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OS1 Final > Hip/Knee > Flashcards

Hip/Knee Flashcards

1
Q

Hip Landmarks

A

ASIS Iliac crest Greater trochanter Pubic tubercles PSIS Ischial Tuberosity SI Joint Inguinal ligament Femoral A. Sartorious M. Adductor longus M. Sciatic N. Femoral triangle

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2
Q

Borders of the hip

A

Superior: Inguinal L. Medial: Medial border of the Adductor Longus M. Lateral: Medial border of Sartorius M.

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3
Q

Flexors of the hip

A

Iliopsoas M. Sartorious M. Rectus Femoris M. Tensor Fascia lata/IT band

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4
Q

Extensors of the hip

A

Gluteus Maximus M. Hamstrings - Biceps Femoris M. - Semitendinosus M. - Semimembranosus M.

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5
Q

Adductors of the hip

A

Adductor Longus M

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6
Q

Abductors of the hip

A

Gluteus medius m. Tensor Fascia Lata/IT band

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7
Q

Hip Flexion ROM

A

90 deg knee extended 120-135 deg knee flexed

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8
Q

Hip Extension ROM

A

15 to 30 deg

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9
Q

Hip Internal Rotation ROM

A

30 to 40 deg

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10
Q

Hip External Rotation ROM

A

40-60 deg

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11
Q

Hip Abduction ROM

A

45-50 deg

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12
Q

Hip Adduction ROM

A

20-30 de

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13
Q

Hip Flexion muscle strength testing

A

Iliopsoas M. Femoral n (L1-2)

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14
Q

Hip Extension muscle strength testing

A

Gluteus Maximus M. Inferior gluteal N. (L5, S1, S2)

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15
Q

Hip Abduction muscle strength testing

A

Gluteus Medius M. Superior gluteal N. (L5, S1)

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16
Q

Hip Adduction muscle strength testing

A

Adductor longus M. Obturator N. (L2-4)

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17
Q

Hip Central Compartment Contents

A

Labrum Ligamentum Teres Articular surfaces

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18
Q

Central Compartment Pathology

A

Labral Tears Ligamentum teres tears Osteochondral defects Chondromalacia/osteoarthritis Congenital hip dysplasia Loose bodies

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19
Q

Hip Peripheral compartment contents

A

Femoral neck Synovial lining

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20
Q

Hip Peripheral Compartment Pathology

A

Loose bodies Impingement syndrome (CAM and Pincer types) Synovitis

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21
Q

Hip Lateral Compartment Contents

A

Gluteus Medius Gluteus Minimus Piriformis IT band Trochanteric Bursae

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22
Q

Hip Lateral Compartment Pathology

A

IT band syndrome Bursitis Rotator cuff tendinopathies (gluteus medius, gluteus minimus, piriformis)

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23
Q

Hip Anterior Compartment Contents

A

Iliopsoas insertion Iliopsoas Bursae

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24
Q

Hip Anterior Compartment Pathology

A

Psoas Tendonitis

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25
Q

Hip Flexion Osteopathic evaluation

A

Pt supine Ease of motion in hip flexion Hip flexor hypertonicity

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26
Q

Thomas Test

A
27
Q

Hip Flexion Muscle Energy

A
28
Q

Hip Extension MET Hamstring Hypertonicity

A
29
Q

Hip Extension MET Gluteus Hypertonicity

A
30
Q

HIp External Rotation MET

A
31
Q

HIp Internal Rotation MET

A
32
Q

Hip ABduction SD/ITB restriction ST, prone

A
33
Q

Hip ABduction/ITB restriction SD MET

A
34
Q

Hip ADDuction SD MET: Hypertonic Long Adductor of Lower Extremity

A
35
Q

Hip ADDuction SD Muscle Energy: Hypertonic Short Adductor of Lower Extremity

A
36
Q

Knee Landmarks

A

Medial tibial plateau

Medial femoral condyle

Adductor tubercle

Lateral tibial plateau

Lateral femoral condyle

Head of fibula

Common fibular nerve

Quadriceps M.

Patellar tendon

Patella

Prepatellar bursa

Medial meniscus

Medial collateral ligament region

Lateral meniscus

Lateral collateral ligament

Sartorius, gracillis, semintendinous, semimembranosus, and biceps femoris tendons

Popliteal fossa

Popliteal artery

Q angle

37
Q

Normal Q angle

A

15 deg

F>Male

38
Q

Knee Flexion ROM

A

145-150 deg

39
Q

Knee Extension ROM

A

0 deg

40
Q

Knee Internal Rotation ROM

A

10 deg

41
Q

Knee External Rotation ROM

A

10 deg

42
Q

Knee Extension Strength muscle

A

Quadriceps

Femoral N (L2-L4)

43
Q

Knee Flexion Strength muscle

A

Hamstrings

Sciatic N (L5-S1)

44
Q

Osteopathic Evaluation of Internal/External Rotation of the tibia on femur

A

Patient supine

Physician faces patient on side that is being tested.

