EVALU

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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