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OS > Upper and Lower Extremity > Flashcards

Upper and Lower Extremity Flashcards

1
Q

Ulnar ABduction

A
  • pt in seated position w/ elbow extended (not locked) hand in supination
  • apply valgus force: pushing on lateral elbow jt apply medial translational force
  • counterF on wrist on medial wrist laterally
  • note hard or soft end feel
  • SD described as ease of motion towards ulnar ABduction, w/ restriction towards ulnar ADduction
  • perform bilaterally
  • documented in objective of SOAP as ulnar ABduction SD
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2
Q

Ulnar ADduction

A
  • pt seated w/ elbow extended (not locked), hand supinated
  • apply varus force on elbow (ulnohumeral joint): contact medial elbow w/ lateral translatory force
  • push on lateral wrist medially (counterF)
  • note hard or soft endfeel
  • SD as ease of motion in ADduction w/ restriction to ulnar ABduction
  • perform bilaterally
  • documented in objective of SOAP as ulnar ADduction SD
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3
Q

Radial Head Motion: Posterior Glide

A
  • dr. facing seated pt.
  • contact radial head b/n thumb and index finger w. one hand and stabilize wrist w/ other hand
  • apply posterior glide to radial end
  • note end feel
  • assess forearm protonation in conjuction w/ posterior glide, noting restriction and ease of motions
  • posterior radial head SD will have ease of motion to posterior glide and forearm protonation w/ restriction to anterior glide and supination
  • perform bilaterally
  • documented in objective of SOAP as posterior glide SD
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4
Q

Radial Head Motion: Anterior Glide

A
  • dr. facing seated pt
  • stabilize wrist w. one hand grasp radial head b.n thumb and index finger w. other hand
  • apply anterior glide noting end feel
  • assess supination and note ease/restriction of motion
  • state anterior glide radial head SD will have ease of motion to anterior glide and supination and restriction to posterior glide and protonation
  • perform bilaterally
  • document in objective portion of SOAP as anterior radial head SD
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5
Q

Wrist Flexion

A
  • dr. facing seated pt.
  • contact pts. hand and grasp radius ulna w. other hand
  • place wrist into flexion and extension noting freedom of motion in posterior glide w/ restriction of carpals to anterior glide
  • state wrist flexion coupled with freedom of motion in dorsal glide of carpals
  • perform bilaterally
  • document in objective of SOAP as writst flexion/posterior carpal glide SD
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6
Q

Wrist Extension

A
  • dr. facing seated pt
  • place wrist into extension stabilizing wrist w/ other hand
  • state freedom of motion in extension and restriction to flexion
  • coupled with extension is freedom in the anterior/ventral glide of the carpals
  • perfrom bilaterally
  • documented in the objective of SOAP as wrist extension/ anterior carpal glide of SD
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7
Q

ABduction of Wrist

A
  • dr. facing seated pt
  • arm in supination, abduct wrist (radial deviation) and adduction (ulnar deviation) notion freedom of motion in abduction and restriction in adduction
  • perform bilaterally
  • documented in objective of SOAP as wrist ABduction SD
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8
Q

ADduction of wrist

A
  • dr facing seated pt
  • one hand place wrist into adduction (ulnar deviation) other hand stabilize distal radius/ulna
  • note freedom in adduction and restriction to abduction (radial deviation)
  • perform bilaterally
  • documented in objective of SOAP as wrist adduction ( ulnar deviation) SD
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9
Q

Finger ABduction

A
  • dr. facing seated pt
  • hand in supination
  • perform on all digits EXCEPT thumb
  • apply force to move distal end of jt away (contact proximal phalanx) from midline (long finger/3rd digit) and towards midline (ADduction) while stabilizing distal metacarpal
  • state ease of motion into ABduction and restriction to adduction
  • perform bilaterally
  • documented in objective of SOAP sepcific to laterality, # of digit, and jt being passive moved eg: right 2nd metacarpophalangeal joint ABduction SD
    *
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10
Q

Finger ADduction

A
  • dr. facing seated pt, w/ forearm in supination
  • contact distal metacarpal w/ one hand and proximal phalanx with other hand
  • move distal end of jt away from midline and toward midline
  • stating ease of motion toward midline (ADduction) and restriction of motion away from midline (ABduction)
  • perform on all 4 lateral digits
  • perform bilaterally
  • noted on objective in SOAP as # finger, laterality, jt and ADduction SD eg: right 2nd metacarpophalangeal jt ADduction SD
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11
Q

ABduction of Thumb

A
  • dr. facing seated pt
  • hand in supination
  • contact distal metacarpal of thumb and proximal phalanx of thumb
  • ABduct distal joint in anterior and posterior direction
  • ease of motion in ABduction of joint and restricted to ADduction
  • perform bilaterally
  • noted in objective of SOAP as thumb ABduction SD
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12
Q

