LQ Checkout Flashcards
Clearing the Lumbar Spine
AROM
-Flexion: Bend forward
-Extension: hands on hips
-Lat SB: arms to the side
-Rotation: arms crossed, stabilize hips
RROM
-Flexion: resist being pulled back
-Extension: resist being pushed
-Lat SB: push shoulder down, stabilize contra pelvis
-Rotation: Pull one shoulder back, stabilize contra pelvis
Overpressure
-Flexion: sitting, Bend forward hands together, stabilize low back with forearm and push upper back with other forearm
-Extension: sitting, cross arms and arch back, stabilize low back with forearm and push chest
-Lat SB: sitting, lean to one side using trunk only, push ipsi shoulder down, stabilize contra pelvis
-Rotation: arms crossed, rotate to one side, push isi shoulder
Passive SLR & Dural Stretch
-hamstring shortness and mobility
-flx hip w/ extended knee
-DF ankle and tthen ask to flex head
SLUMP Tests
-neural tension
-hands behind back, slouched
-knee extended off table and ankle DF
-have patient tuck chin
Valsalva Test
-neuro involvement of spine
-hold breath and press down
-increases intraabdominal pressure
Compression Test
-SI pain test
-sidelying, press on iliac crest creating ant pressure on SI
Distraction Test
-SI pain test
-supine, press on ASIS down and laterally
Sacral Thrust
-SI pain test
-prone, push on sacrum with overlapping hands
Thigh Thrust
-SI pain test
-supine, 90 deg hip flx
-one hand on sacrum, another on bent leg patella
-push into hand
Quadratus Test
-quadratus lumborum strength
-side plank
-lift side up
Trunk & Neck Elevation Test
-prone, hands behind back, raise trunk
-take height
Quadrant Testing (Spine)
-spine pathology
-Flx and RSB: disc on left
-Flx and LSB: disc on right
-Ext and RSB: foramen on right
-Ext and LSB: foramen on left
Hip Flexion ROM
-120 (soft)
-supine, knee flexed
-stabilize pelvis
Stationary: lat midline Pelvis
Axis: greater trochanter
Movement: midline of femur to Lateral epicondyle
Hip Abduction and Adduction ROM
-45 ab, 20 add (firm)
-supine, knee extended
-stabilize pelvis
Stationary: Opposite ASIS
Axis: ASIS
Movement: Midline of femur
Hip Extension ROM
-20 (firm)
-prone, knee extended
-stabilize pelvis
Stationary: lat midline Pelvis
Axis: greater trochanter
Movement: midline of femur to Lateral epicondyle
Hip IR/ER ROM
-45 (firm)
-sitting or prone, knee flexed
-stabilize pelvis, towel under
Stationary: Perpendicular to ground or table
Axis: Patella
Movement: Midline of tibia
Q Angle
-Males: 13-15 & Female: 17-20
-supine
-stabilize pelvis
Stationary: ASIS
Axis: Mid patella
Movement: Tibial tubercle
Knee Flexion ROM
-150 (soft)
-supine, knee flexed
Stationary: lat midline femur to g troch
Axis: lat epi
Movement: lat mal
Knee Extension ROM
-5 (firm)
-supine, knee ext
-towel under ankle
Stationary: lat midline of femur to greater troch
Axis: Lateral Epicondyle
Movement: Lateral malleolus
Hip Flexion MMT
Muscle: Psoas Major (L2-L4)
Position: Sitting, holding onto plinth
Palpate: Distal to inguinal lig
Movement: bring Knee up, resist at distal femur
Stabilize: Ipsi pelvis
GR Position: Sidelying, leg supported by PT
Hip Flexion, Abduction, ER MMT
Muscle: Sartorius (L2-L3)
Position: Siting, holding onto plinth
Palpate: Below ASIS
Movement: flex hip, ER, abduction; resist at distal thigh and ankle
Stabilize: N/a
GR Position: Supine, slide heel on shin of opposite leg
