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) 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