Midterm 1 Flashcards

Question

Four Point Kneeling Position (FPK)

Answer 1

Used to examine Spinal extension range Notice how extension is distributed from middle of thoracic spine down to lumbar spin When spine cant move well in 1 area, might compensate by moving more in area above or below it Contract glutes to keep pelvis neutral

Answer 2

gives us insight into how much joint motion is available and how far lateral flexors on opposite side can lengthen -- so it's kind of a length test for lateral flexors Important when we notice lateral curvature of thoracic or lumbar spine in observations and when we notice that iliac crests are not levelled (reflects lateral pelvic tilt) **AKA: If there is pelvic tilt, you would want to use this test to see if they can get out of that position and tilt to the other side expect about 20* of lateral flexion to each side in lumbar spine and 25* in thoracic

Answer 3

Use this test to see ability of extensors of spine to stretch out and allow flexion Use this test if the individual has a deep lordosis (Hyperextension) because you want to see if they can get out of that position and go into flexion. Most individuals have 7cm increase between the PSIS's and iliac crests is a point where the lumbosacral junction is. Mark 2 points: 10 cm above and 5 cm below (these are the comparator points)

Answer 4

Get a sense if the extensors of Spine are strong Use this test if you see the person in a very flexed spine position to see if extensors are strong enough to get them out of it Average time a person can hold this is about 170s

Answer 5

Targeting flexors of trunk * Into anterior abdominal wall * Flexion through lumbar and thoracic regions Use this test if person's posture shows hyperextension in TL spine to get a sense if flexors of spine are strong enough to get them out Average value is 150s

Answer 6

Gain insight on if the lateral flexors are strong Use this test if you see them laterally flexed to one side, want to see if the other side is weak Side plank/Side bridge Healthy adults may last 1-2 min per side

Answer 7

1 - Passive tissue tension and joint ROM 2 - Skeletal architecture 3 - Balance of tension b/w opposing muscles 4 - Neurological factors 5 - Psychosocial factors

Answer 8

External Rotation (85 degrees) Start with model in supine position Shoulder abducted 90 degrees Elbow Flexed 90 degrees ○ Fingers towards the sky Tester puts support hand at distal end of humerus ○ Helps maintain abducted shoulder position ○ Pivot point for the humerus to spin around Second hand will grab distal end of forearm and take shoulder into external rotation, with emphasis on spinning the humerus End point: no further movement available Internal Rotation (65 degrees) Start with model in supine position Shoulder abducted 90 degrees Elbow Flexed 90 degrees ○ Fingers towards the sky Tester puts support hand at distal end of humerus ○ Helps maintain abducted shoulder position ○ Pivot point for the humerus to spin around Take shoulder into internal rotation Smaller ROM for most people than external rotation FOR BOTH: Watch for scapula, it has tendency to pop off at end of ROM. Don’t want to do this ○ Anterior tilt of scap

Answer 9

Which Muscles Are we Looking at: Infraspinatous, Teres minor, posterior deltoid These muscles cause have tendency to become weak in many individuals ○ Connect this to observation when person stands with internally rotated shoulder Check Strength Start with model in supine lying position with arm right at their side, neutral at the shoulder in terms of ab/adduction Arm flexed 90 degrees and then tester brings one hand in underneath the elbow ○ Helpful to have heel of palm towards medial side of the elbow Second hand comes on the back side of distal end of humerus Using the palm of that hand to apply pressure to the forearm and in that you try to spin the humerus into internal rotation, against model effort to externally rotate

Answer 10

When Pecs are tight, has tendency to draw shoulders forward (Protracted Position) *Model supine lying position * Hands behind their head, around level of occiput * Watch for the fall of the elbow ○ Look at how far off the table the point of the elbow sits ○ Can use tape measure to measure the vertical distance No normative data, Compare Bilaterally To do this Standing: * Go into half squat position/half wall sit * Bring elbow into 90 degree of flexion * Bring shoulders up to 90 degrees of abduction * Try to cross extend through your shoulders ○ Elbows towards the wall ○ Cant change or rotate through the spine or pelvis Does one get to the wall more easily than the other // does it even get to the wall at all?

Answer 11

LFT can do Posteriorly tilt and Superiorly rotation * Start with partner in prone lying position * Abduct shoulder to 150 degres which brings us into superior rotaion position of scap * Make sure that GH joint is laterally rotated so thumb is pointing up ○ Can increase/make it easier for lower trap to activiate * Ask person to lift arm off table against resistance and they have to do posterior tilt of scapula to do this ○ First job is to coach them on this movement ○ Then put a stabilizing hand on pelvis to stop it from popping up ○ Main resistance hand will be on back of scap § Other people might resist into the arm § But we do Scap because that’s what we are trying to target

Answer 12

These muscles Share retraction in Common * Model will retract scap against your resistance that pushes towards protraction * Model in prone lying position with arm over the edge ○ Want to target 90 degree abducted position ○ MFT and Rhomboid competition starts to come in * When in 90 degree abducted position you are in ideal position to emphasize MFT but as shoulder starts to drop from abduction position you might get more rhomboids Make sure they are not doing cross extension // extension through gh joint

