Bony Anatomy
A "bow-legged" appearance of the knees and lower legs indicates what kinematic posture?
Genu varum
Rectus Femoris
Knee extension (hip flexion)
What is the normal range of motion for knee flexion?
135-145 degrees
Flexion and rotation (acute)
Meniscal injury
What is a positive test implication for the ballotable patella test?
effusion within the joint capsule
Which bundle of the ACL is taut in knee flexion?
Anteromedial bundle
Biceps Femoris
Knee flexion and external tibial rotation (hip extension)
What part of the meniscus is vascularized in adults?
Outer edge (10-25% of lat meniscus, 10-30% in med meniscus)
Contact: varus stress OR internal tibial rotation
LCL injury
What occurs to indicate a positive McMurray test?
Palpable popping, clicking, or locking; joint line p! is not a strong enough indicator for a (+) test
What is a normal Q angle range for men and women?
12-15 degrees
Gracilis
What is the normal end feel for knee extension?
Firm (posterior capsule stretch, ACL, PCL)
Non-contact: Rotation and hyperextension
Contact: hyperextension and valgus force
ACL injury
Using the crossover test, stepping in front of the stationary affected leg tests what structures?
Anterolateral structures (ACL, lateral capsule, LCL, IT band, biceps femori, lat. meniscus)
Name the three muscles that form the pes anserine group.
Sartoris, semitendinosis, gracillis
Sartorius
knee flexion and tibial interior rotation (hip flexion, abduction, and lateral rotation)
How do you isolate the biceps femoris in a manual muscle test?
Externally rotate the leg
Insidious onset; repetitive knee flexion
IT band syndrome
What does a positive valgus stress test at 0 degrees of extension implicate?
damage to MCL and other supporting structures (ACL, medial meniscus, pes an serine, etc.)
Identify the structures that would be affected with posteromedial rotational instability (no partial credit).
PCL, popliteal ligament, MCL, semimembranosis, capsule
Tensor Fascia Latae
knee lateral rotation (Hip abduction, medial rotation, and flexion)
At what point does the IT band change its angle of pull on the tibia?
Approx. 20 degrees
Hyperextension, excessive tibial rotation, posterior displacement of the tibia with knee flexed
tibiofemoral dislocation
Name the test: pt is seated with legs off of table flexed at the knee, internally rotates the lower leg and extends the knee. At a point of pain, the pt externally rotates the lower leg and pain is reduced.
Wilson's sign