Goniometry and ROM Values Overview
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Questions and Answers

What is the normative value for hip medial rotation?

  • 0 60
  • 0 30
  • 0 90
  • 0 45 (correct)

During hip abduction measurement, which anatomical landmark is used as a lateral reference?

  • Greater trochanter
  • Lateral epicondyle
  • ASIS (correct)
  • Anterior midline of femur

What is the correct normative value for knee extension?

  • 0 15
  • 0 10 (correct)
  • 0 20
  • 0 5

What stabilizes the pelvis to prevent anterior tilt during hip extension measurement?

<p>Iliac crest (A)</p> Signup and view all the answers

What is the normative range of motion for plantarflexion?

<p>0 50 (A)</p> Signup and view all the answers

Which axis is used for the lateral midline reference during knee flexion?

<p>Lateral epicondyle (A)</p> Signup and view all the answers

For hip adduction measurement, what is the position of the knees?

<p>Knees extended (C)</p> Signup and view all the answers

What should be watched for during hip abduction to ensure accurate measurement?

<p>Lateral flexion (C)</p> Signup and view all the answers

What is the reference point for measuring hip abduction during extension in a supine position?

<p>Greater trochanter of femur (C)</p> Signup and view all the answers

What is indicated when flexion ROM is within 10 degrees of normal?

<p>No length discrepancy exists. (A)</p> Signup and view all the answers

Which position should a patient adopt to prevent hip movement during knee flexion measurements?

<p>Sitting with knees flexed (B)</p> Signup and view all the answers

In measuring ankle dorsiflexion, which lateral structure is used as a reference point?

<p>Lateral aspect of lateral malleolus (A)</p> Signup and view all the answers

What is one of the main purposes of using outcome measures?

<p>To contribute to evidence-based practice. (C)</p> Signup and view all the answers

What is the average distance measured when using the tape measure method for thoracolumbar spine flexion?

<p>10 cm (A)</p> Signup and view all the answers

Which type of outcome measure assesses the quality of life specifically?

<p>SF 36 (B)</p> Signup and view all the answers

Which method involves asking the individual to stand and reach towards the floor?

<p>Fingertip to Floor Method (A)</p> Signup and view all the answers

What might indicate a patient has cyanosis?

<p>A bluish discoloration of the lips and tongue. (C)</p> Signup and view all the answers

When performing inversion measurements, which joint position is recommended?

<p>Sitting with knee flexed at 90 degrees (A)</p> Signup and view all the answers

Which assessment tool is disease-specific for stroke patients?

<p>Fugh Meyer (B)</p> Signup and view all the answers

What could be a first sign of systemic illness as observed by a physical therapist?

<p>Abnormal skin coloration. (C)</p> Signup and view all the answers

What should be used to stabilize the femur during hip extension measurements?

<p>A firm grip on the femur (B)</p> Signup and view all the answers

During ankle plantarflexion assessment, which structure should be referenced laterally?

<p>Lateral malleolus (B)</p> Signup and view all the answers

What role does the integumentary system NOT play?

<p>Producing red blood cells. (A)</p> Signup and view all the answers

Which of the following is true about performance-based outcome measures?

<p>They assess an individual's functional abilities. (C)</p> Signup and view all the answers

What is indicated by Half and Half Nails?

<p>Chronic renal failure (C), Arsenic poisoning (D)</p> Signup and view all the answers

Which condition lacks Schamroth's sign?

<p>Clubbing of digits (A)</p> Signup and view all the answers

Alopecia can be caused by which of the following?

<p>Trauma to the scalp (A), Genetic predisposition (C)</p> Signup and view all the answers

Identifying for melanoma should consider which of the following criteria?

<p>Diameter greater than 6mm (D)</p> Signup and view all the answers

In which patients is a comprehensive skin assessment particularly important?

<p>Patients with autoimmune diseases (D)</p> Signup and view all the answers

Which statement about benign skin lesions is correct?

<p>Usually benign is mobile (B)</p> Signup and view all the answers

What can cause hair loss in localized areas of the body?

<p>Arterial insufficiency (C)</p> Signup and view all the answers

Which of the following is a significant sign of melanoma?

