Testing muscle groups of the lower limb Flashcards
How is the tibialis anterior muscle/tendon examined and what is the nerve responsible?
Turn foot in + up (inversion)
Grasp forefoot to oppose
Tendon becomes prominent + palpated just below + anterior to the medial malleolus.
Deep fibular nerve, L4 + L5.
How are the fibularis longus and fibularis brevis muscles/tendons examined and what are the nerves responsible?
Turn foot out + down (eversion)
Grasp forefoot to oppose
Tendons become prominent + palpated just below the lateral malleolus.
Superficial fibular nerve, L5, S1 + S2.
How are the gastrocnemius, soleus m. and calcaneal (Achilles) tendon examined and what are the nerves responsible?
Stand on toes.
Muscle bellies + calcaneal tendon can be palpated in calf area + on posterior side of the ankle.
Tibial nerve, S1 + S2.
What is the purpose of the Trendelenberg test?
To evaluate motor loss of abductors (gluteus medius + minimus) of the hip joint.
Patients with a positive Trendelenberg test tend to ‘waddle’ when they walk.
How is the Trendelenberg test performed?
Stand on both legs.
Both right + left side of pelvis should remain at same level without any tilt.
Stand behind + feel pelvis.
Ask patient to raise 1 leg off the ground.
Pelvis should remain horizontal.
If pelvis on raised leg side drops downwards= positive Trendelenberg test .
Indicates loss/ weakness of motor function of the abductor muscles in the leg the subject is standing on (supported side).
How is the function of the gluteus maximus muscle tested, and what nerves are responsible for its contraction?
Lie prone with knee flexed.
Extend thigh against resistance
Palpate rounded contour of buttock for muscle contraction.
Inferior gluteal nerve, L5, S1 + S2.
How is the function of the gluteus medius and minimus muscles tested, and what nerves are responsible for their contraction?
Lie on side with lower limb fully extended.
Abduct limb against resistance at distal end of the thigh.
Palpate contraction of the gluteus medius just inferior to iliac crest.
Superior gluteal nerve, L5 + S1.
How is the function of the tensor fascia lata muscle tested, and what nerves are responsible for its contraction?
Lie on side with lower limb fully extended.
Roll slightly towards supine + place finger on tensor fascia lata muscle + ilio-tibial tract
Abduct against resistance
Superior gluteal nerve, L5 + S1.
How is the function of the hamstrings muscles tested, and what nerves are responsible for their contraction?
Lie prone with knee flexed to 30 degrees.
Apply opposing force just above posterior side of the ankle while patient attempts to flex knee further.
Hamstring tendons seen around popliteal region + muscle contraction is palpable on the posterior side of the mid-thigh.
Tibial division of sciatic nerve, L5, S1 + S2,
Except for biceps short head, which is common fibular division, L5, S1 + S2.
How is the function of the quadriceps muscles tested, and what nerves are responsible for their contraction?
Sit on edge of couch
Apply pressure at distal part of the leg while patient attempts extension
Contracting quadriceps can be palpated on anterior thigh.
Femoral nerve, L2-4.
How is the function of the iliopsoas muscles tested, and what nerves are responsible for their contraction?
Lie supine
Raise leg upwards with resistance against thigh
Femoral nerve
How is the function of the adductor muscle group tested, and what nerves are responsible for their contraction?
Lie on side
Support upper leg, request them to adduct lower leg against resistance.
Nerve = obturator nerve L2,3,4
