Determine 6: activity, MOI, location of pain, type of pain, severity of pain, onset of pain, unusual sounds/ sensations, actions that increase & decrease pain, S/S, change in S/S over time, prior injury/ surgery, family history & general medical health
Inspection 1,6:
General: swelling, discoloration, deformity, muscle symmetry/atrophy & gait
Skin: neurofibroma, Faun's Beard, Cafe Au Lait Spots, blisters, discoloration, open wounds, scars& skin infections
Hip Angulations: angle of inclination, angle of torsion
Leg Length Discrepancy: functional leg length discrepancy, true leg length discrepancy, apparent leg length discrepancy
Medial View: adductor group
Lateral View: pelvic tilt, iliac creast, Nelaton’s line
Anterior View: hip flexors, pelvic obliquity
Posterior View: gluteus maximus, PSIS, median sacral crest
Postural Assessment:
Gait Assessment:
Hip Palpation Rollover: using internet explorer rollover the images to trace some anatomy of the hip and thigh
Bony Palpation 1:
Anterior Aspect: ASIS, iliac crest, iliac tubercle, greater trochanter & pubic tubercles
Posterior Aspect: PSIS, ischial tuberosity & SI
Soft Tissue Palpation 1:
Zone 1 (Femoral Triangle): borders (inguinal ligament, sartorius, adductor longus muscle) floor (pectineus, iliopsoas) contents (femoral artery, femoral nerve, femoral vein, lymph chain)
Zone 2 (Greater Trochanter): trochanteric bursa, gluteus medius
Zone 3 (Sciatic Nerve): sciatic nerve
Zone 4 (Iliac Crest): cluneal nerves
Zone 5 (Hip & Pelvic Muscles): iliopsoas, sartorius, rectus femoris, gracilis, pectineus, adductor longus, adductor brevis, adductor magnus, gluteus medius, gluteus maximus, hamstrings
Range of Motion 1,5:
AROM: abduction, adduction, flexion, extension, internal rotation & external rotation
PROM: abduction (45–50°), adduction (20–30°), flexion (120°), extension (30°), internal rotation (35°) & external rotation (45°)
RROM: abduction, adduction, flexion, extension, internal rotation & external rotation
Neurovascular Exam
Gluteus Maximus, Gluteus Medius, Gluteus Minimus, Hip Adductors (Pectineus, Adductor magnus, Gracilis, Adductor brevis, Adductor longus), Hip Internal Rotators (Tensor fasciae latae, Gluteus minimus, and Gluteus medium), Iliopsoas, Biceps Femoris, Semitendinosus, Semimembranosus, Quadriceps, Sartorius, Tensor Fascia Latae
Weber–Barstow Maneuver, Supine to Long–Sit, Supine "True" Leg Length Discrepancy, Supine "Apparent" Leg Length Discrepancy, Clinical Discrimination Between Foral & Tibial Leg Length Discrepancy, Craig's, Gaenslen's, Fulcrum's, Nelaton's Line, Hip Scouring, Torque, Gillet's, Sacroiliac Compression, Sacroiliac Distraction, Piriformis Tightness, 90–90 Straight Leg Raising, Ely's, Thomas's, Patrick's, Trendelenburg's, Valsalva, Oppenheim, Bowstring, Babinski, Slump, Seated Straight Leg Raise, Single Straight Leg Raise, Bilateral Straight Leg Raise, Malinger's, Kernig, Stork, Hoover
Identifies examiner's impression of injury & potientally complicating factors based on subjective & objective information
Explains examiner's goals as well as how the examiner intends on meeting these goals through initial managent, treatment, rehabilitation
