MSK Practical Flashcards

Question

Slump Test

Answer 1

-test neuromobility 1. Hands behind back 2. Head and neck flexed 3. Lumbar flx 4. Straighten knee 5. overpressure 6. DF of ankle 7. Pt moves head

Answer 2

-Neurological s/s -Antalgic Postures -Active or passive mmt Dysfunction -Tenderness to palpation over superficial neural tissues

Answer 3

-Recent repair -Malignancy -Active Inflammatory Disorders -Acute Inflammatory Demyelinating Disorders

Answer 4

-irritable conditions -SC signs -Nerve root signs -Severe night pain w/ no Dx -recent paresthesia or anesthesia -Mechanical spine pain w/ peripheralization s/s

Answer 5

-load opposite ends of nerve -both "on" or "off" -when glides no longer help ex: head flx and ankle DF, the head ext and ankle PF

Answer 6

-load one end of nerve while relieving stress on opposite end - 1 "on" and 1 "off" then switch ex: head flx and ankle PF, the head ext and ankle DF

Answer 7

-load opposite ends of nerve and hold -7-30s -both "on" or "off" -most agressive ex: head flx and ankle DF (hold), the head ext and ankle PF (hold)

Answer 8

Pain: location/movement, MOI/onset, time, description, behavior, intensity, better/worse, 24h bahavior Pt Demopgraphics: age, race, hobbies, work, participation, impact of s/s, psychosocial considerations General Health: Prior Hx, Co-morbidites, surgeries, Pregnancies, Medications Red Flag Qs: Neural involvement, fracture, infection, cancer (Constant pain, intense pain, weight loss), AAA

Answer 9

Flexion: 70-90 Extension: 40-50 Rotation: 20-40 LSB: 25-35

Answer 10

1. Subjective Hx 2. Scan/Not (neuro, no MOI, not MSK) 3. Observation 4. ROM 5. Strength 6. Special Tests 7. Repeated Measures (if needed)

Answer 11

-Dx of exclusion S/s: -hx of trauma so SIJ or glute -pain around SIJ or piriformis -worse with lifting, sitting -palpable tension -+ SLR -(+) provocation pain -(+) LE paresthesias -Glute atrophy

Answer 12

-trauma or MOI -Acute pain -(-) SLR -(+) compression test

Answer 13

-separation of inner layers -LBP or referred hip pain -(-) SLR

Answer 14

-contained -some AF and PLL intact -LBP or referred hip -pain with cough or sneeze -(-) SLR

Answer 15

-uncontained -LBP -Pain with cough/sneeze -True Sciatica (radicular pain) -(+) SLR

Answer 16

-narrowing spinal canal (vascular or neurogenic) -congenital development or acquired S/s: butt pain, limping, lack of sensation, dec walking ability Central: -spinal canal dec -claudication, butt pain Lateral: -narrowing of facets -can impinge nerve roott

Answer 17

-hypomobility at a facet joint S/s: -localized pain -specific AROM deficits -hyper mobility at another level Tx: -manual therapy > mobility > strengthening

Answer 18

-loss of passive restraints to movement -lack of NM control S/s: -catching in back -inconsistent symptoms -(+) Prone instability Tx: -strengthening/stabilization -recurrence is common

Answer 19

CPR: -No sx distal to knee - <16 days (acute/subacute) -FABQ score <19 (fear avoidance beliefs) -1 hypomobile segment -1 hip >35deg internal rotation (loss of ER) Tx: -HVLAT -ROM

Answer 20

CPR: - <40 yrs old - Post parum/SLR >91 deg (flexible) - Instability catch or aberrant movements during flx/ext -(+) Prone instsbility test -Postpartum: (+) posterior pelvic pain provocation, ASLR, mod Trendelenburg OR Pain w/ palpation of long dorsal SI ligament or pubic symphysis Tx: -isolated contraction of deep stabilizers (TA, Multifidi) -Strengthen large spinal stabilizers (ES, Obliques) -Hooklying to Side Plank

Answer 21

CPR: -Sx distant to Butt -Sx centralize with extension -sx peripheralize with flexion -directional preference for extension (standing/walking) Tx: -End range exetnsion -mobilize to promote extension -Avoid flexion

Answer 22

CPR - >50yrs -Directtional preference for flexion -Lumbar Spinal stenosis Tx: -mobilize or manip spine -strength and flexibility exercises -body weight supported treadmill

Answer 23

CPR -visible frontal plane shift -directional preference for lateral translation movements Tx: -exercises to correct shift (manual glide from PT or leaning on walls) -traction

Answer 24

CPR -Sx decrease w/manual or auto traction *don't respond to anything else* *(+) Crossed SLR * *Peripheralization of multipple directions*

Answer 25

-Serious pathology -fracture* -lack of skill -Ligament rupture* -No working hypothesis -Worsening neuro function* -Unremmitting night pain* -Severe multi directional spasms -UMN Lesions*

Answer 26

Note: -abnormal postural sway -assistance -Sx -side ot side diff -(+) Trendelenberg Sign -Poor balance (<30s)

Answer 27

Note: -depth -assistance -Sx -side ot side diff -(+) Trendelenberg Sign -Poor balance (<30s)

