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Active Care PT II > Active Care Exam 2 > Flashcards

Active Care Exam 2 Flashcards

1
Q

where does the most rotation occur in the cervical spine

A

upper cervical (C1-C2); 45 degrees

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2
Q

where does the most flexion/extension occur in the cervical spine

A

lower cervical

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3
Q

non-neural contributors to stability of the cervical spine

A
  • osseoligamentous (20%)

- musculature (80%)

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4
Q

deep muscles control

A

segments (local/intrinsic)

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5
Q

superficial muscles control

A

movement (global/extrinsic)

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6
Q

local (intrinsic) cervical musculature that produces forward sagittal plane rotation during flexion movement

A

upper cervical - (rectus capitis anterior, rectus capitis lateralis)

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7
Q

local (intrinsic) cervical musculature that produces posterior sagittal plane rotation during extension movement

A

upper cervical - (rectus capitis posterior major/minor, obliques capitis sup/inf, semispinalis, splenius, and longissimus (capitis)

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8
Q

global (extrinsic) cervical spine musculature

A
  • SCM
  • anterior and middle scalene
  • levator scapula
  • upper trap
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9
Q

local (intrinsic) cervical spine musculature

A
  • longus capitis and longus coli
  • rectus capitis lateralis and rectus capitis anterior
  • RCPMa, RCPMi, OCinf, OCsup
  • semispinalis/splenius/longissimus capitis
  • semispinalis/splenius/longissimus cervicis
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10
Q

upper cross syndrome

A
  • weak deep neck flexors
  • tight pectorals
  • week lower trap and serratus anterior
  • tight upper trap and levator scapula
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11
Q

cervical extension syndrome is classified by the facilitation and inhibition of which muscles

A
  • facilitated pecs, SCM, suboccipitals, upper trap, levator scapula
  • inhibited serratus anterior
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12
Q

muscle facilitations and inhibitions in cervical extension syndrome cause which postural deficits

A

facilitated pecs - rounded shoulders

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13
Q

what is characteristic of cervical flexion syndrome

A

facilitated pecs - rounded shoulders
facilitated SCM - anterior head carriage
facilitated suboccipitals - head extension
facilitated upper trapezius and levator scapula - elevation of shoulders
inhibited serratus anterior - winging scapula

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14
Q

painful flexion of the cervical spine is a characteristic of

A

cervical flexion syndrome

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15
Q

painful extension of the cervical spine is a characteristic of

A

cervical extension syndrome

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16
Q

breathing in which shoulders elevate and there is reliance on accessory muscles for inspiration

A

paradoxical breathing

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17
Q

during diaphragmatic breathing, which way do the ribs expand

A

mostly laterally; greater space as opposed to elevation of ribs

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18
Q

negative effects of hyperkyphosis in the thoracic spine

A
  • scapular stability
  • cervical motion
  • respiration
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19
Q

hyperkyphosis results in scapular protraction

A

TRUE

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20
Q

what could scapular protraction lead to

A
  • shoulder pain
  • narrows joint space for movement
  • strain on the ligaments in the shoulder
  • decreased shoulder strength
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21
Q

what would indicated a failed wall angel test

A

if the T-L junction does not flatten

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22
Q

the wall slide focuses on mobility in the thoracic spine and stretching is felt in which muscles

A

latissimus and pectoralis

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23
Q

see lab handout for deep squat with overhead reach

A

…

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24
Q

what motions for the scapulae need improvement when there is decreased thoracic extension

A

retraction and depression; external humeral rotation is also implemented in the stretch

