Lab Practical 1 (1-5)

Question 1

Anterior Drawer Test Ankle

Answer 1

Tests: ATFL laxity, pain and endpoint
Notes: position ankle in slight plantar flexion, onfield

Question 2

Talar Tilt Test

Answer 2

Tests: CFL laxity, pain and endpoint
Notes: only clinical (not on field), knee at 90 degrees, invert foot

Question 3

Deltoid Ligament Test

Answer 3

Tests: Deltoid ligament laxity, pain and endpoint
Notes: evert foot

Question 4

Always compare special tests to __

Answer 4

contralateral side

Question 5

Onfield approach:

Answer 5

1) Approach athlete - life or limb? is the area stable? how to remove?
2) Subjective history - MOI, pain, hear anything, previous injury, contralateral injuries
3) Clear above and below
4) Special tests (ext. rot., ant. drawer.
5) Palpate importan structures
6) Help stand and decide on removal

Question 6

Open basket taping is for:

Answer 6

Athlete not returning to competition

Question 7

What to ask before taping?

Answer 7

Shave area

Allergies to tape or adherents (spray)

Question 8

General steps of open basket taping

Answer 8

Have athlete in neutral
Spray area
Apply prowrap 4x up leg and all the way to toes (starting with leg)
Spray again
Anchor
Stirrup (medial to lateral for inversion sprain) and gimmes
Heel locks (medial first then lateral for inversion sprain)
Repeated gimmes
Four pieces of tape to cover ends of anchors
Apply tensor

Question 9

What do you always do after taping?

Answer 9

Ask if itchy or irritated
Instructions for wear (how long, can they sleep with it, ice)
Check for capillary refill

Question 10

Tensor rules

Answer 10

1/2 to 3/4 tension and no more overlap than 1/3 of previous piece

Question 11

Closed basket taping is for?

Answer 11

Competition

Question 12

Steps for closed basket taping:

Answer 12

Have athlete in neutral
Spray area
Apply prowrap 2 1/2x up leg and only until metatarsal heads
Spray again
2 anchors at top
1 anchor in middle of longitudinal arch
3 stirrups starting on medial side that go over fat pad of heel
Two heels locks (medial to lateral first for lateral/inversion sprains)
Two combination heel locks (starting on medial side first)
Louisiana figure 8 (1x starting on ATFL, 2x starting on deltoid)
Close tap (proximal to distal leg, then proximal to distal for foot)

Question 13

Anterior Compartment of Leg

area of pain, stretch, strength, nerve, test sensation

Answer 13

Area of pain: lateral tibia
Stretch: plantar flexion
Strength: dorsiflexion
Nerve: deep peroneal
Sensation: between 1st and 2nd toes

Question 14

Lateral Compartment of Leg

area of pain, stretch, strength, nerve, test sensation

Answer 14

Area of pain: near lateral malleolus
Stretch: Dorsiflexion/inversion
Strength: Plantar flexion/eversion
Nerve: superficial peroneal
Sensation: dorsum of foot

Question 15

Superficial Posterior Compartment of Leg

Answer 15

Area of pain: lower 1/3 posterior medial tibia
Stretch: dorsiflexion/eversion
Strength: plantar flexion/inversion
Nerve: tibial nerve
Sensation: Plantar foot, not heel

Question 16

Thompson Test

Answer 16

Tests: achilles’ rupture

Positive test: no movement because not attached

Question 17

Longitudinal Arch Taping is for:

Answer 17

Plantar fasciitis and to lift the arch

Question 18

Steps of Longitudinal Arch Taping:

Answer 18

Athlete in long leg sitting position
Plantar flex the toes between neutral and full plantar flexion and ankle in neutral
Spray plantar, dosrum and heel with adherent
Anchor on the metatarsal heads with 1.5 inch tape
4-5 1 inch trips going from and back to the metatarsal heads medially around the calcaneus
Anchor (1.5 inch) starting at metatarsal heads and working back to middle of arch - watch extensor tendons
Wear for a few days

Question 19

Low Dye Taping is for:

Answer 19

Excessive pronation (stress fractures, shin splints, patella tendinitis/femoralis)

Question 20

Steps of Low Dye Taping:

Answer 20

Athlete in long leg sitting position
Neutral ankle (subtalar joint) and plantar flex big toe
Spray foot
Anchor across MT heads using 1 inch tape
Two pieces of tape from 1st to 5th metatarsal head going around calcaneus
Anchor around the metatarsal heads
Arch strips from lateral to medial starting at heel until anchor
Re-do longitudinal strips
Anchor MT heads

Question 21

How to test MCL?

Answer 21

Valgus test

• approach at 45 degrees angle
• first in extension
• second in 15-30 degrees knee flexion (relax gastrocs)
• compare to contralateral side

Question 22

How to test LCL?

Answer 22

Varus test

• work in between legs
• only in 15-30 degrees knee flexion
• compare to contralateral side

Question 23

How to test ACL?

Answer 23

1) Lachman’s gold standard
- 20-30 degrees knee flexion

2) Anterior Drawer
- hip 45 degrees flexed and knee 90 degrees flexed
- sit on foot
- thumbs on joint line, fingers wrap around calf to flatten the gastrocs, using index fingers to ensure hamstring tendons are relaxed

Question 24

What does a negative lachmans but positive anterior drawer mean?

Answer 24

False positive

PCL is torn and anterior drawer test is just reducing the deformity of the PCL

Question 25

How to test the PCL?

Answer 25

1) Posterior Drawer
- knee flexed at 90
- sit on foot

2) Sag test
- hips and knees at 90 degrees
- view tibial plateau

Question 26

How to test the meniscus?

Answer 26

McMurray’s Test

• positive test is painful click/pop or apprehension
• 90 degree hip flexion and knee in max flexion

Medial

• external rotation (heel towards midline)
• VARUS force (knee away from body)

Lateral

• internal rotation (heel away from midline)
• VALGUS force (knee towards body)

Question 27

What does Apley’s Compression test?

Answer 27

Meniscus

• athlete is prone
• knee bend at 90
• push down with one hand and other hand grabbing malleoli and twisting

Question 28

What does Apley’s Distraction test?

Answer 28

Anything but meniscus

• with two hands grab around malleoli and pull up and rotate leg
• knee on thigh