Hip_Knee_Ramey

Question 1

Gliding motion

Answer 1

Anterior glide: during ext rotation

Posterior glide: during in rotation

Question 2

Hip flexors

Answer 2

Psoas major, iliacus, pectineus, rectus femoris, sartorius

Question 3

Psoas major

Answer 3

O: TV12-LV5, and IV discs, and TPs of LV1-5
I: lesser trochanter of femur
A: Hip flexion (common associated with LBP, hip problems, limited extension)
N: L 1,2,3
Pain can be referred to ant hip or thigh

Question 4

Gluteus maximus

Answer 4

O: Widespread, ilium, sacrum, coccyx, sacrotuberous lig, fasica of gmed 
I:IT tract of fascia latae 
A: Extension 
N: L5 and S1, S2 (inf gluteal n.) 
May be weakened after prolonged sitting 
Tightness limits flexion

Question 5

adductor tightness

Answer 5

associated with inferior pubic symphysis SD

frequently seen with groin pulls

Question 6

Piriformis

Answer 6

Inserts onto the greater trochanter
A: external rotator
innervated by S1 and S2

tightness decreases IR and may irritate sciatic n.

Question 7

acetabular tear

Answer 7

ssx: sharp, deep pain in the anterior thigh/groin
worse from seated to standing, may also “click” with motion
do not respond to conservative tx
imaged w/ MRI

Question 8

intraarticular hip problems

Answer 8

(i.e. hip fx or degenerative joint disease) the first motion that is lost tends to be Internal rotation

Question 9

Screw home mechanism of the knee

Answer 9

allows the LE to function as a solid column

when knee is fully extended the knee passively locks due to medial rotation of femoral condyles on the tibial plateau

Question 10

gliding motions of the knee

Answer 10

anterior/posterior
medial/lateral
IR w/ posteriorlateral
ER w/ anteriormedial

restrictions in gliding—>SD

Question 11

Grading knee ligament tears

Answer 11

grade 1-2 treat conservatively w/ OMM and rehab

grade 3=complete=surgery

Question 12

Menisci repair/healing

Answer 12

outer 1/3=vascular=heals well
Inner 1/3=avascular=less likely to heal
provide proprioception
Generally observe joint locking, BUT NOT ALWAYS (more subtle tears do not)

Question 13

Menisci dx

Answer 13

• lateral joint line tenderness or palpable tissue texture changes=Lateral tear
• medial joint line tenderness or TTC=medial tear
• tenderness in popliteal fossa=tear to posterior horn of either menisci

Question 14

Unholy triad

Answer 14

tear of ACL, MCL, Medial meniscus

Question 15

Biceps femoris

Answer 15

o: Ischial tuberosity
I:fibular head, LCL, lateral condyle of tibia
A: flexor
N: L5, S1, S2 (sciatic n. )
SD is associated with posterior knee pain

Question 16

Rectus femoris

Answer 16

O: AIIS, above acetabulum
I: base of patella, patellar tendon, tibial tuberosity
A: knee ext
I: L2, L3, L4

Question 17

proximal tibiofibular joint

Answer 17

anterior/lateral and posterior/medial glide of the fibular head

moves opposite to the fibular head
inversion sprains**

associated with lateral knee pain
common fibular n. rungs posterior to head–>foot drop

Question 18

sympathetic tone to the lower extremity

Answer 18

SD to thoracolumbar junction (T10-L3)—>inc SNS tone to LE–>dec lymphatic drainage

can cause swelling and impaired function/recovery

Question 19

Lateral trochanter TP

Answer 19

Location: lateral aspect of greater trochanter
pt is supine or prone
abduc and slightly flex
involves the IT band

Question 20

medial meniscus TP

Answer 20

Location: medial aspect of knee along jt line
pt is supine
knee flexed, abduction/adduction and IR/ER of thigh as needed
involves pes anserinus muscles and possibly the MCL

Question 21

Lateral meniscus TP

Answer 21

Lateral aspect of knee along joint line
pt is supine
slight knee flexion, slight abduction of the thigh and ER of tibia
IT band and LCL

Question 22

PCL TP

Answer 22

midline in popliteal fossa
supine with pillow under proximal tibia
posterior pressure on distal femur
biceps femoris, PCL

Question 23

ACL TP

Answer 23

distal aspect of teh Biceps femoris b/l
supine with pillow under distal femur
posterior pressure on proximal tibia
biceps femoris ACL