MSK Accessory Movements Flashcards
What structure do accessory movements test?
Ligaments
What things might limit movement?
Pain
Resistance
Muscle spasms
What two things are you assessing particularly about the joint?
The end feel (empty, limited, laxity)
The amount of movement (is it normal? Too much or too little?)
How should you set up an accessory test? (2)
Relaxed joint in mid range
Performed by physio
Describe AP and PA of the knee and which ligaments they asses
Anterior to posterior so push the tibia on fixed femur (tests PCL)
Posterior to anterior pull the tibia on fixed femur (tests ACL)
If either move freely, or have soft/absent end feel then test is positive
Both performed in 90 degrees flexion
Describe the valgus and varus test and which ligaments they test
Valgus hand on lateral femur to fix then push tibia laterally (tests MCL)
Varus hand on medial femur to fix then push tibia medically (tests LCL)
Describe the Lachmans test and state the ligament tested
Lachmans is in 30 degrees then pull the tibia anteriorly on fixed femur, if it moves freely test is positive (tests ACL)
Describe the anterior draw of the ankle and which ligament it tests
Fix the distal tibia and hold the calcaneum, pull the foot towards you, if free moving or dimpling occurs then test is positive
Tests the anterior talofibular ligament
Describe the talar tilt test and which ligament it tests
Fix the distal tibia and invert the foot, of free moving test is positive
Tests the calacaneofibular ligament
Describe the concave convex rule in the knee
The tibia rolls and glides around the femur rather than the hinging motion most think occurs (demonstrate with hands)
How would you increase knee extension with an accessory?
Do a PA
How would you increase knee flexion with an accessory?
Do an AP
