Lower Extremity Flashcards
what pulses should be palpated after an acute traumatic injury to the knee
posterior tibial
dorsalis pedis
what action does the rectus femoris muscle do when it contracts
flexes the hip
extends the knee
if a palpable clunk or shift is at approx 2-30 degrees of knee flexion is found during a pivot shift test what is this indicative of
anterolateral rotatory instability of the knee
a positive Thompsons sign is indicative of
ruptured Achilles tendon
what muscle flexes both the foot and the knee
gastrocnemius
following multiple ankle sprains over the course of the year, teh AT detects weakness of the invertors and evertors of the ankle, which muscles invert the ankle
tibialis posterior
flexor digitorum longus
flexor hallucis longus
a basketball players reports with burning pain on lateral aspect of his right knee during and after running, no edema or bruising found, but is tender. what special test would be positive
ober’s test
a lacrosse player is limping with assistance, and his holding his leg in slight hip and knee flexion and a bulge is in the proximal thigh. only partially able to straighten the leg and pain down anterior thigh with movement, what is wrong?
ruptured rectus femoris
what special tests detects a possible meniscal tear
McMurrays
what type of force typically causes injury to MCL, medial meniscus, and ACL
valgus force with tibia in external rotation
what is the recommended position for manual muscle testing of the gluteus medius
side-lying with affected limb on top
what is the proper method to manually muscle test the biceps femoris muscle
lying prone, resisting knee flexion with tibia in external rotation
what are structures of the pelvis
coccyx
pubic symphysis
innominate bones
sacrum
which of the following signs is tested for when DVT is suspected in the leg
Homan’s sign
a tennis player presents with medial thigh pain, limping, and pain with resisted hip adduction and hip flexion, diffuse tenderness and bruising on proximal/medial thigh, what has happened
groin strain
if the calcaneofibular ligament of the ankle is torn, which test would be positive
talar tilt test
what is the best position for the patient to be in to muscle test the piriformis
side-lying
true leg length discreptancy is measured between what 2 points
ASIS to medial malleolus
a grade 1 ankle inversion sprain involves what structure
anterior talofibular ligament
how is the strength of the pes anserinus musculature manually tested
resistance to knee flexion and hip adduction
a 2nd degree MCL sprain is characterized by
-pain along medial joint line
-no gross knee instability, but mild laxity in full knee extension during valgus test
-difficulty active flexing and extending the knee
trendelenburg test is used to evaluate the competence of what structure
hip abductors
which muscles internally rotate the hip
adductor magnus
gracilius
TFL
gluteus minimus
what special tests examines the integrity of the knee LCL
varus stress test
which test is positive of a torn PCL
sag sign
foot drop is indicative of what pathology
peroneal nerve injury
signs/symptoms of anterior compartment syndrome
-paresthesisa in web space between 1st and 2nd toes
-absence or deminished dorsalis pedis pulse
-decreased stregnth in digit extension
-decreased ankle dorsiflexion
what produces the windlass effect
extension of the toes causes the calcaneus to come forward, increases the arch
name of a high-riding patella
patella alta
what would a positive hip scoring test indicate
acetabular labral tear
osteochondral defect
how to measure hip Q angle
proximal arm is on the ASIS
axis on the midpoint of patella
distal arm on tibial tuberosity
what vascular structure is found behind the medial malleolus
posterior tibial artery
a quantitative measure of what motion can be calculated using the navicular drop test
pronation
what are true statements regarding the MCL
-2 layers (deep and superficial)
-attaches to medial meniscus
-reinforces and thickens joint capsule
what structure stabilizes the pelvic girdle
sacrum
what makes up the pelvic girdle
ilium
ischium
pubis bones
which tests are appropriate to assess tightness of the rectus femoris
Thomas test
Ely’s test
what tarsal bone is referred to as the keystone and is the main structure of the medial longitudinal arch
navicular
the relationship between the femoral head and femoral shaft in the transverse plane is known as
angle of torsion (twist)
walking on the heel to avoid push-off may indicate
metatarsal fracture
plantar fascitis
great toe pathology
which describes the hips having an angle of torsion greater than 20 degrees
anteverted
the ankle must be in what position to palpate the dome of the talus
plantarflexion
a decrease in the angle of inclination may lead to observation of what knee pathology
squinting patella
edema following a lateral ankle sprain tends to pool in the area of
sinus tarsi
deformity which involves the 1st metatarsal being shorter than the 2nd
Morton’s toe
the pelvis is formed by pairs of 3 fused bones and jointed anteriorly by what
pubic symphysis
the best diagnostic accuracy is achieved with a high rate of what
true positives
true negatives
in the presence of an ACL rupture, the recommendation is surgery to reconstruct the ACL. which are long-term consequences of an ACL-deficient knee
knee instability
osteoarthritis
meniscal degeneration
at what point does the AT’s initial evaluation of an injury begin
the moment the injury is witnessed
what joints is called the Lisfranc joints
tarsometatarsal
where is pain centralized for plantar fascitis
medial calcaneal tubercle
what structures are in the deep posterior compartment
tibialis posterior
flexor digitorum longus
flexor hallucis longus
which foot posture does the rearfoot become hypermobile, resulting in increased pronation
rearfoot valgus
what structure on the calcanues provides inferior support to the talus and below the medial malleoulus
sustentaculum tali
what portion of the tibialis posterior is most palpable
tendon from medial malleolus to insertion
which bone is most lateral bone of the midfoot
cuboid
what MOI typically causes injury to ATFL
inversion
what ankle joints are involved in pronation and supination
talocrural
subtalar
midtarsal
