Test

Question 1

The hip drop test screens for ____ restrictions

^** If the hip on the unsupported side drops more than 25 degrees, it is a normal test (negative), if it does not drop more than 25 degrees, it is a positive test on the unsupported side

^** In other words, when you bend your right knee, it causes you to side bend to the left so as an example, lets say the patient’s right iliac crest only drops 10 degrees (meaning when they bent their right leg, the iliac crest only went down 10 degrees) therefore they have a + R hip drop test and therefore they have a restriction to ___ side bending and therefore side bent right

AKA IT IS THE OPPOSITE

Also realize the Trendelenburg test checks for ____ problems/___ nerve pathology and if right foot lifted and right hip drops, it’s weakness on the left gluteus medius side

Answer 1

Lumbar Side-Bending

Left

Glutues medius, Superior Gluteal N

Question 2

For the Pelvic side shift test, this asses ___ connections between the ___-___-___ complex

^** The hip is the actual joint between the acetabulum and femoral head whereas the pelvis is the innominate

Translation from left to right or vise versa occurs along the ___ axis, through the central axis

^** If you translate from left to right on the iliac crests, you are inducing side bending to the ___

If one has a tight psoas on the left, you get a pelvic side shift towards the ___, which would cause a restriction to translation from ___ to ___

Answer 2

Fascial, Lumb-pelvic-hip

Horizontal axis

Left

Right, right to left (aka left translation)

Question 3

Which plane is affected in scoliosis?

Which plane is affected in kyphosis/lordosis? (Anterior - Posterior Curves)

Which plane is affected in rotation?

Kyphosis occurs in the ___ vertebra

Lordosis occurs in the ___ vertebra

Answer 3

Coronal

Sagittal

Horizontal

Thoracosacral

Cervicolumbar

Question 4

For shoulder ROM, remember active is them doing it and passive is you helping them do it

Name the degree (For Glenohumoral joint)

1) Flexion
2) Extension
3) Abduction Coronal
4) Abduction Horizontal
5) Adduction Coronal
6) Adduction Horizontal
7) ER
8) IR

Answer 4

1) 180
2) 60
3) 180
4) 130-145
5) 40-50
6) 40-50
7) 90
8) 90

Question 5

A + flexion test, whether it is seated or standing, is when the ___ comes up (cephalad) as the person flexed from the waist.

Therefore, the dysfunction is on the __ side that came up (elevated) first and farthest and also the SI will lock prematurely on the dysfunctional side

These are ___ tests (dynamic or static?)

Answer 5

PSIS

Same

Dynamic

Question 6

For the seated flexion test to evaluate sacrum dysfunctions, you are assessing __-__ motion

For the standing flexion test to evaluate innominate dysfunctions, you are assessing ___-___ motion

Answer 6

Sacro-ileal

Ilio-sacral

Question 7

** The 1st ligament responsible for back pain (aka a postural decompensation pattern) is the ___ ligament

Extends from the tip of the ___ lumbar vertebra’s ____ to the ____

Answer 7

Iliolumbar ligament

4th and 5th, TP, Iliac crest

Question 8

For the Acromion Drop test, you divide the area between the neck and acromion into ___rds then include an ___ force to asses ____

Lateral 1/3rd asses ____

Middle 1/3rd asses ___

Medial 1/3rd asses ____

Answer 8

3rds, inferior, SB

Lower thoracics

Middle thoracics

Upper thoracics

Question 9

The straight leg raise screens for ___, ____ restriction, ____ tension, or tight ____

Sometimes if hamstrings are tight it can lead to a false positive standing flexion test

If pain occurs at 15-30 degrees, it is ___ etiology and if it occurs laterally at less than 15 degrees, it is considered ___ compartment pathology (as the IT band passes over the greater trochanter)

Answer 9

Lumbar radiculopathies (One or more nerves that are affected and does not work properly), Hip flexion restrictions, IT band tension, and tight hamstrings

Lumbar disc, Lateral

Question 10

For evaluating a superior/elevated 1st rib, you can load and spring ____ onto the 1st rib at the posterolateral shaft immediately lateral to the costotransverse articulation, noting for any hard end feels if seated

