EVALUATI

ON-THE K

NEE

M S . BO W M A N

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-MUSCLESAnterior 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-MUSCLESPosterior 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