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Lower Extremity > Test #2 Hip > Flashcards

Test #2 Hip Flashcards

(56 cards)

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1
Q

What do you look for during a visual inspection?

A
  • swelling
  • ecchymosis
  • deformity
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2
Q

What is Trendelenberg?

A
  • the patient stands on the injured leg
  • flexes the contralateral hip to 90 degrees
  • observe the movement of the pelvis
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3
Q

What is a positive Trendelenberg test?

A

If the pelvis on the NON-STANCE side falls, then the test is considered positive for weakness or instability of the gluteus medius on the STANCE SIDE

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4
Q

What are the prone ROM test?

A

Passive hip extension ​

Passive bilateral IR​

Resisted hip extension ​

Resisted hip IR ​

Resisted knee extension ​

Resisted knee flexion

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5
Q

Passive hip extension

A
  • patient = prone
  • examiner = opposite side
  • Stabilize the patient’s ipsilateral ischial tuberosity with one hand (proximal)
  • Grasp the patient’s distal femur from lateral with your other hand and passively extend the hip
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6
Q

Passive hip bilateral IR

A
  • patient = prone; knees 90 degrees
  • examiner = stand at end of treatment table
  • Passively internally rotate bilateral hips bringing the ankles/lower legs laterally
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7
Q

Resisted hip extension

A

Patient = prone
examiner = testing side
- Grasp the malleoli with your distal hand

  • Place your proximal hand on the posterior side of the distal femur ​
  • Apply resistance to the distal thigh while asking the patient to hold in extension
  • Ask the patient to simultaneously kick into your other hand (knee extension) ​
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8
Q

Resisted knee extension

A

Patient = prone
Examiner = testing side
- Grasp the malleoli with your distal hand

  • Place your proximal hand on the posterior side of the distal femur
  • Bring the knee into 45-90 degrees of knee flexion
  • Stabilize the posterior thigh
  • Provide isometric resistance at the distal tibia for knee extension ​
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9
Q

Resisted knee flexion

A

Patient = prone
Examiner = testing side
distal hand

  • Place your proximal hand on the posterior side of the distal femur
  • Bring the knee into 45-90 degrees of knee flexion
  • Stabilize the posterior thigh
  • Provide isometric resistance at the distal tibia for knee flexion
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10
Q

Resisted hip IR

A

Patient = prone; knees flexed 90 degrees
Examiner = end of the treatment table
- Place your hands on the lateral aspect of the distal tibia bilaterally ​

  • Apply isometric resistance to hip IR by having the patient press his/her lower legs into your hands ​
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11
Q

Resisted hip ER

A

Patient = prone; knees flexed 90 degrees
Examiner = end of the treatment table
- Place your hands on the medial aspect of the distal tibia bilaterally in such a way that your forearms are crossed

  • ​Apply isometric resistance to hip ER by having the patient press his/her lower legs into your hands
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12
Q

Supine ROM tests

A

Passive hip flexion ​

Passive hip IR ​

Passive hip ER ​

Passive hip abduction ​
Knee extended & knee flexed​

Passive hip adduction ​

Resisted hip flexion ​

Resisted hip adduction ​
0 vs 45 vs 90 degrees​

Resisted hip abduction

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13
Q

Passive hip flexion

A

Patient = supine
Examiner = testing side
- bring hip into full available hip flexion

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14
Q

Passive hip ER

A

Patient = supine
Examiner = testing side
- Grasp the patient’s posterior thigh just above the knee with your distal hand

  • flex the patient’s hip and knee to 90 degrees.
  • Support the lower leg with your forearm and support the medial knee with your hand.​
  • Move the hip into full available external rotation
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15
Q

Passive hip IR

A

Patient = supine
Examiner = testing side
- Grasp the patient’s posterior thigh just above the knee with your distal hand

  • flex the patient’s hip and knee to 90 degrees.
  • Support the lower leg with your forearm and support the medial knee with your hand.​
  • Move the hip into full available external rotation
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16
Q

Passive hip adduction

A

Patient = supine
Examiner = opposite side
- The clinician bends the knee of the nonaffected leg and cross the leg over the affected leg

  • Place your proximal hand on the ipsilateral ASIS to stabilize the pelvis (opposite side being tested)
  • Cradle the lower leg and knee with your distal hand and bring the hip into adduction.
  • Ensure the hip remains in neutral rotation
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17
Q