Rib 1 = \_\_\_ pump and \_\_\_\_ bucket
Rib 2 = \_\_\_
Rib 3-6 = \_\_\_
Rib 7-10 = \_\_\_
Rib 11 and 12 = \_\_\_

For Inhalation SD, treat the ____ rib

For Exhalation SD treat the ___ rib

For ribs 3-10 contact ____ for pump and ___ for bucket

Restriction of motion for caliper is via ___ muscle

Answer 10

Inferiorly

50/50
Mainly pump
Mainly pump going towards bucket
Mainly Bucket increase further down
Caliper 

Inferior

Top

Costochondral articulations, Midaxillary line

Quadratus Lumborum

Question 11

Name the range of motion for the hip

1) Flexion knee extended
2) Flexion knee flexed
3) Extension
4) Abduction
5) Adduction
6) IR
7) ER

What are the expected ROM for the knee

1) Flexion
2) Extension
3) IR
4) ER

Answer 11

1) 90
2) 120-135
3) 15-30
4) 45-50
5) 20-30
6) 30-40
7) 40-60

1) 145-150
2) 0
3) 10
4) 10

Question 12

A positive ___ test shows the patient has tight IT bands and to treat, a prone or LR technique can be used

Prone consists of the doc on the side of the table ___ the IT band and flexes the knee to 90 degrees and pushes it laterally (___ rotating the hip) and a ____-____ force to the IT band is used

LR has the doc stand facing the front of the patient and cephalad hand is placed on the posterior aspect of the iliac crest to stabilize and then a fist is made placed on the distal lateral thigh over the IT band and pressure is assed into IT band and movement towards the ___ occurs (aka distal to proximal) then proximal to distal is done

Answer 12

Obers

Opposite, internally, posterior-medial

Greater trochanter

Question 13

Name the hip or knee motion for each muscle

1) Iliopsoas
2) Sartorius
3) Rectus femoris
4) Vastus medialis/intermeidus/lateralis
5) Adductor longus/brevis/magnus
6) Glut medius/minimus
7) Glut maximus
8) Biceps femoris
9) Semitendinosus
10) Semimembranosus
11) Tensor fascia lata/IT band
12) Obturator externus and internus
13) Superficial/Inferior Gemellus
14) Quadratus femoris
15) Piriformis

Answer 13

1) Hip flexor
2) Hip flexor, External rotator
3) Hip flexor, Knee Extensor
4) Knee extensor
5) Hip adductor
6) Hip abductor, medial rotator
7) Hip extensor, external roator
8) Hip extensor, Knee flexor
9) Hip extensor, Knee flexor
10) Hip extensor, Knee flexor
11) Hip flexor, abductor, medial rotator
12) External rotator
13) External rotator
14) External rotator
15) External rotator (abduction with hip flexed)

Question 14

ME*

Make sure that when diagnosing a SD for hip flexion or extension, you block linkage at the ___

For a hip flexion SD, if you use the supine technique, you stand on the ___ side as the SD and stabilize the ___ ASIS and ipsilateral leg drops off the table. Then engage barrier by extending hip into the barrier

If you use the prone technique you have the patient lie prone with knee flexed to 90 degrees and stand on the __ side as the SD and stabilize the patients ____ ischial tuberosity. Then extend hip into restriction barrier

For hip extension SD, patient lies ___, stand on __ side as SD and stabilize ____ ASIS. Engage barrier by flexing hip into barrier

Answer 14

Ipsilateral ischial tuberosity

Same, Contralateral

Same, Ipsilateral

Supine, same, contralateral

Question 15

ME*

For knee flexion SDs you have the patient lie ___ and for knee extension SDs you have the patient lie ___

Answer 15

Supine, Prone

Question 16

ME*

*****To evaluate the a fibular head SD, the patient is supine with knee flexed to ___ and then a gliding anterior and posterior motion is made

For a posterior fibular head SD, it is accompanied by foot ___, ____duction, ___flexion, and tibia __ rotation

For a anterior fibular head SD, it is accompanied by foot ___, ____duction, ___flexion, and tibia __ rotation

To treat these SDs, just place the patient with their hip and knee flexed to 90 degree and then go into the barriers *****

