Competency 6 & 7 Flashcards
(31 cards)
6a. Perform the evaluation of the glenohumeral joint for somatic dysfunction and document
appropriately.
Student contacts the olecranon while blocking linkage at the shoulder region.
Student evaluates passive flexion, noting normal to be 180 degrees.
Student evaluates passive extension, noting normal to be 60 degrees.
Student evaluates passive abduction, noting normal to be 180 degrees.
Student evaluates passive adduction, noting normal to be 40‐50 degrees.
Student evaluates passive internal & external rotation, noting normal to be 90 degrees for
both.
Student contacts proximal humerus to assess anterior/inferior glide and posterior/superior
glide passively
Student performs evaluation bilaterally in order to assess for asymmetries
Student names somatic dysfunction found in glenohumeral joint
Student states they would document a glenohumeral somatic dysfunction in the objective
portion of the SOAP note
6b. Perform the evaluation of the acromioclavicular joint for somatic dysfunction and document
appropriately.
Student contacts over the AC joint and palpates for tenderness and tissue texture changes.
Student brings glenohumeral joint into 60° coronal abduction and 60° horizontal abduction
to maximize AC joint motion
While maintain the position, student assesses rotational aspect of AC joint by internally and
externally rotating the glenohumeral joint
Student performs evaluation bilaterally in order to assess for asymmetries
Student names an internal or external rotation dysfunction of the AC joint
Student states they would document an acromioclavicular joint somatic dysfunction in the
objective portion of the SOAP note
6c. Perform the evaluation of the sternoclavicular joint for somatic dysfunction and document
appropriately.
Describes horizontal flexion and extension assessment as follows:
Have patient lie supine, place fingers bilaterally anteriorly on the clavicular head next to the
sternum to monitor motion
Have the patient flex shoulders to 90 then reach towards the ceiling, evaluating the motion
of both clavicles beneath your fingers
States proximal end of clavicle moves posterior as the patient reaches towards the ceiling
(horizontal flexion) as the distal clavicle moves anterior
As the patient returns shoulders back to neutral (horizontal extension), states proximal
clavicle moves anterior and distal clavicle moves posterior
Student states that by performing bilaterally, they can assess for asymmetries
Student states a horizontal extension dysfunction with restriction to horizontal flexion is
most common
Describes abduction and adduction assessment as follows:
Student now places the index fingers of both hands on the superior aspect of the head of
both clavicles, and has patient shrug their shoulders
States proximal end of clavicle moves inferiorly and distal end of clavicle move superiorly as
the patient shrugs shoulders superiorly (abduction)
As patient lowers shoulders to neutral (adduction), states proximal end of clavicle moves
superiorly and distal end of clavicle moves inferiorly
Student states that by performing bilaterally, they can assess for asymmetries
Student states an adduction dysfunction with restriction to abduction is most common
Student states they would document a sternoclavicular somatic dysfunction in the objective
portion of the SOAP note
6d. Perform the evaluation of the scapulothoracic joint for somatic dysfunction and document
appropriately.
Patient in lateral recumbent position with student facing the patient’s anterior aspect
contacting the inferior angle of the scapula with their caudad hand the acromion with their
cephalad hand
Student performs scapular elevation (cephalad and parallel to spine) and states the upper
trapezius and levator scapulae are responsible for the motion
Student performs scapular depression (return from elevation) and states the lower
trapezius and lower rhomboids are responsible for motion
Student performs scapular protraction (away from/perpendicular to the spine) and states
the serratus anterior is responsible for the motion
Student performs scapular retraction (moving closer to the spine) and states the rhomboids
andmiddle trapezius are responsible for the motion
Student performs upward rotation (forward tilt) and states the serratus anterior and upper
trapezius muscles are responsible for the motion
Student performs downward rotation (Backward tilt) and states the levator scapulae,
rhomboid major and minor, and latissimus dorsi muscles are responsible for the motion
Student performs evaluation bilaterally in order to assess for asymmetries
Student names somatic dysfunction found in the scapulothoracic joint
Student states they would document a scapulothoracic somatic dysfunction in the objective
portion of the SOAP note
6e. Perform the evaluation of Ulnar Abduction (valgus testing) coupled with wrist adduction for
elbow somatic dysfunction and document appropriately.
