COMP 12 and OSCE Flashcards
(12a) ME for anterior radial head with supination somatic dysfunction:
A. How this dysfunction diagnosed?
B. How do you engage restrictive barrier?
C. in what direction is the patient’s activating force?
A. Contact the wrist with one hand and the radial head with the other hand’s thumb and index finger and provide an anterior/posterior glide. Anterior radial head will have ease of motion to anterior glide accompanied with supination
B. contact ipsilateral elbow with one hand while other hand grasp the ipsilateral wrist and fully pronating.
C. towards supination
(12a) ME for posterior radial head with pronation somatic dysfunction:
A. Describe diagnostic finding.
B. how do you set up the patient?
C. in what direction is the patient’s activating force?
A. ease of motion to posterior glide accompanied with forearm pronation
B. one hand contacts the ipsilateral elbow and the other hand grasps wrist and fully supinates.
C. towards pronation
(12b) ME for radial deviation/abduction wrist somatic dysfunction:
A. Describe findings. what’s normal ROM?
B. What is the doc’s and pts position?
C. how do you set up the patient to the treatment to engage the restrictive barrier?
D. which direction is the patient’s activating force?
A. ease of motion to radial deviation and restricted toward ulnar deviation. Normal radial deviation is 20-30
B. Patient is seated and doc is standing facing the patient to side of dysfunction
C. Doc contacts the ipsilateral hand with one hand and the distal radius/ulnar with the other hand while placing the ipsilateral elbow at 90 degree flexion. Fully ulnar deviate the hand
D. Towards radial deviation
(12b) Me for ulnar deviation/adduction wrist somatic dysfunction:
A. describe findings. what’s normal ROM?
B. what is the doc’s and pt’s position
C. how do you set up the patient for the treatment to engage restrictive barrier?
D. which direction is the patient’s activating force?
A. ease of motion to ulnar deviation with restriction to radial deviation. normal ulnar deviation is 30-40
B. patient is seated and doc is standing facing the patient to side of dysfunction
C. Doc contacts the ipsilateral hand with one hand and the distal radius/ulnar with the other hand while placing the ipsilateral elbow at 90 degree flexion. Fully radial deviate the hand.
D. towards ulnar deviation
(12c) ME for extension wrist/ventral carpal somatic dysfunction:
A. Extension is associated with what motion of the carpals? what is normal ROM for extension?
B. how is the restrictive barrier engaged?
C. which direction is the patient’s activating force?
A. ventral glide. 70 degrees for extension
B. by fully flexing the ipsilateral wrist
C. towards extension
(12 c) ME for flexion wrist/dorsal carpal somatic dysfunction
A. Flexion is associated with what motion of the carpals? what is normal ROM for flexion?
B. How is the restrictive barrier engaged?
C. which direction is the patient’s activating force?
A. dorsal glide. 80-90 degrees for flexion.
B. By fully extending the ipsilateral wrist
C. towards flexion
(12d) HVLA treatment for ulnar abduction and adduction somatic dysfunction:
A. Describe how and what the diagnostic findings are in terms of valgus and varus.
B. how do you step up the patient for each and engage the barrier?
C. How is the HVLA thrust applied?
A. contact ulna with one hand and distal radius/ulna with the other hand and provide an valgus force toward elbow noting end feel (hard or ease of motion). Abduction will have ease of motion to valgus force and adduction will have ease of motion of varus force.
B Abduction dysfunction: contact ipsilateral medial ulna with one hand and distal radius/ulna with other while placing elbow at full extension and engage restrictive barrier by fully adducting the ulna. For Adduction: one hand on the lateral ulna and other hand grab the distal radius/ulna and extend the elbow fully and bring to restrictive barrier by fully abducting.
C. Varus force for abduction. Valgus force for aductions
(12e) HVLA for an anterior radial head somatic dysfunction
A. how do you set up the patient
B. how is the HVLA thrust applied?
A. One hand’s palm grasps over the anterior aspect of the radial read and the other hand grabs distal radius/ulna. Engage the barrier by flexing the elbow fully while the forearm is fully protonated.
B. Hyperflexion at the elbow and a simultaneous dorsal force on the anterior radial hand with the hand that is in contact with it.
(12f) HVLA for a posterior radial head somatic dysfunction
A. how do you set up the patient
B. how is the HVLA thrust applied?
A. Place thumb of one hand on the posterior aspect of he radial head and the other hand extends the ipsilateral elbow fully so the thumb becomes a fulcrum to work around and displace the force to the posterior radial head. the forearm is also fully supinated.
B. Hyperextension at the elbow and a simultaneous ventral force with the thumb in contact with the radial head.
(12g) HVLA tx for an extension wrist with ventral carpal and flexion wrist with dorsal carpal somatic dysfunction:
A. How do you set up the patient- on which side of patient’s hand should the doc’s thumbs be on?
B How is the restrictive barrier reached for each?
C. How is the HVLA thrust provided?
A. Contact ipsilateral wrist with both hand; thumbs are in contact with the dorsal aspect of the index fingers in contact with the ventral aspect of the wrist.
B. Flexion dys: first place the wrist into flexion and then bring it to extension to the barrier. For extension dys: first plae the wrist into extension and then bring it to extension to the barrier.
C. For flexion dysfunction: HVLA towards wrist hyperextension with simultaneous ventral carpal glide. For extension dysfunction: HVLA towards wrist hyperflexion with simultaneous dorsal carpal glide
(12h): HVLA tx for an ulnar deviation/adduction and radial deviation/abduction wrist somatic dysfunction:
A. How restrictive barrier engaged and in which direction is the HVLA thrust applied?
A. For Ulnar deviation: fully radial deviate and HVLA is towards radial deviation. For Radial deviation: fully ulnar deviate and HVLA is towards ulnar deviation
(12i): HVLA tx for phalangeal somatic dysfunction:
A. Where can the dysfunction be palpated? and hows is it diagnosed?
B. How do you set up for the tx?
C. in which direction is the HVLA?
A. palpated at the MCP, placed through the range of motion of flexion, extension, abduction, adduction, internal and external rotation and noting for ease and restriction.
B. grasp the distal metacarpal with one hand (thumb and index finger) and grasp the proximal phalanx with the other hand’s index and thumb
C. Apply a distraction force and then provide a hyperflexion HVLA thrust
(12j) Interosseous MFR tx for a forearm interosseous membrane somatic dysfunction:
A. How do you set up to treat?
A. Place patient in seated position and stand in front of patient. Grasp the forearm with thumbs on the anterior aspect and the rest of the hand encircling the forearm.
(12k): MFR tx for a wrist flexor retinaculum somatic dysfunction
A. for how long is the MFR maintained?
MFR is maintained and tissue creep is followed until it stops about about 60 secs. Stop tx before the 60 if patient experiences pain, continue if its just tingling feeling.
(12l): articulatory tx for a wrist/carpal somatic dysfunction
A. explain how the tx is performed.
A. Doc places on palm over the dorsal wrist and the other hand on the ventral aspect of wrist and interlace fingers and then provide a squeeze with traction and then provide an articulatory force CW and CCW.