Answer 16

45

Inversion, adduction, plantatrflexion, internal

Eversion, abduction, dorsiflexion, external

Question 17

HVLA*

For HVLA of a posterior fibular head, you contact the ____ of the fibular head with your ___ and then ___ the hip and knee to 90 degrees and place patient into barrier

Then once the barrier is engaged, you must add ___ at the knee and hip and then your thrust is applied by hyperflexing the hip and knee while applying an ___ thurst on the psoterior fibular head from the cephalad hand

Answer 17

Posterior aspect, 2nd MCP, flex

Flexion, anterior

Question 18

HVLA*

For HVLA of a anterior fibular head, you contact the ____ aspect of the fibular head with your ___ and then ___ the hip and knee to 0 degrees and place patient into barrier while applying a ___ force to the fibular head

Then once the barrier is engaged, make your thrust is applied in a ___ direction to the anterior fibular head from the cephalad hand

Answer 18

Anterolateral, thenar eminence, Extend, posterior

Posterior

Question 19

MFR*

Tibia rotation is a ___, ___ motion evaluated supine with the hip and knee flexed to 45 degrees and the tibial plateau is internally and externally rotated to check for SDs by adding a slight ___ force and then internally and externally rotating checking for ease vs restriction of motion

^** Thumbs on anterior aspects of tibial plateau and fingers on posterior aspect

If you engage the restriction barrier, it’s called a ___ force and if you engage the ease of motion barrier it’s called a ___ force

For a direct force, you wait until you feel a ___ and for an indirect force you wait until you feel ___

Answer 19

Passive, accessory, distraction

Direct, indirect

Tissue creep, relaxation (tissue release)

Question 20

MFR*

For MFR of a fibular head (anterior or posterior), you treat the patient with their hip and knee flexed to ___ degree

Contact fibular head with cephalad hand and ____ tib/fib with stabilizing hand

Then do a direct and indirect technique based on if it’s posterior or anterior

Answer 20

45

Distal

Question 21

1) The medial longitudinal arch is made up of ____ (aka the higher arch)
2) The lateral longitudinal arch is made up of ___ (aka the lower arch)
3) The transverse tarsal arch is made up of the ___

The metatarsal arch is made up of the distal metatarsal heads

Answer 21

1) Calcaneus, Talus, Navicular, 1-3 Cuneiforms, and 1-3 Metatarsals
2) Calcaneus, Talus, Cuboid, 4th and 5th Metatarsal
3) Navicular, cuboid, 1-3 Cuneiforms, and Proximal metatarsals

Question 22

A high ankle sprain (associated with ankle eversion and rotation and some dorsiflexion) would include the ___ membrane and ___ ligament and it evaluated with the ___ test

The ligament that always tears first during an inversion ankle sprain is the ___ and is evaluated with the ___ sign

The ligament tested with Talar tilt inversion is the ___ ligament and the ligament tested with Tala tilt eversion is the ___ ligament

The achilles tendon is evaluated with the ____ test, where the patient is prone and doc squeezes gastrocnemius and looks for ankle ____ flexion

Answer 22

Interosseous membrane and Anterior Inferior Tibiofibular Ligament (AITF), Squeeze test

Anterior Talofibular lifament (ATF), Ankle anterior drawer sign

Calcaneofibular ligament, Deltoid ligament

Thompson, Plantar

Question 23

I would prob know the location for the underlined ligaments shown in the OSCE 10

Question 24

Name the range of motion for the following ankle/foot movements

1) Dorsiflexion
2) Plantarflexion
3) Ankle inversion
4) Ankle eversion
5) Subtalar inversion
6) Subtalar eversion
7) Forefoot adduction
8) Forefoot abdution
9) 1st metatarsophalngeal flexion
10) 1st metatarsophalangeal extension

Answer 24

1) 15-20
2) 50-65
3) 35
4) 20
5) 5
6) 5
7) 20
8) 10
9) 45
10) 70-90

Question 25

1) For a posterior tibia on talus, the ankle has ease of motion to ___ flexion and ____ glide. Therefore the tibia is restricted to ___ glide on the talus
2) For an anterior tibia on talus, the ankle has ease of motion to ___ flexion and ___ glide. Therefore the tibia is restricted to ___ glide on the talus

^** Both of these are due to changes in the ____ mechanisms (NOT the talus)

^** In order to perform HVLA for either a posterior or anterior tibia on talus, one first has the patient lie ___ with ipsilateral hip and knee extended (aka leg flat on table) and the stands at the foot of the table.