Flex hip and kee to 90°. Thumbs on each side of tibial tuberosity with hands wrapped around calf. Put the lower extremity in the doctor’s upper extremity.

Induces internal rotation (medial turn) & external rotation (lateral turn) motion of the tibia on the femur.

Internal rotation dysfunction – increased internal rotation with restricted external rotation

External rotation dysfunction – increased external rotation with restricted internal rotation

45
Q

ER Tibiofemoral Somatic Dysfunction: MET

A
46
Q

IR Tibiofemoral SD MET

A
47
Q

Osteopathic Evaluation of Flexion/Extension of tibia on femur

A

Patient: Prone

Observe if knee at rest extends to 0⁰. Instruct patient to attempt to bring the knee to buttocks.

Flexed TF joint dysfunction— resists extension. Pay close attention to ROM, pt discomfort, and end-feel

Extended TF joint dysfunction—resists flexion. Pay close attention to ROM, pt discomfort, and end-feel.

48
Q

Extended Tibiofemoral SD MET

A
49
Q

Flexed Tibiofemoral SD MET

A
50
Q

Evaluation of Anteroposterior glide of tibia on femur

A

Patient: supine, knee flexed, foot flat on table, doctor at side.

Physician sits on patient’s foot anchoring it to table. Wrap both hands around the proximal tibia with thumbs in front of medial & lateral condyles, fingers in popliteal space.

Translate anterior & posterior noting ease of glide. *Note: Identical to Anterior Drawer Test but reduced force used.

Assesses restricted motion (Anterior Drawer Test assesses excessive motion).

51
Q

Evaluation of Abduction/Adduction of tibia on femur

A

Patient: supine, knee fully extended

Physician on the side of table. One hand grasps the distal femur, the other hand grasps the ankle. Create a valgus-varus stress.

ADduction dysfunction – ease of motion with valgus force, restriction to varus. (Valgus>Varus) Ease of medial translatory motion

ABduction dysfunction – ease of motion with varus force, restriction to valgus. (Varus>Valgus) Ease of lateral translatory motion

52
Q

Evaluation of proximal fibular head dysfxn

A

Patient supine, knee flexed, foot flat on table, doctor at side. (Can also do with knee fully extended) Pinch fibular head with thumb & index fingers, stabilize knee with other hand. Translate head anteriorly and posteriorly to assess gliding motion noting asymmetry between anterior and posterior glide.

Anterior fibular head dysfunction – ease of glide anterior, restricted glide posterior

Posterior fibular head dysfunction – ease of glide posterior, restricted glide anterior

*Clinical note: The common peroneal nerve is subject to compression as it courses around the fibular head by either a fibular head fracture or a somatic dysfunction.

53
Q

Posterior Fibular Head MET

A
54
Q

Anterior Fibular Head MET

A
55
Q

Knee Posterior Glide

A

As knee flexes, tibia glides posteriorly on femur

56
Q

Knee anterior glide

A

As knee extends, tibia glides anteriorly on femur

57
Q

Anterior Drawer test

A

Orthopedic: + test indicates disrupted ACL, propioceptive and/or visual anterior translation of the tibia in relation to the femur with a characteristic “mushy” or “soft” end point. In contrast to a definite “hard” end point elicited when the ACL is intact

SD: + test will have “hard” end feel, posterior drawer has a “soft” or “empty” end feel but is not >1mm slide

Associated with extension Tibiofemoral SD

58
Q

What motion leads to Anteromedial glide of tibia on femur?

A

External rotation

Lax ACL/PCL

Taut MCL/LCL

59
Q

What motion leads to posterolateral glide of tibia on femur?

A

Internal rotation

Taut ACL/PCL

Lax MCL/LCL

60
Q

Where is tenderness located in knee ER with anteromedial glide?

A

Anteromedial portion of joint line

61
Q

Where is tenderness located for knee IR with posterolateral glide?

A

Entire joint line

62
Q

Fibular head glides anteriorly with foot ____

A

Pronation: dorsiflexion, eversion, abduction

63
Q

Fibular head glides posteriorly with foot ___

A

Supination: Plantarflexion, inversion, adduction

OS1 Final (11 decks)

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