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278 Cards in this Set
- Front
- Back
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the largest joint in the body
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tibiofemoral joint
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the __ is a modified hinge joint
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tibiofemoral joint
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the tibiofemoral joint is made up of the __ and __
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tibia and femur
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the femur has medial and lateral __
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condyles
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the __ condyles articular surface is longer than the other
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medial
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in the knee, the __ articulates with the __
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tibia, femur
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the actions of the knee are __ and __
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flexion and extension
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the knee joint has a huge __ that encapsultae the knee except for the __ which are outside it.
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synovium, cruciates
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the closed packed position of the knee is __
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full extension with lateral rotation of the tibia
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the patellofemoral joint is a __
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modified plane joint
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the __ surface of the patella is wider
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lateral
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the largest sesamoid bone in the body
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patella
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bones found in tendons and called floating bones
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sesamoid bones
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the patella lies within the __ of the knee
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quadriceps tendon
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the quariceps provide what kind of action? (2)
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-hip flexion
-knee extension |
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muscles that form the pateller tendon (2)
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-vastis muscles
-rectus femoris |
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the hamstrings provide what kind of action? (2)
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-hip extension
-knee flexion |
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what muscles make up the hamstring? (3)
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-semitendinosus
-semimembranosus -biceps femoris |
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discs of fibrocartilage attached to the tibial plateua by the coronary ligament and joint capsule and are joined by the transverse ligament
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menisci
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what are the functions of the menisci? (2)
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-stabilize the joint
-shock absorbers |
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the medical meniscus is __ shaped, __ floating, and attaches to the __
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C, somewhat, MCL
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the lateral meniscus is __ shaped, and is attached to the __ ligament through the __
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O, PCL, ligament of Wrisberg
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in intrapattelar fat pad acts as a __
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shock absorber
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the femur contacts the patellar fat pad for the first __ degrees of knee flexion
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20
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the __ busa is the largest in the body
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suprapetellar bursa
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found between the femur and quadriceps tendon and functions to reduce friction between the two structures
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suprapatellar bursa
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attaches on teh medial epicondyle of the femur and below on the tibia it attaches to the medial meniscus
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medial collateral ligament
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the MCL is tightest during __
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extension
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the purpose of the MCL is to protect the knee from __ forces
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valgus and external
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the MCL is commonly __
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sprained
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attaches on the lateral epicondyle of the femur and to the head of the fibula
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lateral collateral ligament
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the pupose of the LCL is to protect the knee from __ forces
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varus
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the LCL is tightest during __
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extension
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the LCL is __ commonly inured
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not
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attaches by an aponeurosis to the head of the fibula and to the lateral meniscus
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arcuate ligament
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a lateral knee stabilizer and prevents medial tibial rotation
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arcuate ligament
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ligaments that form a cross in the knee
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cruciates
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attaches on the tibial palteau anteriorly, then it rons posteriorly and attaches to the lateral head of the femur
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anterior cruciate ligament
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the purpose of the ACL is to prevent __
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anterior translation of the tibia
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the ACL is taunt at __
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different angles
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works in conjunction with the hamstrings to stabilize the knee joint
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ACL
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the hamstrings do what to help stabilize the knee?
