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Things to remember for the final practical:
- Patient in proper position/posture.
- Which plane does the motion occur?
- What are your landmarks? (= palpate!)
- What arrow are you using?
- How do you get your final reading?
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3 CARDINAL PLANES:
- Get out a paper plate & a pencil.
- Punch the pencil through the center of the plate.
- The paper plate is the plane.
- The pencil is the axis, which is where the action takes place.
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1. Sagittal (Median) Plane:
- Divides body into R & L.
- Allows for flexion & extension to occur.
- Axis of rotation: bilateral (coronal).
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2. Coronal (Frontal) Plane:
- Divides body into A & P.
- Allows for lateral flexion to occur.
- Axis of rotation: sagittal (AP)
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3. Transverse (Horizontal) Plane:
- Divides into S & I (cephalad & caudal respectively).
- Allows for rotation to occur.
- Axis of rotation: VLP (Vertical/Longitudinal/Polar).
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INCLINOMETRY:
- Inclinometry: ROM of the spine.
- Found via AROM.
- Red arrow: rotation... red arrow in red silhouette.
- Yellow arrow: lateral flexion & flexion/extension.
- Subtract bottom number from top number.
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Cervical Landmarks:
- Rot (Trans/Horiz): Top/head & T1.
- Lat Flex (Coronal/Frontal): Top/head & T1.
- Flex/Ext (Sagittal/Median): Top/head & T1.
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Thoracic Landmarks:
- Rot (Trans/Horiz): T1-T12.
- Lat Flex (Coronal/Frontal): T1-T12.
- Flex/Ext (Sagittal/Median): T1-T12.
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Lumbar Landmarks:
(say that 10 times fast)
- Rot (Trans/Horiz): L1-S2.
- Lat Flex (Coronal/Frontal): L1-S2.
- Flex/Ext (Sagittal/Median): L1-S2.
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GONIOMETRY:
- HAVE PATIENT DO AROM FIRST, THEN DO PROM.
- Size matters!
- Within Normal Limits (WNL): +/- 5*.
- Smooth side against the patient.
- Do EVERYTHING bilaterally!!
- We don't need to know normal degrees for lab test.
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Red scale:
(We generally use the black scale).
- 1. Shoulder adduction.
- 2. Hip adduction.
- 3. Hip ABduction.
- 4. Plantar flexion/ankle.
- 5. Dorsi flexion/ankle.
- *Do the dance: Shoulder, Hip, Hip, Foot, Foot!*
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Shoulder Flexion:
- Sagittal/ Median plane.
- Coronal axis.
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Shoulder ABduction:
- Coronal plane.
- Sagittal axis.
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Shoulder Adduction:
- Coronal plane.
- Sagittal axis.
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Shoulder Internal Rotation:
- Horizontal plane.
- VLP axis.
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Shoulder External Rotation:
- Horizontal plane.
- VLP axis.
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Shoulder Extension:
- Sagittal plane.
- Coronal axis.
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Elbow Flexion:
- Sagittal plane.
- Coronal axis.
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Elbow Extension:
- Sagittal plane.
- Coronal axis.
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Wrist Flexion:
- Sagittal plane.
- Coronal axis.
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Wrist Extension:
- Sagittal plane.
- Coronal axis.
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Ulnar Deviation:
- Coronal plane.
- Sagittal axis.
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Radial Deviation:
- Coronal plane.
- Sagittal axis.
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Hip Joint Flexion:
- Sagittal plane.
- Coronal axis.
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Hip Joint Extension:
- Sagittal plane.
- Coronal axis.
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Hip ABduction:
- Using outer RED scale.
- PP: supine.
- Plane: frontal (coronal).
- Axis: sagittal (AP) --> ASIS.
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Hip Adduction:
- Using outer RED scale.
- PP: supine.
- Gaenslen's Orthopedic Test position: leg off tab.
- Pateint helps find ASIS.