For posterior tibia on talus treatment, wrap hands around foot and ankle and engage the restriction barrier (via dorsiflexion) and apply an ___ force while increasing the barrier until the barrier is engaged and an “axial tug” HVLA thrust is induced

For anterior tibia on talus treatment, cusp calcaneus with one hand and anterior aspect of distal tibia with other and then engage barrier by applying a ___ force caudally on the calcaneus with some ____flexion and a simultaneous ___ force on the distal tibia and then once this is done apply the HLVA “axial tug” to the calcaneus and posterior thrust on the distal tibia

Answer 25

Plantar, posterior, anterior

Dorsiflexion, anterior, posterior

Distal tibia

Supine

Axial traction

Distraction, plantarflexion, posterior

Question 26

1) For a posterior lateral malleolus, the lateral malleolus has ease of motion to ___ glide relative to the distal tibia. Therefore the lateral malleolus is restricted to ___ glide

^** ___ portion of the talus is displaced in a lateral direction

2) For an anterior lateral malleolus, the lateral malleolus has ease of motion to ___ glide relative to the distal tibia. Therefore the lateral malleolus is restricted to ___ glide

^** ___ medial border of the talus is more prominent

Answer 26

Posterior, anterior

Anterior

Anterior, posterior

Distal

Question 27

To treat a posterior lateral malleolus SD using HVLA, you first have the patient lie ___ with their ipsilateral hip and knee extended (leg flat on table)

Next, place your ___ onto the ___ aspect of the lateral malleolus (distal fibula)

Engage the restriction barrier by applying an ___ force on the lateral malleolus and a simultaneous ___ force to the ankle and then apply your HVLA thrust

To treat an anterior lateral malleolus SD using HVLA, you first have the patient lie ___ with their ipsilateral hip and knee extended (leg flat on table)

Next, place your ___ onto the ___ aspect of the lateral malleolus (distal fibula)

Engage the restriction barrier by applying an ___ force on the lateral malleolus and a simultaneous ___ force to the ankle and then apply your HVLA thrust

Answer 27

Prone

Thumbs, Posterior

Anterior, plantar flexion

Supine

Thumbs, anterior

Posterior, Dorsiflexion

Question 28

Plantar flexed and dorsiflexed talus SDs are due to changes in the ___ mechanics, NOT the distal tibia

^** Realize this is the opposite as posterior and anterior tibia on talus SDs

To treat these using HVLA, interlock fingers and contact the foot (4th and 5th digits contacting head of talus and thumbs contacting plantar surface)

Then engage the barrier and apply a simultaneous ___ force along with slight ___ for a plantar flexed talus or slight ___ for a dorsiflexed talus in order to allow a “leg tug” HVLA thrust towards the student to be performed

This HVLA thrust re-seats the ___ in ___

Answer 28

Talus

Axial traction, eversion, inversion

Talus, ankle mortise

Question 29

For ME of a plantar flexed talus SD, have patient supine and stabilize ankle by contacting ___ aspect of the distal tibia and the other contacting the ___ aspect of the foot.

^** Then engage the barrier by ___ the ankle and then have student provide activation force towards plantar flexion, then relax (isometric relaxation), etc…

For ME of a dorsiflexed talus, contact ___ aspect of the distal tibia again to stabilize the ankle and then contract the ___ aspect of the foot

Then engage barrier via plantar flexing, etc…

Answer 29

Anterior, plantar

Dorsiflexion

Anterior, dorsal

Question 30

Both inversion and eversion calcaneus SDs are due to changes in the ___ mechanics

For HVLA, you place the patient in the ___ position with leg flat on table and then you cusp the calcaneus with one hand and the other is draped over the dorsum of the foot

Then engage the restriction barrier by applying an ___ force to the ___ first and THEN add a axial traction force with the other hand contacting the ___ of the foot and once the barrier is engaged, perform the “leg tug” HVLA thrust

