Name: knee injury assessment
Uploaded: 2023-04-30T06:45:49.000Z
Duration: 12 min 1 s
Channel: JoVE

K12 Standards

new-york-state-science-learning-standards

New York State Science Learning Standards

High School

Life Science

Structure and Function

HS-LS1-3.

Knee Exam

1. 检查
<ol>
	<li>请患者行走，并观察其是否有跛行和疼痛。</li>
	<li>仔细比较双侧膝关节，注意以下情况：
	<ol>
		<li>肿胀或关节积液：当患侧膝关节明显大于健侧时提示可能存在上述情况。肿胀是指膝关节外部区域的增大，通常由膝周软组织出血或液体过多引起；而关节积液则是指膝关节腔内部出血或液体过多所致。触诊评估积液常有助于判断膝关节增大是由于肿胀还是关节积液引起。</li>
		<li>瘀斑：见于近期外伤后膝关节周围的皮下淤血。</li>
		<li>股四头肌萎缩：在发生较严重的关节内结构紊乱（如韧带或软骨撕裂）数周内即可出现。</li>
	</ol>
	</li>
</ol>
2. 触诊
<ol>
	<li>触诊有无肿胀和积液 
	用手指环绕髌骨，评估是否存在肿胀。髌骨前方的肿胀提示髌前滑囊炎或感染，而髌骨后方的肿胀则提示膝关节积液，可能伴有明显的内部结构紊乱。积液量具有一定的诊断意义，可粗略分为0至3+级：0表示无积液；1+表示少量积液，常见于骨关节炎或陈旧性半月板撕裂；2+表示中等量积液，常见于后交叉韧带（PCL）或半月板撕裂；3+表示大量积液，可能提示前交叉韧带（ACL）撕裂或髌骨脱位。</li>
	<li>触诊有无压痛 
	疼痛部位可提示可能受损的结构。 
	让患者取仰卧位，用指尖触诊以下区域：
	<ol>
		<li>胫骨结节：触摸胫骨近端前表面的粗糙突起（位于膝关节前方中线处）。此处为髌腱的附着点。儿童或青少年在此处有压痛提示可能为奥斯古德-施拉特病（Osgood Schlatter's disease）。</li>
		<li>髌骨：用指尖触诊髌骨（膝关节前方的大骨）表面及其周围区域。髌骨周围或下方压痛或疼痛提示髌股关节疼痛；髌骨上方压痛提示髌前滑囊炎；髌骨下方压痛提示髌股关节疼痛或软骨损伤。髌骨下极压痛提示谢德-拉森病（Synding-Larsen disease，即髌骨骨骺炎）。</li>
		<li>髌腱：触诊一条宽而绳索样的结构，起自胫骨结节上方，延伸至髌骨下极。此处压痛提示肌腱炎。</li>
		<li>关节线：可在膝关节内侧和外侧触及。关节线处压痛或疼痛可能提示半月板撕裂或骨关节炎。</li>
		<li>膝关节内侧：触诊内侧副韧带（MCL），该韧带从股骨内侧髁延伸至近端内侧胫骨，以及位于前内侧关节线下方的鹅足滑囊。</li>
		<li>膝关节外侧：触诊外侧副韧带（LCL），该韧带从股骨外侧髁延伸至近端外侧胫骨和腓骨，以及髂胫束（IT band），后者从髋部沿腿部外侧走行，附着于胫骨外侧的格尔迪结节（Gerdy's tubercle）。</li>
	</ol>
	</li>
</ol>
3. 关节活动范围（ROM）
膝关节的活动范围通常在患者仰卧位时进行被动评估。应检查膝关节是否存在以下运动：
<ol>
	<li>伸展（0°）
	<ol>
		<li>要求患者完全伸直下肢。膝关节伸展受限提示可能存在机械性阻塞（常由半月板撕裂、游离体或大量关节积液引起）。</li>
		<li>为检测更轻微的伸展受限，可让患者俯卧，大腿置于检查台末端边缘以提供支撑，观察双侧足跟高度的差异。</li>
	</ol>
	</li>
	<li>屈曲（130°）：要求患者仰卧，并尽可能弯曲膝关节，使足跟尽量贴近臀部。关节积液或股四头肌痉挛可导致屈曲受限。</li>
	<li>伸肌装置：要求患者在坐位时主动伸直膝关节。检查主动伸膝功能对于评估伸肌装置的完整性至关重要（包括股四头肌及其肌腱、髌骨和胫骨结节）。</li>
	<li>捻发音（Crepitus）：在患者主动或被动屈伸膝关节时，将手掌置于膝关节上方，触诊是否存在捻发音（可触及的摩擦感）。除非伴有疼痛、积液或活动受限，否则该体征在临床上通常无显著意义。</li>
</ol>
4. 韧带测试
<ol>
	<li>检查内侧副韧带（MCL）和外侧副韧带（LCL）是否存在疼痛和松弛。
	<ol>
		<li>让患者仰卧位。</li>
		<li>被动伸展（伸直）患者的膝关节，然后轻微屈曲至20°。</li>
		<li>通过一手握住患者的踝部，另一手在膝关节外侧施加外翻应力，来检查MCL
		<ol>