Hip Extension MMT
Muscle: Glute max (L5-S2), Hamstrings (L5-s2)
Position: Prone, knee extended
-PT on contra side
Palpate: Glute max
Movement: Extend leg and resist distal femus
Stabilize: Pelvis
GR Position: Sidelying, knee extended
Hip Extension isolating Gluteus Maximus MMT
Muscle: Glute max (L5-S2)
Position: Prone, knee flexed
-PT on contra side
Palpate: Glute max
Movement: Extend leg and resist distal femus
Stabilize: Pelvis
GR Position: Sidelying, knee flexed
Hip Extension w/ Tight Hip Flexors MMT
Muscle: Glute max (L5-s2)
Position: Prone, bent over and holding plint, knee extended
-PT on contra side
Palpate: Glute max
Movement: Extend leg and resist distal femus
Stabilize: Pelvis
GR Position: N/a
Hip Abduction MMT
Muscle: Glute Medius (L4-S1)
Position: Sidelying, testing knee extended
Palpate: Below iliac crest
Movement: Abduct hip, resist distal femur
Stabilize: Iliac Crest
GR Position: Supine, abduct while suine
Hip Abduction & Flexion w/ TFL MMT
Muscle: TFL (L4-s1)
Position: Sidelying, knee extended, hip flexed to 45
Palpate: TFL, supeprior lat glute
Movement: Lift leg, resist at distal femur
Stabilize: Iliac crest
GR Position: Longsitting
Hip Adduction MMT
Muscle: Adductors (L2-L4)
Position: Sidelying on testing side, knees extended, PT suppporting higher leg
Palpate: Medial Thigh
Movement: Support non test leg and resist testing leg adduction at distal femur
Stabilize:
GR Position: Supine
Hip ER MMT
Muscle: Piriformis (L4-S1)
Position: Sitting, knee flexed with towel
Palpate: Btwn sacrum and greater trochanter
Movement: inner ankle
Stabilize: Outer knee
GR Position: Supine, knee extended
Hip IR MMT
Muscle: Gluteus Min and TFL (L4-S1)
Position: Sitting, knee flexed with towel
Palpate: Anterior glut/TFL
Movement: Resist at inner knee and outer ankle
Stabilize: inner knee
GR Position: Supine, knee extended
Knee Flexion MMT
Muscle:
-Medial: semitendinosis
-Lateral: biceps femoris (L5-s2)
Position: Prone, flexed knee
Palpate: Hammies
Movement:
-Normal: resist distal tibia
-Medial: IR tibia and resist obliquely (lateral)
-Lateral: ER and resist obliquely (medially)
Stabilize: Pelvis
GR Position: Sidelying on test leg, PT in front of pt
Knee Extension MMT
Muscle: Quads (L2-L4)
Position: Sitting, knee slightly flexed, hold plinth
Palpate: Mid quad
Movement: flex knee and resist distal tibia
Stabilize: Pelvis
GR Position: Sidelying on test limb
Talo-Cural DF/PF ROM
-DF: 20 and PF: 50 (firm)
-supine,leg off plinth for PF
-prone, leg flexed for DF
-stabilize calf
Stationary: lateral fibula
Axis: Lateral malleolus
Movement: 5th metatarsal
Tarsal Joints SUP/PRON/In/Ev ROM
-SUP: 35 & PRON: 20 (firm)
-supine, legs off plinth
-stabilize calf, “down and in” or “up and out”
Stationary: midline of tibia
Axis: Anterior ankle btwn malleoli
Movement: midline of 2nd metatarsal
Subtalar ROM
-inversion and eversion 5 (firm)
-prone, legs off plinth
Stationary: midline of lower leg
Axis: posterior ankle btwn malleoli
Movement: midline of calcaneus
MTP all Toes ROM
-Great toe flx: 45, ext: 70
-2-5 flx: 40, ext: 40
(firm)
-supine, legs off plinth, ankle flexed
-stabilize metatarsals
Stationary: midline of metatarsals
Axis: medial MTP joint
Movement: midline of proximal phalanx
MTP Great Toe AB/AD ROM
-Abd: 10
-Add: 30
(firm)
-supine, feet on floor
