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MSK LQ > Ultimate Review Deck > Flashcards

Ultimate Review Deck Flashcards

1
Q

How do we rule in SIJ?

A

Gaeslen’s test

Sacral thrust

Compression

Distraction

Thigh Thrust

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2
Q

How do we rule out SIJ

A

Gaeslen’s test

FABER

Compression

Distraction

Thigh thrust

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3
Q

What test is this?

which leg is being tested?

A

Gaeslen’s test

Bottom leg

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4
Q

Which part of the SIJ do we treat first, hypo or hypermobile?

How do we find out which side is hypo and which is hyper

A

hypomobile

seated or standing flexion test

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5
Q

In this test which side moves more?

A

The hypomobile side

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6
Q

In the long sitting test which side has a posterior innominate?

A

Posterior innominate- Longer leg

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7
Q

What are the steps of the active SLR test?

A
  1. Lift leg -> causes pain
  2. Lift leg w/ compression -> No pain? Form Closure
  3. Lift leg w/ core activation -> No pain? Force Closure
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8
Q

What SIJ problem does this fix?

A

Can fix general SIJ problems, but mainly for anterior innominate

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9
Q

If you palpate someone’s SIJ and you feel the ASIS lower and the PSIS higher, what is this?

A

Anterior Innominate

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10
Q

You palpate the SIJ and you feel the ASIS and the PSIS higher, what is this?

A

Up slip

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11
Q

What is this correcting?

What is the proper positioning for the patient’s leg

A

Upslip correction

Ext+ IR+ Abd

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12
Q

If a patient is isometrically using their hip flexors, which way are they pulling their innominate

A

into anterior rotation, fixing a posterior innominate

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13
Q

What is this fixing?

What is the therapist essentially doing?

A

Posterior innominate

Providing PA glides to one side of the SIJ while that leg is in EXT, the other leg is in hip flexion which is locking out the opposite side SIJ

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14
Q

What is this for?

A

Whole hip “reset button”

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15
Q

What is this improving?

What is the therapist hand motion?

A

Improves IR, Adduction

Scoop -> lateral distraction

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16
Q

What is this improving

A

improve hip flexion

scoop -> posterior-lateral mob

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17
Q

What is this improving

A

improves hip ext

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18
Q

What is the progression of tests to rule in a labral pathology

A

FADIR -> Hip Quadrant -> Hip Scour
another option: Fitzgerald (anterior labrum)

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19
Q

How do you test for a stress fracture of the hip or femur?

A

Patellar-pubic Percussion test

Listen on the pubic symphysis while tapping on each patella

less noise than other side = fx

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20
Q

How do you preform the fitzgerald test?

What is it for?

A

Passively move hip from FABER into Ext + IR + Adduction

Anterior Labral Tear

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21
Q

What does FADIR test for?

A

Femoral Acetabular Impingement

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22
Q

What is C- Sign

A

Indicates possible FAI/Labral pathology

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23
Q

Where will someone point if SIJ is likely the problem

A

At PSIS (Fortin’s Sign)

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24
Q

How do you preform Hip Quadrant/ Hip Scour

A

Quadrant - Flexion/Abduction/ER -> Flexion Adduction/IR (Bring hip around the world)

Scour- Add compression

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25
Q

What is craigs test?

A

For femoral anteversion/retroversion

Palpate greater troch and find angle of leg off of parallel

normal is 10-15 of IR

15+ is Anteversion

<10 is retroversion

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26
Q

Altman’s clinical criteria for hip OA

5 components

A

Hip Pain

IR Less than 15

Pain with IR

Morning Stiffness up to 60 minutes

Age 50+

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27
Q

Sutlive CPR for Presence of Hip OA

5 components

A

Squatting increases symptoms

Scour test with adduction causes groin or lateral hip pain

active hip flex -> lateral pain

active hip ext -> pain

Passive hip IR less than 25 degrees

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28
Q

What is this improving?

What is the therapist doing?

A

Improving hip IR

Holding onto leg, adding PA mob to opposite SIJ

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29
Q

What motions is this helping?