Answer 28

-Lifting -Squatting -Bending -Twisting -assess quality and duration of movement prior to pain

Answer 29

-Radiating S/s ONLY Extension: 80% -prone to standing -10 reps -want centralization Flexion: -Supine to standing -10 reps -want centralization

Answer 30

-muscle endurance and strength test -stopped at 4 mins if continue 5: hands across chest 20-30s) 4: Hands at side (15-20) 3: Hands at siide (10-15) 2: Hands at side (1-10)

Answer 31

-muscle endurance and strength test 5: hands behind neck (20-30s) 4: Hands crossed on chest (15s) 3: Arms straight (10-15) 2: Hands straight toward knees (1-10) 1: Unable to raise more than head

Answer 32

-Psoas -Rec Fem -Piriformis (>90 IR) -Hamstring

Answer 33

-Neuroprovocation Test -tests femoral nerve 1. Pt prone 2. PT papssively flexes knee 3. (+)= S/s 80-100 degs 4. (-) - Absense of s/s -<80 deg knee joint dysfunction ->100 deg RF or spine dysfunction

Answer 34

-hypo, hyper, normal Central (CPA): -palpate SPs -pisiform and push -INCLUDE SACRUM Unilateral (UPA): -palpate opposite TP -Thumbs and push

Answer 35

-when you suspect instability -hypermobile joint play 1. Pt in prone with legs off 2. Relaxed, PT push on symptomatic joint segments 3. if painful, have Pt lift legs and push again -(+): pain gets better 4. Repeat on each hypermobile section from joint play

Answer 36

-for intermittent claudication****** -bike or walking 1. Start upright and time until Sx occur 2. Stoop until Sx occur (+): Sx improve w Stopped posture (takes longer to produce)

Answer 37

-for non-organic Sx -need 3 or +/5 1. Stimulation -gently compress head, Pt response -trunk rotation at hips, Pt response 2. Regional -sensory weakness or weakness in whole area and not pattern 3. Tenderness -superficial brush on skin in non-surgical area 4. Distraction -look for inconsistencies -SLR: distraction no response, response when brought to their attention -Bending -Limping 5. Over-Reaction -less reliable

Answer 38

1. Pt Sidelying 2. Palpate L5-L4 3. Flex sup leg until movement at L5 4. Rotate Arm/trunk until Movement at L3 5. Rotate in opposite directions *add HVLAT for manipulation*

Answer 39

1.Pt Supine 2.Banana shape with Pt on outside of curve 3.Roll trunk toward PT 4.Place resistance on opp ASIS 5. Rote in opposite directions *add HVLAT for manipulation*

Answer 40

1. Pt Sidelying 2. Palpate L5-L4 3. Flex sup leg until movement at L5 4. Rotate Arm/trunk until Movement at L3 5. Rotate in opposite directions 6. Have Pt try to unwind against PT -hold for 6 sec, relax, go further

Answer 41

*Opening on down side* 1. Pt Sidelying 2. Palpate L5-L4 3. Flex BOTH legs until movement at L5 4. Rotate Arm/trunk DOWN until Movement at L3 (flexion bias) 5. Lift BOTH legs 6. Ask Pt to gently push into hands -hold for 6s, relax, go further

Answer 42

*Closing on up side* 1. Pt Sidelying 2. Palpate L5-L4 3. Flex SUP leg until movement at L5 4. Rotate Arm/trunk UP until Movement at L3 (extension bias) 5. Lift SUP leg 6. Ask Pt to gently push into hands -hold for 6s, relax, go further -might not be great IR

Answer 43

-Pt in hooklying -PT pushes against medial knees to resist add the switch to resisit abduction (can use chest) -Pt pushes against for 3 seconds 3x

Answer 44

-Instability (Stabilization) -Hypomobility (Manual Therapy) -Piriformis Syndrome -Disc Pathology -Spinal Stenosis -Foraminal Stenosis -Facet Dysfunction

Answer 45

-Fortin Sign: pain over PSIS** -Pain with transitional movements** -Pain with SLS activities** -Pain at end range of Active SLR -Prolonged sitting/standing -(-) Neuro -No s/s below knee

Answer 46

Innominate Rotation -anterior rot on one side and posterior on the other -ASIS OR PISIS different heights and superficialness Upslip -ASIS, PSIS, ISCH tub ALL up on one side -leg forced up Downslip --ASIS, PSIS, ISCH tub ALL down on one side -rare -leg pulled down Pubic Lesion -superior or inferior Tx: -manual -core exercises MOI: -unilateral forces -falls -back lifting -swinging

Answer 47

S/s: -pain in post sacrum or groin -radiating into thigh -increase SLS pain -Turning in bed pain -lumbar extension painful -(+) SI stress tests -(+) Compression test with SI Belt Tx: -NSAIDs, ice, core exercises and LE exercises

Answer 48

-suspect hypermobility or nothing from other tests Form Closure: -assessed 1st with ASLR -passive stability malfunction (joint shape, ligaments, bony stability) -Tx: SI Joint compression belt Force Closure: -assessed 2nd with ASLR -active stability malfunction (muscles and fascia) -Tx: core stabilization exercises

