Manualmusletesting 421 450
- 1. SEMITENDINOSUS • ORIGIN Upper inner quadrant of posterior surface of ischial tuberosity • INSERTION Upper medial shaft of tibia below Gracilis • ACTION Flexes and medially rotates knee. Extends hip • NERVE Tibial portion of sciatic nerve (L5, S1)
- 2. Hip Extension Range of Motion – Extension: 115º – 125º to 0º – Extension beyond midline 0º to 10º - 15º • Factors Limiting Motion: – Tension of iliofemoml ligament – Tension of hip flexor muscles • Fixation: – Contraction of Iliocustalis and Quad rat us lumborum muscles – Weight of trunk
- 3. NORMAL AND GOOD • Prone with legs extended. • Stabilize pelvis. • Patient extends, hip through range of motion. • Resistance is given proximal to knee joint.
- 4. NORMAL AND GOOD Test for isolation of Gluteus Maximus) • Prone with knee flexed. • Stabilize pelvis. • Patient extends hip, keeping knee flexed to decrease action of hamstrings. • Resistance is given proximal to knee joint. • Range of motion will be more limited than in position above, owing to tension in the Rectus femoris
- 5. FAIR • Position: prone with legs extended. • Stabilization: Stabilize pelvis. • Desired motion: Patient extends leg through range of motion
- 6. POOR • Position: Sidelying with hip flexed, knee extended and upper leg supported. • Stabilize pelvis. • Patient extends hip through range of motion. • (Knee may be flexed for fair and poor to isolate the action of the Gluteus Maximus.)
- 7. TRACE AND ZERO • Prone. • Contraction of Gluteus Maximus will result in narrowing of gluteal crease. Lower and upper sections of muscle should be pal- pated.
- 8. Note • Patient may lift pelvis and support leg with hamstrings, raising leg from table by extending lumbar spine. • Examiner must be certain that pelvis is stable and movement takes place in hip joint.
- 9. Hip Abduction • GLUTEUS MEDIUS • SARTORIUS
- 10. GLUTEUS MEDIUS • ORIGIN Outer surface of ilium between posterior and middle gluteal lines • INSERTION Posterolateral surface of greater trochanter of femur • ACTION Abducts and medially rotates hip. Tilts pelvis on walking • NERVE Superior gluteal nerve (L4,5,S1)
- 11. Hip Abduction • Range of Motion: Factors Limiting Motion: Tension of distal band of iliofemoral ligament and pubocapsular ligament. Tension of hip adductor muscles Fixation: 1.Contraction of lateral abdominal muscles and Latissimus dorsi 2.Weight of trunk
- 12. NORMAL AND GOOD • Position: Sidelying with leg slightly extended beyond midline. Lower knee flexed for balance. • Stabilization: Stabilize pelvis. • Desired motion: Patient abducts leg through ROM without lateral rotation of the hip.
- 13. FAIR • Position: Sidelying with leg slightly extended beyond midline. Lower knee flexed for balance. • Stabilization: Stabilize pelvis. • Desired motion: Patient abducts leg through ROM.
- 14. POOR • Supine with legs extended. • Stabilize pelvis. • Patient abducts leg through ROM without allowing leg to rotate.
- 15. TRACE AND ZERO • Fibers of the Gluteus medius maybe found on lateral aspect of ilium above greater trochanter of femur. Resistance is given proximal to knee joint.
- 16. Note • Patient may bring pelvis to thorax by strong contraction of lateral trunk muscles, thereby lifting leg through partial abduc-tion. • Examiner must stabilize pelvis to make sure motion takes place in hip joint.
- 17. Note • Lateral rotation at the hip should be eliminated, or hip flexors may substitute for Gluteus medius. Flexion of the hip allows substitution by the Tensor fasciae Latae.
- 18. Hip Adduction 1. GRACILIS 2. PECTINEUS 3. ADDUCTOR BREVIS 4. ADDUCTOR LONGUS 5. ADDUCTOR MAGNUS
- 19. GRACILIS • ORIGIN Outer surface of ischiopubic ramus • INSERTION Upper medial shaft of tibia below sartorius • ACTION Adducts hip. Flexes knee and medially rotates flexed knee • NERVE Anterior division of obturator nerve (L2, 3)
- 20. PECTINEUS • ORIGIN Pectineal line of pubis and narrow area of superior pubic ramus below it • INSERTION A vertical line between spiral line and gluteal crest below lesser trochanter of femur • ACTION Flexes, adducts and medially rotates hip • NERVE Anterior division of femoral nerve (L2, 3). Occasional twig from obturator nerve (anterior division - L2,3)
- 21. ADDUCTOR BREVIS • ORIGIN Inferior ramus and body of pubis • INSERTION Upper third of linea aspera • ACTION: Adducts hip • NERVE Anterior division of obturator nerve (L2, 3)
- 22. ADDUCTOR LONGUS • ORIGIN Body of pubis inferior and medial to pubic tubercle • INSERTION Lower two thirds of medial linea aspera • ACTION Adducts and medially rotates hip • NERVE Anterior division of obturator nerve (L2, 3)
- 23. ADDUCTOR MAGNUS • ORIGIN Adductor portion: ischiopubic ramus. Hamstring portion: lower outer quadrant of posterior surface of ischial tuberosity • INSERTION Adductor portion: lower gluteal line and linea aspera. Hamstring portion: adductor tubercle • ACTION Adductor portion: adducts and medially rotates hip. Hamstring portion: extends hip • NERVE Adductor portion: posterior division of obturator nerve (L2-4). Hamstring portion: tibial portion of sciatic (L4-S3)
- 24. Hip Adduction • Range of Motion: Factors Limiting Motion: Contact with opposite leg When hip is flexed, tension of ischiofemoral ligament. Fixation: Weight of trunk.
- 25. NORMAL AND GOOD • Sidelying with leg resting on table and upper leg supported in approximately 25º of abduction. • Patient adducts leg until it contacts upper • Resistance is given proximal to knee joint.
- 26. FAIR • Sidelying with leg resting on table and upper leg supported in approximately 25º of abduction. • Patient adducts leg until it contacts upper leg.
- 27. POOR • Supine with leg in 45º of abduction. • Stabilize pelvis. • Patient adducts leg through ROM without allowing rotation of hip.
- 28. TRACE AND ZERO • Contraction of fibers of adductor muscles may he palpated on medial aspect of thigh.
- 29. Hip Lateral Rotation • SARTORIUS • GEMELLUS INFERIOR • GEMELLUS SUPERIOR • OBTURATOR EXTERNUS • OBTURATOR INTERNUS • QUADRATUS FEMORIS • PIRIFORMIS
- 30. GEMELLUS INFERIOR • ORIGIN Upper border of ischial tuberosity • INSERTION Middle part of medial aspect of greater trochanter of femur • ACTION laterally rotates and stabilizes hip • NERVE Nerve to quadratus femoris (L4, 5, S1)