Chap 4 MSK Flashcards
1
Q
What % of burn is it if just head and neck are burned
A
9%
2
Q
what % of burn is it if only anterior trunk is burned
A
18%
3
Q
what % of burn is it if only post trunk is burned
A
18%
4
Q
what % of burn is it if both ant and post trunk are burnt
A
36%
5
Q
if both arms and hands are burned ant only what % is it
A
9%
6
Q
if both arms and hands are burned post only what % is it
A
9%
7
Q
if both arms and hands are burned post and ant what % is it
A
18%
8
Q
if both ant legs are burned what % is it
A
18%
9
Q
if both post legs are burned what % is it
A
18%
10
Q
ratio of quads to hams is
A
3 quads 2 hams
11
Q
which energy sx is used for ATP production during high intensity, super short duration exercise like sprinting 100 meters (up to 15 sec).
A
ATP-PC (phosphocreatine decomposes)
12
Q
ATP and PC are stored
A
within contractile tissue
13
Q
anaerobic metabolism is aka
A
lactic acid sx
14
Q
this energy sx is used for shorter duration higher intensity exercise like sprinting 500meters
A
anaerobic glycolosis
15
Q
in this energy system, stored glycogen is split into glucose then glycolosis occurs creating pyruvic acid, then ATP.
A
anaerobic glycolosis (or lactic acid sx)
16
Q
anaerobic glycolosis only uses what to make energy
A
carbs (glycogen and glucose)
17
Q
which energy sx yields the most ATP
A
aerobic, but it requires many complex chemical rxns
18
Q
which type of lever is when the load and effort are on either side of the fulcrum, and give ex
A
class 1, triceps
19
Q
most common lever in the body
A
3
20
Q
type of lever where the load is between fulcrum and effort, and the effort is always longer
A
2 (like a wheelbarrow)
21
Q
biceps contraction, elbow flexion is what type of lever
A
3
22
Q
with a type 3 lever, the effort is where
A
middle
23
Q
type 1 what is in middle
type 2 “ “
type 3 “ “
A
1-Fulcrum in middle
2 load in middle
3- effort in middle
24
Q
the tissue btwn tibia and fibula is what type of joint classification
A
syndesmosis (the interosseous membrane)
25
two boney surfaces connecting like a peg in a hole (like teeth in socket) is what type of joint
gomphosis
26
amphiarthritic joints are aka
cartilaginous
27
the sternum and the rib articulations are what type of joint
synchondrosis
28
if entire trunk, ant and post, is burnt what % is that
36%
29
what are diarthritic joints
true synovial joints (they have a capsule, membrane, fluid, cart)
30
role of golgi tendon organs
sense tension
31
ball and socket joints have ___ degrees of freedom
at least 3
32
what is closed packed position of shoulder
abd and ER
33
what is loose packed position of shoulder
55d abd, 30d hor add
34
what is capsular pattern of shoulder (GH)
ER, IR, ABD
35
normal ROM to GH shoulder joint
```
flexion 0-165 (they say 180)
ext 0-60
abd 0-165 (they say 180)
IR 0-70
ER 0-90
hor add 0-40
hor abd 0-45
```
36
the SC joint is what type
saddle synovial
37
closed packed position of AC joint
arm abd to 90 d
38
shoulder flexors
ant delt, coracobrachialis, pec major, biceps
39
shoulder extensors
lats, post delt, teres major (PLT)
40
shoulder abductors
middle delt, supraspinatus
41
shoulder adductors
pec major, teres major, lats
42
shoulder ERs
infraspinatus, teres minor, post delt
43
shoulder IRs
subscapularis, lats, major major
44
scapular elevators
levator scap, upper trap
45
scap depressors
lower trap, lats, both pecs
46
scap protractors
serratus ant, pec minor
47
scap retractors
traps, rhomboids
48
scap upward rotators
traps, serratus
49
scap downward rotators
rhomboids, levator scap, pec minor
50
elbow flexors
biceps, brachioradialis, brachialis
51
2 main bursa in shoulder
subacromial and subscapular
52
capsular pattern of elbow joint
flexion and ext
53
closed packed of elbow joint
full ext
54
loose packed of elbow joint
70d flexion with slight supination
55
in the proximal radioulnar joint, what is concave and convex
concave radial notch of the ulna, and convex radial head
56
what motions come rom the proximal R/U joint
pronation and supination
57
capsular pattern of R/U joint
sup and pro