A

ER/ABD

use when pt has positive FABER, but does not have reproduction of symptoms with treatment

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30
Q

Contraindications for manual therapy

A

Infection
Febrile state
Acute Circulatory condition
Malignancy
Open Wound
Fracture
Hematoma
Advanced DM
Hypersensitivity
Inappropriate end feel
RA (during exacerbation)
Cellulitis
Constant Severe Pain
Extensive Radiation of pain

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31
Q

3 signs of a positive Neurodynamic test?

A

Reproduces patient symptoms

Test altered by movement of distant bodypart

Test differences from side to sid e

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32
Q

Contraindication for neurodynamic mobilizations

A

Recent repaired nerve

Malignancy or any compression of nerve

Active Inflammatory conditions

Demyelinating diseases

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33
Q

Age 2-13

Gradual onset ache in hip

shorter limb

limited abd/ext

antalgic gait

A

Leg Calve Perthes

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34
Q

8-17

Gradual onset vague pain in hip

Shorter limb, usually obese, Quad atrophy, adductor spasm

Antalgic gait/ trendelenberg sign

A

Slipped Femoral Capital Epiphysis

Urgent care referral, they can walk into the ER on crutches themselves

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35
Q

30-50 year old

sharp pain/ pain with extreme motion in hip

decreased ROM

limping

A

Avascular necrosis

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36
Q

40+

Pain w/ weightbearing in hip

obese, joint crepitus

ROM: Limited, capsular pattern

A

Degenerative joint disease

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37
Q

50+ post menopause female

difficulty climbing stairs, sleeping on side

pain in hip

A

Gluteus Medius Tendinopathy/tear

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38
Q

How can a patient self-treat limited hip IR?

A

Rock back onto legs in quadruped with legs in slight IR

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39
Q

How to progress exercises for hip OA

A

Mobility -> Open chain exercises -> Close chain functional exercises

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40
Q

Valgus force damages:

Hyperext damages:

Dashboard injury damages:

Varus Force damages:

A

Valgus force damages: MCL

Hyperext damages: ACL

Dashboard injury damages: PCL

Varus Force damages: LCL

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41
Q

Deceleration/acceleration valgus force near extension or hyperextension

hear a pop

knee giving way

loss of end range ext

A

ACL

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42
Q

What is a segond fracture

A

(sign of ACL tear) Avulsion of LCL due to too much IR from tear of ACL

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43
Q

Cruciate ligaments limit _______

Collateral ligaments limit ______

A

IR

ER

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44
Q

What tests are for the ACL?

A

Lachmans

Anterior Drawer

Pivot Shift

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45
Q

What is the difference between lachmans and anterior drawer

A

Lachmans is better because of the knee angle being less bent, less guarding from hamstrings

46
Q

How is the MCL tested?

How is the LCL tested?

A

Valgus stress at 20-30 degrees knee flexion

Varus stress at 30 degrees of knee flexion

47
Q

What is the MOI for anteromedial rotary instability

What is the MOI for anterolateral rotary instability

How do you test for anteromedial instability

How do you test for anterolateral instability?

A

Valgus force with tibial ER motion

Valgus force with tibial IR motion

Anterior Drawer with ER

Anterior Drawer with IR

48
Q

What is the mechanism of posteromedial rotary instability

What is the mechanism of posterolateral instability

How do you test for posteromedial instability

how do you test for posterolateral instability

A

traumatic ext + IR

Traumatic ext + ER

Posterior drawer + IR

Posterior Drawer + ER

49
Q

What kind of injury presents with a varus thrust during gait

A

Posterolateral corner injury

50
Q

catching/locking in knee

injury with a twist mechanism

joint line tenderness

pain with forced knee hyperext or passive knee flexion

A

meniscus

51
Q

Criteria for Knee OA

A

Age 50+

Knee Crepitus

Palpable bony enlargement

bony tenderness to palpation

morning stiffness less than 30 minutes

no palpable warmth

52
Q

Criteria that hip mobs can help knee OA

A

Pain with ipsilateral hip distraction

ipsilateral knee flexion < 122

ipsilateral hip IR < 17

Pain or paresthesia in ipsilateral groin or hip

ipsilateral anterior thigh pain

53
Q

Pain with stair climbing, prolonged sitting, squatting

A

PFPS

54
Q

What test is often used for PFPS

A

Step down test

55
Q

Criteria for lumbopelvic manip to treat PFPS

A
  • Difference between sides of >14 IR in hip
  • Ankle DF > 16
  • Navicular drop > 3mm
  • NO reported stiffness in sitting for 20+ mins
  • Squatting reported as most painful activity

