Anatomy
Origin of hamstrings
Ischial tuberosity
Normal knee flexion ROM and end feel
150 degrees; soft
Gold standard test for ACL integrity
Lachman's (both specific and sensitive for ACL laxity/integrity)
Pt reports swelling in the knee with occasional locking and clicking. What is your initial hypothesis?
Possible meniscal tear or loose body within knee joint
Which structure of the knee acts as a "spacer" which increases the internal moment arm of the knee extensor mechanism?
Patella
Insertion of quadriceps femoris
Tibial tuberosity
Knee extension open chain and closed chain arthrokinematics
Closed Chain: anterior roll/posterior glide
Open Chain: anterior roll, anterior glide
What are the two knee angle positions that the various and values stress test should be completed with?
Full extension and 30 degrees
Pt reports traumatic injury that resulted in a posteriorly directed force to tibia during a MVA, what is your initial hypothesis?
Possible PCL injury
What is the normal amount of genu valgum (lateral angle of knee) in degrees?
170-175 degrees
Action of sartorius (at knee joint)
Flexion and internal rotation
What, in full detail, is genuine recurvatum? What is considered to be excessive?
Knee extension beyond 10 degrees
What angle is the knee placed in to perform the anterior and posterior drawer tests?
90 degrees flexion
14 year-old boy comes to PT today with complaints of bilateral anterior knee pain. He participates in Football, Basketball, and Golf. His knee just started bothering him as basketball season gets to its peak. You note an enlarged tibial tuberosity upon exam and localized pain in the area. What would your suspected diagnosis be?
Osgood-Schlatters
Most commonly injured structure of the knee
Meniscus
Insertion of plantaris
Calcaneus
During flexion of the knee, the _________ muscle causes the tibia to medially rotate
Popliteus
Both the Thessaly and McMurrays Test for meniscal integrity are not extremely reliable to determine meniscal tears unless paired with what additional therapy skill/objective measure?
Palpation of the joint line - looking for tenderness
You have a new Eval today – 65-year-old man with complaints of right knee pain and occasional low back pain. During the interview, he points to the posterior portion of his knee and describes the pain as sharp/shooting down his leg. It seems to come and go but it has progressively gotten worse. Per patient report, right leg feels weaker than left and sometimes has a tingling feeling. Based upon his symptom complaint, what diagnosis (s) would you believe this gentleman may have?
Possible sciatica; possible radiculopathy
Terrible triad of knee injury
ACL, MCL, medial meniscus
Origin of biceps femoris shorthead
head of the fibula and lateral condyle of tibia
The knee Screw Home Mechanism occurs in the last _______ to _______ degrees of knee extension
20-30 degrees
A female basketball player was in practice two days ago and had pivoted on her left leg as she was changing directions. Swelling didn't occur right away but it has increased within the last 12 hours. She complains of knee pain when changing directions while walking. She also mentions that it seems to "lock/catch". What special test combination would be the best to perform based on the patient's complaints?
Thessaly and palpation for joint line tenderness or mcmurray and joint line tenderness; also perform Lachman's (possible ACL)
You are covering for another therapist and are seeing a 50-year-old female patient for Hip OA conservative treatment. Today, the patient shows up to clinic with bilateral knee pain, swelling, redness, and limited ROM (8-90). Upon palpation, you find that both knees are warm to the touch, L>R and the patient notes that both of her hands/fingers ache as well. She does not report a traumatic incident. Because you are covering, you do not know this patient's entire health history. But based upon the presentation in clinic today, what pathology could be having a flare-up?
Possible Rheumatoid Arthritis
What are the 5 Ottawa knee rules indicating for knee x-ray?
1. 55 years old and above
2. Pain at the patella
3. Pain at the fibular head
4. Inability to flex knee to 90 degrees
5. Inability to bear weight (4 steps) after injury or in emergency department