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Kinesiology > Hip And Knee > Flashcards

Hip And Knee Flashcards

1
Q

Bony landmarks and additional structures

A
  • femur
  • tibia
  • fibula
  • patella
  • hip
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2
Q

Femur

A
  • longest bone of the body
  • sole bone of the thigh
  • femoral head articulates with acetabulum to form hip joint
  • greater trochanter
  • distal end provides later articular surface for patella and tibia
  • medial and lateral femoral epicondyle = important attachments sites for tendons and ligaments
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3
Q

Tibia

A
  • primary weight bearing bone of lower leg
  • direct link between knee and ankle
  • anterior portion = shin
  • medial malleolus
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4
Q

Fibula

A
  • parallel to tibia
  • bears little weight
  • proximally articulates with tibia
  • lateral malleolus
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5
Q

Patella

A
  • largest sesamoid bone in the body
  • stabilizes knee during flexion
  • attached to quadriceps tendon which then turns into patellar ligament
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6
Q

Joints

A
  • hip
  • knee
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7
Q

Hip joint (image 9)

A
  • ball and socket
  • movements = flexion/extension, abduction/adduction, and internal/external rotation
  • formed by head of femur and acetabulum
  • more stable than shoulder due to increased surface area
    • supported by the iliofemoral, ischiofemoral, and pubofemoral ligaments
    • internally supported by the round ligament
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8
Q

Knee joint

A
  • tibiofemoral joint
  • hinge
  • movements = flexion/extension
  • lined by menisci to increase surface area and deepen tibial plateau
  • ACL (anterior cruciate ligament)/PCL (posterior cruciate ligament) limit anterior/posterior gliding and rotation
  • LCL (lateral collateral ligament)/MCL (medial collateral ligament) prevent varus/vargus
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9
Q

ROM of hip flexion

A
  • prime movers = psoas major, iliacus, rectus femoris
  • patient position = supine with knee in midrange flexion
  • goniometer axis = greater trochanter
  • stationary arm = midline of trunk
  • moving arm = midline of femur
  • compensatory movement = pelvic rotation
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10
Q

Typical ROM of hip flexion

A

120 degrees

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11
Q

Prime movers of hip flexion

A
  • psoas major
  • iliacus
  • rectus femoris
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12
Q

Compensatory movement of hip flexion

A
  • pelvic rotation
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13
Q

ROM of hip extension

A
  • primer movers = gluteus maximus, biceps femoris (long head), semitendinosus, and semimembranosus
  • patient position = prone
  • goniometer axis = greater trochanter
  • stationary arm = midline of trunk
  • moving arm = midline of femur
  • compensatory movement = rotation or elevation of pelvis
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14
Q

Typical ROM of hip extension

A

30 degrees

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15
Q

Prime movers of hip extension

A
  • gluteus maximus
  • biceps femoris (long head)
  • semitendinosus
  • semimembranosus
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16
Q

Compensatory movements of hip extension

A
  • rotation or elevation of pelvis
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17
Q

ROM of hip abduction

A
  • prime movers = gluteus maximus, gluteus medius, gluteus minimus, and tensor fasciae latae
  • patient position = supine
  • goniometer axis = ASIS
  • stationary arm = in-line with bilateral ASIS
  • moving arm = midline of femur
  • compensatory movement = contralateral trunk flexion (side bending)
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18
Q

Typical ROM of hip abduction

A

45 degrees

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19
Q

Prime movers of hip abduction

A
  • gluteus maximus
  • gluteus medius
  • gluteus minimus
  • tensor fasciae latae
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20
Q

Compensatory movements of hip abduction

A
  • contralateral trunk flexion (side bending)
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21
Q

ROM of hip adduction

A
  • prime movers = adductor magnus, adductor longus, adductor brevis, pectinus, and gracilis
  • patient position = supine, non tested leg abducted to allow for adduction of tested leg
  • goniometer axis = ASIS
  • stationary arm = in-line with bilateral ASIS
  • moving arm = midline of femur
  • compensatory movements = ipsilateral trunk flexion (side bending)
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22
Q

Typical ROM of hip adduction

A

30 degrees

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23
Q

Prime movers of hip adduction

A
  • adductor magnus
  • adductor longus
  • adductor brevis
  • pectineus
  • gracilis
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24
Q

