Board Review II Flashcards
What happens to sidebending and rotation as you move down the C-spine?
Sidebending increases
Rotation decreases
What is the “Yes joint”?
OA
True or false: there is no disc between C1 and C2
True
What is the body of the axis (C2)?
Odontoid process (Dens)
What is the uncovertebral joint of Luschka? What is the clinical significance of these?
Lateral portion of vertebral bodies
Place of osteophyte formation
What are zygapophyseal joints?
Joint between the pillars
True or false: there are no type I SD in the cervical spine
True
True or false: since the OA has sidebending and rotational components in opposite directions, it is a type I SD
False
Why is the sidebending and rotational components to the same side with the C-spine?
Zygapophyseal joints
What is Spurling’s test?
Rotate and side bend to assess for nerve root impingement
What is the Wallenberg test?
- Test for vertebral artery insufficiency
- Head and neck are held in extension-rotation for 30 seconds
Spine of scapula = what T level?
T3
Spinous process of T7 is found at what landmark?
Inferior angle of the scapula
8th rib is found by what landmark?
Inferior angle of the scapula points to it
Jugular notch = which spinal level?
T2
Angle of louis = which spinal level? Rib?
T4 (second rib)
What is the nipple dermatome?
T4
What is the umbilicus dermatome?
T10
What is the greatest amount of motion in the thoracic spine? Least?
Greatest = rotation Least = extension
What is the order of motions of the thoracic spine?
Rotation, side bending, flexion, extension
What vertebrae should be treated first with scoliosis?
The apex one
What is the difference between structural and functional scoliosis?
Structural = fixed
What is the Cobb angle?
Measure of the curvature of the spine
What is a moderate Cobb angle?
20-45 degrees
At what Cobb angle is respiratory function compromised? CV function?
Respiratory = 50
CV = 75
What are the true ribs? What makes them “true”?
1-7
Ribs with a direct attachment to the sternum
What are the false ribs? What makes them “false”?
8-12
Connect to the sternum through cartilage
What are the atypical ribs? What makes them “atypical”?
1, 2, 11-12
hat are the atypical ribs? What makes them “typical”?
3-9
Ribs that have 2 facets that articulate with the transverse process and the body of the vertebrae
What are the pump handle ribs?
1-5
What are the bucket handle ribs?
6-10
Bucket handle ribs increase what measurement of the rib cage with inhalation?
Transverse diameter
What is the muscle that is used in ME for rib 1?
Anterior/middle scalene
What is the muscle that is used in ME for rib 2?
Posterior scalene
What is the muscle that is used in ME for ribs 3-5?
Pec minor
What is the muscle that is used in ME for ribs 6-9?
Serratus anterior
What is the muscle that is used in ME for rib 10-12?
Lat dorsi if locked down
QL if locked up
What are the attachments of the diaphragm? (4)
- lower 6 ribs
- L1-3 on the right
- L1-L2 on the left
- XIphoid process
Which spinal vertebrae is the most commonly deformed? What deformity is most common?
- L5
- Facet tropism (asymmetry of the facet joints)
What is the batwing deformity?
Sacralization of L5
What is Ferguson’s angle?
The lumbosacral angle
A ferguson’s angle over what leads to increased pain in the lumbar spine?
30 degrees
What is the nerve that is tested with heel walk?
L5
What is the nerve root that is tested with the toe walk?
S1
What is psoas syndrome?
Tight psoas causes the pelvis to sideshift to opposite side of the contracture
Where do SDs manifest with psoas syndrome?
L1 or L2
What is the thomas test?
Test for psoas contracture
-Patient supine, flexes hip so knee and anterior thigh touches the abdomen. Contracture will cause contralateral leg to lift off the table
What is the hip drop test?
The hip that drops the least is the side to which the lumbar spine is sidebent
What is the innervation of the gluteus medius/minimus?
Superior gluteal nerve (L5, L4, S1)
A posterior innominate rotation will cause an apparent deep sacral sulcus on the contralateral or ipsilateral side?
Ipsilateral
An anterior innominate rotation will cause an apparent deep sacral sulcus on the contralateral or ipsilateral side?
Ipsilateral
Where do all the important things happen in the sacrum?
S2
What is sacral nutation? Counternutation?
Nutation = flexion Counter = extension
The seated flexion test will be positive on the same or opposite side the that the SI joint is “stuck”?
Same
What determines a positive seated flexion, the side that moves first, or the side that moves farthest?
First
A positive seated flexion test is alway the same or opposite the sacral axis?
Opposite
e.g. left on left = left rotation on a left axis
Which part of the sacral diagnosis identifies the axis that the sacrum moves about?
