Book1 Flashcards
anterior deltoid action:
shoulder flexion
posterior deltoid action:
shoulder extension
supraspinatus and deltoid (all fibers) action:
should abduction
Shoulder adductors:
pect major
shoulder internal rotators:
subscapularis
shoulder external rotators:
infraspinatus
elbow flexors:
brachioradialis (with forearm neutral)
triceps brachii action:
elbow extension
pronation muscles:
pronator teres
supination muscles:
supinator
wrist flexion:
palmaris longus
wrist extension:
extensor carpi radialis longus and brevis
radial deviation:
extensor carpi radialis longus and brevis
ulnar deviation:
extensor carpi ulnaris
hip flexion:
iliopsoas
hip extension:
gluteus maximus (with knee flexed)
hip abduction:
gluts
hip adduction:
adductors
hip internal rotation:
gluteus medius
hip external rotation:
Lat 6
knee extension:
quads
knee flexion:
hamstrings
ankle dorsiflexion:
tibialis anterior
ankle plantar flexion:
gastrocnemius and soleus
ankle inversion:
tibialis anterior
ankle eversion:
peroneus longus
cervical extension:
bilateral upper trap
cervical flexion:
bilateral sternocleidomastoid
cervical rotation:
sternocleidomastoid (to opposite side)
trunk flexion:
rectus abdominus
trunk extension:
bilateral erector spinae
trunk lateral flexion:
(all unilaterally)
scapular retraction:
rhomboids
scapular protraction:
serratus anterior
scapular elevation:
upper trap
scapular depression:
lower trap
asymmetrical tonic neck reflex:
stimulus: head position, turned to one side
ATNR interferes with:
-feeding
-visual tracking
-midline use of hands
-bilateral hand use
-rolling
-dev of crawling
symmetrical tonic neck reflex:
stimulus: head position, flexion or extension
STNR interferes with:
- ability to prop on arms in prone position
- attaining and maintaining hands-and-knees position
- crawling reciprocally
- sitting balance when looking around
- use of hands when looking at object in hands in sitting position
Tonic Labyrinthine reflex:
stimulus: position of labyrinth in inner ear-reflected in head position
TLR interferes with:
ability to initiate rolling
-ability to prop on elbows with extended hips when prone
-ability to flex trunk and hips to come to sitting position from supine position
-often causes full body extension, which interferes with balance in sitting or standing
Galant reflex:
stimulus: touch to skin along spine from shoulder to hip
Galant reflex interferes with:
development of sitting balance
palmar grasp reflex:
stimulus: pressure in palm on ulnar side of hand
palmar grasp reflex interferes with:
ability to grasp and release objects voluntarily
plantar grasp reflex:
stimulus: pressure to base of toes
plantar grasp reflex interferes with:
ability to stand with feet flat on surface
rooting reflex:
stimulus: touch on cheek
rooting reflex interferes with:
oral-motor development
moro reflex:
stimulus: head dropping into extension suddenly a few inches
moro reflex interferes with:
balance reactions in sitting
startle reflex:
stimulus: loud, sudden noise
startle reflex interferes with:
sitting balance
positive support reflex:
stimulus: weight placed on balls of feet when upright
positive support reflex interferes with:
standing and walking
walking (stepping) reflex:
stimulus: supported upright position with soles of feet on firm surface
walking (stepping) reflex interferes with:
standing and walking
C1 Nerve Root:
dermatome: vertex of skull
C2 Nerve Root:
dermatome: temple, forehead, occiput
C3 Nerve Root:
dermatome: entire neck, posterior cheek, temporal area, prolongation forward under midline
C4 Nerve Root:
dermatome: shoulder area, clavicular area, upper scapular area
C5 Nerve Root:
dermatome: deltoid area, anterior aspect of entire arm to base of thumb
C6 Nerve Root:
dermatome: anterior arm, radial side of hand to thumb index finger
C7 Nerve Root:
dermatome: lateral arm and forearm to index finger, long and ring fingers
C8 Nerve Root:
dermatome: medial arm and forearm to long, ring, and little fingers
T1 Nerve Root:
dermatome: medial side of forearm to base of little finger
T2 Nerve Root:
dermatome: medial side of upper arm to medial elbow, pectoral and midscapular areas
T3-T12 Nerve Roots:
T3-T6: upper thorax
T1-T2 Nerve Root:
disk lesions at upper two thoracic levels do not appear to give rise to root weakness. Weakness of intrinsic muscles of hand is due to other pathology.
