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Flashcards in Lower Extremity Deck (46):
1

Where does the majority of lymph flow in the lower extremity?

1. Through superficial and deep inguinal LN to the thoracic duct.
2. The flow is impaired with popliteal, pelvic, respiratory, and thoracic inlet baffle "congestion"

2

Where are sympathetic innervation to the lower limb derived from?

T10-L3. Therefore SD at the thoracolumbar junction increases sympathetic tone in lower extremity.

3

What is the effect of increased sympathetic stimulation of T10-L3?

1. Increased sympathetic tone, leading to chronic pain and decreased lymph flow.
- Can lead to lower limb swelling and impaired function.

4

What are the external rotators of the hip?

1. Piriformis
2. Gemellus superior
3. Obturator internus
4. Gemellus inferior.
5. Obturator externus
6. Quadratus femoris

5

What are the internal rotators of the hip?

1. Gluteus minimums
2. Gluteus medius
3. Tensor fascia lata.

6

What is the function of the hip ligaments (iliofemoral, ischiofemoral, ligamentum teres capitis femoris)?

1. Guide/limit hip ROM
2. Can become tight or loose with chronic injury or imbalance and lead to imbalance, ROM restriction

7

What is the acetabular labrum?

1. Fibrocartilaginous rim around the acetabular margin that helps maintain stability and provides proprioceptive information about the motion at the hip.

8

What are signs/symptoms of a torn acetabular labrum?

1. Sharp, deep pain with ant thigh or groin.
2. Worsening pain with seating to standing position
3. Clicking motion.

9

Flexion and extension of the hip occurs through what ranges?

1. Flexion: 90-150 and is improved with knee flexion.
2. Extension: 10-30, improved with knee extension

10

What are the ranges of abduction/adduction of hip?

Abduction: 15-55 degrees

Adduction: 15-45 degrees

11

What are the ranges for internal/external rotation of the hip joint?

Internal: 20-50

External: 10-55

12

External rotation produces what type of movement?

Anterior gliding

13

Internal rotation induces what type of movement?

Posterior gliding.

14

What are the major flexors of the thigh at the hip joint?

1. Psoas major.
2. Iliacus
3. Pectineus
4. Rectus femoris
5. Sartorius

15

What are the extensor of the hip joint?

1. Gluteus maximus
2. Semimembranosus
3. Semitendinosus
4. Biceps femoris

16

What are the abductors of the hip joint?

1. Gluteus medius
2. Gluteus minimus
3. Tensor fascia lata
4. Sartorius.

17

What are the adductor of the hip joint?

1. Adductor longus
2. Adductor brevis
3. Adductor magnus
4. Obturator externus
5. Gacilis

18

What is the "screw home" mechanism that occurs at the knee joint?

1. With full extension the knee joint locks via medial rotation of the femoral condyles on the tibial plateau. Allowing for reduced use of leg muscles.

19

What are the minor gliding motions that occur at the knee joint?

1. Anterior/posterior gliding
2. Medial/lateral gliding
3. Internal rotation with posterolateral gliding.
4. External rotation with anterolateral gliding.

20

What ligaments are crucial for the support of the knee joint?

1. Medial and lateral collateral ligaments (prevent med/lat gliding)
2. Anterior cruciate ligament- prevent tibial anterior displacement
3. Posterior cruciate ligament- prevents tibial posterior displacement.

21

What grade of ligamentous tears can be treated with OMM?

Grades I, and II

22

Of menisci tears/injuries which is more likely to heal?

1. The outer 1/3 due to more vasculature
2. Inner 1/3 less likely to heal due to reduced vasculature.

23

What is the "terrible triad" or the O'Donoghue's triad?

1. Injury to the ACL, MCL, medial menisci

24

What is the purpose of the proximal tibiofibular joint?

Allow anterolateral and posteromedial gliding of the fibular head.
- fibular head moves in combination with lateral malleolus.

25

What is the motion of the lateral malleolus in relation to the proxima tibiofibular joint?

1. Fibular head moves anterior, lateral malleolus moves posterior; vice versa.

2. Inverted ankle sprains can restrict lateral malleolus and fibular head movement.

26

When are you likely to find fibular head restrictions?

1. SD of hamstrings or LCL injury.
- if it still persists after treatment, must look at lateral menisci.

27

What may a posterior fibular head affect?

Can impinge on the common fibular nerve, and therefore lead to foot drop.

28

How is a hip pathology normally presented?

Hip pathology can normally be seen with abnormal gait

29

What is the range of flexion for a hip joint?

90-150 degrees

30

What is the ROM of extension of hip joint?

10-30 degrees

31

What is the ROM of abduction of hip joint?

15-55 degrees

32

What is the ROM of adduction for the hip joint?

15-45 degrees

33

What is the ROM of internal rotation of hip joint?

20-50 degrees

34

What is the ROM of the external rotation of hip joint?

10-55 degrees

35

Restricted hip extension indicates?

Hypertonic iliopsoas muscles

36

Restricted internal hip rotation indicates...

Hypertonic piriformis muscles

37

Restricted hip flexion indicates....

Hypertonic gluteus maximus muscle.

38

Restricted hip external rotation indicates...

Hypertonic gluteus medius and minimus muscles

39

Restricted hip abduction indicates...

Hypertonic adductor magnus muscle

40

Restricted hip adduction indicates...

Hypertonic gluteus medius

41

Which muscle can limit hip flexion?

Any extensors. Biceps femoris, semitendinosus, semimembranosus

42

What techniques work well with hip SD?

MET: isometric contraction and post-isometric relaxation

43

Hypertonic muscles that can limit normal hip extension consist of...

1. Psoas major
2. Iliacus
3. Pectineus
4. Rectus femoris
5. Sartorius

44

A fibular head restriction is caused by what?

Hamstring strain, injury to lateral collateral ligament, lateral menisci injury.

45

A knee joint restrictions with isolation to the tibial plateau is caused by...

Ligament laxity, meniscus injury, knee flexor/extensor dysfunction.

46

Where does sympathetic supply to the lower extremity come from?

T11-T12, affect smooth muscles of lymphatics, blood and sympathetic tone.