lower lab final Flashcards
Calcaneal motion
A-P glide
rotation (ab and ad)
inversion and eversion
SCP- fingers wrapped around calaneous
CP- either hand cupping calcaneous to increase motion and knife edge
LOC- glancing blow in the direction contacting fingers
SH- thenar emenience
2-3 glancing blows
Anterior Talus Correction
- forced dorsiflexion
- 3 moves
1)
SCP- anterior talus
CP- dominant thumb, other on top with fingers interlaced
LOC- long axis traction to open joint and slight impluse A-P
2)
SCP-anterior talus
CP- chiro chiro
LOC- long axis traction to open joint and slight impluse A-P
3) *open pack
PT prone with leg flexed, your knee holding down their leg
SCP- anterior talus
CP- chiro chiro
LOC- long axis traction with slight A-P impulse
4)
CP- outside hand under calcaneous, inside thenar on top of talus, bend elbow to 90 parellel to talus, long axis distraction A-P thrust on knife edge
Inferiors
aka posterior
*navicular/cuboid/cunieforms/met base
PT- prone, or supine with captain morgan
prone(cuineforms 1-2, 2-5 met base, cuboid)
supine(navicular, cunieform 1, 1st met base)
SCP- inferior tarsal bone
CP- dominant thumb overlapped by pisi
LOC- long axis traction and impulse I-S
Criteria
- decreased ROM from I-S
- palpable tender nodule on plantar surface
- mechanism of injury such as dropping something on foot
Superiors
aka anteriors
navicular/cunieforms/met bases
Pt position supine
SCP- sup tarsal bone
CP- chiro/chiro or thumb/thumb
LOC- long axis traction to open joint and impulse S-I
Criteria
- mech of injury such as stepping on a rock
- decrease ROM from S-I
- palpable tender nodule on top of bone
Tips:
- thumbs up plantar surface
- elbows in
Superior Cuboid
muscle test!
-weak peroneus (dorsiflexion and inversion)
PT- supine with knee bent and foot flat on table
SCP- superior cuboid
CP- dominant thumb overlapped by other hand pisi
LOC- tissue pull over to medial edge of cuboid with thumb then place the pisi of other hand and impulse L-M, S-I, and A-P
Criteria 2/4 needed
- MOI such as inversion sprain/strain
- decreased ROM from S-I
- palpable tender nodule on sup cuboid
- muscle test
Fixated Met heads
shear before adjust**
SCP- met head
CP- thenar pad of one hand beside thenar of other hand
LOC- contact hand quickly stresses S-I while other hand stresses I-S
Criteria 3/4
- palpable tender nodule of plantar surface of met head
- decrease ROM from I-S
- mech of injury such as dropping something on foot
- absent knuckle
Strunsky’s maneuver
SCP- metatarsal heads
CP- finger tops on the posterior aspect of the met heads and the thenar emeinence on the anterior aspect of met heads
LOC- contact hand quickly stresses P-A while wrist rolling into flexion
Criteria 3/4 same as individual met heads
Phalanges
distraction and rotation
- look for nail rotation
- distract and derotate
Knee check
- popliteus muscle test (could be rotated tib or post tib)
- int and ext tibial rotation
externally rotated tibia
to increase internal rotation
PP- supine knee and hip flexed at 90
DS- side of involved knee
SCP- lat aspect of ant margin of tibia 1” distal to the tibial tuberosity
CP- ball of the hand or palmar MCP joint
LOC- take joint to tension rotating top hand from lat to med and extend elbows
extend leg then recheck popliteus
internally rotated tibia
to increase external rotation
DS- opposite side of involved knee
PP- supine with knee and hip at 90
SCP- medial aspect of the ant margin of the tib tube
CP- ball of hand
LOC- take joint to tension rotating top of hand from M-L and extend elbows
extend leg and then recheck popliteus
Posterior Tibia Modified Drawer
-popliteus still weak after checking and correcting rotation
PP- supine with leg bent foot on table
DS- at foot sitting on foot
SCP- posterior proximal tib and fib
CP- palm of dominant hand and interlocked fingers with other hand
LOC- take joint to tension from P-A with gentle impulse
Posterior Tibia Pump or Wedge
DS-side of involved knee
PP- supine with involved leg flexed, foot in air
SCP- post proximal tibia and fib with hands; and the anterior distal tibia with elbow
CP- palms interlocked fingers on prox end tib/fib and forearm across distal tib
LOC- take joint to tension by pushing A to P with elbow
Posterior Tibia Prone
*open pack
DS- same side of table of involved knee, stabilizing distal tib with shoulder
PP- prone with involved leg flexed, foot in air
SCP- post proximal tib/fib
CP- interlocked fingers and hands, elbows tucked in
LOC- take joint to tension and impulse P-A
lateral or medial tibial plateau aka?
aka wobble
motion like M, lean back keep leg flexed at 30deg
impulse into the direction of restriction with thenar pads, stabilze with knees
CP- thenars
SCP- tib plateau
SH- ankle b/t knees
LOC- L-M or M-L depending on fixation
Fibula
-check motion of fibula head using pincher grip and dorsi/planter flex
when plantar flex, fib head should move ant/inf/med
when dorsiflex, moves post/sup/lat
lack of motion compared bilaterally gives you a side
visualize and palpate the position of fib head and compare side to side
thumbs on tib tube and slide over to fib head
-longer measurement posterior
Hip adhesions in flexion
- decreased passive hip flexion 135
- anterior hip pain
SCP- distal end of femur
CP- palms of the hands fingers interlocked
LOC- body drop towards hip joint thru femoral shaft 2-3 x with increasing flexion
*reset proprioception by extending leg
Hip adhesions in extension
criteria: 1-decreased ROM 2-posterior hip pain 3- lack of folds -motion of glut fold -lower boot of SI -upper boot of SI -lumbar spine
SCP- posterior femoral acetabular ridge
CP- heel of hand
SH- under knee lifting into extension
LOC- hip joint to restriction of extension and drop P-A 2-3x. 1st at 0, 2nd at 10, 3rd at 20, do not go past 30
Hip rotation
normal ROM
internal 30-40
external 70-90
*over under high 5
Increase external rotation
state normal ROM is 70-90
face feet
over under high 5
SCP- anterior greater trochanter
CP- heel of hand
SH- inside medial hand over and under leg
LOC- CW or CCW to spin femur in rotational vector
Increase Internal rotation
-state normal ROM for internal is 30-40
stand facing head of table
SCP- posterior greater trochanter
CP- heel of hand
SH- inside medial hand over and under leg
LOC- CW or CCW to move femur in a rotational vector
Hip distraction
criteria-
- decreased motion
- leg muscle weakness any 2 tests of lower extrem
- symptoms such as pain in hip
*have patient put knife edge of hand to protect pubic bone
SCP- proximal femoral head against patients hand
CP- interlaced fingers with hands and elbows tucked in
LOC- distract the thigh along the angle of the femoral neck M-L, S-I, A-P impulse
Scoring around the clock aka?
circumduction
SCP-distal femur
CP- interlaced fingers and hand around distal femur
LOC- depends on time, do 1 hour before and after
