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PT Exam > Hip / Knee ROM & MMT > Flashcards

Hip / Knee ROM & MMT Flashcards

1
Q

what is the official name of the hip joint?

A

iliofemoral joint

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2
Q

how many degrees of freedom does the iliofemoral joint have? what motions

A

3 - frontal, transverse, and sagittal
ab/add, IR/ER, flex/ext

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3
Q

what motion does positioning have a significant effect on when testing the hip?

A

ER
better to do it sitting than laying down. Sitting locks the pelvis

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4
Q

what directly effects hip flexion?

A

BMI / Pregnancy
“belly size”
limits sagittal plane motion

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5
Q

mean hip range of flexion is

A

120°

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6
Q

what is the position of hip flexion ROM

A

supine with knees extended
hips in neutral ab/add and rotation

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7
Q

what is the testing motion of hip flexion ROM?

A

lift thigh off table directing patient’s knee toward their head
passive knee flexion is allowed
maintain neutral rotation/abduction

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8
Q

normal end feel of hip flexion?

A

soft

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9
Q

goniometer positions for hip flexion

A

axis - greater trochanter
SA - lateral midline of pelvis
MA - femur aimed at lateral epicondyle

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10
Q

how is the pelvis stabilized during hip flexion/extension rom

A

keep other leg flat on the table to prevent posterior pelvic tilting

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11
Q

what is the mean hip extension ROM

A

20°

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12
Q

what is the testing position for hip extension

A

patient is prone
knees extended with hip in neutral ab/add and IR/ER
no pillow under head, can be under abdomen if preferred by patient

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13
Q

testing motion of hip extension ROM

A

keeping knee in full extension, thigh is raised off of the table

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14
Q

normal end feel of hip extension

A

firm

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15
Q

goniometer placement during hip extension ROM

A

axis - greater trochanter
SA - lateral midline of pelvis
MA - midline of lateral femur toward lateral epicondyle

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16
Q

what is the mean ROM for hip abduction

A

40°

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17
Q

what is the testing position for hip abduction

A

patient is supine with knee extended, everything in neutral

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18
Q

what is the testing motion for hip abduction

A

hip is abducted by sliding LE laterally
ensure lack of rotation during abduction

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19
Q

what is the normal end feel for hip abduction

A

firm

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20
Q

what is the positioning of the goniometer during abduction ROM

A

axis - over the ASIS of testing side
SA - along line extending from ASIS to ASIS
MA - anterior line of femur toward patella

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21
Q

what is a way someone could cheat during abduction ROM

A

hip hiking

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22
Q

what is the normative range of hip adduction ROM

A

20°

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23
Q

what is the testing position for hip adduction

A

patient is supine with knees extended
hip being tested should be in neutral with opposite hip in abduction (moved out of the way)

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24
Q

what is the testing motion for hip adduction

A

hip is adducted by sliding the slower extremity medially toward contralateral lower extremity

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25
Q

what is the normal end feel for hip adduction

A

FIRM

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26
Q

goniometer position for hip adduction

A

axis - over the ASIS of testing leg
SA - from one ASIS to the other ASIS
MA - anterior femur in line with the patella

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27
Q

what is the normative range of motion for hip IR?

A

45

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28
Q

what is the testing position for hip IR

A

patient seated with knees flexed to 90° and leg hanging off of table

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29
Q

what is the testing motion for hip IR

A

medially rotate hip by moving ankle/leg lateral while stabilizing distal femur.

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30
Q

what is the normal end feel of hip IR

A

Firm

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31
Q

goniometer alignment for hip IR/ER

A

axis - over anterior aspect of patella
SA - perpendicular to the floor / supporting surface
MA - anterior midline of the lower leg, pointing midway between the lateral and medial malleoli

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32
Q

what are the two joints of the knee?

A

tibiofemoral
patellofemoral

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33
Q

what are the degrees of freedom at the knee

A

flexion / extension
rotation

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34
Q

where is the greatest range of voluntary knee rotation

A

at 90° flexion

35
Q

at terminal knee extension __________ happens because _______

A

involuntary rotation due to asymmetric shape of femoral condyles

36
Q

what is the locking or screw-home mechanism

A

at end range of knee extension, motion stops at shorter lateral condyle but continues at the longer medial condyle

this must be undone in order to flex knee

37
Q

at what age does one expect to see full knee extension? why?

A

around age 2 because the individuals have not been able to walk or bear weight on the legs

38
Q

what age do flexion contractures tend to develop?

A

> 50
can be developmental to assist with balance

39
Q

how do male and female joints compare? how is this clinically important?

A

females may tend to have more laxity
hyperextension or ability to hyperextend the knee is a possible factor in increased ACL injury in female athletes

40
Q

how does BMI affect range of motion at the knee?

A

less BMI > ROM

41
Q

what is the mean value for knee flexion? extension?

A

flex - 140-150
extension - 0

42
Q

what is the testing position for knee flexion/extension

A

patient is supine with knees extended
hip in neutral
flex patients knee without hip flexing past 90°

43
Q

what can be done to test for hyperextension at the knee?