			<li>根据疼痛和松弛程度对MCL损伤进行评分。 
			当膝关节完全伸直时，若施加外翻应力出现松弛，提示可能同时存在前交叉韧带（ACL）和/或后交叉韧带（PCL）损伤，以及MCL损伤。膝关节完全伸直时，ACL和PCL处于紧张状态，应能防止此位置下的外翻松弛。将膝关节屈曲至20°可使这些韧带松弛，从而实现对MCL的孤立检查。</li>
		</ol>
		</li>
		<li>通过一手握住踝部，另一手在膝关节内侧施加内翻应力，来检查LCL，检查时膝关节先伸直，再屈曲至20°。
		<ol>
			<li>使用与MCL损伤相同的分级方法描述LCL损伤。 
			LCL损伤远较MCL少见。若发现明显的内翻应力松弛，应怀疑膝关节后外侧角存在更严重的损伤。此类损伤可能伴随膝关节脱位，需紧急转诊至骨科。</li>
		</ol>
		</li>
	</ol>
	</li>
	<li>通过以下检查评估ACL：
	<ol>
		<li>拉赫曼试验（Lachman test）：患者仰卧，膝关节屈曲20°（如上所述），一手握住近端胫骨，另一手置于股骨外侧以稳定大腿，同时向胫骨施加向前的力。这是评估ACL断裂的确定性检查。</li>
		<li>前抽屉试验（Anterior Drawer test）：患者仰卧，膝关节屈曲90°，双手环绕胫骨上段，拇指置于膝关节前方，向前牵拉胫骨。由于膝关节屈曲90°时副韧带处于紧张状态并限制了胫骨前移，因此该检查的敏感性有限。</li>
		<li>旋转轴移试验（Pivot shift）：患者仰卧，用手握住足部，内旋小腿的同时将膝关节屈曲超过20°，并施加轻微的外翻应力（向内推膝关节外侧）。观察胫骨是否向前滑动。该试验有助于评估膝关节的次要稳定结构，通常仅在膝关节明显松弛时呈阳性。此试验常引起疼痛，限制了其临床应用。</li>
	</ol>
	</li>
	<li>PCL检查
	<ol>
		<li>后抽屉试验（Posterior drawer test）：体位和手的位置同前抽屉试验，将胫骨向后推。若胫骨出现明显后移，提示PCL损伤。</li>
		<li>下垂征（Sag sign）：患者仰卧，膝关节屈曲90°，足底平放于检查台。观察胫骨是否相对于股骨下垂（向后坠落）。此征象提示PCL断裂并伴有显著的后向松弛。</li>
	</ol>
	</li>
</ol>
5. 半月板检查
用于评估半月板损伤的检查通常缺乏特异性，假阳性率较高。最常见的半月板检查方法包括：
<ol>
	<li>弹跳试验：让患者仰卧，通过向下按压髌骨使膝关节完全伸展。当膝关节伸展时，受损的半月板受挤压会引起明显疼痛。</li>
	<li>关节线压痛：沿内侧和外侧关节线进行触诊，此处为半月板所在位置。此处压痛提示可能存在半月板损伤或骨关节炎。</li>
	<li>俯卧伸膝试验：让患者俯卧，双膝稍悬于检查床末端下方，观察双侧足跟高度是否存在差异。此差异可能提示因撕裂并移位的半月板导致的机械性伸膝障碍。</li>
	<li>鸭步试验：让患者完全下蹲后以蹲姿行走。若患者能够完成此动作，则其发生明显软骨或韧带损伤的可能性较小。</li>
	<li>麦克默里试验
	<ol>
		<li>让患者仰卧，一只手置于膝关节（施加外翻应力），另一只手置于足跟。</li>
		<li>通过同时屈曲和伸展患者膝关节，并在胫骨内旋和外旋过程中观察是否出现明显弹响。该操作中出现明显弹响可能提示存在移位性半月板撕裂。此检查应谨慎进行，因其可能导致撕裂的半月板进一步移位并造成膝关节交锁。该试验的临床价值受限于较高的假阳性率。</li>
	</ol>
	</li>
	<li>阿普利加压试验
	<ol>
		<li>让患者俯卧于检查床上，膝关节屈曲至90°。</li>
		<li>一手被动屈伸患者膝关节，同时在内旋和外旋方向转动胫骨，另一手通过向下按压足跟对膝关节施加轴向负荷。</li>
		<li>观察该操作过程中是否出现明显弹响，若有则可能提示半月板撕裂。该试验的临床实用性同样因假阳性率较高而受到显著限制。</li>
	</ol>
	</li>
</ol>
6. 髌骨检查
可进行多种检查以评估髌股关节功能障碍、疼痛或脱位情况。检查髌骨时，患者取仰卧位。
<ol>
	<li>恐惧试验：将髌骨向侧方推动。当患者表现出担心髌骨可能再次脱位的恐惧感时，试验结果为阳性。这提示既往可能发生过髌骨脱位。</li>
	<li>髌骨研磨试验：向下按压髌骨并前后研磨。该试验可能加重髌股功能障碍引起的疼痛，且假阳性率非常高。</li>
	<li>Q角（股四头肌角）：患者仰卧位时，估算由髋部的髂前上棘（ASIS）至髌骨中心的连线，与由髌骨中心至胫骨结节的胫骨前缘连线之间所形成的夹角。男性大于10°、女性大于15°的Q角易导致髌股关节问题。女性骨盆较宽，Q角较大，因此更易出现髌股疼痛。</li>
</ol>