Passive hip abduction

A

Patient = supine
Examiner = testing side
- Grasp the patient’s leg at the mid-calf with your distal hand​

  • Place your proximal hand over the ASIS
  • Abduct the hip keeping the knee straight until you feel movement of the ASIS ​
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18
Q

Passive hip abduction pain

A
  • Maintain this position and passively flex the knee.
    - If the groin pain disappears, the lesion is likely in the gracilis muscle.
    - If the pain persists, it is likely in the adductor longus, adductor brevis, or pectineus
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19
Q

Resisted hip flexion

A

Patient = supine; knee flexed to 45 and 90 degrees
Examiner = testing side
- Stabilize the ipsilateral shoulder with your proximal hand

  • Place your distal hand on the patient’s anterior thigh directly above the knee ​
  • Keeping your elbow straight provide isometric resistance to hip flexion ​
  • Pain provoked is likely due to a lesion in the iliopsoas or the rectus femoris ​
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20
Q

Resisted hip abduction

A

Patient = supine with the hips and knees extended
Examiner: either side
- Place your hands on the outside distal femur bilaterally
- Apply isometric resistance to abduction

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21
Q

Resisted hip adduction

A

Patient = supine; hips and knees @ 0 degrees flexion
Examiner = either side
- Place your hands on the inside of the distal femur in such a way that your forearms are crossed ​

  • Apply isometric resistance to adduction ​
  • Assess the quality of the contraction, the quantity of strength, and any provocation of symptoms ​
  • Repeat test at 45 degrees and 90 degrees of hip flexion​
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22
Q

Resisted hip adduction: muscles tested at each degree

A

Zero degrees: adductor longus/gracilis​

45 degrees: pubic symphysis ​

90 degrees: pectineus ​

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23
Q

What are the extra tests?

Study These Flashcards
A

Femoral Nerve Tension Test ​

Circumduction Test​

Impingement Tests​

Prone Impingement Test​

Fulcrum Test​

Hamstring Syndrome ​

Piriformis Syndrome ​

Thomas Test​

​

24
Q

Femoral nerve tension test!