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25
Q

agonist-antagonist-synergy loss

A

cross syndrome

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26
Q

pattern of cross syndrome forms a cross when viewed anteriorly

A

FALSE; when viewed laterally

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27
Q

facilitated muscles in lower cross syndrome

A
  • hip flexors
  • rotators
  • erector spinae
  • TFL
  • QL
  • hamstrings
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28
Q

inhibited muscles in lower cross syndrome

A
  • gluteal muscles

- abdominals

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29
Q

postural signs for lower cross syndrome

A
  • lumbar hyperlordosis
  • anterior pelvic tilt
  • protruding abdomen
  • foot flare
  • pain over lateral knee or SI
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30
Q

lumbar hyperlordosis, anterior pelvic tilt, protruding abdomen, foot flare, pain over lateral knee or SI respectively

A
  • shortened erector spinae
  • weakness in gluteals, tight quads
  • weak abdominals
  • tightness in external hip rotators
  • shortened TFL
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31
Q

assessment of lower cross syndrome

A
  • hip extension patterns
  • hip abduction patterns
  • core strength testing
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32
Q

where is the hand placement of the doctor during hip extension motion pattern

A
  • one hand on gluteals

- one hand on T-L paraspinals

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33
Q

which muscle groups does hip extension motion patterns affect

A
  • ipsilateral hamstrings
  • ipsilateral gluteals
  • ipsilateral spinal extensors
  • contralateral spinal extensors
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34
Q

treatment for altered hip extension

A

george costanza method… 1st stretch the tight muscles and then strengthen the weak muscles

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35
Q

describe the hip abduction motor pattern

A
  • side lying with lower leg flexed
  • slowly raise leg toward ceiling
  • observe for normal motion
  • hold position and observe for drift
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36
Q

altered hip abduction pattern

A
  • decreased ROM
  • hip flexion (forward drift)
  • hip external rotation (foot flare)
  • hip hiking (bending at waist)
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37
Q

what causes decreased ROM for altered hip abduction patterns

A

adductor tightness

38
Q

what causes hip flexion (forward drift) for altered hip abduction patterns

A

TFL substitution

39
Q

what causes hip external rotation (foot flare) for altered hip abduction patterns

A

piriformis substitution

40
Q

what causes hip hiking (bending at waist) for altered hip abduction patterns

A

QL substitutions

41
Q

two exercises to help strengthen gluteus medius

A

NAME?

42
Q

combination of upper and lower cross syndrome

A

stratification syndrome; aka layer syndrome

43
Q

layer syndrome

A

stratification syndrome

44
Q

which muscles are weak during stratification syndrome

A
  • lower scapular stabilizers
  • lumbosacral erector spinae
  • gluteals
45
Q

which muscles are tight during stratification syndrome

A
  • cervical erector spinae
  • upper traps
  • levator scapulae
  • thoracolumbar/erector spinae
  • hamstrings
46
Q

when load exceeds strength of tissue causing failure

A

tissue tolerance

47
Q

tissue tolerance depends on which factors

A
  • time
  • load
  • repetitions
  • characteristics of the lifter
48
Q

if load is applied but the failure tolerance is not reached, with rest will the margin of safety be higher or lower than it was before

A

higher; with applied load and rest the margin of safety increases with time

49
Q

is performing heavy work by itself a risk factor for low back disorders

A

no

50
Q

blue collar workers that alternate between position and task have reduced risk for low back disorders

A

TRUE

51
Q

how much height do discs lose throughout the day

A

19mm

52
Q

half of the height lost from the discs during the day occurs within the first 30 minutes

A

TRUE

53
Q

muscles compensate by restricting motion when waking up in the morning due to the increased amount of fluid in the discs

A

FALSE

54
Q

disc bending stress is higher than ligament stress in the morning compared to the evening

A

TRUE; disc bending stress is 300% higher and ligament stress is 80% higher

55
Q

to avoid injury and prolonged stress on the lumbar spine, you should have the lumbar spine in line and lift quickly

