Special Txs Flashcards
(29 cards)
Selective Tissue Tension Test Joints =
Compress or traction
Selective Tissue Tension Test
Muscle =
Stretch or Contract
Muscle Grades 0-5.
0 - No evidence of any muscle contraction
1 – Trace - feeble contraction
3 – Poor –
4 – Fair – Muscle can hold in test position against
gravity
5 – Normal – Hold test position test position
against strong pressure “full strength”
Selective Tissue Tension Test
Circulation =
Pulse palpation
Selective Tissue Tension Test
Nerves=
• Tap • Stretch • Myotomes • Dermatome • Deep Tendon Reflex Grading is described as: 0- Absent 1- Dimished 2- Average (Normal) 3- Exaggerated 4- Clonus (brisk)
Selective Tissue Tension Test
Ligaments =
Stretch / stress
Selective Tissue Tension Test
Organs =
Look at characteristic referral patterns
Referred pain from sacroiliac joint
(A) From the sacroiliac joint
(B) To sacroiliac joint
(A) from sacrum to low back, glutes, deep rotators, leg.
(B) Lumbar/ pubis region to sacrum
PELVIS – Motion Palpation
• (A) Starting position for sacral spine and posterior superior iliac spine. Standing upright with pelvis neutral • (B) Hip flexion; the ilium (PSIS) should drop inferiorly • (C) Starting position for sacral spine and ischial tuberosity. Standing upright with pelvis neutral • (D) Hip flexion; Ischial tuberosity should move inferior + lateral (E) palpating position of sacrum in flexed sitting (F)palpating PSIS for asymmetric movement on backward bending.
Examiner palpating for sacral nutation
One thumb is on the PSIS, other thumb is parallel to it on the sacrum.
Examiner is feeling for:
(A) forward movement (nutation) of the sacrum that occurs early in
movement and (B) backward movement (counternutation) of the
sacrum, which normally occurs around 60° of hip flexion .
Trendelenburg sign
Magee (pg. 680 – 681)
CLIENT: • Balance on one leg then the other THERAPIST: • Observe TESTS FOR: • Weak Hip Abductors (esp.Gluteus Medius) or an unstable hip POSITIVE IF: • Pelvis on the opposite side (nonstance side) drops when the client stands on the affected leg
STORK STANDING TEST
Magee (pg. 665)
CLIENT:
• Standing on one leg with other foot on
opposite knee, hip externally rotated
THERAPIST:
• Observe client
TESTS:
• A. Integrity of the joints of the pelvis
• B. Stability and proprioception of pelvis and
lower limb (w/ eyes open & closed)
POSITIVE IF:
• A. Pain (SI, Pubic, or hip jt’s) & or difficulty in
obtaining the test position
• B. Difficulties balancing on the one leg
Flamingo test
Magee (pg. 638 – 639)
CLIENT:
• Stand on one leg
TESTS:
• Lesions in symphysis pubis or S.I. Joint
POSITIVE IF:
• Pain in symphysis pubis or S.I. Joint
indicates lesions in the painful structure
Clinical features:
• Consist of pain in the region of the pubis,
may radiate to the groin or lower abdomen
• Clicking may be present and indicates
instability. Local tenderness is the only
significant sign.
Gillet’s (sacral fixation) Test
(AKA Ipsilateral posterior rotation test)
Magee (pg. 637 – 638)
CLIENT: • Standing • Flex hip when asked by therapist THERAPIST • One thumb on PSIS • Second thumb parallel on sacrum TESTS FOR: • Hypomobile or “locked” S.I. Joint POSITIVE IF: • S.I. joint on the side that is flexed moves minimally or up – is hypomobile • Normal (-) = the test PSIS moves down or inferiorly
Ipsilateral anterior rotation test
Magee (pg. 638)
CLIENT: • Standing • Extend hip when asked by therapist THERAPIST • One thumb on PSIS • Second thumb parallel on sacrum TESTS FOR: • Hypomobile or “locked” S.I. Joint POSITIVE IF: • S.I. joint on the test side moves down/ inferiorly • Normal (-) = PSIS should move superior / lateral
Ipsilateral prone kinetic test
On extension while lying in prone position, the posterior superior iliac spine and sacral crest
Normally should move superiorly and laterally.
Active movements of the lumbar spine:
forward flexion Extension.
Side flexion
Rotation
joint dysfunctionKemps/ Quadrant test
CLIENT:
Extend, side flex and rotate spine
THERAPIST:
Stand behind client, control movement holding
shoulder and occiput to support head
Apply overpressure
POSITIVE IF:
Symptoms are reproduced, causes maximum
narrowing of intervertebral foramen and closure
Of the facet joints
Segmental instability tests – prone instability tests
The patient lies prone with the body on the examining table and legs over the edge and feet resting on the floor. While the patient rests in this position with the trunk muscles relaxed, the examiner applies posterior to anterior pressure to an individual spinous process of the lumbar spine.
Any provocation of pain is reported. Then the patient lifts the legs off the floor (the patient may hold table to maintain position) and posterior to anterior compression is applied again to the lumbar spine while the trunk musculature is contracted.
The test is considered positive if pain is present in the resting position but subsides in the second position, suggesting lumbo-pelvic instability. The muscle activation is capable of stabilizing the spinal segment.
VALSALVA TEST
CLIENT:
Take a deep breath, hold it and bear down as if evacuating the bowels
POSITIVE IF:
Leads to symptoms in the sciatic
nerve distribution or other nerve involvement
INDICATES: Intrathecal (fluid-filled space between the thin layers of tissue that cover the brain and spinal cord) pressure
Dural SLUMP TEST
purpose
Postulated neurobiomechanics that occur with slump movement.
The approximate points C6, T6, L4, and knee are where the neural tissue does not move in relation to the movements of the spinal canal.
It is important to understand, however, that movement of neurological tissue is toward the joint where movement was intiated.
Dural SLUMP TEST
Sequence of subject postures
Sequence of subject postures in the slump test
Patient sits erect
Patient slumps lumbar and thoracic spine while examiner holds head in neutral
Examiner pushes down on shoulders while patient holds head in neutral
Examiner extends patient’s knee and dorsiflexes foot
Patient flexes head
Examiner carefully applies overpressure to cervical spine
Patient extends head. If symptoms are reproduced at any stage, further sequential movements are not attempted.
Straight leg raise - “Lassegues’s” test
Client: Supine - Therapist: Passively move one hip into flexion, medial rotation and adduction making sure knee is in extension. Observe for signs and symptoms of neurological origin
Bragard’stest:
After having symptom, lower the leg about 10 degrees and Dorsiflex ankle
POSITIVE TEST:
(A) Radicular symptoms are precipitated on the same side with straight leg raising.
(B) The leg is lowered slowly until pain is relieved. The foot is then dorsiflexed (Braggard’s test), causing a return of symptoms
Hyndman’s, Brudzinski’s sign, or Sotoo-Hall:
checks for irritation of the cervical spine and dura
Client is supine - Flex cervical spine –if pain is reproduced assess symptoms –local verses neurological
BOWSTRING SIGN
THERAPIST:
Slightly flex knee after a positive straight leg raise test (20 deg), reducing symptoms.
Digital pressure in popliteal area
POSITIVE IF:
Radicular pain increases after digital pressure
INDICATES:
Tension/ pressure on sciatic nerve