Compensatory movements of hip adduction

A
  • ipsilateral trunk flexion (side bending)
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25
ROM of hip external rotation
- prime movers = gluteus maximus (all fibers), piriformis, quadratus femoris, obturator internus, obturator externus, gemellus superior, gemellus inferior - patient position = sitting with hips and knees at 90 degrees - goniometer axis = patella - stationary arm = perpendicular to floor - moving arm = midline of anterior tibia - compensatory movements = elevation of contralateral pelvis
26
Typical ROM of hip external rotation
45 degrees
27
Prime movers of hip external rotation
- gluteus maximus (all fibers) - piriformis - quadratus femoris - obturator internus - obturator externus - gemellus superior - gemellus inferior
28
Compensatory movements of hip external rotation
- elevation of contralateral pelvis
29
ROM of hip internal rotation
- prime movers = gluteus medius, gluteus minimus, adductor magnus, adductor brevis, and adductor longus - patient position = sitting with hips and knees at 90 degrees - goniometer axis = patella - stationary arm = perpendicular to floor - moving arm = midline of anterior tibia - compensatory movements = elevation of ipsilateral pelvis
30
Typical ROM of hip internal rotation
45 degrees
31
Prime movers of hip internal rotation
- gluteus medius - gluteus minimus - adductor magnus - adductor brevis - adductor longus
32
Compensatory movements of hip internal rotation
- elevation of ipsilateral pelvis
33
ROM of knee flexion
- prime movers = semimembranosus, semitendinosus, biceps femoris (short and long heads) - patient position = supine - goniometer axis = lateral epicondyle of femur - stationary arm = midline of femur - moving arm = midline of fibula - compensatory movements = hip extension, pelvic rotation
34
Typical ROM of knee flexion
0-135 degrees
35
Prime movers of knee flexion
- semimembranosus - semitendinosus - biceps femoris (short and long heads)
36
Compensatory movements of knee flexion
- hip extension - pelvic rotation
37
MMT of hip flexion
- against gravity position = seated with hip flexed got elevated of seat - stabilizing hand = anterior pelvis - resistive hand = midpoint of thigh - force application = against flexion - gravity eliminated = side lying on non test side - stabilization = lateral hip - palpation = anterior hip
38
Palpation for MMT hip flexion
- anterior hip
39
MMT of hip extension
- against gravity position = prone - stabilizing hand = posterior aspect of pelvis - resistive hand = midpoint of posterior thigh - force application = against extension - gravity eliminated = side lying on non test side - stabilization = posterior hip and medial aspect of knee, supporting lower leg - palpation = posterior hip below glutes
40
Palpation for hip extension
- posterior hip below glutes
41
MMT of hip abduction
- against gravity position = side lying on non test side - stabilizing hand = lateral pelvis - resistive hand = distal femur - force application = against abduction - gravity eliminated = supine - stabilization = posterior thigh and lower leg - palpation = tensor fasciae latae at lateral hip
42
Palpation for hip abduction
- tensor fasciae latae at lateral hip
43
MMT of hip adduction
- against gravity position = side lying on test leg - stabilizing hand = supporting non test leg - resistive hand = distal medial thigh - force application = against adduction - gravity eliminated = supine with non test leg abducted - stabilization = posterior thigh and lower leg - palpation = adductor longus, adductor brevis, adductor magnus at medial aspect of proximal thigh
44
Palpation for hip adduction
- adductor longus, adductor brevis, adductor magnus at medial aspect of proximal thigh
45
MMT of hip external rotation
- against gravity position = sitting with hips and knees at 90 degrees - stabilizing hand = anterior thigh - resistive hand = distal, medial tibia - force application = against external rotation - gravity eliminated = supine with hip and knee supported in flexion - stabilization = behind knee
46
MMT of hip internal rotation
- against gravity position = sitting with hips and knees in 90 degrees - stabilizing hand = anterior thigh - resistive hand = distal anterior fibula - force application = against internal rotation - gravity eliminated = supine with hip and knee supported in flexion - stabilization = posterior aspect of distal lower leg
47
MMT of knee flexion
- against gravity position = prone with knee in midrange flexion - stabilizing hand = posterior femur - resistive hand = distal posterior tibia - force application = against flexion - gravity eliminated = side lying on non test side - stabilization = supporting thigh and lower leg - palpation = posterior knee
48
Palpation for knee flexion
- posterior knee
49
MMT of knee extension
- against gravity position = sitting with knee and hip flexed to 90 degrees - stabilizing hand = anterior thigh - resistive hand = distal anterior tibia - force application = against extension - gravity eliminated = side lying on non test side - stabilization = supporting thigh and lower leg - palpation = proximal to patella
50
Palpation for knee extension
- proximal to patella
51
Clinical implications
- IT band syndrome - hip fractures - hip arthroplasty (replacement) - collateral ligament injury - osteoarthritis - lower limb amputation - genu varum - genu valgum
52
IT band syndrome
- overuse condition from repetitive strain of IT (iliotibial) band - long distance runners, cyclists - interventions = rest, activity modification, stretching, anti-inflammatory medications
53
Interventions of IT band syndrome
- rest - activity modification - stretching - anti-inflammatory medications
54
Hip fractures
- common among older adults - most involves the proximal femur = femoral neck fracture and intertrochanteric fracture - require internal fixation to repair - acute care OT - IMN = intermedullary nailing (with no hip precautions)
55
Types of hip fractures
- femoral neck fracture - intertrochanteric fracture
56
Hip arthroplasty (replacement)
- a femur fracture that also involves the hip bone too - due to osteoarthritis, activity - posterior hip precautions = no hip flexion past 90 degrees, no internal rotation, and no crossing your legs
57
Types of hip arthroplasty (replacement)
- total hip arthroplasty (THA) - hemiarthroplasty
58
Total hip arthroplasty (THA)
- replaces femoral head and acetabulum
59
Hemiarthroplasty
- replaces femoral head
60
Collateral ligament injury
- includes surgical repair and then post op therapy - causes instability in the knee
61
Osteoarthritis
- TKR = total knee replacement - none or limited precautions - acute OT - outpatient PT
62
Lower limb amputation
- occur from traumatic injury, peripheral vascular disease (PVD), and diabetes - AKA (above knee amputation) or BKA (below knee amputation) - managing edema, joint contractures, shaping residual limb - issue with sitting majority of time in the wheelchair is lack of hip extension because your hip is flexed constantly - prosthetic phase - prosthetic training
63
Prosthetic phase
- facilitating functional mobility, transfers, ADL participation
64
Prosthetic training
- can take up to a year, donning/doffing prosthetic, bearing weight, increasing tolerance - donning = to put something on - doffing = to take something off
65
Genu varum and genu valgum
- tibia is not aligned with femur in straight line - can create an imbalance of forces between femur and tibia - can cause articular surfaces to degeneration
66
Genu varum
Bow leg (Mnemonic = RUM makes your knees spread apart)
67
Genu valgum
Knock knee (Mnemonic = GUM makes your knees stick together)

Kinesiology (11 decks)

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