T3-T12 nerve Root:
articular and dural signs and root pain are common. Root signs (cutaneous analgesia) are rare and have such indefinite area that they have little localizing value. Weakness is not detectable
L1 Nerve Root:
dermatome: back, over trochanter and groin
L2 Nerve Root:
dermatome: back, front of thigh to knee
L3 Nerve Root:
dermatome: back, upper buttock, anterior thigh and knee, medial lower leg
L4 Nerve Root:
dermatome: medial buttock, lateral thigh, medial leg, dorsum of foot, big toe
L5 Nerve Root:
dermatome: buttock, posterior and lateral thigh, lateral aspect of leg, dorsum of foot, medial half of sole, first, second and third toes
S1 Nerve Root:
dermatome: lateral and plantar aspect of foot
S2 Nerve Root:
dermatome: buttock, thigh, and leg posterior
S3 Nerve Root:
dermatome: groin, medial thigh to knee
S4 Nerve Root:
dermatome: perineum, genitals, lower sacrum
antalgic gait:
a protective gait pattern where the involved step length is decreased in order to avoid weight bearing on the involved side, usually secondary to pain.
ataxic gait:
a gait pattern characterized by staggering and unsteadiness. There is usually a wide BOS and movements are exaggerated.
cerebellar gait:
a staggering gait pattern seen in cerebellar disease.
circumduction gait:
a gait pattern characterized by a circular motion to advance the leg during swing phase; this may be used to compensate for insufficient hip or knee flexion or dorsiflexion.
double step gait:
a gait pattern in which alternate steps are of a different length or at a different rate.
equine gait:
a gait pattern characterized by high steps; usually involves excessive activity of the gastrocnemius.
festinating gait:
a gait pattern where a patient walks on toes as though pushed. It starts slowly, increases, and may continue until the patient grasps an object in order to stop.
hemiplegic gait:
a gait pattern in which patients abduct the paralyzed limb, swing it around, and bring it forward so the foot comes to the ground in front of them.
Parkinsonian gait:
a gait pattern marked by increased forward flexion of the trunk and knees; gait is shuffling with quick and small steps; festinating may occur.
scissor gait:
a gait pattern in which the legs cross midline upon advancement
spastic gait:
a gait pattern with stiff movement, toes seeming to catch and drag, legs held together, and hip and knee joints slightly flexed. Commonly seen in spastic paraplegia
steppage gait:
a gait pattern in which the feet and toes are lifted through hip and knee flexion to excessive heights; usually secondary to dorsiflexor weakness. the foot will slap at initial contact with the ground secondary to decreased control.
tabetic gait:
a high steppage ataxic gait pattern in which the feet slap the ground
trendelenburg gait:
a gait pattern that denotes gluteus medius weakness; excessive lateral trunk flexion and weight shifting over the stance leg.
vaulting gait:
a gait pattern where the swing leg advances by compensating through the combination of elevation of the pelvis and plantar flexion of the stance leg.
weak dorsiflexors or dorsiflexor paralysis can cause what gait deviation?
foot slap
toe down instead of heel strike can be caused by?