^** This re-seats the ___ with the ___

Answer 30

Subtalar

Supine

Axial traction, calcaneus, dorsum

Calcaneus, talus

Question 31

Ease of motion of the distal metatarsal to plantar glide with a restriction to dorsal glide is a ___ SD

The SD is due to changes in the ___ mechanics

To treat with HVLA, patient is supine and student grasps the metatarsal ___ with thumb and index finger and the ____ with the other thumb and index finger

Engage the barrier by applying a ___ force to the ____ and then apply a HVLA thrust into ____ on the metatarsal head

Answer 31

Plantar Metatarsal

forefoot (aka metatarsal head)

Head, proximal phalanx

Distractive, Metatarsal Phalangeal Joint

Hyperflexion

Question 32

The most common navicular SD is a ___ navicular SD and therefore has ease of motion into plantar glide and restriction into dorsal glide

** The ___ aspect of the navicular drops ___

In order to treat the student is placed supine with the ipsilateral extremity slightly ___, ____ rotated, and ___ducted so that the ___ aspect of the foot is on the table

The student then stabilizes the ankle by contacting the calcaneus and talus with one hand and then the other hand contacts the mid-foot aka fore-foot (Talus, 1st Metatarsal, 1st Cuneiform, Navicular) and the barrier is engaged by ___ the fore-foot

^** OSCE says you block out motion at the ___ for a plantar navicular SD

Answer 32

Plantar

Lateral, plantar

Flexed, externally, abducted, lateral

Everting

Talus

Question 33

The most common cuboid SD is a ___ cuboid SD and therefore has ease of motion into plantar glide and restriction into dorsal glide

** The ___ aspect of the cuboid drops ___

In order to treat the student is placed supine with the ipsilateral extremity slightly ___, ____ rotated, and ___ducted so that the ___ aspect of the foot is on the table

The student then stabilizes the ankle by contacting the calcaneus and talus with one hand and then the other hand contacts the mid-foot aka fore-foot (Talus, 1st Metatarsal, 1st Cuneiform, Navicular) and the barrier is engaged by ___ the fore-foot (aka rolling it towards the table)

^** OSCE says you block out motion at the ___ for a plantar cuboid SD

** Also note that this is commonly associated with a ____ SD

Answer 33

Plantar

Medial, plantar

Flexed, externally, abducted, lateral

Inverting

Calcaneus

Posterior fibular head

Question 34

The most common type of cuneiform SD is a ____ cuneiform SD

In order to perform the Hiss-Whip HVLA treatment to a cuneiform SD (which can also be applied to cuboid and navicular plantar SDs), the patient lies ___ with the extremity off the edge of the table and hip and knee slightly flexed

Then wrap fingers around dorsum of the foot and thumbs contact the plantar aspect of the NAMED cuneiform SD

To engage the barier, provide a ___ force at the ankle and a simultaneous ____ force to the plantar aspect of the SD through the thumbs

Also make sure to lock out motion at the ___

*** So just to recap real quick, Transtarsal thrust of cuboid-navicular HVLA has the patient lie ___ and Hiss-Whip for any plantar tarsal dysfunction has the patient lie ___

Answer 34

Plantar

Prone

Plantar flexion, Dorsal

Navicular

Supine, Prone

Question 35

MFR can be done to any joint within the foot or ankle

____ MFR goes into the restrictive barrier and maintained until tissue relaxation stops and this is called a ___ associated with the ___ properties of the tissues

___ MFR goes towards the ease of motion and is maintained until tissue relaxation stops and requires more concentration and proprioceptive input from the doctor

Answer 35

Direct, tissue creep, viscoelastic

Indirect

Question 36

Some other ankle and foot tests

Ankle dorsiflexion test can help determine which muscles are causing a restriction to ankle dorsiflexion. Have the patient ___ their knee to 90 degrees and then have them dorsiflex ankle… and if they can do this, the problem is with the ___ muscle since this crosses 2 joints and flexion at the knee will allow for the laxity in the muscle to produce this motion. If they can’t dorsiflex still, then is is a problem with the ___ muscle (which does not cross 2 joints)

