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Musculoskeletal assessment p2
Terms in this set (42)
What does episodes of locking knees indicate?
Patient reports a knee injury where a pop was heard?
Ligament pi's injury
Probably complete rupture of a ligament (3rd degree tear)
Patient reporting her knee giving way and some knee instability.
Patellar subluxation or ligamentous rupture
The Oxford knee scored ranges from ____ to ___.
You are assessing a knee and you start milking downward on the medial side and tap lateral aspect. You notice a distinct bulge in medial hollow. What does this indicate?
Effusion (4-8ml of fluid)
How to assess the knee when there is a large amount of fluid?
Ballottement of patella
Normal: patella is snug against femur
Abnormal: tap patella displaces fluid and a tap is heard as the patella bumps against the femur, watch for fluid return
What type of meniscus tear is 3x more likely?
Medial as opposed to the lateral
What is the meniscus?
Padding between the 2 bones, C-shaped
A patient heard a pop at time of injury, is experiencing painful locking of his knee, and swelling 12 hours later
A meniscus tear often coexists with an ____.
Stand on affected side
Place hand on lateral side of knee
Hold heel, flex knee and hip
Internally rotate leg adding resistance to the lateral aspect of the knee to assess lateral meniscus
Slowly extend knee
Repeat on medial aspect
Click is heard or felt
The type of injury where the patient is immediately disabled, extreme pain, feels/hears pop or tearing sensation, acute knee swelling, can get chronic instability
Cruciate ligament injury
Is ACL or PCL tear more common?
You flex the patients knee at 45 degrees, sit on his foot, grasp below the knee and you are able to pull the backward and push forward. What does this indicate?
+anterior drawer test
ACL or PCL tear
You flex the patients knee 20 degrees and stabilize the femur. You place your hand around the proximal tibia. You pull the tibia anteriorly and the knee is more laxity than the other knee. What does this indicate?
+ Lachman test
Patient is lying in the lateral decubitus position. You extend the affected knee and internally rotate the tibia. You apply a valgus stress to the know as you flex it. A clunk at about 30 degrees of flexion is found. What does this indicate?
What provides stability side to side in the knees?
Medial and lateral collateral ligaments
How to assess valgus/Varus stress of collaterals?
Stabilize the femur
Knee at full extension or flex knee 25 degrees
Apply valgus (outward) pressure at the foot/ankle to check medial
Apply varus (inward) pressure at the foot/ankle to check lateral
When assessing the collaterals, a positive test indicates a ____ in the joint that should not move. The test is graded on a scale of ____ -_______ based on the size of the joint space opening. 1+ is ____ mm of joint space and 4+ is ____ mm of joint space and may be indicative of an associated cruciate ligament injury and must be clearly examined.
Anterior tuberosity pain r/t age? Common cause of knee pain in aging adults
Tibialis muscle so tight it pulls cover off bone
Patient has pain when lying down on abdomen and bent knee is pulled down.
Inflammation where the patellar tendon attaches to the tibial tubercle. Occurs bc growth plate is still cartilage and the quads pull on this and the repetitive motion causes inflammation.
What increases risk for Osgood schlatter?
Running and jumping sports
Patient comes in with pain and a prominence or bump on the knee. Knee pain and tenderness at the tibial tubercle. Swelling at tibial tubercle. Tight muscles in the front or back of the thigh.
Medial tibial stress syndrome
Pain that occurs below the knee either on the front outside portion of the leg or on the inside of the leg.
How to assess the Achilles?
Patient is prone
Knee bent at 90 degrees
Foot should plantar flex
inflammation of the nerve typically between the 3rd and 4th metatarsals
Resulting from over pronation
Patient comes in with complaints of 3rd and 4 th toes are burning, tingling, cramping, occasional shooting pain and numbness in toes after walking or standing. When you press on toes it replicates the pain
What test do you do for ankle sprain ligament tear?
Pain along bottom of foot?
Bone spurs can cause ___ and ____
Ankle sprain and plantar fasciitis
Patient comes in with complaints of piercing pain and swelling through heel and foot. It's starts in the morning and after resting and gradually disappears with walking
Acute gout is in the _____ and is red, edematous, hot, and extremely tender.
inflammation of the bone and joint
A condition in which the body's bones become weak and break easily.
rheumatoid arthritis (RA)
chronic systemic disease characterized by autoimmune inflammatory changes in the connective tissue throughout the body
Chronic pain disorder with often debilitating symptoms such as muscle, tendon, and joint pain, in addition to fatigue
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