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MSK lower body.docx

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McGill University
NUR1 239
Sandie Larouche

Musculoskeletal AssessmentLower bodyHips InspectionInspect hip joint together with the spineas patient stands Note symmetrical levels of iliac crests gluteal folds and equal sized buttocksA smooth equal gait reflects equal leg lengths and functional hip motionPalpation Palpate hip joints should feel stable and symmetrical with no tenderness or crepitationRange of motionRaise each leg with knee extended Hip flexion of 90 degreesBend each knee up to the chest while keeping the other leg straight hip flexion of 120 degrees the opposite thigh should remain on the tableFlex knee and hip 90 degreesexaminer stabilizes by holding the thigh with one hand and the ankle with the other hand Swing the foot outward Swing the foot inwardfoot and thigh move in opposite directions Internal rotation of 40 degrees external rotation of 45 degreesSwing leg laterally then medially with knee straight Stabilize pelvis by pushing down on the opposite anterior superior iliac spine Abduction of 4045 degrees adduction of 2030 degreesWhen standinglater in examination swing straight leg back behind bodyexaminer stabilizes pelvis to eliminate exaggerated lumbar lordosis The most efficient way is to ask patient to bend over table and support the trunk on the table or lie prone on the table Hyperextension of 15 degrees when stabilized
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