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decrease tibial rotation
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attacehs posteriorly on teh lateral aspect of the tibia and runs upward and foward to the medial femoral condyle
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posterior cruciate ligament
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the purpose of the PCL is to prevent __ and __
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posterior translation of the tibia, hyperextension
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the PCL is taunt at __
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different degrees of knee flexion
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a PCL rupture is very __
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uncommon
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PCL rupture normally occurs in __
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motor vehicle accidents
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if someone dislocates the knee joint, __ will be torn
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both cruciates
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caused by a direct blow from an object or person, falling down, bleeding occurs in the muscle
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knee contusion
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S/S of this ar localized pain, discoloration, swelling (minor), stiff due to tightness in musculature. it gets more tight after the first 12 hours, could have loss of movement
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knee contusion
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the __ bursa makes the knee appear "puffy" when injured
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prepatellar
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any type of synovial herniation on the posterior aspect of the knee. a soft tumorous mass can be palated in the medial popliteal space (may or may not hurt)
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bakers cyst
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caused by a direct blow from the lateral side and or severe valgus stress force during rotation
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MCL sprain
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when a few fibers of the ligament are torn/stretched
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first degree sprain
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S/S are stable valgus stress test, little or no swelling, minimal tenderness of MCL, and full ROM
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1st degree MCL sprain
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characterized by a partial tear of the ligament
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second degree sprain
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S/S are + laxity at 0 and 30 degrees, slight swelling, decreased AROM in extension, pain, and joint tenderness medially, weak, and unstable
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2nd degree MCL sprain
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characterize by a complete rupture of the tendon (not very common)
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3rd degree ligament sprain
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S/S: complete medial instability, moderate selling, pain medially and point tender same, decreased A/PROM flexion/extension, (+) laxity at 0-30 degrees (more so than a second degree)
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3rd degree MCL sprain
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an LCL sprain is __
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not very common
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caused by a direct blow fromt the medial side and or severe varus force during roation
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LCL sprainS/S: pain and point tenderness laterally along joint line (+) joint instability, and minimal swelling
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is vulnerable when the tivia is externally rotaed and the nee is in a valgus position and or when hyperextension occurs with a planted foot
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ACL sprain
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S/S: swelling, joint instability (+) anterior drawer/lachmans test, feels a "pop" and pain
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ACL sprain
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the terrible triad is made up of __
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ACL, MCL, medial meniscus
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is most at risk when teh knee is flexed to 90 degrees and or with a direct blow to the front of a bent knee
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PCLS/S: same as ACL and (+) posterior drawer test
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the PCL is at most risk when the knee is flexed to __
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90
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it is more common to tear the __ menisci
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medial
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caused by a blow from the lateral side directed inward (valgus), forcing the knee into flexion or extension
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medial meniscus tear
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S/S: pain, loss of motion, locked knee (cant flex or extend the knee). "catching", "clicking", swelling, and a sense of "giving way", + McMurray test
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medial meniscus tear
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occurs when teh femur is externally rotated and the knee is forced into extension
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lateral meniscus tear
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S/S; same as medial--some tears within the cartilage fail to heal because of lack of adequate blood supply
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lateral meniscus tear
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caused by indirect trauma, severe pull of the patellar tendon against the femur with the knee semi-flexed. direct: falling on it
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patellar fracture
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as a rule the patella displaces __
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laterally
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can occur as a result of a forceful contraction of the quadriceps puling laterally
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patellar sublexation/dislocaiton
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the main cause of patellar tracking problems is a __
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weak VMO
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when teh patella displaces partially and or retursn to its normal position
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subluxation
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when the patella fully displaces
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dislocation
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S/S: loss of knee funtion, pain, swelling, obvious deformity
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patellar dislocaiton
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gradual degenerative process most often occurring in teenagesr and young adults
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chondromalacia
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what is the only way to diagnose chondromalacia?
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arthroscopy
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a fold in the synovial lining of the knee, it becomes inflamed and thicked fform overuse or trauma as it extends over the medial femoral condyle
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plica syndrome
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S/S: pain with prolonged sitting as the peorson stands and walks, a sharp pain is felt for every 8-10 steps, but disapears, popping with knee flex/ext. signs mimic torn meniscus pain, medial condyle
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plica syndrom
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occurs when either teh VMO is weak or the lateral retinaculum that holds the patella firmly to the femoral condyle is excessively tight--these result in lateral excursion of the patella
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patellofemoral stress syndrome
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patellofemoral stress syndrome is caused by weakness in what two muscles?
