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okay the next joint exam that we're going to do is the knee and we'll start again with inspection and then palpation and then a range of motion and then specific testing of different structures so the next thing that we the first thing I want to look at with the knee exam is inspection and you want to look for swelling so the first thing that I have them doing is tighten up their quadricep muscle and you'll notice that there is a divot here and a divot here if they have a joint effusion that divot will fill with fluid if it's fluid in the bursa sac the fluid will actually sit here on top of the kneecap and you'll still have your divots and if you squeeze the skin that will hurt the bursa sac so once we've seen where where the swelling might be the next thing that we want to do is have them do active range of motion so we have them extend the knee fully and she can actually hyper extend her ankle a little bit that's near Iker bottom and then we have them flex the knee as far forward as

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