Finger Flexion

A
  • dr. facing seated pt
  • contact distal metacarpal and proximal phalanx
  • apply force to distal end of jt into flexion
  • state ease of motion toward flexion and restriction of motion to extension
  • perform bilaterally and all 4 lateral digits
  • noted in objective of SOAP as right 2nd MCP flexion dysfunction
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13
Q

Finger Extension

A
  • dr facing seated pt w/ hand supine
  • contact distal metacarpal and proximal phalanx of digit
  • apply force on distal jt placing finger into extension
  • perform on all four lateral digits
  • perform bilaterally
  • noted in objective of SOAP note eg: right 2 metacarpophalangeal extension SD
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14
Q

GH jt

A
  • dr. contact olecranon while blocking linkage at shoulder region
  • passive flexion: 180
  • passive extension: 60
  • passive ABduction: 180
  • passive horizontal ADduction: 40-50
  • passive external and internal rotation: 90
  • contact proximal humeral to assess anterior/inferior glide and posterior/superior glide passively
  • perform bilaterally, noting for asymmetries
  • name SD found at GH jt
  • noted in objective of SOAP as GH SD
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15
Q

AC jt

A
  • dr. facing seated pt
  • contact AC jt and palpate for tenderness and tissue texture changes
  • bring GH into 60 coronal ABduction and 60 horizontal ABduction to max. AC jt motion
  • maintain the position, student assess rotational aspect of AC jt by internally and externally rotating GH jt
  • perform bilaterally, assessing for asymmetries
  • name internal or external AC SD based on ease/restriction of motion
  • noted in objective of SOAP as AC jt SD
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16
Q

SC jt Flexion/Extension

A
  • pt supine, fingers placed bilaterally anteriorly in clavicular head (lateral to sternum)
  • pt flex shoulders to 90 and then reach toward the ceiling
  • proximal clavicle moves posterior as pt reaches toward ceiling as distal clavicle moves anteriorly
  • pt returns shoulders back to neutral (horizontal extension) states proximal clavicle moves anterior and distal clavicle moves posterior
  • perform bilaterally they can assess for asymmetries
  • horizontal extension SD w/ restriction to horizontal flexion is most common
  • noted in objective of SOAP as SC SD
17
Q

SC jt ABduction and ADduction

A
  • pt lays supine
  • place index fingers of both hands on superior aspect of clavicle heads
  • ask pt to shrug shoulders (ABduction)
  • states proximal end of clavicles move inferiorly and distal clavicles moves superiorly as you shrug
  • as pt moves shoulder back into neutral (ADduction) states proximal end clavicle moves superiorly and distal end of clavicle move inferiorly
  • perform bilaterally, assessing for asymmetries
  • noted in objective of SOAP as SC jt SD
18
Q

Scapulothoracic jt

A
  • pt in lateral recumbent facing dr
  • contact inferior angle of scapula w/ caudad hand and the acromion w/ cephalad hand
  • perform scapular elevation: upper trapezius and levator scapulae M
  • scapular depression: lower trapezius and lower rhomboids
  • scapular protraction: serratus anterior
  • scapular retraction: rhomboids and middle trapezius
  • upward rotation: serratus anterior adn upper trapezius
  • downward rotation: levator scapulae and rhomboids and latissimus dorsi
  • perform bilaterally assessing for asymmetries
  • name SD
  • noted in objective of SOAP as ST SD
19
Q

Anterior/Posterior lateral malleolus

A
  • pt supine w. knee flexed and foot flat
  • contact lateral malleolus w/ thumb and index finger of one hand
  • apply anterior and posterior force assesing gliding motion
  • note asymmetry
  • ease of posterior glide w/ anterior glide restriction => posterior glide lateral malleolus SD
  • noted in objective of SOAP w. laterality noted
20
Q

Talus evaluation

A
  • pts supine, dr facing
  • contact foot and apply passive force to place ankle into dorsiflexion (15-20) and plantarflexion (50-65)
  • motion occuring be/n talus and tibia/fibula
  • talus plantar flexion SD: ease of motion for plantar flexion and restriction to dorsiflexion
    • vice versa
  • noted in objective of SOAP w laterality
21
Q

Calcaneus evaluation

A
  • pts supine, dr. standing at foot of table
  • ankle placed in standing position ( slightly dorsiflexed putting ankle into 90) to avoid excess laxity in subtalar jt
  • contact calcaneus apply passive inversion to 35 and eversion to 20
  • states motion b.c talus and calcaneus (subtalar jt) called subtalar motion
    • 10 for subtalar inversion and eversion
  • calcaneus inversion SD: ease of motion for inversion and restriction towards eversion
    • vice versa true for calcaneus eversion SD
  • noted in objective of SOAP noting laterality
22
Q