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-VMO
-lateral retinaculum |
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when teh patella is lateral when static
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lateral glide
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when conditions of Patellofemoral stress syndrom are presesnt, __ is decreased
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patellar mobility
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S/S: intesnse pain is possible with increased PF stresses, might have aching pain in teh center of the knee, point tender over lateral aspect of teh patella, intense pain and crepitus with grind test and swelling
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PFSS
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3 things to look for when looking at the patella:
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-glides (medial/lateral)
-rotation -tilts (inferior, superior) |
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caused by repetitive or eccentric knee extension activities such as in running and jumping
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patellar tendonosis (jumpers knee)
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S/S: pain occurs after activity on the inferior pole of the a patella and at the tibial tuberosity but as condition worsens, knee hurts before activity, is better after, then hurts after
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paterllar tendonosis (jumpers knee)
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S/S: increased with ascending/descending stairs or after prolonged sitting, pian with passive knee flexion past 120 and during resisted knee extension, fat pad can become inflamed too. can become painful all of teh time where person cannot participate, chronic tendonopathy can lead to more serious problems
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jumpers knee
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caused by a repeated avulsion of teh patelar tendon at the epiphysis of tibial tuberosity. common in males ages 10-15. it can be bilateral or unilateral
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osgood-schlatter disease
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S/S: pain and swelling witha activity, relieved with rest, in many cases the tibial tuberosity becomes enlarged and prominent
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osgood schlaters
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occur at the superior pole of the patella inferior pole, tibal tuberosity, or with the patellar tendon itself
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extensor tendon rupture
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the rupture may result form powerful muscle contractions or in conjunction with severe ligamentsous disruption of the knee. the rupture may be partial or complete
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extensor tendon rupture
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S/S: partial rupture will produce pain and muscle weakness on knee extension, toal rupre distal to the patella-->high riding patella, palpable defect over the tendon, and an inablilty to extend the knee toal ruprue superior to the patella painful and weak knee extension
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extensor rupture
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Hx of __, __, and __ are greatly important to know becuase they greatly incease risk for tendon rupture. can cause softening or weakining of collagen fibersin the muscle tendon
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cortisone, anabolic steriod, or other oral steriods
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common in runners and is caused by overuse and other associated factors
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illiotibial band friction syndrome
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S/S: pain with running initially as it progresses pain is present in uphill and downhill running, climbing starirs, and wlaking, and (+) Ober's test
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illiotibial band friction syndrome
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occurs when a fragment of bone adjacent to the articular surface of a jiont is deprived of blood supply leading to avascular necrosis. the piece of bone may displace and form a loose body within the knee joint leaving a defect in teh articular cartiliage
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osteochondritis dissecans
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S/S: aching, diffuse pain and or swelling with actvity, pain, with knee movemnt. knee may lock, x-rays are needed for a correct diagnosis
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osteochondirtis dissecans
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what should you ask during history of the knee? (10)
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-contact or noncontact
-foot planted? -direction knee went -did knee give out (feel stable) -hear or feel a pop -where was the pain -did it lock -did it swell -what aggravates it what alleviates it PMHx |
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waht extra should you observe from the knee (4)
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-abnornal leg apartment
-genu valgum -genu varum -genu recurvatum |
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knock knees
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genu valgum
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bow legged
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genu varum
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hyperextended knee
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genu recurvatum
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4 things to palpate on teh anterior knee:
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-patella, patellar tendon, quadriceps, sartorius
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3 things to palpate on the posterior knee
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-popliteal fossa, hamstrings, gastroncnemius
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when doing ROM you should do __, then __
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active, passive
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what two strength tests can you do on the knee?
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flexion, extension
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when doing stress tests, do them on the __ leg first
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good
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the valgus and varus stress tests of the knee are done at __ degrees of flexion
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0-20/30
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a + valgus/varus test is __, not __
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laxity, pain
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three tests for the cruciate ligaments are __
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-lachman
-anterior/posterior drawer test -godfrey 90/90 test |
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a + lachmans test is __
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soft, mushy end feel
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a+ test for the ACL with an anterior drawer sign is __
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anterior translation without a good endfeel
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a + posterior drawer test is the __ for the PCL
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sag sign
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athlete supine with the hip and knee of the involved side felxed to 90 degrees. the AT passivley stabilizeds the hips and knee while assessing the location of the tibia on teh longitudinal axis
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the godrey 90/90 test
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(+) test for PCL (the godrey 90/90 test) is __
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the tibia resting more inferiorly than the other side.
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Slocum Drawer Test for Rotary Instability:
__ the tibia checks for the lateral capsule. |
Internally rotating
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Slocum Drawer Test for Rotary Instability:
__ the tibia checks for the medial capsule. |
Externally rotating
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when One hand on the head of the fibula, the other at the ankle.
