Competenct 7: counterstrain for upper and lower extremity Flashcards
1
Q
7g) extension elbow-
A
- TP located on side of olecranon process of the ulna near triceps tendon
- Tx: pt supine, doc same side as TP; grasp pt elbow w/ caudad hand so thumb is on TP & hand around forearm…supinate wrist, hyperextend elbow over monitoring hand, finetune w/ ab-adduction
2
Q
7p) patellar tendon-
A
- TP located on patellar tendon
- Tx: pt supine w/ pillow under distal tib/fib, doc standing same side as TP; push anterior to posterior on distal femur & hyperextend knee
3
Q
7k) Extension wrist-
A
- TP located as a pattern of 2-3 points over dorsal aspect of radioulnar-carpal jxn
- Tx: pt supine, doc seated on same side as TP; extend & ADDuct wrist (ulnar dev.)
4
Q
7v) extension ankle-
A
- TP located on both gastrocnemius heads & both sides of Achilles tendon
- Tx: pt prone, doc standing on same side of TP w/ doc leg on table; flex pt affected knee, plantar flex ankle & place dorsum of ankle on doc thigh…doc add axial compression through ankle, keeping pressure on instep to avoid straining metatarsals
5
Q
7u) medial ankle-
A
- TP located in small arc below medial malleolus
- Tx: pt Lateral recumbent on NON-AFFECTED side, w/ knee flexed & ipsilateral foot over edge of table w/ rolled up towel under ankle, doc standing at end of table; apply force to foot/ankle causing inversion of whole foot
6
Q
7n) lateral trochanter-
A
- TP located inferior- 5 to 6 in inf to greater trochanter in mid-coronal line
- Tx: pt prone, doc standing on same side of TP; Abduct hip, slightly flex
7
Q
7j) flexion wrist & thumb-
A
- FW TP- located at base of any of the proximal 2nd to 5th metacarpals in the mm of the flexor carpi radialis & ulnaris
- FT TP- located on ant/lat aspect of base of the 1st metacarpal bone
- Tx: pt supine, doc seated at side of TP; flex pt entire wrist w/ slight radial/ulnar deviation….thumb-flex wrist, Abduct thumb
8
Q
7b) PAC-
A
- TP located over posterior AC joint
* Tx: Pt prone, doc opposite side of TP; pull pt arm into extension/slight horizontal adduction, apply traction at wrist
9
Q
7w) flexion ankle-
A
- TP located high in the front of the ankle in a depression medial to the big extensor tendon
- Tx: pt prone, doc standing same side of TP; exert force onto the ball of the foot, dorsiflexing the ankle…finetune w/ slight rotation
10
Q
7c) subscapularis-
A
- TP located on ant/lat border of scapula, deep in axilla
* Tx: Pt supine, doc same side of TP; place UE over side of table w/ shoulder extended/IR/slightly Abducted…NO traction
11
Q
7s) ACL-
A
- TP located on medial/lateral aspects of popliteal fossa
- Tx: pt supine w/ pillow under distal femur, doc standing same side as TP; push anterior to posterior on the TIBIA (shortens ACL)
12
Q
7e) long head and short head of biceps-
A
- Long head TP- located over the long head of biceps tendon in bicipital groove
- Short head TP- located inf/lat to coracoid process
- Tx: pt supine, doc same side as TP facing cephalad; pt arm flexed/IR w/ dorsum of hand/forearm lying on forehead….for short head add ADDUCTION w/ arm more across chest
13
Q
7f) supraspinatus-
A
- TP located in belly of supraspinatus mm, in supraspinatus fossa above spine of scapula
- Tx: pt supine, doc same side as TP; pt arm Abducted/flexed/ER to 45 deg (mm should become very soft)
14
Q
7q) medial hamstring-
A
- TP located on medial hamstring mm/tendon near its distal attachment at the posterior medial surface of tibial condyle
- Tx: pt supine, doc standing same side as TP; flex pt knee, ER the tibia on femur, finetune w/ ADDuction at the knee
15
Q
7L) Extensor carpometacarpal & metacarpophalangeal-
A
- Extensor CMC TP- located along jxn of carpal & metacarpal bones on dorsum of hand
- MCP TP- located on metacarpal bones on dorsum of hand
- Tx: pt supine, doc seated same side as TP; extends fingers & wrist
16
Q
7r) PCL-
A
- TP located close to the middle of the popliteal space
- Tx: pt supine, w/ pillow under proximal tib/fib, doc standing same side as TP; push anterior to posterior pushing the FEMUR posteriorly (shortens PCL)
17
Q
7t) lateral ankle-
A
- TP located anterior/inferior to lateral malleolus in the sinus tarsi (talocalcaneal sulcus)
- Tx: pt lateral recumbent on AFFECTED side, w/ other knee flexed & ipsilateral foot over the edge of table w/ rolled up towel under ankle to protect fibula, doc standing at end of table; apply force w/ heel of hand 3 cm below medial malleolus causing eversion of whole foot, w/ mild ER
18
Q
7a) AAC-
A
- TP located slightly medial to tip of clavicle & over the anterior aspect of the AC joint
- TX: pt supine, doc opposite side of TP; pull pt arm into flexion/adduction w/ slight IR & traction across the body
19
Q
7m) posterior lateral trochanter-
A
- TP located along sup/lat aspect of the posterior surface of the greater trochanter (lateral aspect of piriformis)
- Tx: pt prone, doc standing same side of TP; extend pt ipsilateral leg w/ ER/Abduction
20
Q
7i) radial head-
A
- TP located on ant/lat border of radial head
- Tx: pt supine, doc same side as TP; supinate elbow & fully extend elbow over doc knee w/ other hand (NO hyperextend)
21
Q
7d) latissimus dorsi-
A
- TP located deep in axilla on medial side of humerus; slightly posterior to subscapularis TP
- Tx: pt supine, doc same side as TP; pt UE over side of table w/ shoulder extended/IR/slightly Abducted WITH TRACTION
22
Q
7o) Sartorius-
A
- TP located 2-3 cm inferior to ASIS (near attachment for Sartorius)
- Tx: pt supine, doc standing same side as TP; flex hip/knee 135 deg w/ ER
23
Q
7h) flexion elbow-
A
- TP located on coronoid process of ulna
* Tx: pt supine, doc same side as TP; flex pt elbow, pronate & Abduct arm, then pull forearm out laterally