Probability of 94% with atleast 3/5

56
Q

What are the 4 stages of treating patellar tendinopathy

A

isometric loading

isotonic loading

energy storage

return to sport

57
Q

Overuse injury common after jumping and running sports

A

Patellar Tendinopathy (jumpers knee)

58
Q

whats the biggest risk factor for ankle sprains

A

BMI

59
Q

should you use ultrasound on chronic ankle sprains?

A

no

60
Q

Ottawa ankle rule

A

Tenderness at lat mal

Tenderness at med mal

inability to WB 4 steps after and in ER

61
Q

Ottawa foot rule

A

Tenderness at Base of 5th met

Tenderness at navicular tubercle

Inability to WB immediately after and in ER

62
Q

pt complains of burning, worsening with stretching the tissue

pt recently was in an acute injury or had vigorous exertion

A

compartment syndrome (emergent)

63
Q

How do PTs manage developing compartment syndrome

A

elevate extremity to the level of the heart

64
Q

Where is achilles tendinopathy most common

A

mid-substance

65
Q

Loss of arch height

forefoot abduction, rearfoot valgus

limited/painful plantarflexion

abnormal gait w/ decreased pushoff

A

Posterior tibialis tendon dysfunction

66
Q

Can we use isolated foot orthoses or ultrasound for plantar fasciitis?

A

no, evidence says not to use these

67
Q

What does the evidence say is the best treatment for plantar fasciitis

A

Manual therapy

stretching (of gastroc/soleus and the plantar fascia)

taping

night splints

68
Q

How much great toe ext do you need for gait

A

65-70

69
Q

How do we treat hallux rigidus

A

Toe mobilizations

(mob the same way the toe bends)

70
Q

Wells DVT Criteria

A

Active cancer within 6 months +1

Paralysis Paresis or recent immobilization +1

Recently bed ridden 3+ days +1

Localized tenderness amongst deep vein distribution +1

Entire lower extremity swollen +1

Calf swelling by 3+ cm compared to other LE +1

Pitting edema 1+

Collateral superficial veins 1+

Alternative diagnosis likely -2

3 or more = 75% chance

71
Q

What does the foot posture index look at?

A

How palatable different structures are to indicate if you have pronation or supination

scored -2 to 2
2 is pronated
-2 is supinated

72
Q

Can you MMT pronation and supination?

A

NO, dr arnold wants us to focus our tests on specific muscles and NOT motions

73
Q

What is this mobilization improving?

A

ER of fibula -> Increase dorsiflexion

74
Q

What joint is this mobilizing?

What motions are increasing for which direction?

A

Subtalar inversion/eversion

Mobilize in opposite direction of the motion

75
Q

Posterior-> anterior force applied here is improving what motion at the talocrural joint

A

Plantarflexion

76
Q

anterior -> posterior force applied to the talocrural joint is improving what motion at the talocrural joint

A

Dorsiflexion

77
Q

This is improving what motion?

A

Toe extension

78
Q

What are the 2 tests for a syndesmotic/high ankle sprain?

A

Fibular translation test

External rotation test

79
Q

How do you preform the fibular translation test?

A

Move distal tib-fib joint back and forth

should recreate symptoms of high ankle sprain

80
Q

How do you preform the external rotation test?

A

-knee flexed to 90
-externally rotate ankle

should recreate symptoms of high ankle sprain

81
Q

What test can you do to see if the ATFL is intact after lateral ankle sprain?

A

Anterior Drawer test for foot (Pull up on calcaneus)

preform with slight plantarflexion to stay in open packed position

82
Q

What test can you use to see if the CFL Ligament is intact from a lateral ankle sprain?

