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Clinical Practice Test 2 > Hip and Knee MMT > Flashcards

Hip and Knee MMT Flashcards

1
Q

what muscle(s) are primarily assessed with hip flexion MMT?

A
  1. Iliacus
  2. Psoas Major
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2
Q

what muscle(s) assist with hip flexion?

A
  1. rectus femoris
  2. sartorius
  3. TFL
  4. Pectineus
  5. Adductor group
  6. Gluteus Medius (anterior)
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3
Q

for grades 3 and up, how should the pt be positioned during hip flexion MMT?

A
  1. sitting with legs off table
  2. hands on table
  3. instruct the pt to “lift your leg off the table, don’t let me push you dont”
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4
Q

for grades 0,1,2 how should the pt be positioned during hip flexion MMT?

A
  1. side lying
  2. bottom leg bent, top leg straight
  3. PT stabilizes top leg
  4. Instruct the pt to “bring your knees toward your chest”
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5
Q

where does the PT stabilize during hip flexion MMT?

A
  1. nowhere specific for grades 3 and up
  2. at hop for 0,1,2
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6
Q

where should resistance be applied during hip flexion MMT?

A

distal femur

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7
Q

what muscle(s) are primarily assess with hip extension MMT?

A
  1. Gluteus Maximus
  2. Hamstrings
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8
Q

what muscle(s) assist with hip extension?

A
  1. Adductor Magnus
  2. Gluteus medius
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9
Q

for grades 3 and up, how should the pt be positioned during hip extension MMT?

A
  1. pt in prone
  2. therapist on the side of testing leg
  3. Instruct pt to “lift leg as high as you can”

*picture depicts wrong side for the therapist

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10
Q

for grades 0,1,2 how should the pt be positioned during hip extension MMT?

A
  1. side lying
  2. therapist supports lef with forearm and hand under knee
  3. Instruct the pt to “move your leg back towards me”
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11
Q

What is a valid reason for utilizing a modified hip extension MMT?

A

hip flexor tightness

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12
Q

how should a pt be positioned for hip extension MMT if they have tight hip flexors?

A
  1. pt leans chest onto table
  2. therapist on side of testing leg
  3. Instruct pt to “lift your foot off the floor as high as you can and hold it there”
  4. apply resistance to distal femur
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13
Q

where does the PT stabilize during hip extension MMT?

A

at the pelvis for postural alignment

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14
Q

where should resistance be applied during hip extension MMT?

A
  1. for normal exams = at the ankle
  2. for modified test = distal femur
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15
Q

what muscle(s) primarily perform hip abduction?

A
  1. Gluteus medius
  2. Gluteus minimus
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16
Q

what muscle(s) assist with hip abduction?

A
  1. Upper fibers of gluteus maximus
  2. TFL
  3. deep hip rotators
  4. sartorius
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17
Q

for grades 3 and up, how should the pt be positioned during hip abduction MMT?

A
  1. pt in side lying
  2. bottom leg is bent
  3. hips stacked
  4. Instruct pt to “bring your fot to the ceiling”
    • do not let hip roll as the leg lifts up
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18
Q

T/F: grades 4 and 5 have different lever arms?

A

TRUE

grade 5 = resistance applied at ankle

grade 4 = resistance applied to distal femur

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19
Q

for grades 0,1,2 how should a pt be positioned during hip abduction MMT?

A
  1. supine
  2. toes pointed to the ceiling
  3. place a towel under foot
  4. Instruct pt to “move your leg to the side”
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20
Q

where should the PT stabilize during hip abduction MMT?

A

at the pelvis, watch out for hip ER!

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21
Q

What would you expect a pt to be able to do if they recieve a 4 or 5 on hip abduction MMT?

A

they should be able to stand on one limb and keep their pelvis level?

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22
Q

what are common substitutions a pt may demonstrate during hip abduction MMT?

A
  1. hip flexion with ER to recruit TFL
  2. hip extension ro recruit gluteus maximus
  3. may hip hike using quadratus lumborum and other trunk muscles
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23
Q

what muscle(s) primarily perform hip adduction?

A
  1. adductor magnus
  2. adductor brevis
  3. adductor longus
  4. pectineus
  5. gracilis
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24
Q

what muscle(s) assist with hip adduction?

A
  1. obturator externus
  2. gluteus maximus
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25
Q

for grades 3 and up, how should the pt be positioned during hip adduction MMT?

A
  1. side lying
  2. PT is supporting upper leg
  3. bottom leg is the one being tested
  4. Instruct pt to “move the leg on the table up to your other leg and hold”
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26
Q

for grades 0,1,2 how should the pt be positioned during hip adduction MMT?

A
  1. supine
  2. toes pointed up to the ceiling
  3. legs extended
  4. start with tested leg abducted
  5. Instruct pt to “move your leg into the other”
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27
Q

where should the PT stabilize during hip adduction MMT?

A
  1. upper leg for grades 3 and up
  2. pelvis in grades 0,1,2
28
Q

where is resistance applied during hip adduction MMT?

A
  1. distal portion of medial femur
29
Q

what is a common substitution a pt may demonstrate during hip adduction MMT?

A

may attempt to recruit hip flexors = will appear as through trunk rotation is occuring from side lying

30
Q

what MMT is done specifically to target the sartorius?

A

hip flexion, abduction, and ER with knee flexion

31
Q

for grades 3 and up, how is the pt positioned when testing the sartorius with MMT?

