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practical- MSK > Passive Accessory Movements > Flashcards

Passive Accessory Movements Flashcards

1
Q

what are PAMs used for?

A
  • used to assess and improve joint mobility by targeting the joint’s accessory motions, which are necessary for normal physiological motion
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2
Q

what movements are they?

A
  • movements that the joint is capable of performing but cannot be actively performed by a patient
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3
Q

what are the two PAMs in the talocrural joint? what do they increase?

A
  • anteroposterior increases DF
  • posteroanterior increases PF
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4
Q

what is the starting position of AP and PA glide of the talocrural joint ?

A
  • pt in supine with the foot off the plinth
  • place a towel just below the ankle joint
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5
Q

where is stabilised in the AP/PA glide of talocrural joint?

A
  • tibia stabilised just above ankle
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6
Q

where is the hand placed in AP talocrural joint glide? what pressure is put onto the foot?

A
  • hand as close as possible to joint line with thumb on lateral side
  • index finger on medial foot near medial malleolus
  • apply downwards pressure in the direction of the index finger
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7
Q

where is the hand in the PA glide of the talocrural joint? what is the pressure applied?

A
  • palmar aspect placed above talus with thumb on lateral side
  • pull in an anterior direction
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8
Q

what are the two PAMs in the subtalar joint? what do they increase ?

A
  • transverse medial = increases eversion
  • transverse lateral= increases inversion
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9
Q

what is the starting position of the transverse glides of the subtalar joint?

A
  • pt in prone with the foot hanging off the table
  • talocrural joint on lifting part
  • towel underneath the ankle
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10
Q

where is stabilised in the transverse glides of the subtalar joint?

A
  • beneath the talus stabilised
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11
Q

where is the hand in the transverse medial glide of subtalar joint? where is pressure applied?

A
  • hands cups round the calcaneus
  • force applied using the fingers in a medial direction
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12
Q

where is the hand in the transverse lateral glide of subtalar joint? where is pressure applied?

A
  • hand cups the calcaneus
  • force applied by middle of hand in a lateral direction
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13
Q

what are the two PAMs in the tibiofemoral joint? what do they increase?

A
  • Anteroposterior increases flexion
  • Posteroanterior increases extension
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14
Q

what is the starting positions of the tibiofemoral joint AP/PA glides?

A
  • pt in supine with hips flexed to 45 degrees and knees flexed to 90 degrees
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15
Q

what is fixated in the AP/PA glide of the tibiofemoral joint? how is it stabilised?

A
  • foot is fixated by sitting on top of it
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16
Q

how do you do the AP glide on the tibiofemoral joint?

A
  • palpate the joint line with your two thumbs
  • pull the tibia forwards
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17
Q

how do you do the PA glide on the tibiofemoral joint?

A
  • palpate the joint line with the two thumbs
  • push the tibia backwards
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18
Q

what glides can you perform in the patellofemoral joint?

A
  • transverse (med)
  • transverse (lat)
  • longitudinal (caudad)
  • longitudinal (cephalad)
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19
Q

what is the starting position of the transverse glides of the patellofemoral joint?

A
  • pt in supine with fully extended leg
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20
Q

what are the hands like in the transverse glides of the patellofemoral joint?

A
  • both hands around patella border in a diamond shape
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21
Q

how is the medial patellofemoral glide performed?

A
  • pushing patella inwards
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22
Q

how is the transverse lateral patellofemoral glide performed?

A
  • patella pulled outwards
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23
Q

what is the starting point of the longitudinal glides of the patellofemoral joint?

A
  • pt in supine with legs fully extended
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24
Q

what do you do in the longitudinal caudad glide of the patellofemoral joint?

A
  • push patella towards the feet
  • can use pisiform to apply glide
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25
Q

what do you do in the longitudinal cephalad glide of the patellofemoral joint?

A
  • push patella towards head
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26
Q

what is the PAM of the hip?

A
  • caudal glide
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27
Q

what is the starting position of the caudal glide of the hip?

A
  • pt in supine with extended legs
28
Q

what do you do with the hands in the caudal glide of the hip?

A
  • grab the femur above the knee joint line with both hands underneath
  • bring the leg into maximal loose packed position
29
Q

what is the maximal loose packed position of the hip?

A
  • 30 degrees of flexion and abduction
  • a little external rotation
30
Q

what movement do you perform in a caudal glide of the hip?

A
  • extend arms
  • lean backwards pulling the leg with you
31
Q

what are the three main PAMs of the glenohumeral joint?

A
  • anteroposterior
  • posteroanterior
  • longitudinal
32
Q

what is the starting position for the AP/PA glides of GHJ?

A
  • pt in supine with the shoulder off of the table
33
Q

how do you fixate in AP/PA glides of GHJ?

