Lower Gonio Flashcards
Steps for assessing joint ROM
1) stabilize proximal segment
2) palpate landmarks
3) align goniometer
4) have patient move through maximum ROM
5) re-palpate landmarks and read scale
Which ROM comes first? Passive or active?
Active. Passive only if cannot due to injury/dysfunction
When assessing PASSIVE ROM, what is felt?
End feel
What does end-feel provide info on?
information on quality of resistance at end of ROM
What are 4 typical end feels?
Bony, capsular, muscular, soft tissue
Name 3 abnormal end feels?
Empty, springy, muscle spasm
Give an example of a bony/ hard end feel
Elbow extension
Give an example of a capsular/firm end feel
Elbow supination
Give an example of a muscular/firm end feel
Dorsiflexion with knee extension
Give an example of soft tissue end feel?
Elbow Flexion
Give an example of empty end feel?
Injury induced protective response
Give an example of a springy end feel?
Rebound at extreme of possible ROM due to injury
Hip Flexion
Position? SA? Fulcrum? MA Normative values?
120, supine
Knee bent on bed.
SA= midline of pelvis/trunk Fulcrum= Greater trochanter MA= Lateral femoral condyle
Hip Abduction
Position? SA? Fulcrum? MA Normative values?
45 degrees
Put patient on bed away from you to give more room. watch patellar movement.
SA= contralateral ASIS
Fulcrum=ipsilateral ASIS
MA=midline of patella
Hip adduction
return from abduction
Hip Extension
Position? SA? Fulcrum? MA Normative values?
0-15 degrees
Prone
SA= midline trunk pelvis Fulcrum= Greater Trochanter MA= lateral femoral epicondyle
Hip External Rotation
Position? SA? Fulcrum? MA Normative values?
0-45 degrees
Prone, with cloth under knee to raise.
SA= perpendicular to floor Fulcrum= midpoint of patella MA= Anterior tibial crest
Hip Internal Rotation
Position? SA? Fulcrum? MA Normative values?
0-45 degrees
Prone, cloth under knee
SA= Perpendicular to floor Fulcrum= Midpoint of patella MA= Anterior tibial crest
What muscle mainly causes lumbar lordosis?
Psoas Major ; flex opposite leg to alleviate tight iliopsoas.
Always write reading as a what?
Range EX: 0-44
Knee Flexion
Position? SA? Fulcrum? MA Normative values?
Supine, 135 degrees
If hyperextension is present, needs to be measured.
SA=Greater trochanter
Fulcrum= Lateral Epicondyle of Femur
MA= Lateral malleolus
Knee extension
Return from flexion
Knee hyper extension
Have the cloth under achilles and see if you can align to 0
Dorsiflexion with knee extended PRONE
Position? SA? Fulcrum? MA Normative values?
Prone with feet off of the table. Pointed down 0-10 degrees.
SA= Fibular head , midline of fibula Fulcrum= Lies where it may MA= Along midline of 5th metatarsal
Dorsiflexion with knee flexed PRONE
Position? SA? Fulcrum? MA Normative values?
Prone with leg bent at 90 degree angle 15-20 due to relaxation of gastroc and soleus
SA= fibular head , midline of fibula Fulcrum= Lies where it may MA= Midline of 5th metatarsal
Dorsiflexion with knee flexed SUPINE
Position? SA? Fulcrum? MA Normative values?
0-20 supine, with pillow under knee and feet off bed.
SA= fibular head
Fulcrum=Lies where it may
MA= midline of 5th metatarsal
Plantarflexion supine
Position? SA? Fulcrum? MA Normative values?
0-50 degrees supine feet off bed and pillow under ankle
SA= Midline of fibula, fibular head
Fulcrum=Lies where it may
MA= midline of 5th metatarsal
Watch out for what in dorsiflexion?
Eversion
Foot inversion
Position? SA? Fulcrum? MA Normative values?
0-35 degrees, sitting off bed or longsitting with pillow under knees
SA= Midline of tibial crest Fulcrum= Talocrural joint midway between lateral and medial malleolus MA= Along the 2nd metatarsal
How much more inversion than eversion?
x2
Foot eversion
Position? SA? Fulcrum? MA Normative values?
0-15 degrees
Sitting off bed or longsitting with pillow under knees
SA= Midline of tibial crest Fulcrum= Talocrural joint between malleoli MA= 2nd metatarsal midline
First MTP Extension
Position? SA? Fulcrum? MA Normative values?
0-90 degrees , longsitting with pillow under knees
SA= midline of first metatarsal
Fulcrum=First MTP joint
MA=Midline of proximal phalanx of big toe
First MTP flexion
Position? SA? Fulcrum? MA Normative values?
0-30 degrees, longsitting with pillow under knees
SA=midline of first metatarsal
Fulcrum= 1st MTP
MA= midline of proximal phalanx of big toe
