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
Hip Flexion Osteopathic evaluation
Pt supine Ease of motion in hip flexion Hip flexor hypertonicity
26
Thomas Test
27
Hip Flexion Muscle Energy
28
Hip Extension MET Hamstring Hypertonicity
29
Hip Extension MET Gluteus Hypertonicity
30
HIp External Rotation MET
31
HIp Internal Rotation MET
32
Hip ABduction SD/ITB restriction ST, prone
33
Hip ABduction/ITB restriction SD MET
34
Hip ADDuction SD MET: Hypertonic Long Adductor of Lower Extremity
35
Hip ADDuction SD Muscle Energy: Hypertonic Short Adductor of Lower Extremity
36
Knee Landmarks
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
Normal Q angle
15 deg F\>Male
38
Knee Flexion ROM
145-150 deg
39
Knee Extension ROM
0 deg
40
Knee Internal Rotation ROM
10 deg
41
Knee External Rotation ROM
10 deg
42
Knee Extension Strength muscle
Quadriceps Femoral N (L2-L4)
43
Knee Flexion Strength muscle
Hamstrings Sciatic N (L5-S1)
44
Osteopathic Evaluation of Internal/External Rotation of the tibia on femur
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
ER Tibiofemoral Somatic Dysfunction: MET
46
IR Tibiofemoral SD MET
47
Osteopathic Evaluation of Flexion/Extension of tibia on femur
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
Extended Tibiofemoral SD MET
49
Flexed Tibiofemoral SD MET
50
Evaluation of Anteroposterior glide of tibia on femur
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
Evaluation of Abduction/Adduction of tibia on femur
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
Evaluation of proximal fibular head dysfxn
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
Posterior Fibular Head MET
54
Anterior Fibular Head MET
55
Knee Posterior Glide
As knee flexes, tibia glides posteriorly on femur
56
Knee anterior glide
As knee extends, tibia glides anteriorly on femur
57
Anterior Drawer test
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
What motion leads to Anteromedial glide of tibia on femur?
External rotation Lax ACL/PCL Taut MCL/LCL
59
What motion leads to posterolateral glide of tibia on femur?
Internal rotation Taut ACL/PCL Lax MCL/LCL
60
Where is tenderness located in knee ER with anteromedial glide?
Anteromedial portion of joint line
61
Where is tenderness located for knee IR with posterolateral glide?
Entire joint line
62
Fibular head glides anteriorly with foot \_\_\_\_
Pronation: dorsiflexion, eversion, abduction
63
Fibular head glides posteriorly with foot \_\_\_
Supination: Plantarflexion, inversion, adduction