COMP 10 and OSCE Flashcards
(10a) When performing HVLA tx for a posterior tibia and anterior tibia on talus somatic dysfunction:
A. How is posterior tibia on talus dysfunction diagnosed?
B. For a posterior tibia on talus, what ankle motion is associated with this dysfunction?
C. Dysfunction is due to changes in mechanics of which structure?
D. Anterior tibia on talus dysfunction is associated with which ankle motion?
E. When treating these dysfunctions, what is the patient and doc’s position?
F. When treating posterior tibia on talus ankle, how do you engage the barrier?
G. For posterior tibia on talus ankle somatic dysfunction, how is the HVLA thrust applied?
I. How do you set up the patient to treat an anterior tibia on talus ankle somatic dysfunction? How is the restrictive barrier engaged?
J. To treat anterior tibia on talus ankle dysfunction, how is the HVLA applied
A. Distal tibia is restricted to anterior glide relative to the talus with ease of motion toward posterior glide.
B. Ease of motion to ankle plantar flexion
C. Changes in distal tibia mechanics NOT the talus.
D. Dorsiflexion
E. patient is supine with hip and knee extended (flat on the table). Doc is at the foot of the table.
F. Contact foot and ankle by wrapping hands around foot with fingers interlaced on dorsum of foot and thumbs on the plantar aspect of ball of foot and then dorsiflex at the ankle and apply an axial traction while increasing dorsiflexion of foot.
G. Once restrictive barrier is engaged, apply an axial tug HVLA thrust
I. Cup calcaneous with one hand and contact the anterior aspect of the distal tibia with the other. restrictive barrier is engaged by applying a distractive force caudally on the calcaneous with some plantarflexion and applying a simultaenous posterior force on the distal tibia
J. Once restrictive barrier has been engaged, apply an axial tug HVLA thrust on the calcaneous and posterior thrust on the distal tibia.
(10b) For HVLA treatment for a posterior and anterior lateral malleolus ankle somatic dysfunction:
A. How is this dysfunction diagnosed?
B. To treat a posterior lateral malleolus dysfunction, what is the patient’s and doc’s position?
C. How do you set up to perform HVLA for posterior lateral malleolus?
D. How is the restrictive barrier engaged?
E. In what direction is the HVLA thrust applied to treat posterior lateral malleolus?
F. What is the patient position to treat the anterior lateral malleolus?
G. How is the restrictive barrier engaged and in what direction is the HLVA thrust applied for anterior lateral malleolus?
A. glide the lateral malleolus anterior and posterior
B. Patient is prone. Doc is at the foot of the table
C. Hand both hands around ankle and place both thumbs on the posterior aspect of the lateral malleolus
D. apply an anterior force and an plantar flexion force to the ankle
E. anterior HVLA thrust
F. patient is supine
G. Wrap hands around with thumbs on the anterior aspect of lateral malleolus and apply a slight dorsiflexion on ankle. Apply an posterior HLVA thrust on the lateral malleolus.
(10c) HVLA treatment for plantar flexed and dorsiflexed talus somatic dysfunction:
A. What is normal ROM for plantar and dorsiflexion?
B. what is the patient’s and doc’s position?
C. To treat a plantar flexed talus or dorsiflexed, how is the restrictive barrier engaged?
D. in what direction is the HVLA thrust applied for both the dorsiflexed and the plantar flexed talus?
A. Plantar 50-65. Dorsiflexion: 15-20
B. patient’s supine with ipsilateral hip and knee extended. Doc’s at the foot of the table
C. For plantar flexed: Dorsiflex and some axial traction. For Dorsiflexed talus: plantar flex and axial traction
D. For both, once the restrictive barrier has been engaged, apply an leg tug HVLA thrust.
(10d) HVLA tx for inverted and everted calcaneous somatic dysfunction:
A. what is the normal ROM for talocalcaneal inversion and eversion?
B. Inverted and everted calcaneous somatic dysfunction is due to changes mechanics of what structure?
C. How is the restrictive barrier engaged for either of the dysfunction?
D. How is the HVLA thrust applied to treat the dysfunctions?
A. 5
B. Subtalar mechancis
C. Cup the calcaneous with one hand and drape the dorsum of foot with the other hand. To engage barrier, bring to either eversion or inversion and apply an axial traction force to the calcaneous first with one hand in contact with it, then add a traction force with the other hand on the dorsum of foot.