Answer 49

S/s: -persistent low back pain into butt and thigh -(+) pain provocation of piriformis -(+) pain w/ sitting or squatting -persistent hip ER -Difficuly lying -(+) LE paresthesias Tx: manual, stretching, core exercises

Answer 50

1. Do Hip and/or Lumbar Exam 2. Confirm Presence of SIJ dysfunction with Provocation 3. Determine side of Hypomobiltiy (mobility/functional tests) 4. Determine Pathology 5. Determine if Form or Force are a component 6. Select Intervention (treat lumbar or hip dysfunction first, then SIJ hypomobility first)

Answer 51

(+) pain with coughing and sneezing Decreased pain with walking

Answer 52

(-) pain with coughing and sneezing (+) pain with extention or flx (+) pain with PA joint glides

Answer 53

(+) Trendelenburg signs (+) Pain or decreased ability to squat (+) Sign of buttock test

Answer 54

(+) Fortin's Sign (+) Joint gapping or compression tests (+) TTP at SI ligs (+) Pain/weakness with SLS

Answer 55

-foam roll -AROM -Stretches

Answer 56

-AROM -Spinal Stability -Pelvic Floor Strength** -Glute Strength**

Answer 57

1. Pt flexes hip and crease is where bottom of belt will go 2. Middle seam goes in mid back 3. Pull belt traps snugly 4. Pt exercises or performs ADLa for s/s reduction *belt goes on skin*

Answer 58

-Hypomobility -Joint Arthritis -Pelvic Girdle Instability -Piriformis Syndrome

Answer 59

-statistically the best -reproduce pain -FABER -Distraction -Compression -Thigh Thrust -Sacral Thrust -Gaenslen's Test

Answer 60

-Questionable reliabiliy/validity -Iliac Crest Height -ASIS Height -PSIS Height -Isch Tub Height

Answer 61

-questionable reliability/validity -More movement=Hypomobile segment -Standing Flexion Test -Seated Flexion Test -Stork Gilet Marching -Supine to Long Sit Test

Answer 62

1. Do Hip and/or Lumbar Exam 2. Confirm Presence of SIJ dysfunction with Provocation 3. Determine side of Hypomobiltiy (mobility/functional tests) 4. Determine Pathology 5. Determine if Form or Force are a component 6. Select Intervention (treat lumbar or hip dysfunction first, then SIJ hypomobility first)

Answer 63

-pain localized with one finger over PSIS ->2 times

Answer 64

-provocation tests -anterior SI joint stress test -push on ASISs (+) Reproduction of s/s

Answer 65

-provocation tests -in sidelying press down on hip -painful side up (+) Reproduction of s/s

Answer 66

-provocation tests -Palapate sacrum -apply force downward over S3 -repeat multiple times (<6) (+) Reproduction of pt pain over SIJ or posterior ligs

Answer 67

-provocation tests -Thomas Test position, testing leg down -flex non-testing leg and assess s/s -PT presses top leg into flx and bottom into ext (+) reproduction of pt pain at SIJ or pubic symphysis

Answer 68

-provocation tests -pt supine, PT on ipsi side of leg -hip in flx, ER, abduction -press into contra ASIS and knee (+) reproduction of pt pain at posterior pelvis or butt

Answer 69

-provocation tests -PT on contra side of testing leg -PT hand under sacrum -Pt hip flx and adducted -PT pushes hip past sacrum (+) reproduction of pt pain at SIJ

Answer 70

1. Compression 2. Distraction 3. Sacral Thrust* 4. Gaeslen Test 5. Thigh Thrust 3 or more/5 (+) = dysfunction

Answer 71

1. Compression 2. Distraction 3. FABER* 4. Gaeslen Test 5. Thigh Thrust 3 or less /5 (+) = no dysfunction

Answer 72

-provocation tests -PT uses heel of hand 1 superior aspect of pubic ramiu and 1 hand at inferior -slow downward opposite pressure -switch sides (+) reproduction of pain over pubic symphysis or anterior pelvis

Answer 73

-provocation tests -sign of serious pathology (hip absess, fracture, infection, cancer) -nerve on slack and pain still there 1. Passive SLR (+) 2. Return to neurtral and bend hip and knee 3. Passive bent leg raise (+) and same ROM

Answer 74

-ASIS -PSIS -Pubic Tubercle -Sacral Base Depth -Inferior Lateral Angle -Isch tubs

Answer 75

-Mobility/functional test -Pt seated -PSIS found then Pt bends over -PSISs should move superiorly equally -rules out Leg length diff or hamstring tightness** (+) Don't move equally, affected (hypomobile) side moves more than unaffected

Answer 76

-Mobility/functional test -Pt supine -palpate medial malleoli on both ankles -Pt sits up, Med mals should come down equally (+) malleoli don't move equally longer limb= posterior innominate Shorter limb= anterior innominate

Answer 77

-Mobility/functional test -Pt standing -PSIS found then Pt bends over with knees extended -PSISs should move superiorly equally (+) Don't move equally, affected (hypomobile) side moves more than unaffected