Answer 13

Passive test that helps get insight into length and tension of hamstrings * Model in supine position and start with leg along table * First thing you do is lift femur up into hip flexed position * The second hand will now progressively increase the extension of the knee, lifting through Achilles and lifting through posterior aspect of calcaneus until you get to end range of knee extension When you get to what you think is end point, Then you would measure the popliteal angle (angle between the middle of femur and a line that runs through the center of the leg Normal popliteal angle is about 140 degrees

Answer 14

Passive test; shows how much tension is coming from hip flexors * Model starts in standing/leaning position with icial tuberosity sitting right at the edge of the table * Have them bring one leg up to their chest, and they roll backwards until they are lying fully supine on table * Other leg is hanging off entirely (no support at all) * Check if pelvis is in position you want ○ When in dangling leg position, mass of leg will have tendency to tilt pelvis anteriorly ○ Make correction for this, maybe putting pressure with own hand against asis on the front and push pelvis back a bit or they can use their abdominis region ○ Deep lordosis = good change pelvis in anterior tilt * The hanging leg is of interest * Measure an angle between the two lines shown * First line is horizontal line that would extend from greater trochanter of femur and run straigh across * Second line would go along length of femur, greater trochanter to center of knee * Normal value is that Femur drops 10 degrees below that horizontal line

Answer 15

Lateral hip rotators have an actual compartment: deep gluteal region Do this test if someone has too much medial rotation of femur? Need lateral rotators to limit how much internal rotation hip falls into bc it's a position we fall into easily * Model sit at edge of table with thigh fully supported * Their leg to start would be dangling straight down but we take it into a little lateral rotation -- this is start position * One hand on lateral side of thigh -- palm on lateral epicondyle * Distal hand is near the medial malleolus -- use broad hand contact model try to externally rotate and WE trying to internally rotate femur

Answer 16

Superficial gluteal muscles like glute max, med, min and TFL are primary abductors of hip One of their jobs is to limit how much adduction you can do An adducted hip position helps drive a valgus knee position * Model in side lying position on non-target side with hip and knee flexed a little so that they don’t roll forward or back * Then ask them to abduct hip to about 30 degrees (make sure femur moving and pelvis is not tilting) * Stabilizing hand on iliac crest to prevent pelvic tilt and pressure hand on distal end of femur at lateral femoral condyle * Now model tries to abduct against the resistance you apply in the direction of adduction

Answer 17

Ankle inverters tied directly to arch control (medial longitudinal arch) Inversion = drives supination do this test If someone has a lot of pronation to see if inverters strong enough to supinate * Model seated at edge of table * Leg dangling off * Tester applies pressure in direction of eversion * Top hand applies pressure through the heel of the palm against lateral side of leg (above lateral malleolus) * The other hand uses palm of hand to apply pressure against the medial side of 1st metatarsal in direction of eversion * So tester trying to evert and model trying to invert * Stabilizing hand above, pressure hand below

Answer 18

Do this test for someone with posterior pelvic tilt Limitation: The strength the person can generate can only match what you can do Evaluate strength from 0-5, and do this only isometrically * Model in seated position and thigh initially fully supported by table * Upright position with neutral lumbar spine * Tester would usually be standing in front of model with 2 hand contact points ○ One on contact on iliac crest, stabalizing hand for pelvis so it doesn’t rock back ○ Other hand is applying pressure on anterior aspect of thigh just above the knee, and press it down * Ask model to lift femur off ground just a couple inches and that is the position they will hold when you apply resistance downward Hold test for about 5 secodns Compare right and left

Answer 19

* Model in prone lying position * Lift leg off ground about 20 degrees aprox ○ With extended knee * Tester will stabilize pelvis ○ Heel of palm hand around level of PSIS ○ Resistance hand will come in on posterior side of calcaneus or achilles (depends how far you can reach) * Extensors are strong muscles so when they do hip extension you are in ideal situation where you can lean body weight into the hand and can step to side closer to the foot so you cana lean more BW down into the hand * Easy as the hamstring/glute complex, it will easily lift pelvis so you need to make sure pelvis doesn’t lift 5 seconds Bi lateral comparison Isometric contraction

Answer 20

This test helps you gain insight into how much dorsiflexion a person has at their ankle * Have a person do a lunge a few times in such a way that if you drew a line from the center of their heel that it would come out through their second toe and that line would be perpendicular to the wall that ur lunging toward * Then go into lunge position and make sure knee lines up too (not caving medially/laterally) and make sure ASIS's are facing forward too * Heel needs to stick to the ground; if heel lifts, you've gone too far * get to a point where the knee JUST touches the wall, everything else lined up perfectly ○ Measure the horizontal space b/w big toe and wall * You have to repeat test a few times to get this JUST RIGHT * Normal Range: 12-15 cm * Normal to see diff b/w left and right leg ; a difference of 1.5 cm is normal

Midterm 1 Flashcards

(44 cards)