Orthopedics 2

chantalinha's version from 2017-12-21 17:36


Question Answer
Neck dysfunction 1ROM (chin to chest, shoulder to shoulder, side to side)
Neck dysfunction 2palpation and observation (deep creases indicate chronically lengthened neck flexors)
Neck dysfunction 3spider veins indicate deficiency of vascular system (SP not holding blood)
Neck dysfunction 4facet impingement test (patient's neck is guided to extension and lateral flexion toward side of pain, while practitioner palpates besides cervical vertebrae.
Neck dysfunction 5during facet impingement test, if pain on same side => impingement of facets/foramen. Opposite side => sprain/strain of muscle. On vertebrae => fracture
Neck dysfunction 6compression/lifting test. Compression pain => nerve. Lifting pain => muscle.
Scapula Dysfunction 1winging of scapula, or excessive proctration (weak rhomboids or tight pecs/serratus) or excessive elevation (tight upper traps or levator scapula)
Scapula Dysfunction 2palpation (left/right, tightness, ropey zones, deficiency...)
Scapula Dysfunction 3palpation of thoracic jia ji and bladder for tightness/tenderness
Scapula Dysfunction 4observe spider veins on upper back
Scapula Dysfunction 5AROM (elevation, depression, protraction, retraction, rotation)
Scapula Dysfunction 6Kibler's test (compare distances b/w spine and inferior angle of scapula when patient: 1) stands w/ arms to sides; 2) moves hands to hips; 3) makes T
Lumbar dysfunction 1Observe standing flexion/extension
Lumbar dysfunction 2Observe spinal rotation
Lumbar dysfunction 3Observe if patient leans to any side when sitting/standing
Lumbar dysfunction 4Gillet's Test (walk in place with high knees, while practitioner has thumbs on PSIS). Checking for SI fixation (when it doesn't move) or if moves superiorly
Lumbar dysfunction 5Straight leg raise - test for pain. If pain b/w 0-35º => disc herniation. If pain b/w 35-70º => sciatic indicated. Normal ROM => 80-90º
Lumbar dysfunction 6Meridian palpation
Posterior Rotator Cuff Dysfunction 1ROM (externally/internally rotation, abduction, adduction) - watch for stiffness/pain
Posterior Rotator Cuff Dysfunction 2Meridian palpation (SI channel)
Posterior Rotator Cuff Dysfunction 3Manual Muscle Testing - pain w/ resisted ROM indicates muscle tear. Pain w/ PROM indicates ligamentous sprain.
Posterior Rotator Cuff Dysfunction 4MMT Supraspinatus - patient lie supine, tries to abduct extended arm w/ palms down against resistance (make a "T")
Posterior Rotator Cuff Dysfunction 5MMT Teres Minor - patient lie supine, tries to externally rotate bended arm against resistance
Posterior Rotator Cuff Dysfunction 6MMT Infraspinatus - patient lie supine, tries to against resistance ???
Posterior Rotator Cuff Dysfunction 7MMT Subscapularis - patient lie supine, tries to "throw ball" internally rotating bended arm above head against resistance
Anterior Rotator Cuff Dysfunction 1LI + SJ meridian palpation (anterior cuff muscles) + ST (pectoralis muscle - probably shortened)
Anterior Rotator Cuff Dysfunction 2Patient should move arm in an arch in all directions. Looking for stiffness, pain
Anterior Rotator Cuff Dysfunction 3Patient should move neck side to side, indicating possible fascial constriction b/w neck and anterior shoulder girdle / pecs
Anterior Rotator Cuff Dysfunction 4Full/Empty Can Test - to differentiate b/w pain caused by supraspinatus (pain b/w LI-15 and SJ-14) from infraspinatus/teres minor (pain b/w SI-9 and SI-10)
Anterior Rotator Cuff Dysfunction 5Lift-Off Sign (placie back of hand on lower back, try to lift hand off back) - if painful => tension in anterior cuff muscles or injury to subscapularis
Anterior Rotator Cuff Dysfunction 6Appley's Scratch test (touch opposite scapula, same side scapula to assess ROM)
Anterior Rotator Cuff Dysfunction 7Speed test (elbow extended, supine, shoulder flexed at 45º. Patient contracts biceps against resistance) - positive if pain at bicipital groove (bicipital tendonitis)
Anterior Rotator Cuff Dysfunction 8Observation of pec minor shortness (patient lies supine)
Tenis ElbowLateral epicondylitis - use Extensor Carpi Radialis and SanChi
Supinator Syndromesimilar but different than Tenis Elbow - entrapment of radial nerve under LI-9/LI-10 by supinator muscle (for restaurant servers)
Golf ElbowMedial epicondylitis (caused by large force when hitting the ball while flexors are tight - cause inflammation in the area) - treat Pronator Teres
Pronation Syndromethose that repetitively force pronation (swimmers, surfers, throwers...) are susceptible to median nerve entrapment
Carpal Tunnel Syndromecompression of the median nerve at the wrist d/t overwork of little muscles that work the fingers and extend wrist - use Pronator Quadratus and P-7
Arm & Wrist Dysfunction 1Palpate along LI for swollen, tender, tight wrist extensors. If pain is on the bone => chronic lateral epicondylitis
Arm & Wrist Dysfunction 2Phalen's/Reverse test (palms together for 1min, dorsum of palms together for 1min) - test for carpal tunnel
Arm & Wrist Dysfunction 3Thenar eminence (O-ring) test () - px forms ring with thumb/pinky , practitioner pulls fingers apart. Same w/ px pressing to bring ulna/radius together. Test positive if this way strength increases. => use Pronator Quadratus
Arm & Wrist Dysfunction 4Pronator test (patient pronates and extends elbow against supinator force of practitioner). If tingling/pain => pronator teres sd (and not carpal tunnel)
Arm & Wrist Dysfunction 5Tinel's Sign (tap ulnar nerve group - funny bone - 4-6 times) - positive if ???
