LOWER LIMB

Question 1

test the movement of the hip joint

Answer 1

Ask patient to stand 
lift knee up - flex
down again - ex
adduction
abduction
circumduction

Question 2

assess the movement of the knee joint

Answer 2

ask patient to bend knee back and then bring it back to normal position (flex and exts), foot planted on ground turning knee L and R (limited rotation)

Question 3

Test movement of the ankle joint

Answer 3

ask patient to raise the toes (dorsiflexion)

and point toes (planter flexion)

Question 4

Test the movement of the talo-calcaneal joints

Answer 4

ask patient to turn sole of foot inwards (inversion) 
and outwards (eversion)

Question 5

Test movement of the metatarsal phalangeal joints

Answer 5

ask the patient to flex and extend their toes

Question 6

Test the function of the gluteus medius muscle

Answer 6

ask the patient to lie on their side on the couch and abduct their leg upwards against resistance - palpate the muscle

Trendelenburg test - ask patient to stand up straight and lift one leg - observe level of iliac crest (drooping will occur on opposite side if gluteus medius and minimus are paralysed)

Question 7

innervation of gluteus medius

Answer 7

superior gluteal nerve

Question 8

innervation of gluteus maximus

Answer 8

inferior gluteal nerve

Question 9

innervation of iliopsoas

Answer 9

femoral nerve

Question 10

action of iliopsoas

Answer 10

flexion and lateral rotation of the thigh

Question 11

innervation of quadriceps

Answer 11

femoral nerve

Question 12

what muscles make up the quadriceps group

Answer 12

vastus medialis + intermedius + lateralis + rectus femoris

Question 13

test the function of the qauds

Answer 13

ask patient to sit on the edge of the bed and extend their leg against resistance while you palpate the muscles of the thigh

Question 14

innervation of the adductors of the thigh

Answer 14

obturator nerve

Question 15

test the function of the adductors of the thigh

Answer 15

ask patient to lie down on their side - lift their leg to abducted position and ask them to adduct against resistance while you palpate their inner thigh

Question 16

innervation of the hamstrings

Answer 16

sciatic nerve

Question 17

test the function of the hamstrings

Answer 17

ask patient to lie on their front - ask them to bend their leg at the knee against resistance while you palpate the back of the thigh

Question 18

innervation of tibialis anterior

Answer 18

deep peroneal nerve

Question 19

test the function of the anterior leg compartment muscles

Answer 19

ask subject to dorsiflex the foot (lift toes up) as you resist and stabilise the ankle joint

Question 20

what is the action of the fibular compartment muscles?

Answer 20

eversion of the foot (sole outwards)

Question 21

innervation of the fibular compatment of the leg

Answer 21

peroneal nerve

Question 22

innervation of the muscles of the posterior compartment of the leg

Answer 22

tibial nerve

Question 23

test the function of the calf muscles

Answer 23

ask patient to plantar flex the foot (point toes) while sitting or lying down while you resist and palpate bellies of gastrocnemius

Question 24

nerve roots of sciatic nerve

Answer 24

L4 L5 S1 S2 S3

Question 25

surface mark the sciatic nerve

Answer 25

curve between midpoint of PSIS and ischial tuberosity --> travels down half way between ischial tuberosity and greater trochanter --> then travels in straight line to popliteal fossa

Question 26

test the motor function of the sciatic nerve

Answer 26

ask patient to flex the knee against resistance

Question 27

test the motor function of the gluteal nerve

Answer 27

ask patient to abduct their thigh against resistance

Question 28

test the motor function of the femoral nerve

Answer 28

ask patient to extend knee against resistance

Question 29

femoral nerve roots

Answer 29

L2 L3 L4

Question 30

test the motor function of the obturator nerve

Answer 30

ask patient to adduct thighs against resistance

Question 31

obturator nerve roots

Answer 31

L2 L3 L4

Question 32

test the motor function of the superficial peroneal nerve

Answer 32

ask patient to evert their foot (soles out)

Question 33

test the motor funtion of the deep peroneal nerve

Answer 33

ask patient to dorsiflex the foot

Question 34

demonstrate the dermatomes of the lower limb

Answer 34

L1 groin, L2 mid thigh, L3 knee, L4 inner leg to floor, L5 outer leg to mid foot, S1 outer foot and ankle, S2 calf and back of thigh

Question 35

test the patellar tendon reflex

Answer 35

ask patient to sit on edge of the bed - strike their patellar tendon with the hammer

Question 36

nerve root responsible for patellar reflex

Answer 36

L4

Question 37

test the achilles tendon reflex

Answer 37

ask patient to lie on their front and completely relax their legs - dorsiflex the patients foot slightly and strike the achilles tendon

Question 38

nerve root responsible for achilles tendon reflex

Answer 38

S1

Question 39

where would you feel the femoral pulse?

Answer 39

tips of finger feel at midway between ASIS and pupic symphysis

Question 40

where would you feel the popliteal pulse?

Answer 40

midline in the inferior part of the popliteal fossa while knee is flexed to relax hamstring

Question 41

palpate the dorsalis pedis pulse

Answer 41

dorsum of foot in first intermetatarsal space just lateral to extensor digitorum hallucis tendon

Question 42

palpate the posterior tibial artery pulse

Answer 42

behind and below the medial malleolus

Question 43

surface mark the long saphenous vein

Answer 43

the vein extends up the medial side of the lower limb, passing anteriorly to medial malleolus - drains into femoral vein at the femoral triangle immediately inferior to the inguinal ligament

Question 44

surface mark the short saphenous vein

Answer 44

passes posteriorly to the lateral mallelous and along lateral border of calcaneal tendon --> passes up to popliteal fossa where it drains into the popliteal vein

Question 45

define the gluteal safe area

Answer 45

superior lateral region of gluteal space - heel of hand at greater trochanter of femur - index finger at ASIS andrest of fingers along iliac crest

Question 46

boundaries of the popliteal fossa

Answer 46

``` (diamond shape) superomedially: semimembranosus Superolaterally: biceps femoris Inferomedilly: gostrocnemius (med head) Inferolaterally: gastrocnemius (lat head) ```