Placement of Goniometer - Stima PDF

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Summary

Placement of Goniometer - Stima...

Description

Objective Physical Examination – Active Movements (Pain, Range, Willingness) Body Part

Movement at the joint

Dynamic Anatomy

Measured how?

Flexion

Wrist flexors activating, anterior structures local to wrist compressed, wrist extensors stretched at end of range.

Goniometer aligned to distal radial tubercle, line of 5th MC, line of radius.

Extension

HAND AND WRIST

Fulcrum: align over the lateral aspect of the wrist over the triquetrum Proximal arm: align with the lateral midline of the ulna, projecting to the olecranon / ulnar styloid Distal arm: align with the lateral midline of the fifth metacarpal Fulcrum: center over the middle of the dorsal aspect of the wrist over the capitate Proximal arm: align with the dorsal midline of the forearm, using the lateral epicondyle of the humerus for reference Distal arm: align with the dorsal midline of the third metacarpal

Radial Deviation

Ulnar Deviation

R/U Pronation

R/U Supination

Supinators activating, radial head compressed against ulnar, pronators stretched at end of range.

Flexion

Biceps working, some compression to anterior elbow structures, unlikely to stretch triceps due to bi-articular nature of muscle

Extension

ELBOW

R/U Pronation

R/U Supination

Goniometer aligned to lateral epicondyle, line of humerus, line of radius.

Fulcrum: align over the lateral epicondyle of the humerus Stationary arm: align with the lateral midline of the humerus, projecting to the center of the acromion process Distal arm: align with the lateral midline of the radius, projecting toward the radial styloid process Fulcrum: lateral and proximal to the ulnar styloid process Proximal arm: align parallel to the anterior midline of the humerus Distal arm: place across the dorsal aspect of the forearm, just proximal to the styloid processes (ulnar & radial) Fulcrum: center it medial and proximal to the ulnar styloid process Proximal arm: align parallel to the anterior midline of the humerus

Distal arm: place across the ventral aspect of the forearm, just proximal to the styloid processes (radial & ulnar) Flexion

Goniometer aligned to humeral head, line of humerus, line of axilla vertical. Fulcrum: lateral aspect of the greater tubercle Proximal arm: parallel with the midaxillary line of the thorax Distal arm: align with the lateral midline of the humerus projecting toward the lateral epicondyle (or olecranon process)

Extension

Abduction

SHOULDER

Adduction

Abductors activating in sequence, scapula moving across thoracic cage, superior structures of the GHJ compressed, inferior joint capsule and lats stretched at end range

Lateral Rotation

Fulcrum: over the olecranon process Proximal arm: align either parallel or perpendicular to the floor Distal arm: align with the ulna, projecting toward the ulnar styloid process

Medial Rotation

Flexion Extension

HIP AND PELVIS

Abduction

Adduction

Fulcrum: close to the anterior aspect of the acromial process Proximal arm: align parallel to the midline of the anterior aspect of the sternum Distal arm: along the medial midline of the humerus projected to the medial epicondyle of the humerus

Depends on level of control at Lsp but generally anterior structures stretched, hip extensors activating, Lsp compressed if not controlled.

Goniometer aligned to lateral trochanter of the femur Fulcrum: over greater trochanter of the femur Proximal arm: align with the lateral midline of the pelvis Distal arm: align with the lateral midline of the femur projecting to lateral epicondyle Fulcrum: center over the anterior superior iliac spine (ASIS) of the extremity being measured Proximal arm: align with an imaginary horizontal line extending from one ASIS to the other ASIS Distal arm: align with the anterior midline of the femur projecting to the midline of the patella

Lateral Rotation

Fulcrum: center over the anterior aspect of the patella Proximal arm: align so that it is perpendicular to the floor or parallel to the supporting surface Distal arm: align with the anterior midline of the lower leg, projecting down to the crest of of the tibia and a point mid-way between the two malleoli

Medial Rotation

Flexion

KNEE

Quadriceps stretched at end range if completed in prone. Generally, compresses structures posterior on the tibial plateau.

Extension

Plantarflexion

Dorsiflexion

ANKLE AND FOOT

Inversion Eversion

Flexion

Extension

SPINE Side Flexion (Right)

Side Flexion (Left)

Rotation (Right)

Lateral muscles activating, medial TC structures stretched, local structures immediately distal to lateral malleolus compressed at end range.

Fulcrum: center over the lateral epicondyle of the femur Stationary arm: align with the lateral midline of the femur, using the greater trochanter for reference Distal arm: align with the lateral midline of the fibula, projecting to the lateral malleolus and fibular head Fulcrum: center over lateral aspect of the lateral malleolus Proximal arm: align with the lateral midline of the fibula, projecting to the head of the fibula Distal arm: align parallel to the lateral aspect of the fifth metatarsal; inferior aspect of calcaneus Fulcrum: posterior aspect of ankle midway between malleoli Proximal arm: align with posterior midline of lower leg Distal arm: align with posterior midline of calcaneus

Rotation (Left)...