-stabilize metatarsals
Stationary: dorsal midline of metatarsals
Axis: dorsal MTP joint
Movement: dorsal midline of proximal phalanx
Toes IP ROM
-Great toe: flx: 60, ext: 0
(firm)
-PIPs: flx: 35, ext: 0
-DIPs: flx: 60, ext: 5
-supine, legs off plinth, ankle flexed
-stabilize metatarsals
Stationary: Dorsal midline of proximal phalanx
Axis: dorsal IP joint
Movement: midline of distal phalanx
Ankle Plantarflexion MMT
Muscle: Gastroc and soleus (S1-s2)
Position: Standing, 2 fingers for balance
Palpate: Achilles
Movement: Heel Raises
5: 25+
4: 10-24
3:1-9
2+: full range prone with resistance
2: partial range in standing and completes full range without resistance
2-: partial range prone
Stabilize: n/a
GR Position: Prone, feet off plinth
Dorsiflexion and Subtlar Inversion MMT
Muscle: Tibialis Anterior (L4-L5)
Position: Sitting
Palpate: Ant tib
Movement: Patient puts foot up and in, resist
Stabilize: Ankle
GR Position: Long sit/supine
Inversion MMT
Muscle: Tibialis Posterior (l4-L5)
Position: Sidelying on test side, foot off plinth
Palpate: btwn medial mal and navicular
Movement: Hold foot inward, and down, resist over medial side
Stabilize: Calf/ankle
GR Position: Longsit/supine
Eversion with Plantarflexion MMT
Muscle: Fibularis Longus/Brevis (L5-S2)
Position: Sidelying on non testing side, foot off plinth
Palpate: Lateral fibula
Movement: Move foot outward, resist laterally
Stabilize: ankle/calf
GR Position: Longsit/supine
Great Toe Abduction MMT
Muscle: Abductor Hallucis (L5-S1)
Position: Long sit, feet off
Palpate: Medial, plantar big toe
Movement: Move toe outward, resist
Stabilize: Foot
GR Position: N/a
2-4 and Hallux MTP Flexion MMT
Muscle: Lumbricals and Flexor hallucis Brevis (L5-S3)
Position: Long sitting, foot off table
Palpate: Lumbricals, proximal big toe plantar side
Movement: Flex toes, resist at proximal phalanx (2-4 together, big toe alone)
-only 0-5
Stabilize: foot
GR Position: N/A
2-4 and Hallux DIP and PIP Flexion MMT
Muscle: Flexor digitorum (both) and Flexor hallucis longus (L5-S2)
Position: Long sitting, foot off table
Palpate: FDL, posterior leg medial to achilles
Movement: Flex toes, resist at distal phalanx (2-4 together, big toe alone)
-only 0-5
Stabilize: Metarsald or proximal phalanx
GR Position: N/A
2-4 and Hallux MTP and IP Extension MMT
Muscle: Extensor digitorum (both) and Extensor hallucis Brevis (L4-S1)
Position: Long sitting, foot off table
Palpate: EDL: anterior, medial lower leg
EDB/EHB: lateral dorsum of foot
Movement: extend toes, resist at proximal phalanx (2-4 together, big toe alone)
-only 0-5
Stabilize: metatarsals
GR Position: N/A
Big Toe Extension MMT
Muscle: Extensor hallucis longus (L5-S1)
Position: Long sitting, foot off table
Palpate: EHL: dorsal proximal phalanx of toe
Movement: Extend toes, resist at distal phalanx (2-4 together, big toe alone)
-only 0-5
Stabilize: proximal phalanx
GR Position: N/A
Thomas Test
-LE flexibility
-edge of plinth
-bend both knees
-bend one, let other down and check for discrepancies
-Thigh doesn’t touch first: extended knee
-flexed hip with knee 90: iliopsoas
-ext hip with >90: rectus
-abducted: ITB
-flx hip and ER: short sartorius
Ober’s Test
-tightness of TFL and ITB
-sidelying, lower leg flexed
-abduct, ER, extend hip
-lower and look for movement
Single Leg Raise Test
-short hamstrings
