EXAM 2 Flashcards
What are the superior, medial, and lateral borders of the femoral triangle?
Superior: inguinal ligament
Medial: medial border of adductor longus m.
Lateral: medial border of sartorius m.
What are the flexors of the hip?
iliopsoas, sartorius, rectus femoris, and tensor fascia lata/IT band
What are the extensors of the hip?
gluteus maximus and hamstrings (biceps femoris, semitendinosus, semimembranosus)
What are the adductors of the hip?
adductor longus m.
What are the abductors of the hip?
gluteus medius and tensor fascia lata/IT band
Tight hamstrings lead to a decrease in hip flexion. What is the name of this dysfunction?
hip extension dysfunction
TO check for hip flexion how should the patient be laying?
Supine
To check for hip extension how should the patient be laying?
Prone
How do you check for hip external/internal rotation?
Patient supine or prone with knee flexed to 90 degrees
For hip adduction and abduction how do you set up the patient?
Supine
Iliotibial band restriction presents as:
lateral knee pain and restriction to hip adduction
What are the best ways to check for IT band restriction?
supine or lateral recumbent
ROM of hip flexion
90 degrees knee extended; 120-135 with knee flexed
ROM of hip extension
15-30 degrees
ROM of hip internal rotation
30-40 degrees
ROM of hip external rotation
40-60 degrees
ROM of hip abduction
45-50 degrees
ROM of hip adduction
20-30 degrees
Iliopsoas m. is innervated by what nerve?
femoral nerve (L1-L2)
Gluteus maximus is innervated by what nerve?
inferior gluteal nerve (L5, S1-S2)
Gluteus medius is innervated by what nerve?
superior gluteal nerve (L5, S1)
Adductor longus is innervated by what nerve?
obturator nerve (L2-L4)
What does 0/5 mean on Strength Scale?
no muscle contraction detected
What does 1/5 mean on Strength Scale?
barely detectable flicker/trace of muscle contraction
What does 2/5 mean on strength scale?
active muscle movement with gravity eliminated
What does 3/5 mean on strength scale?
active muscle movement against gravity
What does 4/5 mean on strength scale?
active muscle movement against gravity and some resistance
What does 5/5 mean on strength scale?
active muscle movement against gravity and resistance without signs of fatigue (NORMAL MUSCLE STRENGTH FINDING)
What are the contents of the central compartment?
Labrum, ligamentum teres, and articular surfaces
What pathology is associated with the central compartment?
Labral tears, ligamentum theres tears, osteochondral defects, chondromalacia/osteoarthritis, congenital hip dysplasia, loose bodies
What are the contents of the peripheral compartment?
femoral neck and synovial lining
What pathology is associated with the peripheral compartment?
loose bodies, impingement syndrome (CAM and Pincer types) and synovitis
what are the contents of the lateral compartment?
gluteus medius, gluteus minimus, piriformis, IT band and trochanteric bursae
What pathology is associated with the lateral compartment?
IT band syndrome, bursitis, rotator cuff tendinopathies (gluteus medium, gluteus minimum, piriformis)
What are the contents of the anterior compartment?
iliopsoas insertion and iliopsoas bursae
What is the pathology associated with the anterior compartment?
psoas tendonitis
Describe a flexion dysfunction.
ease of motion to flexion and a restriction of motion to extension
Describe a extension dysfunction.
ease of motion to extension and a restriction of motion to flexion n
Describe internal rotation dysfunction
ease of motion to internal rotation and restriction to external rotation
Describe external rotation dysfunction
ease of motion to external rotation and restriction to internal rotation
Describe abduction dysfunction.
ease of motion to abduction and restriction to adduction
Describe adduction dysfunction.
ease of motion to adduction and restriction to abduction
When assessing for internal rotation/external rotation of the knee, how do you assess the patient?
patient is supine with hip and knee flexed to 90 degrees or prone with knee flexed to 90 degrees
put them on either side of tibial tuberosity
NOTE: these movements are in relation to the tibia on the distal femur
When assessing for adduction of the knee joint, what do you do and what is another word for adduction in this case?
VALGUS TEST: one hand contacts lateral aspect of distal femur and the other grabs the medial ankle
You apply a lateral to medial force on the distal femur and a medial to lateral force on the medial ankle
When assessing for abduction of the knee joint, what do you do and what is another word for abduction in this case?
VARUS TEST: one hand contacts MEDIAL aspect of distal femur and the other hand grabs the LATERAL aspect of the ankle
You apply a medial to lateral force on the distal femur and then push the ankle medially
Describe an adduction somatic dysfunction of the knee.
ease of motion with valgus force and a restriction of motion with varus force
EASE OF MEDIAL TRANSLATORY MOTION
Describe an abduction somatic dysfunction of the knee.
ease of motion with varus force and restriction of motion with valgus force
EASE OF LATERAL TRANSLATORY MOTION
Describe a posterior fibular head somatic dysfunction.
ease of posterior glide with anterior glide restriction
Describe an anterior fibular head somatic dysfunction
ease of anterior glide with posterior glide restriction
When assessing the proximal fibula of the knee joint what do you do?
patient is supine with knee flexed and foot flat on the table
student contacts head of the fibula with the thumb and index finger of one hand and slowly applies and anterior then posterior force to assess for gliding motion of the fibular head with the tibia
What is the normal Q angle?
15 degrees (females sometimes have increased Q-angle)
ROM of flexion of the knee
145-150 degrees
ROM of extension of the knee
0-5 degrees (Most of the time its 0)
ROM of internal rotation and external rotation of the knee
10 degrees
What muscles are involved in extension of the knee?
quadriceps (innervated by femoral nerve) (L2-L4)
What muscles are involved in flexion of the knee?
hamstrings (innervated by sciatic nerve) (L5-S1)
What nerve is subject to compression as it courses around the fibular head by either a fibular head fracture or a somatic dysfunction?
common fibular (peroneal) nerve
What makes up the medial longitudinal arch?
Calcaneus, Talus, Navicular, Cuneiforms 1-3 and Metatarsals 1-3
What makes up the lateral longitudinal arch?
Calcaneus, cuboid and metatarsals 4-5
What makes up the transverse distal tarsal arch?
navicular, cuboid, cuneiforms 1-3 & proximal metatarsals
What is the primary stabilizer of the medial ankle?
deltoid ligament
What ligaments make up the lateral ankle and which tears first?
Posterior talofibular ligament, anterior talofibular ligament (TEARS FIRST), and calcaneofibular ligament
What is a Jones Fracture?
inversion injury to forefoot causes avulsion fracture of 5th metatarsal head
When assessing the lateral malleolus, how would you perform the assessment?
patient is supine with knee flexed and foot flat on the table
pinch lateral malleolus and translate anterior and posterior
ROM of dorsiflexion of the foot
15-20 degrees
ROM of plantar flexion of the foot
50-65 degrees
ROM of ankle inversion (talocalcaneal)
35 degrees
ROM of ankle eversion (talocalcaneal)
20 degrees
ROM of forefoot adduction
20 degrees
ROM of forefoot abduction
10 degrees
ROM of metatarsophalangeal flexion
45 degrees
ROM of metatarsophalangeal extension
70-90 degrees
Pronation includes what movements of the foot
dorsiflexion, abduction & eversion of the calcaneus
Supination includes what movements of the foot
plantar flexion, adduction & inversion of the calcaneus