- Plane: frontal (coronal).
- Axis: AP (sagittal) --> ASIS.
- Normal: 30*.
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Hip External Rotation:
- PP: supine.
- Kernig's Orthopedic Test position: knee & hip flexed, straight leg, femur perpendicular with table.
- Plane: transverse (horizontal).
- Axis: VLP (longitudinal) --> patella.
- Normal: 45*.
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Hip Internal Rotation:
- PP: supine.
- Positioned like Kering's Orthopedic Test: knee flexed, hip flexed, leg straight, femur perpendicular with table.
- Plane: transverse (horizontal).
- Axis: VLP (longitudinal) --> patella.
- Normal: 45*.
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Knee Flexion:
- PP: prone.
- Knee extended, bring leg toward butt.
- Plane: sagittal (median).
- Axis: coronal (bilateral) --> lateral condyle of femur.
- Normal: 135*.
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Knee Extension:
- PP: supine.
- Knee extended, bring leg forward.
- Plane: sagittal (median).
- Axis: coronal (bilateral) --> lateral condyle / femur.
- Normal: 0*.
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Ankle Plantar Flexion:
- Using outer RED scale.
- PP: prone.
- Knee flexed @ 90, foot flexed @ 90, foot toward ceiling.
- Plane: sagittal (median).
- Axis: coronal (bilateral) --> lateral malleolus.
- Normal: 50*.
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Ankle Dorsi Flexion:
- Using outer RED scale.
- PP: prone.
- Knee flexed @ 90, foot flexed @ 90, foot toward table.
- Plane: sagittal (median).
- Axis: coronal (bilateral) --> lateral malleolus.
- Normal: 20*.
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Subtalar Inversion:
- PP: Prone.
- Feet off table, leg fully extended.
- Plane: coronal (frontal).
- Axis: AP (sagittal) --> mid calcaneus.
- Normal: 5*.
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Subtalar Eversion:
- PP: Prone.
- Knee flexed @ 90, foot flexed @ 90, foot pointed toward table.
- Plane: coronal (frontal).
- Axis: AP (sagittal) --> mid clacaneus.
- Normal: 5*.
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Fibularis Longus
-Superficial Peroneal N
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Fibularis Brevis:
-Superficial Peroneal N.
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Psoas Major:
-Lumbar plexus.
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TFL:
-Superior Gluteal N, L4, L5, S1.
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Piriformis:
-Sacral plexus.
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Sartorius:
-Femoral, L2, L3.
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Medial Hamstring Group:
-Sciatic N (Tibial branch)
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Semimembranosus:
-Sciatic N (Tibial branch)
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Lateral Hamstrings (Biceps femoris)
-Long head: Sciatic N (tibial branch).
-Short head: Sciatic N (fibular branch).
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Glute Max:
-Inf. Gluteal N
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Glute Med:
-Superior Gluteal N
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Hip Adductor Group:
-Adductor magnus: obturator & sciatic N.
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Rectus Abdominus:
Illiohypogastric & illioinguinal N.
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Oblique Abdominus:
Illiohypogastric & illioinguinal N.
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SCM:
CN IX (Spinal Accessory N).
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Anterior Medial Neck Flexors:
- -Scalenus ant, med, post: C3-C8.
- -Longus cap & colli: C1-C6.
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Post Med Neck Extensors:
C1-C8.
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Brachioradialis:
Radial N.
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Deltoids:
-Anterior
-Middle
-Posterior
Axillary N.
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Pec Major Inferior:
MPN & LPN.
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Serratus Anterior:
Long Thoracic N.
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Subscap:
Upper & lower subscap.
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Teres Major:
Lower subscapular.
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Superior Traps:
CN XI (Spinal Accessory N).
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Rhomboids:
Dorsal Scapular N.
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Latissimus Dorsi:
Thoracodorsal N.
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Supraspinatus:
Suprascapular N.
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