Answer 78

-mobility/functional test -Pt in standing with testing leg down and opp hip flexed -P palpates PSIS and contra sacrum -Pt flexes opp hip -PSIS should move inferiorly to sacrum (+) PSIS doesn't move inferiorly to sacrum (hypomobile) OR causes SI joint pain

Answer 79

Form Closure Test Step 1. Pt actively lifts leg (+) reproduces SIJ pain OR abberant movements during *1 must be positive to move on to 2 and 3* Step 2: PT compresses pelvis laterally and Pt lifts leg (+) Pt has less pain OR fewer abberant movements -Tx: SI compression belt Step 3: Pt contracts core then lifts leg -PT can reisist contra shoulder to help (+) Pt can perform ASLR with less pain OR few abberant movements Tx: stabilization exercises

Answer 80

1. Pt sidelying with hips flexed 90 deg, shoulders stacked ( PT behind pt) 2. Pt rotated by pulling "table arm" across Pt 3. Pelvis remains stable with PT hand 4. Pt then rotated more to take up slack while pushing hip medially 5. Quick thrust to manip,

Answer 81

-2 person technique -Pt prone with legs off table in closed packed (ext, abd, IR) -PT grabs affected LE and lifts up and out -other PT stabilizes sacrum -PT takes of slack on leg then quickly pulls

Answer 82

-Palapate sacrum -assess glide of sacrum -apply force downward over base (counternutated) or apex (nutated)

Answer 83

-Pt prone with unaffect LE relaxed or off table -PT extends affected legwhile stabilizing ipsi PSIS -Mobilize joint into anterior rotation if stuck in posterior -maintain extension

Answer 84

-Pt supine with hips and knees flexed -PT puts hand on ipsi knee and contra posterior thigh -Simultaneously push into flexion and extention -Pt reissts for 6 sec -Resist flexion: brings pelvis ant -Resist extension: brings pelvis post *brings both sides closer together*

Answer 85

-synovial joint -Designed for stability and less mobility -Convex head of femur and concave acetabulum -Femoral head faces Medially, anteriorly, superiorly Resting Position: Flx 30, Abd 30, Slight ER Closed Packed: Full ext, IR, ABD Capsular Pattern: Flx, Abd, IR (sometimes IR first)

Answer 86

Flx: 110-120 Ext: 10-15(20) IR: 30-40 ER: 40-60 Abd: 30-50 Add: 25-30

Answer 87

Flexion: sup spin, post glide Extension: inf spin, ant glide Abd: inf glide, med glide Add: sup glide, lat glide IR: posterior glide ER: anterior glide

Answer 88

Age: 2-13yrs -avascular necrosis -Males > S/s: -gradual onset, ache in hip, thigh, knee Observation: -short limb -higher g troch -quad atrophy -adductor spasm -antalgic gait ROM: -limited abduction -ext Intervention: -ROM and positioning

Answer 89

Age: 10-17 yrs males, 8-15yrs female -ice cream falling off cone -Male> S/s: -gradual onset -vague pain in knee, suprapatellar, thigh and hip Observation: -short limb, usually obese, quad atrophy -adductor spasm -hip abducted and ER ROM: -limited IR, abd, flex Gait: antalgic acutely, Trendelenburg chronically

Answer 90

-do you have hip OA? 1. Hip pain 2. IR <15deg 3. Pain with IR 4. Morning stiffness up to 60min 5. Age >50yrs

Answer 91

-what are the odds you have hip OA 3/5 present= 68% 4/5 present= 91% 1. Self-reported squatting is aggravating 2. SCOUR test w/ ADD causes groin or lat hip pain 3. Active hip flx causes lat pain 4. Active hip ext causes hip pain 5. Passive hip IR less than or equal to 25deg

Answer 92

->50yrs -hip pain Observation: -decreased stance time -morning stiffness -painful squatting ROM: -Dec IR -Decreased >2 planes of motion -flex causes latt pain

Answer 93

-inflammation of pubic tubercles -during surgery or pregnancy

Answer 94

-gradual onset; overuse -Ober's test S/s: -lat hip, thigh, knee pain -snapping IT band over greater troch Tx: -activity modification -stretching -footwear

Answer 95

-pain over greater troch w/ resisted abd -pain on greater troch

Answer 96

-Brittany spears -gradual onset, obese, pregnancy S/s: -pain and paresthesia of ant lat thigh -lateral femoral cutaneous Tx: Nerve glides

Answer 97

-post menopausal, >50yrs -Aggravating factors: stair climbing and sleeping on side -muscle wasting Diffx: -troch bursitis -hip OA Testing Cluster: -FABER -external de-rotation tests -palpation of glute med -SLS -Load dependent pain Tx: 1. isometrics 2. Isotonics 3. Energy Storage 4. Sport Specific

Answer 98

-FAI, labral pathology Cam Impingement: -related to femoral head and neck morphology -early contact -damages labrum Observations: Anteversion, coxa vara Pincer Impingement: -acetabular abnormalities Observations: retroversion Pain locations: -Anterior-medial: flx/IR positioning -Posterior: flx/abd/ER positioning (ischtub pain)

