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ECOS2 Exam 1 > Extremity Counterstrain > Flashcards

Extremity Counterstrain Flashcards

(79 cards)

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1
Q

List the counterstrain steps

A
  1. Find most signficiant tenderpoint
  2. Physician establishes a tenderness scale
  3. Monitor Tenderpoint throughout
  4. Place patient in “Position of Ease” of at least 70% improvement
  5. Hold for 90 seconds
  6. Slowly return to neutral
  7. Recheck tenderness and associated TART findings
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2
Q

Supraspinatus counterstrain

Location?

A

Midsupraspinatus muscle just superior to spine of scapulae

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3
Q

Supraspinatus counterstrain

Pt. position

Doc position

A

Pt: Supine

Doc: Ipsilateral to tenderpoint

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4
Q

Supraspinatus counterstrain

Treatment Positioning

A

F Abd ER

  • Patient’s arm is flexed 45 degrees, abducted 45 degrees, and externally rotated*
  • Think Statue of Liberty*
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5
Q

Levator Scapulae

Location

A

In levator at the superior angle of the scapula

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6
Q

Levator Scapulae

Pt position

Doc position

A

Pt: Prone, head rotated away

Doc: Ipsilateral to TP

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7
Q

Levator Scapulae

Treatment positioning

A

IR Abd traction

IR pt’s shoulder, add mild-mod traction with minimal abduction

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8
Q

Subscapularis

Location

A

Anterolateral border of the scapula on the subscapularis muscle (press posterior and medially)

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9
Q

Subscapularis

Pt & Doc position?

A

Pt: Supine

Doc: Seated ipsilateral

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10
Q

Subscapularis

Treatment Positioning

A

E IR

Patient’s shoulder extended and internally rotated, traction can help

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11
Q

Biceps Brachii (Long Head)

Location

A

Over long head of biceps tendon in bicipital groove

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12
Q

Biceps Brachii (Long Head)

Pt & Doc Position

A

Pt: Supine

Doc: Ipsilateral

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13
Q

Biceps Brachii (Long Head)

Treatment positioning

A

F Abd ir

Elbow & shoulder flexed, arm is minimally abducted and internally rotated

Dr. Joy’s way of remebering: place hand on head (F Abd ir) and think “ugh this is the LONGEST technique”

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14
Q

Biceps Brachii (Short Head) & Coracobrachialis

Location

A

Inferolateral aspect of the coracoid process on short head tendon of biceps or coracobrachialis

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15
Q

Biceps Brachii (Short Head) & Coracobrachialis

Pt & Doc position

A

Pt: Supine

Doc: Ipsilateral

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16
Q

Biceps Brachii (Short Head) & Coracobrachialis

Treatment positioning

A

F Add ir

Elbow and shoulder flexed, arm is minimally adducted and internally rotated

Note: like long head except ABd –> ADd

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17
Q

Radial Head - Lateral (Supinator)

Location

A

Anterolateral aspect of the radial head at supinator attachment

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18
Q

Radial Head - Lateral (Supinator)

Pt & Doc position

A

Pt: Supine or seated

Doc: ipsilateral

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19
Q

Radial Head - Lateral (Supinator)

Treatment positioning

A

E SUP Val

Pt’s elbow in full Extension, forearm markedly supinated, fine tune with vaLgus force

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20
Q

Medial Epicondyle (Pronator Teres)

Location

A

Near medial epicondyle of humerus associated with common flexor tendon and pronator teres

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21
Q

Medial Epicondyle (Pronator Teres)

Pt & Doc Position

A

Pt: Supine or seated

Doc: Ipsilateral

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22
Q

Medial Epicondyle (Pronator Teres)

Treatment positioning

A

F PRO Add

Pt’s elbow Flexed, marked pronation, forearm slightly aDducted

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23
Q

Dorsal Wrist (Extensor Carpi Radialis)

Location

A

Dorsal surface of second metacarpal associated with extensor carpi radialis muscle (may also be in any extensor muscle)

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24
Q

Dorsal Wrist (Extensor Carpi Radialis)

