CCEP Adjusting Techniques for Extremities 5 — Questions and Answers
Question 1: The 'Farfan torsion' or rotational thrust applied at the hip most effectively restores which restricted motion?
- Internal rotation in flexion (Correct answer)
- Extension and abduction
- External rotation in extension
- Long-axis distraction
Correct answer: Internal rotation in flexion
The Farfan rotational technique specifically targets internal rotation restriction in the flexed hip by applying a rotational thrust in that direction.
Question 2: Which ankle listing is corrected by a supine long-axis distraction with a simultaneous anterior-to-posterior calcaneal thrust?
- Anterior talus
- Posterior talus (Correct answer)
- Valgus calcaneus
- Dorsiflexion-restricted subtalar joint
Correct answer: Posterior talus
A posterior talus restriction is corrected by gapping the mortise with long-axis distraction and thrusting the calcaneus posteriorly to restore anterior talar glide.
Question 3: When adjusting the sternoclavicular joint for an anterior clavicle listing, the patient's arm is positioned to:
- Abducted 90° in the coronal plane
- Flexed 90° in the sagittal plane
- Extended behind the body to retract the clavicle (Correct answer)
- Internally rotated across the chest
Correct answer: Extended behind the body to retract the clavicle
Extending the arm behind the body retracts the clavicle and pre-tensions the SC joint capsule anteriorly, setting up a posterior corrective thrust.
Question 4: Clicking or 'clunking' at the wrist during ulnar deviation that resolves after a triquetrohamate adjustment implicates which structure?
- Triangular fibrocartilage complex (TFCC)
- Triquetrohamate joint (Correct answer)
- Lunotriquetral ligament
- Extensor carpi ulnaris tendon sheath
Correct answer: Triquetrohamate joint
A palpable clunk at the triquetrohamate joint during ulnar deviation that resolves post-adjustment confirms that joint as the source of the catch.
Question 5: Which parameter distinguishes a Grade III Maitland mobilization from a Grade IV in extremity joint technique?
- Speed of oscillation
- Amplitude of movement (Correct answer)
- Direction of thrust
- Number of repetitions
Correct answer: Amplitude of movement
Grade III uses large-amplitude oscillations into resistance, while Grade IV uses small-amplitude oscillations at the end range; amplitude is the defining variable.
Question 6: Post-adjustment swelling and ecchymosis appearing within minutes at the medial knee after a lateral tibial plateau thrust indicates injury to the:
- Medial collateral ligament (Correct answer)
- Anterior cruciate ligament
- Medial meniscus
- Pes anserine bursa
Correct answer: Medial collateral ligament
Immediate swelling with ecchymosis at the medial knee following a lateral tibial thrust suggests MCL sprain from excessive valgus stress during the technique.
Question 7: The preferred patient position for adjusting a posteriorly-restricted 2nd through 5th metatarsophalangeal joint (dorsal fixation) is:
- Supine with ankle at 90°, practitioner applies dorsal contact with plantar thrust (Correct answer)
- Prone with foot plantar-flexed, practitioner applies plantar contact with dorsal thrust
- Supine with foot plantar-flexed, practitioner applies dorsal contact with plantar thrust
- Side-lying with hip in neutral
Correct answer: Supine with ankle at 90°, practitioner applies dorsal contact with plantar thrust
Supine with the ankle at 90° stabilizes the forefoot; a dorsal contact with a plantar thrust corrects a dorsal MTP fixation by restoring plantar glide.
CCEP Adjusting Techniques for Extremities 5
The 'Farfan torsion' or rotational thrust applied at the hip most effectively restores which restricted motion?