Quiz 9 Flashcards by Sara Morris

Name three special tests for the ACL?

Anterior drawer
Lachman’s
Pivot shift
Jerk
FRD (Flexion Rotation Drawer Test)

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Which ACL test is the gold standard and why?

Lachman’s - Has the highest sensitivity

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Explain how you would determine if an ACL test was positive

Positive Test Findings:

Pain
> 3 mm translation
“Empty” end feel
Increased anterior motion on stress testing

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What might the patient say to make you believe their ACL is involved?

History of macrotrauma including twisting, deceleration
History of giving way
History of hearing “pop”

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Name three special tests for the meniscus?

Recurvatum,
McMurray’s (and with DDV),
Apley’s compression (and with DDV),
Steinman’s

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Which special test implicates the anterior horn of the meniscus?

Recurvatum

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What indicates a positive meniscus test?

Joint line pain
Click/clunk
Catching/locking
Pseudo-catching/locking

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Explain how to perform the Apley’s Dynamic Compression (DDV) test.

Patient is prone, compress the tibia into the femur and externally rotate, then extend.
Repeat with tibia in internal rotation, then extend.

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What are two factors that occur when running that increase the risk of injury in runners?

Increased GRF and Increased velocity

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For a runner with a “high arch” what is their foot alignment and what kind of shoe should they wear?

Supination; neutral-cushioning shoe

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Alignment and shoe for runner with“normal arch”?

Neutral; stability shoe

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Alignment and shoe for runner with “flat foot”?

Pronation; motion-control shoe

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How long does the typical running shoe last?

~ 500 miles

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What type of orthotic would you use for rigid pes planus?

Rigid orthotic

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What type of orthotic for pes cavus?

Soft orthotic

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Where do you typically see calluses?

1st Met head

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Where would you see calluses that would be abnormal?

Medial side of the big toe, pinched callus

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How do you prevent forefoot varus with orthotics?

Medial post

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What orthotic could you use for a Morton’s neuroma?

Metatarsal bar

What can the max heel lift be inside of the shoe?

1/2 inch

What is the initial goal of rehab for an acute ankle sprain?

To decrease swelling

Name three PT interventions that can be done to address an acute ankle sprain

Cryotherapy, 
compression, 
elevation, 
milking massage, 
e-stim, 
NSAIDs, 
ankle pumps

What is the best way to wrap an acute ankle sprain? Name it and describe it

Horseshoe wrapping
Place the horseshoe around the lateral malleolus to fill the space and then do figure-8 wrap
Check compliance by looking for the indentation at next session

What is an example of e-stim for decreasing swelling?

IFC or Hi-Volt

What is the capsular pattern of the hip?

Capsular Pattern: Flexion > Abduction > Internal Rotation

Name a hip mobilization to improve hip ER.

Figure four anterior or anterior glides

Name a hip mobilization that can be done to improve hip flexion

Inferior glide or posterior glide

Name a hip mobilization to improve hip extension.

Anterior glide

Name 4 Patellofemoral Tests

Medial glides- checks superficial fibers on lateral retinaculum Lateral glides- check superficial fibers of medial retinaculum Medial Tilts- checking deep fibers of lateral retinaculum Lateral Tilts- Deep fibers of medial retinaculum Caudal Glides- checking quad tendon Cephalic glides- checking infrapatellar tendon

Name 2 PF tests used for patellar tracking

Passive tracking Active Tracking OKC Active Tracking CKC

Why should we not use a bolster under the knee when performing PF tilts?

Want to loosen deeper structures so you can tilt the patella (knee is in most lax position)

What instructions should you give someone who has just gotten their orthotic? (If you don’t like this one, you can change it)

It must be worn in every shoe May need to purchase a wider shoe to accommodate the orthotic

What glide do you perform with the Moving Patellar Apprehension Test?

Lateral Glide

If the Moving Patellar Apprehension Test is positive, what do you do? (second step of the test)

Medial Glide

Name the four PCL tests on the knee algorithm

Recurvatum, Sag test, Clancy step up, and Posterior drawer

Give an example of an injury that may cause a PCL tear.

Hyperextension injury Fall on anterior tibia with ankle in plantarflexion

What other ligament would you want to examine in a suspected PCL tear?

ACL

Describe a positive PCL test:

Pain, Instability, Increased posterior motion with Stress testing

Which part of the knee do you measure when performing anthropometric measurements of the knee?

- 20 cm proximal to the joint line - 10 cm proximal to the joint line - Joint line - 15 cm distal to the joint line

Why do you measure at each part when performing anthropometic measurements of the knee?

20 cm proximal to the joint line- atrophy in the chronic knee 10 cm proximal to the joint line- swelling in the acute knee, atrophy in the chronic knee Joint line- Swelling in the acute knee 15 cm distal to the joint line-Atrophy in the chronic knee. The bulk of the gastroc soleus is here for most people. Can adjust for an especially tall or short individual.

Name four special tests for LE flexibility and what structures are implicated

Thomas Test: Iliospoas and RF Ober's or Modified Ober's: IT Band Ely's: Rectus Femoris 90/90 SLR: Hamstrings

When assessing hip flexor length, how do you differentiate between the two muscles?

Bend the knee - if thigh rises, RF is implicated and if no movement, iliopsoas is implicated OR Straighten the knee - if thigh lowers, RF is implicated and if no movement, iliopsoas is implicated

What are the three aspects of the femoral triangle?

Inguinal ligament Sartorius Adductor Longus

What structures pass through the triangle?

Femoral vein, artery and nerve (medial to lateral)

What position is best for accurate palpation of these structures?

Supine figure-4