Answer 99

-not on Xray -unable to passively rotate hip -Patella Percussion Test ROM: cannot passively rotate hip

Answer 100

-30-50yr -Male> S/s: -50% sharp pain, 50% intermittent -Limp gait ROM: -decreased

Answer 101

->40yr -Female> -insidious onset, pain with weight-bearing Observation: -often obese -joint crepitus -muscle atrophy of glutes ROM: limp Radiographic: increased density, osteophytes

Answer 102

-H/o LBP -Hip problems as a child -Clicking/popping/catching (w/ or w/o pain) -OA -Surgical Hx

Answer 103

1. Hx 2. Observation 3. Gait/Squat/SLS 4. Scan/Not 5. Hip ROM > Back ROM > Knee ROM 6. MMT 7. Flexibility 8. Joint Play 9. Palpation 10. Special Tests

Answer 104

-OA -Avascular Necrosis -Degenerative Joint Disease -Legg-Calve-Perthes -SCFE -Stress Fx -FAI -Bursitis -Muscle Lesion -Glute Med Lesions

Answer 105

-Open pack: 30 flx/ 30 abd/ ER -pull on leg *targets entire capsule*

Answer 106

-Open pack -for loss of flx 1. Pt in supine, hip flx 2. PT on table, leg over shoulder

Answer 107

-Open pack -loss of extension 1. Pt prone, leg in ext and abd (other leg off table if needed) 2. PT hand on isch tub and lift knee up 3. Push on isch tub 4. Progress with more hip ext and knee flx

Answer 108

-Open Pack -lack of ADD 1. Pt in supine, knee flexed 30 2. PT pulls down and out laterally (can use belt or hands) 3. Can add more ADD during progression *Progression: AP Lat Mobilization*

Answer 109

-discomfort -Antalgic gait -foot drop -Stand in OPP -Weight shifts -leg length discrepancy

Answer 110

-(+) Trendelenburg -(+) Inability or pain with squat -(+) Sign of buttock

Answer 111

-provocation tests -pt supine, PT on ipsi side of leg -hip in flx, ER, abduction -press into contra ASIS and knee (+) reproduction of pt ain at posterior pelvis or butt

Answer 112

-provocation tests -sign of serious pathology (hip absess, fracture, infection, cancer) -nerve on slack and pain still there 1. Passive SLR (+) 2. Return to neurtral and bend hip and knee 3. Passive bent leg raise (+) and same ROM

Answer 113

-Flx/Ext -Abd/ADD -IR/ER AROM > Overpressure > PROM *all must be measured* *test back and knee*

Answer 114

-Ober's -Modified Thomas -Elys -Piriformis -Hamstrings

Answer 115

-Open pack: 30 flx/ 30 abd/ ER -pull on leg to assess joint 1. Pt supine, flx/abd/ER 2. PT holds above talocrural *targets entire capsule*

Answer 116

-inferior/posterior capsule -for loss of flx 1. Pt in supine, hip flx 2. PT on table, leg over shoulder 3. PT scoops and pulls out and down

Answer 117

-target anterior capsule -loss of extension 1. Pt prone, leg in ext and abd (other leg off table if needed) 2. PT hand on isch tub and lift knee up 3. Push on isch tub

Answer 118

-Open Pack -targets lateral capsule 1. Pt in supine, knee flexed 30 2. PT pulls inferolateral 3. Can add more ADD during

Answer 119

1. Fitzgerald Test 2. FADIR Test 3. Hip Quadrant 4. Hip Scour 5. FABER

Answer 120

-anterior labral tear 1. Pt in supine 2. PROM from FABER to Ext/Add/IR (+): reproduces s/s w/ or w/o click

Answer 121

-FAI or Labrum 1. Pt in supine 2. PT PROM from FADIR to FABER (+): reproduces s/s w/ or w/o click

Answer 122

-FAI or Labrum 1. Pt in supine 2. PT PROM into flx/add/IR (+): reproduces s/s w/ or w/o click

Answer 123

-FAI, Labrum, acetabular dysfunction 1. Pt in supine 2. PT hugs knee and PROM from FADIR to FABER WITH COMPRESSION 3. Can scallop for specific areas (+): reproduces s/s w/ or w/o click

Answer 124

-impingement, SIJ, capsular tightness 1. Pt in supine 2. PT PROM into flx/abd/ER (+): reproduces s/s in ant hip or posterior hip

Answer 125

-femoral anteversion/retroversion 1. Pt in prone 2. Move into IR/ER until Greater troch is parallel to table (most into hand) 3. Measure ROM -normal 10-15 IR (+): ->15: anteverted ~10 IR: Normal -<10: retroverted

Answer 126

-fx oof the hip or femur 1. Stethoscope over pubic symphysis 2. Tap on Patella on affected sound and compare (+): diminished sound on involved side

Answer 127

-inferior/posterior capsule -for loss of flx 1. Pt in supine, hip flx 2. PT stands with belt at hips 3. PT pulls out and down 4. Add more flexion to progress

Answer 128

-progressive mobilization -more aggressive lat mobilization -add adduction and IR (piriformis stretch position) -target posterio-lateral capsule, ADD ROM -use when (+) FABER, quadrant, or SCOUR

