Lower Extremity Flashcards
Complete this equation:
Legs = ________ + ________
Legs = strength + mobility!
Legs are support base for many functional activities and they need to support our entire body weight
Name four basic reasons why the LE’s are important
- they are a strong support base for many activities/a set of pillars for standing
- locomotor movement is important to daily function (when walking, one leg supports all body weight while other leg swings forward to walk forward)
- LE’s are involved in daily activities (i.e. sitting, toileting, getting out of bed, up/down stairs etc.)
- sole of foot is our point of contact with the ground (to sense texture/friction surface properties)
What are the three segments of the LE and what are the segments separated by?
Thigh, leg, and foot
Separated by joints
How many degrees of freedom does the hip joint have?
3 - it is a ball and socket joint
In contrast to the shoulder capsule, the capsule around the hip joint is _______ and ________
strong and dense
True or False: The capsule around the hip joint is attached to the entire periphery of the acetabulum
True
True or False: The capsule around the hip joint covers part of the femoral head and neck like a sleeve
False - it covers it ENTIRELY
True or False: The capsule around the hip joint is thickest anterior and superior
True - it’s where the most stress occurs (when walking)
True or False: The capsule around the hip joint is thinnest posterior and inferior
True (this is where hip replacements first occurred because it is not as thick)
What provides for most of the stability of the hip joint?
Ligaments
ROM of the femur is influenced by whether motion is _______ or ________
passive or active
If the knee is extended, can you flex the hip more or less?
Less - if knee is extended, hip flexion is 90 degrees
If the knee is flexed, can you flex the hip more or less?
More - if knee is flexed, hip flexion is 120-130 degrees
If the knee is flexed, can you extend the hip more or less?
Less - if knee is flexed, hip extension is decreased (due to rectus femoris)
If the knee is extended, can you extend the hip more or less?
More - if knee is extended, hip extension is 30 degrees
Name 4 different types of motion of the pelvis at the hip joint
anterior, posterior pelvic tilt
lateral pelvic tilt
pelvic rotation
When the pelvis is tilted posteriorly, the hip is ________ and the ASIS points _____
extended; up
When the pelvis is tilted anteriorly, the hip is ___________ and the ASIS points __________
flexed; down
When the pelvis is tilted laterally and hip hike occurs (adduction of hip on side of hike) it results in _____________ on opposite side
abduction
When the pelvis is tilted laterally and pelvic drop occurs (abduction of hip on either side of drop) it results in ________ on opposite side
adduction
When the pelvis rotates forward, it causes ______ rotation of the hip
Medial
When the pelvis rotates backward, it causes ________ rotation of the hip
Lateral
Name 2 functions of the hip flexor muscles
primary: mobility of the muscles to bring the LE forward
secondary: resist hip extension forces
Name the 4 primary flexor muscles and which one is the most important
- iliopsoas (most important)
- rectus femoris (strongest when flexed)
- tensor fascia lata
- sartorius
Name 2 primary hip extensor muscles and which one is the strongest
- gluteus maximus (strongest)
2. hamstrings
Name 3 primary hip adductors
- pectineus
- gracilis
- adductors: longus, brevis, magnus
Name 2 primary hip abductors
- gluteus medius
2. gluteus minimus
How many lateral/external rotator muscles are there that serve to also compress the joint?
6 (not responsible for names)
Name 2 primary hip internal rotators
- gluteus medius
2. tensor fascia lata
Name this pathology:
Pelvis drops on unsupported side because the abductors on the supported side are weak (see this when walking)
Trendelenburg’s sign
Yes or No: Are there precautions for hip replacements that take an anterior approach?
No
Name 4 precautions for hip replacements that take a posterior lateral approach or go through the capsule and lateral rotators
- no internal rotation
- no adduction across midline (bringing knees together - place pillow between legs)
- flexion less than 90 degrees
- weight bearing as tolerated or a flat foot gait
What are two functions of the knee?
