Practical 1 Flashcards
MAPPSSO
Mechanism of injury Acute or chronic Previous injury Pain Signs and symptoms Sounds Other
Dermatomes
L1
Proximal lateral femur to distal medial femur
Dermatomes
L2
Proximal lateral femur to distal medial femur
Dermatomes:
L3
Lateral femur anterior to Medial knee
Dermatomes:
L4
Distal lateral femur anterior to medial shank
Dermatomes:
L5
Lateral knee anterior to anterior foot
Dermatomes:
S1
Lateral foot posterior to posterior shank and thigh
Dermatomes:
S2
Posterior shank and thigh
Circulation(2)
Capillary refill
Skin color/temp
Pulse(2)
Dorsal pedal
Posterior tibial
Functional testing
Ottawa ankle rules explanation
To reduce unneccesory test on foot and ankle injuries
Myotomes:
L1
Resist hip flexion
Myotomes:
L2
Resist hip flexion
Myotomes:
L3
Resist knee extension
Myotomes:
L4
resist dorsiflexion
Myotomes:
L5
resist great toe extension
Myotomes:
S1
resist eversion
Myotomes:
S2
resist knee flexion
Anterior drawer
Examiner Position: Sitting or standing in front of the patient, one hand grasping the calcaneus with the same forearm holding the foot and the other hand stabilizing the distal tibia and fibula
Forces Applied: Stabilizing hand applies resistance on the tibia/fibula while the other hand anteriorly glides the calcaneus and talus
Bump test
Examiner Position: Standing to the side of the affected leg with one hand holding the top of the foot in a maximal dorsiflexed position
Forces Applied: The examiner’s top hand holds the top of the foot in a dorsiflexed position and the examiner firmly taps the bottom of the patient’s heel
Dorsal glide
Examiner Position: At patient’s feet. One hand stabilizes rearfoot and ankle mortis, one foot cups base of metatarsal.
One hand stabilizes the metartarsal head/ proximal phalynx, the other cups the phalynx
Forces Applied: A plantarly directed force is applied on the metatarsal or phalynx
Dorsiflexion eversion test
Examiner Position: At the patient’s feet. One hand on medial side of heel. one hand on head of metatarsals
Forces Applied: Passively evert the heel and dorsiflex the foot and toes, holding the position for 5 to 10 seconds
Eversion stress test
Examiner Position: Stand in front of the patient. One hand should be grasping the calcaneus and the talas, with the thumb on the deltoid ligament. The other hand should stabilize the leg.
Forces Applied: Roll the calcaneus laterally which causes the talas to tilt.
Feiss line
Examiner Position: Sitting and observing at the patient’s feet.
Forces Applied: Draw a line from the inferior aspect of the medial malleolus to the plantar aspect of the first MTP.
After the drawing of the dots, the patient steps down and the navicular tuberosity is marked.
Tubercle above the line = Pes Cavus
Tubercle below the line = Pes Planus
Tubercle on the line = Normal
Homan’s test
Examiner Position: Examiner is at end of table, stabilization hand is on distal portion of tibia and fibula and examining hand is on plantar portion of foot being tested
Forces Applied: Foot is passively dorsiflexed by the examiner on the side being tested with the knee fully extended
Inter-metatarsal glide
Examiner Position: Standing in front of the patient’s feet
One hand grasping the first MT head
The other hand grasping the second MT head
Forces Applied: Stabilize one of the MT heads while moving the other in
opposite, plantar and dorsal direction
Repeat procedure by moving to the lateral MT heads until all four intermetatarsal joints have been evaluated
Inversion stress test
Examiner Position: In front of the patient, one hand grasps the calcaneus and talus, the opposite hand stabilizes the leg 10 degree of dorsiflexion. the thumb or forefinger is place along the calcaneofibular ligament so that any gapping of the talus away from the mortise can be felt.
Forces Applied: the hand holding the calcaneus provides an inversion stress
Kleigers test
Forces Applied: The foot and talus are externally rotated while maintaining a stable leg.To stress the syndesmosis, place the foot in dorsiflexion, and to stress the deltoid ligament, place the foot in neutral or slight plantarflexion.
Positive Test: Deltoid ligament: Medial joint pain. Examiner could feel displacement of talus away from med. malleolus.
Mortons test
Examiner Position: Standing at the patient’s feet, grasp the forefoot just behind the head of the 1st and 5th MT.
Place the index finger and thumb of the opposite hand dorsal and plantar to the web space respectively, as if to pinch.
Forces Applied: Compress the transverse arch.
Use the thumb and forefinger to apply pressure over the symptomatic interspace between the metatarsals.
Forces should be moderately applied.
Navicular drop
Examiner Position: Kneeling in front of the patient.
Forces Applied: On an index card, mark the height of the navicular tubercle while seated, mark position again while weight bearing.
Measure distance between 2 marks.
Plantar glide
Examiner Position: At patient’s feet. One hand stabilizes rearfoot and ankle mortis, one foot cups base of metatarsal.
One hand stabilizes the metartarsal head/ proximal phalynx, the other cups the phalynx
Forces Applied: A plantarly directed force is applied on the metatarsal or phalynx
Posterior drawer
Examiner Position: Place stabilizing hand on the distal leg, and have the mobilizing hand grasp the talus and midfoot to maintain the joint in a loose-packed position
Forces Applied: Apply an anteroposterior (AP) force to the talus perpendicular to the tibia’s long axis as you examine the amount of quality of movement and end feel
Squeeze test
Examiner Position: Standing next to, or in front of the injured leg, with hands cupped behind tibia and fibula away from the site of pain
Forces Applied: Gently squeeze (compress) the tibia and fibula, gradually adding more pressure if no pain or other symptoms are elicited. Progress toward the injured site until pain is elicited
Thomson
Examiner Position: Standing next to the patient with their hand on their calf.
Forces Applied: Squeeze mid-muscle belly on affected side
Toe collateral
Examiner Position: One hand is stabilizing the proximal bone close to the joint being tested. The other hand is grasping the bone distal to the joint being tested near the middle of its shaft
Forces Applied: Valgus testing is moving the distal bone laterally to open up the joint on the medial side.
Varus testing is moving the distal bone medially to open up the joint on the lateral side.