D. an axial “leg tug” HVLA
(10e) HVLA tx for a plantar metatarsal somatic dysfunction:
A. When diagnosing plantar metatarsal, the ease of motion is in which portion of the metatarsal (proximal or distal) is to plantar glide
B. This dysfunction is due to changes in mechanics of which structure?
C. How to you set up and engage the restrictive barrier to treat?
D. How is the HVLA applied?
A. distal metatarsal
B. forefoot (metatarsal heads)
C. Grasp metatarsal head with thumb and index finger of one hand the other thumb and index finger grasp the proximal phalanx and apply a distractive force to the metatarsal phalangeal joint.
D. hyperflexion HVLA thrust force on the metatarsal head
(10f) Trans-tarsal HVLA treatment for a plantar navicular somatic dysfunction:
A. what portion of the navicular drops plantar for this dysfunction?
B. How is the restrictive barrier engaged?
C. In what direction is the HVLA trust applied?
A. the lateral aspect
B. Stablize ankle to the table by contacting the calcaneous/talus with one hand, the other hand contact the talus and first metatarsal/first cuneiform/nacivular. TO engage the barrier, evert the forefoot/midfoot (roll the forefoot towards the table
C. toward eversion of the forefoot
(10g) Trans-tarsal HVLA treatment for a plantar cuboid somatic dysfunction:
A. what portion of the cuboid drops plantar int his dysfunction?
B. What is the doc’s hand positions to treat this?
C. how is the HVLA thrust applied?
A. Medial
B. One hand contact calcaneus talus with one hand, and the other hand contact the talus 1st metatarsal/1st cuneiform/navicular. Restrictive barrier is engaged by inverting the forefoot/midfoot (roll foot towards the table)
C. towards inversion of the forefoot.
(10h) Hiss/Whip HVLA plantar cuneiform somatic dysfunction:
A. What is the patient’s position and the doc’s position in order to treat this?
B. in proper hand placement to treat this, the thumbs should be on what side of the foot?
C. How is the restrictive barrier engaged?
D. how is the HVLA thrust applied?
A. patient is prone with foot hanging off the table. Doc at the foot of the table
B. Plantar aspect over the cuneiform
C. Provide a plantar flexion force at the ankle and a dorsal force to the plantar aspect of the dysfunctional cuneiform through the thumbs.
D. HVLA thrust toward plantar flexion at the ankle and dorsal glide on the dysfunctional cuneiform in a whip like fashion
(10i) To perform ME treatment for plantar flexed talus and dorsiflexed talus:
A. what is the patient and doc’s position?
B. In plantar flexed talus dysfunction, in what direction is the patient’s activating force? In dorsiflexed talus dysfunction?
A. patient supine with hip and knee extended.
B. Towards to plantarflexion
C. Towards the dorsiflexion
If a patient has restriction of ankle to dorsiflexion, what test can you use to determine which muscles is the cause of the restriction?
Ankle dorsiflexion test.
Your patient presents with restriction of ankle to dorsiflexion. When performing the ankle dorsiflexion test you find that patient is able to dorsiflex. What muscle is involved in the patient’s restriction to dorsiflexion?
Gastrocnemius. If the soleus was involved, then there would be no improvement in the dorsiflexion restriction while performing the ankle dorsiflexion test.
What is the ankle drawer sign used to determine? How is it performed? and what is a positive sign?
It is used to determine integrity of talofibular ligament. When performing grab distal tib/fib with one hand and the other hand grab calc and glide anterior. normally it should glide anterior with some medial rotation but it should spring back. Positive sign is if it does not spring back.
How do you perform the Homan’s sign and what is positive sign and what does it indicate?
Used to indicate thrombophlebitis or acute venous thrombosis. Grasp the calf of the affected lower extremity and gently squeeze calf while applying a dorsiflexion. Positive sign is pain.
What is the moses signed used for? how do you perform it and what is positive sign?
Used to indicate deep vein thrombosis of the posterior tibial veins. Patient is seated or supine and doc induces an anterior compression on the gastrocnemius into the posterior aspect of tibia. positive sign is pain with anterior compression - NOT lateral compression
What is the squeeze test used for? how do you perform it and what is positive sign? This type of injury usually occurs with what ankle motions?
Used to determine high ankle sprain (anterior inferior tibiofibular ligament) and/or interosseous membrane tear.
-Doc places one hand medial and one hand lateral and squeeze the calves. Pain on the lateral aspect indicates positive test. usually occurs with dorsiflexion and eversion of the foot.