58
elbow extensors
triceps, anconeus
59
supinators
biceps, supinator
60
pronators
pronator teres and quadratus
61
the radial collateral ligg is aka
lateral collateral ligg
62
the LCL of elbow attaches where
lateral epicondyle of humerus to olecranon process of ulna and annular ligg
63
LCL of elbow prevents
adduction of elbow
64
the UCL is aka
medial collateral ligg
65
attachments of UCL
medial epicondyle of humerus to the ulna
66
UCL prevents what motion
excessive abd of elbow
67
where is the annular ligg
surrounding head of radius (allows rotation of head)
68
main joints in wrist
RC, mid carpal
69
loose packed of wrist joint
neutral and in ulnar deviation
70
closed packed wrist joint
full ext with radial deviation
71
wrist flexors
flexor carpi radialis, flexor carpi ulnaris, palmaris longus
72
shoulder scapular depressors
pecs, lats, lower traps
73
wrist extensors
extensor carpi radialis longus and brevis, extensor carpi ulnaris
74
only wrist ligg on dorsal side, it limits flexion
dorsal radiocarpal ligg
75
main ligg in wrist to limit ext
palmar radiocarpal ligg
76
ligg in wrist that limits ulnar deviation
radial collateral ligg
77
what nerve enters the carpal tunnel
median
78
what is the condition called when the retinaculum in the wrist becomes inflammed
tenosynovitis (it can press on median nerve causing carpal tunnel syndrome)
79
what 2 tendons run closely together on the thumb side of the wrist
extensor pollicus brevis and abd pollicus longus
80
loose packed position of hip
30d flexion and abd, slight ER
81
closed packed position of hip
full ext and IR
82
capsular pattern hip
flexion, abd, IR
83
hip flexors
iliopsoas, pectinineus, sartourious, rectus femoris
84
hip extensors
glut max and med, all 3 hamstrings
85
hip abductors
TFL, glut med and min, piriformis
86
hip adductors
adductor longus magnus and brevis, gracilis
87
hip IRs
TFL, glut med and min, pectinius, adductor longus
88
hip ERs
piriformis, glut max, obtoratur externus, sartourious
89
main axns glut med and min
hip abd and IR
90
main axns piriformis
hip abd and ER
91
ligg that reinforce the hip joint capsule
ileofemoral, pubofemoral, ischifemoral
92
which hip ligg limits hip ext and excessive abd of femur
pubofemoral
93
in the knee joint, what parts are convex/convace
femur condyles are convex, tibia is concave
94
closed packed position of knee
full ext with tibia ER
95
loose packed position of knee
25d flexion
96
knee flexors
all hamstrings and sartorious
97
sartorious axns
hip and knee flexion, ER
98
knee extensors
rectus femoris, vastus lateralis and medialis
99
3 main bursa in the knee
pre patellar (over the patella), superficial infrapatellar (at tendon and skin), deep infrapatellar (btwn tendon and bone)
100
deep fibers of the MCL attach where
medial meniscus
101
where is the arcuate ligg complex
lateral, post knee (comprised of lateral structures)
102
what bones comprise the talocrural jt and what motions occur at it
talus, tibia, fibula (PF, DF)
103
how many degrees of freedom does ankle have (talocrural)
1
104
how many degrees of freedom does knee have
2
105
normal ROM of knee
0-145
106
ROM of hip, flexion
120
107
ROM hip ext
30
108
ROM hip add
30
109
ROM hip abd
45
110
ROM hip ER and IR
ER 45
| IR 45
111
subtalar joint articulations and axns
talus and calcaneous (inversion and eversion)
112
liggs in ankle
```
ATF (ant talofib)
CF (calcaneal fib)
PTF (post talofib)
deltoid
interosseous membrane
```
113
these ligg resists inversion of ankle
ATF, CF
114
this ankle ligg resists eversion
deltiod
115
medial to lateral, list the hamstrings
semi membranosis, tendinosis, biceps femoris
116
C1-C2 are aka
atlas, axis
117
atlanto occipital joint is where
C1 facet joints
118
what motions occur at atlanto occiptial joint
head flexion/ext (yes)
119
rotation of cspine occurs from what joint
atlantoaxial
120
what joints are formed from facets in cspine
zygoapophaseal
121
muscles that flex neck
SCM, longus colli, scalenes
122
muscles that extend neck
ILS cervicis's (iliocostalis, longismus, semispinalis), multifidi, traps