膝关节检查最好在患者处于坐位和仰卧位时，按照有序的步骤进行。应观察患者进出检查室时是否存在跛行或疼痛。应让患者脱去足够的衣物，以便观察膝关节的体表解剖结构，并与健侧进行比较。膝关节检查应首先进行视诊，观察患侧与健侧膝关节是否存在不对称，注意患侧膝关节是否增大（提示肿胀）或缩小（提示肌肉萎缩）。随后对膝关节周围的关键结构进行触诊，检查是否存在压痛、肿胀、发热或畸形。接下来应评估关节活动度（ROM），先进行主动活动度检查，再进行被动活动度检查，并与健侧进行比较。之后应进一步评估膝关节常见的疼痛来源，包括各条韧带、半月板以及髌骨。

膝关节检查

来源：<a href="https://www.jove.com/author/Robert+E._Sallis">Robert E. Sallis</a>，医学博士，美国加利福尼亚州丰塔纳凯撒医疗集团
膝关节是一个连接股骨与胫骨的铰链关节。它是人体中最大的关节，由于位于小腿中部，容易受到多种创伤性和退行性外力作用。膝关节的检查可能相当复杂，因为它本质上是一个不稳定的关节，依靠多条韧带连接，并由半月板提供支撑；半月板起到缓冲作用，并增加关节的接触面积。此外，髌骨位于膝关节前方，作为支点，使膝部能够有力地伸展，以满足跑步和踢腿的需要。作为人体最大的籽骨，膝关节是因创伤或过度使用而引起疼痛的常见部位。
检查膝关节时，应脱去足够的衣物，使整个大腿、膝关节和小腿均暴露出来。检查首先通过视诊和触诊关键解剖标志点，随后评估患者关节活动范围（ROM）。接着进行韧带或半月板损伤的检查，并针对髌股关节功能障碍和髌骨脱位进行特殊检查。应以对侧膝关节作为对照标准来评估受伤膝关节，前提是该侧膝关节既往无损伤史。

