Lower Extremities Flashcards
Hip (planes and angles)
Flexion 115 Extension 0 Hyperextension 30 Adduction 30 Abduction 50 Internal Rotation 30 External Rotation 50
Knee (planes and angles)
Flexion 135
Extension 0
Hyperextension 10
Ankle (planes and angles)
Plantar flexion 50
Dorsiflexion 20
Inversion 30
Eversion 20
Foot/Toe (planes and angles)
Flexion 30
Extension 0
Hyperextension 50
Patellar reflex
L2, L3, L4
Achilles reflex
S1 and S2
Clonus
Partially flex pt’s knee, dorsiflex foot, maintain flexion. Presence of oscillations indicate upper motor neuron disease.
Thompson or Simmonds test
Tests for achilles tendon rupture
feet hang off edge of table, squeeze calf
- no movement=(+) test/ruptured tendon
Patellar ballottement
Test for major effusion
With knee extended, push patella into trochlear groove and quickly release
Fluid displaced to sides of joint, patellar rebound = ballotable patella
Anterior/posterior drawer sign
Test for ACL (anterior) and PCL (posterior)
Knee bent at 90degrees w/ foot flat on table (sit on foot)
Cup knee w/ thumbs on medial/lateral joint lines
Pull/push tibia
True/apparent leg length
True: Measure from anterior superior iliac spine to medial malleoli
Apparent: measure from umbilicus to medial malleoli
Homan sign
Test for DVT
forcibly dorsiflex foot at ankle
Pain = positive Homan
Ortolani/Barlow test
Test for congenital dislocation of the hip in infants
flex thigh and hear a click to indicate dislocation
AB-duction: Ortolani
AD-duction: Barlow
Patellar bulge sign
Test for joint effusion
Leg extended/relaxed, press patella into trochlear groove and quickly release
If there is fluid under joint, it is forced to the sides
Apprehension test
Test patellar joint stability/potential for dislocation
Supine w/relaxed quads
Place digital pressure on medial border of patella to try to dislocate laterally
McMurray test
Test medial and lateral meniscus
Pt supine, hand on knee and ankle and passively bend knee to 90 degrees
Medial: apply external rotation to ankle and push internal rotation of knee with extension - click/pop/pain indicates tear
LateraL apply internal rotation to ankle and push external rotation of knee with extension - click/pop/ pain indicates tear
Apley distraction/grinding test
Test for ligament damage
Pt prone with leg bent 90 degrees at knee
Secure thigh to table and pull up and twist on foot to apply pressures to knee
Pain=ligament damage
Patellofemoral grinding test
Pt supine w/legs extended/relaxed
Push patella distally into trochlear groove
Have pt tighten quads and palpate/resist patella as it moves under fingers
Palpate for smoothness vs roughness or crepitation
Pain=positive test
Varus/valgus stress
Pt supine w/ one leg flexed slightly; hold ankle and knee of leg
Valus: apply pressure medially against knee and laterally against ankle - tests MCL
Varus: apply lateral pressure against knee and medial pressure against ankle - test LCL
Genu varum
Bowed legs
Knees angle outward
“Var is de pig?!”
Hammer toe
Hyperextension of metatarsophalangeal and distal interphalangeal joint and flexion of interphalangeal joint
Usually involves the second toe
Genu valgum
Knock knees
Knees angle inward
Pes planus
Flat feet
Arch remains flat even without bearing weight
Loss of medial longitudinal arch
Genu recurvatum
Back knee
Excessive hyperextension of knee with weight bearing
Hallux valgus
Lateral deviation of great toe
Causes big toe to overlap second toe
Claw toe
Hyperextension of metatarsophalangeal joints and flexion of proximal and distal interphalangeal joints
Usually involves all toes
Pes cavus
Abnormally high arch
Morton’s neuroma
Chronic irritation around the nerve that leads to fibrosis
Creates foot pain
Usually between 3rd and 4th or 4th and 5th
Apley Compression Test/Grinding Test
Test for meniscus damage
Pt prone with leg bent 90 degrees at knee
Secure thigh to table and push down and twist on foot to apply pressures to knee
Pain=meniscus damage
