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Musculoskeletal Assessment (Back, Hips, Knees)

Terms in this set (45)

What will tend to worsen sciatica pain
coughing, sneezing or valsalva
What will you want to palpate in a lower back exam?
spinous processes
Paraspinous muscls
Sacroiliac joint
tip of coccyx
hands on bilateral iliac crest for limb length discrepancy
What will firm percussion over the posterior spin aggravate pain from?
infection of the spine, cancer of the spine or nerve impingement
How much ROM will forward flexion of the spine produce
80-90 degrees
How much ROM will extension of the lower back produce?
20-30 degrees
What is the ROM of lateral bending of the back?
20-30 degrees
How much twisting ROM there be of the spine?
30-40 degrees in each direction
If there is pain with forward flexion of the lower back what will this indicate?
disc disease (stress fractures, etc etc)
if there is pain with extension of the lower back what will this indicate?
facet disease
what will pain with lateral bending of the back indicate?
muscle strain
What nerve root are you testing with heel walking?
L4
what nerve root are you testing with toe walking?
S1
What nerve root are you testing with resisted great toe dorsiflexion
L5
What is the stork test?
performed by having the pt hyper extend the back while standing on one leg.
What will pain associated with the stork test indicate?
spondylosis, spondylolisthesis or SI joint pain
What is the FABER test?
performed by placing the help and leg into figure 4 position
what will pain with the FABER test indicate?
SI joint pain
If there is pain in the front of the hip what will you suspect
Hip joint pathology (OA, Fracture, OCD)
If there is pain on the side of the hip what will you suspect
Suspect trochanteric Bursitis, IT band problems or meralgia paresthetica
What if the patient is complaining of pain in the back of their hip, what do you suspect?
Sciatica, SI joint arthritis, Hamstring pull or ischeal bursitis
If there is snapping or clicking with movement at the lateral aspect of the hip what is this likely due to
IT band tightness or gluteus maximus
If there is snapping or clicking from the medial aspect of the hip what do you suspect?
Iliopsoas tendon or hip subluxation
Hip pathology in newborns will be
congenital hip dislocation, synovitis
Hip pathology in patients that are 2-8 year old would be
legg perthese, synovitis
Hip pathology in patients that are 10-14 years old would be?
Slipped Capital Femoral epiphyses
Hip pathology in patients that are 14 to 25 would be
stress fracture or synovitis
Hip pathology in patients that are 20 to 60 years old will be
AVN or synovitis
What is the normal ROm of internal rotation of the HIP
30
what is the normal ROM of external rotation of the HIP
60 degrees
What is the normal ROM of flexion of the HIP?
120 degrees
What is the normal ROM of extension of the hip?
15 degrees
what is the normal Abduction of the Hip?
45 degrees
what is the normal adduction of the hip
30 degrees
Patients that complain of knee pain with lateral movement will most likely have
MCL injury
patients that have a feeling of instability in their knee with movement is most likely
ACL
Patients that have knee swelling withing 12 hrs is mostly due to
ACL tears
if you have swelling in the knee are injury that is delayed to 12 to 24 hours suspect
meniscal tears
Mechanical symptoms in the knee referring to swelling, locking or giving away means
miniscal tears
How do you test for MCL patholgy
exerting a vaglus stress on the knee with it extended and then flexed to 20 degrees
What is a grade 1 MCL tear?
Pain without laxity with valgus stress
what is a grade II MCL tear?
Pain with slight laxity with valgus stress
What is a grade III MCL tear?
less pain with significant laxity
what is the McMurray test?
performed by flexing and extending the knee combined with internal and external rotation. A significant clunk with this maneuver may indicate a displaced mensical tear
what forms the Q angle?
line connecting the ASIS of the hip and center of the patella to the anterior tibia
What is the Pivot shift?
performed with the leg internally rotated by flexing the knee past 20 degrees while applying a slight valgus stress and looking for the tibia to shift backwards
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