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kinesiology > hip assessment > Flashcards

hip assessment Flashcards

lab week 7/week8

1
Q

hip assessment

describe set up, instructions, tips and alternatives for hip flexion hand-held dynamometry.
what is the moment arm positions?

A

setup: the patinet should be seated on the end of a plinth. the patient may hold onto the plinth for stability. the tester should stand over top of the patinets leg being tested and postiont the HHD just proximal to the knee. the tester should instruct the patient to raise their thigh just off the table.

instructions: “on my go, push upward with your thigh as hard as you can life you are trying to raise your knee to the ceiling”

tips: the tester should lock out their elbows in a braced position. do not pus hdown on the patients thigh - let them push up into you

alternatives: this assessment may also be perofrmed in a supine position –> better job of precision due to gravity minimzed positon

moment arm: anterior thigh (where HHD is) to greater trochanter

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2
Q

hip assessment

describe set up, instructions, tips and alternatives for hip internal rotation (seated) hand-held dynamometry.
what is the moment arm positions?

A

setup: the patient should be seated on the end of a plinth. the patient may hold onto the plinth for stability. the tester should position the HHD just proximal to the lateral malleolus

instructions: on my go, push outward with the outside of your ankle. make sure to keep your thigh down on the table

tips: watch carefully that the patient does nto flex, adduct, or abduct their hip

alternatives: this assessment may also be perofrmed in prone

moment arm: contact (HHD) lateral malleolus to lateral epicondyle of femur

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3
Q

hip assessment

describe set up, instructions, tips and alternatives for hip external rotation (seated) hand-held dynamometry.
what is the moment arm positions?

A

setup: the patient should be sethis ated on the end of plinth. patient may hold onto plinth. tester should position the HHD just proximal to the medial malleolus

instructions: on my go, push inward with the inside of your ankle as hard as you can. make sure to keep your thigh down on the table

tips:watch carefully the patinet does not flex, adduct, or abduct their hip

alternatives: may be performed prone

moment arm: medial malleolus (HHD contact) to medial epicondyle of femur

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4
Q

hip assessment

describe set up, instructions, tips and alternatives for hip IR (prone) hand-held dynamometry.

A

set up: patinet should be lying in a prone position on a plinth with their knee flexed to 90°. a belt may be secured around the table to help stabilize the patients pelvis. the tester should position the HHD just proximal to the medial malleolus

instruction: push outward as hard as you can

tips: watch carefully to make sure the patinet maintains 90° of knee flexion and does not compensate with knee flexors or knee extensors

alternatives: may be performed seated

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5
Q

hip assessment

describe set up, instructions, tips for hip ER (prone) hand-held dynamometry.

A

setup: the patinet should be lying in a prone position on a plinth with their knee flexed to 90°. a belt may be secured around the table to help stabilize pelvis. tester should position the HHD just proximal to medial malleolus

instruction: on my go push inward with the iside of your ankle as harda s you can like you are trying to bring your leg across your body

tips: watch carefully to make sure the patient maintains 90° of knee flexion and does not compensate with knee flexors or knee extensors

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6
Q

hip assessment

describe set up, instructions, tips and alternatives for hip extension hand-held dynamometry.
what is the moment arm positions?

A

setup: the patinet should be lying in a prone position on a plinth with their knee flexed to 90°. a belt may be secured around the table to help stabilize the patients pelvis. the tester should position the HHD at the distal thigh. the tester should instruct the patient to raise their thigh just off the table

instruction: on my go push upward with your leg as hard as you can like you are trying to bring the bottom of your foot toward the ceiling

tips: the tester should lock out their elbows in a braced position. do not push down on the patients thigh

alternatives: this may be performed in a supine position with the hip flexed to 90°, or in prone with the legs off the end of the table - though the tester will likely have a difficult time not being overcome by the hip extension force produced

moment arm: distal hamstring (HHD contact) to greater trochanter

leg at 90 will keep the movement primarily recruiting the glute max

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7
Q

hip assessment

describe set up, instructions, tips and alternatives for hip abduction (supine) hand-held dynamometry.
what is the moment arm positions?