A

Medial Talar Tilt Test

Provide medial force at calcaneus while stabilizing malleoli

+ test is excess laxity

83
Q

How do you test for ankle impingement?

A

Forced Dorsiflexion test

Positive test = recreation of symptoms

84
Q

how do you gain motion at the proximal tibiofibular joint?

A

Proximal Tibiofibular manip:

-Check knee flexion PROM
-Bring a flat hand in pit of knee

ER tibia

Slow knee flexion to take up slack -> quick knee flexion

85
Q

How do you mob the distal tib-fib joint?

A

Provide A->P pressure to distal fib while stabilizing tibia

or turn patient prone and do a P->A mob

86
Q

What kind of manips can improve dorsiflexion

A

ER of the tibiofibular joint

Talocrural gapping

Talocrural anterior->posterior mob

87
Q

This is improving what?

A

Plantarflexion

88
Q

What is this improving

A

Dorsiflexion

89
Q

How do you improve inversion?

A

Stabilize talus, Mob calcaneus laterally

90
Q

How do you improve eversion?

A

Stabilize talus, mob calcaneus medially

91
Q

Pt has lateral foot pain and feels like there’s a pebble in their shoe

A

cuboid displaced inferiorly

Use cuboid whip or cuboid squeeze

92
Q

How do you preform the more aggressive dorsifleixon talocrural mob

A

Stabilize tibia, mobilize talus posteriorly

use thigh to increase dorsiflexion

93
Q

How do you preform “mobilization with movement” for dorsiflexion

A

mobilize talus back or mobilize tibia forward

94
Q

What are the 2 parts to thesslays test

A

closed chain rotation w/ 5 degree knee flex

closed chain rotation w/ 20 degree knee flex

95
Q

What is the correct position for the lateral patella apprehension test

A

position patient as shown

96
Q

High foot posture index score means:

Low score means:

A

Pronation

Supination

97
Q

How do you asssess achilles tendon integrety

A

Thompson test

squeeze calve and see if foot plantarflexes

98
Q

To increase dorsiflexion in close chain you either need to

_____________

or

______________

A

Push the talus back as the knee comes over the toes

or

pull the tibia forward with a belt as the knee comes over the toes

99
Q

what kind of foot is predisposed to tarsal tunnel syndrome

A

overpronation

100
Q

Pt has just sprained their ankle 1 day ago and now see’s you in the clinic? Would you recommend they temporarily wear a brace that immobilizing the joint to prevent re-injury

A

No

101
Q

You’re doing rehab for an achilles tendinopathy patient and you tell them it’s normal for the eccentric exercise to cause pain, but their pain doesn’t return to normal in 24 hours.. is this normal?

A

No you loaded them too much. Should always work within a pain level that returns to baseline in 24 hours. it is too early to eccentrically load this patient

102
Q

Pt has swelling at medial ankle and weakness with pushoff, what can we palpate to help diagnose the patient

A

posterior tib tendon

103
Q

What kind of boney abnormality will present as loss of IR in the hip?

A

Femoral Retroversion

104
Q

Pt is stiff in AM, better with activity, then worse in evening

A

OA

105
Q

Warm-up phenomenon w/ tendons/tendinopathy

A

Tendon hurts at beginning and end of activity (ex: running)

106
Q

Neutral + inversion tests =

Neutral + PF tests =

Neutral + DF tests =

A

CFL

ATFL

PTFL

107
Q

Manual therapy Criteria for LBP

A

No symptoms distal to knee
Less than 16 days of pain
Less than 19 FABQ
Atleast 1 hypomobile segment
1 hip with IR over 35

108
Q

Stabilization Criteria for LBP

A

Less than 40YO

Post partum

SLR 91+

Catch/abberant movements

Prone instability test

109
Q

When is the only time we prescribe patients with repeated motions exercises

A

If they have radiating pain

110
Q

How many SIJ provocation tests have to be positive to rule in SIJ?

A

3/5

111
Q

Important ankle sprain subjective Q: Do they have history of ____________

A

recurrent ankle sprains

it is the #1 predictor of future ankle sprains

MSK LQ (26 decks)

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