A
  • fixate the pt arm with outer hand between your upper arm and body
34
Q

what do you do in the AP glide of GHJ?

A
  • with the inner hand, translate the humerus posteriorly
35
Q

what do you do in the PA glide of the GHJ?

A
  • using the same arm, use the hand to grab onto the humerus in armpit
  • with the other hand fixate the coracoid process, scapula and acromion
  • translate the humerus anteriorly
36
Q

what is the starting position of a longitudinal glide of the GH joint?

A
  • pt in supine
37
Q

where are the hands in the longitudinal glide of the GH joint?

A
  • one hand fixates arm at the elbow
  • other hand grabs onto the humerus/ armpit
38
Q

how do you move in the longitudinal glide of GH joint?

A
  • move the humerus laterally
39
Q

what PAMs can be performed in the acromioclavicular joint?

40
Q

what is the starting position of the AP-PA glide of the AC joint?

A
  • pt in sitting with forearm resting on the plinth
  • shoulder brought into 20 degrees of abduction
41
Q

where are the hands in the AP-PA glide of AC joint?

A
  • one hand palpates joint line between clavicle and acromion in sagittal plane
  • other hand fixates the acromion between thumb and middle finger
  • using the other thumb place it against the dorsal lateral part of clavicle & index/ middle finger against ventral lateral part of the clavicle
42
Q

what movement do you perform for the AP-PA glide of the AC joint?

A
  • translate the clavicle ventrally and dorsally
43
Q

what are the two main PAMs at the elbow?

A
  • AP glide radius on humerus
  • PA glid radius on humerus
44
Q

what is the starting position of the AP and PA glide of radius on humerus?

A
  • pt starts in sitting with the forearm resting on the plinth
  • radio humeral joint taken into its MLPP
45
Q

what is the MLPP of the radiohumeral joint?

A
  • full elbow extension
  • forearm supination
46
Q

what do you fixate in the AP and PA glide of the radiohumeral joint?

A
  • fixate the humerus with one hand and palpate the joint line with your thumb
47
Q

what do you remove in the AP glide of the radius on humerus? what can you feel?

A
  • remove all the forearm extensors and dig until dip found (Can be sensitive)
  • can feel the head of the radius
48
Q

what direction is the AP glide of the radius on humerus?

A
  • distal and caudal direction of movement
49
Q

what do you need to find in the PA glide of the radius on humerus?

A
  • find the radius with the other hand
50
Q

what pressure is applied and where in the PA glide of radius on humerus?

A
  • using the two thumbs
  • give pressure into the direction of your pt chest
51
Q

what are the two main distractions at the elbow joint?

A
  • olecranon on humerus
  • radius on humerus
52
Q

what is the starting position of the distraction of the olecranon on humerus?

A
  • pt in supine with legs extended
  • ulnar humeral joint in MLPP
53
Q

what is the ulnar humeral joint MLPP?

A
  • 70 degrees of flexion
  • 10 degrees of supination
54
Q

where are the hands in the distraction of the olecranon on humerus?

A
  • fixate the humerus with one hand and palpate joint line laterally with your thumb
  • other hand grabs onto the ulna
55
Q

what direction is the ulna pulled on in the olecranon on humerus distraction?

A
  • pulled dorsally and distally
56
Q

what is the starting position of the radius on humerus distraction?

A
  • pt in sitting with forearm resting on the plinth and elbow fully extended
  • wrist should be in 5 degrees of supination
57
Q

where are the hands in the radius on humerus distraction?

A
  • fixate the humerus with one hand and palpate the joint line with index finger
  • grab onto radius proximal to the wrist with the other hand
58
Q

what do you provide in the radius on humerus distraction?

A
  • provide distal traction
59
Q

what are the 4 PAMs of the radiocarpal joint?

A
  • AP
  • PA
  • lateral
  • medial
60
Q

what is the starting position of all 4 of the PAMs at the radiocarpal joint?

A
  • pt in sitting with forearm resting on plinth
61
Q

what is fixated in all the PAMs of the radiocarpal joint?

A
  • distal forearm always fixated
62
Q

where is the other hand in the AP and PA glide of the RC joint?

A
  • other hand should grab the proximal row of the carpal bones
  • no gap between hands
63
Q

what direction do you pull in for the AP glide of the RC joint?

A
  • pull the proximal row upwards
64
Q

what direction do you push on in the PA glide of the RC joint?

A
  • push the proximal row downwards
65
Q

where does the other hand go in the lateral and medial glide of the radiocarpal joint?

A
  • moving hand grabs the proximal row of the carpal bones
66
Q

where does the lateral glide of the RC joint move the carpal bones?

A
  • away from the thumb
67
Q

where does the medial glide of the RC joint move the carpal bones?

A
  • moves towards thumb

practical- MSK (10 decks)

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