Prac Viva Revision Flashcards
Explain the Concave/Convex Rule
When a concave bone moves within a convex socket, the movement moves as you’d expect.
For example, Shoulder Flexion moves AP
When a convex bone moves on a concave surface, the movement moves in the opposite direction to what you’d expect.
For example, Hip Flexion = Femur Head PA
Trendelenburg Special Hip Test
> Describe how to execute the test
> What does the test identify?
> What does a positive test appear like?
Process = pt. standing on one leg for ~15-30s. Examiner checks ASIS levels are equal.
Findings = Glute Medius and Minimus
Positive = hip with leg in the air drops due to adductor weakness
Thomas Test - Hip
> Describe how to execute the test
> What does the test identify?
> What does a positive test appear like?
Process = pt. perched on edge of the plinth. pt. hold one leg to their chest, slowly lying down.
Findings = Iliopsoas + Rectus Femoris
Positive = extended leg cannot reach the plinth + if moving laterally, tight TFL and ITB
Quadrant Scour Test - Hip - NON-IRRITABLE
> Describe how to execute the test
> What does the test identify?
> What does a positive test appear like?
> Sn and Sp?
Process = pt supine. Therapist bring hip to ~90 degrees flexion. From there, therapist glides/scours into adduction, IR, and compression of the joint.
Findings = this tests intra-articular joint pathology/restriction
Positive = onset/reproduction of pain
Sn = 50, Sp = 29
Ober’s Test - Hip
> Describe how to execute the test
> What does the test identify?
> What does a positive test appear like?
Process = pt. side lying. Therapist supports top leg in flexion. Therapist then extends and abduct’s top leg. The test is excited by slowly bringing the leg into adduction
Findings = TFL + ITB tightness
Positive = top leg cannot get parallel with plinth OR if lateral knee pain occurs
FADIR Test - Hip
> Describe how to execute the test
> What does the test identify?
> What does a positive test appear like?
> Sn and Sp?
Process = pt. in supine. flex knee to 90, adduct, and IR.
Findings = this tests for mechanical anterior impingement intra-articular labarum tear
Positive = reproduction/onset of groin pain
Sn = 99, Sp = 5
Adductor Squeeze Test - Hip
> Describe how to execute the test
> What does the test identify?
> What does a positive test appear like?
> Sn and Sp?
Process = pt. supine, knees flexed with feet flat on plinth. therapist places hand between pt. knees and instructs pt. to squeeze knees together.
Findings = tests for adductor tendinopathy + osteitis pubis
Positive = reproduction of groin pain
Sn = 43, Sp = 91
Anterior-Posterior (AP) Glide - Hip
> Describe how to execute the test for all grades
> What movement does AP Glide assist with?
Process =
Grade 1 and 2 - pt. in supine. Therapist places thumbs on greater trochanter
Grade 3 and 4 - pt. supine. Therapist uses heel of hand
Useful for increasing Hip Flexion ROM
Posterior-Anterior (PA) Glide - Hip
> Describe how to execute the test for all grades
> What movement does PA Glide assist with?
Process =
Grade 1 and 2 - pt. prone. Therapist places thumbs on greater trochanter
Grade 3 and 4 - pt. prone. Therapist uses heel of hand
Useful for increasing Hip Extension ROM
Lateral transverse Hip Glide
> Describe how to execute the test for all grades
> What movement does Lateral Transverse Glide assist with?
Process =
Grade 1 and 2 - pt. supine. Therapist uses hands to laterally move femur
Grade 3 and 4 - pt. supine. Therapist uses belt around mid femur whilst hip in 90 flexion
Useful for increasing flexion and IR due to capsular tightness
Caudad Hip Glide - Hip
> Describe how to execute the test for all grades
> What does a Caudad Glide assist with?
Process =
For all grades - pt. supine with hip at 90 flexion. Pull leg towards feet/end of the bed
Useful for pain relief in intra-articular pathologies
Talar Tilt Test - Ankle
> Describe how to execute the test
> What does the test identify?
> What does a positive test appear like?
> Sn and Sp?
Process = pt. seated on edge of plinth. One hand stabilises distal tib/fib and the other rotates foot into inversion and eversion
Findings = Inversion tests ATFL and CFL. Eversion tests deltoid ligament
Positive = excessive translation movement
Sn = 58-80, Sp = 88
Anterior Drawer Test - Ankle
> Describe how to execute the test
> What does the test identify?
> What does a positive test appear like?
> Sn and Sp?
Process = pt. sits on edge of plinth. Distal tib/fib stabilised with one hand, the other pulls calcareous forwards
Findings = Tests ATFL and CFL
Positive = excessive translation OR altered end feel, pain onset, or clunk
Sn = 58-80, Sp = 74-79
Squeeze Test - Lower Leg
> Describe how to execute the test
> What does the test identify?
> What does a positive test appear like?
> Sn and Sp?
Process = pt. supine on bed. Therapist bends knee into flexion and squeezes mid tib and fib together. Repeats distally.
Findings = Tests for Syndesmosis, Tib/Fib ligaments & Interosseous membrane/ligament
+
Common w/ #
Positive = reproduction of pain
Sn = 30-100, Sp = 14-93
Thompsons Test - Lower Leg
> Describe how to execute the test
> What does the test identify?
> What does a positive test appear like?
> Sn and Sp?
Process = pt. prone w/ ankle hanging off plinth. Therapist squeezes gastrocnemius and observes for PF
Findings = Tests achilles tendon integrity
Positive Test = no PF –> indicating toren tendon
Sn = 96, Sp = 93
Inferior Tibia Fibula Joint Accessory Move.
Explain how to execute the following:
AP
PA
Compression
Distraction
AP and PA
- pt. supine/prone with knee flexion 90
- stabilise tibia and move fibular by pushing in opposite direction
- Supine = AP VS Prone = PA
Compression
- squeeze malleolus together
Distraction
- passive dorsiflexion
Talocrural Joint Accessory Movement
Explain how to execute the following:
AP
PA
Compression
Distraction
AP (for DF) and PA (PF)
- pt. supine w/ ankle off end of plinth
- stabilise tip/fib and move talus in desired direction
Compression
- pt. prone w/ knee flexed to 90
- compress ankle pushing weight down into the leg
Distraction
- pt. prone w/ knee flexed to 90
- pull talus upwards
Subtalar Joint Accessory Movement
Explain how to execute the following:
Medial/Lateral Glide
Compression
Distraction
Medial/Lateral Glide
- pt. prone w/ knee flexed to 90
- stabilise talus and move calcaneus
(medial glide = assists with eversion, vice versa)
Compression
- push ankle into closed packed position
Distraction
- pt. supine w/ ankle off plinth
- stabilise talus + pull calcaneus
Transverse Tarsal Joint Accessory Movement
(between talus and navicular and cuboid and cuneiform)
Explain how to execute the following:
AP/PA
Medial/Lateral
AP and PA + Medial and Lateral
- pt. seated supine with ankle off plinth
- stabilise talus and move cuneiforms + cuboid
Intra-Articular Effusion Budge Sign/Sweep