KNEE EXAMINATION

Name : 1. Ayu Cahyaningtyas Oktaviani (P27220017129)

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Nurse : “Good morning Ma’am?” (Perform hand hygiene and check room for contact
precautions)

Patient : “Morning Nurse.”

Nurse : “I would like to introduce my self. I’m nurse Rara , one of nurse in charge in this
hospital. Would you tell me your name and date of birth? ”

Patient : ‘Sure nurse, My name is Cahya and I was born on 4 October 1979.”

Nurse : “Do you have any problems with mobility?”

Patient : “My knee hurts when walking up stairs.”

Nurse : ”Have you had any recent trauma ?”

Patient : “Yes Nurse, 3 days ago I slipped on the floor.”

Nurse :” Have you noticed a change in your gait or the way you walk?”

Patient : ”Not yet.”

Nurse : “How long have you had the pain?”

Patient : “Maybe for 2 days Nurse.”

Nurse : “Does the pain keep you from performing your usual activities?

Patient : “I continued my normal activities, but my knees hurt when I climbed the stairs.”

Nurse : ” Okay Ma’am, at this time I will do your knee examination because it is important
to have a systemic plan for the examination of knee arrive at the correct diagnosis, to
identify its impact on the patient, to understand the patient needs and concerns and
then to formulate a treatment plan that is individualized for the particular patient. The
knee exam will take 15 minutes. Do you agree Ma’am?”

Patient : “Yes Nurse, I agree.”

Nurse : “Start with try walking and I will observe it Ma’am. And then, stand with your feet
and knee together . (Nurse look for any varus or valgus deformity by observing the
patient from the front. Nurse observe from the side to identify any flexion deformity
or hyperextension deformity. Nurse look at the popliteal fossa from behind. Observe
muscle bulk and symmetry especially of quadriceps.”

Patient : (performs Nurse directions)

Nurse : “Could you sit on a chair with the knee bend to 90 degrees Ma’am? ( Nurse observe
the position of patella. In the normal the anterior surface of patella will be at an angle
of 45 degrees to the floor and it will be placed centrally within the femoral trochlea.
In patella alta, it will be more horizontal and in patella infera it will be more
vertical.)”

Patient : “Yes Nurse.”

Nurse : “Could you lie supine on a couch Ma’am? (Nurse look suprapatellar and parapatellar
fullness, observe the position of tibial tuberosity. Nurse look at the shape of the bones
of the knee and the soft tissues to detect any swelling or muscle wasting, observe the
medial and lateral surfaces of the knee from either side.)”

Patient :”Yes Nurse.”

Nurse : ” Could you prone in the bed Ma’am? (Nurse observe the back of thigh, popliteal
fossa and the calf.”

Patient : “Yes Nurse,”

Nurse : “ Next about palpation. May I touch and feel your knee, please?”

Patient : “Sure Nurse.”

Nurse : “ Okay Ma’am. ( Nurse feel for elevated temperature with the dorsum of examiners
fingers at the joint line, patella, suprapatellar pouch, femoral and tibial condyles, popliteal
fossa and the calf.) Does it hurt in this area Ma’am (Nurse feel for tenderness, break in
continuity, swelling, thickening and their position in relation to normal location.)?”

Patient : “Ouch, Yes Nurse it hurts.”

Nurse : “Could you flex the knee to 90 degrees to locate the joint line Ma’am? Iwill palpate
the joint line. And then extend the knee. (Nurse feel the undersurface of patella.)”

Patient : “Slowly Nurse, because it hurts.”

Nurse : “Yes Ma’am. Next, could you prone again ? (Nurse palpate the back of thigh,
popliteal fossa and the calf, Nurse palpate the hamstrings and feel for the popliteal
pulse.)”

Nurse : “