CCEP Adjusting Techniques for Extremities 3 — Questions and Answers
Question 1: The 'gun-stock' deformity after a supracondylar fracture contraindicates which elbow adjustment?
- Medial glide of the ulnohumeral joint
- Long-axis distraction of the elbow
- Valgus stress mobilization (Correct answer)
- Lateral epicondyle soft-tissue technique
Correct answer: Valgus stress mobilization
A gun-stock deformity indicates malunion with cubitus varus; valgus stress mobilization is contraindicated because it stresses compromised medial structures.
Question 2: Which carpal bone is most commonly restricted in an anterior (palmar) direction and adjusted with a posterior-to-anterior thrust?
- Hamate
- Lunate (Correct answer)
- Trapezium
- Pisiform
Correct answer: Lunate
The lunate commonly subluxates anteriorly; an anterior lunate adjustment uses a P-to-A thrust to restore it toward its anatomic position.
Question 3: A 'pinch-roll' or 'facet' adjustment to the interphalangeal joint of the finger primarily restores which motion?
- Axial rotation
- Lateral glide (shear) (Correct answer)
- Long-axis distraction only
- Circumduction
Correct answer: Lateral glide (shear)
The pinch-roll technique applies a lateral (shear) glide to gap the IP joint and restore restricted lateral motion.
Question 4: When performing a posterior fibular head adjustment, excessive force risks injury to which structure?
- Anterior talofibular ligament
- Common peroneal nerve (Correct answer)
- Posterior tibial artery
- Popliteal vein
Correct answer: Common peroneal nerve
The common peroneal nerve wraps around the fibular neck just below the fibular head, making it vulnerable to compression or traction during adjustment.
Question 5: In a Gonstead-style knee adjustment for a lateral-restricted tibia, the patient is prone and the tibial contact is:
- Medial tibial plateau with medial-to-lateral thrust (Correct answer)
- Lateral tibial plateau with posterior-to-anterior thrust
- Tibial tuberosity with cephalad thrust
- Medial tibial plateau with lateral-to-medial thrust
Correct answer: Medial tibial plateau with medial-to-lateral thrust
For a lateral tibial restriction, contact is on the medial tibial plateau and the thrust is medial-to-lateral to restore the restricted lateral glide.
Question 6: A spring test on the first tarsometatarsal joint that reproduces dorsal pain with absent springiness indicates which listing?
- Plantar-flexed 1st ray
- Dorsiflexed 1st ray
- Dorsal fixation of the 1st TMT (Correct answer)
- Eversion restriction of the 1st ray
Correct answer: Dorsal fixation of the 1st TMT
Absent dorsal springiness with pain during a dorsal spring test at the 1st TMT indicates a dorsal fixation (restricted plantar glide) at that joint.
Question 7: The 'scapular-thoracic' adjustment performed with the patient seated and the arm draped over the practitioner's thigh primarily mobilizes which joint?
- Acromioclavicular joint
- Glenohumeral joint
- Sternoclavicular joint
- Scapulothoracic articulation (Correct answer)
Correct answer: Scapulothoracic articulation
This technique levers the scapula away from the thorax to mobilize the scapulothoracic articulation, improving dyskinesis.
CCEP Adjusting Techniques for Extremities 3
The 'gun-stock' deformity after a supracondylar fracture contraindicates which elbow adjustment?