___ sign is used to indicate thrombophelbitis or acute venous thrombosis via squeezing the calf and applying ____flexion

The ___ sign is used to indicate deep vein thrombosis of the posterior tibial veins and a positive test is when ___ compression (NOT lateral compression) of the gastrocnemius muslce into the posterior aspect of the tibia produces pain

Answer 36

Flex, Gastrocnemius, Soleus

Homan’s sign, Dorsiflexion

Moses, anterior

Question 37

The shoulder joint is made up of 3 bones including the ___, ___, and ___

It has 3 true synovial joints including the ___, ____, and ___ joints

It has 2 functional joints including the ____ and ____ join and 2 accessory joints including the ____ and ____ joints

Answer 37

Clavical, Humerus, and Scaupula

GH, SC, AC

Suprahumeral and Scapulothoracic

Costosternal and Costovertebral

Question 38

Joints can be grouped into functional groups that correspond to pahses of motion including EARLY shoulder abduction which includes the ___ + ____ joints and the MID-LATE shoulder abduction which includes the ___ + ___ + ____ joints

Answer 38

GH + Suprahumeral

Scapulothoracic + SC + AC

Question 39

Name the scapular movements

1) Upward and parallel to the spine
2) Moving closer to the spine
3) Turning on a horizontal axis so that the posterior surface faces downward and the inferior angle is anterior
4) Return from elevation
5) Away from the spine, combined with a lateral tilt around the thorax
6) Turning on a horizontal axis so that the posterior surface faces upward and the inferior angle protrudes

All 6 of these movements are motions of the scapula at the ____ joint

Note that when testing these have the patient lie in a lateral recumbent context with involved shoulder up

^** Also MFR can be done

Answer 39

1) Elevation
2) Retraction (adduction)
3) Downward rotation (backward tilt)
4) Depression
5) Protraction (abduction)
6) Upward rotation (forward tilt)

Scapulothoracic joint

Question 40

Spencer’s techniques treat ____ joint dysfunctions and is a ___ velocity ___ amplitude ___ technique

These are designed to articulate the humeral head throughout ROM in the fossa while stretching periarticular soft tissues

Patient is in a LR position with knees and hips flexed and back straight/perpendicular to the table.

The physician grasps the patients forearm and ___ their elbow and the docs other hand contacts the ___ to lock the shoulder girdle into place in order to limit ___ movement

Each of the 7 spencer steps are repeated 6-8 times and only stopped if it becomes painful and each motion tries to exceed the point reached in the previous excursion

Answer 40

Glenerohumeral (GH), Low, High, springing articulatory

Flexes, shoulder, scapula

Question 41

Name the exact order for spencers steps

Know the pictures

It is noted in the plan portion of the SOAP note as “articulatory for the shoulder”

Answer 41

Extension -> Flexion -> Circumduction -> Circumduction with traction -> Abduction/Adduction -> Internal rotation -> Traction stretch

Question 42

For ME of a flexion/extension/Internal/External/Abduction/Adduction note that these are all ____ SDs

For all of them, make sure you block out linkage at the ipsilateral ___ joint when diagnosing

And when treating stabilize the ___ with one hand and contact the ___ with the other

Then just engage the barrier and perform the ME techniques

Answer 42

Glenohumeral (GH)

AC joint

Shoulder girdle, Olecranon process

Question 43

For sternoclavicular (SC) somatic dysfunctions

If there is SC adduction SD, the patient is restricted to abduction and ease of motion to adduction

Since the patient is therefore restricted to abduction, we can have the patient perform an abduction motion and which ever clavicle is restricted to that motion would be the one with the adduction SD

Therefore, we must first know the movements of the clavicle for an abduction motion (shrug ones shoulders)… This motion consists of the distal ends of the clavicles moving ___ and the proximal ends moving ___

So if the patient performs the shoulder shrug and the left proximal clavicle does not move as for inferior as the right, that means the left clavicle is restricted to abduction and therefore the LEFT clavicle has an ADduction SD

^** AKA the side that does not go as far inferior is the side of the adduction SD

In order to treat this, patient is supine and at edge of table; doc contacts proximal clavicle head and then upper extremity is brought off the table and ___ rotated and ___ into the restriction barrier and patient is instructed to provide activating force towards the ceiling (___ at the shoulder)

