Hip lab & palpations Flashcards
what should be observed at the hip in a standing position
if the hip is flexed, ER,
if there is decreased WB on a given side
presence of bruising or swelling
what should be observed at the hip in supine
if one hip is more ER than the other
how should hip flexion for AROM/PROM be assessed
in a supine position
palpate the PSIS and sacrum with one hand , and end of hip flexion is achieved when you feel the pelvis start to move in that hand
how should hip ADD for AROM/PROM be assessed
in supine
move the opposite leg in a slight ABD and then take the given leg in ADD palpating ASIS on the same side
once you feel ASIS start to move you are at the end of add.
how should hip ABD for AROM/PROM be assessed
hold opposite ASIS and when you fee it push against you you have reached the end of ABD
How should the plint be positioned for ABD of the hip, what happens if it isnt in this proper position
should be sufficiently high to avoid combined motion of abd and flexion
how should IR of hip be assessed for AROM/PROM
Flex the hip at 90 degrees, knee flexed at 90 degrees and IR (foot out)
what should we be careful to when IR/ER the hip of the
to avoid hip abd/add
how should we assess ER of the hip in AROM/PROM
supine
flex the hip and knee at 90 degrees and ER rotate the hip (foot in)
how should we assess extension of the hip for AROM/PROM
In prone,
palpate the sacrum and the lumbar spine and when it begins to move we have reached the end of hip extension
how to assess for risom of the hip in flexion, extension, IR and ER
the pt will be in supine position with the hip flexed at 90 degrees and will resist the mvmts applied on the femur
how to assess for risom of the hip in ABD
pt leg is straight and force is applied inwards
how to assess for risom of the hip in ADD
pt leg is straight and force is applied outwards
how to palpate for the greater trochanter
have pt in prone and locate the middle of the iliac crest, slide finger pads distally about 4-5 inches along the side of the thigh where you should feel a significant hump
how to palpate for ischial tuberosity. what may you feel attach to this boney landmark?
have the pt in prone and locate the gluteal fold, place fingers along the center of the fold and press superiorly and medially until finger hit a large bump
could feel hamstring tendon attach to it
how to palpate for glute max
have the pt in prone
ask pt to extend the hip with knee extended and then with knee flexed
there should be greater glute activation and less hamstring when knee is flexed
where does glute max insert?
on gluteal tuberosity
how to palpate for the hamstring muscles
have the pt in prone and begin at the ischial tuberosity.
ask pt to flex the knee w/ foot off of the table.
follow biceps femoris laterally to the head of the fibula
semi-membranosus and semitendinosus should be followed medially. the tendon of ST will be more superfiscial, it can be followed to pes anserine to the anterior medial tibia
how should the pt be positionned in order to palpate quad muscles
pt in supine with a roll under the knee
how to palpate for rectus femoris
locate the patella w/ one hand, and AIIS w/ other hand and connect both with an imaginary line
ask pt to extend knee and flex the hip
how to palpate for AIIS
Have the pt in supine and the the hip, locate ASIS and slide inferomedially by around 1 inch, palpate deep to overlying tendons
how to palpate for vastus medialis
ask the pt to fully contract the quad ms, by fully extending the knee
palpate medial and proximally to the patella
how to palpate for vastus lateralis
have the pt sidelying and ask them to extend/flex the knee
palpate on either side of the IT band along the entire length
what are the 5 muscles that form the adductor muscles of the hip
pectinus adductor longus adductor brevis gracilis adductor magnus
how do we palpate for the adductors of the hip
palpated as a group
the pt is in supine with a rool uinder the knee and the hip slightly flexed and ER
when the pt is wearing shorts, ask them to tuck a towel along their short on the medial side of their leg and roll it up to exposed the muscles
place hand on the medial thigh and ask pt to adduct against resistance, palpate both proximally and distally
how to palpate for tensor fascia latae
in supine locate ASIS and place hand posteriorly and distally and ask pt to medially rotate the hip
how to palpate for sartorius
the pt is in supine and asked to rest their foot on their opposite knee with the hip flexed and ER
pt is asked to raise knee to the ceiling
follow the muscle body from ASIS to pes anserine
how to palpate for glute medius and minimus
the pt is sidelying with one hand on the ms belly (illiac crest between PSIS and ASIS) and the other on the greater trochanter
pt is asked to slightly abduct the hip
how to palpate for IT band
pt is sidelying and palpate from distal to proximal while rolling fingers horizontally across the fibers
pt is asked to abduct