The tibia is internally rotated with a fully extended knee; then the hip is flexed to 30 degrees, and the knee is flexed while a valgus force is placed on the knee. (+) test is a palpable shift (and audible “pop”) at 30-40 degrees of knee flex. During ext. the anterior subluxation is felt. |
Pivot Shift Test
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a + Pivot Shift Test is a __ at __ degrees of knee flex. During ext. the anterior subluxation is felt.
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palpable shift (and audible “pop”), 30-40
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Supine, one hand on the foot and the other on the top of the knee with the fingers over the joint line. Fully flex the knee. Using the ankle hand, move the leg in a small circle and pull the leg into extension.
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McMurray Test
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McMurray Test:
ER tests the __ |
medial meniscus
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McMurray Test:
IR tests the __ |
lateral meniscus
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a + McMurray test is __
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clicking or the knee locking (loose body).
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if the knee locks during a McMurray test it indicates a __
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loose body
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Supine, legs out in front. Cup the heel in one hand, fully flex the knee, and then allow the knee to passively extend.
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Bounce Home Test
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Bounce Home Test is + If __
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extension is not complete or there is a rubbery endfeel/sharp pain in joint line
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Seated on the edge of table with both knees flexed to 90 degrees. Place a finger over one patella to palpate during movement. Have athlete slowly extend the knee.
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Stutter Test
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Stutter Test is a + test if the patella __ (0 is full ext) during otherwise smooth movement.
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stutters or jumps btwn 60 and 45 degree of flexion
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Supine, AT flexes knee and IR tibia w/ 1 arm and hand while pressing the patella medially w/ the heel of the other hand and palpating the medial femoral condyle w/ the fingers of the same hand. The athlete’s knee is passively flexed & extended while the examiner feels for “popping” of the plical band under the fingers.
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Hughston’s Plica Test
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a + Hughston’s Plica Test test is__.
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popping
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Athlete’s knee extended to discomfort. AT applies slight pressure over the patella. When this is done, a floating of the patella should be felt.
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Ballotable Patella
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+ Ballotable Patella test: fingers/thumb __.
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separated by the fluid
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AT presses down slightly proximal to the upper pole or base of the patella w/ the web of the hand as the athlete lies supine with the knee extended. The athlete is asked to contract the quadriceps muscles while the AT pushes down (control the pressure).
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Clarke’s Sign (Hook Test)
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(+) Clarke’s Sign (Hook Test): If the test causes __
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patellar pain and the athlete cannot hold a contraction.
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Supine with the leg extended. The athlete then contracts the quadriceps while the AT watches the movement of the patellar movement.
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Lateral Pull Test
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If there is __ the Lateral Pull Test is (+) for lateral overpull of the quadriceps, resulting in patellofemoral pain.
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excessive lateral movement,
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Supine with quads relaxed and knee flexed to 30 degrees while the AT carefully pushes the patella laterally.
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Apprehension Test
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+ Apprehension Test: If athlete feels like the patella is going to dislocate, the athlete will __ Will also have an apprehensive look.
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contract the quad to bring the patella back “into line.”
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Supine with knees flexed to 90 degrees. The examiner stands on the involved side and places the thumb over the lateral epicondyle of the knee w/ the other hand at the ankle. The A.T. passively extends and flexes the knee while maintaining pressure over the epicondyle.
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Noble Test
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+Noble Test test: Pain present under the thumb w/ the knee in __ degrees of flexion indicates __
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30, ITB Friction Syndrome.
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The angle btwn the quadriceps muscles(rectus femoris) and the patellar tendon. Found by drawing a line from the ASIS to the midpt of the patella on the same side & from the tibial tubercle to the midpoint of the patella.
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Q-Angle
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Q-Angle:
Males: __ degrees with knee straight |
13
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Q-Angle:
Females: __ degrees with knee straight |
18
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Any angle less than __ degrees may be associated w/ CMP. Any angle greater than __ degrees is often associated w/ CMP, subluxing patella, or lateral displacement of the tibial tubercle.
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13, 18
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If measured in seated position, Q-angle should be __. If measured standing with the quads contracted and the knee fully extended, the Q-angle should be __ degrees. Greater than __ is abnormal.
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0, 8-10, 10
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the hip is a __ joint
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Multiaxial ball and socket
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the hip is very stable because of the __of the head of the femur into the acetabulum.
