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Flashcards in hip and knee mechanics Deck (22)
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1

What are the major motions of the hip?

FlexionAbductionAdductioninternal and external rotation

2

Dysfunction of tensor fascia lata

Frequently seen with lateral hip and knee pain

3

Tightness of adductor muscles

Frequently results in inferior pubic symphysis shear - dysfxn of pubic symphysisFrequently seen with persistent groin pulls

4

Tightness of piriformis muscle

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

5

Hip disfunction

Associated with decreased hip extension due to - decreased hip extension due to psoas major mm - decreased internal rotation due to piriformis m, tensionResponds well to OMM, muscle energy techniques

6

Acetabular labrum Tear

Symptoms:sharp, deep pain anterior thigh/groinworsens when rising from a seated to standing positioncan click with motion

7

Hip Pearls

Compare injured and uninjured sideExamine joint above and below injured area for other potential problemsWith intraarticular hip problems, the first motion lost is typically internal rotation

8

Motions of the Knee

Flexion and ExtensionMinor gliding motions of tibial plateau include:anterior/posterior glidingmedial/lateral flidinginternal rotation with posterolateral glidingexternal rotation with anteromedial gliding

9

Knee "screw home" mechanism

Allows lower extremity to fxn as a solid columnWith knee fully extended the knee passively locks due to medial rotation of the femoral condyles on the tibial plateau

10

Knee Restrictions

Restrictions involving the gliding motions are frequently associated with somatic dysfxn

11

History of subjective knee instability

Sometimes indicates meniscal tear

12

Knee joint locking

Can indicate a very significant meniscal tear - indication for an MRI and probable surgery - can have less severe meniscal tear without joint locking

13

Palpating menisci

Lateral joint line tenderness, or palpable TART - can indicate lateral meniscal tearMedial joint line tenderness, or papable TART - can indicate medial meniscal tearTenderness in popliteal fossa may indicate a tear of the posterior horn of either meniscus

14

Terrible Triad

AKA Unholy triad. O'Donoghue's triad - MCL, medial meniscus, and ACL tear

15

Flexors of the leg include

Biceps femoris, semimembranosus, semitendinosus, popliteus, and gastrocs

16

Dysfxn of leg flexors

Associated with posterior knee painExcessive tightness will limit knee extension

17

Extensors of the leg include

Rectus femorisvastus lateralisvastus medialisvastus intermedius

18

Dysfxn of leg extensors

Associated with anterior knee painExcessive tightness will limit knee flexion

19

Movement of the fibular head

Allows for anterolateral and posteromedial gliding of fibular headFibular Reciprocal MotionFibular head moves in combo with lateral malleolus - when head moves anteriorly, lat malleolus glides posteriorly and vice versaInversion ankle sprains may result in restriction of lateral malleolus and fibular head

20

Fibular head restrictions

Often with hamstring strains and injuries to lateral collateral ligamentIf restriction persists despite treatment, may be associated with injury to lateral meniscus

21

Somatic dysfxn of the knee

Often associated with restriction of tibiofibular joint - lateral knee pain - common fibular nerve runs near herePosterior fibular head may affect fxn of this nerve and contribute to foot drop

22

Lower limb arterial supply

Mostly from femoral aa - affected by sympathetics from T10-L3\ - somatic dysfxn affecting these levels can increase sympathetic tone to lower limb and decrease aa supply