Pt & Doc position

A

Pt: Supine or seated

Doc: Ipsilateral

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25
**Dorsal Wrist (Extensor Carpi Radialis)** Treatment positioning
E Abd/rd ## Footnote *Pt’s wrist passively Extended and aBducted*
26
**Dorsal Wrist (Extensor Carpi Ulnaris)** Location
Dorsal surface of fifth metacarpal associated with extensor carpi ulnaris muscle (may also be in any extensor muscle)
27
**Dorsal Wrist (Extensor Carpi Ulnaris)** Pt & Doc position
Pt: Supine or seated Doc: Ipsilateral
28
**Dorsal Wrist (Extensor Carpi Ulnaris)** Treatment position
E ADD ## Footnote *Pt’s wrist passively Extended and aDducted*
29
**Palmar Wrist (Flexor Carpi Radialis)** Location
Palmar base of second or third metacarpal in the flexor carpi radialis muscle (may also be found in any flexor muscle)
30
**Palmar Wrist (Flexor Carpi Radialis)** Pt & Doc position
Pt: Supine or seated Doc: Ipsilateral
31
**Palmar Wrist (Flexor Carpi Radialis)** Treatment position
F Abd ## Footnote *Pt’s wrist passively Flexed and aBducted*
32
**Palmar Wrist (Flexor Carpi Ulnaris)** Location
Palmar base of fifth metacarpal in the flexor carpi ulnaris muscle (may also be found in any flexor muscle)
33
**Palmar Wrist (Flexor Carpi Ulnaris)** Pt & Doc position
Pt: Supine or seated Doc: Ipsilateral
34
**Palmar Wrist (Flexor Carpi Ulnaris)** Treatment position
F Add ## Footnote *Pt’s wrist passively Flexed and aDducted*
35
**First CMP (Abductor Pollicis Brevis)** Location
Palmar base (radial aspect) of first metacarpal in the abductor pollicis brevis muscle
36
**First CMP (Abductor Pollicis Brevis)** Pt & Doc position
Pt: Supine or seated Doc: Ipsilateral
37
**First CMP (Abductor Pollicis Brevis)** Treatment position
F (wrist) Abd (thumb) ## Footnote *Pt’s wrist passively Flexed, thumb is aBducted*
38
**Lateral Trochanter (Tensor Fasciae Latae)** Location
Just inferior to iliac crest in body of TFL
39
**Lateral Trochanter (Tensor Fasciae Latae)** Pt & Doc position
Pt: Supine or **prone** Doc: Ipsilateral to TP
40
**Lateral Trochanter (Tensor Fasciae Latae)** Treatment position
Patient's knee is aBducted and slightly flexed. May require slight internal rotation of the hip
41
**Iliotibial band** Location
Along the iliotibial band distal to the greater trochanter
42
**Iliotibial band** Pt & Doc position
Pt: Supine or prone Doc: Ipsilateral to TP
43
**Iliotibial band** Treatment position
f ABD ## Footnote *Patient's hip/thigh is abducted and slightly flexed until the tenderness is greater than or equal to 70% reduction. May require slight internal or external rotation of the hip*
44
**Lateral hamstring** Location
Distal aspect of the biceps femoris near attachment to the posterolateral surface of the fibular head
45
**Lateral hamstring** Pt & Doc position
Pt: Supine or **prone** Doc: Ipsilateral to TP
46
**Lateral hamstring** Treatment position
F ER ABd ## Footnote *knee is flexed and the tibia is externally rotated with slight abduction; compression on the calcaneus is added to plantar flex the ankle*
47
**Medial Hamstring** Location
Distal aspect of the medial hamstring tendons near their attachment to the posterior medial surface of the tibial condyle
48
**Medial Hamstring** Pt & Doc position
Pt: Supine or **prone** Doc: Ipsilateral to TP, grasp lateral ankle/foot to control the lower leg
49
**Medial Hamstring** Treatment position
F IR Add ## Footnote *Patient's knee is flexed and the tibia is Internally rotated with slight aDduction; compression on the calcaneus is added to plantar flex the ankle*
50
**Lateral Meniscus: Lateral (Fibular) Collateral Ligament** Location
Lateral aspect of meniscus along the joint line
51
**Lateral Meniscus: Lateral (Fibular) Collateral Ligament** Pt & Doc position
Pt: Supine Doc: Ipsilateraland seated
52
