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ECOS2 Exam 1 > Extremity Counterstrain > Flashcards

Extremity Counterstrain Flashcards

1
Q

List the counterstrain steps

A
  1. Find most signficiant tenderpoint
  2. Physician establishes a tenderness scale
  3. Monitor Tenderpoint throughout
  4. Place patient in “Position of Ease” of at least 70% improvement
  5. Hold for 90 seconds
  6. Slowly return to neutral
  7. Recheck tenderness and associated TART findings
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2
Q

Supraspinatus counterstrain

Location?

A

Midsupraspinatus muscle just superior to spine of scapulae

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3
Q

Supraspinatus counterstrain

Pt. position

Doc position

A

Pt: Supine

Doc: Ipsilateral to tenderpoint

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4
Q

Supraspinatus counterstrain

Treatment Positioning

A

F Abd ER

  • Patient’s arm is flexed 45 degrees, abducted 45 degrees, and externally rotated*
  • Think Statue of Liberty*
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5
Q

Levator Scapulae

Location

A

In levator at the superior angle of the scapula

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6
Q

Levator Scapulae

Pt position

Doc position

A

Pt: Prone, head rotated away

Doc: Ipsilateral to TP

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7
Q

Levator Scapulae

Treatment positioning

A

IR Abd traction

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

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8
Q

Subscapularis

Location

A

Anterolateral border of the scapula on the subscapularis muscle (press posterior and medially)

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9
Q

Subscapularis

Pt & Doc position?

A

Pt: Supine

Doc: Seated ipsilateral

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10
Q

Subscapularis

Treatment Positioning

A

E IR

Patient’s shoulder extended and internally rotated, traction can help

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11
Q

Biceps Brachii (Long Head)

Location

A

Over long head of biceps tendon in bicipital groove

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12
Q

Biceps Brachii (Long Head)

Pt & Doc Position

A

Pt: Supine

Doc: Ipsilateral

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13
Q

Biceps Brachii (Long Head)

Treatment positioning

A

F Abd ir

Elbow & shoulder flexed, arm is minimally abducted and internally rotated

Dr. Joy’s way of remebering: place hand on head (F Abd ir) and think “ugh this is the LONGEST technique”

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14
Q

Biceps Brachii (Short Head) & Coracobrachialis

Location

A

Inferolateral aspect of the coracoid process on short head tendon of biceps or coracobrachialis

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15
Q

Biceps Brachii (Short Head) & Coracobrachialis

Pt & Doc position

A

Pt: Supine

Doc: Ipsilateral

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16
Q

Biceps Brachii (Short Head) & Coracobrachialis

Treatment positioning

A

F Add ir

Elbow and shoulder flexed, arm is minimally adducted and internally rotated

Note: like long head except ABd –> ADd

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17
Q

Radial Head - Lateral (Supinator)

Location

A

Anterolateral aspect of the radial head at supinator attachment

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18
Q

Radial Head - Lateral (Supinator)

Pt & Doc position

A

Pt: Supine or seated

Doc: ipsilateral

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19
Q

Radial Head - Lateral (Supinator)

Treatment positioning

A

E SUP Val

Pt’s elbow in full Extension, forearm markedly supinated, fine tune with vaLgus force

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20
Q

Medial Epicondyle (Pronator Teres)

Location

A

Near medial epicondyle of humerus associated with common flexor tendon and pronator teres

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21
Q

Medial Epicondyle (Pronator Teres)

Pt & Doc Position

A

Pt: Supine or seated

Doc: Ipsilateral

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22
Q

Medial Epicondyle (Pronator Teres)

Treatment positioning

A

F PRO Add

Pt’s elbow Flexed, marked pronation, forearm slightly aDducted

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23
Q

Dorsal Wrist (Extensor Carpi Radialis)

Location

A

Dorsal surface of second metacarpal associated with extensor carpi radialis muscle (may also be in any extensor muscle)

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24
Q

Dorsal Wrist (Extensor Carpi Radialis)

Pt & Doc position

A

Pt: Supine or seated

Doc: Ipsilateral

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25
Q

Dorsal Wrist (Extensor Carpi Radialis)

Treatment positioning

A

E Abd/rd

Pt’s wrist passively Extended and aBducted

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26
Q

Dorsal Wrist (Extensor Carpi Ulnaris)

Location

A

Dorsal surface of fifth metacarpal associated with extensor carpi ulnaris muscle (may also be in any extensor muscle)

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27
Q

Dorsal Wrist (Extensor Carpi Ulnaris)

Pt & Doc position

A

Pt: Supine or seated

Doc: Ipsilateral

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28
Q

Dorsal Wrist (Extensor Carpi Ulnaris)

Treatment position

A

E ADD

Pt’s wrist passively Extended and aDducted

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29
Q

Palmar Wrist (Flexor Carpi Radialis)

Location

A

Palmar base of second or third metacarpal in the flexor carpi radialis muscle (may also be found in any flexor muscle)

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30
Q

Palmar Wrist (Flexor Carpi Radialis)

Pt & Doc position

A

Pt: Supine or seated

Doc: Ipsilateral

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31
Q

Palmar Wrist (Flexor Carpi Radialis)

Treatment position

A

F Abd

Pt’s wrist passively Flexed and aBducted

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32
Q

Palmar Wrist (Flexor Carpi Ulnaris)

Location

A

Palmar base of fifth metacarpal in the flexor carpi ulnaris muscle (may also be found in any flexor muscle)

33
Q

Palmar Wrist (Flexor Carpi Ulnaris)

Pt & Doc position

A

Pt: Supine or seated

Doc: Ipsilateral

34
Q

Palmar Wrist (Flexor Carpi Ulnaris)