- plantar flexor spasticity
- plantar flexor contracture
- weak dorsiflexors
- dorsiflexor paralysis
- leg length discrepancy
- hindfoot pain
clawing of toes causes:
- toe flexor spasticity
- positive support reflex
heel lift during midstance causes:
- insufficient dorsiflexion range
- plantar flexor spasticity
no toe off gait deviation causes:
- forefoot/toe pain
- weak PF’s
- weak toe flexors
- insufficient PF ROm
exaggerated knee flexion at contact causes:
- weak quads
- quads paralysis
- hamstrings spasticity
- insufficient extension ROM
hyperextension in stance causes:
- compensation for weak quads
- plantar flexor contracture
exaggerated knee flexion at terminal stance causes:
- knee flexion contracture
- hip flexion contracture
insufficient flexion with swing causes:
- knee effusion
- quad extension spasticity
- plantar flexor spasticity
- insufficient flexion ROM
excessive flexion with swing causes:
- flexor withdrawal reflex
- lower extremity flexor synergy
insufficient hip flexion at initial contact causes:
- weak hip flexors
- hip flexor paralysis
- hip extensor spasticity
- insufficient hip flexion ROM
insufficient hip extension at stance causes:
- insufficient hip extension ROM
- hip flexion contracture
- lower extremity flexor synergy
circumduction during swing causes:
- compensation for weak hip flexors
- compensation for weak DF
- compensation for weak hamstrings
hip hiking during swing causes:
- compensation for weak DF
- compensation for weak knee flexors
- compensation for extensor synergy pattern
exaggerated hip flexion during swing causes:
- lower extremity flexor synergy
- compensation for insufficient ankle DF
Lateral Bending (prosthetic causes):
- prosthesis may be too short
- improperly shaped lateral wall
- high medial wall
- prosthesis aligned in abduction
Lateral Bending (amputee causes):
- poor balance
- abduction contracture
- improper training
- short residual limb
- weak hip abd’s on prosthetic side
- hypersensitive and painful residual limb
Abducted Gait (prosthetic causes):
- prosthesis may be too long
- high medial wall
- poorly shaped lateral wall
- prosthesis positioned in abduction
- inadequate suspension
- excessive knee friction
Abducted gait (amputee causes):
- abduction contracture
- improper training
- adductor roll
- weak hip flexors and adductors
- pain over lateral residual limb
Circumducted gait (prosthetic causes):
Circumducted gait (prosthetic causes): -prosthesis may be too long
- too much friction in the knee
- socket is too small
- excessive plantar flexion of prosthetic foot
circumducted gait (amputee causes):
- abd contracture
- improper training
- weak hip flexors
- lacks confidence to flex the knee
- painful anterior distal residual limb
- inability to initiate prosthetic knee flexion
excessive knee flexion during stance (prosthetic causes):
- socket set forward in relation to foot
- foot set in excessive DF
- stiff heel
- prosthesis too long
excessive knee flexion during stance (amputee causes):
- knee flexion contracture
- hip flexion contracture
- pain anteriorly in residual limb
- decrease in quads strength
- poor balance
vaulting (prosthetic causes):
NAM-prosthesis may be too long
- inadequate socket suspension
- excessive alignment stability
- foot in excessive plantar flexion
vaulting (amputee causes):
- residual limb discomfort
- improper training
- fear of stubbing toe
- short residual limb
- painful hip/residual limb
Rotation of forefoot at heel strike (prosthetic causes):
-excessive toe-out built in
- loose fitting socket
- inadequate suspension
- rigid SACH heel cushion
Rotation of forefoot at heel strike (amputee causes):
-poor muscle control
-improper training
-weak medial rotators
-short residual limb
forward trunk flexion (prosthetic causes):
- socket too big
- poor suspension
- knee instability
Forward trunk flexion (amputee causes):
- hip flexion contracture
- weak hip extensors
- pain with ischial weight bearing
- inability to initiate prosthetic knee flexion
medial or lateral whip (prosthetic causes):
#NAME?-excessive rotation of the knee -tight socket fit -valgus in the prosthetic knee -improper alignment of toe break
medial or lateral whip (amputee causes):
-improper training
-weak hip rotators
-knee instability
heparin (anticoagulant):
most common side effect: excessive bleeding
nerve root pain:
sharp, shooting and burning
muscle pain:
cramping, dull, aching, worsens when muscle’s contracted or lengthened
bone pain:
deep, intolerable, boring and highly localized
vascular pain:
diffuse, throbbing, aching and poorly localized. often referred to other parts of the body
volumetric measurements:
are used to quantify the presence of edema in the wrist and hand by examining the amount of water displaced following immersion.