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deep insertion
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The acetabulum is formed by the __ (3).
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ilium, ischium, and pubis
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the acetabulum is deepened by the __.
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labrum
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The joint capsule is large and completely__ the joint.
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surrounds
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Several __ are present at the hip to help reduce the amount of friction between muscles and other structures.
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bursae
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positioned between the iliopsoas and the articular capsule.
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Iliopsoas Bursa
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provides a cushion between the greater trochanter of the femur and the gluteus maximus at it’s attachment.
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Deep Trochanteric Bursa
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(y-shaped iliofemoral ligament) strengthens the hip anteriorly.
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Y Ligament of Bigelow
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(located anteriorly) connects the pubic ramus to the intertrochanteric line.
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Pubofemoral Ligament
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reinforces the hip posteriorly.
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Ischiofemoral Ligament
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Anterior musculature of the hip (3)
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Rectus femoris
Sartorius Iliopsoas group |
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Degenerative hip changes
Include: (4) |
Arthritis
Osteochondritis dissecans Acetabular labrum tears Avascular necrosis |
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__causes the two articular surfaces to compress and rub on one another
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Hip scouring
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Ischemic lesions of the femoral head that develops during the first decade of life
Internal hip rotation and abduction are limited Pain in the medial thigh, buttock, of suprapatellar region |
Legg-Calve-Perthes disease
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with Legg-Calve-Perthes disease, the __ leg may appear shorter, but actual difference is rare
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affected
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Most prevalent in endurance athletes
Tension-side or compression-side fractures Deep aching pain that increases with duration and intensity of activity ROM is limited and painful near end ranges |
Femoral neck stress fracture
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with Femoral neck stress fracture __ is reported
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night pain
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common in runners and most often involves the trochanteric bursa. Because streets are crowned to allow for run-off, the condition usually affects the down leg (closest to the gutter).
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Bursitis (hip)
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S/S: A burning or deep, aching feeling is felt just posterior to the tip of the greater trochanter, aggravated by resisted hip AB and hip flex/ext.
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Bursitis (hip)
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Chronic Bursitis leads to __
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“snapping hip syndrome”.
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Sprains: Hip joint sprains are rare but do occur in violent twisting or in catastrophic trauma when the knee is driven into a stationary object like __.
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motor vehicle accidents
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S/S: pain with hip rotation.
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hip sprains
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These are uncommon but result in immediate intense pain, and an inability to walk or move the hip.
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hip Dislocations
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S/S: hip is in a flexed and internally rotated position, may have nerve impingement, shock.
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hip dislocation
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Causes of Labral tears: (5)
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Hip dislocations
Repeated subluxations Slipped capital epiphysis Acetabular dysplasia Repeated athletic trauma |
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Fall onto flexed knee with hip abducted or jump-stop pivot
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Hip subluxations
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The sciatic nerve passes through the notch beneath the piriformis muscle to travel into the posterior thigh and can become compressed from trauma, hemorrhage, or spasm of the piriformis muscle. The symptoms may mimic a herniated lumbar disk problem.
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Piriformis Syndrome
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caused by a history of prolonged sitting, overuse, a recent increase in activity, or trauma to the area.
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Piriformis Syndrome
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S/S: dull ache in the midbuttock region, pain that worsens at night, difficulty walking up stairs or on an incline, weakness or numbness down the back of the leg, normally does not have LBP, point tenderness in the midbuttock region and weakness on hip AB and ER.
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Piriformis Syndrome
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things to observe for the hip (5)
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gait, balance (weight evenly distributed), posture, proprioception, any shortening of a leg.
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Palpation:
Anterior Aspect: (5) |
iliac crest, greater trochanter, ASIS, inguinal ligament, femoral triangle
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Palpation:
Posterior Aspect: (5) |
iliac crest, posterior superior iliac spine, ischial tuberosity, greater trochanter, sacroiliac joint
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AROM:
Hip flexion (__) |
0-120
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AROM:
hip Extension (__) |
0-30
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AROM
Hip Abduction (__) |
45
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AROM:
Hip Adduction (__) |
0-20/30
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AROM:
Hip External Rotation (__) |
45
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AROM:
hip Internal Rotation (__) |
45
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Athlete is supine, resting the foot and ankle of the involved leg on the contralateral knee. The flexed knee is then slowly lowered into AB. The final position of flex, AB, and ER at the hip should place the involved leg on the table or at least near a horizontal position with the opposite leg.