123
muscles that rotate and lateral bend neck
scm, scalenes, ILS, levator scap, multifidi
124
ILS muscles in cspine motions
extension, rotation and lateral bend
125
longus colli vs longismus cervicis
longus colli is ant neck, longismus cervicis is part of ILS and is post neck
126
3 ILS muscles
ileocostalis, longismus cervicis, semispinalis
127
this ligg resists cervical flexion
post longitudinal lig
128
this ligg resists cervical ext
ant longitudinal lig
129
spinal nerves exit via the
vertebral foramina
130
foramina open with what motion
flexion and contra side bend (they close with ext and ipsi side bend)
131
muscles that flex thoracolumbar region (trunk forward)
rectus abdominus, both obliques
132
muscles that extend thoracolumbar region (trunk back)
erector spinae, QL
133
ribs that are attached
1-10 (attach at costovertebral and costotransverse joints)
134
type 1 muscle fibers are aka
aerobic, red, slow twitch
135
type 2 muscle fibers are aka
anaerobic, white, fast twitch
136
these receptors have to do with muscle LENGTH or rate of LENGTH change or POSTURE
spindles
137
types of muscle contractions
isotonic (eccentric, concentric)
isometric
isokinetic (constant speed-machine)
138
pt marks on a diagram to indicate area of pain, pt chooses 1 word to describe the pain, pt describes pattern of pain including agg/ease factors, pt rates intensity 0-5. This all describes what
McGill pain questionaire (remember McGill is 0-5)
139
describe VAS
a line pts rate pain on
140
myotomes upper body
```
C1- cervical rotation
C2-C4 shoulder elevation
C5- shoulder abd
C5-C6 elbow flexion
C6 only - wrist ext
C7-elbow ext and wrist flexion
C8- thumb ext
T1-finger adduction
```
141
glut max does what type of rotation at hip
ER
142
shoulder abd is what myotome
C5
143
list reflexes UE
C5-biceps
C6 -brachioradialis
C7-triceps
144
C6 only myotome test
wrist ext
145
C7 myotome test
elbow ext and wrist flexion
146
dermatomes for Upper body (remember, dearmatomes for upper are individual, not like myotomes)
```
C2 - post head
C3- lateral post neck
C4- AC joint
C5-lateral elbow area
C6-lateral thumb and forearm
C7-palm side of middle finger
C8-lateral pinky and ulnar side of hand
T1-medial elbow area
```
147
having a pt walk on their heels would test what segments
L4-L5
148
having a pt up on toes would test what segments
S1
149
active SLR tests what segments
L4-S1
150
myotomes lower body
```
hip flexion L1-L2
knee ext L3-L4
dorsiflexion L4-L5
big toe ext L5
plantar flexion S1
```
151
patellar reflex is what segment
L4
152
achilles reflex is what segment
S1
153
L4 dermatome location
patella to medial malleolus
154
fibular head and dorsum of foot is what dermatome
L5
155
perianal area is what dermatome
S3-S5
156
lateral foot is what dermatome
S1
157
to be consistant, all skin fold measurements should always be taken on what side
R
158
skinfold measurement sites
abs, triceps, chest, calf, biceps
159
formula used in bioelectrical impedence testing
ht squared/resistance
160
in good standing posture, palms face
towards body
161
in good standing posture, scapulas should be approx how far appart
4 inches
162
plumb line in posture, note main points
through auditory meatus, through shoulder joint, post to hip, ant to knee, ant to lateral maleolous
163
loose packed position of GH joint
55d abd, 30d hor adduction
164
closed packed position of GH joint
abd with ER
165
loose packed position of elbow
70d flexion 10d supination
166
closed packed position of elbow
full ext
167
loose packed wrist joint
neutral with slight ulnar deviation
168
closed packed wrist joint
extension and radial deviation
169
loose packed hip joint
30/30
flexion and abd
ER
170
closed pack hip joint
full ext with IR
171
loose packed knee joint
25d fleion
172
closed pack knee joint
full ext
173
loose packed ankle joint (talocrural)
10d plantarflexion
174
closed packed ankle joint
full dorsi
175
what is loose packed vs closed packed
stress on the joint (max or min). So in closed packed the liggs and structures are being stressed and compressed.
