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OPP Claire's decks > Ramey's Hip and Knee Mechanics > Flashcards

Ramey's Hip and Knee Mechanics Flashcards

1
Q

The Hip joint, what bones involved and what kind of joint?

A

Consists of the articulation of the head of the femur with the acetabulum of the innominate

Ball and socket joint designed for stability

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2
Q

Hip major motions

A

flexion, extension, abduction, adduction, internal rotation and external rotation

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3
Q

Hip Minor Motions

A

gliding motions- are frequently restricted with somatic dysfunction

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4
Q

External Rotation and Gliding motion

A

head of femur glides anteriorly in acetabulum

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5
Q

Internal Rotation and Gliding motion

A

head of femur glides posteriorly in acetabulum

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6
Q

Three major ligaments of the hip

A

Iliofemoral ligament
Ischiofemoral ligament
Ligamentum teres capitis femoris

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7
Q

Major Hip Flexors

A

psoas major, iliacus, pectineus, rectus femoris and sartorius muscles

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8
Q

Psoas Major disfunction results in

A

Low back pain and hip problems
Increased tension limits hip extension
Commonly tight with low back pain
Pain can be referred to the anterior hip or thigh

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9
Q

Major Hip extensors

A

gluteus maximus and hamstring muscles

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10
Q

Hip major abductors

A

gluteus medius and minimus, tensor fascia lata and sartorius muscles

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11
Q

Dysfunction of tensor fascia lata symptoms?

A

Lateral hip and lateral knee pain

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12
Q

Hip major adductors

A

adductors longus, brevis and magnus, obturator externus and gracilis muscles

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13
Q

Hip major internal rotators

A

tensor fascia lata, gluteus minimus and medius muscles

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14
Q

Tightness of Adductor Longus

A

Can result in inferior pubic symphysis shear (dysfunction of symphysis pubis)

Frequently seen with persistent groin pulls, especially those that are slow to respond to conservative treatment

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15
Q

Hip external rotators

A

obturators, gemelli, quadratus femoris, gluteus maximus, sartorius and piriformis muscles

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16
Q

Piriformis Tightness

A

Tightness will decrease hip internal rotation and may irritate the sciatic nerve

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17
Q

Hip dysfunction is frequently associated with

A

decreased hip extension due to psoas major muscle tension and decreased internal rotation due to piriformis muscle tension.

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18
Q

What is the best way to treat Hip Dysfunction with OMM?

A

MET

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19
Q

What are the signs and symptoms of a torn acetabular labrum ?

A

Sharp, deep pain in the anterior thigh and/or groin.

Worsens when rising from a seated to standing position. May also “click” with motion.

20
Q

What should you suspect with hip injuries that are nonresponsive to conservative treatment?

A

torn acetabular labrum

21
Q

Intraarticular hip problems (fracture or degenerative joint disease) will loose what kind of motion first?

A

internal rotation

22
Q

KNEE major motions

A

flexion and extension

23
Q

KNEE minor motions

A

gliding motions of the tibial plateau include:
Anterior/posterior gliding
Medial/lateral gliding
Internal rotation with posterolateral gliding
External rotation with anteromedial gliding

24
Q

injuries to the outer 1/3 of the menisci?

A

vascular and more likely to heal

25
Q

injuries to the inner 1/3 of the menisci?

A

avascular and less likely to heal

26
Q

Menical tears symptoms?

A

A history of subjective instability may (but not always) indicate a meniscal tear

Joint locking may indicate a very significant meniscal tear and is an indication for an MRI and probable surgery.

You can have a less severe meniscal tear without joint locking!

27
Q

Lateral joint line tenderness or palpable tissue texture changes?

A

may indicate a lateral meniscal tear

28
Q

Medial joint line tenderness or tissue texture changes?

A

may indicate a medial meniscal tear

29
Q

Tenderness in the popliteal fossa?

A

may indicate a tear of the posterior horn of either meniscus

30
Q

Dysfunction of the hip flexors?

A

may be associated with posterior knee pain

31
Q

Dysfunction of the hip extensors?

A

Dysfunction may be associated with anterior knee pain

32
Q

Excessive tension (tightness) in the knee flexors?

A

will limit knee extension

33
Q

Excessive tension (tightness) in the knee extensors?

A

will limit knee flexion

34
Q

PROXIMAL TIBIOFIBULAR JOINT motions

A

anterolateral and posteromedial gliding of the fibular head

35
Q

When the fibular head glides anteriorly?

A

The lateral malleolus glides posteriorly

36
Q

When will you frequently find fibular head restriction

A

with hamstring strains and injuries to the lateral collateral ligament

37
Q

If a fibular head restriction persists despite treatment?

A

It may be associated with injury to lateral meniscus

38
Q

Somatic dysfunction of the knee is frequently associated with?

A

restriction of the tibiofibular joint – produces lateral knee pain

39
Q

The common peroneal (common fibular) nerve runs near?

A

the fibular head

40
Q

What might contribute to foot drop?

A

A posterior fibular head affecting the function of the common fibular nerve.

41
Q

Somatic dysfunction affecting what spinal levels can increase sympathetic tone to the lower extremity and reduce arterial supply?

A

T10-L3

42
Q

Where can somatic dysfunction affect to the arterial supply to the lower extremity?

A

Somatic dysfunction affecting the femoral triangle and/or subsequent fascial restriction associated with somatic dysfunction of the lumbar spine, innominates, sacrum and lower extremities

43
Q

Counterstrain and hip injuries?

A

Associated with lateral trochanter tender points

May also see greater trochanteric bursitis

44
Q

Counterstrain and knee injuries?

A

Associated with meniscal and cruciate ligament tenderpoints

45
Q

Return to work/play/sports criteria

A

Full painless ROM

Strength at least 90% of the uninjured side

Able to tolerate work/sport/play without increasing symptoms

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