stages of ulcers: stage I-
observable pressure related alteration of intact skin whose indications as compared to another area of skin, may have changes in skin color, temperature, stiffness or sensation.
stages of ulcers: stage II-
partial-thickness skin loss that involves the epidermis and/or dermis. ulcers superficial and presents as an abrasion, a blister or shallow crater.
stages of ulcers: stage III-
full thickness skin loss that involves damage or necrosis of subcutaneous tissue that may extend down to, but not through, underlying fascia. clinically presents as a deep crater with or without undermining adjacent tissue.
stages of ulcers: stage IV-
full thickness skin loss with extensive destruction, tissue necrosis or damage to muscle, bone, or supporting structures (ex tendon, joint capsule)
epigastric area:
upper central region of abdomen. located between costal margins and the subcostal plane. Applying manual hand pressure INWARDS & UPWARDS over the epigastric area can assist the patient to cough and promote airway clearance.
hip extension end feel:
firm due to anterior joint capsule and the iliofemoral ligament
ultrasound:
3mhz-treats less than 2 cm
wheelchair measurements:
-between edge of seat and posterior aspect of leg should be 2” (3-4 fingers).
wheelchair ramp measurement:
MAX recommendation-8.3%. 1 inch rise/12 inch run.
hertz:
unit of measure describes the number of cycles per second using alternating current.
coulomb:
amount of electrical charge transported in one second by a steady current of one ampere.
S&S of Anemia(decreased RBC’s, delivery of oxygen to tissues is impaired):
SOB and heart palpitations, pallor, cyanosis, cool skin and malaise.
RULE OF 9’S (adult burn % of body):
head-9%
QRS complex:
depolarization of Right and Left ventricles of heart seen on ECG machine. Normally lasts .06-.10s (ex. 81 bps x 10=.80 bpm)
Cor Pulmonale:
right sided heart failure, secondary lung disease.
intermittent claudication:
lower extremity cramps which develop during activity and disappear after rest. Peripheral pulses are often diminished.
pulmonary embolism:
one or more arteries in the lungs becomes blocked, secondary to blood clots in LE’s.
dysmetria:
inability to modulate movement where patients will either overestimate or underestimate their targets.
cerebellum:
is normally responsible for the timing, force, extent and direction of the limb movement in order to correctly reach a target.
dysdiadochokinesia:
inability to perform rapid alternating movements. (ex: pronation/supination quickly). Secondary to cerebellum damage
rotator cuff:
-large tears (3-5 cm). Able to return to recreational activities @ 24-28 weeks.
medial ligament of talocrural joint aka:
deltoid ligament
kinesthesia:
aweareness of the position and movement of body parts by means of sensory organs in muscles and joints.
fibrous joints:
synarthroses
cartilaginous joints:
diarthroses
dyspnea:
shortness of breath
Semmes-Weinstein monofilaments:
effective and inexpensive device for identifying diabetic patients at risk of foot ulceration.
Hodgkins lymphoma:
cancer affecting lymphatic system
Graves disease:
immune system disorder that results in overproduction of thyroid hormones
exophthalmos:
protruding eyeball anteriorly out of socket
Legg Calve perthes disease:
childhood disease effecting the hips. Ages 4-8. Occurs when blood supply to ball and socket joint is interrupted, breaking easily and healing poorly.
Spina Bifida:
part of group of birth defects called neutral tube defects. Neural tube doesn’t develop or close properly causing defects in the spinal cord and backbones.
Spina Bifida Occulta:
mildest form. separation/gap of vertebrae.