**Lateral Meniscus: Lateral (Fibular) Collateral Ligament** Treatment position
Pt’s thigh abducted so leg is off table, flex knee~35-40 degrees, tibia is abducted and externally or internally rotated until the tenderness is ≥70% reduction. May require ankle dorsiflexion and eversion of the ankle.
53
**Medial Meniscus: Medial (Tibial) Collateral Ligament** Location
Medial knee joint line
54
**Medial Meniscus: Medial (Tibial) Collateral Ligament** Pt & Doc position
Pt: Supine Doc: Ipsilateral and seated
55
**Medial Meniscus: Medial (Tibial) Collateral Ligament** Treatment position
Pt’s thigh abducted so leg is off table, flex knee~35-40 degrees, tibia is adducted and internally rotated until the tenderness is ≥70% reduction. May require plantar flexion and inversion of the ankle
56
**Anterior Cruciate** Location
Superior aspect of popliteal fossa adjacent to the hamstring tendons
57
**Anterior Cruciate** Pt & Doc position
Pt: Supine Doc: Ipsilateral
58
**Anterior Cruciate** Treatment position
Towel roll or pillow under distal femur for fulcrum, apply force to proximal tibia to translate tibia posteriorly on distal femur until the tenderness is ≥70% reduction
59
**Posterior Cruciate** Location
Slightly below center of popliteal fossa
60
**Posterior Cruciate** Pt & Doc position
Pt: Supine Doc: Ipsilateral
61
**Posterior Cruciate** Treatment position
Towel roll or pillow under proximal tibia for fulcrum, apply force to distal femur to translate femur posteriorly on proximal tibia until the tenderness is ≥70% reduction
62
**Popliteus** Location
In the muscle belly just inferior to the popliteal spac
63
**Popliteus** Pt & Doc position
Pt: Prone Doc: Ipsilateral
64
**Popliteus** Treatment position
Pt’s knee flexed and tibia is internally rotated until the tenderness is ≥70% reduction
65
**Extension Ankle (Gastrocnemius)** Location
Within the proximal gastrocnemius muscles distal to popliteal margin
66
**Extension Ankle (Gastrocnemius)** Pt & Doc position
Pt: Prone Doc: Ipsilateral
67
**Extension Ankle (Gastrocnemius)** Treatment position
Pt’s knee flexed and dorsum of foot on doc’s thigh, add compressive force through calcaneus until the tenderness is ≥70% reduction
68
**Medial Ankle (Tibialis Anterior)** Location
Anterior and inferior to the medial malleolus along deltoid ligament.
69
**Medial Ankle (Tibialis Anterior)** Pt
Lateral recumbent with pillow under affected leg
70
**Medial Ankle (Tibialis Anterior)** Treatment position
Apply inversion force to foot and ankle with slight internal rotation until the tenderness is ≥70% reduction
71
**Lateral Ankle Fibularis (Peroneus) Longus, Brevis, Tertius** Location
Anterior and inferior to the lateral malleolus in the sinus tarsi (talocalcaneal sulcus)
72
**Lateral Ankle Fibularis (Peroneus) Longus, Brevis, Tertius** Pt position
Lateral recumbent with pillow under affected leg
73
**Lateral Ankle Fibularis (Peroneus) Longus, Brevis, Tertius** Treatment position
Apply eversion force to foot and ankle with slight external rotation until the tenderness is ≥70% reduction
74
**Flexion Calcaneus (Quadratus Plantae)** Location
Anterior aspect of plantar surface of calcaneus at attachment of plantar fascia
75
**Flexion Calcaneus (Quadratus Plantae)** Pt & Doc position
Pt: Supine or **prone** Doc: Ipsilateral to TP
76
**Flexion Calcaneus (Quadratus Plantae)** Treatment position
Patient's knee is flexed, dorsum of foot on doc’s thigh, marked flexion while translating calcaneus toward the forefoot until the tenderness is ≥70% reduction
77
**Navicular** Pt & Doc position
Pt: Supine or **prone** Doc: Ipsilateral to TP
78
**Navicular** Treatment position
Patient's knee is flexed, dorsum of foot on doc’s thigh, plantar flexion of subtalar joint, supination of forefoot until the tenderness is ≥70% reduction
79
Piriformis counterstrain
Supine F Abd ER

ECOS2 Exam 1 (1 decks)

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