A

FALSE; lift slow and smooth

56
Q

hip hinge can help with what action

A

standing from a sitting position or lifting

57
Q

describe how the hip hinge is performed

A
  • keep abdomen tense
  • keep the knees behind the toes
  • grip the floor (spread the floor)
  • don’t flex lumbar spine (maintain lordosis)
58
Q

a region of laxity around the neutral resting position of a spinal segment

A

neutral zone

59
Q

neutral zone

A

a region of laxity around the neutral resting position of a spinal segment

60
Q

a significant decrease in the capacity of the stabilizing system of the spine to maintain the intervertebral neutral zones within physiologic limits which results in pain and disibility

A

clinical instability

61
Q

what happens to the neutral zone after high-speed trauma

A

neutral zone increases

62
Q

the most stable position for stress on the spine

A

within the neutral zone

63
Q

what influences the neutral zone

A
  • passive system (vertebrae, IVD, Z-joints, ligs)
  • neural system (CNS and PNS)
  • active system (muscles, tendons)
64
Q

provide stability through increasing spinal segmental stiffness

A

local system

65
Q

anatomically more superficial muscles

A

global system

66
Q

play a role in anticipation of motion

A

local system

67
Q

larger torque producing muscles

A

global system

68
Q

anatomically deep muscles

A

local system

69
Q

control spinal orientation and balance or external loads

A

global system

70
Q

local system includes which muscles

A
  • transversus abdominis
  • pelvic floor
  • diaphragm
  • multifidus
71
Q

a force pulling in one direction is equally opposed by a force pulling in the opposite direction

A

tensegrity; stability

72
Q

balance of tension and compression forces

A

geodesic dome

73
Q

deepest of the abdominal muscles

A

transversus abdominus

74
Q

where does the transverse abdominus originate

A

thoracolumbar fascia between iliac crest and 12th rib

75
Q

where does the transverse abdominus insert

A
  • inguinal ligament
  • iliac crest
  • lower six ribs
  • anteriorly to the abdominal aponeurosis
76
Q

contraction of the transversus abdominus achieves what

A
  • increases intra-abdominal pressure
  • causes core stiffening
  • stiffens lumbar spine
  • provides compression to SI joints (closes/stabilizes SIJs)
77
Q

muscle recruited before any limb movement occurs

A

transversus abdominus

78
Q

is the multifidus muscle a part of the local or global system

A

it has local action

79
Q

the multifidus muscle contains many type I fibers

A

TRUE

80
Q

functions of multifidus muscle

A
  • postural maintenance
  • stiffens the spine
  • controls motion in the neutral zone
  • controls lumbar lordosis
81
Q

muscles that make up pelvic floor. which make up the levator ani

A
  1. coccygeus
  2. iliococcygeus
  3. pubococcygeus
    (iliococcygeus and pubococcygeus = levator ani)
82
Q

since kegel exercises strengthen the muscle that stops urine flow it is only logical to stop urine flow as an exercise

A

FALSE; empty bladder first

83
Q

vleeming active straight leg raiser test graded on a scale from 0-5 based on pain findings

A

FALSE; it is concerned about the ability to perform the test.

84
Q

grading for the vleeming active straight leg raiser test

A 
0 - no difficulty
1 - slight difficulty
2 - moderate difficulty
3 - marked difficulty
4 - significant difficulty
5 - unable to perform
85
Q

there are more than 20 primary and accessory muscles associated with respiration, and almost all of them have a postural function

A

TRUE

86
Q

where does the diaphragm attach (4)

A
  • lower 6 ribs
  • xiphoid process
  • L1-L4
  • central tendon
87
Q

forms top of abdominal core

A

diaphragm

88
Q

paradoxical respiration includes which findings

A
  • chest breathing predominates
  • clavicles or shoulders elevate
  • abdomen moves in on inspiration
89
Q

limb loading or extremity movement activates trunk musculature via

A

feed-forward mechanism

90
Q

end-range stress of normal structures

A

postural syndrome

91
Q

end-range stress of shortened structures

A

dysfunction syndrome

92
Q

anatomical disruption or displacement within the motion segment

A

derangement syndrome

Active Care PT II (2 decks)

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