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OS 3 Midterm > UE/LE COunterstrain > Flashcards

UE/LE COunterstrain Flashcards

1
Q

Counter-strain Steps

A

Counter-strain Steps

  1. Structural exam to find SD
  2. Find a significant tenderpoint
  3. Establish pain scale
  4. Shorten the local tissues while monitoring
  5. Reduce pain by at least 70% by putting pt in comfortable position
  6. Maintain position for 90 seconds
  7. Passively return to neutral
  8. Recheck/reassess (tenderness, asymmetry, ROM, etc.)

3

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2
Q

Which TP do you treat in counterstrain?

A
  • Most tender 1st
  • If more than 1 that are similar in tenderness, tx the most central/proximal
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3
Q

Lateral Trochanter Counterstrain

  • TP:
  • Pt position
  • Doc:
  • Position:
A
  • TP: inferior to the iliac crest in the body of the tensor fascia lata
  • Pt position: supine or prone
  • Doc: same side of TP
  • Position: f ABD hip
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4
Q

IT Band Counterstrain

  • TP:
  • Pt position
  • Doc:
  • Position:
A
  • TP: along IT band, below lateral trochanter
  • Pt position: supine/prone (back)
  • Doc: same side to TP
  • Position: f ABD hip/thigh
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5
Q

Lateral hamstring Counterstrain

  • TP:
  • Pt position
  • Doc:
  • Position:
A

TP: distal aspect of the biceps femoris muscle, where it attaches to the fibular head (near the back of the knee)

Pt position: supine or prone

Doc: same side as TP

Position: F ER Abd & compress calcaneous to plantar flex ankle

  • flex knee
  • ER and abduct tibia
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6
Q

Medial hamstring Counterstrain

  • TP:
  • Pt position
  • Doc:
  • Position:
A

MEdial hamstring Counterstrain

TP: distal part of medial hamstring, near attachment of posterior medial part of tibial condyle

Pt position: supine of prone

Doc: ipsilateral to TP

Position: F IR Add

  • Flex knee
  • IR and adduct tibia by grabbing ankle
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7
Q

Lateral meniscus (lateral fibular) collateral ligament

TP:

Pt position

Doc:

Position: F Abd IR/ER

A
  • TP: Lateral aspect of menicus on joint line
  • Pt postion: supine (back)
  • Doc: same side as TP, seated
  • Position F Abd IE/ER
    • Abduct the patients thigh so leg is off table
    • Flex knee to 35-40%
    • Abduct tibia and IR/ER until tenderness is less than 70% reduced
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8
Q

Medial meniscus (medial tibial) collateral ligament

  • TP:
  • Pt position
  • Doc:
  • Position:
A
  • medial knee joint line
  • supine (on back)
  • ipsilateral seated
  • Abduct the patients thigh so leg is off table
    • Flex knee to 35-40%
    • Adduct tibia and IR/ER until tenderness is less than 70% reduced
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9
Q

Anterior cruciate counterstrain

TP:

Pt position

Doc:

Position:

A

TP: superior aspect of popliteal fossa

Pt position: supine (back)

Doc: same side

Position:

  • Fulcrum (pillow) on distal femur
  • Push proximal tibia posterior on distal femur
    *
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10
Q

Posterior cruciate counterstrain

TP:

Pt position

Doc:

Position:

A

TP: right below center of popliteal fossa

Pt position: supine (back)

Doc: supsilateral

Position:

  • Fulcrum (pillow) under proximal tibia
  • Push posterior on distal femur
    • moves femur posterior on proximal tibia
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11
Q

Popliteus TP

  • TP:
  • Pt position
  • Doc:
  • Position:
A
  • TP: Muscle belly inferior to popliteal space
  • Pt position: prone (stomach)
  • Doc: ipsi
  • Position:
    • flex knee and IR tibia
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12
Q

Extension Ankle (Gastrocnemius) TP

TP:

Pt position

Doc:

Position:

A
  • TP: proximal gastroc muscle, distal to popliteal margin
  • Pt: prone
  • Doc: same side
  • Position
    • Flex knee
    • Plantarflex ankle and rest on you
    • Compress through calcaneus
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13
Q

Medial ankle (tibialis anterior) TP

  • TP:
  • Pt position
  • Doc:
  • Position:
A
  • TP: Anterior and inferior to medial malleolus on deltoid L

Pt position: LR with pillow under affected leg

Doc:

Position:

* Inversion of foot and ankle + IR
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14
Q

Lateral ankle fibularis (longus, brevis tertius) TP

  • TP:
  • Pt position
  • Doc:
  • Position:
A
  • TP: anterior and inferior to lateral malleolus in the sinus tarsi
  • Pt position: LR with pillow under affected leg
  • Doc:
  • Position:
    • Evert w slight ER
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15
Q

Flexion Calcaneus (Quadratus Plantae) TP

TP:

