Exam prep sheet 3

Question 1

Give example/s of a Daily Functional Activity where you use Knee joint movements

Answer 1

Stepping up

Question 2

What movement is occurring at the knee joint during step up? Identify planes and axes for each movement.

Answer 2

Knee flexion, then extension. Sagittal plane, mediolateral axis.

Question 3

Explain which muscles are producing the movement of step up and identify the Prime movers and Assistant movers. List the antagonist muscles

Answer 3

Knee flexion = hamstrings
Knee extension = quadriceps

Question 4

Explain morphology, attachments and actions of Gastrocnemius and Glut Maximus. Which nerve supplies the muscle.

Answer 4

Gastrocnemius is a large powerful, bipennate muscle located in the posterior lower leg. It originates as two heads. It is more superficial than the other muscle in the posterior compartment, soleus. The origin for the medial head is popliteal surface of femur and the lateral head originates from the outer aspect of lateral condyle of femur. The insertion is the achilles tendon. Actions are plantar flexion and some knee flexion. The nerve supply is the tibial nerve.

Gluteus maximus is a large, powerful quadrilateral muscle, with the fibres in line with the pull. The origin is the outer surface of ilium and outer surface of sacrum and coccyx to the gluteal tuberosity and iliotibial tract of fascia lata. The nerve supply is the gluteal nerve.

Question 5

List the joints of Lumbar spine and classify facet joints. Name parts of intervertebral disc and name two ligaments in the spine

Answer 5

1x intervertebral joint (symphysis)
2x facet joint (synovial plane)
Body (main section), intervertebral canal (where things pass through), pedicle (connecting body to processes), transverse process (pointing out laterally), lamina (connecting transverse process to spinous process), spinous process (pointing out posteriorly)

supraspinous ligament
interspinous ligament

Question 6

Observe Pelvic girdle. Explain normal features you would inspect around pelvic region?

Answer 6

Observe Pelvic girdle. Explain normal features you would inspect around pelvic region?
Pubic symphysis, ASIS, PSIS, Iliac crest, Greater trochanter

Question 7

Palpate the base of the 5th metatarsal or tuberosity of Navicular. Name the muscle that attaches to the bony point.

Answer 7

Lateral aspect of foot, slide finger down from head to base of metatarsal, provides attachment for peroneus brevis
1 inch below medial malleolus and 1 inch forward, provides attachment for tibialis posterior

Question 8

Surface mark Ankle joint line and explain how you do it.

Answer 8

2cm above lower malleolus, 1cm above higher malleolus. Line between the two

Question 9

Measure Active Hip abduction using goniometer and identify the end feel.

Answer 9

Patient supine. Place goniometer on ASIS ask them to move their leg to the side and measure ROM. End feel is firm

Question 10

What are knee Extensors ? Test their strength using MRC/Oxford grading(Grade 3).

Answer 10

Quadriceps (rec fem, vastus lat/med/intermed)
Patient sitting with legs over edge of plinth. Ask them to extend their leg.

Question 11

Palpate contraction of Transverse Abdominus

Answer 11

Place fingers 1cm medially and 1cm below ASIS. Ask patient to cough. For more prolonged contraction ask them to tilt their pelvis forward.

Question 12

Demonstrate a passive accessory movement of your choice at the superior tibio-fibular joint

Answer 12

PA – use thumb to push head of fibula from posterior to anterior.

Question 13

Test the flexibility (put the muscle on stretch) of Rectus Femoris or Hamstrings

Answer 13

Rec Fem – Patient lying on front, flex their knee, if full flexion is achieved then extend the hip partially to increase stretch

Hamstrings – Patient lying on back, raise their straight leg to the ceiling or place hip in 90 degrees flexion then raise lower leg

Question 14

Demonstrate Ober’s test and explain outcome

Answer 14

Ober’s – Patient in side lying with lower leg flexed for support. Extend and abduct the higher leg and while stabilising the pelvis allow it to drop. Positive sign is that the leg remains in abduction, this could mean tension in tensor fascia lata and/or ITB

Question 15

Demonstrate Trendelenburg Test -what is Trendelenburg sign positive

Answer 15

Trendelenburg – Ask patient to stand on one leg, the pelvis should remain level rather than tilting one way or the other. Positive sign is opposite pelvic side drops