来源：Robert E. Sallis，医学博士，美国加利福尼亚州丰塔纳凯撒医疗中心  
膝关节是连接股骨与胫骨的屈戌关节。它是……

由于所处位置特殊，膝关节会受到多种创伤性和退行性力量的影响，其复杂的结构使得膝关节检查相当复杂。尽管膝关节是人体中最大的关节，但其结构本质上不稳定，依靠多种韧带连接，并由半月板提供支撑。半月板可增加关节的接触面积，并起到缓冲震荡的作用。髌骨是人体中最大的籽骨，位于膝关节前方，附着于股四头肌腱和髌腱。它作为支点，使膝关节能够有力地伸展，这种功能对于跑步等活动至关重要，因此髌骨常因创伤或过度使用而成为疼痛的常见来源。本文将回顾进行全面膝关节检查所需的关键步骤，并结合相关的解剖学图示进行说明。我们还将解释在膝关节评估过程中可能遇到的各种发现的诊断意义。与大多数肌肉骨骼检查一样，我们从视诊和触诊开始。在开始之前，请确保患者已脱去足够的衣物，以充分暴露其膝盖和下肢。请患者来回行走，观察是否存在跛行、疼痛、肿胀、积液、瘀斑以及股四头肌萎缩。请注意，如果患者一侧膝关节受伤，则应以未受伤的膝关节作为评估的对照标准。下一步是触诊。在接触患者之前，请务必彻底洗手。请患者坐在检查台上，然后让其仰卧躺下。首先评估髌骨周围是否有肿胀。从膝关节上方和下方分别向下滑动挤压，然后用手指按压髌骨，以感知其上方和下方是否存在积液。另一侧膝关节也需进行相同的检查。髌骨前方的肿胀提示可能存在髌前滑囊炎或感染，而髌骨后方出现积液则提示膝关节积液，可能伴有明显的关节内部结构紊乱。接下来，触诊胫骨结节是否有压痛。此处为髌腱的附着点。屈曲患者的膝关节，触摸近端胫骨前表面粗糙的隆起部分。在儿童和青少年群体中，胫骨结节处的压痛可能提示奥斯古德-施拉特病（Osgood Schlatter's disease）。随后，触诊髌腱，髌腱为一条宽阔的绳索样结构，起自胫骨结节上方，延伸至髌骨下极。沿髌腱走行区域的压痛提示存在炎症。随后，触诊髌骨周围区域，此次重点检查有无压痛。从髌骨下极开始，然后触诊内侧和外侧，最后触摸髌骨上缘。若下极处有压痛，可能提示儿童和青少年患有奥斯戈德-施拉特病（Osgood-Schlatter disease）；若压痛位于周围或下方，可能提示髌股疼痛综合征；若压痛位于髌骨上缘，则可能提示髌前滑囊炎。接下来，触诊关节线。将手指和拇指分别放在髌腱两侧，然后沿内外侧推动，检查关节线处是否有压痛或疼痛。若存在压痛或疼痛，提示可能存在半月板撕裂或骨关节炎。最后，触诊膝关节的内侧和外侧。从内侧股骨髁开始，此处是内侧副韧带的附着点，该韧带从股骨髁延伸至近端内侧胫骨。接着，检查位于前内侧关节线稍下方的鹅足滑囊是否有压痛。然后，触诊外侧股骨髁，即外侧副韧带的起始点，该韧带可触及直至其止于近端外侧胫骨和腓骨。最后，触诊髂胫束，该结构起自髋部，沿大腿外侧走行，止于胫骨的格尔迪结节（Gerdy's tubercle）。完成检查和触诊部分后，继续进行膝关节活动范围的测试。患者取仰卧位时，让其将下肢完全伸直并稍微抬高，以检测伸展功能。正常情况下，应呈现0°的角度。接下来，检查膝关节屈曲。被动地将患者的足跟尽量靠近臀部以弯曲其膝关节。该动作的正常活动范围约为130°。若活动受限，可能提示关节积液或股四头肌痉挛。接下来，让患者转为坐位，并要求其伸直膝关节，以检查伸肌装置的完整性。最后，将手掌置于膝关节上方，在膝关节被动或主动屈伸时触诊是否存在捻发音（即运动时可触及的摩擦感）。除非伴有疼痛、积液或活动受限，否则该体征在临床上通常无显著意义。完成上述所有操作后，通过多种特殊检查来评估膝关节的结构。第一项检查是韧带测试，这些操作用于评估内侧和外侧副韧带以及前交叉韧带和后交叉韧带的疼痛与松弛情况，分别简称为 MCL、LCL、ACL 和 PCL。