A

setup: the patient should be lying in a supine position on a plinth with one leg straight with the foot off the end of the table, and the other leg bent with the foot flat on the table. the patient may hold onto plinth. tester should stand on the outside of the patients leg being tested and position the HHD just proximal to the lateral malleolus

instruction: on my go push outward with your leg as hard as you can

tips: make sure the patients elg being tested is just off the table so that friction between the leg and the table does not affect their ability to push into HHD

alternatives: can be performed in sidelying

moment arm: from HHD (lateral malleolus to greater trochanter)

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8
Q

hip assessment

describe set up, instructions, tips and alternatives for hip adduction supine hand-held dynamometry.
what is the moment arm positions?

A

setup: patient should be lying in a supine position on a plinth with one leg straight with the foot off the end of the table, and the other leg bent with the footflat on the table. the patient may hold onto the plinth. the tester should stand on the inside of the patients leg being tested and position the HHD just proximal to the medial malleolus

instruction: on my go push inward with your leg as hard as you can

tips: make sure the patinets leg being tested is just off the table so that friction between the elg and the table doesnt affect ability to push into HHD

alterative: may be done in sidelying

moment arm: from HHD (medial malleolus) to greater trochanter

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9
Q

hip assessment

straight leg raise MMT

setup
landmarks
normal rom
end feel

A
  • foot, ankle relaxed
  • landmarks: greater trochanter, LE, midaxillary line
  • palpate: ASIS (superior aspect)
  • lift leg until you feel ASIS pop into fingers

-AOR: greater trochanter
- MA: Lateral epicondyle
- SA: midaxillary line

AAOS ROM: 70°-80° of hip flexion
end feel: firm

knee remains in full extension

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10
Q

hip assessment

thomas test - rectus femoris length
set up
landmarks
ROM
end feel

A

patient position: supine with lower extremities off table, supported by clinician

stabilization: patient assists with stability of contralateral limb

testing motion: extend hip to the end of the ROM, determined by resistance to movement, APT, lumbar spine extension, or hip deviation from sagittal plane
if patient displays stiffness at end ROm, extend knee to differentiate between rectus femurs and iliopsoas
if patients hip adducts - the adductor group may be short
if patients hip abducts and externally rotates the sartorius may be short
if patients hip abducts and interally rotates the TFL may be short

landmarks:
- SA: greater trochanter
- AOR: lateral epicondyle of knee
- MA: lateral malleolus

end feel: firm due to joint capsule, muscle tension or ligaments

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11
Q

hip joint -arthrokinematics

motion: flexion

primary movement (remember movement still occurs in other planes)

A

anterior roll
posterior glide

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12
Q

hip joint - arthrokinematics

motion: extension

primary movement (remember movement still occurs in other planes)

A

posterior roll
anterior glide

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13
Q

hip joint- arthrokinematics

motion: abduction

primary movement (remember movement still occurs in other planes)

A

lateral roll
inferior glide

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14
Q

hip joint -arthrokinematics

motion: adduction

primary movement (remember movement still occurs in other planes)

A

medial roll
superior glide

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15
Q

hip joint -arthrokinematics

motion: internal rotation

primary movement (remember movement still occurs in other planes)

A

medial roll
posterior glide

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16
Q

hip joint- arthrokinematics

motion: external rotation

primary movement (remember movement still occurs in other planes)

A

lateral roll
anterior glide

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17
Q

hip joint -arthrokinematics

closed kinetic chain: pelvis/acetabulum moving on femur

motion: flexion

concave on convex (same direction) a CC on a CV is same same

A

anterior roll
anterior glide

18
Q

hip joint - arthrokinematics

closed kinetic chain: pelvis/acetabulum moving on femur

motion: extension

CC on CV

A

posterior roll
posterior glide

19
Q

hip joint -arthrokinematics

closed kinetic chain: pelvis/acetabulum moving on femur

motion: abduction

for CKC the glide is opposite of OKC but roll stays the same

A

lateral roll
superior glide

20
Q

hip joint- arthrokinematics

closed kinetic chain: pelvis/acetabulum moving on femur

motion: adduction

for CKC the glide is opposite of OKC but roll stays the same

A

medial roll
inferior glide

21
Q

hip joint- arthrokinematics

closed kinetic chain: pelvis/acetabulum moving on femur

motion: Internal rotation

for CKC the glide is opposite of OKC but roll stays the same

A

medial roll
anterior glide

22
Q

hip joint - arthrokinematics

closed kinetic chain: pelvis/acetabulum moving on femur

motion: external rotation

for CKC the glide is opposite of OKC but roll stays the same

A

lateral roll
posterior glide

23
Q

goniometry

hip flexion:

normal rom:

