Lower Limb Study Guide Flashcards
What is the Hip Flexion ROM?
N: 0-120
What is the Hip Extension ROM?
N: 0-20
What is the Hip ABduction ROM?
N: 0-45
What is the Hip ADduction ROM?
N:0-20
What is the Hip Int Rotation ROM?
N: 0-45
What is the Hip Ext Rotation ROM?
N: 0-45
What is the Knee Flex ROM?
N: 0-135
What is the Knee Ext ROM?
N: 135-0
What is the PF ROM?
N: 0-45
What is the DF ROM?
N: 0-30
What is the Eversion ROM?
N: 0-20
What is the Inversion ROM?
N: 0-35
How to assess FIRST RAY MOBILITY?
Subtalar neutral, hold 1st MTH with one hand, 2nd-5th with the other and plantar/dorsal translate (move up and down), should be equal.
How do you perform a subtalar neutral non weight bearing assessment?
Patient prone on table with feet hanging off. Use hand on medial side foot to palpate medial and lateral horns of talus. use other hand pronate and supinate foot (at 90 degrees)by pushing 4th/5th MTH until both horns are felt equally. mark calcaneus and distal 1/3 of leg
How do you perform a resting calcaneal stance and tib/fib alignment?
Have patient stand with no shoes or socks, have them walk in
place for about 5 steps, patient stand normal and evaluate tib/fib alignment vs. calcaneus using the marks
previously used on our non-wb foot and ankle assessment
How do you perform a Leg length discrepancy test?
Patient lay supine, perform 3 pelvic thrust, then measure from ASIS to distal tip of
medial malleolus
How do you perform a Coleman block test?
Test varus (lateral edge of foot with 4/5th met heads on block)/valgus (place 1st
-3 met
heads on block), put block medial or lateral, shows flexibility or rigidity. (if goes neutral then shows
flexible)
What is the definition of a MMT of 1/5?
Trace: Unable to produce active motion but muscle contraction can be palpated or visualized by the
examiner
What is the definition of a MMT of 2/5?
Poor: Full ROM in a gravity-eliminated position or partial ROM against gravity
What is the definition of a MMT of 3/5?
Fair: Pt can perform full ROM against gravity but not with extra resistance. (threshold of functional
strength)
What is the definition of a MMT of 4/5?
Good: Pt can perform full ROM against gravity plus extra resistance but fails the break test
What is the definition of a MMT of 5/5?
Normal: pt can perform full ROM against gravity plus extra resistance and passes a “break test”
How do you perform aHamstrings Length Test?
Pt supine with contra leg flat, passively flex ipsilateral hip to 90, stablize thigh while passively extending the knee to patient tolerance ( normal= 180)
How do you perform a Ober Test?
Pt sidelying on contralateral hip with slight hip and knee flexion for stability, passively
abduct ipsilateral hip slightly then extend the knee straight or flex to 90⁰. Allow the more
superior leg to drop nto adduction. Failure of leg to drop or lx sidebending indicates tightness IT
band.
How do you perform a Thomas Test?
Pt supine with edge of table at mid thigh and hugs contralateral thigh to chest. Ipsilateral
leg should passively drop to table and knee should flex to 90⁰. Hip abduction and rotation should
also be neutral
How do you perform an Anterior Drawer test and what is a positive Anterior Drawer Test?
(ACL) ant glide of femur on tibia, pt flex knee, fix foot, fingers on popliteal fossa and
pull towards.
How do you perform a Posterior Drawer test and what is a positive Posterior Drawer Test?
(PCL) posterior glide, opposite of anterior drawer test
What are the Anterior Compartment Muscles (Below Knee)?
Tibialis anterior;
extensor digitorum longus,
extensor hallucis longus
What are the Lateral Compartment Muscles (Below Knee)?
Fibularis longus,
fibularis brevis
What are the Posterior Compartment Muscles (Below Knee)?
(superficial) : gastrocnemius, soleus
(deep) : tibialis posterior, flexor digitorum longus, flexor hallucis longus
What are the HIP FLEXORS?
psoas major and illiacus,
pectineus, TFL, adductor bevis,
adductor longus, adductor magnus,
rectus femoris, sartorius
What are the HIP EXTENSORS?
gluteus maximus, biceps (long head), semitendinosus, semimembranosus, adductor magnus (posterior head)
What are the KNEE FLEXORS
biceps femoris, semitendinosus,
semimembranosus, sartoius, gracilis,
gastrocnemius, plantaris, popliteus
What are the KNEE EXTENSORS?
vastus lateralis, intermedius, and medialis,
recturs femoris, and TFL
What are the HIP ABDUCTORS?
gluteus medius and minimus, TFL, sartoius
What are the HIP ADDUCTORS?
adductor bevis, longus, and mangnus, gracilis, and pectineus
What are the LATERAL ROTATION OF THE THIGH?
piriformis, superior and inferior gemellus,
obturator internus and externus, quadrates femoris, gluteus max
What are the muscles that MEDIALLY ROTATE THE THIGH?
gluteus medius and minimus, TFL
What is the plantar aponeruorsis?
Connects medial tubercle of calcaneus to proximal phalanges.
Plantar Fasciitis is most common, palpate from pusing on medial plantar of calc.
What are the columns of the foot?
Medial: talus, navicular, 3 cuneiforms, metatarsals 1,2,3; flexible
Lateral: calcaneous, cuboid, metatarsals 4/5, rigid
What are the joints and axis of the foot?
Talocrural (ankle joint): Subtalar Midtarsal Tarsometatarsal Intermetatarsals Metatarsophalangeal Interphalangeal
What is the windlass mechanism?
-first described by Hicks (1954) is the tightening action of the long plantar fascia (aponeurosis) of the foot to maintain arch stability when the heel comes off the ground (late stance phase of gait). Without the windlass function, the inner arch of the foot would collapse at heel lift preventing the foot from acting as an efficient level during push off
