Lab 3: LE HVLA/BLT Flashcards Preview

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Flashcards in Lab 3: LE HVLA/BLT Deck (12)
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1

What is the HVLA for a Anterior Fibular Head?

- Pt is supine with doc ipsilateral to dysf.

- Thenar eminence of most lateral hand on anterolateral fibular head

- Grasp foot with most medial hand, invert, IR, plantarflex the foot

- Closepack the knee then slightly flex; thrust rapid knee extension with downward and medial thrust THROUGH fibular head

2

What is the HVLA for a Posterior Fibular Head; technique 1 (supine)?

- Pt supine w/ doc contralateral to dysf.

- Index finger of thrusting hand monitors fibular head with MCP

- Opposite hand flexes hip and knee to 90° then everts, dorsiflexes and ER at the ankle

- Thrust is anterior on fibular head while rapidly flexing the knee

3

What is the HVLA for a Posterior Fibular Head; technique 2 (prone)?

- Pt is prone w/ knee flexed to 90° and doc contralateral to dysf.

- MCP of cephalad index finger on posterior aspect of fibular head w/ hypothenar eminence on hamstrings (creates a "wedge")

Externally rotate tib-fib complex

- Thrust further flexion of knee

4

What is the HVLA for an ankle inversion and eversion?

- Pt supine w/ doc at foot of table

- One hand on calcaneus, other on dorsum of foot

- Thrust for inversion SD: caudad traction with hypereversion of the ankle

- Thrust for eversion SD: caudad traction with hyperinversion of the ankle

5

What is the HVLA for a plantarflexed talus?

- Pt is supine w/ doc at foot of table

- Fingrs interlace on the dorsum of the foot, thumbs on the ball of the foot

- Traction with dorsiflexion

- Thurst = tractional with increased dorsiflexion

 

6

What is the HVLA for Metatarsal Dysfunction?

- Pt is supine w/ doc ipsilateral to dysfunction

- Thumbs placed over the distal end of the metatarsal and proximal end of the first phalanx

- Thurst downward through the thumb (separates the joint)

7

What is the "Hiss Whip" technique for cuboid, navicular dysfunctions?

- Pt prone with hip and knee of affected leg at edge of table, doc at the foot of table

- Both thumbs over plantar surface of affected structure with fingers on dorsum of foot

- Slightly abduct patients LE off the table and flex the knee

- Thrust downward through thumbs with a "whip-like" motion ankle and knee

8

What is the HVLA for a transtarsal dysfunction (both plantar cuboid and plantar navicular SD)?

- Pt supine with knee flexed, abducted, and ER. Doc ipsilateral to dysf

- Cephalad thenar eminence over calcaneus and caudad hand over 1st metatarsal and talus

- Thrust: rotational with caudad hand and simultaneosuly downward THROUGH the calcaneus

- For plantar cuboid SD ---> Invert forefoot

- For plantar navicular SD ---> Evert forefoot

9

What is the BLT for a Posterior Fibular Head?

- Pt supine with doc ipsilateral to dysf.

- Thumb of cephalad hand on the superolateral aspect of the fibular head

- Caudad hand inferior to the distal fibula

- Thumb on fibular head applies pressure straight towards the foot while caudad hand inverts the foot to point of BLT

10

What is the BLT for Femorotibial (knee) dysf (cruciate ligaments)?

- Pt supine w/ doc ipsilateral to dysf.

- Cephalad palm over anterior femur w/ caudad palm over tibial tuberosity

- Lean onto the pt's leg w/ posterior force and approximate femur and tibia with a compressive force

- Induce internal or external rotation to obtain BLT

11

What is the "Boot-Jack" technique?

- Pt supine w/ knee under physicians axilla. Doc ipsilateral to dysf.

- Medial hand holds calcaneus w/ thumb and index finger

- Fingers of lateral hand wrap around the medial foot

- Elbow on medial aspect of knee creates a fulcrum with proximal pressure

- Doc leans back inducing further flexion of hip and knee while distracting the calcaneus from the talus

- Induce slight plantar flexion to obtain BLT

12

What is the Cuneiform and Metatarsal BLT?

- Pt supine w/ doc at foot of table

- Thumbs on dorsum of distal metatarsal and fingers on plantar aspect of foot

- Press thumbs down toward the metatarsals until reaching BLT