<p>Color variation (C)</p> Signup and view all the answers

What is the purpose of stabilizing the pelvis during the measurement of forward bending in the Modified Modified Schober Test?

<p>To prevent anterior tilt (C)</p> Signup and view all the answers

In the Thomas Test, what position should the patient be in before testing the hip flexor length?

<p>Sitting at the edge of the table (D)</p> Signup and view all the answers

What indicates a tight hamstring during the Single Leg Raise (SLR) Test?

<p>Flexion ROM at least 10 less than normal (B)</p> Signup and view all the answers

During the Modified Modified Schober Test, how is the measuring tape positioned?

<p>Between the two marks on the back (D)</p> Signup and view all the answers

If a patient shows a measured extension ROM that surpasses normal by a significant amount, what does this indicate?

<p>Hypermobile muscle (D)</p> Signup and view all the answers

Which is the normal end range of motion (ROM) for hip extension during the Thomas Test?

<p>0 to 20 degrees (A)</p> Signup and view all the answers

What action should the patient perform when measuring lumbar flexion in the Modified Modified Schober Test?

<p>Bend forward as far as possible (D)</p> Signup and view all the answers

While measuring the Single Leg Raise Test, which position should be maintained for the knee of the limb being tested?

<p>In full extension (C)</p> Signup and view all the answers

What method involves measuring the distance from the middle finger to the floor after bending to the side?

<p>Fingertip to Floor Method (C)</p> Signup and view all the answers

Which method requires stabilizing the pelvis to prevent posterior tilt while measuring extension ROM?

<p>Tape Measure Method (B)</p> Signup and view all the answers

In the Rotation sitting Goni Method, what does the clinician need to align with the imaginary line between the iliac tubercles?

<p>The patient's head (C)</p> Signup and view all the answers

What is measured at the end of the bending motion in the Fingertip to Thigh Method?

<p>The distance from the mark on the thigh to the standing position (A)</p> Signup and view all the answers

For the Lateral Flexion measurement, how should the patient's feet be positioned?

<p>Shoulder-width apart (D)</p> Signup and view all the answers

What is required to ensure accuracy during the Goni Method for measuring rotation?

<p>Preventing lateral tilting of the pelvis (B)</p> Signup and view all the answers

What should be avoided when measuring spine rotation to ensure the patient's trunk remains erect?

<p>Allowing pelvic rotation (C)</p> Signup and view all the answers

In the Tape Measure Method, what is done at the beginning of the range of motion (ROM)?

<p>Mark T1 and S2 (C)</p> Signup and view all the answers

Flashcards

Goniometry ROM

The range of motion (ROM) at which a joint can move, measured using a goniometer.

Abduction

The movement of a joint away from the midline of the body.

Adduction

The movement of a joint towards the midline of the body.

Medial Rotation

The rotation of a joint towards the body's midline.

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Lateral Rotation

The rotation of a joint away from the body's midline.

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Flexion

The movement of a joint that decreases the angle between two bones.

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Extension

The movement of a joint that increases the angle between two bones.

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Circumduction

The movement of a joint that involves moving the far end of the limb in a circular pattern.

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Range of Motion (ROM)

The range of motion a joint can move through. For example, how far you can bend your knee.

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Goniometry

A test to measure the range of motion of a joint.

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Modified Schober Test (MM ST)

A test that measures the flexibility of the spine by assessing the distance between two marked points on the back as the patient bends forward.

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MM ST Measurement

During the Modified Schober Test, the distance between the marks should increase as the patient bends forward. A reduced increase in this distance indicates limited spinal flexibility.

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Thomas Test

A test to assess the length of the hip flexors by measuring the amount of hip extension while the patient lies supine with one leg extended and the other flexed.

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Thomas Test Interpretation

In the Thomas Test, a decreased hip extension ROM (e.g., less than 10 degrees) suggests tight hip flexors. An excessive extension ROM indicates lengthened hip flexors.

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Single Leg Raise (SLR) Test

A test to assess the length of the hamstrings by measuring the amount of hip flexion while the patient lies supine with one leg extended.

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SLR Test Interpretation

In the SLR Test, a decreased hip flexion ROM (e.g., less than 100 degrees) suggests tight hamstrings. An excessive extension ROM indicates lengthened hamstrings.

