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Methods > Comp Eval: Hip/Foot > Flashcards

Comp Eval: Hip/Foot Flashcards

1
Q

6-221 Bimanual reinforced interphalangeal grasp/anterior talus pull; long axis distraction

A

-PP: Supine with pelvic piece raised or pt holding table
-DP: Face cephalad at foot of table
-CH: Use either hand interphalangeal contact with middle finger on dome of talus
-IH: Reinforce middle finger contact, thumbs of both hands on plantar surface of foot
-VEC: LAD

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2
Q

6-222 Reinforced web/anterior talus push anterior to posterior glide

A

-PP: Supine with heel off end of table
-DP: Face cephalad at end of table
-CH: Outside hand establishes web contact on talar dome, grasp foot with thumb and fingers
-IH: reinforce CH or grasp distal tibia for stabilization
-VEC: A to P

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3
Q

6-223 Reinforced middle interphalangeal/talus pull; lateral to medial glide (eversion) or medial to lateral glide (inversion) with long axis distraction

A

-PP: Supine with foot off end of table
-DP: Face cephalad at end of table
-CH: Middle finger contact to talar dome, establish inversion/ eversion
-IH: grasp posterior aspect of calcaneus (note the picture does not show this)
-VEC: L to M or M to L with LAD

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4
Q

6-224 Web/talus, mid-hypothenar (knife- edge)/calcaneus; long axis distraction with either inversion or eversion

A

-PP: Supine, pelvic piece raised or pt holding table
-DP: At foot of table facing affected ankle
-CH: Cephalad hand web contact on talar dome, forearm along the line of tibia
-IH: grasp distal tibia and knife edge to superior aspect of calcaneus
-VEC: LAD

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5
Q

6-225 Reinforced web/talus push; posterior to anterior glide

A

-PP: Prone with foot off table
-DP: Foot of table facing cephalad
-CH: Caudal hand web contact on posterior talus
-IH: Cephalad hand stabilizing distal tibia
-VEC: P to A

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6
Q

6-227 Interlaced bimanual grasp/calcaneus; lateral to medial glide; medial to lateral glide; anterior to posterior glide; posterior to anterior glide

A

-PP: Prone with knee flexed to ~45o
-DP: Face cephalad at foot of table with pt foot resting on chest/abdomen
-CH: Praying hands position, interlaced fingers
-VEC: A-P, P-A, L-M, or M-L

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7
Q

6-228 Hypothenar/cuboid with forefoot distraction; plantar to dorsal glide

A

-PP: Prone, knee bent to 90o
-DP: Stand between pt legs facing affected side at its medial aspect
-CH: Cephalad hand pisiform/hypothenar on plantar aspect of cuboid, wrap fingers around foot
-IH: caudal hand cradles dorsum of foot with interlaced fingers
-VEC: Plantar to Dorsal

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8
Q

6-229 Hypothenar/navicular (cuneiforms) with forefoot distraction; plantar to dorsal glide

A

-PP: Prone, knee bent to 90o
-DP: Stand at affected side facing lateral aspect of foot
-CH: Cephalad hand pisiform/hypothenar on plantar aspect of navicular, wrap fingers around foot
-IH: caudal hand cradles dorsum of foot with interlaced fingers
-VEC: Plantar to Dorsal

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9
Q

6-230 Reinforced thumbs/cuneiform (cuboid, navicular with forefoot distraction; plantar to dorsal glide

A

-PP: Prone, knee flexed ~45o
-DP: At foot of table facing cephalad
-CH: Inside hand thumb contact on cuneiform, wrap fingers around foot
-IH: Thumb reinforces
-VEC: Plantar to dorsal (snapping type thrust)
*Don’t take to full plantar flexion

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10
Q

6-231 Reinforced hypothenar/navicular (cuboid, cuneiforms); anterior to posterior glide

A

-PP: Supine with knee and hip flexed to rest foot on table -DP: Face cephalad at foot of table
-CH: pisiform contact of either hand on tarsal
-IH: Reinforced pisiform
-VEC: Dorsal to Plantar
*A drop section could also be used