Study These Flashcards
A

Patient = side-lying with the affected side up
Examiner = behind the patient ​
-

25
Circumduction Test​!
Patient = supine Examiner = testing side - Place your cranial hand on the patient's contralateral ASIS to stabilize the pelvis ​ - With your caudal hand on the patient's posterior distal femur, bring the hip into flexion/abduction/external rotation ​ - Move the hip in a scouring motion from flexion/abduction/external rotation to flexion/adduction/internal rotation​
26
Impingement Test (axal OP) ​!
Patient = supine Examiner = testing side - Use both hands to bring the patient's hip into flexion, adduction, and IR ​ - At the end of the movement, axial compression is given in line with the femur ​
27
Impingement Test (axal OP) ​positive test
In the femoroacetabular impingement or labral pathology, this test could provoke groin pain or buttock pain ​
28
Impingement Test (IR OP)!
Patient = supine Examiner = testing side - Grasp the lower leg of the patient, just above the ankle, with the distal hand - Place the other hand anterolateral just proximal to the patient's knee​ - Use both hands to bring the hip into flexion, adduction, and IR​ - At the end of the movement, overpressure is given in the direction of internal rotation ​
29
Impingement Test (IR OP) positive test
In femoroacetabular impingement or labral pathology this could provoke groin pain​
30
Prone Impingement Test​!
Patient = prone Examiner = testing side - With your cranial hand stabilize the ischial tuberosity​ - Passively take the affected limb into extension, ER, and abduction ​ - Assess for provocation ​
31
Fulcrum Test​
Patient = The patient sits in a relaxed sitting position - Clinician places one forearm under client's thigh to be tested. - With the other hand applies downward pressure to the proximal knee. - Repeat test up the the femur to test the entirety of the femur. ​ ​
32
What is a positive fulcrum test?
Test is considered positive for stress fracture if the client reports pain
33
Hamstring syndrome test
Patient = supine Examiner = testing side - Flex the patient's hip to 80-90 degrees ​ - Extend the knee to 15 degrees of dorsiflex the foot/ankle ​ - Ask the patient to resist knee flexion (dig into your shoulder) ​ - Assess for provocation
34
What is a positive Hamstring syndrome test?
Positive test is a reproduction of their symptoms in the buttock or back of the thigh suggesting possible compression of the sciatic nerve ​
35
Piriformis test
Patient = side-lying with hip in flexion, adduction, and internal rotation ​ Examiner = testing side; stabilize ASIS - With your other hand, resist internal rotation just below the knee ​
36
Thomas test
- The patient sits at the end of the table, hugs the contralateral knee to their chest, and lays back on the table ​ - Clinician stands or kneels to the side being assessed ​ - The back of the thigh should contact the table, if not a tightness of the hip flexors is present ​
37
Bones in the pelvis
Ilium * Ishium * Pubic
38
Bones in the hip
Femur Pelvis * Ilium * Ishium * Pubic Sacrum Coccyx
39
Osteology- Angle of Inclination
Normal = 130 degrees Coxa Vara = < 125 degrees Coxa Valga = > 125 degrees
40
Osteology- Femoral Anteversion
Normal Anteversion =15 - 25 degrees Excessive Anteversion = > 25 degrees - Toe In Retroversion = < 10 degrees - Toe Out
41
What are the bursae of the hip?
Trochanteric Iliopsoas Ischiogluteal
42
Groin & Anterior Thigh Pain Pathologies
* Sports Hernia * Stress Fracture * Femoroacetabular Impingement * Labral Tear * Muscle Strain * Hip Pointer
43
Femoroacetabular Impingement (FAI)
+ anterior impingement test + FABER
44
Labral Tear
+++ passive IR in 90 degrees hip flexion (supine) (+) pain: passive IR in 90 degree hip flexion (+) pain: passive IR in hip extension Resistive tests = negative
45
Stress Fracture
Onset of pain with weight bearing activities - immediate resolution with stopping weight bearing (-) basic clinical examination (+++) hop test (+) fulcrum test (+) scanning
46
Sports Hernia "Athletic Pubalgia"
Cluster of 5 signs and symptoms: * Subjective complaint of deep groin/lower abdominal pain * Pain is exacerbated with sport specific activity (sprinting, cutting, kicking, sit-ups) and is relieved with rest * Palpable tenderness over the pubic ramus at the insertion of the RA and/or conjoined tendon * Pain with resisted adduction at 0, 45, and/or 90 degrees of hip flexion * Pain with resisted abdominal curl-u
47
Adductor/Hip Flexor Strain (Groin Strain)
Differentiation for adductors: o Add Longus: +++ resisted hip adduction at 0 degrees of hip flexion o Pubic Symphysis: +++ resisted hip adduction at 45 degrees of hip flexion o Pectineus: +++ resisted hip adduction at 90 degrees hip flexion
48
Quadriceps Strain
Stretching or tearing of the quadriceps muscle(s) * Pain & limited knee flexion * ++ pain resisted knee extension
49
Hip Pointer
Contusion (bruising) of iliac crest or abdominal musculature result of direct blow
50
Myositis Ossificans
Irritated tissue produces calcified formations that resemble cartilage or bone Causes * Single severe impact * Repeated impact to soft tissue * Improper care of a contusion Presentation * Pain * Muscle weakness * Soreness * Swelling * (+) palpation
51
Buttock & Posterior Thigh Pain Pathologies
* Sacroiliac Joint Dysfunction * Proximal Hamstring Rupture * Hamstring Syndrome * Piriformis Syndrome * Muscle Strain
52
Hamstring Syndrome
Possibly preceded by: * Episodes of hamstring injury * Previous low back pain or surgery Triad: * Painful sitting * Positive SLR and/or slump * Painful resisted knee flexion Negative SIJ provocation tests
53
Piriformis Syndrome
Follows direct trauma to gluteal region Compression of sciatic nerve + SLR and/or slump Painful sitting Negative SIJ provocation (-) resisted knee flexion Extra Tests: * (+) resisted IR in F, Add, ER (FADER) * (+) passive ADD in sidelying with hip flexed 60 degrees * (+) tenderness at sciatic notch
54
Hamstring Strain
Stretching or tearing of the hamstring muscle(s) Nonpainful sitting (-) SLR and/or slump (-) SIJ Provocation (+) resisted knee flexion (+) palpation
55
Trochanteric Bursitis
Inflammation/irritation of the bursa Pain in the lateral hip pain may radiate down to the knee Palpation reveals tenderness over the lateral aspect of the greater trochanter
56
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Lower Extremity (4 decks)

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