- allow functional shortening/lengthening
2. mobility
Name the 2 distinct articulations in this single joint capsule
- tibiofemoral
2. patellofemoral
What kind of joint is the tibiofemoral joint and how many degrees of freedom does it have?
double condyloid and 2 degrees of freedom
Varus (adduction) and valgus (abduction) movements are prevented by these 2 ligaments
MCL and LCL
Anterior or posterior displacement of tibia beneath the femur is prevented these 2 ligaments
ACL and PCL
Name the 2 primary movements of the knee joint
Flexion and extension
True or False: Hip joint position can influence knee ROM
True
True or False: Knee flexion is reduced when hip is hyperextended
True
True or False: Knee flexion is increased when hip and knee are flexed with body weight on the joint
True (think like a catcher’s stance)
Name 4 two joint knee flexor muscles
- semimembranosus
- semitendinosus
- biceps femoris
- gastrocnemius
Yes or No: Is the ability to produce effective force affected by the position of the two joints muscles crosses
Yes (for example: the hamstrings are most effective at knee if the hip is flexed b/c it lengthens the hamstrings)
Which of the knee flexor muscles functions to prevent hyperextension at the knee?
gastrocnemius
What are the 4 knee extensor muscles?
Quadriceps
If you have had a knee replacement, should you mobilize immediately?
Yes! (by a continuous passive motion machine, active exercise, stretching)
Which joint provides a stable base of support with minimal energy expenditure and acts as a rigid lever for effective push off during gait?
Ankle
Which joint is flexible to absorb shock of body weight as foot hits the ground, permits foot to conform to changing terrain, and dampens the rotations imposed by proximal joints?
Ankle
The official name of the ankle joint is:
talocrural joint
What kind of joint is the ankle joint and how many degrees of freedom does it have?
synovial hinge joint with 1 degree of freedom
The ankle joint is the least congruent joint in the body
FALSE…it is a mortise joint that grips the talus like an adjustable wrench!
True or False: the structural integrity of the ankle joint is maintained throughout ROM
True
The capsule of the ankle joint is thin and weak, anteriorly and posteriorly - true or false?
True
Is the stability of the ankle joint dependent on intact ligaments - yes or no?
Yes
The lateral side of the ankle joint is stronger than the medial side - true or false?
FALSE
True or False: Dorsiflexion is more limited with knee extension
True (because of tension in the gastrocnemius)
Ankle muscles: no muscles act on only one joint - true or false?
TRUE
What are the 2 muscles involved with plantarflexion called?
- gastrocnemius
- soleus
(known as the triceps surae)
What are the 2 muscles involved with dorsiflexion called?
- tibialis anterior
2. extensor hallucis longus
With weak ________flexors, you will have loss of ROM and problems with gait
weak dorsiflexors
With weak ____________flexors, you will have excessive knee extension
weak plantarflexors
Overall, are dorsiflexors or plantarflexors weaker?
Dorsiflexors
if you have an ANTERIOR pelvic tilt, the accompanying hip joint motion and compensatory lumbar spine motion is:
hip flexion
lumbar extension
if you have a POSTERIOR pelvic tilt, the accompanying hip joint motion and compensatory lumbar spine motion is:
hip extension
lumbar flexion
if you have a LATERAL pelvic tilt (pelvic drop on left), the accompanying hip joint motion and compensatory lumbar spine motion is:
right hip adduction
right lateral flexion
if you have a LATERAL pelvic tilt (pelvic hike on left), the accompanying hip joint motion and compensatory lumbar spine motion is:
right hip abduction
left lateral flexion
if you have forward rotation in the pelvis (on left), the accompanying hip joint motion and compensatory lumbar spine motion is:
right hip medial rotation
rotation to the left
if you have backward rotation in the pelvis (on left), the accompanying hip joint motion and compensatory lumbar spine motion is:
right hip lateral rotation
rotation to the right