A

stationary arm: lateral midline of pelvis, along mid axillary line of trunk
AOR: greater trochanter
movement arm: midline of lateral femur to the lateral epicondyle of knee

normal AROM: 120°

patient is supine

you don’t want the patient to go into PPt
watch for knee can bother people

24
Q

goniometry

hip abduction

normal rom

A

SA: align between booth anterior superior iliac spines
AOR: ipsilateral anterior superiro iliac spine
MA: midline of anterior femur to center of patella

normal ROM: 45°

supine

watch for ER–> don’t want this
iliac crest moving = stop (exhausted abduction)
starting with the goni at 90° already so beware of #

25
Q

goniometry

hip adduction

normal rom

A

SA: align between both ASIS’s
AOR: ipsilateral ASIS
MA: midline of anteriro femur to center of patella

norma ROM: 20°

supine

  • watch for IR this is use of iliopsoas –> don’t want this
  • when iliac crest drops (moves away from fingers) this is when to stop
26
Q

goniometry

hip extension

normal rom

A

SA: lateral midline of pelvis, along mid axillary line of trunk
AOR: greater trochanter
MA: midline of lateral femur to the lateral epicondyle of ipsilateral knee

normal ROM: 20°

prone

  • have hand on PSIS –> watch for back extension, pelvic rotation
  • glute muscles can cramp
27
Q

goniometry

internal rotation-prone

normal rom

A

SA: perpendicular to floor
AOR: center of anteriro patella (move patient to end of bed to expose patella)
MA: midline of anterior tibia to the center of talocrural joint (find med/lat malleoli and come to center from there)

normal rom: 45°

pron

  • bend knee to 90°
  • if this postion bothers knee move to seated alt position
28
Q

goniometry

external rotation - prone

normal rom

A

SA: perpendicular to floor
AOR: center of anteriro patella
MA: midline of anterior tibia to the center of talocrural joint

normal rom: 45°

pelvis has a tendency to move - hand on PSIS
move to alt seated positon if uncomfortable to pt

29
Q

goniometry

internal rotation -seated

normal rom

A

SA: perpendicular to floor
AOR: center of anterior patella
MA: midline of anterior tibia to the cetner of talocrural joint

normal rom: 45°

use a towel under knee to keep leg in a true 90°

30
Q

goniometry

external rotation- seated

normal rom

A

SA: perpendicular to floor
AOR: center of anterior patella
MA: midline of anteriro tibia to the center of talocrural joint

normal rom: 45°

  • hand on iliac creat on ipsilateral side to watch for hip rising
  • use of towel under knee to keep leg in true 90°
31
Q

end feel

hip flexion

A

soft: due to muscle bult
firm: due to tight postesrisor capsule

only motion that has both soft and firm endfeel

32
Q

end feel

hip extension

A

firm due to muscle tension, anterior joint capsule or ligaments

33
Q

end feel

hip abduction

A

firm due to medial joint capsule, muscle tension or ligaments

34
Q

end feel

hip adduction

A

firm due to lateral joint capsule, muscle tension or ligaments

35
Q

end feel

hip external rotation

A

firm due to posterior joint capsule, muscle tension or ligaments

36
Q

end feel

hip internal rotation

A

firm due to posterior joint capsule, muscle tension or ligaments

37
Q

MMT- hip

hip flexion
grade 3-5 positon
grade 0-2 position

A
38
Q

MMT - hip

hip extension
grade 3-5 position
grade 0-2 position

A
39
Q

MMT -hip

hip abduction
grade 3-5 position
grade 0-2 position

A
40
Q

MMT- hip

hip adduction

grade 3-5 position
grade 0-2 position

A
41
Q

MMT hip

hip internal rotation

grade 3-5 position
grade 0-2 position

A
42
Q

MMT- hip

hip external rotation

grade 3-5 position
grade 0-2 position

A

kinesiology (11 decks)

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