A

towel roll or support under ankle

44
Q

end feels for knee flexion/extension

A

flex - soft
ext - firm

45
Q

goniometer placement for knee flexion/extension

A

axis - lateral epicondyle
SA - lateral midline of femur aimed toward greater trochanter
MA - lateral midline of fibula aimed at lateral malleolus

46
Q

what muscles may contribute to lack of knee ROM

A

muscle length of rectus femoris and/or hamstrings

47
Q

what muscles assist in hip flexion

A

iliacus
psoas major

48
Q

gravity resisted position for flexion

A

seated with knees flexed over edge of table (allowed to hold on)
taken through passive ROM
lifted actively to highest point and pressure is applied over anterior aspect of distal thigh
stabilize pelvis at iliac crest

49
Q

gravity eliminated position for hip flexion

A

patient is sidelying on the testing side with hip extended and knee flexed
taken through passive ROM
asked to bring their knee to their chest with knee flexed

50
Q

if the patient’s hip abducts and externally rotates during active hip flexion, they are ________

A

substituting the sartorius

51
Q

if the patient’s knee extends as they attempt active knee flexion, they are ______

A

substituting rectus femoris

52
Q

if the patient has a weak trunk, what is the best way to test hip flexion?

A

having them in supine position

53
Q

what motions does the sartorius do?

A

flexion, abduction, and lateral rotation

54
Q

what is the gravity resisted position for the sartorious

A

seated with knees bent off of table
passively flexed, abducted and laterally rotated (sliding their ankle up the shin) and then actively completed, returning to their highest point
resistance is applied over anterior lateral thigh toward extension and adduction while applying pressure to ankle toward hip IR and knee extension

55
Q

gravity eliminated position for sartorious

A

patient is supine with heel of testing LE resting on anterior portion of the opposite ankle w/ legs extended
taken through passive ROM by sliding testing leg up shin of opposite leg
ask patient to reproduce motion

56
Q

what muscles produce hip extension

A

glute max
semitendinosus
semimebranosus
biceps femoris

57
Q

gravity-resisted position for hip extension

A

prone with LE extended
passively taken through ROM
ask patient to lift leg off of table without bending the knee
resistance applied over posterior aspect of distal femur toward hip flexion
stabilize posteriosuperior aspect of pelvis if needed

58
Q

gravity eliminated hip extension

A

side-lying with LE extended
move / hold uppermost limb out of the way
patient is to move leg back toward therapist while keeping the knee straight

59
Q

what muscles assist in hip abduction

A

gluteus medius/minimus

60
Q

what is the gravity resisted test for hip abduction

A

side lying with testing limb stacked upon other limb
hip in line with trunk in a neutral position
passively abducted, then actively
resistance applied over distal thigh toward adduction

61
Q

what could be a variation of hip abduction MMT?

A

a longer lever arm could be used by therapist with resistance at the ankle

62
Q

what is the gravity eliminated position for hip abduction

A

supine with knees extended and hips in neutral
patient passively abducted
told to pull their leg out to the side with toes pointing the ceiling

63
Q

what occurs if the pelvis posteriorly rotates during abduction mmt

A

tensor fascia lata may be used to substitute for weak hip abductors

64
Q

what happens if the hip externally rotates during hip abduction mmt

A

hip flexors may be used instead of hip abductors

65
Q

what muscle produces hip abduction with flexion

A

tensor fascia lata

66
Q

MMT for tensor fascia lata

A

patient in sidelying with uppermost hip being tested
hip placed in 45° flexion with neutral rotation
testing procedure similar to hip abduction

67
Q

gravity eliminated for TFL muscle

A

patient in long sitting position with hips flexed to 45
normal hip abduction

68
Q

what muscles produce hip adduction

A

adductor:
magnus
longus
brevis
Pectineus
Gracilis

69
Q

gravity resisted position for hip adduction

A

patient in sidelying with lowermost hip being tested
uppermost hip being supported
passively taken through adduction then actively
patient lifts up as high as they can, apply force at distal thigh

70
Q

gravity eliminated test for hip adduction

A

supine with nontested hip in full abduction, pelvis in neutral with knees extended
passively adducted, returned to start
actively adduct with knee toward ceiling

71
Q

if the hip posteriorly / anteriorly rotates, the ____ will be used to compensate for weak adductors

A

post - hip flexors
ant - hip extensors

72
Q

what muscles assist in hip internal rotation

A

tensor fascia lata
gluteus minimus
gluteus medius

73
Q

gravity resisted hip IR/ER MMT

A

patient seated with legs hanging off table, towel roll under the knees
patient can hold on to edge of table
hip is passively IR, then actively
resistance is applied over distal leg medially

HIP ER
same position
passively ER then active
resistance applied in a lateral direction instead

74
Q

gravity eliminated hip IR/ER

A

patient is supine with legs extended with leg that is tested in full ER
passively IR then returned
patient is asked to roll leg toward the other

opposite for ER
in full IR told to roll externally

75
Q

muscles that do ER at hip

A

piriformis
gamellus twins
obturator internus/externus
quadratus femoris

76
Q

how might a patient cheat during rotation testing

A

may lean toward testing limb to substitute for lateral hip rotation
may hike the hip or shift weight on other side to substitute medial rotation

77
Q

muscles that do knee extension

A

rectus femoris
vastus - medialis, lateralis, intermedius

78
Q

gravity resisted test for knee extension

A

seated with legs off of the table with a towel roll under tested leg thigh
allowed to hold onto table
passively then actively extended
resistance applied over anterior leg toward knee flexion

79
Q

gravity eliminated for knee extension / flexion

A

sidelying on side of tested limb
knee is flexed with hip extended
passively gone through extension
asked to straighten the knee

flexion
hip and knee extension
passively flexed
asked to bend the knee

80
Q

muscles that do hip flexion

A

biceps femoris
semitendinosus
semimembranosus

81
Q

gravity resisted knee flexion mmt

A

patient is prone with LE extended
knee passively then actively flexed
resistance applied to posterior distal leg toward extension

82
Q

how can semimembranosus/tendinosus be isolated?

A

medial rotation and flexion

83
Q

how can biceps femoris be isolated

A

lateral rotation with flexion

84
Q
A

PT Exam (12 decks)

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