A
  1. sitting with legs off table
  2. PT should place pt into the position
  3. Can also instruct pt to “slide your hel up your other leg’s shin, resist my push”
32
Q

for grades 0,1,2 how should the pt be positioned when testing the sartorius with MMT?

A

same test as grades 3 and up only place the pt in supine

33
Q

where should the PT stabiilze during sartorius MMT?

A

no stabilization, both hands used for resistance

34
Q

where should resistance be applied when testing the sartorius with MMT?

A
  1. one hand at ankle to move pt’s foot laterally and straighten the knee
  2. other hand at knee to move the hip into extension and adduction
35
Q

what muscle(s) are primarily assessed with hip external rotation MMT?

A
  1. Obturator Externus/Internus
  2. Quadratus femoris
  3. piriformis
  4. gemellus superior/inferior
  5. gluteus maximus
36
Q

what muscle(s) assist with hip ER?

A
  1. sartorius
  2. biceps femoris long head
  3. gluteus medius
  4. psoas major
  5. adductor magnus
  6. adductor longus
  7. popliteus
37
Q

for grades 3 and up, how should a pt be positioned during hip ER MMT?

A
  1. sitting
  2. knees off the table
  3. instruct pt to bring their foot inward
38
Q

for grades 0,1,2 how should the pt be positioned during hip ER MMT?

A
  1. supine
  2. as pt to roll leg outward
  3. can’t truly palpate for a grade 1 or 2 since most primary movers are deep
39
Q

how can you discern between a grade 1 and 2 and 0 for hip ER?

A
  1. grade 2 = pt able to roll hip past midline voluntarily
  2. grade 1 = no discernable movement, give a grade 1
  3. no grade 0
40
Q

where should the PT stabilize during hip ER MMT?

A

stabilize at the knee

41
Q

where should resistance be applied during hip ER MMT?

A

medial ankle towards PT

42
Q

what are some common subsitutions that may be observed during hip ER MMT?

A
  1. hip hiking
  2. hip abduction
  3. recruting knee flexors
43
Q

what muscles are primarily assessed with hip internal rotation MMT?

A
  1. gluteus minimus
  2. gluteus medius
  3. TFL
44
Q

what muscles assist with hip IR?

A
  1. semitendinosus
  2. semimembranosus
  3. adductor magnus
  4. adductor longus
45
Q

for grades 3 and up, how should a pt be positioned during hip IR MMT?

A
  1. sitting
  2. knees off the table
  3. leg positioned outward
  4. Instruct pt to “keep your leg where it is, don’t let me pull it in”
46
Q

for grades 0,1,2 how should the pt be positioned during hip IR MMT?

A
  1. supine
  2. toes towards ceiling
  3. legs extended
  4. ask pt to roll leg inward
  5. palpate muscles
47
Q

where should the PT stabilize during hip IR MMT?

A

knee

48
Q

where should resistance be applied during hip IR MMT?

A

lateral ankle towards PT

49
Q

what muscles are primarily assessed during knee flexion MMT?

A

Hamstrings

50
Q

what muscles assist with knee flexion?

A
  1. Gracilis
  2. TFL
  3. Sartorius
  4. Popliteus
  5. Gastrocnemius
  6. Plantaris
51
Q

for grades 3 and up, how should the pt be positioned during knee flexion MMT?

A
  1. prone
  2. knee flexed between 45-90
  3. Instruct pt to “keep your leg where it is, don’t let me push it down”
52
Q

for grades 0,1,2 how should the pt be positioned during knee flexion MMT?

A
  1. side lying
  2. PT supports top leg and ask pt to flex the knee
53
Q

where should the PT stabilize during knee flexion MMT?

A

knee

54
Q

where should resistance be applied during knee flexion MMT?

A

calf

55
Q

How can a PT bias the medial hamstring?

A

internally rotating leg (toes pointed toward midline)

apply and downward and outward force

56
Q

how can a PT bias the lateral hamstring?

A

externally rotating the leg (toes pointed laterally)

apply a downward and inward force

57
Q

what are some common substitutions that may be observed during knee flexion MMT?

A
  1. pt may utilize hip flexion to initiate
  2. sartorius activation will cause hip and knee flexion and ER
  3. if adduction observed, pt is using gracilis
  4. may dorsiflex to use hamstring shortening to cause knee flexion
58
Q

what muscles primarily extend the knee?

A

quadriceps

59
Q

what muscles assist in knee extension?

A

TFL

60
Q

for grades 3 and up, how should a pt be positioned during knee extension MMT?

A
  1. sitting
  2. knee off the table
  3. good posture (not leaning back), keep hands on table
  4. pt should not be in full extension
61
Q

for grades 0,1,2 how should the pt be positioned during knee extension MMT?

A
  1. side lying
  2. PT supports top leg and starts off with it slightly flexed
  3. Instruct pt to “try and extend your knee back out”
62
Q

where should the PT stabilize during knee extension MMT?

A

under the knee

63
Q

where should resistance be applied during knee extension MMT?

A

at the ankle

64
Q

T/F: It is necessary to test hamstring length prior to this test?

A

TRUE

may impact ROM,

65
Q

what is an alternative way to test knee extension?

A

chair stand test

66
Q

how much strength is needed to rise up out a chair without arms??

A

strength equal to half the body weight

67
Q

approximately how much force is transmitted through the knee during stair descent?

A

nearly 3x body weight

Clinical Practice Test 2 (7 decks)

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