Meningocele (form of spina bifida):
meninges of spinal cord pushes out through vertebrae. can be surgically removed with little to no damage.
Myelomenigocele (form of spina bifida):
open spina bifida-most sever. spinal canal remains open along several vertebrae. Causing both membranes and spinal cord to protrude at birth forming a sac on the babys back.
emphysema:
COPD characterized by abnormal and permanent enlargement of the air spaces distal to the terminal bronchiole, accompanied by obstructive changes in the walls. Lungs become hyperinflated due to the loss of elastic recoil, obstruction to airflow is seen as an increase in total lung capacity, residual volume and functional residual capacity.
superficial burn:
only outer epidermis. may be red with slight edema. healing without scarring within 2-5 days.
superficial partial thickness burn:
involves epidermis and the upper portion of the dermis. The involved area may be extremely painful and exhibit blisters. Healing occurs with minimal to no scarring within 5-21 days.
deep partial thickness burn:
complete destruction of the epidermis and the majority of the dermis. Discolored with broken blisters and edema. Damage to nerve endings may result in only moderate levels of pain. Healing occurs with potential for hypertrophic scars and keloids in 21-35 days.
full thickness burn:
destruction of epidermis and dermis completely with partial damage of subcutaneous layer. presents with eschar formation and minimal to no pain. Patients w/ full thickness burns requiregrafts and may be susceptible to infections.
compression garments:
10mmHg-50mmHg
max effort:
failure of the heart rate to increase with further increases in intensity
perceived exertion scale:
20-Jun
dyspnea scale:
ex: 2-4 = moderate, bothersome degree of breathlessness.
iontophoresis:
process by which medications are induce through the skin into the body by means of continuous direct current e-stim. Check pt every 3-5 minutes.
primary purpose of arterial line:
to measure blood pressure and can sample arterial blood.
balloon tipped catheter:
measures right arterial pressure or pulmonary pressure.
dexamethasone:
corticosteroid. used to treat inflammation.
Innvervations:
S1-S2: lateral hamstring reflex
max heartrate:
220-age
weak ____ gluteus medius–>____ pelvic dropping during _____ swing phase.
Right, left, left
athetosis:
slow, writhing, and involuntary movements that may occur with damage to the BASAL GANGLIA. May look “worm like”.
cerebellar degeneration S&S:
dysmetria, nystagmus, dysdiadochokinesia.
nystagmus:
gaze evoked attempt to look toward an object in periphery, but eyes will drift back to neutral.
Autonomic dysreflexia:
occurs when a noxious stimulus below the level of the lesion triggers the autonomic nervous system causing a sudden elevation IN BLOOD PRESSURE. Common in patients with SCI ABOVE T6 level.
stereognosis:
the perception of a form of an object by means of TOUCH.
posterior cord syndrome:
refers to a relatively rare incomplete lesion caused by compression of the posterior spinal artery.
Brown Sequards Syndrome:
incomplete lesion usually caused by a stab wound, which produces hemisection of the spinal cod.
Cauda Equina injury:
occurs BELOW the L1 spinal level where the long nerve roots transcend. can be complete, however, are frequently incomplete due to the large number of nerve roots in the area.
areflexia:
absence of reflexes
Brunnstrom stages of Recovery:
stage 2: movement occurs primarily in the form of associated reactions and spasticity develops.
sulfadiazine:
eliminates bacteria that causes infection, especially UTI’s.
_____ helps maximize all steps of an effective cough.
sitting
osteognosis imperfecta:
genetic disorder where bones break easily. caused by one of several genes not working right.
Guillain Barre Syndrome:
BODY’S IMMUNE SYSTEM ATTACKS YOUR NERVES.
Hydrotherapy tanks:
transfers heat through water (wound care, edema control).
extremity tanks:
used for distal UE or LE.
lowboy tank:
used for larger parts of the extremities and permits long sitting with water up to the midthoracic level.