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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
Q

ROM of hip external rotation

A
  • 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
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26
Q

Typical ROM of hip external rotation

A

45 degrees

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27
Q

Prime movers of hip external rotation

A
  • gluteus maximus (all fibers)
  • piriformis
  • quadratus femoris
  • obturator internus
  • obturator externus
  • gemellus superior
  • gemellus inferior
28
Q

Compensatory movements of hip external rotation

A
  • elevation of contralateral pelvis
29
Q

ROM of hip internal rotation

A
  • 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
Q

Typical ROM of hip internal rotation

A

45 degrees

31
Q

Prime movers of hip internal rotation

A
  • gluteus medius
  • gluteus minimus
  • adductor magnus
  • adductor brevis
  • adductor longus
32
Q

Compensatory movements of hip internal rotation

A
  • elevation of ipsilateral pelvis
33
Q

ROM of knee flexion

A
  • 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
Q

Typical ROM of knee flexion

A

0-135 degrees

35
Q

Prime movers of knee flexion

A
  • semimembranosus
  • semitendinosus
  • biceps femoris (short and long heads)
36
Q

Compensatory movements of knee flexion

A
  • hip extension
  • pelvic rotation
37
Q

MMT of hip flexion

A
  • 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
Q

Palpation for MMT hip flexion

A
  • anterior hip
39
Q

MMT of hip extension

A
  • 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
Q

Palpation for hip extension

A
  • posterior hip below glutes
41
Q

MMT of hip abduction

A
  • 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
Q

Palpation for hip abduction

A
  • tensor fasciae latae at lateral hip
43
Q

MMT of hip adduction

A
  • 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
Q

Palpation for hip adduction

A
  • adductor longus, adductor brevis, adductor magnus at medial aspect of proximal thigh
45
Q

MMT of hip external rotation

A
  • 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
Q

MMT of hip internal rotation

A
  • 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
Q

MMT of knee flexion

A
  • 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
Q

Palpation for knee flexion

A
  • posterior knee
49
Q

MMT of knee extension

A
  • 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
Q

Palpation for knee extension

A
  • proximal to patella
51
Q

Clinical implications

A
  • IT band syndrome
  • hip fractures
  • hip arthroplasty (replacement)
  • collateral ligament injury
  • osteoarthritis
  • lower limb amputation
  • genu varum
  • genu valgum
52
Q

IT band syndrome

A
  • overuse condition from repetitive strain of IT (iliotibial) band
  • long distance runners, cyclists
  • interventions = rest, activity modification, stretching, anti-inflammatory medications
53
Q

Interventions of IT band syndrome

A
  • rest
  • activity modification
  • stretching
  • anti-inflammatory medications
54
Q

Hip fractures

A
  • 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
Q

Types of hip fractures

A
  • femoral neck fracture
  • intertrochanteric fracture
56
Q

Hip arthroplasty (replacement)

A
  • 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
Q

Types of hip arthroplasty (replacement)

A
  • total hip arthroplasty (THA)
  • hemiarthroplasty
58
Q

Total hip arthroplasty (THA)

A
  • replaces femoral head and acetabulum
59
Q

Hemiarthroplasty

A
  • replaces femoral head
60
Q

Collateral ligament injury

A
  • includes surgical repair and then post op therapy
  • causes instability in the knee
61
Q

Osteoarthritis

A
  • TKR = total knee replacement
  • none or limited precautions
  • acute OT
  • outpatient PT
62
Q

Lower limb amputation

A
  • 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
Q

Prosthetic phase

A
  • facilitating functional mobility, transfers, ADL participation
64
Q

Prosthetic training

A
  • can take up to a year, donning/doffing prosthetic, bearing weight, increasing tolerance
  • donning = to put something on
  • doffing = to take something off
65
Q

Genu varum and genu valgum

A
  • 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
Q

Genu varum

A

Bow leg
(Mnemonic = RUM makes your knees spread apart)

67
Q

Genu valgum

A

Knock knee
(Mnemonic = GUM makes your knees stick together)

Kinesiology (11 decks)

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