-supine, both knees extended
-passive SLR to 70 deg is norm
-more than 91 deg hypermobile
Popliteal Angle Test
-distal hamstring flexibility
-supine witth test leg 90 deg hip with relaxed knee
woman: can extend to 30
men: can extend to 40
Ely’s Test
-short rectus fem
-prone, passive knee flexion
-check for hip rise
FABER
-like quadrant without compression
-test for inguinal pain, SI pain
-hip flex, abducted, ER
-press on opposite ASIS
Craig’s Test
-femoral retro/anteversion
-prone, knee flexed
-ER and IR until Greater troch is parallel with mat
-light reliable
Piriformis Flexibility Test
-hip flexed to 100, maximally ER
-slowly adduct to get stretch of piriformis
-stand on opp side
Clearing the Lumbar Spine
AROM
-Flexion: Bend forward
-Extension: hands on hips
-Lat SB: arms to the side
-Rotation: arms crossed, stabilize hips
RROM
-Flexion: resist being pulled back
-Extension: resist being pushed
-Lat SB: push shoulder down, stabilize contra pelvis
-Rotation: Pull one shoulder back, stabilize contra pelvis
Overpressure
-Flexion: sitting, Bend forward hands together, stabilize low back with forearm and push upper back with other forearm
-Extension: sitting, cross arms and arch back, stabilize low back with forearm and push chest
-Lat SB: sitting, lean to one side using trunk only, push ipsi shoulder down, stabilize contra pelvis
-Rotation: arms crossed, rotate to one side, push isi shoulder
Leg Length
Apparent leg length: umbilcus to med mall
True length: ASIS to med mall
*3 bridges first
Quadrant Scour Test
-degeneration of hip/labrum
-flex hip to 90
-compress joint in 4 quadrants
FADIR Test
-like quadrant without compression
-test for labral, impingement, normal end feels
-hip flex, adducted, IR
Girth Meausurement
-Mid mal on dorsum
-head of 5th metatarsal
-under heel
-above mal
-back to center
Windlass Test
-test plantar fascia
-check for medial arch drop with WB
-if dropped, extend big toe and look for rise
Feiss Line
-draw line from med mall to first met head
-if navicular tuberosity is above: high arch
-if navicular tuberosity is below: low arch
Dorsiflexion Lunge Test
-how close can the toes get when lunging without heel lifting
<9cm is restriction of DF
Y Balance Test
-hip mobility, quad strength, single leg strength
-anterior, posteriorlateral, posteriormedial
8 Inch Step Down
-DF, single leg strength, quad, hip
-hands on hip, step down and tap heel
-# in 30s
-no pelvic drop, arms
Passive SLR & Dural Stretch
-hamstring shortness and neural
-flx hip w/ extended knee
-DF ankle and then ask to flex head
SLUMP Tests
-neural tension
-hands behind back, slouched
-knee extended off table and ankle DF
-have patient tuck chin
Compression Test
-SI pain test
-sidelying, press on iliac crest creating ant pressure on SI
Distraction Test
-SI pain test
-supine, press on ASIS down and laterally
Sacral Thrust
-SI pain test
-prone, push on sacrum with overlapping hands
Thigh Thrust
-SI pain test
-supine, 90 deg hip flx
-one hand on sacrum, another on bent leg patella
-push into hand
Quadratus Test
-quadratus fem strength
-side plank
-lift side up
Trunk & Neck Elevation Test
-prone, hands behind back, raise trunk
-take height
Quadrant Testing
-spine pathology
-Flx and RSB: disc on left
-Flx and LSB: disc on right
-Ext and RSB: foramen on right
-Ext and LSB: foramen on left
