Shared Flashcard Set

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Hoppenfeld Knee Palpation
Palpation landmarks for the knee as described by Hoppenfeld.
24
Medical
Graduate
10/07/2009

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Cards

Term
Medial Tibial Plateau
Definition
Push your thumb inferiorly into the soft tissue depression until you can feel the sharp upper edge of the plateau. The upper non articulating edge is palpable posterior to femoral condyle and anterior to infrapatellar tendon.
Term
Tibial Tubercle
Definition
Follow infrapatellar tendon distal to tibial tubercle. Just medial to tubercle is tibial flare - just inferior to flare is pes anserine insertion and bursa.
Term
Medical Femoral Condyle
Definition
Move thumb upward from tibial flare. More of the condyle is accessible if the knee is flexed more than 90 degrees. The sharp medial edge is also palpable as far as the superior portion of the patella and distally to the junction of the tibia and femur.
Term
Adductor Tubercle
Definition
From the medial surface of the medial femoral condyle move further posteriorly to adductor tubercle in the distal end of the natural depression between the vastus medialis and hamstring muscles.
Term
Lateral Tibial Plateau
Definition
Push down with your thumb into the soft tissue depression until you feel the upper edge of the lateral tibial plateau.
Term
Lateral Tubercle
Definition
The large prominence of bone immediately below the lateral tibial plateau.
Term
Lateral Femoral condyle
Definition
From the soft tissue depression move upward and laterally onto the sharp edge of the lateral femoral condyle. More of the condylar articulating surface is more palpable if knee is flexed more than 90 degrees.
Term
Lateral Femoral Epicondyle
Definition
Lies lateral to the lateral femoral condyle.
Term
Head of Fibula
Definition
From the lateral femoral epicondyle move your thumb inferiorly and posteriorly across the joint line to the fibular head which is situated about the same level as the tibial tubercle.
Term
Trochlear Groove
Definition
Place thumbs over the medial and lateral joint lines and move upward along the two femoral condyles to the highest point of the patella, above the patella palpate toward the midline until you reach the depression of the trochlear groove.
Term
Patella
Definition
The patella is fixed in the trochlear groove in flexion and mobile in extension so the medial and lateral portions of the patella's undersurface are much more accessible when the knee is extended. Note: It is easier to push the patella medially than laterally.
Term
Quadriceps
Definition
Medialis and lateralis form bulges on the medial and lateral sides of the knee are palpable and more prominent with isometric contraction. The other quads are wrapped in a common fascial covering that makes it difficult to palpate them - so do so as a unit. Defects most often found distally in rectus or proximal to patella in intermedius. Medialis frequently atrophies after knee joint effusion and knee surgery. Evaluate by measuring circumference three inches above tibial plateau - any difference R<>L is significant.
Term
Infrapetellar Tendon
Definition
Runs from inferior border of patella.
Term
Supra Infrapatella Bursa
Definition
Superficial infrapatellar bursa lies in front of the infrapatellar tendon and become inflammed with excessive kneeling.
Term
Prepatellar Bursa
Definition
Overlies the anterior portion of the patella. Aids in allowing skin to glide freely over the patella especially in flexion.
Term
Pes Anserine Bursa
Definition
Located between the tendons of the sartorius, gracilis and semitendinosus muscles and the upper-medial aspect of the tibial tubercle. IT IS NOT PALPABLE. If inflammed you may feel some effusion and thickening.
Term
Medial Meniscus
Definition
The anterior margin of the medial meniscus is just barely palpable deep within the joint space. The medial edge is more prominent when the tibia is internally rotated. Medial meniscus tears are much more common than lateral and the medial joint line becomes tender when tear present.
Term
Medial Collateral Ligament
Definition
LIGAMENT NOT DISTINCTLY PALPABLE. Anatomic region of MCL palpable from medial joint line move medially and posteriorly along the joint line, ligament lies directly under fingertips.
Term
Lateral Meniscus
Definition
Knee flexed in slight flexion probe firmly into lateral joint space with your thumb to feel anterior margin.
Term
Lateral Collateral Ligament
Definition
Have patient cross legs with ankle on opposite knee - IT tract relaxes and makes LCL easier to isolate.
Term
Hamstring Tendons
Definition
Knee flexed biceps femoris tendon prominent where it crosses knee joint before inserting on fibular head.
Term
Iliotibial Tract
Definition
Situated more anteriorly on lateral aspect of knee, palpable to point where it inserts into lateral tibial tubercle. Easier to palpate when knee is extended and the leg raised OR against resistance the knee is flexed
Term
Common Peroneal Nerve
Definition
Gently roll between the tip of finger and the neck of fibula slightly inferior to the insertion of the biceps femoris.
Term
Popliteal Fossa
Definition
Superior-lateral border: biceps femoris tendon; superior-medial border: semitendinosus and semimembranosus muscles; inferior borders: two heads of gastroc. Structures that cross the popliteal area: Posterior Tibial Nerve, Popliteal Vein, Poopliteal Artery. Baker's cyst may be found as painless, mobile swelling on medial side of the fossa - with knee extended.
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