thumb on or posterior to the fibular head.

Action:

Internally rotate the tibia with the distal hand, apply a valgus force with the proximal hand, and slowly flex the knee. The same procedure applies for the alternate test positioning, except a slight axial load is first applied to the extended knee.

Positive Finding:

A palpable “clunk” or shift at ~20 to 30 degrees of flexion is indicative of anterolateral rotary instability secondary to tearing of the ACL and posterolateral capsule.

pivot shift test66
pivot shift test

Normal

Symptomatic

posterior drawer test
Posterior Drawer Test

Test Positioning:

The athlete lies supine with the test hip flexed to 45 degrees, knee flexed to 90 degrees, and foot in neutral position. The examiner sits on the subject’s foot with both hands behind the subject’s proximal tibia and thumbs on the tibial plateau.

Action:

Apply a posterior force to the proximal tibia.

Positive Finding:

Increased posterior tibial displacement as compared to the uninvolved side is indicative of a partial or complete tear of the PCL.

posterior drawer test68
posterior drawer test

Normal

Symptomatic

posterior sag test
Posterior Sag Test

Test Positioning:

The athlete lies on a table with the involved knee flexed to 90 degrees and the ipsilateral hip placed in 45 degrees of flexion.

Action:

The examiner observes the position of the tibia relative to the femur in the sagittal plane. The examiner then instructs the subject to actively contract the quadriceps muscle group in an attempt to extend the knee while retaining hip flexion. The ipsilateral foot should remain fixated to the table during the attempted knee extension.

Positive Finding:

Posterior displacement of the tibia upon the femur while the subject’s quadriceps remain silent indicates a posterior instability. This may be reflective of injury to any of the following structures: PCL, arcuate ligament complex, and posterior oblique ligament.

godfrey s test
Godfrey’s Test

Test Positioning:

The athlete lies supine on a table with both the hip and knee of the involved side flexed to 90 degrees.

Action:

The examiner passively stabilizes the positioning of the athlete’s hip and knee while assessing the location of the tibia along the longitudinal axis.

Positive Finding:

The recognition of one tibia resting more inferiorly than the contralateral side may indicate a posterior sag or instability. The may be related to the PCL.

mcmurray s test
McMurray’s Test

Test Positioning:

The athlete lies supine. The examiner stands with the distal hand grasping the subject’s heel or distal leg (medially), and the proximal hand on the subject’s knee with the fingers palpating the medial and lateral joint lines.

Action:

With the knee fully flexed, externally rotate the tibia, introduce a valgus force, and extend the knee (medial meniscus). Repeat with the tibia internally rotated and a varus force applied to the knee (lateral meniscus).

Positive Finding:

A “click” along the medial joint line is indicative of a medial meniscus tear. Likewise, a “click” along the lateral joint line is indicative of a lateral meniscus tear.

apley compression test
Apley Compression Test

Test Positioning:

The athlete lies prone with the test knee flexed to 90 degrees. The examiner stands with the proximal hand on the subject’s distal thigh for stabilization and the distal hand on the subject’s heel.

Action:

With the distal hand, medially and laterally rotate the tibia while applying a downward force through the heel.

Positive Finding:

Pain, clicking, and/or restriction is indicative of either a medial or lateral meniscus tear, depending on the location of the symptoms.

patellar apprehension test
Patellar Apprehension Test

Test Positioning:

The athlete lies supine with both knees fully extended. The examiner stands opposite the involved side and places both thumbs on the medial border of the patella being tested.

Action:

The athlete must remain relaxed with no quadriceps contraction, while the examiner gently pushes the patella laterally.

Positive Finding:

If the athlete is apprehensive to this movement or contracts the quadriceps muscle to protect against subluxation, the test is indicative of patellar subluxation or dislocation.

ballotable patella
Ballotable Patella

Test Positioning:

The athlete lies supine with both knees fully extended. The examiner stands with the proximal hand over the suprapatellar pouch and the distal hand (thumb or first two fingers) over the patella.

Action:

Compress the suprapatellar pouch with the proximal hand, then compress the patella into the femur.

Positive Finding:

Downward movement of the patella followed by a rebound will give the appearance of a floating or ballotable patella and is indicative of moderate to severe joint effusion.

sweep test
Sweep Test

Test Positioning:

The athlete lies supine with the involved knee in full extension. The examiner places both hands on the medial aspect of the patella.

Action:

The examiner attempts to “milk” or “sweep” any intracapsular swelling by applying pressure to the proximal, distal, and lateral aspects of the patella.

Positive Finding:

Fluid that accumulates on the medial aspect of the patella is representative of intracapsular swelling.