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Patrick or FABER Test
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If the leg is unable to relax to this position and remains above the opposite leg, it may indicate a iliopsoas spasm, tight piriformis muscle, or hip joint contracture. Overpressure of the involved leg and the contralateral iliac crest may produce pain in the sacroiliac joint on the side of the involved leg.
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FABER Test
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what does FABER stand for?
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F=flexion, AB=abduction, ER=External Rotation
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__ is caused by an anatomic or structural change in the lower leg resulting from congenital maldevelopment or trauma.
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True leg length
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__ is the result of compensation for a change that may have occurred because of positioning rather than structure (one foot pronates or scoliosis).
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Apparent leg length
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Patient lies supine with the hips and knees flexed. The medial malleoli are palpated with the thumbs. The athlete then lifts the pelvis off the table and returns to the starting position. The AT passively extends the legs and compares the medial malleoli.
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Webster-Barstow Maneuver
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side lying with the test leg uppermost. The athlete flexes the test hip with the knee flexed. The AT stabilized the hip with one hand and applies a downward pressure to the knee. If the piriformis muscle is tight, pain is elicited in the muscle. If the muscle is pinching the sciatic nerve, pain results in the buttock and sciatica may be experience by the athlete.
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Piriformis Test
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Athlete is supine, with (both) hips at 90 degrees of flexion.
The athlete actively extends one knee, then the other. |
90/90 Straight Leg Raise Test
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a + 90/90 Straight Leg Raise Test means tight hamstrings if the knee is flexed greater than __ degrees.
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20
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Athlete lies prone with the A.T. standing next to the table and with one hand over the ipsilateral pelvis.
The AT passively flexes the subject’s knee and notes the reaction at the hip joint. Repeat on the other side. |
Ely’s Test
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a + Ely’s Test is if the hip also __ when the knee is flexed, a tight __ is indicated.
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flexes, rectus femoris
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help to transfer the weight from the spine to the lower limbs.
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Sacroiliac Joint and Symphysis Pubis:
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The pelvis protects organs & is a site for __.
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muscle attachments
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Act as shock-absorbers by decreasing the force of the spine & upper body caused by jars & bumps when the lower limbs contact the ground.
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Sacroiliac Joint and Symphysis Pubis:
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Involved with associated back/leg pain
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Sacroiliac Joint and Symphysis Pubis:
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__ are relatively mobile in young people & become stiffer with age.
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SI joints
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The pelvis consists of innominate bones made up of the: (5)
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ilium, ishium, & pubis, the sacrum, & coccyx.
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The__ forms the major portion of the pelvis, including the iliac crests.
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ilium
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The __ is a palpable anterior landmark of the pelvis.
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anterior superior iliac spine (ASIS)
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The __ is an indentation in the soft tissues lateral to the sacrum.
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posterior superior iliac spine (PSIS)
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when the ASIS moves anteriorly.
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Anterior Pelvic Tilt
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when theASIS moves posteriorly
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Posterior Pelvic Tilt
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A contusion to an unprotected iliac crest. Sometimes fractures occur too. Many muscles attach here.
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Hip Pointers
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S/S: pain with any trunk movement such as coughing, laughing, & breathing; pain, discoloration, spasm, NWB in some cases.
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Hip Pointers
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These are a result of severe trauma.
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Pelvic Fractures
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These follow violent or explosive muscular contractions, sudden deceleration of the involved muscle, or direct trauma.
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Avulsion Fracture
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seldom occur in sports. A possible fracture can be determined with slight compression to the sides of the ilium and ASIS.
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Pelvic Fractures
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is a stress fracture caused by continued rotational tension/shear forces placed on the symphysis pubis from repeated overload of the adductor muscles. Pain is localized over the symphysis pubis and increases with activity.
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Osteitis pubis
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“Sports Hernia” Result of increased muscular loads placed on the pubic bone &/or pubic symphysis as the result of high-speed, high-velocity twisting and turning.
