Ortho Special Tests > LE differentals > Flashcards

LE differentals Flashcards

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1
Q

MOI of lateral ankle sprain

A
  • inversion ankle injury
  • landed on the lateral side of the foot when running or jumping
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2
Q

Subjective of lateral ankle sprain

A
  • pt reporting landing on side of the foot
  • potential swelling and bruising
  • potentially painful wt bearing
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3
Q

objective for a lateral ankle sprain

A
  • decreased ROM or inversion and eversion limited by pain and edema
  • increased joint play with medial glides and PA glides
  • special tests: positive anterior drawer for ATFL and positive medial talar tilt for CTFL
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4
Q

treatment ideas for lateral ankle sprain

A

acute: pettrisagge for swelling, iso holds, elevation to decrease swelling
Sub-acute: restore ROM through Calf stretch and AP mob with movement, balance exercises, T band ankle 4 way

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5
Q

grade 1lat ankle sprain

A

pain and ATFL stretched no swelling and able to wt bear

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6
Q

grade 2 lateral ankle sprain

A

pain and ATFL and CFL partially torn, brusing and swelling, PWB

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7
Q

grade 3 lateral ankle sprian

A

full tear of the ATFL, CFL and PTFL, increased swelling and bruising, unable to wt bear

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8
Q

posterior tib tendon disfunction MOI

A

chronically stretched tendon leading to pain and dysfunction. common in people with flat feet as posterior tib supports the medial longitudinal arch

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9
Q

posterior tib tendon dysfunction subjective

A

pain on the posterior medial shin, medial malleolus, or near the navicular. pain with repetitive walking and activity

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10
Q

posterior tib tendon dysfunction objective

A
  • unable to do SLS without the arch collapsing
  • pain with PF and In
  • increased heel valgus
  • special test: positive jack test for a ridged arch
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11
Q

post tib tendon dysfunction treatment ideas

A
  • cross friction at tendon, T-band inversion and foot intrinsics
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12
Q

MOI planter faciitis

A

tightness of the planter fascia. usually an insidious onset

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13
Q

planter faciitis subjective

A
  • increased pain when waking up in the morning, with increased activity and prolonged sitting
  • pain on the heel and medial foot
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14
Q

planter faciitis objective

A
  • decreased DF ROM due to gastroc tightness
  • tenderness to touch the heel and medial foot
  • special test: positive windless
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15
Q

planter faciitis treatment

A

calf stretch with AP glides to increase DF ROM, toe intrisitcs, can roll to the bottom of the foot to increase vascularity

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16
Q

achillies tendon dysfunction MOI

A
  • eccentric loading of the tendon in DF and knee extension
  • common in runners and sprinters
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17
Q

achillies tendon dysfunction subjective

A
  • pain with walking
  • pain when lifting up to toes
  • swelling
  • increased pain in the morning that improves with activity
  • rupture: “feels like being shot in the leg”
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18
Q

achillies tendon dysfunction objective

A
  • tenderness along the tendon
  • pain with PF
  • pain with DF
  • gait: limited toe off, limited DF, valgus heel
    • tomptson test with a rupture
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19
Q

treatment of achillies tendon dysfunction

A

cross friction massage, calf stretch, concentric progressing to eccentric toe raises, towel calf stretch at home

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20
Q

MOI high ankle sprain

A

planted foot in DF and tibial ER

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21
Q

high ankle sprain subjective

A
  • pain and tenderness on anterior/lateral leg/foot
  • increased swelling a bruising
  • painful to wt bear
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22
Q

objective for high ankle sprain

A
  • tenderness to touch
  • decreased ROM in DF, inversion and eversion
  • increased joint play
  • special test: klinger, syndemosis squeeze, anterior drawer, medial talar tilt
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23
Q

treatment for high ankle sprain

A

pettrisage to reduce edema, iso holds for vascularization, elevate the foot to reduce edema