Treatment position

A

F Add

Pt’s wrist passively Flexed and aDducted

35
Q

First CMP (Abductor Pollicis Brevis)

Location

A

Palmar base (radial aspect) of first metacarpal in the abductor pollicis brevis muscle

36
Q

First CMP (Abductor Pollicis Brevis)

Pt & Doc position

A

Pt: Supine or seated

Doc: Ipsilateral

37
Q

First CMP (Abductor Pollicis Brevis)

Treatment position

A

F (wrist) Abd (thumb)

Pt’s wrist passively Flexed, thumb is aBducted

38
Q

Lateral Trochanter (Tensor Fasciae Latae)

Location

A

Just inferior to iliac crest in body of TFL

39
Q

Lateral Trochanter (Tensor Fasciae Latae)

Pt & Doc position

A

Pt: Supine or prone

Doc: Ipsilateral to TP

40
Q

Lateral Trochanter (Tensor Fasciae Latae)

Treatment position

A

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

41
Q

Iliotibial band

Location

A

Along the iliotibial band distal to the greater trochanter

42
Q

Iliotibial band

Pt & Doc position

A

Pt: Supine or prone

Doc: Ipsilateral to TP

43
Q

Iliotibial band

Treatment position

A

f ABD

Patient’s hip/thigh is abducted and slightly flexed until the tenderness is greater than or equal to 70% reduction. May require slight internal or external rotation of the hip

44
Q

Lateral hamstring

Location

A

Distal aspect of the biceps femoris near attachment to the posterolateral surface of the fibular head

45
Q

Lateral hamstring

Pt & Doc position

A

Pt: Supine or prone

Doc: Ipsilateral to TP

46
Q

Lateral hamstring

Treatment position

A

F ER ABd

knee is flexed and the tibia is externally rotated with slight abduction; compression on the calcaneus is added to plantar flex the ankle

47
Q

Medial Hamstring

Location

A

Distal aspect of the medial hamstring tendons near their attachment to the posterior medial surface of the tibial condyle

48
Q

Medial Hamstring

Pt & Doc position

A

Pt: Supine or prone

Doc: Ipsilateral to TP, grasp lateral ankle/foot to control the lower leg

49
Q

Medial Hamstring

Treatment position

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

50
Q

Lateral Meniscus: Lateral (Fibular) Collateral Ligament

Location

A

Lateral aspect of meniscus along the joint line

51
Q

Lateral Meniscus: Lateral (Fibular) Collateral Ligament

Pt & Doc position

A

Pt: Supine

Doc: Ipsilateraland seated

52
Q

Lateral Meniscus: Lateral (Fibular) Collateral Ligament

Treatment position

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.

53
Q

Medial Meniscus: Medial (Tibial) Collateral Ligament

Location

A

Medial knee joint line

54
Q

Medial Meniscus: Medial (Tibial) Collateral Ligament

Pt & Doc position

A

Pt: Supine

Doc: Ipsilateral and seated

55
Q

Medial Meniscus: Medial (Tibial) Collateral Ligament

Treatment position

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

56
Q

Anterior Cruciate

Location

A

Superior aspect of popliteal fossa adjacent to the hamstring tendons

57
Q

Anterior Cruciate

Pt & Doc position

A

Pt: Supine

Doc: Ipsilateral

58
Q

Anterior Cruciate

Treatment position

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

59
Q

Posterior Cruciate

Location

A

Slightly below center of popliteal fossa

60
Q

Posterior Cruciate

Pt & Doc position

A

Pt: Supine

Doc: Ipsilateral

61
Q

Posterior Cruciate

Treatment position

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

62
Q

Popliteus

Location

A

In the muscle belly just inferior to the popliteal spac

63
Q

Popliteus

Pt & Doc position

A

Pt: Prone

Doc: Ipsilateral

64
Q

Popliteus

Treatment position

A

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

65
Q

Extension Ankle (Gastrocnemius)

Location

A

Within the proximal gastrocnemius muscles distal to popliteal margin

66
Q

Extension Ankle (Gastrocnemius)

Pt & Doc position

A

Pt: Prone

Doc: Ipsilateral

67
Q

Extension Ankle (Gastrocnemius)

Treatment position

A

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

68
Q

Medial Ankle (Tibialis Anterior)

Location

A

Anterior and inferior to the medial malleolus along deltoid ligament.

69
Q

Medial Ankle (Tibialis Anterior)

Pt

A

Lateral recumbent with pillow under affected leg

70
Q

Medial Ankle (Tibialis Anterior)

Treatment position

A

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

71
Q

Lateral Ankle Fibularis (Peroneus) Longus, Brevis, Tertius

Location

A

Anterior and inferior to the lateral malleolus in the sinus tarsi (talocalcaneal sulcus)

72
Q

Lateral Ankle Fibularis (Peroneus) Longus, Brevis, Tertius

Pt position

A

Lateral recumbent with pillow under affected leg

73
Q

Lateral Ankle Fibularis (Peroneus) Longus, Brevis, Tertius

Treatment position

A

Apply eversion force to foot and ankle with slight external rotation until the tenderness is ≥70% reduction

74
Q

Flexion Calcaneus (Quadratus Plantae)

Location

A

Anterior aspect of plantar surface of calcaneus at attachment of plantar fascia

75
Q

Flexion Calcaneus (Quadratus Plantae)

Pt & Doc position

A

Pt: Supine or prone

Doc: Ipsilateral to TP

76
Q

Flexion Calcaneus (Quadratus Plantae)

Treatment position

A

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

77
Q

Navicular

Pt & Doc position

A

Pt: Supine or prone

Doc: Ipsilateral to TP

78
Q

Navicular

Treatment position

A

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

79
Q

Piriformis counterstrain

A

Supine

F Abd ER

ECOS2 Exam 1 (1 decks)

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