Pt position

Doc:

Position:

A
  • TP: Plantar surface of calcaneus at, where it attaches to plantar fascia

Pt position: supine or pronse

Doc: ipsilateralt TP

Position:

* Flex knee
* Put dorsum of foot on docs thigh
* Move calcaneus toward forefoot
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16
Q

Navicular TP

TP:

Pt position

Doc:

Position:

A

Navicular TP

TP:

Pt position

Doc:

Position:

17
Q

Shoulder TART

A
  • Joints: GH, SC, AC
  • Myofascial:
    *
18
Q

Supraspinatus TP

A
  • TP: Middle of supraspinatus muscle; above spine of scapula
  • Postion:
    • Lay supine
    • F (45 deg) Abduct (45 deg) and ER
19
Q

Infraspinatus TP

TP:

Pt position

Doc:

Position:

A
  • TP:
    • Upper: inferior and lateral to spine of scapula (posterior medial aspect of GH joint)
    • Lower:
      • Lower portion of muscle
        • inferior to spine
        • Lateral to medial morder
  • Position
    • Upper: Supine (on back)
      • Flex (90-120); abduct and adjust
        • Upper (ER/IR)
    • Lower TP: LR with TP up; doc in front of
      • Flex (135- 150) abduct and adjust
        • ER
20
Q

Levator Scapulae TP

A
  • TP: in levator at the superior angle of the scapula
  • POSITION
    • Lay prone and rotate head away
    • IR arm by addiing traction with a little abduction
21
Q

Rhomboid Minor/Major tP

A
  • TP: Medial border of the scapular where rhomboids attach
  • Position:
    • seated or prone
    • Pull on elbow and extend shoulder and adduct elbow
22
Q

Arm undwind

A
  1. Place cephalad hand near patients shoulder
  2. Flex and abudcut patients arm and rest forearm in YOUR antecubital fossa so it wont hang
  3. Slide caudal hand UNDER scapula and grab medial scapular border
  4. Put cephalad hand on anterior shoulder
  5. Pull laterally and superior until fascia pull eases
  6. Slowly ER deep fascia all the way to the wrist and finish ST of thenar and hypothenar eminence and pull fingers;

DO NOT ER THE SHOUDER

23
Q

Subscapularis TP

A
  • Anterolateral border of scapula on subscapularis m (push posterior and medial) (deep in armpit)
  • Pos (E IR)
    • pt supine ( on back) with arm handing off
    • Extend arm, IR wrist and add traction
24
Q

Biceps Brachii (Long Head) TP

A
  • TP: tendon of long head of bicep in bicipal grove
  • Pt
    • supine
    • oh me oh my position (
      • Shoulder and elbow are flexed
      • Arm is abducted and IR
25
Q

Biceps Brachii (Short Head) TP

coracobrachialis

A
  • tendon of Short head of biceps or coracobrachialis (inferolateral aspect of corocoid process)
  • Pos F Add IR
    • supine
    • Arm and shoulder are flexed
    • Arm is Adduction and IR
26
Q

Pec Minor TP

A
  • Inferomedial to coracoid process
  • Pos (F Add)
    • Pt is supine
    • Cross arm oveer chest (flexion and adduction)
      • Pull pts arm across chest by pulling the shoulder and scapula anterior
        • pull inferroir and medial to shorten
27
Q

Lateral Radial Head (supinator) TP

A
  • Anterolateral aspect of radial head, where supinator attaches
  • Pos
    • Pt is supine; doc is sitting
    • Extend elbow and forearm supinated
    • Fine tune with valgus
28
Q

MEdial epidcondyle (pronator teres)

A
  • TP: near medial epicondyle where flexor tendons are and pronatro teres (TREX)
  • Pos: )TREX)
    • Patient supine (on back)
    • Doc
      • Flex, Pronate (palm down) elbow and adduct arm
        *
29
Q

Dorsal wrist (extensor carpi radialis m) TP

A

TP: Dorsal surface on the 2nd metacarpal assx with extensor carpi radialise

Pos

Seated/supine

Extend and abduct wrist

30
Q

Dorsal Wrist (Extensor Carpi Ulnaris) TP

A

TP: dorsal surface of te 5th metacarpal )

Extend and ADDUCT wrist

31
Q

Palmar Wrist (Flexor Carpi Radialis): TP

A

TP: 2nd/3rd metarpal on pal in the flexor carpi radialis

Pos

Flex and abduct wrist

32
Q

Palmar Wrist (Flexor Carpi Ulnaris) TP

A
  • 5th metarpal on the palmar base in flexor carpi ulnaris
    • Pos
      • Flex and adduct
33
Q

First CMP (Abductor Pollici sBrevis):

A

TP: 1st metacarpal in the abductor polliics brevis m on palm

Flex wrist; abduct thumb

OS 3 Midterm (18 decks)

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