PHYSICAL EXAMINATION OF THE LOWER EXTREMITY MUSCULOSKELETAL SYSTEM Flashcards
Assess hip Muscle Strength
(a) Flexion
(b) Extension: _______
(c) Abduction: _______
(d) Adduction: ________
(e) External & Internal Rotation
b) Gluteus Maximus
c) Gluteus Medius
d) Adductor Longus / Brevis / Magnus
Special Tests hip
Detects hip and sacroiliac pathology
Faber test aka Figure of 4 test, Patrick test, Jansen test
Special Tests hip
Detects gluteus medius muscle weakness
-The test is positive if the PSIS on the unsupported side descends
Trendelenburg Test
Special Tests hip
Performed to detect acetabular or femoral neck pathology such as osteoarthritis or osteonecrosis
-Pain in the hip or groin, particular with internal rotation is positive
Log Roll Test
Special Tests hip
Tests for a tight piriformis impinging the sciatic nerve
-If the test is positive then pain will be produced in the buttock and even down the leg
Piriformis Test
Special Tests hip
Test for labral pathology, loose body, or other internal derangement of the hip
-Pain or grating sensation or sensation is positive
Scour Test
Special Tests
If patient is unable to obtain within 10 degree of full knee extension are considered to have hamstring tightness
Hamstring Flexibility
Special Tests hip
Detects flexion contractures or tightness of the hip
-The test is positive if the hip does not fully extend or lumbar curve arches (lordosis)
Thomas Test
Special Tests knee
Tests for Patellar instability
-Positive would be absence of a firm end feel or patient apprehension
Patellar Apprehension Sign
Special Tests knee
Assesses for cartilage degeneration
-Positive would be pain and/or grinding sound
Special Tests knee
Evaluates the health of the menisci
-Joint line clicking and or pain is positive for possible meniscus tear.
McMurray Test
Special Tests knee
Assess posterior cruciate ligament stability
-If the PCL is injured the proximal tibia falls back
Posterior Drawer
Special Tests
1) ______ evaluates the integrity of the lateral collateral ligament.
2) _______ evaluates the integrity of the medial collateral ligament.
- The test is positive if the patient complains of pain and/or there’s instability.
1) Varus Stress
2) Valgus Stress
Special Tests hip
Detects instability of the anterior cruciate ligament
-The absence of a firm end point is indicative of an anterior cruciate ligament tear
-Increased anterior translation indicated partial or complete tear
Lachmans
Special test knee
Detects iliotibial band (ITB) contractures or tightness
-The test is positive with patient’s inability to lower knee to table or they complain of pain at the ITB insertion site
Ober Test
Foot strength, what muscle is being tested?
Dorsiflexion / Inversion: ______
Tibialis Anterior
Foot strength, what muscle(s) is being tested?
Plantar Flexion:
Gastrocnemius & Soleus
Foot strength, what muscle(s) is being tested?
Eversion:
Peroneal Longus / Brevis
Foot strength, what muscle(s) is being tested?
Toe Flexion
Flexor Digitorum / Hallucis Longus
Foot strength, what muscle(s) is being tested?
Toe Extension
Extensor Digitorum / Hallucis Longus
Special tests foot
Detects anterior instability of the ankle joint
-The test is positive if the talus slides anteriorly under the ankle mortise. You may also hear an audible “clunk”.
Anterior Drawer Test
Special tests foot
Evaluates laxity of the calcanofibular ligament
-If the patient does not have an end point, then the test is positive for a CFL tear.
Inversion (VARUS) Stress Test
Special tests foot
Assess the integrity of the achilles tendon
-The test is positive if the foot doesn’t move into plantar flexion
Thompson Test
Special tests foot
Tests for possible Tibiofibular syndesmosis injury.
-If pain is felt to the lower ankle mortise region of the ankle the test is positive
Tib/Fib Squeeze