进行内侧副韧带（MCL）和外侧副韧带（LCL）检查时，首先用一只手托起患者的踝关节，将膝关节伸直，然后用另一只手将其屈曲至约20°。评估MCL时，保持膝关节处于屈曲位，通过向外推动踝关节施加外翻应力；随后在膝关节伸直位重复此操作。检查LCL时，交换双手位置，在膝关节伸直和屈曲状态下，分别通过向内侧推动踝关节施加内翻应力。在上述任何情况下，均根据疼痛和松弛程度，按照下表对韧带损伤进行评分。接下来的几项检查，即拉赫曼试验和前抽屉试验，用于评估前交叉韧带（ACL）。进行拉赫曼试验时，请患者放松双腿，将其膝关节屈曲至约20°角。用一只手向前牵拉近端胫骨，同时用另一只手向下按压股骨。通过这一操作，您将感知前交叉韧带受到应力时是否存在明确的终末点。接下来，进行前抽屉试验。请患者弯曲膝关节，并将足部平放在检查台上。然后，医生坐在患者足部上以固定其位置。双手置于膝关节下方，双侧食指放在后侧关节线处，向前牵拉，检查胫骨是否向前移动，正常情况下不应出现前移。通过两种检查手法——后抽屉试验和寻找Sag征——来评估后交叉韧带（PCL）。进行后抽屉试验时，让患者像做前抽屉试验一样弯曲膝关节，然后将双手拇指置于髌腱两侧，向后拉动并施加压力于胫骨上段。若出现明显移位，可能提示PCL损伤。最后，进行Sag征检查。将患者的膝关节屈曲至90°，足底平放在检查台上，观察胫骨相对于股骨是否出现下垂或后移。建议双侧对比观察。若出现此体征，可能提示后交叉韧带（PCL）撕裂并伴有明显的后向松弛。在完成韧带测试后，应进行以下检查半月板损伤的操作。但需注意，这些检查通常缺乏特异性，需要进一步确认。第一项测试是回弹试验。患者仰卧位时，抬起其脚踝处的腿部，并通过将膝关节强制伸展至完全伸直来轻轻“回弹”膝关节。如果半月板撕裂，此操作会引起疼痛。为评估关节线压痛，应沿内侧和外侧关节线进行触诊，因为半月板位于这些位置。此处任何压痛均可能提示半月板损伤或骨关节炎。接下来，让患者转为俯卧位，双膝悬于检查床末端边缘。此为俯卧位伸膝试验。双侧足跟高度的差异可能提示由撕裂并移位的半月板导致的膝关节伸展机械性阻碍。随后进行麦克默里试验（McMurray's test）。首先，弯曲患者膝关节并完全屈曲，然后内旋并逐渐伸展膝关节。重复相同操作，但改为外旋膝关节。该检查过程中若出现明显的弹响声，可能提示存在移位的半月板撕裂。此操作应谨慎进行，因为可能使撕裂的半月板发生移位，导致膝关节交锁。接下来，进行 Apley 压迫试验。患者取俯卧位，被动屈曲膝关节至 90°，内旋胫骨，施加轴向负荷，并持续屈伸膝关节，以检查是否存在弹响声。重复该操作，同时外旋胫骨。明显的弹响可能提示半月板撕裂。对于最后一项半月板检查，即蹲走试验，要求患者采取完全蹲伏的姿势，然后行走。如果患者能够完成此动作，则其发生明显软骨或韧带损伤的可能性较小。最后，可进行几项称为髌骨试验的检查，以评估髌股关节功能障碍、疼痛或脱位情况。该组检查中的第一个动作为恐惧试验。将患者的髌骨向侧方推动，观察患者是否表现出担心髌骨脱位的恐惧感，若存在此反应则提示既往可能发生过髌骨脱位。接下来进行髌骨研磨试验，即向下按压患者的髌骨并前后推动研磨。患者在此操作过程中出现疼痛，可能提示存在髌股关节功能障碍。最后，检查股四头肌角（Q角）。患者取仰卧位，估测由髂前上棘至髌骨中心的连线，与从髌骨中心沿胫骨前缘至胫骨结节的连线之间形成的夹角。男性Q角大于10°、女性大于15°时，提示存在髌股关节问题的易感性。您刚刚观看了一段 JoVE 视频，详细介绍了膝关节评估。在本视频中，我们回顾了该检查的关键内容，包括视诊、触诊、关节活动范围测试，以及用于缩小与膝关节问题相关鉴别诊断范围的其他特殊诊断操作。一如既往，感谢您的观看！

