Lab 3: LE HVLA/BLT Flashcards Preview

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


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


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


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


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



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)


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


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


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


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


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


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