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OS1 Final > Hip and knee > Flashcards

Hip and knee Flashcards

1
Q

Central Compartment (3)

A

Labrum,

Ligamentum teres,

Articular surfaces

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2
Q

Peripheral Compartment (2)

A

Femoral neck,

Synovial lining

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3
Q

Lateral Compartment (5)

A
  1. Gluteus medius,
  2. Gluteus minimus,
  3. Piriformis,
  4. IT band,
  5. Trochanteric bursae
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4
Q

Anterior Compartment

A

Iliopsoas insertion,

Iliopsoas bursae

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5
Q

Borders of femoral t

A
  1. Superiorly – Inguinal Ligament
  2. Medially – Medial border of Adductor Longus muscle
  3. Laterally – Medial border of Sartorius muscle
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6
Q

Adduction Somatic Dysfunction

A

Hypertonic Long or Short Adductors

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7
Q

Muscles that IR:

A

tensor fascia lata,

gluteus medius,

gluteus minimus

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8
Q

Muscles that ER:

A
  1. gluteus maximus,
  2. piriformis,
  3. sartorius,
  4. obturator internus/externus,
  5. superior/inferior gemellus,
  6. quadratus femoris
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9
Q

Hip Extension Somatic Dysfunction

A

hypertonic Hamstrings (straight leg)

or

Gluteus Maximus (knee bent)

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10
Q

Hip Flexion Somatic Dysfunction

to test:

A

Thomas Test: Flexion of opposite Hip causes hip flexion in dysfunctional side

Typically due to hypertonic hip flexors, commonly the iliopsoas

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11
Q

Abduction Somatic Dysfunction

A

d/t hypertonic IT band

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12
Q

how to dx hypertonic SHORT adductors

A

FABER

Flexed

ABduct

Externally Rotate at thight and knee

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13
Q

Major and Minor Motions of the Tibiofemoral Joint

A

major: F and E
min: IR/ER, AD/AB, ant/post glide

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14
Q

Posterior Glide

A

As Knee Flexes, tibia Glides Posteriorly on femur

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15
Q

Anterior Glide

A
  • As Knee Extends, tibia Glides Anteriorly on femur

think of it as if the femur does not move

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16
Q

Anterior Drawer Test

+ orthopedic test

A

positive test indicating disruption of the anterior cruciate ligament

tibia in relation to the femur with acharacteristic “mushy” or “soft” end point

17
Q

Anterior Drawer Test

+ SD test

A

A positive test is one in which there is a“hard” end-feel

and the posterior drawer has a “soft” or “empty” end- feel, but is not greater than 1 mm of slide.

18
Q

normal finding for anterior drawer test

A

Normal finding: A “firm” end point is elicited with a “recoil” due to a healthyviscoelastic response.

19
Q

Flexed Tibiofemoral Somatic Dysfunction

—-what is special about this?

A

pillow under patients legs

20
Q

Diagnose ABduction/ADduction Tibiofemoral SD

A

Induce ABduction of distal tibia by applying a Valgusforce to knee (gaps)

Induce ADduction of distal tibia by applying a Varusforce to knee (compress)

21
Q

Tibiofemoral Joint IR/ER angles

A

10 degrees

10 degrees

22
Q

normal Q angle of knee

A

M - 15

W- increased

23
Q

External Rotation of tibiofemoral joint leads to

A

anteromedial glide of tibia on femur

24
Q

Internal Rotation of tibiofemoral joint leads to

A

posterolateral glide of tibia on femur

25
Q

Diagnosing IR/ER Tibiofemoral Joint SD

A

Pt seated: hips flexed to 45, knee at 90

Place hands around tibial plateau

Externally Rotate tibia to assess for restriction of motion

Internally Rotate tibia to assess for restriction of motion

26
Q

MET/ART for External Rotation Tibiofemoral SD

A

Patient: Seated with legs off table

Physician: Seated, facing dysfunctional leg

Grasps the lateral aspect of the patient’s foot and ankle with one hand. Other hand contacts the medial tibial plateau to monitor motion (anteromedial and posterolateral glide)

Dorsiflex and IR the distal tibia to restrictive barrier

  1. InstructpatienttoturnfootintoERfor3-5 seconds against your resistance
  2. Repeat 3-5 times or until motion is fully restored
27
Q

MET/ART for Internal Rotation Tibiofemoral SD

A

Patient: Seated with legs off table

Physician: Seated, facing dysfunctional leg

Grasps the medial aspect of the patient’s foot and ankle with one hand. Other hand contacts the medial tibial plateau to monitor motion (anteromedial and posterolateral glide)

Dorsiflex and ER the distal tibia to restrictive barrier

InstructpatienttoturnfootintoIRfor3-5 seconds against your resistance

  1. Repeat 3-5 times or until motion is fully restored
28
Q

Diagnosing Proximal Fibular Head SD

A
  1. Patient: Seated or supine with hip flexed to 45°and knee flexed to 90°
  2. – Modification: patient seated, legs hanging off table• Physician: Seated at end of table on side of
  3. dysfunction, facing head of table
  4. Grasp proximal fibular head between index finger and thumb
  5. Translate anterior/posteriorly noting any ease and restriction of motion
29
Q

Fibular head glides anteriorly with foot ________

A

pronation

30
Q

Fibular head glides posteriorly with foot ______

A

supination

31
Q

Pronation:

A

dorsiflexion, eversion, abduction

32
Q

SUPINATION

A

plantarflexion, inversion, adduction

add

plants

in

yuour

SUP

33
Q

MET/ART for Posterior Fibular Head SD

A

Patient: Supine or seated, hip and knee flexed to 90°

Physician: Standing on dysfunctional side, facing

patient

  1. Cephalad hand holds fibular head between thumb and index finger or with the 1st MCP joint
  2. Caudad hand grasp foot and engage restrictive barrier by moving the foot into Pronation(Dorsiflexion+Eversion+Abduction)
  3. Have patient move foot medially against resistance for 3-5 seconds while providing anterior glide on fibular head
  4. Repeat 3-5 times or when motion is restored
34
Q

MET/ART for Anterior Fibular Head SD

A

Patient: Supine or seated with hip and knee straight or flexed to 90°

Physician: Standing on dysfunctional side, facing patient

  1. Cephalad hand holds fibular head between thumb and index finger or place the thenar eminence on the anterior aspect of the fibular head
  2. Caudad hand grasps foot and engage restrictive barrier by moving the foot into Supination(Plantar Flexion+Inversion+Adduction)
  3. Have patient move foot laterally against resistance for 3-5 sec while providing posterior glide on fibular head
  4. Repeat 3-5 times or until motion is restored

OS1 Final (11 decks)

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