Student has patient in seated position with arms in anatomical position.
Student contacts the wrist with one hand and the lateral elbow with the other.
Student takes the elbow into extension and a valgus force is applied to the ulnohumeral
joint.
Student notes hard or soft end feel.
Student describes dysfunction as the ease of motion prefers abduction at the ulnohumeral
joint.
Student states they would document an ulnar abduction somatic dysfunction in the
objective portion of the SOAP note.
6f. Perform the evaluation of Ulnar Adduction (varus testing) coupled with wrist abduction for
elbow somatic dysfunction and document appropriately.
Student has patient in seated position with arms in anatomical position.
Student contacts the wrist with one hand and the medial elbow with the other.
Student takes the elbow into extension and a varus force is applied to the ulnohumeral
joint.
Student notes hard or soft end feel.
Student describes dysfunction as the ease of motion prefers adduction at the ulnohumeral
joint.
Student states they would document an ulnar adduction somatic dysfunction in the
objective portion of the SOAP note.
6g. Perform the evaluation of Radial Head Motion‐Posterior Glide coupled with pronation for
elbow somatic dysfunction and document appropriately.
Student has patient in seated position and faces them
Student contacts the wrist with one hand and the radial head with the other.
Student provides a posterior glide force to the radial head noting end feel
Student assesses forearm pronation and notes if there is ease of motion orrestriction to full
pronation
Student states a posterior radial head dysfunction will have ease of motion to posterior glide
and forearm pronation with restriction to anterior glide and forearm supination
Student states they would document a posterior radial head somatic dysfunction in the
objective portion of the SOAP note.
6h. Perform the evaluation of Radial Head Motion‐Anterior Glide coupled with supination for
elbow somatic dysfunction and document appropriately.
Student has patient in seated position and faces them.
Student contacts the wrist with one hand and the radial head with the other.
Student provides an anterior glide force to the radial head noting end feel.
Student assesses forearm supination and notes if there is ease of motion or restriction to
full supination.
Student states an anterior radial head dysfunction will have ease of motion to anterior glide
and forearm supination with restriction to posterior glide and forearm pronation.
Student states they would document an anterior radial head somatic dysfunction in the
objective portion of the SOAP note.
6i. Perform the evaluation of Wrist Flexion with coupled Dorsal/Posterior Carpal Glide for wrist
somatic dysfunction and document appropriately.
Student has patient in seated position and contacts the hand with one hand and the distal
radius/ulna with the other
Student places wrist into flexion and extension and notes freedom of motion is in flexion
with restriction to extension
Student states the carpal bones will have coupled freedom of motion in dorsal/posterior
glide with restriction to ventral/anterior glide
Student states they would document a wrist flexion/posterior carpal glide somatic
dysfunction in the objective portion of the SOAP note
6j. Perform the evaluation of Wrist Extension with coupled Ventral/Anterior Carpal Glide for wrist
somatic dysfunction and document appropriately
Student has patient in seated position and contacts the hand with one hand and the distal
radius/ulna with the other
Student places wrist into flexion and extension and notes freedom of motion is in extension
with restriction to flexion
Student states the carpal bones will have coupled freedom of motion in ventral/anterior
glide with restriction to dorsal/posterior glide
Student states they would document wrist extension/anterior carpal glide somatic
dysfunction in the objective portion of the SOAP note.
6k. Perform the evaluation of Abduction of the Wrist (deviation toward the radial side in the
anatomical position) for wrist somatic dysfunction and document appropriately.
Student has patient in seated position and contacts the hand with one hand and the distal
radius/ulna with the other.
Student places forearm in full supination.
Student places wrist into abduction (radial deviation) and adduction (ulnar deviation) and
notes freedom of motion is in abduction (radial deviation) with restriction to adduction
(ulnar deviation)
Student states they would doc
6l. Perform the evaluation of Adduction of the Wrist (deviation toward the ulnar side in the
anatomical position) for wrist somatic dysfunction and document appropriately.
Student has patient in seated position and contacts the hand with one hand and the distal
radius/ulna with the other.
Student places forearm in full supination.