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11
Q

Reinforced middle interphalangeal/ cuneiform (cuboid, navicular) pull; anterior to posterior

A

-PP: Supine with leg straight
-DP: Face cephalad at foot of table
-CH: use either hand middle finger
-IH: reinforce contact and wrap hands to plantar surface of foot
-VEC: Plantar to Dorsal

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12
Q

6- 237 Web metatarsal/finger grasp phalanx; medial to lateral glide with pendular distraction

A

-PP: Supine
-DP: Face cephalad at foot of table
-CH: Outside hand grasp proximal phalanx between you index and middle finger
-IH: Inside hand web contact over medial aspect of metatarsophalangeal joint
-VEC: M to L; use gravity to create LAD and use pendular motion to mobilize joint initially and shallow thrust M to L with IH

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13
Q

6-233 Bimanual web/ tarsals; long axis distraction

A

PP: Supine, leg externally rotated and abducted off table DP: On affected side face caudal with patient lateral foot resting on doctor’s thigh CH: web contact over navicular IH: web contact over proximal metatarsal VEC: Distraction using thigh as fulcrum

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14
Q

6-234 Bilateral thenar/metatarsals grasp shear; anterior to posterior, posterior to anterior

A

PP: supine DP: Face cephalad at foot of table CH: thumb-thenar contact on metatarsal IH: thumb-thenar contact on adjacent metatarsal VEC: Shear A to P or P to A

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15
Q

6-235 Thumb/metatarsal/thumb phalanx shear; plantar to dorsal glide

A

PP: Supine, unaffected leg on table DP: Face cephalad at end of table CH: Outside hand applies thumb contact to plantar aspect of metatarsal IH: Inside hand thumb contact on dorsal aspect of phalanx just distal to metatarsal contact VEC: Plantar to Dorsal using thumbs to shear

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16
Q

6-236 Thumb index grasp/phalanx; long axis distraction

A

PP: Supine, affected foot off end of table DP: Face cephalad, at foot of table CH: Use either hand thumb grasps phalange, index finger curled underneath IH: grasps foot to stabilize VEC: LAD over the index contact and dorsal to plantar distractive thrust

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17
Q

6-238 Thumb index grasp/phalanx; long axis distraction, internal and external rotation, anterior to posterior or posterior to anterior glide, lateral to medial or medial to lateral glide

A

PP: Supine DP: Face Cephalad at foot of table CH: grasp distal member of the phalange IH: grasp proximal member of joint to be adjusted VEC: A to P; P to A; internal or external rotatio

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18
Q

Squeeze Test

A

Deep pain indicates injury to syndesmosis (post ankle sprain)

19
Q

Anterior Drawer of ankle

A

Anterior movement of the calcaneus compared with other side indicates anterior talofibular ligament laxity

20
Q

Morton’s Test

A

Sharp pain in the forefoot indicating metatarsalgia or neuroma

21
Q

Strunsky’s Sign

A

Pain in the transverse arch of the foot indicates metatarsalgia

22
Q

Homan’s Sign

A

Deep pain in the posterior leg or calf indicates thrombophlebiti s

23
Q

Metatarsal Tap

A

Pain indicates metatarsalgia

24
Q

Tinel’s Foot Sign

A

Paresthesia radiating to the foot or tingling indicates irritation to the posterior tibial nerve possibly in the tarsal tunnel or Ta r s a l tunnel syndrome

25
Q

Inversion Stress Ankle (Lateral Stability Test)
Increased inversion compared with other side indicates anterior talofibular and /or calcaneofibular ligament tear

A

Increased inversion compared with other side indicates anterior talofibular and /or calcaneofibular ligament tear

26
Q

Eversion Stress Ankle (Medial Stability Test)

A

Increased eversion compared with other side indicates a tear of the deltoid ligament

27
Q

Thompson’s Test

A

Foot does not plantar flex indicating an Achilles tendon rupture

28
Q

Achilles Tap Test

A

Pain and a loss of plantarflexion indicates a rupture of the Achilles tendon

29
Q

Hoffa Test (Hoffa Sign)