Answer 43

Superiorly, inferiorly

Internally rotated and extended, flexion

Question 44

For SC horizontal extension SDs, this would mean the patient is restricted to horizontal flexion with ease of motion into horizontal extension

Since the patient is therefore restricted to flexion, we can have the patient perform a flexion motion and which ever clavicle is restricted to that motion would be the one with the extension SD

Therefore, we must first know the movements of the clavicle for an flexion motion (reach for the ceiling)… This motion consists of the distal ends of the clavicles moving ___ and the proximal ends moving ___

So if the patient performs the flexion motion and the left proximal clavicle does not move as for posterior as the right, that means the left clavicle is restricted to flexion and therefore the LEFT clavicle has an Horizontal Extension SD SD

^** AKA the side that does not go as far poster is the side of the horizontal extension SD

To treat this, doc places one hand on __ aspect of the proximal clavicular portion of the joint and the other placed behind the ipsilateral ___ (to cover the scapula)

The patient reaches up and grasps students shoulder in order to begin to engage the barrier via horizontal flexion and this is continued as the doctor begins to straighten up and therefore increase the horizontal flexion of the clavicle which brings it towards the ____. This is done until movement is palpated at the SC joint and at the same time the doc is pulling the scapula ____. Also a ___ force is simultaneously applied to the proximal clavicle from anterior to posterior

The activating force consists of the patient pulling the ipsilateral shoulder girdle ___ (towards or away?) the table

Answer 44

Anterior, posterior

^** Note that the opposite occurs in the horizontal extension motion aka the proximal clavicles would move anterior and the distal would move posterior

Anterior, shoulder/scapula

Manubrium, anterior, posterior

Towards

Question 45

For HVLA treatment of an adducted SC joint, you diagnosis it the same way as discussed in another notecard

The treatment consists of the doc contacting the ___ aspect of the dysfunctional SC joint with the ___ of the hand and then the other hand of the doc fully ___ the ipsilateral upper extremity and the shoulder

A ___ traction force to the arm is applied with a simultaneous __ force on the proximal clavicle and this is the direction the HVLA thrust is applied in

Answer 45

Superior, thenar eminence, flexes

Cephalad, inferior (downward)

Question 46

The carrying angle for the elbow is between ___ and ___ degrees

If it is greater than 15 degrees, it is cubitus ___ and if it is less than 5 degrees it is cubitus ___ aka gunstock deformity

The wrist extensors are attached to the ___ epicondyle and the wrist flexors are attached to the ___ epicondyle

Flexion ROM for the elbow is ___ and extension is ____

Answer 46

5-15

Valgus, Varus

Lateral, medial

140-150, 0 (could go to -5_)

Question 47

For the radial head, anterior glide is associated with ____ and posterior glide is associated with ___

So depending on the motions you can have an anterior radial head SD or posterior radial head SD

Posterior radial head is also associated with ulnar ___duction and anterior radial head is associated with ulnar ___duction

^**To treat via ME place patient into barrier (pronation or supination) and have the perform the techniques

Answer 47

Supination, pronation

Abduction, adduction

Question 48

Radial deviation is associated with ___duction of the wrist and Ulnar deviation is associated with ___duction of the wrist

Radial deviation ROM is ___ and Ulnar deviation ROM is ___

In order to treat using ME just engage barrier

^** HVLA just engage barrier and apply thrust

Answer 48

Abduction, adduction

20-30, 30-40

Question 49

Extending the wrist results in ___ carpal glide and flexing the wrist results in ___ carpal glide

Extension ROM is ___ and flexion ROM is ___

Engage restriction barrier for ME

Answer 49

Ventral, dorsal

70, 80-90

Question 50

For ulnar abduction and ulnar adduction SDs, you diagnosis them via having them supinate their arm and contacting the patients ulna with one hand and the distal radius/ulna with the other hand and provide a ___ and ___ force

^** So realize that here, ulnar SDs are referring to dysfunctions of the olecranon where as the other “Ulnar deviation/adduction wrist SD” is referring the the distal ulna near the wrist

An ulnar abduction SD will have ease of motion to ___ force and an ulnar adduction SD will have easy of motion to ___ force