Navicular evaluation

A
  • pt supine, dr at foot of table
  • contact navicular w/ thumb and index finger
  • apply passive force for dorsal and plantar gliding
  • state motion should demonstrate symmetry
  • dorsal navicular SD: ease of motion to dorsal gliding and restriction to plantar gliding
    • vice versa true for plantar navicular glide SD
  • common to have plantar glide SD
  • dorsal navicular associated w/ tight plantar fascia
  • noted in objective of SOAP w. laterality
23
Q

Cuboid evaluation

A
  • pts supine, dr at foot of table
  • contact cuboid bone b/n thumb and index finger
  • apply passive dorsal and plantar gliding motion
  • stating motion should be symmetric
  • plantar cuboid SD= ease of motion to plantar glide and restriction to dorsal glide
    • vice versa true for dorsal cuboid SD
  • noted in objective of SOAP w. laterality
  • more common to have plantar glide cuboid SD**
  • plantar cuboid associated w/ posterior fibular head***
24
Q

cuneiform eval

A
  • pt supine, dr at foot of table
  • contact cuneiform b/n thumn and index finger
  • apply plantar and dorsal glide noting ease and restriction
  • state symmetry for both glides is normal
  • name different SD
  • more common to have plantar cuneiforms SD***
  • noted in objective of SOAP w. laterality and specified cuneiforms (1-3)
25
Q

Metatarsal eval

A
  • pts supine, with dr at foot of table
  • contact distal metatarsal w/ thumb and index finger
  • block linkage at neighboring metatarsals w/ other hand
  • apply plantar and dorsal gliding motion noting ease and restriction
  • name different SD possible
  • state symmetry normal
  • more common to have plantar SD***
  • noted in objective of SOAP w/ laterality and metacarpal # specified
26
Q

Metatarso-phalangeal eval

A
  • pt supine, dr at foot of table
  • contact MTP jt w/ thumb and index finger
  • block linkage at metatarsal head w/ other hand
  • apply force for dorsi/plantarflexion, ABduction/ADduction, internal/external rotation
  • state motion should normally by symmetrical
  • name all possible SDs (6)
  • noted in objective of SOAP w. laterality and # of jt
27
Q

Hip jt flexion/extension

A
  • pt supine, dr. facing pt
  • passive flexion and block linkage noting 90 ROM
  • assess bilaterality
  • hip extension w/ pt in prone, block linkage noting 15-30 ROM
  • assess bilaterality
  • state possible SDs
  • noted in objective of SOAP w. laterality
28
Q

Internal/ External rt of hip jt

A
  • pt supine, hip and knee flexed 90 OR prone w. knee flexed 90
  • apply passive internal rotation noting 30-40 ROM and block linkage
  • assess bilaterality
  • apply passive external rotation notive 40-60 ROM and block linkage
  • assess bilaterality
  • for prone pts external rt linkage at ipsi GLUT and interal rt linkage at contra PSIS
  • name possible SDs
  • noted in objective of SOAP w. laterality
29
Q

ABduction/ADduction hip jt

A
  • pt supine, dr at foot of table
  • passive ABduction noting 45-50 ROM
  • passive ADduction noting 20-30 ROM
  • name possble SDs
  • noted in objective of SOAP w. laterality
30
Q

internal/external rt of knee jt

A
  • pt supine, dr. same side as side being assessed OR prone w/ knee flexed to 90
  • hip and knee flexed to 90
  • student assess passive internal rt. of tibia noting 10 ROM
  • passive external rt. noting 10 ROM
  • assess bilaterally
  • movements are in relation of tibia to distal femur
  • name possible SD s
  • noted in objective of SOAP w. laterality
31
Q

ABduction/ADduction of knee

A
  • pt supine, stand at side being assessed
  • ADduction: contact lateral distal femur and medial ankle: apply VALGUS force assessing for ease/restriction
  • assess bilaterally
  • contact medial distal femur and lateral ankle apply: VARUS force assessing for ease/restriction
  • assess bilaterally
  • state possible SDs
  • noted in objective of SOAP w. laterality
32
Q

proximal fibula eval

A
  • pt supine, stand at side being treated
  • knee flexed, foot flat on table (can also perform w. knee extended)
  • contact fibular head w/ thumb and index finger
  • apply anterior and posterior gliding force
  • assess bilaterally
  • note eases and restriction stating possible SDs
  • noted in objective of SOAP w. laterality

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