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Athletic Pubalgia
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The term pubalgia is preferred because it does not always result in __.
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tissue herniation
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what to look for when evaluating the history of the pelvis (2):
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chronic or acute
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things to Observe when evaluating the pelvis:(2)
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ASIS same height, ASIS anteriorly or posteriorly rotated.
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This is the relationship between the femoral head and femoral shaft but is determined by the relationship between the femur and the tibia.
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Angle of Inclination
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increase in the angle of inclination (more than 125 degrees)…might cause bowleggedness (genu varum).
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Coxa Valga
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decrease in the angle of inclination (less than 125 degrees)….might cause knock knees (genu valgum).
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Coxa Vara
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increase in the angle of torsion greater than 20 degrees)…causes internal femoral rotation…pigeon-toed, squinting patellae.
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Anteversion
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the angle of torsion is less than 15 degrees….external femoral rotation…toe out.
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Retroversion
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structural leg length. Shortening results from congenital maldevelopment or trauma.
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True Leg Length
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The result of compensation for a change that may have occurred because of positioning rather than structure.
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Apparent/Functional Leg Length
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Femoral triangle is important because the __ are located within this area.
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femoral nerve, femoral artery, and femoral vein
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A femoral pulse may be felt here
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femoral triangle
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Lymph nodes may be palpated here if someone has an infection.
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femoral triangle
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lies between the right ASIS and the umbilicus (one third of the distance from the ASIS) - - tender with an appendicitis.
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McBurney’s Point
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things to palpate on the posterior aspect of the pelvis (5)
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Iliac crest, PSIS, ischial tuberosity, ischial bursa, hamstring muscles,
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This is a test for a sprain of the anterior sacroiliac ligaments. The athlete lies supine while the AT applies crossed-arm pressure to the ASIS (pushing down and out with the arms). The test is positive only if unilateral gluteal or posterior leg pain is produced - - be careful not to pinch the soft tissue at the hip.
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Gapping Test (SI Joint Stress Test)
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Sharp pain elsewhere along the pelvis in a Gapping Test (SI Joint Stress Test) may indicate a __
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pelvic fracture
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The athlete lies supine while the AT pushes both ASIS downward and inward at a 45 degree angle. This stresses the posterior sacroiliac ligaments, and is positive if pain is present.
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Squish Test
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The athlete stands on one leg. The weight of the trunk causes the sacrum to shift forward and distally with forward rotation. Pain in the symphysis pubis or SI joint indicates a positive test for a lesion to either areas (stress x-ray in this position).
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Flamingo Test
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The athlete lies supine with the legs straight. The AT ensures that the medial malleloi are level. The athlete is asked to sit up, the examiner observes whether one leg moves up farther than the other. If one leg moves up, there is a functional leg length difference resulting from a pelvic dysfunction caused by pelvic torsion or rotation.
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Long Sitting Test
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The athlete balances on one leg and then on the other leg. The AT watches the movement at the pelvis. IF the pelvis on the non-stance leg falls, the test is considered positive and is an indication of weakness or instability of the hip abductor muscles, especially the gluteus medius on the stance side (even though watching the non-stance side).
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Trendelenberg’s Test (Sign)
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Strongest bone in the body.
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Femur
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what muscles make up the Quadriceps:
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Rectus Femoris, Vastus Medialis, and Vastus Lateralis, and Vastus Intermedius.
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what actions are the Quadriceps responsible for:
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Hip Flexion and Knee Extension
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what muscles make up the Hamstrings:
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Biceps Femoris, Semitendinosus, and Semimembranosus
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what actions are the hamstrings responsible for:
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Hip Extension and Knee Flexion
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what muscles make up the Adductors (groin): (4)
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Gracilis, Adductor Magnus, Adductor Longus, & Adductor Brevis
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what muscles make up the Abductors: (3)
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Sartorius, Tensor Fascia Latae, and Gluteus Medius.
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what muscles make up the hip Rotators: (2)
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Gluteus Maximus, Piriformis and more.
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what muscles make up the Hip Internal Rotators (2):
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Tensor Fascia Latae, Gluteus Medius, and the internal rotators.
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S/S: localized tenderness, swelling, bruising/ ecchymosis, sometimes unable to bear weight and/or fully flex the knee, and a palpable hematoma results in the inability to contract the quad or do a straight leg raise (SLR).