what motions occurs in closed-chain supination of the ankle
external tibia rotation
knee extension
external hip rotation
proper way to determine a Kleiger test
foot and talus are externally rotated and stabilizes the leg
what accounts for higher incidence of inversion ankle sprains
deltoid ligament of the medial side is strong causing less eversion
what makes up the midfoot
navicular, 3 cuneiforms, and cuboids
injury to the deep peroneal nerve occurs in which compartment
anterior
unexplained redness and swelling of posterior calf may indicate
DVT
what can be palpated directly posterior to fibular head
common peroneal nerve
what of the foot is responsible for assisiting in absorbing and redirecting WB forces, reducing friction, and protect its tendon
sesmoids
signs/symptoms of anterior compartment syndrome
severe pain
loss of motor function
paresthesia
individual cannot resist gravity in resisted position but can complete movement in gravity assisted position, what is the score
2/5
patient reports redness, swelling, and pain of great toe with no MOI. pain with palaption, no increase pain with ROM, what is it
gout
(obesity, weight gain, alcohol, impaired renal fxn)
bony landmarks of the calcaneus
sustentaculum tali, peroneal tubercle, and calcaneal tubercle
functions of the fibula
-site of ligamentous attachment
-muscular origin and attachment
-pulley to increase muscle efficiency that run posteriorly to it
muscles of the pes anerinus group
gracilis
sartorius
semitendinosus
which test is the best to detect an ACL sprain
Lachman’s
what can occur post ACL surgery
loss of knee extension
what injury typically occurs with repetitive jumping, running, or weightlifting
patellar tendinitis
patella is high-riding and sitting laterally
frog-eyed patella
what position should the knee be placed in the anterior drawer test of the knee
90 degrees knee flexion
roles of the menisci
-shock absorption
-improve lubrication
-deepen atriculation and fill in the gaps
best test for assessing a meniscal lesion
Thessaly
valgus and varus of the knee should be performed at what degree of angle
0 degrees
origin and insertion of the sartorius
origin: ASIS
insertion: pes anserine tendon
indicated by a ballottable patella
knee effusion
what is most reliable in determining who will have patellofemoral pain
levels of ASIS
a straight isolated valgus force injures what ligament
MCL
what would be most difficult if PCL was injured
backward running
best describes the J-sign
as the knee moves from flexion to extension, the patella slides superiorly and tracks slightly laterally
conclusive special test for determining both the presence and absence of the PCL
posterior drawer
anterolateral rotary instability is characterized by
subluxation of the lateral tibial plateau with anterior translation
what bony landmark does the patella glide thru as knee flexes and extends
femoral trochlea
what muscle is responsible for unscrewing or unlocking the tibia
popliteus
injury to the common peroneal nerve would elicit motor weakness in which muscle
dorsiflexors
evertors
observations of alignment relative to patellofemoral disorder includes
Q-angle
tibial torsion
patellar alignment
what bursa lies at the deep end of the quad femoris group and is extension of the knees joint capsule
suprapatellar bursa
AROM knee flexion is how many degrees
135 degrees
end-feel of passive knee extension
firm
lateral pivot shift maneuver identifies which rotary instability
anterolateral
a sprain to the hip joint results from which movements
abduction and lateral rotation
hip angle of torsion greater than 20 degrees
anterversion
Y-shaped ligament of the hip that originates from AIIS
illiofemoral
what blood supply supplies the femoral head and neck
femoral circumflex arteries
decrease angle of inclination
coxa vara
Legg-Calve-Perthes diseased affects what age range
2-14
primary complaint of early stages of articular degeneration of the hip
pain only with WB activities
Ober’s test examines tightness of which muscle
TFL
MOI for acute hip labral tear
hip dislocation
osteitis pubis results from overuse and repetitie stress on which muscle group
adductors
when the hip joint dislocates, the leg is typically shortened in what position
medial rotation
the special tests associated with exam of the SI joint reproduce what forces
compression
distraction
shearing
test used to examine flexibility of hip flexors
Thomas test
coxa valga in which the angle of the femoral shaft and neck is
greater than 135
pain characteristic associated with unstable slipped capital femoral epiphysis
pain that prevents walking
what muscle compresses the sciatic nerve
piriformis
normal angle of inclincation of the hip
125 degrees
during what type of muscle contractions do muscle strains most frequently occurs
eccentric
name of the ligament that originates off of the ASIS and inserts at pubic symphysis
inguinal ligament
which muscle is the primary hip flexor with the knee extended
iliopsoas
borders of the femoral triange
lateral: sartorius
superior: inguinal ligaments
medial: adductor longus
-femoral artery, vein, and nerve lie within
what vascular structure would you palpate if you suspect a serious hip or pelvic injury
femoral artery
possible complication of a lateral ankle sprain
superficial peroneal nerve palsy
which MOI typically cause injury to the anterior talofibular ligament (ATFL)
inversion
signs and symptoms of anterior compartment syndrome
-severe pain
-loss of motor function over the distribution of the deep peroneal nerve
-parasthesia
most ankle sprains occurs when the ankle if forced into what positions
inversion
plantarflexion
what special test examines a syndesmosis separation and the integrity of the ATF ligament
Kleiger test
an athlete with rearfoot varus is likely to develop what chronic injury
medial tibial stress syndrome
which tests are used to examine the integrity of the calcaneofibular and deltoid ligaments
talar tilt test
what anatomical feature likely accounts for the higher incidence of inversion sprain in the ankle joint
deltoid ligament on the medial side is strongs, causing fewer eversion sprains
if an acute compartment syndrome is not accurately recognized, muscle ischemia, and necrosis can occur within
6-12 hours
