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6 Orthopedics > Final Practical > Flashcards

Final Practical Flashcards

1
Q

McMurrary Test

A

for meniscus tears

knee is passively flexed, ER< and axially loaded while brought into extension. Repeat in IR

Positive if palpable/audible click or pain

high spin, mod snout

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2
Q

Pivot Shift Test

A

for the ACL

patient is supine, examiner grasps at heel and passively flexes the hip to 45° keeping knee extended

examiner applies a valgus stress while IR the tibia. Knee is brought slowly into 30° flexion

positive = tibia jumps posteriorly, clunk

high spin, low snout

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3
Q

Reverse Pivot Shift Test

A

assess PLC

knee at 90°, rotates tibia in ER. apply valgus foce at proximal lateral tibia. Knee is extended

positive = visible or palpatory reduction would occur

high spin, low snout

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4
Q

Slocum Test

A

testing rotary instability

foot/tibia is placed in 30°of IR. Stabilize foot with your thigh and draw tibia forward. then foot is placed in 15° ER and drawn forward.

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5
Q

Positive Test for Slocum

A
  1. Placement in medial rotation = positive movement occurs on lateral side of knee
  2. Placement in lateral rotation = positive movement occurs on medial side
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6
Q

Structures tested in Slocum with foot in IR

A

ACL
posterolateral capsule
LCL
IT band
arcuate-popliteus complex

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7
Q

Structures tested in Slocum with foot in ER

A

MCL
posterior oblique ligament
posteromedial capsule
ACL

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8
Q

Moving Patellar Apprehension Test

A

patient is supine with ankle off exam table and knee fully extended. Examiner flexes the knee to 90° and back to extension while holding patella in lateral translation.

positive = patient exhibits apprehension during lateral glide and no apprehension during medial glide

high spin and snout

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9
Q

Thompson Test

A

patient is prone with lower leg off table. Examiner squeezes calf muscle and observes ankle motion

positive = lack of PF

high spin and snout

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10
Q

Talar Swing Test

A

Pt seated, legs over end of plinth

thumbs on neck of talus. guide knee into flexion which df ankle thumbs track talus posteriorly into mortise and foot should evert allow for full closed pack position

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11
Q

Treatment with Talar Swing Test

A

increase df and ER for fully closed pack position
Glide to point of resistance, than provide HR technique.

Ask pt to resist you as your provide pf and inversion. Hold 10 s. Relax, glide talus more post and lateral while DF ankle, repeat 3 times. Can do 3 sets of the program

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12
Q

Windlass Test for PF

A

NWB, knee flexed to 90°. Sitting is the best

ankle at 90°/neutral

extend 1st MTP while keeping IP in flexion to avoid motion limitation from short hallucis longus. Palpate plantar fascia

high spin, low snout

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13
Q

External Rotation Stress Test

A

pain over syndesmosis is elicited with ER and df of the foot with knee flexed to 90°
high spin

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14
Q

Oblique Midtarsal Joint Axis

A

stabilize neutral calcaneous with inside hand
move foot at distal 5th metatarsals

invert calcenous and then evert. Inversion should have less because it is locking the midtarsal joint

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15
Q

Longitudinal Midtarsal Joint Axis

A

stabilize calcaenous with outside hand
pivot MTJ by grasping navicular or cuneiform

lock the axis by inverting calcaneous and see if there is still motion

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16
Q

Medial glide of subtalar joint

A

should do for restricted joint motion ot increase inversion

post: sidelying with foot off end of plinth, rolled towel under table

giving downward force to the calcaneous after it has been placed in neutral

17
Q

Lateral Glide of subtalar joint

A

used to increase eversion

sidelying with foot off the end of plinth table. rolled towel under later ankle

mobilizing the calcaneos in a downawrd motion

18
Q

Anterior glide of talocrural joint

A

used for restricted joint motion, increases plantar flexion

mobilizing the calcaneous in an upwards direction/anterior force after being placed in motion barrier position

19
Q

Posterior Glide of talocrural joint

A

used for restricted joint motion, and to increase DF

applying a towards mobilization to the navicular area of the top of the foot

20
Q

Paper pull test

A

testing the strength of the flexor intrinsics of the 1st MTP

could be correlated with low heel rise height and low 1 MTP strength

21
Q

Strength assessment of Ankle/Foot

A

PF: heel rise 20 reps, with consistent height. Plantar pressure through 1st met

DF: walk on heels

Subtalar: isolate everters and inverters

Midtarsal: doming

Big Toe: paper pull, toe curl, manual resistance

22
Q

Functional tests for DF

A

stairs
squatting
knee to wall (rom)
walk on heels

23
Q

Subtalar eval

A

prone, stabilize the tibia, cup the calcaneus and invert/evert

24
Q

Plantarflexion Functional Tests

A

Calf raises (20 at least)
Walking at fast pace

25
Q

Basic Foot Intrinsic

A
  1. Toe mobility
  2. Toe spread out
  3. Foot core
26
Q

Toe mobility

A
  1. press little toes down and lift big toes up
  2. press the big toe down and lift little toes up (FL)
  3. keep big toe down and lift all little toes, bring small toe back down

if having difficulty, can use your hands to hold down. Also pair with mobilizing midfoot and forefoot

27
Q

Foot doming

A

keep toes on floor, bring ball of foot towards the heel, making the foot shorter. Hold for 10 s

28
Q

Errors of Doming

A

toe flexion
anterior tib over activation
supination

29
Q

Basic foot intrinsics prescription

A

perform seated
do 10 of each, then repeat for a total of 5 minutes, 3-5 times a day

30
Q

Intermediate Foot intrinsics

A
  1. Short foot in active standing
  2. Short foot in SLS
31
Q

Short foot in active sitting

A

stand w/toes pointing forward, slightly out and dome feet

unlock the knees and squeeze you butt

tip pelvis to neutral, draw naval towards spine, pull shoulders down, draw chin in

32
Q

Short foot in single leg

A

from active standing, pick up one leg while activating arch and doming foot

can progress to weight shifting and mini heel raise

variations: single leg deadlift, unstable surfaces, rotation

33
Q

Advanced foot intrinsics

A
  1. short foot with hopping
  2. Box jumps
  3. Lateral/forward bounds
34
Q

Short foot with hopping

A

perform a small hop and land back in active standing

perform barefoot, dome your feet, and land in a domed position

35
Q

Hop laterally

A

focus on increasing distance, speed, and focus on soft landings with the dome

can change directions or do bilateral to single leg

36
Q

Box jumps

A

start with 2-4 in

focus on landing light with dome
progress height of boxes or to jumping down

6 Orthopedics (17 decks)

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