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Quadriceps (Thigh) Contusion
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an abnormal ossification involving bone depositing within the muscle tissue.
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Myositis Ossificans
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Rectus Femoris becomes strained by a sudden stretch…normally at the beginning of a sprint.
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Quadriceps strain
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S/S: point tenderness, pain, spasm, loss of function, deformity, pain with hip flexion, discoloration, and pain with passive knee flexion.
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Quadriceps strain
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Has a high incidence of strains…normally at the end of a sprint… caused by a rapid contraction of the muscle during a ballistic action or violent stretch…can become chronic and recurring.
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Hamstring strain
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S/S: tightness, pain, weakness in knee flexion, hemorrhage, limited knee flexion, discoloration, limping and swelling.
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Hamstring strain
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involves the sartorius, rectus femoris, iliopsoas, gracilis, or other adductors.
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Adductor strain
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S/S: feel a sudden twinge of pain in the groin, stiffness, weakness in hip adduction and flexion, internal hemorrhaging, and pain with lateral movements.
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Adductor strain
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what are the three kinds of neurological tests
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Dermatomes
Myotomes Reflexes |
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Assess hip contracture. Athlete lies supine (look for excessive lordosis which is common with tight hip flexors) and AT flexes one of the hip, bringing the knee to the chest to flatten out the lumbar spine, and the athlete holds the flexed hip against the chest. If tightness in hip flexors, opposite leg will raise up. Can check hip flexors, knee extension, & lateral structures.
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Thomas Test
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: Athlete is side lying with the lower leg flexed at the hip and knee. The AT passively AB and extends the (hip slightly) upper leg with knee straight or flexed, and then slowly lowers the limb. If tightness is present, the leg remains AB and does not fall to the table.
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Ober’s Test for IT Band and Tensor Fascia Latae Tightness
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Athlete sits with one knee flexed against the chest to stabilize the pelvis and the other knee extended. The athlete tries to touch the toes of the extended leg with the fingers and do this on the other leg. (+) test for tight hamstrings is inability to touch the toes.
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Hamstring Sit and Reach Test
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Athlete sits with both knees flexed to 90 over the edge of the table and the AT passively extends one knee. If hamstring is tight, the athlete extends the trunk to relieve the tension on the hamstrings. The other side is then tested.
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Tripod Sign for Tight Hamstrings
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Athlete lies supine and flexes the hip to 90 and the knee to 90; then extends the knee as far as possible. For normal flexibility, knee extension should be within 20 degrees of full extension.
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90/90 Straight Leg Raising Test for Hamstrings
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the hip joint is also called the __
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coxofemoral joint
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originates off the ASIS and inserts at the pubic symphysis. serves to contain the soft tissues as they course anteriorly form the trunk to the lower extremity
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inguinal ligament
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what motions does the adductor longus, brevis, and magnus do? (2)
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hip adduction
hip IR |
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what motions does the biceps femoris do? (4)
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hip ext
hip ER knee flex ER of tibia |
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what motions does the gluteus maximus do? (4)
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hip ext
hip ER hip add hip abd |
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what motions does the gluteus medius do?
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hip add
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what motions does the gluteus minimus do? (3)
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hip abd
hip IR Hip flex |
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what motions does the gracilis do?
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hip add
hip IR hip flex |
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what motions does the piriformis do?
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hip ER
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what motions does the psoas major and minor do?
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hip flex
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what motions does the sartorius do? (5)
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hip flex
hip abd hip ER knee flex IR of the tibia |
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what motions does the semimembranosus and semitendinosus do (4)
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hip ext
hip IR knee flex IR of tibia |
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what motions does the tensor fasciae latae do? (3)
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hip flex
hip IR knee abd |
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the distal portion of the patellar tendon and tibial tuberosity recieves protection against friction and blows by the __
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subcutaneous infrapatellar
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busae located between the patellar tendon and tibia
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deep infrapatellar bursa
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acts as a weight bearing bursa while seated, cushioning teh ischial tuberosity where it passes under the gluteus maxiumus
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ischial bursa
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the largest synocial bursa in the body
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iliopsoas bursa
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