Quiz 9 Flashcards
Name three special tests for the ACL?
Anterior drawer Lachman’s Pivot shift Jerk FRD (Flexion Rotation Drawer Test)
Which ACL test is the gold standard and why?
Lachman’s - Has the highest sensitivity
Explain how you would determine if an ACL test was positive
Positive Test Findings:
- Pain
- > 3 mm translation
- “Empty” end feel
- Increased anterior motion on stress testing
What might the patient say to make you believe their ACL is involved?
History of macrotrauma including twisting, deceleration
History of giving way
History of hearing “pop”
Name three special tests for the meniscus?
Recurvatum,
McMurray’s (and with DDV),
Apley’s compression (and with DDV),
Steinman’s
Which special test implicates the anterior horn of the meniscus?
Recurvatum
What indicates a positive meniscus test?
Joint line pain
Click/clunk
Catching/locking
Pseudo-catching/locking
Explain how to perform the Apley’s Dynamic Compression (DDV) test.
Patient is prone, compress the tibia into the femur and externally rotate, then extend.
Repeat with tibia in internal rotation, then extend.
What are two factors that occur when running that increase the risk of injury in runners?
Increased GRF and Increased velocity
For a runner with a “high arch” what is their foot alignment and what kind of shoe should they wear?
Supination; neutral-cushioning shoe
Alignment and shoe for runner with“normal arch”?
Neutral; stability shoe
Alignment and shoe for runner with “flat foot”?
Pronation; motion-control shoe
How long does the typical running shoe last?
~ 500 miles
What type of orthotic would you use for rigid pes planus?
Rigid orthotic
What type of orthotic for pes cavus?
Soft orthotic
Where do you typically see calluses?
1st Met head
Where would you see calluses that would be abnormal?
Medial side of the big toe, pinched callus
How do you prevent forefoot varus with orthotics?
Medial post
What orthotic could you use for a Morton’s neuroma?
Metatarsal bar
What can the max heel lift be inside of the shoe?
1/2 inch
What is the initial goal of rehab for an acute ankle sprain?
To decrease swelling
Name three PT interventions that can be done to address an acute ankle sprain
Cryotherapy, compression, elevation, milking massage, e-stim, NSAIDs, ankle pumps
What is the best way to wrap an acute ankle sprain? Name it and describe it
Horseshoe wrapping
Place the horseshoe around the lateral malleolus to fill the space and then do figure-8 wrap
Check compliance by looking for the indentation at next session
What is an example of e-stim for decreasing swelling?
IFC or Hi-Volt
What is the capsular pattern of the hip?
Capsular Pattern: Flexion > Abduction > Internal Rotation
Name a hip mobilization to improve hip ER.
Figure four anterior or anterior glides
Name a hip mobilization that can be done to improve hip flexion
Inferior glide or posterior glide
Name a hip mobilization to improve hip extension.
Anterior glide
Name 4 Patellofemoral Tests
Medial glides- checks superficial fibers on lateral retinaculum
Lateral glides- check superficial fibers of medial retinaculum
Medial Tilts- checking deep fibers of lateral retinaculum
Lateral Tilts- Deep fibers of medial retinaculum
Caudal Glides- checking quad tendon
Cephalic glides- checking infrapatellar tendon
Name 2 PF tests used for patellar tracking
Passive tracking
Active Tracking OKC
Active Tracking CKC
Why should we not use a bolster under the knee when performing PF tilts?
Want to loosen deeper structures so you can tilt the patella (knee is in most lax position)
What instructions should you give someone who has just gotten their orthotic? (If you don’t like this one, you can change it)
It must be worn in every shoe
May need to purchase a wider shoe to accommodate the orthotic
What glide do you perform with the Moving Patellar Apprehension Test?
Lateral Glide
If the Moving Patellar Apprehension Test is positive, what do you do? (second step of the test)
Medial Glide
Name the four PCL tests on the knee algorithm
Recurvatum,
Sag test,
Clancy step up, and
Posterior drawer
Give an example of an injury that may cause a PCL tear.
Hyperextension injury
Fall on anterior tibia with ankle in plantarflexion
What other ligament would you want to examine in a suspected PCL tear?
ACL
Describe a positive PCL test:
Pain, Instability, Increased posterior motion with Stress testing
Which part of the knee do you measure when performing anthropometric measurements of the knee?
- 20 cm proximal to the joint line
- 10 cm proximal to the joint line
- Joint line
- 15 cm distal to the joint line
Why do you measure at each part when performing anthropometic measurements of the knee?
20 cm proximal to the joint line- atrophy in the chronic knee
10 cm proximal to the joint line- swelling in the acute knee, atrophy in the chronic knee
Joint line- Swelling in the acute knee
15 cm distal to the joint line-Atrophy in the chronic knee. The bulk of the gastroc soleus is here for most people. Can adjust for an especially tall or short individual.
Name four special tests for LE flexibility and what structures are implicated
Thomas Test: Iliospoas and RF
Ober’s or Modified Ober’s: IT Band
Ely’s: Rectus Femoris
90/90 SLR: Hamstrings
When assessing hip flexor length, how do you differentiate between the two muscles?
Bend the knee - if thigh rises, RF is implicated and if no movement, iliopsoas is implicated
OR
Straighten the knee - if thigh lowers, RF is implicated and if no movement, iliopsoas is implicated
What are the three aspects of the femoral triangle?
Inguinal ligament
Sartorius
Adductor Longus
What structures pass through the triangle?
Femoral vein, artery and nerve (medial to lateral)
What position is best for accurate palpation of these structures?
Supine figure-4