Education

教育

JoVE Science Education

Clinical Skills

临床技能

Physical Examinations III

体格检查 III

膝关节考试

knee injury assessment

Knee injury assessment focuses on the largest joint in the body, where the femur meets the tibia. Because the knee sits in the middle of the lower leg, it faces traumatic and degenerative forces. Its structure also makes the exam more detailed. The joint is inherently unstable and relies on ligaments and menisci for support.

The menisci act as shock absorbers and help increase the contact area of the joint. The patella sits in front of the knee and acts as a fulcrum for forceful extension. That movement is important for actions like running and kicking. The patella is also the largest sesamoid bone in the body, so the knee is often a source of pain after trauma or overuse.

A proper knee exam starts with enough clothing removed to expose the entire thigh, knee, and lower leg. The clinician first inspects and palpates, which means looking at and feeling key anatomic landmarks. Next, the examiner checks range of motion, or ROM. The exam then moves to tests for ligament or meniscus injury and special tests for patellofemoral dysfunction and dislocation of the patella.

The opposite knee is often used as the standard for comparison. This works best when the other knee has not been injured before. Using the healthy side helps the examiner judge changes in the injured knee more accurately.

Knee Injury Assessment

cranial nerves exam i (i-vi)

Cranial Nerve Exam: Eye and Face Checks

Cranial nerve testing uses careful observation to check how the eyes, face, and related muscles are working. Some problems are easy to spot. A patient may report loss of smell or double vision, and facial nerve palsy can also be seen on exam. Other issues, such as sixth nerve palsy, may be subtle and need a careful neurological exam to find them. Cranial nerve problems can also appear when a person has changes in mental status. Some neurodegenerative disorders and brain lesions can affect...

cranial nerves exam ii (vii-xii)

Testing Cranial Nerves VII-XII

Cranial nerves VII-XII are tested as part of the neurological exam after the mental status evaluation. The examination begins with simple observations made during the first greeting. Facial weakness may already be visible, since the facial muscles are controlled by cranial nerve VII. Cranial nerve VII is the facial nerve. It also carries taste from the anterior two-thirds of the tongue and part of the external auditory canal. If facial weakness is paired with taste loss on the same side, that...

motor exam i

Motor Function Assessment Basics

Motor function assessment begins with careful observation. Abnormal motor findings can appear in many diseases, including movement disorders, myopathies, and strokes. The clinician first watches how the patient walks into the exam area. They also note walking without help, speed, and coordination while moving. Patient history gives another chance to look for signs such as tremors. It can also reveal other abnormal movements, including chorea and tardive dyskinesia. These early observations may...

motor exam ii

Neurological Reflexes, Coordination, and Gait

Neurological motor exams often include testing reflexes, coordination, and gait. These parts of the exam help localize neurologic problems and show how the nervous system is working. Reflex testing includes deep tendon reflexes and superficial reflexes. A deep tendon reflex, or DTR, begins when a stretch-sensitive receptor in a neuromuscular spindle is stimulated. That signal travels through a single synapse to a motor nerve and produces a muscle contraction. DTRs are often increased in...

sensory exam

Sensory Pathways and Nerve Mapping

A sensory exam checks pain, temperature, light touch, vibration, and joint position sense. It helps localize nerve and brain problems by showing which sensory pathways are affected. Sensation from the face is covered in Cranial Nerves Exam I and II, along with smell, vision, taste, and hearing. Pain and temperature signals travel in the spinothalamic tract. These fibers cross 1 to 2 spinal nerve segments above where they enter, then move through the brainstem to the thalamus. From there, the...

neck exam

Cervical Spine and Neck Injury

The neck contains the cervical spine, a group of seven vertebrae arranged in a gentle C-shaped curve. These bones, joints, and ligaments make the neck complex to examine. The cervical spine supports the head and helps protect the nerves that come from the brain and spinal cord. Each vertebra has a thick bony body at the front. Intervertebral discs connect the bodies above and below, and they add stability and shock absorption. The back part of each vertebra includes the laminae, transverse and...

