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57 Cards in this Set
- Front
- Back
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radioulnar (interosseous) membrane FPR |
-pt seated -grasp distal radius & ulna -compress them together -translate R & U back/forth in opposite directions in A-P plane -progress proximally and repeat; get to midpoint of forearm |
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BLT of clavicle |
-pt seated -grasp lateral to SC joint & AC joint -have pt lean forward -push superiorly on AC joint until a "give" is felt -ask pt to lean C/L shoulder posteriorly -balance the ligaments until a slight shift is felt in the clavicle -inhale/exhale -move C/L shoulder back anteriorly
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BLT of humerus -how do you ddx humerus? -actions of tx |
-test internal/external rotation of humerus -look for restriction in motion -both hands grasp around humerus -fingers clasp posteriorly; thumbs are on anterior side of humerus -external/internal rotate humerus -pt's arm is on C/L shoulder -have them lean that shoulder posteriorly -can add superior motion to disengage joint capsule |
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BLT of radius/ interosseous membrane of forearm |
-grasp radial head with one hand; flex the elbow -grasp distal radius with other hand -hold the radius and let the rest of forearm "fall" -gradually extend the elbow -create equal tension in membrane |
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-carpal separation technique for restriction within carpal bones |
-clasp both hands around pt's hand -pt's hand is relaxed and open; add compressive force -have pt make a fist --> add more CF -have pt open their fist --> maintain compression
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ulnar abduction/adduction HVLA |
-diagnose whether ulna is abduct/adducted -put wrist between your body & arm -stabilize radius and ulna -put ulna into RB -one hand on ulna/ other hand C/L on humerus -HLVA thrust thru RB |
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MCP/PIP joint HVLA |
-add traction, release a little, then do HVLA thrust on the joints |
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nursemaid's elbow treatment |
-pt seated -grasp radial head w/ one hand; other hand grasps wrist -supinate/pronate forearm to accentuate glide of radial head -reassess RH movement |
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7 stages of spencer |
1: extend shoulder; have pt flex against R 2. flex shoulder; have pt extend against R 3. circumduct w/o traction; gradually make bigger circles 4. circumduct w/ traction; 5a. abduct --> have pt adduct against R 5b. place pt's forearm on your forearm; push their elbow anteriorly; have them resist this movement 6. internal rotation; flex pt's elbow and put arm behind their back; push elbow anteriorly and have them resist 7. abduct with traction; pt's arm on your shoulder; grasp elbow and stabilize shoulder with other hand; lean back to add traction; push arm into abduction and have pt resist |
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shoulder mobilization |
-lateral recumbent position -grasp with both hands to cup the shoulder -mobilize shoulder in all directions |
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shoulder wobble |
-pt supine -pt's elbow is between your body/ operating arm -grasp humerus w both hands -mobilize the shoulder in all planes of motion |
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re-balancing thoracic-scapular joint -scapula is found to be laterally deviated and elevated; serratus anterior is hypertonic |
-pt seated; you stand behind the pt -one hand in mid axillary line along thoracic cage (inferior to axilla along pt's side) -other hand around scapula -add inferior traction to scapula to balance serratus anterior, teres, rhomboids -hold this position until serratus anterior relaxes |
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soft tissue thoracic technique |
pt prone knead the erector spinae muscles
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assessing clavicular motion -superior/inferior -anterior/posterior |
S-I motion: pt seated; index fingers on superior aspect of SC joint; have pt elevate & depress shoulders and assess for asymmetry A-P motion: pt supine; index fingers on superior aspect of SC joint; have pt flex arms forward and retract them back --> assess for asymmetry |
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assessing AC joint motion |
pt seated -grasp distal end of clavicle at AC joint -grasp forearm -adduct and ER arm -assess for restriction in those motions |
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assess glenohumeral motion |
abduct, adduct, ER, IR, flex, extend shoulder --> find restriction |
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assess the 4 different motions of the scapula |
1. depress 2. elevate 3. retract 4. protract |
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assess radial head motion |