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Modified Schober Test (Extension)

A test assessing the spine's flexibility by measuring the distance between two marked points on the back as the patient bends backward.

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MM ST Extension Measurement

During the Modified Schober Test (Extension), the distance between the marks should decrease as the patient bends backward. A reduced decrease in this distance indicates limited spinal flexibility.

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Outcome Measures: What are they?

A set of tools used to assess changes in a patient's condition over time. They help track progress and identify any improvements or regressions in function, pain, and other aspects of health.

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Baseline Data in Outcome Measures

Data collected at the start of treatment to create a baseline and compare later assessments against. It sets a starting point for observing any change or improvement.

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Justification for Treatment with Outcome Measures

Outcome measures help to justify the need for treatment based on demonstrated improvements or changes in a patient's condition, which can be used to support billing for third-party payers like insurance.

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Performance-Based Outcome Measures

The process of using objective measurements, such as ROM or strength testing, to assess a patient's physical function and limitations.

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Self-Report Outcome Measures

A way of gathering information from the patient about their subjective experience and perception of their health and wellbeing. This can include questionnaires or self-reports on pain levels, quality of life, or overall health.

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General Health Status Outcome Measures

This type of measure assesses the overall health status of a patient, encompassing various factors like physical function, social well-being, and emotional health.

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Function-Specific Outcome Measures

Function-specific measures evaluate a patient's ability to perform everyday activities and tasks, such as walking, dressing, or bathing. These are tailored to specific functional limitations a patient might have.

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Disease-Specific Outcome Measures

These types of measures are designed to assess a patient's specific health condition, such as stroke, Parkinson's disease, or low back pain. They often use standardized instruments with scores that can be compared across different patients with similar conditions.

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Half and Half Nails

A nail condition where the top half of the nail is brown and the bottom half is white, indicating chronic renal failure.

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Clubbing of Digits

A change in fingertip shape, often associated with heart and lung diseases. The fingertip appears wider and the angle between the nail and proximal nail fold is increased.

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Alopecia

Hair loss that occurs quickly and starts in areas other than the frontal parietal scalp may indicate an underlying medical condition.

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Skin Lesion

A skin lesion is any change in the tissue structure, continuity, or function of the skin. It can be due to disease or trauma.

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ABCD Rule for Melanoma

Melanoma is the most aggressive form of skin cancer. It is characterized by its asymmetry, irregular borders, color variation, a diameter greater than 6mm, and other factors such as ulceration, mobility, and rate of change.

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Comprehensive Skin Assessment

A comprehensive skin assessment is a thorough examination of the skin for any abnormalities, including skin lesions, changes in skin texture, color, or moisture, and other signs of disease.

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Skin Assessment Inpatient Facility

PTs working in inpatient facilities should check with nursing about skin assessments because nurses are usually responsible for them.

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Skin Assessment Outpatient Facility

PTs working in outpatient facilities are typically responsible for performing comprehensive skin assessments.

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Lumbar Extension: Fingertip to Floor Method

A method to measure lumbar extension ROM where the patient bends forward with extended knees and the distance from their middle fingertip to the floor is measured.

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Lumbar Extension: Tape Measure Method

A method to measure lumbar extension ROM where the distance between T1 and S2 is measured at the beginning and end of the movement. The difference between these measurements is the extension ROM.

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Lumbar Lateral Flexion: Fingertip to Floor Method

A method to measure lumbar lateral flexion ROM where the patient keeps their back against a wall and bends to the side, and the distance from their middle fingertip to the floor is measured.

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Lumbar Lateral Flexion: Fingertip to Thigh Method

A method to measure lumbar lateral flexion ROM where the patient keeps their back against a wall and bends to the side, and the distance from their middle fingertip to their thigh is measured.

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Lumbar Rotation: Goni Method

A method to measure lumbar rotation ROM where the patient sits with their feet flat on the floor and rotates their torso to the side, aiming to line up the imaginary line between their two iliac tubercles with the imaginary line between their acromion processes.

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Lumbar Flexion: Fingertip to Floor Method

A method to measure lumbar flexion ROM where the patient stands straight and bends forward as far as possible with their knees straight and back straight. Measured by the distance between fingertip and floor.