shoulder exam i

Shoulder Exam: Joint Structure and Motion

Shoulder exam starts with understanding the joints and muscles that control shoulder movement. The shoulder is made up of four separate joints: the glenohumeral (GH) joint, the acromioclavicular (AC) joint, the sternoclavicular joint, and the scapulothoracic joint. The GH joint is the main joint for shoulder motion. It is also the most mobile joint in the body. Because it is shaped like a golf ball sitting on a tee, it can be prone to instability. The GH joint is held in place by the four...

shoulder exam ii

Shoulder Strength and Instability Tests

The shoulder exam continues with strength testing of the rotator cuff muscles and the biceps tendons. These tests help assess common sources of shoulder pain and guide the next steps in the exam. The rotator cuff includes the supraspinatus, infraspinatus, teres minor, and subscapularis muscles. These muscles act as compressors that hold the humeral head in place against the glenoid. Injury and wear of the rotator cuff tendons are among the most common causes of shoulder pain. Strength is...

elbow exam

Elbow Injury Checks and Stability Tests

The elbow is a hinge joint made by the humerus, radius, and ulna. It is more stable than the shoulder, so it has less range of motion. The elbow and nearby structures can still be injured, especially with repetitive motion. Lateral epicondylitis and medial epicondylitis are two common elbow problems. Lateral epicondylitis is also called tennis elbow, and medial epicondylitis is also called golfer's elbow. These conditions often develop from occupational activities. A full elbow exam starts...

wrist and hand examination

Wrist and Hand Injury Exam

The wrist and hand injury exam checks bones, joints, tendons, nerves, and blood flow. The wrist is a complex joint made of 8 carpal bones and many ligaments. The hand has 5 metacarpal bones, and the fingers have 14 phalanges. Tendons and muscles lie over these bones and help move the hand and fingers. Wrist and hand problems can follow impact, weight-bearing activities such as gymnastics, or twisting and throwing motions. The exam starts with inspection. The examiner then looks for tenderness...

lower back exam

Lower Back Pain Evaluation

The lower back exam checks for pain, injury, and changes in the spine and nearby tissues. Back pain is a common source of pain in the body. Because the lower back includes bones, discs, ligaments, nerves, and muscles, each of these structures can contribute to symptoms. The exam starts with inspection and palpation. Inspection means looking for signs of deformity or inflammation. Palpation means feeling the area with the hands to check for tenderness or swelling. The exam also includes range...

hip exam

Assessing Hip Pain and Movement

The hip is a ball-and-socket joint made by the femoral head fitting into the acetabulum. The hip ligaments help make it a very strong and stable joint. Even so, the hip still has a wide range of motion and can wear down over time or after injury. Hip pain can affect people of many ages. It may be linked to problems inside the joint or outside the joint. The location of pain in the hip region can give early clues about the cause. A hip exam looks for asymmetry, swelling, and changes in gait,...

knee exam

Knee injury assessment focuses on the largest joint in the body, where the femur meets the tibia. Because the knee sits in the middle of the lower leg, it faces traumatic and degenerative forces. Its structure also makes the exam more detailed. The joint is inherently unstable and relies on ligaments and menisci for support. The menisci act as shock absorbers and help increase the contact area of the joint. The patella sits in front of the knee and acts as a fulcrum for forceful extension.

ankle exam

How to Assess an Injured Ankle

The ankle exam helps assess an injured ankle by checking the joint, the ligaments, and the surrounding foot. The ankle and foot form the base for body support and upright movement. Because this area bears weight, ankle injuries are common in athletes and in the general population. Ankle injuries can happen after sudden trauma or from repeated overuse, such as running. The ankle is a fairly simple joint. It includes the distal tibia, the talus, and the fibula on the lateral side. Its main...

foot exam

Assessing Foot Pain and Injury

Foot pain and injury can be evaluated by checking the foot carefully from side to side. The foot is a complex structure made of many bones and joints. It gives the body flexibility, serves as the main point of contact for walking, and helps absorb shock. Because the foot supports the weight of the whole body, it is often prone to pain and injury. A full exam starts by removing shoes and socks on both feet. This lets the examiner inspect the entire foot and compare the painful or injured side...

physical examinations iii

本文集包括身体检查两个主要系统在我们的身体: 神经和肌肉骨骼, 与视频解释相关的解剖, 步骤背后的基本原理, 以及对考试结果的解释。

Learn how the knee is examined for injury, from inspection and range of motion to ligament, meniscus, and patella tests used in high school anatomy.

