Midterm Flashcards
PRONE SACROILIAC JOINTS PALPATION SERIES
- Gapping Test
- SIJ Extension Assessment
- SIJ Flexion Assessment
- SIJ Internal Rotation Assessment
- SIJ External Rotation Assessment
- Posterior to Anterior Glide of the Sacral Ala
- Inferior to Superior Glide of the Sacral Ala
WEIGHT BEARING SACROILIAC PALPATION SERIES
- Piedau’s Sign
- Sacral Push
- Gillet’s Test
- SIJ Quick Scan
PRONE LUMBAR SERIES
- Posterior to Anterior Glide
- Rotation
- Lateral Flexion
SEATED (weight bearing) LUMBAR SERIES
- Quick Scan
- Posterior to Anterior glide
- Lateral Flexion
- Rotation
- Flexion
SIJ
Extension
Assessment
PSIS and Acetabulum
- tissue slack: I-S, M-L
- LoD: P-A on PSIS
SIJ
Flexion
Assessment
Ischial Tuberosity and ASIS
- Tissue slack: S-I on ischial tube
- LoD: S-I and P-A
hypertonisity
refers to a muscle that is usually shortened and as a lowered threshold.
Hypotonicity
refers to a muscle that is usually lengthened and has a raised threshold
hyperactivity
it will contract faster or sooner
hypoactivity
it will contract slower or not at all. other muscles will substitute
upper crossed syndrome
muscles that shorten and tighten: pectoralis minor and major, upper trapezius, levator scapulae, SCM.
Muscles that weaken: lower and middle trapezius, serratus anterior, rhomboids, deep neck flexors
consequences: forward head carriage,rotation and abduction of scapulae, refered pain to chest shoulders, arms, TMJ problems, inapropriate breathing function
Lower crossed syndrome
Muscles that shorten and tighten: hip flexors (iliopsoas, rectus femoris,…), erector spinae group, quadratus lumborum, piriformis
muscles that weaken: abdominal, gluteals
consequences: anterior pelvis tilt, increased lumbar lordosis, decreased trunk stability
Active end range
occurs when patient has maximally contracted the muscles controling a particular motion
Passive end range
occurs when patient passivley moves a joint from active end range through physilogic/ elastic joint range. aka joint play
Paraphysiologic (SPACE) end range
a short range that occurs between the passive end range and the anatomical limit of the joint
Anatomic end range
the anatomical barrier is the limit of anatomic integrity
Hooke’s law
deformation (resulting from strain ) imposed on an elastic body is in porportion to the stress (force/load) placed on it
strain
change in shape, deformation, as a result of stress
Creep
continued deformation (increasing strain) of a tissue over time under a constant load (traction, compression, twist)
Wolff’s Law
tissues deform in relation to the lines of force imposed on them
Passive Insuffiecency
when full ROM is limited by the antagonist muscle length rather than by the joint and the joint structures themselves
active Insufiency
refers to lack of agonist muscle strength
class one muscles
test from shortest position
One joint muscles
ex.) tricep, deltoid, iliopsoas
Class two muscles
test from mid range
2 joint muscles
- can span both joints, can concentrically contract simultaneously over both joints
ex. ) sartorious
class 3 muscles
2 joint muscles
- they shorten over one joint and lengthen over the other
ex) rectus femoris, hamstrings
Sherrington’s law
impulses from the contracted muscles facilitate motor units in the antagonist, and inhibit the antagonist muscle’s motor units
- stretching tight muscles also reults in improved strength of inhibited antagonist muscles
dynamic listings
- this one better reflects what is actually happening better than static listing
refrences movement restrictions of the bones and joints (not bone position)
static listing
refrences postions of bones, not the motion of joints. i.e. where the bone is stuck in refrence to the one under it (bone out of place)
SOAP
S- subjective (things the patient tells you)
O- Objective (findings of all tests and observations)
A- Assessment (the diagnosis)
P- Plan (for treatment and follow up)
Mobilization
- passive oscillatory movement or sustained stretch
- passive movement administered within the paraphysiologic or elastic joint space to increase range of joint motion
closed pack position
end of range of movement postion best fit ligaments stretched, joint screwed home by spin approached but not fully realized: comfortable and energy saving
Loose Packed
loose fitting surfaces can spin, roll and slide, reduced area of contact, little friction wedge shaped gaps circulate fluid like peristalic pump
SIJ Internal Rotation Assessment
SIJ External Rotation Assessment
contact: two fingers on ipsilatteral SI joint (just medial to PSIS)
- no tissue slack
- take femur to end range and acess end feel
P-A glide of the sacral ala
BILATERAL
- tissue slack: inferior to superior
- thumb contact on sacral ala
Inferior to Superior glide of the sacral ala
-contact: thumb on sacral ala, other thumb on lateral border of the sacrum
-LOD- on sacral ala= inferior to superior and posterior to anterior
on lateral border of the sacrum= lateral to medial
weight bearing
Piedau’s
thumbs on sacral apex, index fingers on PSIS
weight bearing
Sacral Push
patient is seated
bilateral thumb contact on sacral ala’s
tissue slack: inferior to superior and medial to lateral
-patient extends back until sacrum stops then checks P-A bilaterally
weight bearing
Gillet’s
1 thumb on s2 other thumb on PSIS
flexion brings thumbs together
-Test BILATERALLY
weight bearing
SIJ quick scan
?
