Exam prep sheet 6 Flashcards
Give example/s of a Daily Functional Activity where you use Hip joint movements
Sit to stand
Ask the model to demonstrate the action of kicking a ball.
What movement is occurring at the hip joint? Identify planes and axes for each movement.
Hip extension, then flexion, then extension as it returns to default. Sagittal plane, mediolateral axis
Explain which muscles are producing this movement and identify the Prime movers and Assistant movers. List the antagonist muscles
Flexors – Rec fem, iliopsoas
Extensors – glut max, hamstrings
Name the tarsal bones . Identify articular surfaces and movements of sub-talar joint. Name the muscles responsible for Inversion and Eversion.
Tarsal bones = Talus, calcaneum, cuboid, navicular, medial/ intermediate/ lateral cuneiform.
Sub-talar joint allows for eversion and inversion. It articulates between talus and calcaneum
Invertors – tibialis posterior, tibialis anterior
Evertors – Peroneus longus, peroneus brevis, peroneus magnus
Name the arches of foot and explain their function
Medial longitudinal arch – good for shock absorption
Lateral longitudinal arch – good for weight transmission
Transverse arch – provides strength
Name the three ligaments that attach to the lateral malleolus. Provide attachments of ATFL or PTFL or CF ligament
Ligament attaching to lateral malleolus – Anterior tibiofibular ligament, calcaneofibular and posterior talofibular liagement.
ATFL – Anterior part of lateral malleolus to anterior talus
PTFL – Malleolar fossa to posterior talus
CF – posteromedial side of lateral malleolus to lateral side of calcaneum
Describe the attachments, actions ,nerve supply, morphology of Quadriceps and Glut Medius.
Quadriceps – Made of rectus femoris, vastus lateralis/intermedialis/medialis. Rec fem is bipinnate and spindle shaped, its deep surface is smooth to allow movement over vastus intermedialis. It originates from ASIS. Vastus lateralis is fusiform and has a distal tendon inserting with rec fem, lateral side of patella and ITB, it originates from femur, greater trochanter, intertrochanteric line, gluteal tuberosity and linea aspera. Vastus intermedialis is deep and bledns with VL in mid portion, and VM distally, it originates from the shaft of femur. Vastus medialis has fibres running downwards, lower fibres run horizontally to form vastus medialis oblique, it originates from the intertrochanteric line and shaft of femur. Actions are knee extension and rec fem performs hip flexion. Nerve supply is femoral nerve. All insert into the tibial tuberosity via patella tendon.
Gluteus Medius – Originates from outer surface of ilium, inferior to iliac crest. Inserts into lateral surface of greater trochanter. Performs hip abduction and medial rotation of hip. Flat triangular shape, supplies by superior gluteal nerve.
Observe Lumbar Spine. Explain normal features you would inspect around Lumbar Spine. Explain primary and secondary curves of spine?
Around lumbar spine you would expect the spinous processes of each vertebrae, as well as the PSIS being in the same sort of area, with the iliac crest on either side. The primary curves belong to the thoracic and pelvic areas – they are known as kyphosis. The secondary curves belong to cervical and lumbar regions and are known as lordotic.
Palpate the ASIS/Greater Trochanter and name a muscle that attach here.
ASIS - find iliac crest and follow it forward. Sartorious attaches here.
Greater trochanter- Hand length down from ASIS. Gluteus medius inserts here.
Surface mark superior tibio-fibular joint
Palpate head of fibula, role finger medially to find gap between fibula and tibia.
Measure AROM knee Flexion using goniometer and test end feel.
Place goniometer on joint line, ask patient to flex knee and measure. End feel is soft.
What are Hip Abductors ? Test their strength using MRC/Oxford grading(Grade 4).
The hip abductors are – gluteus medius/minimus
Patient side lying, apply some resistance to lateral ankle of higher leg, ask them to push into your hand
Palpate contraction of Quadriceps
Patient sitting with legs over edge of plinth. Ask them to push into your hand with your hand on their ankle. Feel contraction at quadricep
How could you differentiate between gastrocnemius and soleus when performing a flexibility (stretch) test ?
Gastrocnemius crosses the knee so straight leg applies more strain to gastrocnemius.
Demonstrate a central PA on L1-L5
Locate L4 by moving horizontally between highest point of iliac crest. Use pisiform on hand to press down on spinous process.