Student places wrist into adduction (ulnar deviation) and abduction (radial deviation) notes
freedom of motion is in adduction (ulnar deviation) with restriction to abduction (radial
deviation)
Student states they would document wrist adduction somatic dysfunction in the objective
portion of the SOAP note.
6m. Perform the evaluation of Finger Abduction (index, long, ring and little fingers) for finger
somatic dysfunction and document appropriately.
Student has patient in seated position and contacts the distal metacarpal with one hand and
the proximal phalanx of the metacarpal joint in question with the other.
Student has hand/wrist in full supination for anatomical position.
Student provides a force to move the jointaway from the midline and towards midline.
Student states the ease of motion is into abduction and restriction is to adduction.
Student states they would document the specifically named joint plus abduction somatic
dysfunction (e.g. right 3rd metacarpal abduction somatic dysfunction) in the objective
portion of the SOAP note
6n. Perform the evaluation of Finger Adduction (index, long, ring and little fingers) for finger
somatic dysfunction and document appropriately.
Student has patient in seated position and contacts the distal metacarpal with one hand and
the proximal phalanx of the metacarpal joint in question with the other.
Student has hand/wrist in full supination for anatomical position.
Student provides a force to move the joint toward the midline and away from midline.
Student states the ease of motion is into adduction and restriction is to abduction.
Student states they would document the specifically named joint plus adduction somatic
dysfunction (e.g. right 3rd metacarpal adduction somatic dysfunction) in the objective
portion of the SOAP note
6o. Perform the evaluation of Abduction of Thumb for finger somatic dysfunction and document
appropriately.
Student has patient in seated position and contacts the distal first metacarpal with one hand
and the proximal phalanx of the thumb with the other.
Student has hand/wrist in full supination for anatomical position.
Student provides a force to move the joint in an anterior direction.
Student states the ease of motion is to abduction of the joint and restricted to adduction.
Student states they would document thumb abduction somatic dysfunction in the objective
portion of the SOAP note.
6p. Perform the evaluation of Finger Flexion (index, long, ring and little fingers) for finger somatic
dysfunction and document appropriately.
Student has patient in seated position and contacts the distal metacarpal with one hand and
the proximal phalanx of the joint in question with the other.
Student provides a force to move the joint into flexion.
Student states the ease of motion is to flexion of the joint and restricted to extension.
Student states they would document finger flexion dysfunction of the joint name in question
(e.g. third MCP flexion dysfunction) in the objective portion of the SOAP note.
6q. Perform the evaluation of Finger Extension (index, long, ring and little fingers) for finger
somatic dysfunction and document appropriately.
Student has patient in seated position and contacts the distal metacarpal with one hand and
the proximal phalanx of the joint in question with the other.
Student provides a force to move the joint into extension.
Student states the ease of motion is to extension of the joint and restricted to flexion.
Student states they would document finger extension dysfunction of the joint name in
question (e.g. third MCP extension dysfunction) in the objective portion of the SOAP note.
7a. Perform the flexion/extension evaluation of the hip joint for somatic dysfunction (prone and
supine) and document appropriately.
Student is standing at side of table facing patient and places patient in a supine position.
Student assesses passive flexion of the hip joint by blocking linkage and noting 90 degrees
expected
Student assesses bilaterally.
Student places patient in prone position and assesses passive extension of the hip joint by
blocking linkage and noting 15‐30 degrees expected
Student assess bilaterally
Student states flexion dysfunction has ease of motion to flexion and restriction to extension
Student states extension dysfunction has ease of motion to extension and restriction to
flexion.
Student notes a hip flexion or extension dysfunction would be noted in the objective portion
of the chart noting side of laterality
7b. Perform the internal rotation/external rotation evaluation of the hip joint for somatic
dysfunction (prone and supine) and document appropriately.
Student is standing at side of table facing patient and places patient in a supine position
with hip and knee at 90 degrees.
Student places patient in supine or prone position and assesses passive internal rotation of
the hip joint by blocking linkage and noting 30‐40 degrees expected
Student places patient in supine or prone position and assesses passive external rotation of
the hip joint by blocking linkage and noting 40‐60 degrees expected
Student states internal rotation dysfunction has ease of motion to internal rotation and
restriction to external rotation.