Answer 129

-progressive mobilization -target ER and ABD ROM -use when (+) FABER 1. Pt prone with hip flexed and abducted off of bed (progress to more ER) 2. PT mobilize into ER

Answer 130

-progressive mobilization -target posterior capsule and IR ROM 1. Pt prone in IR 2. PT maintains IR while mobilizing contra pelvis

Answer 131

1. Sprains, strains, tendinopathies 2. Contusions 3. Meniscal or ligamentous

Answer 132

25 deg of flexion

Answer 133

Flexion > Extension

Answer 134

-Rolling and gliding same

Answer 135

-Rolling and gliding opposite

Answer 136

-ligaments -Instabilities -Meniscal and articular cartilage injuries

Answer 137

-instabilities -OA -Patellofemoral pain -Patellar Tendonopathy

Answer 138

-MCL -ACL -Med Meniscus -Posteriormedial capsule

Answer 139

-ACL -Sometimes PCL -Meniscus

Answer 140

-LCL -Posterolateral capsule -PCL

Answer 141

MOI: Contact: hyperext, valgus force Non-contact: deceleration valgus force near extension (cutting, popping) S/s: -hear/ feel a pop -rapid swelling -knee gives away -loss of end range ext Tests: -Lachman's -Anterior Drawer -6m Single Limb Timed Test

Answer 142

MOI: -trauma with posterior tibial shear in flx or hypertext -dashboard injury, sudden stopping S/s: -bruising or abrasion on tibia -loss of knee extension -localized knee posterior pain with kneeling or decelerating Tests: -Posterior Drawer -Posterior Sag Sign -Valgus Stress at 0 Deg

Answer 143

MOI: -traumatic valgus force -rotational trauma S/s: -normal ROM -painful palpation -medial knee pain Tests: -Valgus Stress Test 20-30 deg flx *heals well on it's own*

Answer 144

MOI: -traumatic varus force S/: -swelling over LCL -pain over LCL -lack of LCL Tests: -Varus Stress at 30 deg flx

Answer 145

-anterior and ER force -MCL, Medical Meniscus, ACL MOI: -valgus force and tibial ER -anterior sublux of medial tibial plateau Tests: -Anterior Drawer with ER

Answer 146

-anterior and IR force -ACL, LCL, Lateral mensiscus, ITB MOI: -valgus force and tibial IR -anterior sublux of lateral tibial plateau -ACL tear Tests: -Anterior Drawer Test with IR -Pivot shift

Answer 147

-Posterior and IR force -valgus force -PCL, MCL, Medial meniscus, Semimembranosis, ACL MOI: -force into extension and tibial IR -valgus movement Tests: -Hughston's Posteriormedial Drawer (posterior drawer with IR)

Answer 148

-posterior and ER force -Varus force -PCL, LCL, Biceps femoris MOI: -laxity of PCL in addition to other structures -tib posterior and ER Tests: -Dial Test/PLR Tests -Posterolateral Drawer -Reverse Pivot Shift

Answer 149

MOI: -direct varus hit to tibial on an extended knee -posterior force on flexed knee with tibial ER -chronically after trauma to ACL or PCL S/s: -varus thrust gait -posterolateral instability -knee giving way -common fib irritation

Answer 150

MOI: -twisting -valgus/ hyperextension force CPR: -catching or locking -joint line tenderness -twisting MOI -pain with knee hyperextension or max flx -pain or click w/ McMurrays test >4 positive

Answer 151

MOI: -trauma -overuse -patellar tracking -muscle imbalance Observations: -dec quad strength, flexibility, coordination of quads -over-pronation -patellar position -weight-bearing pain -pain after sitting, squatting Tx: -hip strengthening -quad strengthening

Answer 152

-Cruciates -Collaterals -OA -Patellar Tendinopathy -PFPS

Answer 153

-pain on tendon -overuse common in jumping and running Observation: -pain with loading -pain on tendon Tx: -load on tendon -quad eccentrics

Answer 154

-MOI -pain/location/changes/time of day -Swelling -Noise -Locking -Giving out -length of symptoms

Answer 155

PAD: claudication, cook extremities, decrease filling time DVT: pain, warmth, swelling Compartment Syn: swelling, absent pulses, neuro Septic Arthritis: pain, swelling, infection signs Cellulitis: skin warmth, redness, rash

Answer 156

1. >55 2. Tenderness at head of fib 3. Tenderness at Patella 4. Inability to flex knee 90 5. Inability to WB 4 steps (+) 2/5= need imaging

Answer 157

-abrasion, bruising, atrophy, swelling -LE rotation -knee position -flx or hyperextensionon -tibial torsion -foot position

Answer 158

-Flex (0-140) then Ext (0-15) -AROM > Over > PROM

Answer 159

-knee flx/ext -Hip ROM -Ankle DF and PF

Answer 160

-Ober's -Modified Thomas -Prone Rectus (ELy) -Gastroc Length -Hamstring Length

Answer 161

Ext: ant roll AND glide (concave on convex) 1. Pt supine (prone if dec ext) 2. Towel under tibia 3. Push femur posteriorly OR -Push tibia ant if in prone w/ knee flx Mob: -ad ER

