Manual Muscle Testing of the Hip, Knee, and Ankle Flashcards
what is the against gravity position for hip flexion?
sitting with thigh fully supported on the table and legs hanging over the edge
what is the gravity minimized position for hip flexion?
sidelying or supine
what is the palpation for hip flexion?
the muscle just distal to the inguinal ligament on the medial side of the sartorius
what is the primary mover for hip flexion?
illiacus and psoas major
what are the primary movers of hip extension?
glute max, semitendinosus, bicep femoris long head, semimembranosus
what is the against gravity position for hip extension?
prone
what is the gravity minimized position for hip extension?
sidelying
what is the palpation for hip extension?
The hamstrings at the ischial tuberosity. Palpate the glute max at the center of the buttocks.
what is the against gravity position to isolate the glute max in hip extension?
prone with the knee flexed to 90 degrees
what is the gravity minimized position to isolate the glute max in hip extension?
sidelying.
what is the primary mover during hip flexion, abd, ER, with knee flexion?
sartorius
what is the against gravity position during hip flexion, abd, ER, with knee flexion?
short sitting
what is the gravity minimized position during hip flexion, abd, ER, with knee flexion?
supine
what is the palpation during hip flexion, abd, ER, with knee flexion?
palpate the sartorius muscle origin at the ASIS
what are the primary movers of hip abduction?
glute medius and glute minimus
what is the against gravity position of hip abduction?
sidelying
what is the gravity minimized position of hip abduction?
supine
what is the palpation of hip abduction?
palpate the glute med on the lateral aspect of the hip just above the greater trochanter
what are the primary movers of hip adduction?
Adductors (magnus, brevis, longus), pectineus, gracilis
what is the against gravity position for hip adduction?
sidelying
what is the gravity minimized position for hip adduction?
supine
what is the palpation for hip adduction?
the adductor mass on the proximal medial thigh
what are the primary movers of hip ER?
the obturator internus and externus, the superior and inferior gemellus, the piriformis, quad fem, and glute max
what is the against gravity position for hip ER?
short sitting with thigh fully supported
what is the gravity minimized position for hip ER?
supine
what is the palpation for Hip ER?
cant really palpate the deep 6 but can palpate the glute max
what are the primary movers of hip IR?
glute minimus and glute medius, and TFL
what is the against gravity position for hip IR?
short sittin
what is the gravity minimized position for hip IR
supine
what is the palpation for hip IR?
can palpate the glute med above the greater trochanter and can palpate the TFL below the ASIS
what are the primary movers for knee flexion?
semitendinosus
semimembranosus
bicep femoris
what is the against gravity position for knee flexion?
prone with legs straight and toes hanging over the edge of the table. Place the limb in about 45 degrees of knee flexion and provide resistance just above the ankle
what is the medial hamstring test?
the patient is in prone and toes point toward the midline.
testing for semitendinosus and semimembranosus
what is the lateral hamstring test?
the patient is in prone and the toes point outward.
testing for bicep femoris
what is the gravity minimized position for grade 2 knee flexion?
sidelying
what is the palpation for knee flexion
the medial and lateral hamstring tendons just above the posterior knee
what are the primary movers of knee extension?
rectus femoris and vastus muscles (intermedius, medialis, lateralis)
what is the grade 3-5 position for knee extension?
short sitting with resistance placed downward just above the ankle
what is the position for a grade 2 in knee extension?
sidelying
what is the palpation for knee extension?
the quad tendon just above the knee with the tendon held gently between the thumb and fingers
can also palpate the patellar tendon just below the knee
what are the primary movers of plantarflexion?
gastroc and soleus
what is the position for grade 3-5 for plantarflexion?
standing
if the patient can do 25 heel raises they get a
5
what is a grade 4 in plantarflexion?
2-24 heel raises
what is the position for a grade 2 in plantarflexion?
prone with feet off the end of the table.
what is the palpation of plantar flexion?
the achilles tendon or the muscle bellies of the gastroc and soleus at mid-calf
what is the primary mover of foot dorsiflexion and inversion?
tibialis anterior
what is the testing position for foot dorsiflexion and inversion?
all grades are tested in supine.
the pt places the hand providing resistance on the medial aspect of the foot over the first ray. Resistance goes down and out.
where do you palpate during foot dorsiflexion and inversion?
the tendon of the TA is on the anteromedial aspect of the ankle at the level of the malleolus
what is the primary mover of foot inversion?
tibialis posterior
what is the position for testing foot inversion?
sitting
the pt places the stabilizing hand on the posterior calf just above the malleoli.
the hand providing resistance is placed on the foot with the hand over the medial side of the forefoot
what is the palpation for foot inversion?
the tendon of tibialis posterior is between the medial malleolus and navicular bone.
what is the primary mover of foot eversion and flexion?
fibularis longus and brevis
the ________ contributes to foot ____ and _______.
fibularis tertius
eversion
dorsiflexion
what is the testing position for foot eversion and plantarflexion?
sitting. the PT’s stabilizing hand is at the ankle just above the the malleolus. The hand providing resistance is contoured around the dorsum and lateral border of the forefoot.
what is the palpation of foot eversion and plantarflexion?
the fibularis longus tendon can be felt posterior to the lateral malleolus but behind the tendon of the fib brevis
