CPA 2 Flashcards
Lower Crossed Syndrome/Hip Region Pseudoparesis
What is hypertonic? What is weak?
Hypertonic POSTURAL muscles (iliopsoas, r. femoris, hammies, pirifomis, LE short adductors, QL, TFL)
Hypotonic MOVEMENT muscles (a. tibilais, gluteals, v. medialis, peroneals, abdominals)
Pseudoparesis: Patient perception
- Ask pt to flex 1 leg at hip ~12 in., then put down
- Repeat on other side
- Compare for any difference and tell examiner
Pseudoparesis: Patient Perception w/ SI joint stabilization
Repeat pt perception test and induce medial compression through:
1. iliac crests
2. midway b/w iliac crests and greater trochanters
3. greater trochanters
Communicate perceived change to examiner
Affected muscles when change is noted with compression at iliac crests?
Multifidus, Lat Dorsi, Levator scapula, lumbar vertebrae and structures above/including lumbosacral junction
Affected muscles when change is noted with compression between iliac crests and greater trochanter?
Gluteals, SI joints, sacrum, innominate
Affected muscles when change is noted with compression at greater trochanter?
Pelvic diaphragm, hammies, STL, structures below pelvic diaphragm
LE Extension muscle balance: ideal firing pattern?
- Ipsilateral hamstring
- Ipsilateral gluteus maximus
- Contralateral erector spinae
- Ipsilateral erector spinae
LE Abduction muscle balance: ideal firing pattern?
- Ipsilateral gluteus medius
- Ipsilateral TFL
- Ipsilateral QL
- Ipsilateral erector spinae
Upper Crossed Syndrome/Shoulder region pseudoparesis
What is hypertonic? What is weak?
Hypertonic POSTURAL muscles (L. scapula, upper trapezius, pectorals, lats, SCM, scalenes, subscap, UE flexors)
Hypotonic MOVEMENT muscles (deep neck flexors, s. anterior, deltoid, UE extensors, rhomboids, supraspinatus, infraspinatus, mid/lower trapezius)
Cervical Flexion Test
Patient flexes their chin to their chest
Positive test = facilitated SCM/scalenes, inhibition of longus colli, substitution by SCM and scalenes
(+) immediate recruitment of SCM/scalenes, absence of chin nod
(-) longus colli activation causes chin nod with SCM/scalenes firing late
Scapular Stabilization Test
Excessive winging of medial border of scapula - indicates weakness of lower trapezius, serratus anterior, and rhomboids
Patient on all fours, lifts one hand from table causing other arm to support all upper body weight
(+) scaula on weight-bearing UE protrudes away from body
Bilateral Shoulder Flexion Test
Flex both arms to assess resting length of latissimus dorsi to assess length and influence on T/L spine
(-) Allows full overhead flexion of bilateral UEs at shoulders with minimal influence on T/L spine
Unilateral (+) allows full overhead flexion on one side at shoulders with noticeable influence on T/L spine
Bilateral (+) restricted overhead flexion on both sides at shoulders with noticeable influence on T/L spine
Pec Minor Asymmetry and PROM
- Pt supine
- Physician stabilizes other shoulder
- Physician applies posteriorly directed force against patient’s shoulder, noting PROM and end-feel
- Repeat on other side
(+) diminished PROM of one side compared to other and/or hard end feel
Direct/Indirect Thoracolumbar MFR Prone
One hand at R T/L junction, other hand at L T/L junction
Myofascial stress applied
Engage SB/R/F/E barriers
Activating Forces: Inhalation/Exhalation, Leg Extension/Flexion, Arm ABduction/ADduction
Direct/Indirect Thoracic MFR Prone
Hands on bilateral sides of thoracic spine
Myofascial stress applied
Engage SB/R/F/E barriers
Activating Forces: Inhalation/Exhalation, Leg Extension/Flexion, Arm ABduction/ADduction
