I need joint _________, to improve my ________.
I need joint mobilization, to improve my situation.
I present with 2+/5 hip ADDUCTION. What PERIPHERAL NERVE is most likely affected, and describe the most distal place I would have sensory loss?
Obturator
proximal medial thigh
Define capsular pattern
predictable loss of motion in a joint d/t capsular restriction
I present with 2+/5 hip flexion. What DERMATOME is most likely affected, and describe the place I would have sensory loss?
L2
Proximal anterior thigh
Knee ROM
Flexion: 140-150 (soft tissue end feel)
Extension: 0 (hard end feel)
Lumbar Capsular Pattern
SB = Rot/Ext
I present with 2+/5 ankle PF/INV. What PERIPHERAL NERVE is most likely affected, and describe the most distal place I would have sensory loss?
Tibial
Back of heel
Shoulder
ER > Abd > FL/IR
I present with 2+/5 Great Toe extension. What DERMATOME is most likely affected, and describe the most distal place I would have sensory loss?
L5
Dorsum of foot in line with 3rd digit
Hip ROM (Flex, Ext, Abd, Add, ER, IR)
Flexion: 120 (soft tissue approximation)
Extension: 10-15 (tissue stretch/capsular)
Abd: 30-50 (tissue stretch/capsular)
Add: 20-30 (capsular/tissue stretch)
IR: 40-60 (capsular)
ER: 30-40 (capsular)
Knee Capsular Pattern
Flexion > Extension
I present with 2+/5 ankle INVERSION. What TWO peripheral nerves could be affected, and describe the most distal place I would have sensory loss for each?
Tibial (back of heel)
Deep Peroneal (web space between 1st and 2nd digit)
Elbow
Flexion > Ext
Pronation = Supination
I present with 2+/5 knee extension. What DERMATOME is most likely affected, and describe the most distal place I would have sensory loss?
L3
Anterior (slightly medial) thigh just proximal to knee
Lumbar ROM
Flexion: 40-60
Extension: 20-35
SB: 15-20
Rot: 3-18
Hip Capsular Pattern
IR > Ext/FL > Abd
I present with 2+/5 ankle DF. What dermatome could be affected AND what peripheral nerve?
L4
Deep peroneal n.
Cervical (atlanto-occipital, lower cervical, TMJ)
AO: ext = SB
lower cervical: SB = Rot/ext
TMJ = limitation of mouth opening
I present with 2+/5 ankle eversion and hip extension. What DERMATOME is most likely affected, and describe the most distal place I would have sensory loss?
Lateral aspect of foot
Ankle ROM
PF: 40-50 (capsular/tissue stretch)
DF: 15-20 (capsular/tissue stretch)
INV: 20-30 (capsular/tissue stretch)
hindfoot INV: 20
EV: 15-20 (capsular/tissue stretch)
hindfoot EV: 10
(talocrural, subtalar, 1st MTP, 2-5 MTPs)
PF>DF
Varus>Valgus
EXT>FL
Variable, tend toward FL restriction
I present with 2+/5 ankle EVERSION. What PERIPHERAL NERVE is most likely affected, and describe the most distal place I would have sensory loss?
Superficial Peroneal N.
Dorsum of foot
Radiocarpal/Midcarpal: Flex=Ext
Thumb CMC: Abd=Ext
MCP: FL>Ext
IP: FL>Ext
I present with 2+/5 knee flexion and ankle plantarflexion. What DERMATOME(S) is most likely affected, and describe the most distal place I would have sensory loss?
(bonus what is the other nerve root contributing to knee flexion?)
S1 (lateral foot)
S2 (medial heel)
L5 also contributes to knee flexion
Foot ROM (1st MTP, 2-5 MTP)
1st MTP Flexion: 70 (capsular/tissue stretch)
1st MTP Extension: 45 (capsular/tissue stretch)
2-5th MTP Flexion: 40 (capsular/tissue stretch)
2-5th MTP Extension: 40 (capsular/tissue stretch)