Answer 162

Flex: Post roll and glide 1. Pt supine (sitting if distracting or dec) 2. PT supporting femur 3. PT Push tibia posteriorly Mob: -Ad IR

Answer 163

Crab hand: tiny Bear Claw: big 1. Pt in supine, slightly flexed 2. Move patella up and down

Answer 164

Claw hand 1. Pt in Supine, slightly flexed 2. Move patella side to side

Answer 165

-use if lacking last bit of flexion and has pain at fib head -or frequent ankle sprains AP Glide: 1. Pt supine in hooklying 2. Push posteriorly PA Glide: treat in this position 1. Pt in quadruped 2. Push anteriorly

Answer 166

1. Subjective Hx (MOI and pain description) 2. Observation 3. ROM (knee, hip, ankle) 4. MMT (knee, hip, ankle) 5. Joint Play 6. Palpation (or before joint play) 7. Special Tests

Answer 167

ACL: Lachman, anterior drawer, pivot shift PCL: Posterior Drawer, Posterior sag, valgus at 0 MCL: valgus stress test at 20 LCL: Varus stress test at 20

Answer 168

AMRI: Anterior drawer + ER ALRI: anterior drawer + IR, pivot shift PMRI: Posterior drawer + IR PLRI: Posterior drawer + ER, reverse pivot shift, dial test

Answer 169

McMurray, Thessaly, Apley

Answer 170

Patellar Grind Test Patellar Apprehension

Answer 171

ACL -less flx than Anterior drawer 1. Pt supine, knee flexed slightly 2. PT stabilizes femur and pulls tibia ant 3. 1-2 reps

Answer 172

ACL -more flx ~ 60 1. Pt supine with knee flexed 60 2. PT sits on foot 3. Pull tibia anteriorly

Answer 173

PCL -more flx ~ 60 1. Pt supine with knee flexed 60 2. PT sits on foot 3. Find norm of tibia 4. Push tibia posteriorly

Answer 174

PCL 1. Pt supine 2. PT flexes knee and hip ot 90 passively and looks for sag of tibia

Answer 175

PCL (0 deg) , MCL (20 deg) 1. Pt supine w/ leg at 0 then 20 deg flexion 2. PT outside of leg holding medial tibia and lateral thigh (take up slack) 3. PT provides valgus stress

Answer 176

Cruciates (0 deg), LCL (20 deg) 1. Pt supine w/ leg at 0 then 20 deg flexion 2. PT inside of leg holding lateral tibia and medial thigh (take up slack) 3. PT provides varus stress

Answer 177

Anterior Drawer w/ ER

Answer 178

anterior drawer + IR

Answer 179

Posterior drawer + IR

Answer 180

Posterior drawer + ER

Answer 181

PLRI 1. Pt supine 2. PT flexes knee to 90 while ER tibia (check for medial sublux 3. PT slowly extends knee while adding valgus stress (reduction at full extension)

Answer 182

-Meniscus -NWB -tells you which one is involved -provocative Medial: 1. Pt supine at 90/90 2. PT palpates or watches medial joint line 2. PT passively flexes knee 3. PT puts tibia into ER while extending knee Lateral: 1. Pt supine at 90/90 2. PT palpates or watches lateral joint line 2. PT passively flexes knee 3. PT puts tibia into IR while extending knee

Answer 183

-Meniscus test -NWB Distraction: 1. Pt prone with knee bent 2. PT stabilizes femur with leg 3. PT ER then distracts, IR then distracts Better: meniscus Worse: Ligament Compression: 1. Pt prone with knee bent 2. PT stabilizes femur with leg 3. PT ER then comrpesses, IR then compresses Worse: Mensicus

Answer 184

-meniscus -WB test -5 deg of knee flx, then 20 deg 1. Pt stands on one leg with leg bent 5/20 with PT support 2. PT askes Pt to twist from side to side (+): clock, pop, or reproduction of pain

Answer 185

-lateral patellar subluxation 1. Pt supine with leg off of plinth slightly flexed ~15 2. Pt foot on PT leg 3. PT lateral mobs patella (+): Pt feels apprehensive about it subluxing

Answer 186

-Chondromalacia, PF dysfunction 1. Pt supine in full knee ext 2. PT uses web space to push superir patella down 3. Pt then contracts quad (+): reproduction of patients pain

Answer 187

1. Knee Pain 2. >50 3. Knee Crepitus 4. Palpable bony enlargement 5. Bony tenderness 6. Morning stiffness <30mins 7. No warmth

Answer 188

1. Plantarflexes 2. Invert foot 3. Supports medial longitudinal arch

Answer 189

Midfoot zone Rules: -Inability to bear weight -tenderness to base of 5th MT -Tenderness to navivular Malleolar zone rules: -inability to bear weight -tenderness to lateral malleolus -tenderness to medial malleolus

Answer 190

- at Tibiofibular syndesmosis -interosseous membrane -anterior talofibular lig -during ER and DF

Answer 191

Loose Adaptor (swing): sup/pro/sup Initial contact to loading response: sup to pro Shock Absorber (weight acceptance): pronation Midstance: pro to sup Rigid Level (midstance to toe off): supination Preswing to initial: sup to pro

