Exam 3 Flashcards
What makes up mid foot?
Cuneiform
Navicular
Cuboid
What makes up the forefoot?
Metatarsals
Phalanges
What makes up the medial longitudinal arch?
Calcaneus Talus Navicular Cuneiforms 1-3 Metatarsals 1-3
What makes up the lateral longitudinal arch?
Calcaneus
Talus
Cuboid
4th and 5th metatarsals
What makes up the transverse tarsal arch?
Navicular
Cuboid
Cuneiforms 1-3
Proximal metatarsals
What makes up the metatarsal arch?
Distal metatarsal heads
How do you assess for high ankle sprain?
Where?
Squeeze test
Proximal 1/3 of lower extremity
What do you evaluate with ankle drawer sign?
Anterior talofibular ligament
What do you evaluate with talar tilt test inversion?
Eversion?
Calcaneofibular l.
Deltoid l.
How do you evaluate for Achilles tendon?
Thompson test
Dorsiflexion ROM?
plantar flexion?
15-20
50-65
Ankle inversion ROM?
Eversion?
35
20
Subtalar inversion?
Eversion?
5
5
Forefoot adduction?
ABduction?
20
10
1st MTP flexion ROM?
Extension?
45
70-90
Anterior tibia on talus dysfunction has what FOM?
Restriction?
Due to changes in what?
Ankle prefers dorsiflexion and anterior glide
Tibia restricted in gliding posteriorly on the talus
Distal tibia mechanics
Posterior tibia on talus dysfunction has what FOM?
Restriction?
Due to changes in what?
Ankle prefers plantar flexion and posterior glide
Tibia restricted in gliding anteriorly on the talus
Distal tibia mechanics
Anterior lateral malleolus has FOM where?
Restriction?
Free anterior glide relative to distal tibia
Posterior glide
Posterior lateral malleolus has FOM where?
Restriction?
Posterior glide relative to distal tibia
Anterior glide
Dorsiflexed talus and plantar flexed talus dysfunction is due to what kind of mechanics?
Changes in talus mechanics
Inversion/Eversion calcaneus dysfunction is due to what kind of mechanics?
Changes in subtalar mechanics
With a plantar navicular dysfunction, how does the navicular move?
Lateral navicular drops plantar
With a plantar cuboid dysfunction, how does the navicular move?
Medial cuboid drops planar
A plantar cuboid dysfunction so commonly associated with what?
Posterior fibular head dysfunction
With a plantar flexed talus dysfunction, what do you tell the patients to do?
Press on the gas pedal
Trans tarsal thrust of navicular, do you invert or evert the foot into the barrier?
Evert foot
Trans tarsal thrust of cuboid, do you invert or evert the foot into the barrier?
Invert into barrier
ROM: flexion w/knee extended?
Knee flexed?
90
120-135
Hip ROM: ABduction?
ADduction?
45-50
20-30
What are the hip flexors?
Iliopsoas
Sartorius
Rectus femoris
What are the hip extensors?
Glut MAX
Biceps femoris
Semitendinosus
Semimembranosus
What are the hip abductors?
Glut Med
Glut Min
Happy now?
ROM knee flexion?
135-150
If a knee extends past 0 degrees, what is it called?
Genu recurvatum
ROM internal/external rotation of knee?
10
Flexion of knee is with what kind of glide?
Extension?
Posterior
Anterior
For a knee flexion dysfunction, what position is the patient in?
Supine
For a knee extension dysfunction, what position is the patient in?
Prone
Posterior fibular head dysfunction accompanied with what?
Plantar flexion, inversion, adduction, lower leg internal rotation
Anterior fibular head dysfunction accompanied by what?
Dorsiflexion, eversion, abduction, lower leg external rotation
Patient with inversion ankle sprain most likely also has what?
posterior fibular head
Provide set up for posterior fibular head HVLA:
Flex hip and knee to 90 degrees
Use 2nd MCP to contact posterior aspect of fibular head
Dorsiflex, evert, abduct, externally rotate foot
Rapid knee flexion w/anterior thrust
Provide set up for anterior fibular head HLVA
Pt supine, knee extended
Plantar flex, invert, adduct, internally rotate foot
use thenar eminence to contact Anterolateral aspect of fibular head
Slightly flex knee
Exert posteromedial thrust through fibular head
For myofascial release for a ant/post fibular head, what is the set up for the hip and knee?
Flexed to 45 degrees
How do you describe the shoulder joint?
Most mobile and unstable
What bones make up the shoulder joint?
Clavicle
Humerus
Scapula (coracoid and acromion)
What are the 3 true synovial joints of the shoulder?