-pt seated -grasp radial head with one hand and wrist with other -pronate and supinate the forearm -normally: when pronating, the RH moves posteriorly; supinating, the RH moves anteriorly -assess for restriction in motion of RH in these directions |
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assess the 4 diff motions of the elbow |
1. supinate 2. pronate 3. flex 4. extend |
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wrist/carpal bone motion -when the wrist moves, the carpal bones move with it -what are the 4 motions of the wrist? |
1. flex 2. extend 3. adduct 4. abduct |
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apley scratch test |
-general test for rotator cuff motion -have pt reach between their scapulae -measure both sides and see if there's asymmetry |
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external rotation test (for which 2 muscles?) |
-infraspinatus and teres minor -flex elbow to 90 -IR the arm and have pt ER against R -asymmetry in strength = possible infraspinatus/ TM pathology |
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empty can (Jobe) test |
for supraspinatus -IR the arm (empty a can) -push down on pt's arms -have them resist -see if there is asymmetry in resistance |
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lift off test |
-subscapularis -IR and place hand behind back -have pt lift hand off back against R -asymmetry in strength = subscapularis pathology |
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compression test for labrum |
-flex elbow to 90 -abduct to 90 -add compression thru shoulder -ER & IR shoulder -audible clicking = (+) test |
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Still Technique: |
-pt supine -one hand: holds occiput; SS OA into POE/ add Flex/extend as the ddx says -add traction -put them into flex/extend of RB; add SS into OA into RB |
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Still Technique: AA |
-pt supine -hold occiput with one hand -rotate AA into POE w other -compressive force thru TP of C2 -rotate AA into RB |
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Still Technique: cervical spine |
-pt supine -operating hand puts the affected segment into POE (ddx) -other hand compresses head to level of segment -operating hand puts segment into RB (opposite of ddx) |
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Still Technique: thoracic dysfunction (flexed) |
-pt seated -put them in ddx position -add CF: axilla on one shoulder; hand on other shoulder -rotate, SB, extend them to opposite the ddx |
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Still Technique: thoracic dysfunction (extended) |
-pt seated -put them in ddx -add CF with axilla on one shoulder and hand on other shoulder -flex, rotate, SB to opposite the ddx |
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how to find the key lesion in thoracic dysfunction according to Dr. Van Buskirk |
-palpate paraspinal muscles while pushing down on shoulders one at a time --> assess SB -place pt in SB with greatest restriction -induce flexion/extension by moving the shoulder anteriorly and posteriorly -put them in the position with greatest restriction -in this position, palpate each TP and find the one that feels "hard" and will not move -this is the key lesion |
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Still Technique: Anterior rib |
-pt seated -you are behind the pt -one arm across their chest; palpate the anterior rib -other hand - grasp their distal humerus, adduct the arm -add CF -then flex, abduct, extend in smooth arc (backstroke) while maintaining CF |
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Still Technique: Posterior rib |
-pt seated -you are behind the pt -palpate the posterior rib head -other hand grasp the elbow -put the I/L arm into extension -add CF thru the rib head -abduct, flex, adduct the arm (forward stroke) --> so arm ends up on abdomen |
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Still Technique: First rib (inhaled/superior rib) S.O. |
-pt supine -palpate superior rib w/ one hand -other hand move pt's I/L arm medially (place their hand on their C/L shoulder) -add CF thru elbow -bring pt's elbow to their ear (IR) -swing elbow outward & back down to their chest |
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Still Technique: First rib (exhaled/inferior rib)
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-pt supine -put their I/L arm/hand on their chest -abduct elbow/ slightly extend arm -add CF thru elbow -bring elbow to pt's ear -inferior/inward arc towards chest |
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Still Technique: Extended lumbar segment |
-pt supine -flex I/L hip & knee to 90 -abduct the hip to relax the segment -add CF thru knee -adduct the leg until it crosses the midline -push the knee inferiorly to extend the leg while maintaining CF |
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Still Technique: Flexed lumbar segment |
-pt supine -flex hip/knee to 90 -adduct the leg past midline to relax the segment -add CF -abduct the leg --> extend leg while maintaining CF |
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Still Technique: Posterior innominate |
