LE counterstain

Question 1

posterior lateral trochanter

Answer 1

• superolateral aspect of posterior surface of greater trochanter (lateral aspect of piriformis m)
• pt prone, dr standing at table on side of dysfxn
• extend pt’s leg with marked external rotation and fine-tunes with abduction

Question 2

lateral trochanter

Answer 2

• 5-6 in inferior to greater trochanter in mid-coronal line
• pt prone, dr standing at table on side of dysfxn
• abduct pt’s hip, may slightly flex

Question 3

sartorius

Answer 3

• 2-3 cm inferior to ASIS
• pt supine, dr same side of dysfxn
• flex knee/hip 135, slight external rotation with other hand

Question 4

patellar tendon

Answer 4

• on patellar ligament tendon, just below patella
• pt supine, dr standing at table on side of dysfxn
• dr places pillow under distal tib/fib. Push anterior to posterior on distal femur and hyperextends knee

Question 5

medial hamstring

Answer 5

• medial hamstring m/tendon near its distal attachment at the posterior medial surface of tibial condyle
• pt supine, dr standing at table on side of dysfxn with foot on table
• flex pt’s knee, external rotate tibia on femur and fine tune with adduction

Question 6

posterior cruciate ligament

Answer 6

• close to middle of popliteal space
• pt supine, dr standing at table on side of dysfxn. Place pillow beneath PROXIMAL tibia
• push femur posteriorly with cephalad hand

Question 7

anterior cruciate ligament

Answer 7

• on medial and lateral aspects of popliteal fossa
• pt supine, dr standing at table on side of dysfxn. Place pillow beneath DISTAL femur
• push tibia posteriorly with caudad hand

Question 8

lateral ankle

Answer 8

• anterior and inferior to lateral malleolus in sinus tarsi (talocalcaneal sulcus)
• pt lateral recumbent on affected side, with knee bent and foot over edge of table with pillow under ankle to protect fibula
• dr standing at end of table
• apple force-with heel of hand 3cm below medial malleolus causing eversion of whole foot, with mild external rotation

Question 9

medial ankle

Answer 9

• small arc below medial malleolus
• pt lateral recumbent on non-affected side, with knee bent and foot over edge of table with pillow under ankle
• dr standing at end of table
• invert foot without much internal rotation

Question 10

extension ankle

Answer 10

• on both gastrocnemius heads and both sides of achilles tendon
• pt prone, dr standing at table on side of dysfxn, with distal leg on table
• flex pt’s affected knee, plantar flex ankle and place dorsum of ankle on dr’s thigh
• add axial compression thru ankle, keeping pressure high to instep to avoid straining metatarsals

Question 11

flexion ankle

Answer 11

• high in front of ankle in a depression medial to the big extensor tendon
• pt prone, dr standing at table on side of dysfxn
• flex pt’s affected knee, and exert force on ball of foot to dorsiflex the ankle (fine-tune with slight tibial rotation)