Student states external rotation dysfunction has ease of motion to external rotation and
restriction to internal rotation.
Student notes a hip internal or external rotation dysfunction would be noted in the
objective portion of the chart noting side of laterality.
7c. Perform the adduction/abduction evaluation of the hip joint for somatic dysfunction (supine)
and document appropriately.
Student is standing at foot of table facing patient and places patient in a supine position
with knee extended
Student assesses passive abduction of the hip joint by blocking linkage and noting 45‐50
degrees expected
Student assesses passive adduction of the hip joint by blocking linkage by lifting the
contralateral lower extremity and sweeping the ipsilateral leg into adduction, noting 20‐30
degrees expected
Student states abduction dysfunction has ease of motion to abduction and restriction to
adduction.
Student states adduction dysfunction has ease of motion to adduction and restriction to
abduction.
Student notes a hip adduction or abduction dysfunction would be documented in the
objective portion of the chart noting side of laterality.
7d. Perform the internal rotation/external rotation evaluation of the tibia/knee joint for somatic
dysfunction and document appropriately.
Student is standing at side of table facing patient and places patient in a supine position
with hip and knee flexed to 90 degrees or prone with knee flexed to 90 degrees.
Student assesses passive internal rotation of the tibia by blocking linkage proximally and
noting 10 degrees expected range of motion.
Student assesses passive external rotation of the tibia by blocking linkage proximally and
noting 10 degrees expected range of motion.
Student states internal rotation dysfunction has ease of motion to internal rotation and
restriction to external rotation.
Student states external rotation dysfunction has ease of motion to external rotation and
restriction to internal rotation.
Student notes a tibia/knee internal rotation or external rotation dysfunction would be
documented in the objective portion of the chart noting side of laterality.
7e. Perform the abduction/adduction evaluation of the knee joint for somatic dysfunction and
document appropriately.
Doctor standing at side of table with patient in a supine position.
Doctor contacts the lateral aspect of the knee with one hand and the medial ankle with the
other.
Doctor applies a valgus force to assess for adduction ease or restriction of motion
Doctor reverses hand to medial knee and lateral ankle and applies a varus force to assess for
abduction ease or restriction of motion.
Doctor notes this is evaluating for a functional change not a structural change in the tissues.
Doctor states that an adduction somatic dysfunction will have ease of motion with valgus
force.
Doctor states that an abduction somatic dysfunction will have ease of motion with varus
force.
An adduction or abduction dysfunction will be documented in the objective portion of the
chart with the side of laterality noted.
7f. Perform the proximal fibula evaluation of the knee joint for somatic dysfunction and document
appropriately.
Doctor standing at side of table and patient supine with knee flexed and foot flat on table.
(Can also do supine with knee fully extended)
Doctor contacts the head of the fibula with the thumb and index finger of one hand
Doctor slowly applies an anterior then posterior force to assess for gliding motion of the
fibular head with the tibia.
Doctor notes if there is asymmetry between anterior and posterior glide.
Doctor notes an ease of anterior glide with posterior glide restriction defines an anterior
fibular head somatic dysfunction
Doctor notes an ease of posterior glide with anterior glide restriction defines an posterior
fibular head somatic dysfunction
Doctor notes an anterior or posterior fibular head somatic dysfunction will be documented
in the objective portion of the chart with the side of laterality noted.
7g. Perform the anterior/posterior lateral malleolus (distal fibula) evaluation of the ankle joint for
somatic dysfunction and document appropriately.
Doctor standing at side of table and patient supine with knee flexed and foot flat on table.
Doctor contacts the lateral malleolus (distal fibula) with the thumb and index finger of one
hand
Doctor slowly applies an anterior then posterior force to assess for gliding motion of the lateral malleolus (distal fibula) with the tibia.
Doctor notes if there is asymmetry between anterior and posterior glide.
Doctor notes an ease of anterior glide with posterior glide restriction defines an anterior lateral malleolus (distal fibular) somatic dysfunction
Doctor notes an ease of posterior glide with anterior glide restriction defines a posterior lateral malleolus (distal fibular) somatic dysfunction
Doctor notes an anterior or posterior lateral malleolus (distal fibular) somatic dysfunction
will be documented in the objective portion of the chart with the side of laterality noted.