GAS
Glenohumeral
Acromioclavicular
sternoclavicular
What are the functional joints of the shoulder?
Suprahumeral
Scapulothoracic
What are the accessory joints of the shoulder?
Costosternal
Costovertebral
What is responsible for EARLY shoulder abduction?
Glenohumeral + suprahumeral
What is responsible for MID-LATE shoulder abduction?
Scapulothoracic + sternoclavicular + acromioclavicular
SAS
What muscles attach on the coracoid process?
Short head biceps brachii
Pec minor
ROM of adduction of shoulder in coronal plane?
40-50
ROM of horizontal abduction horizontal plane?
Horizontal adduction?
130-145
40-50
What position must the shoulder be in to maximize motion at the AC joint?
GH joint into 60 degrees horizontal abduction
60 degrees coronal abduction
Internal rotation of GH joint causes what in the AC joint?
internal rotation
Normal AC rotation ROM?
10 degrees
What are the 6 motions of the scapula?
Elevation/depression
Protraction/retraction
Upward/downward rotation aka tilt
What are the 2 dysfunctions of the SC joint?
Abduction
Flexion
In abduction of the SC joint, how does the proximal clavicle move?
Inferior
If during abduction the proximal clavicle does not move inferior and stays cephalad/superior, what kind of dysfunction is that?
Adduction dysfunction
During flexion of the AC joint how does the proximal clavicle move?
Distal clavicle?
Posterior
Anterior
If on palpation of the proximal clavicle 1 side stays anterior and does not move posterior, what is the dysfunction?
What is the restriction?
Extension dysfunction
Restricted to flexion
Spencer technique is described how?
LVHA, articulately technique for GH dysfunction
What position is the pt in for Spencer’s technique?
Block what linkage?
Lateral recumbent, dysfunction side up
Dr. Stands on side of table facing patient
Lock the shoulder girdle
How many times is the spencer technique repeated per motion?
Stop when?
6-8
If painful
Give the 7 motions of spencer in order
Extension Flexion Circumduction Circumduction w/traction Abduction/Adduction Internal rotation Traction Stretch
Describe the HLVA set up for SC Adduction dysfunction:
Pt supine, dr head of table
Dr applies inferior force with thenar eminence of monitoring hand over SC joint that is restricted
Dr grasps pt’s arm on side of dysfunction and exerts a cephalad traction force on arm
Downward thrust and rapid traction force simultaneously
Describe set up for SC horizontal extension dysfunction ME:
Pt supine, dr on side of affected shoulder
Place 1 hand on clavicle and other behind axilla to cover scapula
Dr flexes clavicle up
Pt activating force down to table
Describe set up for SC adduction dysfunction ME:
Pt supine, dr on side of affected shoulder
Dr places hand on prox clavicle, other hand grabs pt wrist
EXTEND and IR arm
Pt activating force to ceiling
What is a cubitus valgus deformity?
Carrying angle of elbow > 15 degrees
What is a cubitus varus deformity?
Also called what?
Carrying angle of elbow of less than 5 degrees
Gunstock deformity
What runs between the medial epicondyle and olecranon?
Ulnar nerve
How does the radial head glide with supination of the forearm?
What motion of ulna?
Anteriorly
ADduction
How does the radial head glide with pronation of the forearm?
What motion of ulna?
Posteriorly
ABduction
Bouchard’s is due to what?
Affects what?
RA
PIP
Heberden’s is due to what?
Affects what?
Osteoarthritis
DIP
Extension of the wrist is paired with what?
Ventral carpal dysfunction
Flexion of the wrist is paired with what?
Dorsal carpal dysfunction
For HVLA or wrist extension/flexion dysfunction where do you grasp the patient?
Thumbs grasp dorsally at the Radiocarpal joint
How do you perform HVLA for any phalange all dysfunction?
Traction with hyper flexion thrust
What is the sympathetic innervation of the upper extremity?
T3-T8
What makes up the hind foot?
Talus
Calcaneus
Where is the 1st tender point associated with a postural decompensation pattern located?
Iliolumbar ligament
What does the hip drop test screen for?
Lumbar side bending restrictions
What does the pelvic side-shift test asses for?
Fascial connections between the lumbo-pelvic hip complex
What test screens for lumbar radiculopathies, hip flexion restriction, IT band tension, and tightness of hamstrings?
What degrees indicates this?
Straight leg raise
30-60
When performing a hip drop test, what indicates restriction?
Less than 20 degrees ROM
How can the acromion drop test be divided?
Lateral
Middle
Medial thirds
The medial third testing of the acromion drop test assesses for what?
SB restriction of upper thoracics
