Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

ECOS 3 Midterm > Counterstrain - Extremity review, new anterior counterstrain & Diabetes screening > Flashcards

Counterstrain - Extremity review, new anterior counterstrain & Diabetes screening Flashcards

1
Q

Counterstrain Steps (7)

A
  1. Find most significant Tenderpoint.
  2. Physician establish a tenderness scale.
  3. Monitor Tenderpoint throughout.
  4. Place patient in “Position of Ease” of at least 70% improvement.
  5. Hold 90 seconds.
  6. Slowly return to neutral.
  7. Recheck tenderness and associated TART findings.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Supraspinatus: counterstrain positioning/treatment

A

F Abd ER patient’s arm is flexed 45 degrees, abducted 45 degrees, and externally rotated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Levator Scapulae: counterstrain positioning/treatment

A

IR Abd traction IR pt’s shoulder, add mild-mod traction with minimal abduction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Subscapularis: counterstrain positioning/treatment

A

E IR pt’s shoulder extended and internal rotated, traction can help

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Biceps Brachii (Long Head): counterstrain positioning/treatment

A

F Abd ir elbow and shoulder flexed, arm is minimally abducted and internally rotated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Biceps Brachii (Short Head)Coracobrachialis: counterstrain positioning/treatment

A

F Add ir elbow and shoulder flexed, arm is minimally adducted and internally rotated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Radial Head–Lateral (Supinator): counterstrain positioning/treatment

A

E SUP Val pt’s elbow in full Extension, forearm markedly supinated, fine tune with vaLgus force

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Medial Epicondyle (Pronator Teres): counterstrain positioning/treatment

A

F PRO Add pt’s elbow Flexed, marked pronation, forearm slightly aDducted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Dorsal Wrist (Extensor Carpi Radialis): counterstrain positioning/treatment

A

E Abd/rd pt’s wrist passively Extended and aBducted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Dorsal Wrist (Extensor Carpi Ulnaris): counterstrain positioning/treatment

A

E ADD pt’s wrist passively Extended and aDducted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Palmar Wrist (Flexor Carpi Radialis): counterstrain positioning/treatment

A

F Abd pt’s wrist passively Flexed and aBducted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Palmar Wrist (Flexor Carpi Ulnaris): counterstrain positioning/treatment

A

F Add

pt’s wrist passively Flexed and aDducted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

First CMP (Abductor Pollicis Brevis): counterstrain positioning/treatment

A

F (wrist) Abd (thumb) pt’s wrist passively Flexed, thumb is aBducted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Lateral Trochanter (Tensor Fasciae Latae): counterstrain positioning/treatment

A

patient’s knee is aBducted and slightly flexed •May require slight internal rotation of the hip

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Iliotibial band: counterstrain positioning/treatment

A

f ABD patient’s hip/thigh is abducted and slightly flexed until the tenderness is ≥70% reduction •May require slight internal or external rotation of the hip

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Lateral hamstring tender point: counterstrain positioning/treatment

A

F ER ABd patient’s knee is flexed and the tibia is externally rotated with slight abduction; compression on the calcaneus is added to plantar flex the ankle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Medial hamstring: counterstrain positioning/treatment

A

F IR Add patient’s knee is flexed and the tibia is Internally rotated with slight aDduction; compression on the calcaneus is added to plantar flex the ankle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Lateral Meniscus: Lateral (Fibular) Collateral Ligament counterstrain positioning/treatment

A

pt’s thigh abducted so leg is off table, flex knee~35-40 degrees, tibia is abducted and externally or internally rotated until the tenderness is ≥70% reduction •May require ankle dorsiflexion and eversion of the ankle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Medial Meniscus: Medial (Tibial) Collateral Ligament counterstrain positioning/treatment

A

pt’s thigh abducted so leg is off table, flex knee~35-40 degrees, tibia is adducted and internally rotated until the tenderness is ≥70% reduction •May require plantar flexion and inversion of the ankle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Anterior Cruciate: counterstrain positioning/treatment

A

towel roll or pillow under distal femur for fulcrum, apply force to proximal tibia to translate tibia posteriorly on distal femur until the tenderness is ≥70% reduction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Posterior Cruciate: counterstrain positioning/treatment

A

towel roll or pillow under proximal tibia for fulcrum, apply force to distal femur to translate femur posteriorly on proximal tibia until the tenderness is ≥70% reduction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Popliteus: counterstrain positioning/treatment

