study guide exam III

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study guide exam III
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2011-11-13 19:47:22
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study exam III
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  1. axis and planes of movement for all LE joints
    Hip

    flexion/extension/hyperextension:

    plane

    saggital

    axis

    frontal

    abduction/adduction:

    plane

    frontal

    axis

    saggital

    lateral(external) rotation/medial(internal) rotation

    plane

    transverse

    axis

    longitunal

    Knee

    Flexion/Extension:

    plane

    saggital

    axis

    frontal

    Ankle

    Dorsi/Plantar flexion:

    plane

    saggital

    axis

    frontal
  2. all movements at each joint
    flexion,etc
  3. What motions occur at each joint (osetokinematics)
    hip joint

    • ball & socket
    • convex-shaped femoral head fits into and articulates with the concave-shaped acetabulum.

    femoral head slides in the direction opposite the movement of the thigh

    triaxial joint

    Knee joint

    synovial joint

    distal end of femur w/ proximal end of the tibia

    fibula not part of knee joint

    • ankle/foot joint
    • talocrural joint

    tibia, weight bearing
  4. Verbally identify:
    Positions for MMT,
    • Hip
    • Flexion

    • 2+-5 sit. "lift your leg off the table, don't let me push it down"
    • 2-0 sidelying

    extension

    • 2+-5 prone
    • 2-0 sidelying

    abduction

    • 2+-5 sidelying effected side up
    • 2-0 supine

    adduction

    • 2+-5 sidelying effected side down
    • 2-0 supine

    external rotation:

    • 2+-5 sit-watch hip bone "raise your leg up and in, dont let me push it out"
    • 2-0 supine, roll the foot in, "try to roll your leg out"

    internal rotation:

    • 2+-5 sit-watch hip bone "raise your leg
    • up and out,don't let me push it in"
    • 2-0 supine roll the leg out "Try to roll your leg in"

    Knee

    flexion:

    • 2+-5 prone, toes hanging over table
    • 2-0 sidelying

    extension:

    • 2+-5 sit/feet on floor,straighten knee"Don't let me bend it"
    • 2-0 sidelying

    Ankle

    dorsi

    • 2+-5 sit.flex/hold "don't let me push it down"
    • 2-0 sit "raise your foot"

    Plantar

    stand, one leg, two fingers on table to balance

    • 5/5-25 toe lifts
    • 4/5-10-24 toelifts
    • 3/5- 1-9 toe lifts
    • 2-0 sit and try to raise heel
  5. Verbally identify:
    Positions for Goniometry
    Hip

    flexion

    • supine, stabilize pelvis, knee flex,
    • femurgreater trochanter

    extension

    • prone, stabilize pelvis,maintain knee
    • femur greater trochanter & ASIS

    abduction:

    • supine, stablize pelvis
    • femur & ASIS

    adduction:

    • supine, stabilize pelvis, move other leg outward
    • ASIS & femur

    external/internal rotation:

    • sitting, towel, stabilize distal femur
    • patella

    KNEE:

    flexion/extension:

    • supine, flex thigh 90 degrees, stabilize thigh
    • lateral epicondyle & femur

    ANKLE

    Dorsi/plantar

    sit-high,feet hang off, stabilize tibial/fibula

    lateral malleolus
  6. Verbally identify:
    Definitions of muscle grades
    5-max resistance

    4- mod resistance

    3+

    a little resistance

    3

    AROM=PROM against gravity

    3-

    minus some AROM. AROM<PROM

    2+

    resistance in the form of gravity "Initiates mov't against gravity"

    2

    AROM=PROM gravity eleminated

    2-

    • minus some AROM
    • AROM<PROM

    1

    feel muscle twitch but no movement

    0

    no movement & no muscle twitch
  7. Lumbosacral plexus
    formed by anterior rami of L1-S3.

    • lumbar plexus-L1-L4
    • thigh muscles
    • sacral plexus-L5-S3
    • leg & foot muscles

    • Femoral nerve
    • L2,3,4
    • iliopsoas
    • saartorius
    • pectineus
    • quadricep femoris

    • weakened hip flexion
    • loss of knee extension

    Obturator nerve

    • L2,3,4
    • hip adductors
    • obturator externus
    • loss of hip adduction
    • weakened hip lateral rotation

    sciatic nerve

    • L4,5 S1,2,3
    • hamstring muscles
    • adductor magnus

    tibial nerve

    • L4,5, S1,2,3
    • popliteus
    • ankle plantar flexors
    • tibialis posterior
    • foot intrinsics(medial & lateral plantar)

    • loss ofankle plantar flexion
    • weakened ankle inversion
    • loss of toe flexion

    peroneal nerves

    • L4,5 S1,2
    • peroneals(mostly superficial peroneal)
    • tibialis anterior(deep peroneal)
    • toe extensors(deep peroneal)

    • loss of ankle dorsiflexion(foot drop)
    • loss of toe extension
    • loss ofankle eversion
    • weakened hip extension
    • loss of knee flexion
  8. Review end feels and relate them to the LE (similar principles apply as for UE)
    Normal end feel:

    full PROM, normal anatomical structures stop movement

    abnormal end feel:

    pain, muscle guarding, swelling, or abnormal anatomy stops joint movement

    • Soft tissue/firm end feel:
    • hip extension
    • knee extension
    • ankle dorsi & plantar flexion

    • soft tissue approximation(muscle bulk):
    • hip flexion
    • knee flexion
  9. Bones and Bony landmarks of LE
  10. Concentric and Eccentric contractions
    concentric:

    • muscle shortens
    • joint angle changes
    • prime mover
    • usually against gravity

    eccentric:

    • muscle lengthens
    • joint angle changes
    • produces greater forcethan concentric
    • antagonist
    • usually with gravity

    Concentric muscle/joint motions:

    Flexor muscles/flexion joint motion

    extensor muscles/extension joint motion

    abductor muscles/abduction joint motion

    adductor muscles/adduction joint motion

    medial rotator muscles/medial rotation joint motion

    lateral rotator muscles/lateral rotation joint motion

    ECCENTRIC

    flexor muscles/extension joint motion

    extensor muscles/flexion joint motion

    abductor muscles/adduction joint motion


    medial rotator muscles/lateral rotation joint motion

    lateral totator muscles/medial rotation joint motion
  11. Which muscles of the LE are 2 joint muscles and which are 1 joint muscles?
    2 joint

    • rectus femoris
    • Hamstrings
    • biceps femoris
    • semimembranosus
    • semitendinosus
    • sartorius
    • gracilis
    • gastrocnemius
    • tensor fascia latae

    1 joint

    • vastus lateralis/medialis/intermedialis
    • biceps femoris
    • popliteus
  12. What do the hamstrings and Quads do at both the hip and knee?
    Hamstrings:

    • Hip:
    • extension

    • Knee:
    • flexion

    • Quads:
    • Hip: flexion

    knee:extension
  13. Be able to name the deep lateral rotators (6)
    obturator internus/externus

    gemellus superior/inferior

    piriformis

    quadratus femoris

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