Arm & Wrist Dysfunction 6Cozen's Sign (forearm pronated, elbow flexed, try to extend wrist agains resitance. Practitioner palpate lateral epicondyle) - confirm if pain is from lateral elbow (tennis elbow)
Lumbar Stabilizers 1Observe standing flexion and ROM (spinal extension, flexion, rotation)
Lumbar Stabilizers 2Observe sitting and standing. If px leans to one side => QL is shortened
Lumbar Stabilizers 3Observe short leg discrpepancy
Lumbar Stabilizers 4GIllet's test (walk in place with high knees while practitioner has thumbs on PSISes) => evaluates SI joints
Lumbar Stabilizers 5Straight Leg Rais - if pain b/w 0-35º=>disc herniation. If pain b/w 35-70º=>sciatic neuritis. Normal ROM: 80-90º.
Lumbar Stabilizers 6Meridian palpation
Lumbar Stabilizers 7Observe patient walk to and fro
Sacrum 1straight leg raise - test for pain. If b/w 0-35º=>disc herniation. If 35-70º=>sciatica. Normal ROM=>80-90º.
Sacrum 2patient supine, bend hip, adduct and abduct.
Sacrum 3palpate IT band on both sides - It compression test (flex + press)
Sacrum 4Ober's Test (patient side lying, leg extended, lower it into adduction). Positive if leg stays in the air and doesn't fall into table.
Sacrum 5Trendelenburg Sign (patient stand on one leg while raising the opposite knee. If pelvis on the same side as the lifted leg drops, gluteus medius/minimus muscles on the standing leg are weak.
Posterior Leg 1Patient lies supine, should be able to raise leg 80-90º without pain.
Posterior Leg 2Patient lies prone, flex knee 25º-45º-90º, press against hand
Posterior Leg 3Patient standing bends w/ straight legs to touch their toes. If pain, hamstring might be tight.
Hip Flexor 1Postural assessment - lordosis, PSIS leveled
Hip Flexor 2walk 2 or 3 times to identify hip restriction
Hip Flexor 3patient lie supine, put right ankle on left knee to stretch psoas. Patient should have both knees leveled (if not=> tight iliopsoas muscle). Pressing knee, if pain on back => psoas restricted. If opposite ASIS elevates=> also restriction
Hip Flexor 4patient sitting - press against hand on ankle (checking for knee pain (rectus femoris tightness) and symmetry of strength)
Hip Flexor 5patient lie prone, flex knee to gluteus. If hip rises off table => rectus femoris tightness
Hip Flexor 6patient sit at end of table w/ legs hanging off table. one knee is brought to chest, other stretches down to floor. If leg rises => tightened psoas
Knee and Leg 1observe patient standing: feet at symmetrical direction, patellas aligned, check for varus (cowboy) or valgus
Knee and Leg 2observe patient bending knees "elbow to knee"
Knee and Leg 3patient lie supine, knees extended. Wiggle patella around and check for texture, range of motion...
Knee and Leg 4patient lie supine, press knee from outside while angle from inside => checking for valgus disorder if there is pain or lack of stability
Knee and Leg 5patient lie supine, press knee from inside while angle from outside => checking for varus disorder if there is pain or lack of stability
Knee and Leg 6drawer test -> patient lie supine, practitioner sit on px's foot and pulls tibia. This tests for torn ACL
Knee and Leg 7patient lie prone, check for patella mobility
Knee and Leg 8wobble ankle, looking for an even play of the ankle joint
Knee and Leg 9squeeze metatarsals to check for metatarsal neuroma
Knee and Leg 10patient lie prone, bend knee (raise foot), practitioner press sole of foot towards floor to evaluate meniscus pain