NORCET-11 Mains: Which test is performed for a suspected meniscal tear by flexing the knee and rotating the tibia while extend…

NORCET-11 Mains

Medical & Surgical Nursing

Easy

Appeared in: NORCET-11 Mains

Explanation

The McMurray test is a specific maneuver designed to assess the integrity of the medial and lateral menisci of the knee.
The procedure involves passively flexing the knee, rotating the tibia (lower leg), and then extending the knee, as described in the question stem.
A positive test is indicated by a painful click, a 'pop', or a 'locking' sensation, which suggests a tear in the meniscus that is being caught between the femur and tibia during the maneuver.
The image visually demonstrates the clinician applying the rotational force to the lower leg while controlling the knee joint, which is characteristic of the McMurray test.

Option A: The Lachman test assesses the stability of the Anterior Cruciate Ligament (ACL), not the meniscus.
Option C: The Anterior Drawer test also checks for tears in the Anterior Cruciate Ligament (ACL).
Option D: The Thomas test is used to assess for a hip flexion contracture, specifically tightness of the iliopsoas muscle, and is unrelated to knee ligament or meniscal injuries.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Clinical examination tests for knee injuries, specifically for meniscal tears as background academic context rather than a clinical decision trigger.
Nurses often perform or assist with initial musculoskeletal assessments. Correctly identifying the purpose of tests like McMurray's is vital for accurate patient triage, documentation, and communication with physicians or physical therapists.
A positive McMurray test is a significant clinical finding that often warrants referral to an orthopedic specialist for further evaluation, typically with Magnetic Resonance Imaging (MRI), to confirm the diagnosis and plan treatment.
Patient education is key. A nurse can explain the purpose of the maneuver to the patient to reduce anxiety and improve cooperation during the examination.

How to Approach the Question

First, break down the question to identify the key components: the suspected injury ('meniscal tear') and the specific actions performed ('flexing the knee', 'rotating the tibia', 'extending the knee').
Next, analyze the provided image. Observe the patient's position (supine) and the clinician's hand placement and action (holding the knee and foot, applying a rotational force). This visual information confirms the maneuver described in the text.
Review the options and recall the purpose of each orthopedic test.
Match the described maneuver and suspected injury to the correct test. The Lachman and Anterior Drawer tests are for the ACL. The Thomas test is for the hip.
The McMurray test is the only option that involves tibial rotation combined with flexion and extension specifically to check for meniscal tears.
Conclude that the McMurray test is the correct answer as it aligns with the question's description, the visual evidence, and the clinical purpose.

Concept Tested & Keywords

Concept Tested: Clinical examination tests for knee injuries, specifically for meniscal tears.
Stem keywords: meniscal tear, flexing the knee, rotating the tibia, extending the knee
Lead-in keywords: Which test
Negative lead-in flag: false

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