Clinical A+K sheet 3

Daily functional activity using knee movements

Sitting to standing; walking; step up; stair climbing

Knee movement during step up

Extension → flexion → extension

Plane and axis of knee movements

Sagittal plane; mediolateral axis

Prime movers for knee flexion

Hamstrings: biceps femoris; semitendinosus; semimembranosus

Assistant movers for knee flexion

TFL; gastrocnemius; gracilis; sartorius; popliteus; plantaris

Antagonists to knee flexion

Quadriceps

Prime movers for knee extension

Quadriceps: rectus femoris; vastus lateralis; vastus intermedius; vastus medialis

Assistant movers for knee extension

Tensor fascia latae

Antagonists to knee extension

Hamstrings

Morphology of gastrocnemius

Two-headed superficial calf muscle

Action of gastrocnemius

Plantarflexion and knee flexion

Origin of gastrocnemius

Lateral and medial femoral condyles

Insertion of gastrocnemius

Posterior calcaneus via Achilles tendon

Nerve supply of gastrocnemius

Tibial nerve (S1–S2)

Morphology of gluteus maximus

Large quadrilateral muscle with fibres running laterally and inferiorly

Action of gluteus maximus

Hip extension and lateral rotation

Origin of gluteus maximus

Gluteal surface of ilium and posterior iliac crest

Insertion of gluteus maximus

IT band and gluteal tuberosity

Nerve supply of gluteus maximus

Inferior gluteal nerve

Joints of lumbar spine

Intervertebral joint + 2 facet joints

Classification of facet joints

Synovial plane joints allowing gliding

Parts of intervertebral disc

Nucleus pulposus; annulus fibrosus; vertebral end plates

Spinal ligaments

Anterior longitudinal ligament; posterior longitudinal ligament

Pelvic observation features

Pelvic tilt; ASIS/PSIS symmetry; iliac crest level; skin changes

Muscle attaching to base of 5th metatarsal

Peroneus brevis; abductor digiti minimi

Muscle attaching to navicular tuberosity

Tibialis posterior

Surface marking ankle joint line

0.5 cm above medial malleolus; 1 cm above lateral malleolus

Hip abduction ROM and end feel

30–50 degrees; firm

Knee extensors

Quadriceps group

Grade 3 knee extension test

Sitting; extend knee against gravity

Palpating transverse abdominis

Crook lying; palpate medial to ASIS during draw-in

Superior tibiofibular PAM

AP or PA glide

Rectus femoris flexibility test

Side lying; extend hip with knee flexed

Hamstring flexibility test

Supine; hip flexion with knee extension

Ober’s test purpose

Assess TFL/ITB tightness

Positive Ober’s test

Leg remains abducted

Trendelenburg test purpose

Assess hip abductor function

Positive Trendelenburg sign

Pelvis drops on unsupported side