Therefore for an ulnar abduction SD, you contact the ipsilateral ___ ulna and then make sure the elbow is fully ___ and the engage the restriction barrier by adducting and apply a ___ HVLA thrust

The opposite for an ulnar adduction SD occurs. Contact ___ ulna, extend, and apply ___ HVLA thrust

Answer 50

Valgus, varus

Valgus, Varus

Medial, extended, Varus (direction of ulnar adduction)

Lateral, valgus (direction of ulnar abduction)

Question 51

If a patient has ease of motion to anterior glide of the radial head and forearm supination, they have a ___ SD and this is treated by HVLA via engaging the restriction barrier by placing a hand on the ___ aspect of the radial head (palm of the hand in direct contact) and then the other doctors hand ___ the patients ipsilateral elbow so the hand can act as a fulcrum.

Also make sure the patients arm is ___nated

HVLA thrust is in the direction of ___ at the elbow and simultaneous ___ force with hand in contact at radial head

Answer 51

Anterior radial head SD

Anterior, flexes

Pronated

Hyperflexion, dorsal

Question 52

A posterior radial head SD is treated via HVLA by placing thumb of one hand on the ___ aspect of the radial head and other hand ___ the elbow so that the thumb can act as a fulcrum and then make sure the arm is fully ___nated

HVLA thrust is in the direction of ___ at the elbow and simultaneous ___ force with the thumb in contact with the radial head

Answer 52

Posterior, extends, supinated

Hyperextension, ventral

Question 53

For an extension or flexion wrist/ carpal SD HVLA treatment has the patient contacting the ipsilateral wrist with both hands (thumbs are in contact with the ___ aspect and the index fingers are in contact with the ___ aspect)

**For HVLA, you first engage the ____ of motion and THEN you engage the restriction barrier ***

HVLA thrust is into direction of wrist hyperextension/hyper-flexion and simultaneous ventral/dorsal carpal glide

Answer 53

Dorsal, ventral

Ease

Question 54

Phalangeal SDs are palpated at the ___ joints and moved through flexion, extension, abduction, adduction, internal, and external rotation

Grasp the ___ with one hand and the ___ with the other hand

Provide a ___ force and then a HVLA thrust into ___ of the joint being treated is applied

Answer 54

MCP

Distal metacarpal and proximal phalanx

Distraction, hyperflexion

Question 55

MFR for a forearm interosseous memrbane SD occurs by first diagnosing the problem via contacting the forearm with both thumbs on the __ aspect and concentrating on the tissues deep between the ulna and radius feeling for tissue texture changes deep in the tissues or tenderness

Then use thumbs to move the tissue ___ (name all positions)

The once SD is determined, you can perform direct or indirect MFR

Answer 55

Anterior

Right/Left, Clockwise/Counterclockwise, Cephalad/Caudad

Question 56

MFR for a wrist flexor retinaculum SD is first diagnosed via contacting the wrist with both thumbs over the anterior aspect and concentrating on the tissue between the ___ and ___ eminence

This can be associated with ___

For treatment, grasp the wrist with thumbs on the anterior aspect with one at each end of the flexor retinaculum and the fingers wrap around dorsal aspect of wrist, then provide force with thumbs by pressing ___ onto the wrist and pushing ___ WITHOUT sliding the fingers across the skin

^** Therefore, this is ONLY a ___ MFR treatment

If severe pain and paresthesias in median nerve distribution occurs, stretch is released and if only mild tingling then the stretch can be repeated

Answer 56

Thenar and hypothenar

Carpal Tunnel Syndrome

Posterior, apart

Direct

Question 57

Articulatory treatments for a wrist/carpal SD occurs via taking the patient through flexion, extension, abduction (radial deviation), adduction (ulnar deviation) to asses for SDs

To treat any of these, doc places palm over dorsal and ventral aspects of patients wrist

Then a ___ force is applied with simultaneous ___ force

Then an articulatory force in a ___ pattern in a clockwise and then counter-clockwise motion occurs

Answer 57

Squeezing, traction

Circumduction

Question 58

Articulator treatment of the phalangeal SD can also be accomplished and once the SD is determined, the doc grasps the distal metacarpal and proximal phalanx and provides an ___ force to the joint in a clockwise and then counterclowise manner

Answer 58

Articulatory