practical 2 Flashcards
semimembranosus TP location
distal third of muscle on posterior/medial thigh
S/CS set up for biceps femoris
prone, flex knee, externally rotate tibia, bring lower leg lateral
S/CS set up for popliteus
prone, flex knee 60-65, internally rotate tibia, plantar flex & invert foot
soleus TP location
posterior midline of tibia on lower third of muscle
gastrocnemius TP location
inferior to popliteal space on medial head of muscle
ATFL TP location
in a depression 3 cm anterior and caudad to the lateral malleolus
what is a positive test for the straight leg raise?
reproduction of radicular sx i sciatic nerve distribution (b/w 30-70 degrees)
what does a positive straight leg raise test indicate?
nerve root irritation of sciatic nerve
hip flexion normal end feel, ROM
soft, 140 degrees
what does a positive thomas sign indicate?
a flexion contracture
normal end feel for internal rotation and external rotation of hip
elastic
positive faber’s test indicates what
sacroiliac dysfxn (if pain to posterior pelvis) OR hip dysfxn (if pain in anterior or lateral pelvis)
capsular pattern of the hip results in gross limitation of
internal rotation, abduction, flexion
resisted ROM muscles: hip flexion
rectus femoris, iliacus, psoas
resisted ROM muscles: hip extension
hamstrings, gluteus maximus
resisted ROM muscles: abduction
gluteus medius, gluteus minimus, TFL
resisted ROM muscles: adduction
gracilis, adductors, pectineus
normal end feel for hip extension, ROM
elastic, 30 degrees
how to do passive ROM for hip extension
prone, 1 hand over butt, grasp leg just above patella, bring into extension
what does passive knee flexion assess?
rectus femoris tightness, irritation of femoral nerve
positive ely test
whe patient cannot touch heel to butt during passive knee flexion–>indicates tightness in rectus femoris or femoral nerve irritation due to lumbosacral or hip dysfxn
resisted ROM muscles: external rotation
gluteus maximum, piriformis, gemelli sup/inf, oburator internus/externus, quadratus femoris
resisted ROM muscles: internal rotation
gluteus minimus, gluteus maximus, TFL
resisted ROM muscles: knee flexion
hamstrings
resisted ROM muscles: knee extension
rectus femoris, quads
how to do resisted ROM for knee extension
prone, knee held at 70 degrees flexion when doctors knee supporting under ankle, patient asked to push into table
resisted ROM muscles: hip extension
hamstrings, gluteus maximus
knee flexion normal end feel
soft or spongy
knee extension normal end feel
hard; limited by PCL or posterior capsule
are you evaluating ligaments or tendons when doing passive ROM for knee flexion & extension?
ligaments/contractile tissue
are you evaluating ligaments or tendons when doing resisted ROM for knee flexion & extension?
muscles/tendons
what to assess for with lachmans test
hard endpoint (for acl) and laxity
when doing varus and valgus stress test, assess for what?
elastic endpoint, laxity, pain
should knee be flexed or straight during varus and valgus stress test?
30 degrees flexion
what pathology is associated with patellofemoral compression?
patellofemoral pain sydreom chondromalacia patella
what pathology is associated with patellar tap/ballottement?
intraarticular joint effusion
apleys distraction tests ligaments or cartilage?
medial and lateral collateral ligaments
apleys compression tests ligaments or cartilage?
cartilage–>medial and lateral meniscus
is the apleys distraction test or compression test the pool cue one?
apleys compression
HVLA of posterior fibular head tx process
doctors 2nd metacarpophalangeal joint behind fibular head, flex knee to motion barrier, EXTERNALLY ROTATE LEG @ KNEE, HVLA thrust
when is an ATFL test considered to be positive?
- incr anterior translation 2. reproduction of pain 3. apprehension
when is PTFL test considered to be positive
- incr posterior translation 2. reproduction of pain 3. apprehension
what are you looking to document with ATFL or PTFL?
ligamentous laxity
inversion stress of the foot tests what ligament?
calcaneofibular ligament
squeeze test is for what?
syndesmotic injury (either high ankle sprain or fracture)
external rotation test is for what?
syndesmotic injury
how is patient positioned for external rotation test?
seated with leg off table
if a patient needs to have their talus reset, what might indicate this?
- hx of inversion ankle sprain OR
2. decr dorsiflexion
how to reset the talus/mortise
supine, grasp calcaneus, apply traction, dorsiflex & evert–>apply HVLA tug inferiorly
why milk the peroneus longus & brevis?
- tender or tight peroneal msucles
2. h/o inversion sprained ankle
tx navicular SD
supine, interdigitate fingers over foot, doctor’s forearm is parallel with tibia, dorsiflex, thrust applied inferiorly
