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OMM Final > Lower Extremity > Flashcards

Lower Extremity Flashcards

1
Q

lateral trochanter counterstrain

  • tenderpoint location
  • tx position
A
  • along IT band: 12 cm inferior to greater trochanter
  • position
    • prone
    • hip ABduction + slight flexion (leg off table)
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2
Q

posterior lateral trochanter counterstrain

  • tenderpoint location
  • tx position
A
  • posterior aspect of greater trochanter
  • pt is
    • prone
    • hip extension (dr knee props leg up)
    • hip ABduction + MARKED ER
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3
Q

medial meniscus

  • tenderpoint location
  • tx position
A
  • on antero-medial joint line 5 cm posterior to patellar midline
  • position
    • knee flexion (pt seated) with
      • tibial ADduction
      • ankle dorsiflexion / eversion
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4
Q

lateral meniscus

  • tenderpoint location
  • tx position
A
  • on anteromedial joint line 5 cm posterior to patellar midline
  • position
    • knee flexion (pt seated) with
      • tibial adduction
      • ankle plantarflexion & inversion
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5
Q

medial hamstring

  • tenderpoint location
  • tx position
A
  • two locations
    • on muscle belly, halfway down femur shaft
    • on muscle tendon, near distal attachment
  • position
    • knee flexion + IR
    • slight tibial adduction
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6
Q

lateral hamstring

  • tenderpoint location
  • tx position
A
  • two locations
    • on muscle belly, halfway down femur shaft
    • on muscle tendon, near distal attachment
  • position
    • knee flexion + ER
    • slight tibial adbudction
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7
Q

medial calcaneous

  • tenderpoint location
  • tx position
A
  • on calcaneus, 2-3 cm posteroinferior to medial malleolus
  • position
    • subtalus - inversion
    • forefoot - pronation/inversion

“wring out of the foot”

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8
Q

navicular

  • tenderpoint location
  • tx position
A
  • plantar surface of navicular bone
  • position
    • plantarflexion
    • subtalar joint - inversion
    • forefoot - supination
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9
Q

gastrocnemius

  • tenderpoint location
  • tx position
A
  • locations
    • proximal gastroc - within two bellies, just below popliteal region
    • distal gastroc - achilles tendon
    • soleus
  • position
    • pt prone
      • knee flexion
      • marked plantarflexion
      • translate calcaneus proximally → towards knee
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10
Q

flexion calcaneous

  • tenderpoint location
  • tx position
A
  • plantar surface of calcaneus
  • position
    • prone
      • marked plantar flexion
      • translate calcaneus distally → towards forefoot
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11
Q

medial ankle tenderpoint

  • tenderpoint location
  • tx position
A

= tibialis anterior

  • on calcaneus, 2cm inferior to medial malleolus
  • position:
    • subtalar inversion
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12
Q

lateral ankle tenderpoint

  • tenderpoint location
  • tx position
A
  • two locations
    • proximal - inferior to fibular head
    • distal - 2 cm anteroinferior to lateral malleolus
  • position
    • subtalar eversion + slight plantarflexion
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13
Q

how is counterstrain tx for the medial meniscus & medial hamstring tenderpoints similar?

A

both involve

  • knee flexion + IR
  • tibial adduction

medial meniscus: adds ankle plantarflexion + inversion

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14
Q

how is counterstrain tx for the lateral meniscus & lateral hamstring tenderpoints similar?

A

both involve:

  • knee flexion + ER
  • tibial abduction

meniscus adds: ankle dorxiflexion + eversion

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15
Q

tibiofemoral joint motion:

how does the tibial head (plateau) move during

  • tibiofemoral flexion?
  • tibiofemoral extension?
A
  • flexion - anteriorly
  • extension - posteriorly
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16
Q

tibiofemoral joint motion:

how does the tibial head (plateau) move during

  • tibiofemoral adduction?
  • tibiofemoral abduction?
A
  • adduction - laterally
  • abduction - medially
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17
Q

tibiofemoral joint motion:

how does the tibial head (plateau) move during

  • tibiofemoral ER?
  • tibiofemoral IR?
A
  • ER - anteromedial glide
  • IR - posterolateral glide
18
Q

direct tx of abducted tibia?

A

tibial abduction associated with medial glide of tibial plateau. so, pt contacts medial side of tibial plateu & pushes it laterally, IR tibia in the process

19
Q

direct tx of adducted tibial?

A

tibial abduction associated with lateral glide of tibial plateau. so, pt contacts lateral side of tibial plateau & pushes it medially, ER tibia in the process

20
Q

direct tx of adducted vs abducted tibia?

