Lower extremities Flashcards
(59 cards)
Thompson or simmonds test
Pt lies face down, feet hanging off end of bed. Squeeze calf (tendon). If there is no movement (should be plantar flexion), it is positive for an achilles tendon rupture
Patellar ballottement test
Tests for joint effusion. Have pt extend knee, relax quad, and push down gently on the patella. If large amount of fluid the patella will rebound quickly
Anterior drawer sign knee
Tests the integrity of the ACL. Pt lies supine, knees flexed 90 degrees. Cup hands around knee, push on hamstring insertion points and pull the tibia towards you. If the tibia slides forward, it is most likely an ACL tear.
Homan sign
Have pt dorsiflex their foot. If they have severe pain, it may be indicative of a DVT
Ortolani
Tests for anterior hip dislocation in newborns (congenital). Hip is flexed, externally rotated, and abducted.
Patellar bulge sign
Tests the knee joint for minor effusions. Milk the fluid from the supra patellar pouch and lateral side into medial side. Fluid will refill on lateral or medial side depending on which way the milking occurred
Apprehension test
Test to see if patella is prone to lateral dislocation. Attempt to dislocate by pushing from medial to lateral. Look and see if patients face is apprehensive (may mean the patella is about to dislocate)
McMurray test
Test for posterior meniscus tears. Pt lies supine, legs flat.. Hold heel, flex leg, place other hand on knee joint, fingers medially and laterally. Rotate the leg internal and externally push on lateral side while rotating. If the pt has a posterior meniscus tear you will hear a “click”
Posterior drawer
Tests the integrity of PCL. Same position as anterior drawn, just push away on tibia. If tibia moves backward under the femur, it may be a torn PCL
Barlow test
Test used to see if the hip can be pushed easily out of its socket posteriorly. Done on newborns with congenital hip dislocation (opposite test of ortolani)
True leg length
Testing true leg length discrepancy . Measure from bone to bone (ASIS to medial malleolus) and compare legs.
Apparent leg length
Testing for no leg length discrepancy. The look of different length may be due to pelvic obliquity from hip or spinal issues. Measure from umbilicus to medial malleolus. If distances are unequal it is an apparent leg length discrepancy.
Apley compression or grinding test
Apley test is used to asses for meniscus tears. Pt should lie prone, with leg bent at 90 degrees. Clinician pushes down on heal to compress medial/lateral menisci. Rotate the tibia internally/externally. If painful, most likely a meniscal tear.
Apley distraction test
Determines if it is meniscal or ligament problems. Start with apley compression, then stabilize thigh by placing knee on pt, then pull up on the foot and rotate internally/externally. If it is ligament damage, the pt will complain of pain. If meniscus tear, test will not be painful.
Patellofemoral grinding test
Tests for quality of articular surfaces of patella and trochlear groove of femur. Pt supine, push patella towards feet (into trochlear groove), then have pt flex quad and keep resistance on the patella. The movement should be smooth. If any problem, there will be crepitus and is often associated with climbing stairs or standing up.
Varus stress
Tests the LCL stability. Press laterally against the knee, while pushing medially on the ankle.
Valgus stress
Tests the MCL stability. Press medially against the knee, while also pushing laterally on ankle. This will open the medial aspect of the knee if there is an MCL tear. This is the more common than tearing the LCL
Quad muscle names
Vastus lateralis/medialis
Where does patellar ligament attach
Inferior border of the patella, to the anterior portion of tibia (tibial tuberosity)
Hamstring muscle name
Biceps femoris
Bursae of patella (4)
- suprapatellar
- Superficial/deep infrapatellar
- pes anserine
- superficial prepatellar
4 ROM for the knee
- Flexion
- Extension
- Internal rotation
- external rotation
Flexion ROM for knee
135
Extension ROM knee
0