A

Achilles tendon is less taught, palpates loose fragments, and the foot is in a dorsiflexed position on the affected side is a significant indication for a fractured calcaneus

30
Q

Bimanual Grasp/Distal Tibia Pull; Long axis distraction (Fig. 6-153)

A

PP: Supine
DP: At foot of table
CH: Both hands grasp distal tibia above ankle
Procedure: Have patient hold table or raise pelvic piece. This can also be performed with a towel wrapped around the patient’s ankle
VEC: Long axis Distraction (test + impulse)

31
Q

Bimanual Grasp/Proximal Femur; Internal or External Rotation (Fig. 6-155 and 6-156)

A

PP: supine with hip and knee flexed to 90o
DP: Stand on side of involvement, facing cephalad, patient’s leg on inside shoulder
CH: Cephalad hand and caudal hand to proximal aspect of femur
Procedure: Patient’s leg/knee on inside shoulder flexed, induce internal or external rotation, lift leg slightly
VEC: Internal or External Rotation with impulse thrust

32
Q

Bimanual Grasp/Proximal Femur; Inferior Glide in Flexion (Fig. 6-158)

A

PP: supine with hip and knee flexed to 90o
DP: Stand on side of involvement, facing cephalad, patient’s leg on inside shoulder
CH: Cephalad hand and caudal hand to proximal aspect of femur
Procedure: Using both hands thrust caudally
VEC: S to I

33
Q

Hypothenar/Trochanter Push; LAD (Fig. 6-159)

A

PP: Side posture position, affected side up
DP: Stand on side of patient, thigh to thigh
CH: Caudal hand pisiform hypothenar contact posterosuperior aspect of greater trochanter
IH: Cephalad hand on patient’s shoulder
VEC: LAD down line of femur

34
Q

Hypothenar/Proximal Femur, Palmar/Distal Femur Grasp; Anterior to Posterior Glide (Fig. 6-157)

A

PP: Supine with hip and knee flexed slightly
DP: On opposite side of table of involved leg
CH: Cephalad hand knife edge over anterior proximal femur
IH: Caudal hand distal femur with fingers in popliteal fossa
P: Flex hip and deliver shallow thrust
VEC: A to P

35
Q

Hypothenar/Proximal Femur, Palmar Distal Femur Grasp; Posterior to Anterior Glide (Fig. 6-160)

A

PP: Prone
DP: At side of table on involved side
CH: Cephalad hand knife edge to posterior aspect of proximal femur
IH: Caudal hand grasps distal femur on medial side
P: Draw hip into extension by lifting knee. Deliver thrust. Can also be done on a drop table.
VEC: P to A

36
Q

Anvil Test

A

Local pain in the leg or thigh may indicate femoral, tibial, or fibular fracture. Pain in the calcaneus may indicate calcaneal fracture

37
Q

Allis Sign

A

The patient has a short leg this indicates which bone is short femur or tibia

38
Q

Patrick’s Test (FABERE)

A

Pain in the hip indicates Coxa pathology

39
Q

Laguerre test

A

Positive test produces pain within sacroiliac joint. Pain felt within the iliofemoral joint indicates possible hip pathology

40
Q

Thomas Test

A

Contralateral leg is unable to lay flat on the table lumbar spine stays in a lordosis as they pull their knee to their chest = flexion contracture of the iliopsoas muscle

41
Q

Gaenslen’s

A

Positive test = pain in the sacroiliac area Dull, anterior thigh pain could indicate tight hip flexors Radiating symptoms down the thigh could indicate lumbar disc involvement If test is negative, a lumbosacral lesion is suspected

42
Q

Lewin-Gaenslen test

A

Positive test produces pain within the sacroiliac joint Dull, ache along the anterior thigh of the extended leg indicates tight hip flexors

43
Q

Ober’s Test

A

Thigh remains abducted as opposed to internally rotating and adducting indicates iliotibial band contracture

44
Q

Trendelenburg Test

A

Iliac crest drops on the raised leg side indicative of weak hip abductors on the contralateral side (gluteus medius)

Methods (15 decks)

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