Knee Injury Assessment | JoVE K12

Robert E. Sallis

Kaiser Permanente

Overview

Inspection and Palpation

Range of Motion Testing

Ligament Testing

Meniscal Tests

Patella Tests

Summary

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Transfection is the process of inserting genetic material, such as DNA and double stranded RNA, into mammalian cells. The insertion of DNA into a cell ...

Chromatin Immunoprecipitation

Histones are proteins that help organize DNA in eukaryotic nuclei by serving as &#8220;scaffolds&#8221; around which DNA can be wrapped, forming a complex ...

An Overview of Epigenetics

Since the early days of genetics research, scientists have noted certain heritable phenotypic differences that are not due to differences in the ...

community-dna-extraction-from-bacterial-colonies

Community DNA Extraction from Bacterial Colonies

Source: Laboratories of Dr. Ian Pepper and Dr. Charles Gerba - The University of Arizona
Demonstrating Author: Luisa Ikner
Traditional methods of analysis ...

Cytogenetics

Cytogenetics is the field of study devoted to chromosomes, and involves the direct observation of a cell&#8217;s chromosomal number and structure, ...

embryonic-stem-cell-culture-and-differentiation

Embryonic Stem Cell Culture and Differentiation

Culturing embryonic stem (ES) cells requires conditions that maintain these cells in an undifferentiated state to preserve their capacity for self-renewal ...

DNA Gel Electrophoresis

DNA gel electrophoresis is a technique used for the detection and separation of DNA molecules. An electric field is applied to a gel matrix comprised of ...

Enzyme Assays and Kinetics

Enzyme kinetics describes the catalytic effects of enzymes, which are biomolecules that facilitate chemical reactions necessary for living organisms. ...

DNA Ligation Reactions

In molecular biology, ligation refers to the joining of two DNA fragments through the formation of a phosphodiester bond.  An enzyme known as a ligase ...

explant-culture-for-developmental-studies

Explant Culture for Developmental Studies

Explant culture is a technique in which living cells or tissues are removed from an embryo for continued development outside of the organism. This ex vivo ...

DNA Methylation Analysis

Methylation at CpG dinucleotides is a chemical modification of DNA hypothesized to play important roles in regulating gene expression. In particular, the ...

Expression Profiling with Microarrays

Microarrays are important tools for profiling gene expression, and are based on complementary binding between probes that are attached to glass chips and ...

Density Gradient Ultracentrifugation

Density gradient ultracentrifugation is a common technique used to isolate and purify biomolecules and cell structures. This technique exploits the fact ...

F&#246;rster Resonance Energy Transfer (FRET)

F&#246;rster resonance energy transfer (FRET) is a phenomenon used to investigate close-range biochemical interactions. In FRET, a donor photoluminescent ...

detecting-environmental-microorganisms-with-polymerase-chain-reaction

Detecting Environmental Microorganisms with the Polymerase Chain Reaction and Gel Electrophoresis

Source: Laboratories of Dr. Ian Pepper and Dr. Charles Gerba - Arizona University
Demonstrating Author: Bradley Schmitz
Polymerase chain reaction (PCR) is ...

Gel Purification

Gel purification is used to recover DNA fragments after electrophoretic separation. DNA recovery from an agarose gel includes three basic steps: binding, ...

Detecting Reactive Oxygen Species

Reactive oxygen species are chemically active, oxygen-derived molecules capable of oxidizing other molecules. Because of their reactive nature, there are ...

Gene Silencing with Morpholinos

Morpholino-mediated gene silencing is a common technique used to study roles of specific genes during development. Morpholinos inhibit gene expression by ...

development-and-reproduction-of-the-laboratory-mouse

Development and Reproduction of the Laboratory Mouse

Successful breeding of the laboratory mouse (Mus musculus) is critical to the establishment and maintenance of a productive animal colony. Additionally, ...

Construct an explanation based on evidence for how the structure of DNA determines the structure of proteins which carry out the essential functions of life through systems of specialized cells.

HS-LS1-1.

Knee Injury Assessment

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