-pt supine -flex hip past 90 & knee to 90 -sensing hand is on S2 level -add CF thru knee to SI joint -flex hip up more, abduct the hip; extend the leg while maintaining CF |
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Still Technique: Anterior innominate |
-pt supine -sensing hand on level of S3 -flex hip & knee to 90 -add CF thru knee to SI joint -flex hip up more, adduct the leg, extend the leg while maintaining CF |
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order of actions for FPR |
1. neutral position 2. POE 3. compression |
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FPR: |
1. neutral: tilt chin down to flex OA 2. POE: ddx; push into SS R 3. compress thru head |
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FPR: (palpate the neck & find hypertonicity or restrictions in splenius, semispinalis) |
1. neutral: flex neck to flatten cervical lordosis 2. POE 3. compression thru head |
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FPR: cervical: segmental extension (C4 E SL RL) |
1. neutral: flex neck to flatten cervical lordosis 2. POE: extend, SB L & rotate L 3. compression thru head |
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FPR: cervical: segmental flexion (C5 F SR RR) |
1. neutral: flex neck to flatten cervical lordosis 2. POE: flex, SB R & rotate R 3. compress thru head |
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FPR: superficial anterior thoracic (feel thoracic muscles on anterior side to be hypertonic) |
-pt seated; monitor area to be tx 1. neutral: ask pt to sit up straight to flatten thoracic kyphosis 2. POE: flex & SB to the side of the hypertonic muscles 3. add compression thru the cervicothoracic junction |
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FPR: superficial posterior thoracic (feel thoracic muscles on posterior side to be hypertonic) |
-pt seated; monitor area to be tx 1. neutral: ask pt to sit up straight to flatten thoracic kyphosis 2. POE: extend & SB to the side of dysfunction 3. add compression thru CT jxn |
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FPR: thoracic: segmental flexion T7 FSR RR |
-pt seated; monitor the segment 1. neutral: pt sits up straight to flatten thoracic kyphosis 2. POE: flex to level & SB & R to R 3. compress thru CT jxn |
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FPR: thoracic segmental extension T7 E SL RL |
-pt seated; monitor segment 1. neutral: pt sits up straight to flatten thoracic kyphosis 2. POE: extend, SB L & R L 3. compress thru CT jxn |
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FPR: group curve (type I lesion) in lumbar region Ex. ddx: L2-L5 N SR RL |
-pt prone; monitor apex of curve 1. neutral: place pillow under abdomen to flatten lumbar lordosis 2. POE: place your knee on pt's I/L ilium to induce SB to I/L side; place C/L thigh over I/L thigh to induce rotation 3. the compression is induced when you lift up C/L hip |
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FPR: lumbar segmental flexion DDx: L4 F SR RR |
-pt prone; monitor segment 1. neutral: place pillow under abdomen to flatten lumbar lordosis 2. POE: flex hip & knee off table to level of segment; adduct knee, then IR leg 3. compressive force = when IR leg |
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FPR: lumbar extension segmental L5 E SR RR |
-pt prone; monitor segment 1. neutral: place pillow under abdomen to flatten lumbar lordosis 2. POE: place pillow under pt's thigh to extend; abduct the thigh; flex at knee & turn ankle outwards to IR the leg 3. CF: push leg towards the floor using pillow as fulcrum |
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FPR: SI restriction |
-pt prone -cephalad hand on ILA -caudad hand holds thigh 1. neutral: place pillow under abdomen to flatten lumbar lordosis 2. POE: place cephalad pressure on ILA while pt inhales/exhales 3. CF: IR leg
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BLT: fibular interosseous -test fibular head for ROM for ddx --> note which side has decreased motion |
-pt supine -hold both ends of fibula (head & distal end) -lift F head up and push down (A-P plane) -compress together -pull laterally -balance point; POE |
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knee/tibia BLT |
-pt seated -hold foot in between your knees -contact tibia with both hands --> fingers posterior to tibia & thumbs on anterior joint line -lift up superiorly on tibia -use your knees to add AB/ADduction -can ER or IR |
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fibular head FPR |
-pt supine -hold fibular head with one hand -induce dorsiflexion with other hand -translate fibular head back & forth in AP plane |
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CS: medial meniscus |
-TP on medial meniscus of tibial plateau -pt prone -abduct thigh off table -flex knee to 60 degrees -internally rotate & adduct knee toward table |
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CS: lateral meniscus |
TP: lateral meniscus of tibial plateau -pt supine -affected leg is flexed off table -abduct thigh and ER |
