MSK Lower Extremity Conditions Video #6

Question 1

What is normal Hip ROM?

Answer 1

FLX - 120
EXT - 15
ABD - 50
ADD - 30
ER - 60
IR - 40

Question 2

Which glide of the hip joint can be used to increase hip FLX and IR?

Answer 2

Posterior Glide

Question 3

Which glide of the hip joint can be used to improve EXT and ER?

Answer 3

Anterior Glide

Question 4

What is the resting position of the hip?

Answer 4

30 FLX
30 ABD
slight ER

Question 5

Describe Ely’s Test?

Answer 5

Passive Insufficiency Test
- Hip FLX Contracture

Prone, Knee FLX

(+) = spontaneous hip FLX w/ knee FLX

Question 6

Describe Ober’s Test…

Answer 6

Passive Insufficiency Test
- IT band tightness

Sidelying, hip extended
Modified = knee extended

(+) = The leg cannot be lowered into ADB

Question 7

Describe Thomas Test..

Answer 7

Passive Insufficiency Test
- Hip Flexor Tightness

Supine, single knee to chest

(+) = straight leg raises from the table

Question 8

Describe FABER’s test…

Answer 8

Patrick’s Test
- Iliopsoas, SI or Hip joint abnormal

Supine w/ test leg flexed, abducted, and ER onto opposite leg

(+) = failure of the test leg to ABD below the level of opposite leg, spasm ir hip joint issue/p!

Question 9

Describe Hip Scour Test

Answer 9

Femoral Acetabular Impingement
Hip Pathology

Supine, knee FLX to 90, PT applies compression and moves LE through 4 quadrants

(+) = irregularity in movement, p!, patient apprehension

Question 10

Craig’s Test

Answer 10

Femoral Anteversion

Prone w/ test knee flexed
- testing for the angle between the neck and femoral condyles

(+) = angle > 8-15 indicates anteversion

angle < 8-15 indicates retroversion

Question 11

Retroversion @ the Hip

Answer 11

Toeing - Out

Question 12

Anteversion

Answer 12

Toeing - IN

Question 13

Barlow’s Test

Answer 13

“Bad Guy”

Detects developmental dysplasia of the hip

PT pushes posterior to dislocate the hip

Question 14

Ortolani’s Sign

Answer 14

“Good Guy”

Detects congenital hip dislocation

(+) = clunk as the hip relocates onto the acetabulum

Question 15

Slipped Capital Femoral Epiphysis

Answer 15

“Skippy PB” Teenagers

Most common hip disorder in adolescents

results in Avascular Necrosis of femoral head

Groin/Medial Thigh p!, dull, aching, decreased ROM into IR

Question 16

Legg- Calve Perthes

Answer 16

LCP “Limping Child Problem”

Young child, insidious onset, limp w/ hip/knee p!

Goal for Treatment:
- Maintain femur in acetabulum
- WBAT
- “ABD & IR”

Question 17

Hip Pointer

Answer 17

trauma to iliac crest (ASIS)

Question 18

Myositis Ossificans

Answer 18

Ossification of contusion

most commonly in quadriceps and brachialis muscles

P!, swelling, TTP, decreased ROM, possible palpable mass

Question 19

Iliospoas Bursitis

Answer 19

pain/snapping in medial groin/thigh

Question 20

Arthritis

Answer 20

Progressive Pain
Stiffness
+ = Scour Test

Question 21

Femoroacetabular Impingment (FAI)

Answer 21

Anterior groin pain w/ FADIR test

Question 22

Which direction of mobilization of the knee joint would help to increase knee extension in an Open Kinematic Chain position?

Answer 22

Anterior Glide

Question 23

Which direction of mobilization of the knee joint would help to increase knee flexion in an Open Kinematic Chain position?

Answer 23

Posterior Glide

Question 24

What is the resting position of the knee?

Answer 24

25 FLX

Question 25

How much knee FLX is required for proper foot clearance during gait?

Answer 25

70 FLX

Question 26

Insufficient Knee flexion during gait results in....?

Answer 26

Vaulting/Circumduction Gait Patterns

Question 27

function of the popliteus muscle

Answer 27

Screw Home Mechanism "Unlocks" the knee Open chain - IR of the tibia Closed chain - ER of the Femur

Question 28

The top of the patella is called the......

Answer 28

Base

Question 29

The bottom of the patella is called the...

Answer 29

Apex

Question 30

Lachman's Test

Answer 30

Tests for ACL injury Supine, 20 knee FLX (+) = mushy feel

Question 31

Anterior Drawer Test (Knee)

Answer 31

ACL injury Supine, knee flexed to 90 Abnormal tibial anteroposterior translation

Question 32

Posterior Drawer Test (Knee)

Answer 32

PCL Injury Supine, knee flexed to 90 Abnormal posterior tibial translation

Question 33

Posterior Sag Test

Answer 33

PCL Injury Supine, hip flexed to 90, knee flexed to 90 Abnormal posterior translation of the tibia

Question 34

Slocum's Test

Answer 34

Anterior rotary Instability (ACL) Supine, knee flexed to 90, 30 IR, then 30 ER Excessive tibial movement in relation to knee

Question 35

Pivot-Shift Test

Answer 35

ACL rupture Supine, Knee IR, examiner flexes knee to 90 (+) = when the knee flexes tibia clunks backward at 30-40

Question 36

Valgus Stress Test

Answer 36

MCL Supine, knee flexed 20-30 (+) = Tibia moves away from the femur

Question 37

Varus Stress Test (Knee)

Answer 37

LCL

Question 38

McMurray's Test

Answer 38

Meniscal tear Supine, 90 hip flx, 90 knee flx, Medial Meniscus: ER Lateral Meniscus: IR (+) = click and/or knee p!

Question 39

What are the Ottowa Knee rules?

Answer 39

- inability to walk 4 steps - inability to flex knee to 90 - TTP over head of fibula - isolated patellar tenderness - Age > 55 yrs

Question 40

To increase ankle DF and PF, mob which directions?

Answer 40

Posterior = DF Anterior = PF

Question 41

Talipes Equinovarus (Clubfoot)

Answer 41

congenital deformity PF, supination, ADD, inversion, cavus, varus Flexible - bracing/stretching Rigid - sugerical intervention

Question 42

Metatarus Adductus

Answer 42

- Hooked Forefoot Most common foot deviation in children ADD, Supination

Question 43

Mobilization of talocrural joint to increase Eversion?

Answer 43

Medial glide

Question 44

Mobilization of talcrural join to increase inversion?

Answer 44

Lateral glide

Question 45

Anterior Drawer Test (Ankle)

Answer 45

ATFL stabilize tibia, ankle PF 10-20, pull talus anterior (+) = excessive movement