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Lumbar Flexion: Goni Method

A method to measure lumbar flexion ROM using a goniometer. The goniometer is placed with its stationary arm along the imaginary line between the two prominent tubercles on the iliac crest and the moving arm is placed over the center of the cranial aspect of the individual's head. The angle is measured while the patient is in a standing, neutral posture.

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Study Notes

Normative ROM Values

  • Hip Flexion: 0° - 120°
  • Hip Extension: 0° - 20°
  • Hip Abduction: 0° - 40°
  • Hip Adduction: 0° - 20°
  • Hip Medial Rotation: 0° - 45°
  • Hip Lateral Rotation: 0° - 45°
  • Knee Flexion: 0° - 135°
  • Knee Extension: 0° - 10°
  • Ankle Dorsiflexion: 0° - 20°
  • Ankle Plantar Flexion: 0° - 50°
  • Ankle Inversion: 0° - 35°
  • Ankle Eversion: 0° - 15°
  • First MTP Flexion: 0° - 45°
  • First MTP Extension: 0° - 70°
  • Thoracic and Lumbar Spine Flexion: 0° - 80°
  • Thoracic and Lumbar Spine Extension: 0° - 25°
  • Right Lateral Flexion: 0° - 35°
  • Right Rotation: 0° - 45°

Goniometry ROM Landmarks

  • Hip Flexion (supine): Reference: lateral midline of pelvis, greater trochanter
  • Hip Extension (prone): Reference: lateral midline of pelvis, greater trochanter
  • Hip Abduction (supine): Reference: imaginary line between both ASIS's, ASIS
  • Hip Adduction (supine): Reference: imaginary line between both ASIS's; ASIS
  • Hip Internal Rotation (sitting): Reference: 1 to the floor ; anterior aspect of patella
  • Hip External Rotation (sitting): Reference: 1 to the floor, anterior aspect of patella
  • Knee Flexion (supine): Reference: lateral midline femur, greater trochanter
  • Knee Extension (supine): Reference: lateral midline femur, greater trochanter
  • Ankle Dorsiflexion (sitting): reference: lateral midline of fibula, head of fibula.
  • Ankle Plantar Flexion (sitting): reference: lateral midline of fibula, head of fibula
  • Ankle Inversion (sitting): reference: anterior aspect of ankle, between malleoli

Other Information

  • Outcome Measures: Tools to assess changes in outcomes from initial visits throughout care. Examples include fatigue, falls risk, TUG results, and pain. Outcome measures contribute to evidence-based practice by providing baseline data, objective outcomes, measuring change over time, and justifying care for third-party payers. Types of outcome measures include performance-based and self-report.
  • Clinical Measurements: Include ROM (Range of Motion), MMT (Muscle Manual Muscle Testing), and Functional Assessments (quality of life, FIM).
  • Disease-Specific Measures: Examples include stroke (Fugl-Meyer, stroke impact scale), multiple sclerosis (EDSS), Parkinson's disease (Unified Parkinson's Disease Rating Scale).
  • Population-Specific Measures: include pediatric (Wee FIM, Peabody Developmental Motor Scale) and certain home health measures
  • Skin Assessment: Factors to consider in a comprehensive skin assessment include moisture level and skin integrity (open areas, rashes). Patients with certain conditions or risk factors warrant special attention.
  • Skin Color/Conditions: Conditions like pallor (pale), cyanosis (blue), and jaundice (yellow) might indicate underlying issues, such as anaemia or respiratory problems.
  • Nail Changes: Changes in the nails (Terry's nails, Koilonychia, Beau's lines) can suggest systemic conditions or medical problems.
  • Hair Growth Patterns and Lesions: Hair loss (alopecia) and skin lesions are significant findings that may necessitate investigation.
  • ABCD Rule for Melanoma: A simple guide to spot skin cancer (asymmetry, border irregularity, color variation, diameter).

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Description

This quiz covers normative range of motion values for various joints including hip, knee, and ankle, as well as landmarks used in goniometry. Test your knowledge on the expected degrees of movement for each joint and the techniques to measure them accurately. Ideal for students and professionals in physical therapy and related fields.

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