Chapter 10, Problem 4CCS

45-Year-Old Female with Motor Nerve Damage

In Chapters 7 and 8, you met Kayla Tanner, who suffered a dislocated right hip in a car accident. Six weeks later, Mrs. Tanner was still unable to walk or run without hip pain, and had weakness in flexion at the knee, excessive foot inversion and plantar flexion, and significant “foot drop” (the inability to dorsiflex the foot).

Electromyography (measurement of muscle electrical activity) and nerve conduction studies (measurement of the speed of nerve impulses) revealed sciatic nerve damage, most likely a result of the nerve being compressed when the hip was dislocated. This large nerve innervates many lower limb muscles. Since her surgery, Mrs. Tanner has been undergoing intense physical therapy and has shown significant improvement.

4. For each description below, name the muscle (or muscles) that the therapist was assessing.

a. With Mrs. Tanner in the seated position, the therapist positioned Mrs. Tanner’s knees shoulder-width apart, then asked Mrs. Tanner to bring her knees together while the therapist applied resistance to the right thigh.

b. The therapist applied resistance to the top of Mrs. Tanner’s foot and asked her to pull her forefoot up toward her shin.

c. With Mrs. Tanner in the prone position (on her stomach), the therapist applied resistance to the leg while Mrs. Tanner tried to bring her heel up toward her buttocks (flex her leg at the knee).