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24
Q

MOI medial meniscus tear

A
  • ER with running or during other activity
  • hit on the outside of the knee while foot is planter flexed
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25
subjective of a medial meniscus tear
- felt a pop or click at the time of injury - pain with knee flexion - feel unstable
26
objective of medial meniscus tear
- pain with knee flexion - decreased knee flexion ROM - special tests: positive mcmurrys with ER, positive thessilies, positive applys with compression
27
treatment for medial meniscus tear
- usually NWB post op - tibiofemoral distraction to get fluid into the joint space, AAROM hell slides to increase ROM, hip stabilization
28
MCL strain MOI
- foot planted with valgus force
29
MCL strain subjective
- feel unstable - knee giving out - pain and tenderness over medial knee - constant or persistent pain with increased pain with movement
30
MCL strain objective
- pain with palpation - special test: valgus stress at 30 and or 0
31
grade 1 MCL
tenderness to palpation but no laxity
32
grade 2 MCL
laxity at 30 degrees
33
grade 3 MCL
laxity at both 30 and 0 degrees with no end feel
34
treatment ideas for MCL sprain
cross friction, adduction strengthening, hip abduction strengthening
35
LCL strain MOI
planter flexed foot with varus force
36
LCL strain subjective
- pain on lateral knee - feel unstable - localized swelling
37
LCL strain objective
- tenderness to touch - increased joint play - special test: positive varus stress test. negative nobles compression for ITB
38
LCL strain treatment
cross friction, adduction strengthening, abduction strengthening
39
patellofemoral dysfunction MOI
insidious onset of pain due to potential lateral tracking issues
40
patellofemoral dysfunction subjective
- anterior knee pain - increased pain with increase in ground reaction forces ex running and jumping - pain with increases knee flexion
41
patellofemoral dysfunction objective
- mildly decrease in knee flexion due to pain - decreased patellar mobilization - special tests: negative sweep test, positive clarks test
42
treatment of patellofemoral dysfunction
patellar mobs with movement, eccentric loading of the quads (step downs), hip stabilization
43
donahues injury MOI
traumatic anterior and valgus force to the knee
44
donahues injury subjective
swelling, brusing, unable to wt bear pain and instability in all ranges
45
donahues injury objective
- increased joint play - decrease of ROM due to pain (empty end feel) - special tests: positive valgus stress test, positive lachmanns, positive anterior drawer, postive mcmurries with ER, positive thesislies, positive applys
46
treatment of donahues
- send to the doctor for imaging - post op: PROM into AAROM medial meniscus, efflarage , iso hold for vascularization, AAROM heel slides to increase ROM and imbibe the joint space elevate to reduce edema.
47
MOI of a medial HS strain
overstretch of the hamstrings with hip flexed and knee extended
48
Medial hamstring strain subjective
- feel a pull - painful to bend knee and extend the hips
49
medial hamstring strain objective
- pain with palpation - pain with resisted knee flexion and IR - pain with 90/90 - check for leg length discrepancy
50
treatment for medial HS strain
PNF with PROM into flexion and extension, HS AAROM, HS curls, HEP light HS stretch
51
FAI MOI
- sports with repeatitive end range hyperextension or hyper flexion combined with adduction - ideopathic tears for slipping and twisting injury
52
FAI subjective
- anterior hip pain - C sign - "clicking", "locking" or "catching" - 20-40 year olds - pain worse with prolonged sitting
53
FAI objective
- postive anterior hip impingement test - pain with FADIRS (CAM) - pain with extension and ER (pincer)
54
FAI treatment
distraction, PNF leg press, hamstring slides
55
Adductor strain MOI
overstretched of the adductors
56
Adductor strain subjective
- twisting and stabbing pain in the groin area with quick starts and stops - endema and eccymosis several days post injury - increased symptoms with running, kicking, single leg exervises, cutting and lunging
57
Adductor strain objective
- tingiling or stabbing pain in the groin area - symptoms aggrevated with passive abduction at different angles of hip flexion 0= gracillis 45= adductor longus and brevis 90= pectinuous
58
adductor strain treatment
PNF rhythmic initiation of hip adduction and abduction hip abduction stabilization adductor stretch at home
59
Piriformis syndrome MOI
tightness of the periformis that leads to impingement of the sciatic nerve
60
piriformis syndrome subjective
posterior hip pain with rediating symtpoms down posterior leg
61
piriformis syndrome objective
- pain with resisted ER - pain with passive IR - special test: positive fadirs and fair test
62
piriformis treatment
- soft tissue message of the pirifomis - pnf hond relax into fadirs - piriformis stretch at home
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