Lower Extremities

Question 1

Hip (planes and angles)

Answer 1

Flexion 115
Extension 0
Hyperextension 30
Adduction 30
Abduction 50
Internal Rotation 30
External Rotation 50

Question 2

Knee (planes and angles)

Answer 2

Flexion 135
Extension 0
Hyperextension 10

Question 3

Ankle (planes and angles)

Answer 3

Plantar flexion 50
Dorsiflexion 20
Inversion 30
Eversion 20

Question 4

Foot/Toe (planes and angles)

Answer 4

Flexion 30
Extension 0
Hyperextension 50

Question 5

Patellar reflex

Answer 5

L2, L3, L4

Question 6

Achilles reflex

Answer 6

S1 and S2

Question 7

Clonus

Answer 7

Partially flex pt’s knee, dorsiflex foot, maintain flexion. Presence of oscillations indicate upper motor neuron disease.

Question 8

Thompson or Simmonds test

Answer 8

Tests for achilles tendon rupture
feet hang off edge of table, squeeze calf
- no movement=(+) test/ruptured tendon

Question 9

Patellar ballottement

Answer 9

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

Question 10

Anterior/posterior drawer sign

Answer 10

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

Question 11

True/apparent leg length

Answer 11

True: Measure from anterior superior iliac spine to medial malleoli
Apparent: measure from umbilicus to medial malleoli

Question 12

Homan sign

Answer 12

Test for DVT
forcibly dorsiflex foot at ankle
Pain = positive Homan

Question 13

Ortolani/Barlow test

Answer 13

Test for congenital dislocation of the hip in infants
flex thigh and hear a click to indicate dislocation
AB-duction: Ortolani
AD-duction: Barlow

Question 14

Patellar bulge sign

Answer 14

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

Question 15

Apprehension test

Answer 15

Test patellar joint stability/potential for dislocation
Supine w/relaxed quads
Place digital pressure on medial border of patella to try to dislocate laterally

Question 16

McMurray test

Answer 16

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

Question 17

Apley distraction/grinding test

Answer 17

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

Question 18

Patellofemoral grinding test

Answer 18

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

Question 19

Varus/valgus stress

Answer 19

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

Question 20

Genu varum

Answer 20

Bowed legs
Knees angle outward
“Var is de pig?!”

Question 21

Hammer toe

Answer 21

Hyperextension of metatarsophalangeal and distal interphalangeal joint and flexion of interphalangeal joint
Usually involves the second toe

Question 22

Genu valgum

Answer 22

Knock knees

Knees angle inward

Question 23

Pes planus

Answer 23

Flat feet
Arch remains flat even without bearing weight
Loss of medial longitudinal arch

Question 24

Genu recurvatum

Answer 24

Back knee

Excessive hyperextension of knee with weight bearing

Question 25

Hallux valgus

Answer 25

Lateral deviation of great toe

Causes big toe to overlap second toe

Question 26

Claw toe

Answer 26

Hyperextension of metatarsophalangeal joints and flexion of proximal and distal interphalangeal joints
Usually involves all toes

Question 27

Pes cavus

Answer 27

Abnormally high arch

Question 28

Morton’s neuroma

Answer 28

Chronic irritation around the nerve that leads to fibrosis
Creates foot pain
Usually between 3rd and 4th or 4th and 5th

Question 29

Apley Compression Test/Grinding Test

Answer 29

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