Session 2: capsular pattern, loose/closed packed, special tests

what are the capsular pattern for

Glenohumeral joint :

Knee :

Carpometacarpal joints of II-V :

Glenohumeral joint : ER>abd>IR

Knee : flexion > extension

Carpometacarpal joints of II-V : equal

joint capsular patterns

zShoulderER > ABD > IR

ElbowFlexion > Extension

WristFlexion > Extension

carcomet jt 1: abd and exten restric

carpomet jt 2-5: equally restricted in all directions

HipIR > Flexion > ABD > ER

KneeFlexion > Extension

AnklePF > DF

SubtalarINV = EV

what happens if your shoulder is ABD+ER

this is closed pack position

in open packed position it is? what are the capsule and ligaments?

least amount of jt surface congruency

capsule and support ligaments are lax

accessory motion or jt play is maximized

in closed packed position it is? what are the capsule and ligaments?

most amount of jt surface congruency

capsule and lig max tight

accessory motion is minimized

PT decides to use manual therapy techniques to address limitation in knee flexion ROM. Which of the following is the MOST appropriate direction for mobilization?

A. Distal glide to patella in supine

B. Proximal glide to patella in supine

C. Compression of the patella in supine

D. Anterior glide to tibia on a stable femur in prone

A

think first convex concave, knee is concave to convex so SAME direction

knee flexion is gliding posterior and sliding posterior

patella does not follow the convex/concave rule!! when extend the knee goes superior/proximal glide

for knee flexion inferior/distal glide

THIS ONLY APPLIES TO OPEN CHAIN

CLOSED CHAIN IS OPPOSITE!

A patient reports of intense shoulder pain and limited range of motion in the capsular pattern. She was diagnosed with "frozen shoulder". Which grade and direction should the physical therapist mobilize the glenohumeral joint to address the patient's impairments? A. Anterior glide using a grade III mobilization

B. Posterior glide using a grade I mobilization

C. Anterior glide using a grade II mobilization

D. Posterior glide using a grade IV mobilization

B

shoulder capsular pattern is Er>ABD>IR so improving ER first. so ER is first posterior so opposite is anterior BUT FROZEN SHOULDER DOES NOT APPLY TO THIS

since has pain will do grade 1/2

Which of the following muscle imbalances would MOST likely be found in a patient with a left anteriorly rotated innominate bone?

A. (-) Thomas test on L LE

B. Stretched erector spinae on L

C. Glute max MMT 4/5 L LE

D. (-) Tripod sign on the L LE

D

tripod sign is for hamstrings so negative means hams are stretched

unilaterally is called innominate so only left is rotated anteriorly. so hip flexors tight and back extensors

abs and glutes are weak

wrong:

a- should be a POSITIVE THOMAS TEST

b- back extensors will be TIGHT

c- glutes will be WEAK

muscle imbalances with pelvic tilt/posture

anterior pelvic tilt:

shortened: hip flexors and back extensors

lengthened/weak: glutes and abs

posterior pelvic tilt:

shortened: abs and hams

lengthened/weak: hip flexors and back extensors

A clinician flexes the patient's thumb into the palm, wraps the fingers around it, and ulnarly deviates the wrist. This reproduces sharp pain over the radial styloid. What condition is MOST likely present?

A. Carpal Tunnel Syndrome

B. De Quervain Tenosynovitis

C. Lateral Epicondylalgia

D. Scaphoid Fracture

B. De Quervain Tenosynovitis

A patient's hip and knee are flexed to 90°. The clinician stabilizes the femur and applies a posterior force through the tibia. Excessive posterior translation is noted. Which structure is MOST likely injured?

A. ACL

B. MCL

C. PCL

D. LCL

C. PCL

During testing, the patient's shoulder is flexed to 90° with the elbow extended and forearm supinated. Resistance is applied while the patient attempts to elevate the arm, reproducing anterior shoulder pain. Which structure is MOST likely involved?

A. Supraspinatus Tendon

B. Long Head of Biceps Tendon

C. Teres Minor

D. Subscapularis

B. Long Head of Biceps Tendon

explaining speeds test

A clinician rapidly rotates the patient's head to the right while the patient maintains visual fixation on a target. A corrective saccade is observed. What is the MOST likely finding?

A. Right Vestibular Hypofunction

B. Left Vestibular Hypofunction

C. Central Vestibular Disorder

D. BPPV

A. right Vestibular Hypofunction

A patient performs a single-leg squat and rotates on the involved knee at approximately 20° of flexion. Joint-line pain and locking are reproduced. What pathology is MOST likely present?

A. ACL Tear

B. Patellofemoral Pain Syndrome

C. Meniscal Tear

D. MCL Sprain

C. Meniscal Tear

A patient reports lateral elbow pain that worsens with gripping and resisted wrist extension. Which special test would most likely reproduce symptoms?

A. Finkelstein Test

B. Cozen Test

C. Phalen Test

D. Tinel Sign

B. Cozen Test

A patient presents with numbness and tingling in the thumb, index, and middle fingers that worsens at night. Which special test is commonly used to assess this condition?

A. Phalen Test

B. McMurray Test

C. Hawkins-Kennedy Test

D. Lachman Test

A. Phalen Test

A patient reports pain over the first dorsal compartment of the wrist with lifting an infant and repetitive thumb movements. Which test is most appropriate?

A. Tinel Sign

B. Finkelstein Test

C. Allen Test

D. Speed Test

B. Finkelstein Test

A patient presents with suspected ACL injury after a non-contact cutting maneuver. Which special test is considered most sensitive?

A. Posterior Drawer Test

B. Lachman Test

C. McMurray Test

D. Thessaly Test

B. Lachman Test

A patient complains of dizziness when rolling in bed and looking upward. Which test would be used to confirm posterior canal BPPV?

A. Head Thrust Test

B. Dynamic Visual Acuity Test

C. Dix-Hallpike Test

D. Romberg Test

C. Dix-Hallpike Test