PE final exam review

Describe hip flexion PROM

Supine, axis at greater trochanter, stat arm at midline of trunk, moving arm in line with lateral femoral epicondyle

normal value for hip flexion

120

describe hip extension PROM

prone, axis greater trochanter, stationary arm midline trunk, moving arm in line with lateral femoral epicondyle

normal value for hip extension

30

describe hip abduction/adduction PROM

supine, axis ipsilateral asis, stationary in line with contralateral ASIS, Moving arm in line with patella

normal value for hip abduction

45

normal value for hip adduction

30

describe hip internal/external rotation PROM

seated, axis at patella, stationary arm perpendicular to floor, moving arm in line with tibial crest

hip internal rotation normal value

45

hip external rotation normal value

45

hip flexion MMT grades 5-3

seated, resistance applied at distal thigh

hip flexion MMT grade 2

side-lying, support limb, flex knee and ask patient to bring knee to nose

hip flexion mmt grade 1/0

supine, support hip in flexion at 90, ask patient to move knee to nose, while palpating distal inguinal ligament on medial side of sartorius, feel for muscle action

hip flexion compensations

external/internal rotation, abduction, trunk extension

hip external rotation grades 5-3

seated, stabilizing at distal femur, applies res at ankle

hip external/internal rotation grades 2-0

supine, evaluate motion or palpate

hip external/internal rotation compensations

lifting of contralateral pelvis, increased flexion of knee on side being tested, abduction of hip on reference side

hip abduction grades 5-3

side lying, stabilize pelvis, res applied distal tibia

hip abduction grades 2-0

supine, support limb, visualize palpation

hip adduction grades 5-3

side-lying, examiner behind patient, supporting upper limb, res applied at knee

hip adduction grades 2-0

supine, support limb or palpate

hip extension grades 5-3

prone, examiner places stabilizing hand on pelvis and applies resistance at distal calf

hip extension grade 2

side lying, maintain pelvis and support limb movement

hip extension grade 1-0

prone, palpation

Describe thomas test

supine, close to edge of table, grasps knee to chest, then relaxes limb to table

positive: patient cannot move hip into extension without lumbar lordosis

describe ryder’s/craig’s test

prone, flexes knee, grasp distal tibia, palpate greater trochanter and midline, rotate limb until GT is most prominent at midline, measure ankle between tibia and vertical line

axis: patella

stationary: vertical

moving: tibial crest

positive for femoral torsion: less than 8 deg is retroversion, 15+ is excessive anteversion

describe trendelenburgs test

ask patient to stand and lift one foot off ground, holding it up for 10 sec

positive: pelvis on nonweight bearing drops below pelvis on weight-bearing side

describe knee flexion and extension

supine, towel under ankle

axis: lateral epicondyle of femur

stationary arm: greater trochanter

moving arm: lateral malleolus

normal value for knee flexion

135

normal value for knee extension

0

describe grade 5-3 mmt for knee extension

seated, resistance applied at ankle, stabilizing at distal femur

describe grade 2 mmt for knee extension

side-lying, hold flexed limb at thigh and ankle

describe grade 1-0 mmt for knee extension

supine, watch for patellar movement while performing motion

compensation for weak knee extensors

hip internal rotators in grade 2 to force knee to fall into extension

describe grade 5-3 mmt for knee flexion

prone, with knee flexed 45*, resistance at ankle, stabilizing limb at lateral knee

describe grade 2 mmt for knee flexion

side lying, examiner behind patient, support thigh and ankle

describe grade 1-0 mmt for knee flexion

supine, support knee while going through motion

describe varus/valgus stress test on knee joint

supine, lift limb off table, allow slight flexion, observe gapping between femur and tibia

describe anterior/posterior drawer test for knee stability

supine, knee flexed on table. Sit on foot, grasp knee at proximal tibia, firm and quick anterior and posterior motions to assess any laxity

describe hamstring length test aka popliteal test

pt supine, hip flexed to 90, extend knee to end range, measuring knee extension

describe obers/modified obers test

side lying, examiner slightly extends the top limb and supports it while allow gravity to adduct the limb, testing for tight TFL and ITB, if the limb does not drop below horizontal

describe ankle dorsiflexion and plantarflexion testing

seated, foot hanging free

axis- align with lateral malleolus, then drop to plantar surface

stationary arm- fibular head

moving arm- plantar surface of foot

ankle dorsiflexion normal value

20

ankle plantarflexion normal value

50

describe hindfoot varus/valgus

prone, feet hanging off table, manipulate hindfoot to determine flexibility

axis- Achilles tendon between malleoli

stationary arm- midline of calf

moving arm- midline of calcaneus

describe ankle inversion/eversion

seated, foot lax

axis- anterior ankle between malleoli

stationary arm- crest of tibia

moving arm- in line with 2nd metatarsal

normal ankle inversion value

35

normal ankle eversion value

15

describe first MPJ flexion and extension

axis- lateral aspect of 1st met head

stationary arm- shaft of first met

moving arm- along 1st phalange

describe ankle dorsiflexion and inversion mmt grades 5-0

seated or supine, examiner stabilizes lower limb and applies res at ankle

describe ankle eversion and plantarflexion mmt grades 5-0

seated or supine, examiner asks to ‘turn foot down and out’

describe ankle inversion and plantarflexion mmt

seated, slight plantarflex

‘turn foot down and in’

resistance on plantar medial foot

compensations for weak inversion and plantarflexion

flexion of toes and poor ability to do a single leg heel rise

describe ankle plantarflexion mmt grade 5-3

standing minimal support doing single leg heel raises

describe ankle plantarflexion grade 2-0

prone, goes through plantarflexion

compensations for weak gastroc/soleus, which limits heel raise ability

rocking up onto toes by flexing knee, using upper body strength to force standing

describe tibial torsion testing

axis- mid calcaneous

moving arm- 2nd metatarsals

stationary arm- midline of thigh

prone, knee flexed to 90

normal assessment for tibial torsion

0-10 deg of external rotation

describe silfverskiold test

assesses gastroc length, assessment of ankle dorsiflexion with knee flexed and knee extended

normal difference up to 10 degrees

describe coleman block test

determines flexibility of hindfoot varus deformity

pt stands with foot on block, then shifts forefoot so that the medial meta can drop off the block

describe navicular drop test

midfoot flexibility, pt stands on 2 feet in subtalar neutral, measures distance between navicular tuberosity and floor, pt shifts full weight onto test side, remeasures. more than a 4 mm difference is positive

describe function assessment of leg length discrepancy

place end of tape to measure umbilicus to distal tip of medial malleolus, determine differences

describe anatomical assessment of leg length discrepancy

measure tape to ASIS, then to distal tip of medial malleolus. measure both legs and compare.