Final- 5. LE HVLA and BLT Flashcards
1
Q
What is a positive squat test?
What does this indicate?
Why perform?
A
- Pt’s heels lift off floor and/or pt unable to bend knees past 90 degrees
- Must perform further structural and functional eval of joints and tissues of the LE indicated
- tests strength and flexibility of hips, knees, ankles, feet
- If positive= further joint and tissue eval needed
2
Q
Femorotibial Dysfunction BLT
A
- Pt supine, Physician ipsilateral to dysfunction
- Cephalad palm over the anterior femur, caudad palm over the tibial tuberosity
- Lean onto the pt’s leg w/ slight posterior force
- More caudal hand pressure for ACL
- more cephalad hand pressure for PCM
- Approximate the femur and tibia with a compressive force
- Induce IR/ER to obtain BLT
3
Q
Boot Jack Technique
A
- Pt supine with knee under physicians axilla, physician ipsilateral
- Medial hands hold calcaneus w/ thumbs and index finger, fingers of lateral hand wrap around the medial foot
- Elbow on medial aspect of knee creates a fulcrum w/ proximal pressure
- Physician leans back inducing further flexion of hip and knee while distracting the calcaneus from the talus
- Induce slight plantar flexion to obtain BLT
4
Q
Anterior Tibia on Femur - Supine HVLA
A
- Pt supine w/ knees flexed to 90 and feet flat on table, physician seated on pts foot on dysfunctional side
- Thenar eminences over the anterior tibial plateau with fingers wrapped around leg
- Engage RB by pushing posteriorly on the tibia
- Deliver thrust posteriorly parallel to the long axis of the femur
5
Q
Anterior Tibia on Femur - Seated HVLA
A
- Pt seated w/ legs off table and pillow under thigh, physician in front
- Thumbs on the anterior tibial plateau w/ fingers wrapped around leg
- Spring leg up and down to relax thigh
- Deliver thrust straight toward the floor, simultaneous w/ posterior pressure w/ the thumbs
6
Q
Posterior Tibia on Femur - Prone HVLA
A
- Pt prone, dysfxnal knee flexed to 90, physician standing at end of table w/ dorsum of pt’s foot on shoulder
- Fingers interlaced around tibia just distal to the popliteal region
- Engage barrier by leaning forward to plantarflex the foot and relax gastroc
- Thrust w/ both hands parallel to table toward the physician
7
Q
Posterior Tibia on Femur - Seated HVLA
A
- Pt seated w/ legs off table, physician seated in front of pt
- Thumbs on anterior tibial plateau w/ fingers wrapped around leg
- Slightly flex knee
- Spring leg up and down to relax thigh
- Thrust w/ both hands down toward floor and simultaneously anterior
8
Q
Anterior Fibular Head HVLA
A
- Pt supine w/ pillow under knee, physician standing ipsilateral or contralateral
- Cephalad hand: thenar eminence on the anterior aspect of fibular head, Caudad hand: on ipsilateral foot
- Supinate foot (invert, internally rotate, plantarflex)
- Pt activating force - towards pronation of foot
- On final round of MET, direct thrust into table, supinate
9
Q
Posterior Fibular Head supine HVLA
A
- Pt supine, physician contralateral to dysfunction
- Index finger of thrusting hand monitors fibular head w/ MCP
- Opposite hand flexes hip and knee 90 deg then everts, dorsiflexes, and externally rotatees at the ankle
- Thrust anterior on fibular head while rapidly flexing the knee
10
Q
Posterior Fibular Head prone HVLA
A
- Pt prone w/ knee flexed to 90 deg, physician contralateral to dysfunction
- MCP of cephalad index finger on posterior aspect of fibular head w/ hypothenar eminence on hamstrings (creates wedge)
- Externally rotate tib-fib complex
- Thrust further flexion of knee
11
Q
Tibiotalar Gapping HVLA
A
- Pt supine physician at foot of table
- Hands interlaced on bottom of the foot, thumbs on ball of foot
- Caudad traction
- Engage barrier
- Caudad traction with thrust into barrier
12
Q
Anterior Tibia on Talus HVLA
A
- Pt supine
- One hand cups calcaneus w/ slight traction, other hand on anterior tibia proximal to the ankle
- Thrust delivered with the hand on the tibia stright into table
13
Q
Calcaneus Inversion/Eversion HVLA
A
- Pt supine, physician at foot
- One hand on calcaneus, other on dorsum of foot
- Caudad traction with hypereversion/inversion (into barrier) and thrust into barrier
14
Q
Hiss Whip HVLA
A
- Pt prone w/ hip and knee of affected leg at edge of table, pt at foot
- Both thumbs over plantar surface of affected structure w/ fingers on dorsum of foot
- Slightly abduct pts lower extremity off the table and flex the knee
- Thrust downward through thumbs with whip-like motion at ankle and knee
15
Q
Plantar Navicular Dysfunction HVLA
A
- Pt supine w/ knee flexed, abducted, and externally rotated, physician ipsilateral to dysfunction
- Cephalad thenar eminence over calcaneus, pinning calcaneus to table
- Eversion/rotational thrust
