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Evaluation-The Knee

Evaluation-The Knee. Ms. Bowman. 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)

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Evaluation-The Knee

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  1. Evaluation-The Knee Ms. Bowman

  2. Anatomy Review-Bones • Femur • Tibia • Patella • Joints • Tibiofemoral Joint • Patellofemoral Joint

  3. Anatomy Review-Soft Tissue • Medial Collateral Ligament (MCL) • Lateral Collateral Ligament (LCL) • Anterior Cruciate Ligament (ACL) • Posterior Cruciate Ligament (PCL) • Medial Meniscus • Lateral Meniscus

  4. Anatomy Review-Muscles • Anterior Muscles- • Quadriceps Muscle Group-knee extension • Rectus femoris-and hip flexion • Vastuslateralis • Vastusmedialis • Vastusintermedius • Gracilis-knee flexion, internal tibial rotation, hip adduction • Popliteus-knee flexion • Sartorius-knee flexion, interaltibial rotation, hip flexion, hip abduction, hip external rotation • IT Band

  5. 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 tibialroation, hip internal rotation

  6. 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

  7. 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)

  8. Palpation • Patella, patellar tendon, and tibial tuberosity • Joint line • MCL and LCL • Femoral condyles • Tibial plateau • IT Band

  9. Rom Testing • AROM, PROM, and RROM should be assessed as necessary • Knee flexion and extension • Patella mobility should also be examined in eval

  10. Ligamentous Testing • ACL- • Anterior Drawer Test • Lachman’s Test • PCL- • Posterior Drawer Test • Godfrey’s Test • MCL • Valgus Stress Test • LCL • Varus Stress Test

  11. Neurological Testing • Lower quarter screen – will learn when we get to the hip

  12. 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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