LOWER EXTREMITY EXAM

Question 1

INSPECTION

Answer 1

- evidence of local trauma
⦁	abrasions
⦁	contusions
⦁	lacerations
- landmark position
- erythema
- effusion
- atrophy
- asymmetry
- ambulation / gait
- limb length discrepancy

Question 2

6 ROM PLANES

Answer 2

⦁	flexion
⦁	extension
⦁	abduction
⦁	adduction
⦁	internal rotation
⦁	external rotation

Question 3

HIP FLEXION MUSCLES

Answer 3

⦁	anterior muscles
⦁	iliopsoas
⦁	rectus femoris
⦁	sartorius
⦁	pectineus

Question 4

HIP EXTENSION MUSCLES

Answer 4

⦁ posterior muscles
⦁ gluteus maximus
⦁ hamstrings
⦁ adductor magnus

Question 5

HIP ABDUCTION MUSCLES

Answer 5

⦁ gluteus medius
⦁ gluteus minimus
⦁ tensor fascia lata

Question 6

HIP ADDUCTION MUSCLES

Answer 6

⦁ adductor longus / brevis / magnus

⦁ gracilis, pectineus, obturator externus

Question 7

HIP INTERNAL ROTATION MUSCLES

Answer 7

⦁ gluteus medius
⦁ gluteus minimus
⦁ tensor fascia lata

Question 8

HIP EXTERNAL ROTATION MUSCLES

Answer 8

⦁	obturator externus / internus / superior / inferior
⦁	gemelli
⦁	piriformis
⦁	quadratus femorus
⦁	gluteus maximus

Question 9

FAdAxL

Answer 9

Labral injury (flex, adduct, axial load)

Question 10

FAbER

Answer 10

SI joint (flex, abduct, external rotation)

Question 11

FAIR

Answer 11

Piriformis (flex, add, IR)

Question 12

FAdIR

Answer 12

FAI (flex, add, IR)

Question 13

modified Thomas test

Answer 13

supine and pull knee to chest with other leg straight

• tests iliopsoas & quadriceps muscles

Question 14

ober’s test

Answer 14

IT band

Question 15

tests for hip flexibility

Answer 15

• Modified Thomas Test = bringing knee to chest while laying supine - tests flexibility of iliopsoas and quadriceps muscles
• Ober’s Test = patient lateral, bend superior leg and raise till knee is downward, leg is up - tests the IT band

Popliteal angle

Question 16

varus vs valgus

Answer 16

valgus = knock knees (feet apart, knees together) - tests the MCL

varus = bow legged (knees apart, feet together) - tests the LCL

Question 17

KNEE LIGAMENT ROLES

Answer 17

The medial collateral ligament (MCL) prevents the knee from buckling inwards (valgus injury)

The lateral collateral ligament (LCL) prevents the knee from buckling outwards (varus injury)

The anterior cruciate ligament (ACL) prevents the tibia from sliding forward under the femur

The posterior cruciate ligament (PCL) prevents the tibial from sliding backward under the femur

Question 18

NEUROVASCULAR ASSESSMENT - 5Ps

Answer 18

⦁	Pain
⦁	Pulse
⦁	Pallor
⦁	Paresthesias
⦁	Paralysis

Question 19

pedal pulses

Answer 19

• dorsalis pedis
• posterior tibial
• anterior tibial
• peroneal

also remember to evaluate skin color, cap refill, hair growth, temperature

**if you can’t find a pedal pulse = use DOPPLER!!

Question 20

PERONEAL NERVE
(sensation & motor function)

Answer 20

⦁ sensation = palpation of dorsal surface of foot

⦁ motor function = ability to dorsiflex ankle and toes

Question 21

TIBIAL NERVE 
(sensation & motor function)

Answer 21

⦁ sensation = plantar surface of foot

⦁ motor function = plantar flexion of ankle and toes

Question 22

Mulder’s Sign = for

Answer 22

Morton’s Neuroma

Mulder’s Sign = squeeze foot at 1st and 5th metatarsal heads. positive = symptoms or a palpable click

Question 23

anterior drawer test (ankle) = tests for

Answer 23

ATFL instability - frequently injured during inversion ankle sprain

Question 24

talar tilt test = tests for

Answer 24

tests the lateral ligaments of the ankle

shifting ankle side to side - testing for deltoid / calcaneofibular and ATFL instability

Question 25

peroneal tendon instability test

Answer 25

Place downward and medial force on the ankle and have the patient plantarflex/dorsiflex the ankle. Look for/feel for peroneal tendon subluxation over the lateral malleolus.

Question 26

homan’s test

Answer 26

for DVT; patient supine; hold on to patients thigh. grab foot and firmly/abruptly dorsiflex the foot –> deep calf pain = positive Homan’s sign

Question 27

Thompson test

Answer 27

for achilles tendon rupture;

pt prone - squeeze gastroc - normal = pt has slight plantar flexion. No response = achilles tendon not intact