PRONE LUMBAR SERIES
P-A glide
SP’s with hypothenar
- tissue slack: inferior to superior
PRONE LUMBAR SERIES
Rotation
ASIS
Side of SP
tissue slack I-S and L-M
PRONE LUMBAR SERIES
Lateral Flexion
interspinous space with thumb, pick up the knee
tissue slack I-S and L-M
Seated (weight bearing) Lumbar Series
quick scan
contact lumbar with flat part of fist on SP’s
tissue slack is I-S
Seated (weight bearing) Lumbar Series
P-A glide
Sp with soft pisiform contact
tissue slack is I-S
Seated (weight bearing) Lumbar Series
Rotation
thumb contact on side of SP
tissue slack I-S and L-M onto SP
Seated (weight bearing) Lumbar Series
Flexion
contach midline interspinous spaces with fingers
-have patient cross arms and flex forward
Hip extension movement pattern
prone, lift leg to hand : Gleut, hamstring, contr errector, ipsi errector
neck flexion movment pattern
supine, lift head to chest, fail = chin judding, shaking
trunk flexion movment pattern
supine, knees slightly flexed, patient does slight crunch 10 times alst time holding for 20-30 sec., failure= feet lifting up, excessive shaking,chin judding would mean weak erectors
LENGTH & STRENGTH
prirformis
L=prone, legs externally rotated to about 45*, acess end feel
S= slot machine, leg internally rotate and resist
LENGTH & STRENGTH
erector spinae group
L= seated, find bilateral ASIS, ask patient to bend forward until ASIS rocks then check distance between head and knees
S= prone, ASIS at edge of table, cross patients legs and hold ankles and knees down for support ask patient to lift up and hold for 2 minutes. 1 correction is ok
LENGTH & STRENGTH
PSOAS
L= have patient sit on edge of bench and grab one knee, guide the back to supine, make sure ischial tube is on end of bench, place patients foot against body, take to end range and acess end feel
S= supine, hip flexed and externally rotated, lift one leg stabilize contralateral ASIS apply resistance to IPSI leg
LENGTH & STRENGTH
Quadratus Lumborum
L= side lying proping yourself up with elbow, looking for smooth curve
S= side bend off table for 10 sec., stabilize hip/leg
LENGTH & STRENGTH
Latissimus Dorsi
L=supine, knees bent, thumbs up raise arms above head
S= prone, arm adducted, internally rotated and extension
LENGTH & STRENGTH
Levator Scapulae
L= supine,flexion,contra contra contra, contact superior angle of scapula
S= chicken wing
LENGTH & STRENGTH
Upper Trapezius
L= supine, flexion, contralateral laterl flexion, ipsilateral rotation, contactshoulder
S=seated or supine, extension, contrlateral lateral flexion, ipsi rotation, bring shoulder to ear and resist
LENGTH & STRENGTH
Mid/Low trapezius
S ONLY= prone, thumbs up, to 90= midd stabilize contr scapula, upper= 135 stabilize contra rib cage
LOD down to floor
LENGTH & STRENGTH
scalene
L=seated, extension, rotated away, calcanial contact below ipsi clavicle
S= supine, head flexed, knife edge on frontal bone, I-S and A-P hold 5 sec. give grade
LENGTH & STRENGTH
SCM
L= supine, head off table, extension, ipsi rotation, contra lateral flexion (ear to chest), contact inferior to clavicle
S= seated, flexion, contra rotation, ipsi lateral flexion (ear to chest)
