MSK hip, knees and feet Flashcards
In what position do you assess the patient for hip examination?
Both standing and sitting down
What are you looking for when patient is standing in hip examination?
Muscle atrophy and bulking
What are you looking for when patient is lying in hip examination?
Flexion deformity
One leg longer than other (measure)
scars
What bony landmark are you measuring from for the length of the leg?
ASIS to medial malleolus
What bony landmark are you feeling for in hip examination?
Greater tronchanter and surrounding muscles
What movements do you do in hip examination?
flexion
Internal and external rotation
Thomas test
Trendelenburg’s test
What is Thomas test looking for?
A fixed flexed deformity
What is Trendelenburg’s test looking for?
Proximal gluteal muscle strength
If their is positive tranderlengurgs test what does that indicate?
Weak hip abductor muscle to the contralateral side of the pelvis
In function what are you assessing for in hip examination?
Gait
What two gaits are you looking for in function part of hip examination?
Antalgic (painful) gait and trandelengurg’s (waddle) gait
What are you looking for anterior when the patient is standing in knee examination?
Scars Rash --> psoriasis Effusion Quadriceps wasting valgus and varus deformity Asymetery
What are you looking for side on when the patient is standing in knee examination?
Fixed flexion deformity
Swelling in the popliteal area
What are you looking for posteriorly on when the patient is standing in knee examination?
Scars Rash --> psoriasis Effusion Quadriceps wasting valgus and varus deformity Asymetery Popliteal swelling
What is
a) valgus
b) varus deformity?
a) knocked knee
b) bowed leg
When the patient is lying down what are you feeling for
Temperature Alignment of the knee for any tenderness and swelling Popliteal swelling Patella tap Cross fluctuation
What are you investigating in patella tap?
effusion
If the patella tap is negative what other assessment do you do?
cross fluctuation test
What landmarks are you palpating when you feel around the knee?
Femoral condyle
Inferior pole of the patella
Inferior patella tendon
Tibial tuberosity
What movements do you assess in knee examination?
flexion and extension
What are the special test?
Anterior and posterior draw test
Medial and lateral collateral ligament test
What is the anterior and posterior draw test examination?
Anterior and posterior crucial ligaments respectively
What does a positive anterior or posterior draw test indicate?
Anterior or posterior cruciate damage/laxity
What are you looking for at the feet when the patient is lying down?
Nail changes Rash Swelling Toe alignment --> halux valgus Skin changes Plantar aspect for callus formation
What are you looking for at the feet when the patient is lying down?
a) anterior
b) posteriorly
a) weight bearing, arch of the foot, toe clawing
b) valgus or varus of the subtalar joint and Achilles tendon
How do you assess the arch of the foot?
Ask the patient to go on tip toes and the downwards arch will disappear
What do you feel in foot and ankle assessment?
Temperature
Peripheral pulses
Achilles tendon
The joints in the foot and ankle
What are the joints in the foot and ankle that you feel?
Gentally squeeze the MTP joints for pain Taral joints Ankle joint Subtalar joint Medial and lateral malleolus Proximal fibula
What movements do you do actively and passively in the foot examination?
Foot dosiflexion, plantar flexion, inversion and eversion
Toe dorsiflexion, plantar flexion, abduction and adduction
What extra joint do you move in passive movement in ankle?
Midtarsal joint movement
What do you look for in gait in foot and ankle examination?
Heal lift, stance, toe off and full cycle
What is the Ottowa Ankle Rule for acute kidney injury?
Palpate and ask if they have pain in the navicular, base of 5th metarsal and posterior aspect of the laterl/medial malleolus