A

pt’s knee flexed and tibia is internally rotated until the tenderness is ≥70% reduction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Extension Ankle (Gastrocnemius): counterstrain positioning/treatment

A

pt’s knee flexed and dorsum of foot on doc’s thigh, add compressive force through calcaneus until the tenderness is ≥70% reduction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Medial Ankle (Tibialis Anterior): counterstrain positioning/treatment

A

Inversion apply inversion force to foot and ankle with slight internal rotation until the tenderness is ≥70% reduction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Lateral Ankle Fibularis (Peroneus)Longus, Brevis, Tertius: counterstrain positioning/treatment
Eversion apply eversion force to foot and ankle with slight external rotation until the tenderness is ≥70% reduction
26
Flexion Calcaneus (Quadratus Plantae): counterstrain positioning/treatment
patient's knee is flexed, dorsum of foot on doc’s thigh, marked flexion while translating calcaneus toward the forefoot until the tenderness is ≥70% reduction
27
Navicular: counterstrain positioning/treatment
F patient's knee is flexed, dorsum of foot on doc’s thigh, plantar flexion of subtalar joint, supination of forefoot until the tenderness is ≥70% reduction
28
Why do we examine diabetic feet?
Elevated levels of blood sugar cause damage to nerves and smaller blood vessels ◦Loss of sensation ◦Decreased blood flow
29
Lack of sensation puts (diabetes) patients at risk for:
◦Repetitive trauma ◦Unnoticed injuries ◦Structural deformities
30
◦Decreased blood flow puts (diabetes) patients at risk for:
◦Infection ◦Insufficient wound healing ◦Tissue breakdown (gangrene)
31
Steps for diabetic foot exam (6)
Steps 1.Inspection 2.Palpation 3.Vascular evaluation 4.Reflexes 5.Monofilament Testing 6.Sensation testing
32
Most commonly missed foot inspection site?
Toe web spaces
33
Monofilament Exam - how?
◦Patient supine or seated with eyes closed and plantar surface exposed ◦Provide patient with reference sensation ◦Instruct patient to inform you when they feel the monofilament ◦Apply monofilament perpendicularly to skin at testing sites with enough pressure to buckle the filament for 1 second ◦Testing sites should be assessed in random order so patients cannot anticipate it
34
Anterior Thoracic Counterstrain Indication • Chief complaints
Chest Pain •21-49% is MSK in origin Abdominal Pain Must rule out all other pathologies before approaching with OMM
35
Anterior Thoracic Counterstrain Anterior T1-T6 Tenderpoints (1,2,3-6) Associated anatomy?
* AT1: suprasternal notch * AT2: angle of the manubrium (Louis) * AT3 to AT6 on the sternum as the same numbered costal level. * Associated anatomy: Pectoralis major, intercostal muscles
36
Anterior Thoracic Counterstrain AT1-2 Treatment
example AT 2 •Pt: supine •Doc: at head of bed •Position of ease: f-F Flex cervical to use linkage to T2
37
Anterior Thoracic Counterstrain AT3-6 Treatment
example AT 3 •Pt: seated •Doc: Standing behind •Position of ease: f-F Arms internally rotated –Flex by -Letting the patient slump back toward physician -Flex cervical to link thoracic
38
Anterior Thoracic Counterstrain Anterior T6-T12 Location •AT7 (3)
inferior tip of xiphoid and 1/4 from xiphoid and umbilicus
39
Anterior Thoracic Counterstrain AT8 Location
halfway between xiphoid and umbilicus
40
Anterior Thoracic Counterstrain AT9 Location?
3/4 from xiphoid and umbilicus
41
Anterior Thoracic Counterstrain AT10 location?
1/4 from the umbilicus to the pubic symphysis
42
Anterior Thoracic Counterstrain AT11 location?
halfway between the umbilicus and pubic symphysis
43
Anterior Thoracic Counterstrain AT12 location?
on the anterior superior surface of the iliac crest at the mid-axillary line
44
Anterior Thoracic Counterstrain Anterior T6-T12 associated anatomy?
Associated anatomy: Rectus abdominus, obliques
45
Anterior Thoracic Counterstrain AT7-9 Treatment