A
21
Q

direct tx of flexed tibia?

A

flexed tibia = anterior tibial plateau. move tibial plateau moved → posteriorly

22
Q

direct tx of extended tibia?

A

extended tibial = posterior tibial plateau. move tibial plateau → anteriorly

23
Q

direct tx of flexed vs extended tibia?

A
24
Q

direct tx of externally rotated tibia?

A

tibial ER = anteromedial tibial plateau.

  • move tibial into IR with one hand (cranial), +
  • move tibial plateu posterolaterally with the other hand (caudad)
25
Q

direct tx of internally rotated media?

A

tibial IR = posterolateral tibial plateau.

  • move tibial into ER with one hand (cranial), +
  • move tibial plateu anteromedially with the other hand (caudad)
26
Q

direct tx of externally rotated vs internally rotated tibia?

A
27
Q

indirect tx of externally rotated tibia?

A

tibial ER = anteromedial tibial plateau

  • move tibial into ER with one hand (cranial), +
  • move tibial plateu anteromedially with the other hand (caudad)
28
Q

indirect tx of internally rotated tibia?

A

tibial IR = posterolateral tibial plateau.

  • move tibial into IR with one hand (cranial), +
  • move tibial plateau posterolaterally with the other hand (caudad)
29
Q

tibiofibular motion

what is the position of the ankle when

  • fibular head is posterior?
  • fibular head is anterior?
A
  • when the fibular head is posterior, the distal fibula is anterior, resulting:
    • ankle plantarflexion (inversion)
  • when the fibular head is anterior, the distal fibula is posterior, resulting in:
    • ankle dorsiflexion (eversion)
30
Q

tibiofibular motion

what is the position of the tibia when

  • fibular head is posterior?
  • fibular head is anterior?
A

posterior - tibia is internally rotated (b/c ankle inversion?)

anterior - tibial is externally rotated (b/c of ankle eversion?)

31
Q

tibiofibular motion

what is the position of the foot when

  • fibular head is posterior?
  • fibular head is anterior?
A
  • posterior - supinated foot (supination = foot inversion)
  • anterior - pronated foot (pronation = foot eversion)
32
Q

direct tx of fibular head posterior?

A

posterior fibular head = anterior distal fibula, thus:

  • plantarflexed / inverted ankle
  • IR tibia
  • supinated foot
33
Q

direct tx of fibular head anterior?

A

anterior fibular head = posterior distal fibula. thus

  • dorsiflexed / everted ankle
  • ER tibia
  • pronated foot
34
Q

what lines form the Q-angle?

motion at what joint affects the Q-angle? & how so?

A
  • Q angle formed by:
    • line from patellar center to tibial tubercle
    • line from patellar center to ASIS
  • Q angle changes based on tibiofemoral (i.e. knee) joint
    • tibial abduction / medial glide - increases Q-angle
    • tibial adduction / lateral glide - decreases Q-angle
35
Q

how to assess the stability of the lateral and medial collateral ligaments?

A

with the valgus and varus tests. pt is

  • seated or supine
  • knees flexed at 20-30 degrees
36
Q

applying varus force

  • positions the knee how?
  • affects the Q-angle how?
  • assesses / stresses what ligament?
A

laterally directed force

  • knee (tibiofemoral joint):
    • adducts tibia
    • laterally glides tibial plateau
  • decreases Q-angle
  • stresses lateral collateral ligament
37
Q

applying valgus force

  • positions the knee how?
  • affects the Q-angle how?
  • assesses / stresses what ligament?
A
  • knee (tibiofemoral joint)
    • abducts tibia
    • medially glides tibiofemoral joint
  • increases Q-angle
  • assesses / stresses the medial collateral ligament
38
Q

how to assess the stability of the anterior and posterior cruciate ligaments?

A

with the anterior and posterior drawer test. pt is

  • pt is supine with
    • hips flex at 45
    • knees flex to 90
  • can sit on pts foot to stabilized
39
Q

the anterior cruciate ligament test

  • assesses the knee how?
  • stresses what ligament?
A
  • tibiofemoral joint (knee): asses position of
    • tibial plateau - would have anterior glide
    • tibia - would be flexed
      • active test: by isometric knee extension
  • stresses the anterior cruciate ligament
40
Q

the posterior cruciate ligament test

  • assesses the knee how?
  • stresses what ligament?
A
  • tibiofemoral joint (knee): assesses position of
    • tibial plateau - would have posterior glide
    • tibial - would be extension
      • active test: by isometric knee flexion
  • stresses the posterior cruciate ligament

OMM Final (1 decks)

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