Lower Limb Study Guide

Question 1

What is the Hip Flexion ROM?

Answer 1

N: 0-120

Question 2

What is the Hip Extension ROM?

Answer 2

N: 0-20

Question 3

What is the Hip ABduction ROM?

Answer 3

N: 0-45

Question 4

What is the Hip ADduction ROM?

Answer 4

N:0-20

Question 5

What is the Hip Int Rotation ROM?

Answer 5

N: 0-45

Question 6

What is the Hip Ext Rotation ROM?

Answer 6

N: 0-45

Question 7

What is the Knee Flex ROM?

Answer 7

N: 0-135

Question 8

What is the Knee Ext ROM?

Answer 8

N: 135-0

Question 9

What is the PF ROM?

Answer 9

N: 0-45

Question 10

What is the DF ROM?

Answer 10

N: 0-30

Question 11

What is the Eversion ROM?

Answer 11

N: 0-20

Question 12

What is the Inversion ROM?

Answer 12

N: 0-35

Question 13

How to assess FIRST RAY MOBILITY?

Answer 13

Subtalar neutral, hold 1st MTH with one hand, 2nd-5th with the other and plantar/dorsal translate (move up and down), should be equal.

Question 14

How do you perform a subtalar neutral non weight bearing assessment?

Answer 14

Patient prone on table with feet hanging off. Use hand on medial side foot to palpate medial and lateral horns of talus. use other hand pronate and supinate foot (at 90 degrees)by pushing 4th/5th MTH until both horns are felt equally. mark calcaneus and distal 1/3 of leg

Question 15

How do you perform a resting calcaneal stance and tib/fib alignment?

Answer 15

Have patient stand with no shoes or socks, have them walk in
place for about 5 steps, patient stand normal and evaluate tib/fib alignment vs. calcaneus using the marks
previously used on our non-wb foot and ankle assessment

Question 16

How do you perform a Leg length discrepancy test?

Answer 16

Patient lay supine, perform 3 pelvic thrust, then measure from ASIS to distal tip of
medial malleolus

Question 17

How do you perform a Coleman block test?

Answer 17

Test varus (lateral edge of foot with 4/5th met heads on block)/valgus (place 1st
-3 met
heads on block), put block medial or lateral, shows flexibility or rigidity. (if goes neutral then shows
flexible)

Question 18

What is the definition of a MMT of 1/5?

Answer 18

Trace: Unable to produce active motion but muscle contraction can be palpated or visualized by the
examiner

Question 19

What is the definition of a MMT of 2/5?

Answer 19

Poor: Full ROM in a gravity-eliminated position or partial ROM against gravity

Question 20

What is the definition of a MMT of 3/5?

Answer 20

Fair: Pt can perform full ROM against gravity but not with extra resistance. (threshold of functional
strength)

Question 21

What is the definition of a MMT of 4/5?

Answer 21

Good: Pt can perform full ROM against gravity plus extra resistance but fails the break test

Question 22

What is the definition of a MMT of 5/5?

Answer 22

Normal: pt can perform full ROM against gravity plus extra resistance and passes a “break test”

Question 23

How do you perform aHamstrings Length Test?

Answer 23

Pt supine with contra leg flat, passively flex ipsilateral hip to 90, stablize thigh while passively extending the knee to patient tolerance ( normal= 180)

Question 24

How do you perform a Ober Test?

Answer 24

Pt sidelying on contralateral hip with slight hip and knee flexion for stability, passively
abduct ipsilateral hip slightly then extend the knee straight or flex to 90⁰. Allow the more
superior leg to drop nto adduction. Failure of leg to drop or lx sidebending indicates tightness IT
band.

Question 25

How do you perform a Thomas Test?

Answer 25

Pt supine with edge of table at mid thigh and hugs contralateral thigh to chest. Ipsilateral leg should passively drop to table and knee should flex to 90⁰. Hip abduction and rotation should also be neutral

Question 26

How do you perform an Anterior Drawer test and what is a positive Anterior Drawer Test?

Answer 26

(ACL) ant glide of femur on tibia, pt flex knee, fix foot, fingers on popliteal fossa and pull towards.

Question 27

How do you perform a Posterior Drawer test and what is a positive Posterior Drawer Test?

Answer 27

(PCL) posterior glide, opposite of anterior drawer test

Question 28

What are the Anterior Compartment Muscles (Below Knee)?

Answer 28

Tibialis anterior; extensor digitorum longus, extensor hallucis longus

Question 29

What are the Lateral Compartment Muscles (Below Knee)?

Answer 29

Fibularis longus, | fibularis brevis

Question 30

What are the Posterior Compartment Muscles (Below Knee)?

Answer 30

(superficial) : gastrocnemius, soleus | (deep) : tibialis posterior, flexor digitorum longus, flexor hallucis longus

Question 31

What are the HIP FLEXORS?

Answer 31

psoas major and illiacus, pectineus, TFL, adductor bevis, adductor longus, adductor magnus, rectus femoris, sartorius

Question 32

What are the HIP EXTENSORS?

Answer 32

``` gluteus maximus, biceps (long head), semitendinosus, semimembranosus, adductor magnus (posterior head) ```

Question 33

What are the KNEE FLEXORS

Answer 33

biceps femoris, semitendinosus, semimembranosus, sartoius, gracilis, gastrocnemius, plantaris, popliteus

Question 34

What are the KNEE EXTENSORS?

Answer 34

vastus lateralis, intermedius, and medialis, | recturs femoris, and TFL

Question 35

What are the HIP ABDUCTORS?

Answer 35

gluteus medius and minimus, TFL, sartoius

Question 36

What are the HIP ADDUCTORS?

Answer 36

adductor bevis, longus, and mangnus, gracilis, and pectineus

Question 37

What are the LATERAL ROTATION OF THE THIGH?

Answer 37

piriformis, superior and inferior gemellus, | obturator internus and externus, quadrates femoris, gluteus max

Question 38

What are the muscles that MEDIALLY ROTATE THE THIGH?

Answer 38

gluteus medius and minimus, TFL

Question 39

What is the plantar aponeruorsis?

Answer 39

Connects medial tubercle of calcaneus to proximal phalanges. | Plantar Fasciitis is most common, palpate from pusing on medial plantar of calc.

Question 40

What are the columns of the foot?

Answer 40

Medial: talus, navicular, 3 cuneiforms, metatarsals 1,2,3; flexible Lateral: calcaneous, cuboid, metatarsals 4/5, rigid

Question 41

What are the joints and axis of the foot?

Answer 41

``` Talocrural (ankle joint): Subtalar Midtarsal Tarsometatarsal Intermetatarsals Metatarsophalangeal Interphalangeal ```

Question 42

What is the windlass mechanism?

Answer 42

-first described by Hicks (1954) is the tightening action of the long plantar fascia (aponeurosis) of the foot to maintain arch stability when the heel comes off the ground (late stance phase of gait). Without the windlass function, the inner arch of the foot would collapse at heel lift preventing the foot from acting as an efficient level during push off