Fichas
Lower Extremity Lab
Fichas del conjunto (34)
- 1Hip & KneeHip: inspect gross deformity, symmetry of ASIS
Palpation (ASIS, SI joints, greater trochanter, lumbar spinous processes, gluteal m.'s, anything indicated by history)
ROM: restriction in int. rotation suggestive of hip joint pathology - 2Strength Grade ROM
- 3Neurovascular TestSensation over Ant., Post., Medial & Lateral Leg
Check femoral & distal pulses - 4Ober's TestPatient in lateral decubitus position with knees and hips flexed to 90˚, top leg is passively further flexed followed by abduction and extension. Leg is allowed to gently fall toward the exam table.
Test is positive if the top knee does not adduct to the table or if passive knee extension occurs.
Test is for IT band inflexibility. (Common cause of runner’s knee)
https://www.youtube.com/watch?v=Amjv6FzDeLE - 5Modified Thomas TestPatient sits on edge of exam table, pulls opposite knee to chest, and then lies supine.
Exam positive if the thigh rises off of the exam table, or the knee passively extends past 90 degrees.
Suggestive of iliopsoas contracture, rectus femoris contracture or quadriceps inflexibility.
https://www.youtube.com/watch?v=-c0albG73po - 6FABER Test (Flexion, Abduction, External Rotation)With patient supine, the hip is passively flexed, abducted and externally rotated. An Axial load can be transmitted by the examiner down the femur.
Test is positive if the ipsilateral SI joint hurts. Test is for SI joint dysfunction.
Reduced ROM (Hip arthritis, Femoral acetabular impingement, Other hip pathology)
Groin or side of hip pain (Hip pathology)
Low back pain (SI dysfunction)
https://www.youtube.com/watch?v=V1a0E0ssTqA - 7Trochanteric BursitisIrritation of the bursa (by trauma/ hip surgery/ movement) between the femoral trochanteric process and Gluteus Medius / iliotibial tract
- 8Meralgia ParestheticLateral femoral cutaneous is entrapped between the ASIS and the inguinal ligament
- 9Knee ExamInspect: asymmetry, effusion, redness, deformity
- 10Knee Positions
- 11Knee Palpation 1Subtle effusion, Suprapatellar Bursa, Pre-patellar Bursa, Patella
Bulge sign: Medial or lateral side compression to move fluid away from medial or lateral compartment - 12Knee Palpation 2MCL/ LCL of 90 degree flexed knee
Patellar tendon and insertion
Posterior knee ( bogginess)
Baker cyst
Pes Anserine
Fibular Head/ Proximal Tibia - 13Knee ROM & StrengthMeasure flexion and extension, has minimal appreciable rotation or adductive or abductive ROM
Strength: Flexion and Extension- grade X/5
Injured Knee (no extension): Consider quadriceps rupture (needs immediate surgery)
Patient supine: have patient perform a straight leg raise with foot neutral or slightly externally rotated.
If the patient internally rotates, the patient can still raise the leg using the Tensor fascia lata and Sartorius muscles - 14Knee NeurovascularSensation over medial and lateral knee
Check Proximal and Distal Pulses - 15Patellar J SignWith the patient’s leg strait, apply resistance to the superior pole of the patella with the Thenar Space, ask the patient to flex their quadriceps
Positive Test if the patella moves medially or laterally before moving caudally, or if pain occurs with this maneuver
Suggestive of Patellar Femoral Pain Syndrome
https://www.youtube.com/watch?v=4dHF6LxhAMw - 16Patellar Grind TestWith the leg in extension, compress the patella against the femur longitudinally and transversely
Positive test if pain or crepitus
Suggestive of Patellar Femoral Pain Syndrome
https://www.youtube.com/watch?v=4AO_VtrU3yE - 17Patellar Apprehension TestPatient supine, relaxed quadriceps, knee flexed 30˚-45˚, press against the medial border of the patella.
Test positive if the patella begins to sublux, the patient will ask you to STOP! and feel as if their patella is about to dislocate.
Suggestive of a patellar retinaculum disruption/ patellar instability
https://www.youtube.com/watch?v=4TnCQppTy1g - 18Lachman's TestKnee flexed to 30˚, hands placed around distal thigh and proximal tibia with the thumb on the tibial crest, attempt anterior translation with the distal hand.
Test is positive if endpoint is not detected, or excessive anterior translation occurs
Suggestive of ACL injury - 19Posterior & Anterior Drawer TestWith the knee flexed at 90˚, with both hands placed on the tibia, anterior and posterior translation is transmitted through the joint
Test is positive if endpoints are not detected or if excessive anterior translation occur
Anterior drawer tests for ACL, Posterior drawer tests for PCL - 20Varus & Valgus StressWith the knee flexed to 30˚ stabilize the femur, and apply varus and valgus stress to the knee
Test is positive if there is pain or laxity
Valgus Stress tests the MCL
Varus Stress tests the LCL - 21Apley's GrindPatient is prone with knee flexed to 90˚, examiner pushes straight down on the foot while rotating the tibia and partially flexing and extending the knee
Test is positive if there is pain over the medial joint line during external tibial rotation, or over the lateral joint line during internal tibial rotation
Suggestive of Medial or Lateral Meniscal injury
https://www.youtube.com/watch?v=6Z_9lfX_Pc8 - 22Thessaly's TestPatient standing on the affected limb, flexed 20˚-30˚, patient rotates their body weight on the knee
Test is positive if there is pain with rotational movement on the medial or lateral joint line
Suggestive of Medial or Lateral Meniscal injury
https://www.youtube.com/watch?v=ebraZ4jM36A - 23Leg Bones
- 24Foot & Ankle Bones
- 25Ankle Joints
- 26Anterior Leg Anatomy
- 27Posterior Leg Anatomy
- 28Medial Ankle Anatomy
- 29Medial Ankle
- 30Lateral Ankle
- 31Ankle Soft Tissue Landmarks
- 32ROM of Ankle
- 33Achilles Tendon
- 34Manual Muscle Testing of Ankle