Example R AT 7 •Pt: Seated •Doc: Standing behind •Position of ease: F St Ra –Thoracic flexion –Sidebend right –Rotate left
46
Anterior Thoracic Counterstrain AT 10-12 Treatment
Example: R AT11 •Pt: Supine •Doc: Standing behind •Position of ease: F ST RA –Flex hips (thoracic flexion) –pull ankles to right (sidebend right) –pull knees to the right (rotate left) •Support with physician knees
47
Anterior Lumbar and Pelvic Counterstrain Indications
Chief complaints –Abdominal Pain •UTI, Ovarian Cysts –Low Back Pain •Anterior musculature pelvic ring •Must rule out all other pathologies before approaching with OMM
48
Anterior Lumbar Counterstrain AL 1 location? Associated anatomy?
•AL 1: Medial to ASIS Associated anatomy: Obliques (AL 1), Illiopsoas(AL1-4)
49
Anterior Lumbar Counterstrain AL2 location? Associated anatomy?
AL 2: Medial to AIIS Associated anatomy: Illiopsoas(AL1-4)
50
Anterior Lumbar Counterstrain AL 3 location? AL 4 location? Associated anatomy?
AL 3: Lateral to AIIS AL 4: Inferior to AIIS Associated anatomy: Illiopsoas(AL1-4)
51
Anterior Lumbar Counterstrain AL5 location? Associated anatomy?
AL5: Anterior superior aspect of pubic ramus Associated anatomy: Adductor longus (AL 5)
52
Anterior Lumbar Counterstrain AL 1 Treatment
Example R AL 1 (medial ASIS) •Pt: Supine Doc: ipsilateral side •Position of ease: F St RA –Flex hips (lumbar flexion) –Pull ankles toward doc (sidebend right) –Pull knees toward doc (rotate left) •Support with physician knees
53
Anterior Lumbar Counterstrain AL 2 Treatment
Example R AL 2 (Medial AIIS) •Pt: Supine, Doc: contralateral side •Position of ease: F SA RT –Flex hips (lumbar flexion) –Pull ankles toward doc (sidebend right) –Pull knees toward doc (rotate left), lots of rotate! •Support with physician knees
54
Anterior Lumbar Counterstrain AL 3 & 4 Treatment
Example R AL 3 (Lateral AIIS) or R AL 4 (Inferior AIIS) •Pt: Supine, Doc: contralateral side •Position of ease: F SA Rt –Flex hips (lumbar flexion) –Pull ankles toward doc (sidebend right) –Pull knees toward doc (rotate left) •Support with physician knees
55
Anterior Lumbar Counterstrain AL5 Treatment
Example R AL 5 (superior/lateral to pubic symphysis) •Pt: Supine, Doc: ipsilateral side •Position of ease: F SA RA –Flex hips (lumbar flexion) –Pull ankles away doc (sidebend right) –Pull knees toward doc (rotate left) •Support with physician knees
56
Anterior Pelvic Counterstrain Psoas Major tenerpoint location?
2/3 distance from ASIS to midline
57
Anterior Pelvic Counterstrain Iliacus tenderpoint location?
Iliacus: 1/3 distance from ASIS to midline
58
Anterior Pelvic Counterstrain Low Ilium tenderpoint location?
Low Ilium: Superior pubic ramus, where psoas passes pelvic rim
59
Anterior Pelvic Counterstrain Inguinal Ligament tenderpoint location?
Inguinal Ligament: Lateral Pubic Tubercle
60
Anterior Pelvic Counterstrain Psoas Major Treatment
Example Right Psoas Major TP (2/3 from ASIS to midline) •Pt: Supine, Doc: ipsilateral side •Position of ease: F ST er –Extreme hips flexion –Pull ankles toward physician (Sidebend left external rotation) •Support with physician knees
61
Anterior Pelvic Counterstrain Iliacus Treatment
Example R Iliacus TP (1/3 distance from ASIS to midline) •Pt: Supine, Doc: ipsilateralside •Position of ease: F ER Abd –Flex hips –Cross ankles (external rotation) –Let knees drop out (abduction) * Support with physician knees * Criss cross Iliacus sauce
62
Anterior Pelvic Counterstrain Low Ilium Treatment
Example Right Low Ilium TP (Superior pubic ramus, where psoas passes pelvic rim) •Pt: Supine, Doc: ipsilateralside •Position of ease: F –Flex hips \>90
63
Anterior Pelvic Counterstrain Inguinal Ligament Treatment
Example R Inguinal Ligament TP (Lateral pubic tubercle) •Pt: Supine, Doc: ipsilateralside •Position of ease: F ADD IR –Flex hips to 90 –Cross contralateral knee over (adduction) –Pull ankles toward TP (Internal rotation) •Support with physician knees

ECOS 3 Midterm (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions