Hip Exam and Eval Lab Flashcards
Observation/Posture - Anterior View
Pelvic heights GT heights Femoral torsion (ante) Leg rotation (knee caps) Genur varum/valgus Tibial torsion Subtalar supinat/pron Toeing in or out
Observation/Posture - Lateral View
Degree of pelvic tilt Lumbar lordosis Position of femur as related to pelvis Knee recurvatum Dorsi/plantar of ankle
Observation/Posture - Posterior view
Rotation of hip, popliteal fossa, calcaneal eversion/inversion
Lumbar Scan
Observation, AROM and overpressure, Gait, neuro and others if needed
Hip Flexion end feel
springy/elastic
Hip IR and ER end feel
can be more capsular than springy
Hip abduction end feel
Elastic of adductors
Hip adduction end feel
Elastic with lateral muscles of hip
Hip Extension test done in sidelying, knee is
End feel
extended
End feel depends but will likely be springy
Palpating Iliac Crests
Palpate heights
Also along outer rim secondary to insertion of flut max and med
Palpate ASIS
Attachment of TFL and Sartorius
Common for avulsions
Palpate AIIS
located in space formed by Sart and TFL, lateral femoral cutaneous nerve passes through triangle
Origin of rectus
Palpate Greater Troch
Multiple muscles attaching - glut med, piriformis, super and inf gemelli, obt internus and ext, subtrochanteric bursa
Palapte pubic symphysis
through gown
Palpate pubic tuberosity
lateral to symphysis
Palpate inguinal ligament
From ASIS to pubic tubercle
Palpation from medial to lateral
Femoral artery and nerve
Palpate Sartorius/TFL/RF
position leg in slight flex and ER
TFL will be most lateral, sartorius most medial, RF in btw
Palpate Adductor longus
Horizontal adduct at 90 degrees hip flexion
Cordlike
Palpate pectineus
lateral to adductor longus
Palpate gracilis
hip in flexion and ER, resist horizontal add, medial and posterior to longus
Palpate iliopsoas
Medial to sartorius, lateral to pectineus, resist hip flexion
Femoral triangle
Medial = adductor longus Lateral = sartorius Superiorly = inguinal lig Lateral floor = iliopsoas Medial floor = pectineus
Palpate femoral head
Supine, just superior to middle of inguinal ligament
Sidelying - place hand at inguinal lig
Extend hip and feel it move
Greater troch - what attaches here
Piriformis = internal/superior
Glut med = external/superior
Gemelli = medial on trach fossa (cant palpate)
Obt ext and int = medial on troch fossa (cant palpate)
Subtrochanteric burs
Ischial Tuberosity - what attaches here
Adductor magnus = medial
Biceps femoris = semitend/mem
Sacrotuberous lig = superior
Ischial bursa
Glut max palpate
Palpate iliac crest/running hands inf medial to find proximal attachment
Glut med palpate
hands on lateral hip btw GT and iliac crest have pt abduct Ant fibers = IR Post fibers = ER Stay in neutral
TFL Palpate
distinguish from glut med
move into slight hip flexion
Piriformis palpate
locate sacrum, GT, piriformis runs in btw
Sciatic Nerve palpate
local ischial tub and GT - at midpoint is where sciatic nerve runs