The second part (e.g. left on left = left rotation on a left axis)
What side is the seated flexion test in a unilateral flexion?
Same
What side is the seated flexion test in a L on L FST?
Right
What side is the seated flexion test in a L on R FST?
Left
If the sphinx test is positive, what does this mean?
The sacral base if posterior
If the sphinx test is negative, what does this mean?
Sacral base is anterior
If there is a FST, what happens to L5?
Neutral
If there is a BST, what happens to L5?
Flex or extends
Bother ILA posterior,both sulci deep = ?
Bilateral sacral flexion, or sacral base anterior
Bother ILA anterior ,both sulci shallow = ?
Bilateral sacral extension
What is the order of the 7 stages of spencer?
- Extension
- Flexion
- Circumduction w/o traction
- Circumduction w/ traction
- Abduction/adduction
- Internal rotation
- Abduction with traction
Why are the 7 stages of spencer in the order that they’re in?
Goes from easiest to hardest in terms of shoulder movements, to help isolate the problems with the shoulder
What does the arm drop test assess for?
Rotator cuff tear
What does Yergason’s test assess for?
Bicep tendonitis or to check for the stability of the biceps tendon in the groove
What is the Speed’s test for?
Biceps tendonitis
What is the apprehension test?
Chronic shoulder dislocations
What does the first motion of the Apley scratch test assess?
Flexion
Adduction
Internal rotation
What does the second motion of the Apley scratch test assess?
Flexion
Abduction
External rotation
What does the third motion of the Apley scratch test assess?
Extension
Adduction
Internal rotation
What is the innervation of the serratus anterior?
Long thoracic nerve
What is the scapulo-humeral rhythm?
2:1 movement of the glenohumeral joint:scapular rotation
What is the test for anterior/middle scalene syndrome?
Adson’s test–The loss of the radial pulse in the arm by rotating head to the ipsilateral side with extended neck following deep inspiration. It is sometimes used as a sign of thoracic outlet syndrome (TOS).
What is the test for pectoralis minor outlet syndrome?
Hyperabduction test
What is the test for a cervical rib causing thoracic outlet syndrome?
CXR
What is the test for a 1st rib and clavicle caused thoracic outlet syndrome?
Military test
What is the carrying angles for men and women respectively? What is the significance of this?
Men = 5 degrees Women = 10-15 degrees
Women more likely to get a posterior radial head
Posterior fat pad at the elbow = ?
Intraarticular fracture
Hand adduction causes what motion at the ulna?
Ulnar abduction
Hand abduction causes what motion at the ulna?
Ulnar adduction
What does Finkelstein’s test assess for?
Abductor pollicis longus and extensor pollicis brevis inflammation (deQuervain’s tenosynovitis)
What is the most commonly fractured bone in the hand? What is the test for this?
Scaphoid
Snuffbox TTP
What is the most commonly dislocated bone in the wrist?
Lunate
The term glide refers to what?
The freedom of motion in a joint
What are the three muscles that insert at the pes anserine?
Sartorius
Gracilis
SemiTendinosus
(SGT)
Is the knee more stable in extension or flexion?
Extension
What are the components of the terrible (O’Donoghue’s) triad?
MCL
ACL
Medial meniscus
What is the ME treatment for a posterior fibular head? What is the muscle that is utilized to treat this?
- Have patient dorsiflex and evert the foot
- Peroneal
(PED)
What is the ME treatment for an anterior fibular head?
- Have pt plantarflex and evert the foot
- Soleus
(APE)
What is the Q angle?
Line measured from the ASIS to the patella, and then from the patella through the midline of the tibia
What is a normal Q angle?
10-12 degrees
What is the bone that is present in both the medial and lateral arches?
Calcaneus
What is Morton’s syndrome?
Short 1st metatarsal
What is Morton’s neuroma?
Nerve impingement usually between the 3rd and 4th metatarsals
What is the spring ligament in the foot?
Calcaneonavicular ligament
What are the s/sx of cuboid SDs?
Decreased motion of the 4th and 5th metatarsal
What are the s/sx of navicular SDs?
- Decreased motion of the 1st and 2nd toes
- Dropped medial arch
What is/are the ligament(s) that are damaged in a grade 1 ankle sprain?
Anterior talofibular
What is/are the ligament(s) that are damaged in a grade 2 ankle sprain?
ATF and calcaneofibular
What is/are the ligament(s) that are damaged in a grade 3 ankle sprain?
ATF
CF
Posterior talofibular
What is a high ankle sprain?
Involves the syndesmosis between the tibia and the fibula
What is the Thompson test?
Absence of the foot-plantar flexion motion with contraction of the soleus–indicates a ruptured achilles tendon