Answer 192

-high arch -supinated -decreased shock absortion -ankle sprains common

Answer 193

-low arch -decreaed rigid lever -pronated -hallux valgus

Answer 194

-tibial nerve > medial and lateral plantar nerves

Answer 195

-deep peroneal/fibular nerve -goes to between big and 2nd toe -common site for retinaculum compression

Answer 196

-superficial peroneal/fibular -can be stretched by ankle sprain

Answer 197

-tissue pressure increased by trauma -muscle and nerve ischemia S/s: -swelling -Pain -no pulses Tx: -fasciotomy -rest (for developing)

Answer 198

S/s: -pain at junction, tendon, at bony insertion Tx: -eccentric loading -heavy load, low speed -stretching -patient education

Answer 199

-degenerative and progressive condition S/s: Observation: loss of arch height, abduction Mobility: limited and/or painful PF Functional: abnormal gait, decreased push off, pain with WB or single leg balance Strength: weak and painful SL heel raise, weakness with inversion and PF

Answer 200

-almost always plantar subluxation -lateral ankle sprain -COG in front of midtarsals -"i feel like there's a rock in my shoe" Tx: -Cuboid Whip -Cuboid Squeeze

Answer 201

-Cuboid subluxation -Planar fascitis -Post Tib Tendon -Achilles Tendonopathy -Lateral Ankle Sprain -Medial Ankle Sprain -High Ankle Sprain -Stress Fx

Answer 202

-plantar fascia slack until ext of big toe during push off 1. Check arch 2. Lift big toe and check for arch

Answer 203

Pt Hx Observation Scanning Exam Palpate** ROM Flexibility MMT Joint Play Special Tests

Answer 204

-Activities? -Flat feet or high arches -Types of shoes -Pop? -Child bracing? -Surgeries? -OA?

Answer 205

-Achilles tendon -Calcaneus -Great Toe/phalanges -Cuneiform -Navicular -Malleoli -Deltoid ligament -ATFL -Shin -Fibulari

Answer 206

DF/PF: 20/50 Sup/Pro: 45-60/15-30 (measure at top of ankle) Inv/Env: 20/10 (measure calcaneus) Great toe Ext/Flx: 70/45

Answer 207

-Gastroc/Soleus -Tib ant/post -Fibulars -Hallucis Flex/ext -Foot Intrinsics

Answer 208

-AP glide or PA -Lacking last ext or flx Knee Joint: -Flx: anterior -Ext: posterior Ankle Joint: -DF: ER -PF: IR

Answer 209

-AP and PA -For lacking DF 1. Pt supine, foot PF 2. Stabilize tibia and mobilize fibula

Answer 210

-improve PF 1. Pt prone, slightly PF 2. PT stabilizes Tibia 3. Anterior mob through calcaneus

Answer 211

-improve DF 1. Pt supine, slightly PF 2. PT stabilizes tibia 3. Posterior mob through anterior talus

Answer 212

-improve eversion 1. Pt sidelying 2. Push medially

Answer 213

-improve inversion 1. Pt sidelying 2. Push laterally

Answer 214

-Distraction -Extension 1. Stabilize distal MT 2. Mobilize dorsally

Answer 215

-Flexion 1. Stabilize distal MT 2. Mobilize plantarly

Answer 216

-Fibular translation test -External Rotation test

Answer 217

-Anterior Talus Displacement- Anterior Drawer -Lateral Ligament Integrity - Medial Talar Tilt

Answer 218

-Forced Dorsiflexion Test

Answer 219

-Navicular Drop Test -Feiss Line

Answer 220

-Thompson Test

Answer 221

-high ankle sprain 1. Pt supine 2. PT mobs tibia and fibula (+): ROS and/or increased displacement

Answer 222

-high ankle sprain 1. Pt supine; knee flexed to 90 2. PT ER and DF ankle (+): ROS or excessive movement

Answer 223

-stress ATFL -Lateral ankle sprain 1. Pt supine in PF 2. PT give anterior glide of talus and calcaneus (+): Excessive translation

Answer 224

-stress CFL -lateral ankle sprain 1. Pt supine, foo in neutral 2. PT stabilizes malleoli med mobilization at calcaneus (+): excessive laxity

Answer 225

-anterior ankle impingement 1. Pt supine, knee flexed 2. PT stabilizes distal tibia 3. Forceful DF (+): ROS

Answer 226

-open packed positions Proximal and Distal Tibiofibular Joint Talocrual Joint Cuboid (whip/squeeze) Forefoot Joints Mobs

Answer 227

1. Pt prone 2. Foot in PF, INV, ADD 3. PT thumb over thumb on plantar surface of cuboid 4. Sharp Whip motion or squeeze

Answer 228

-talocrual mobilization -go the end range 1. Pt in long sitting 2. PT Stabilize tibia 3. PT Mobilize in AP direction while using high to increase

Answer 229

1. Pt in squat or lunge 2. AP mob at talus under tibia OR PA mob at distal tibia with belt 3. During squat or lunge to increase

MSK Practical Flashcards

(256 cards)