Lower Limb Palpation and Muscle Testing Flashcards
(44 cards)
What is the normal torsion angle?
10-15 degrees is considered “normal anteversion”
Coxa Norma is considered ___ degrees between the femoral neck and the medial side of te femoral shaft
125 degrees
140 degress is considered coxa ___
vara
valga
What structures pass above the piriformis?
The superior gluteal vessels and nerve
What structures pass below the piriformis (7)?
- sciatic nerve
- posterior femoral cutaneous nerve
- inferior gluteal vessels and nerve
- nerve to obturator internus (and superior gemellus)
- nerve to quadratus femoris (and inferior gemellus)
- pudendal nerve
- internal pudendal vessels
The femoral triangle is bounded by the _______ superiorly, the _______ medially and the _______ laterally.
- the inguinal ligament
- the medial border of the adductor longus muscle
- the medial border of the sartorius muscle
What forms the floor of the femoral triangle?
The pectineus and adductor longus muscles medially and iliopsoas muscle laterally
What forms the roof of the femoral triangle?
The fascia lata, except at the saphenous opening where it is formed by the cribriform fascia
What are the 3 components of the femoral sheath?
- Femoral Artery
- Femoral Veins
- Femoral Canal
What are the 2 superficial veins of the lower limb?
great and small saphenous veins
What does the great saphenous vein drain?
the dorsal venous arch of the foot
Describe the path of the great saphenous vein
It ascends anterior to the medial malleolus along the medial side of the leg in relation with the saphenous nerve and continues upward running posterior to the medial condyles of the tibia and femur and then along the medial aspect of the thigh where it terminates with the femral vein
Where is the best place to palpate the great saphenous vein?
anterior to the medial malleolus
When are handheld dynometers more effective at sensing change in muscle strength than MMT?
for MMT grades 3.5 and above
If a patient performed a gastrocnemius and soleus MMT grade of 3 what were they able to do?
Maintaining the heel off the floor through one to two repetitions only with subsequent attempts resulting in decreased range
If a patient performed a gastrocnemius and soleus MMT grade of 4 what were they able to do?
Maintaining the heel fully off the floor through three to five repetitions with subsequent attempts resulting in decreased range
If a patient performed a gastrocnemius and soleus MMT grade of 5 what were they able to do?
Maintaining the heel fully off the floor through more than six repetitions
What is the Thomas test used to measure the flexibility of what 4 muscles/muscle groups?
- Iliopsoas muscle group
- Rectus Femoris
- Tensor Fascia Latae/Iliotibial Tract
- Sartorius
What reflects a negative Thomas test result?
The lower back and sacrum remain on the table.
The hip can make a 10° posterior tilt or a 10° hip extension.
The knee must be able to make 90° flexion.
What reflects a positive Thomas test result?
The patient is not able to maintain their lower back and sacrum against the table.
The hip has a large posterior tilt
The hip is not able to reach neutral position
The knee is not able to meet flexion of 80° or more
When should hamstring length be assessed?
In patients who display altered hip extension or increased muscle bulk in the distal two thirds of the hamstrings on postural assessment
What is the normal length of the hamstrings?
80° of hip flexion with the contralateral leg extended, and 90° with the contralateral leg flexed
When should adductor length be assessed?
When an adductor notch is noted during the postural assessment or when a patient stands with excessive hip adduction with or without excessive medial femoral rotation
What is the normal length of the adductors?
hip abduction to 45° without lateral movement of the pelvis
