CRAM REVISION Flashcards
how is gillet test/ipsilateral kinetic test conducted
Start in iliac crest - L4/L5
PSIS - dimples - go below PSIS for inferior aspect of PSIS
Allow patient for lumbar flexion (ask patient to touch their toes can bend their knees )
One thumb on inferior aspect of PSIS , other thumb on sacrum
Hip flexion - normal response inferior PSIS drops inferiorly - posterior innominate rotation
Hip extension normal response. - inferior PSIS moves superiorly - anterior innominate rotation
how is gaenslens test conducted
One leg lying over the bed other leg pushes knee to their chest
Apply pressure on both legs
how is the compression test conducted
Separate front of innominate in SIJ apply compression force on SIJ
Cross my arms find medial ASIS and use palms of hands to separate them
how is the gapping test conducted
Push the front of innominates together causes a distraction force on SIJ
Place palms of hands lateral to ASIS push towards each other
how is the piriformis flexibility test conducted in supine
patient in supine
get patient to do knee and hip flexion against plinth on onel leg
external rotation with heel of foot on opposite knee
get patient to push the bottom leg to their chest
how is a piriformis flexibility test conducted in prone
Image below shows how it can be done in prone
Neutral hip flexion and neutral femur
Stretched by medial rotation
how is the ASLR conducted
Patient in supine
Ask patient to place their hands on their ASIS position it yourself
Place your hand around 20cm above their leg
Ask the patient to get the leg to touch your hand
what structural integrity is assessed using the ASLR
What structures takes load in SLR - lumbar spine vertebrae, sacroiliac joint, pelvic ring
how is the ASLR with form closure conducted?
Ask patient to place their hands on their ASIS position it yourself
Place your hand around 20cm above their leg
Ask the patient to get the leg to touch your hand
Place hand on both innominates or side of the ASIS and press towards each other
Ask patient to raise their leg
what is the grading interpretation of the ASLR conducted
0 = not difficult at all
1 = minimally difficult
2 = somewhat difficult
3 = fairly difficult
4 = very difficult
5 = unable to do
SIJ POSH test
Ask for knee flexion and 90 degree hip flexion
Stabilise contralateral ASIS - to prevent pelvic rolling
Apply downward pressure on on the patella
how is the dorsal ligament of SIJ palpated
PSIS - look for dimples
palpate inferior and medial
Patient in prone
apply transverse pressure similar to the DTF
When is MET rotation indicated
using supine to longsit test
when conducting a supine to longsit test what would indicate anterior innominate rotation
longer leg
what muscle energy technique if the patient was to correct anterior innominate rotation
patient can be in supine
ask patient to drive knee into their chest directed into their ipsilateral shoulder
place one hand on the plinth other hand on the medical aspect of their knee
ask patient to push against you using their hips extension not by straightening knee - hold 6 seconds
6 new boundaries
what muscle energy technique is used to correct posterior innominate rotation
patient in prone
palpate PSIS to promote anterior rotation - using dimples
knee flexion
passive hip extension while cupping the knee in your hand on the contralateral side of the patient
ask patient to dig knee into plinth
hold for 6 seconds 6 boundaries
how would you get a patient to be able to correct posterior innominate rotation independently as a HEP
instructions as mentioned
get towels under their knee
ask patient to dig knee into towel
how would you get patient to correct anterior innominate rotation METS independently as a HEP
supine
knee to chest in direction of ipsilateral axilla
get them to dig into their own shoulder resisting against their own hands
hold 6 seconds
how to conduct posterior innominate rotation sidelying
patient sidelying
placing hand on ASIS
forearm resting on ischial tuberosity
initiate rotation should induce passive hip flexion
how to conduct posterior innominate rotation sidelying in end of range
patient sidelying
patient in full knee extension and 90 degree hip flexion
hold leg between your iliac crest and forearm
placing hand on ASIS
forearm resting on ischial tuberosity
initiate rotation should induce passive hip flexion
how is thoracic rotation PPIVM conducted
patient side lying
ask patient to cross arms and place hands on contralateral shoulder
ensure no scapular retraction or protraction occurs
palpate the desired spinal level use forearm to stabilise the spine
using the patients elbow as a torque to gently rotate lifting the elbow upwards
how is thoracic side flexion occur in sitting
position plinth at level of hip
ask patient to cross arms and place hands on contralateral shoulder
ensure no scapular protraction or retraction occur
grasp one hand on shoulder
place other hand on vertebral space making an L shape
position yourself in a squat
work in lever lift the hand on the shoulder upwards
lower the hand on the vertebrae as you squat
how is rib 1 longitudinal caudad conducted
patient in supine
therapist seated in direct of head
palpate clavicle - palpate
push in direction on feet
how is cervical PPIVM side flexion conducted
patient - supine, head of table,
physio - supporting weight of patients with abdomen, palpate articular pillar between C2/C3, other hand support head, compare findings
movement - lateral flexion, feel for the opening and closing of the joint
how is cervical PPIVM rotation conducted
Physio - Palpate contralateral articular pillar, reinforced index finger, as joint opens during rotation, other hand support weight of occiput,
patient - supine, head lying off edge of bed
movement - on same hand while index finger on lamina produce produce cervical rotation away from palpating hand
positive findings of cervical PPIVM side flexion
increased resistance through motion,
muscle spasm,
decreased opening or closing of the joint,
pain provocation
how is the craniocervical flexion test conducted
place towel on occiput
place pressure biofeedback in 3rds
aim patient to nod target - 22, 24, 26, 28, 30 mmHg
observe any compensatory behaviours - retraction, SCM, scalene activity
determine the pressure the patient can hold steady with no palpable superficial muscle activity
measure enurace - 10secs hold, 10 reps
what is the normal reps and pressure that can be maintained by patient during craniocervical flexion test
26-30 mmHg 10 secs x 10reps
how is the cervical flexion/extension test conducted
Patient - side lying with head cradled in physios forearm, head on bed
therapist - facing patient, back elbow contacts front of facem forearm contacts side of head, palmar surface of hand contacts back of head one hand supporting head, other hand palpate C2 spinous process, forearm stabilise vertebral column, palpate interspinous space C2-C3
Movement - guide head into flexion
not as clinically useful
how is ULNT 1 conducted
ULNT 1 = median nerve
lie patient in supine
stand facing patient
grasp pt hand,
extend wrist and fingers fully straighten out thumb and fingers
abduct shoulder
supinate forearm
LR of shoulder
lateral cervical flexion
extend elbow