Hip lab & palpations

Question 1

what should be observed at the hip in a standing position

Answer 1

if the hip is flexed, ER,
if there is decreased WB on a given side
presence of bruising or swelling

Question 2

what should be observed at the hip in supine

Answer 2

if one hip is more ER than the other

Question 3

how should hip flexion for AROM/PROM be assessed

Answer 3

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

Question 4

how should hip ADD for AROM/PROM be assessed

Answer 4

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.

Question 5

how should hip ABD for AROM/PROM be assessed

Answer 5

hold opposite ASIS and when you fee it push against you you have reached the end of ABD

Question 6

How should the plint be positioned for ABD of the hip, what happens if it isnt in this proper position

Answer 6

should be sufficiently high to avoid combined motion of abd and flexion

Question 7

how should IR of hip be assessed for AROM/PROM

Answer 7

Flex the hip at 90 degrees, knee flexed at 90 degrees and IR (foot out)

Question 8

what should we be careful to when IR/ER the hip of the

Answer 8

to avoid hip abd/add

Question 9

how should we assess ER of the hip in AROM/PROM

Answer 9

supine

flex the hip and knee at 90 degrees and ER rotate the hip (foot in)

Question 10

how should we assess extension of the hip for AROM/PROM

Answer 10

In prone,

palpate the sacrum and the lumbar spine and when it begins to move we have reached the end of hip extension

Question 11

how to assess for risom of the hip in flexion, extension, IR and ER

Answer 11

the pt will be in supine position with the hip flexed at 90 degrees and will resist the mvmts applied on the femur

Question 12

how to assess for risom of the hip in ABD

Answer 12

pt leg is straight and force is applied inwards

Question 13

how to assess for risom of the hip in ADD

Answer 13

pt leg is straight and force is applied outwards

Question 14

how to palpate for the greater trochanter

Answer 14

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

Question 15

how to palpate for ischial tuberosity. what may you feel attach to this boney landmark?

Answer 15

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

Question 16

how to palpate for glute max

Answer 16

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

Question 17

where does glute max insert?

Answer 17

on gluteal tuberosity

Question 18

how to palpate for the hamstring muscles

Answer 18

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

Question 19

how should the pt be positionned in order to palpate quad muscles

Answer 19

pt in supine with a roll under the knee

Question 20

how to palpate for rectus femoris

Answer 20

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

Question 21

how to palpate for AIIS

Answer 21

Have the pt in supine and the the hip, locate ASIS and slide inferomedially by around 1 inch, palpate deep to overlying tendons

Question 22

how to palpate for vastus medialis

Answer 22

ask the pt to fully contract the quad ms, by fully extending the knee
palpate medial and proximally to the patella

Question 23

how to palpate for vastus lateralis

Answer 23

have the pt sidelying and ask them to extend/flex the knee

palpate on either side of the IT band along the entire length

Question 24

what are the 5 muscles that form the adductor muscles of the hip

Answer 24

pectinus
adductor longus
adductor brevis
gracilis
adductor magnus

Question 25

how do we palpate for the adductors of the hip

Answer 25

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

Question 26

how to palpate for tensor fascia latae

Answer 26

in supine locate ASIS and place hand posteriorly and distally and ask pt to medially rotate the hip

Question 27

how to palpate for sartorius

Answer 27

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

Question 28

how to palpate for glute medius and minimus

Answer 28

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

Question 29

how to palpate for IT band

Answer 29

pt is sidelying and palpate from distal to proximal while rolling fingers horizontally across the fibers
pt is asked to abduct