176
good BMI %s
males is 12-18 females is 18-23
177
capsular pattern of hip
flexion, abduction, IR
178
capsular pattern means what
limitation due to the joint itself (capsular restriction occurs during these motions)
179
firm end feel (describe and list example)
stretching, like dorsiflexion or finger ext
180
hard end feel (describe and list example)
bone to bone, elbow ext
181
soft end feel (describe and list example)
tissue to tissue, elbow flexion
182
4 examples of abnormal end feels
empty-cant reach endp bc of ain
firm-increased tone, tight capsule
hard-arthritis or fx
soft - edema or ligg sprain
183
L4 dermatome location
patella and medial malleolus
184
L5 dermatome location
fibular head and dorsum of foot
185
how to test L4 with a functional test (muscle)
L4 toes off the floor, heel walking
186
how to test S1 with a functional muscle test
toe walking
187
to test all L4-S1 functionally do what
have them do active SLR
188
spacticity would cause what type of abnormal end feel
firm
189
list grades of MMT
0 no contraction felt
1 contraction felt but no movement
2- movement initiated but cannot do in gravity elim
2 (COMPLETES in gravity elimitated)
2+ can do against gravity some movement
3- can do some against gravity (more than half)
3 can do full motion in gravity (no resistance)
3+ can take some resistance against gravity
4- can take min-mon resistance againt gravity
4 can take mod resistance against gravity
4+ can take mod to almost max against gravity
5 normal (max)
190
with MMT what numbers only have 1 level
0, 1, 5
191
what grade of MMT is can complete motion in gravity eliminated
2
192
what grade of MMT is: can complete against gravity but without resistance
3
193
what muscles must be tested in side lying
glut min and med
lateral abdominals
hip adductors
194
teres major aids in shoulder _____ (flexion or ext)
shoulder ext
195
3 shoulder IRs
subscap, x2 major, lats
196
2 scap retractors
traps, rhomboids
197
4 hip ERs
piriformis, glut max, obtoratur externus, sartourious
198
to mmt lats, pt must be
prone
199
what is active and passive insufficiency
active- when a 2 joint muscle shortens (contracts) over both joints at same time
passive- when a 2 joint muscle lengthens over the joints at the same time
200
why use a dynomometer on dominate hand side
dominant hand is usually 10 lbs stronger
201
2 main phases of gait
stance
| swing
202
what are the phases of stance phase of gait (all about the planted foot)
```
heel strike
flat foot
mid stance
heel off
toe off
```
203
what are the phases of swing phase of gait (this is about the moving limb)
acceleration
midswing
deceleration
204
explain acceleration phase
when toe off occurs on LE and leg is behind rest of body
205
stance phase is what % of gait, swing phase is what %
stance 60
| swing 40
206
how much motion at each joint is required for gait
30d hip flexion
10d hip ext
60d knee flexion
0d knee ext
10d ankle dorsi
20d ankle PF
207
what is the number os steps over a period of time
cadence (normal is 120/min)
208
diff btwn step length and stride length
step is 2 diff feet
| stride is same foot
209
what is equine gait
high steps, lots of PF activity
210
with festination, pt is usually on their
toes
211
what is steppage gait pattern
dorsiflexors are weak, pt flops or drops foot to ground, hip and knee flexion is excessive to compensate
212
normal ROM elbow
0-150
213
normal ROM pronation and supination
80
214
normal ROM wrist
flexion 80
ext 70
UD 30
RD 20
215
how much hip flexion and ext is needed for gait
30 flexion
| 10 ext
216
hip ROM norms
120d flexion
45d IR, ER, abd
30d ext and add
217
normal DF/PF ROM
20d DF
| 50d PF
218
normal cervical ROM
flexion 45
ext 45
lateral SB 45
rotation 60
219
normal thoracolumbar ROM
80 flexion
25 ext
35 SB
45 Rotation
220
biceps tendon pathology special tests
Ludingtons (hands on head alternating bicep contractions)
Speeds
Yergasons-yer resisting them supinating, elbow at 90
221
RC special tests
drop arm- PROM to abd and see if they can hold
hawkins kennedy-
neers-thumb down and PROM raise full shoulder flexion
supraspinatus test- full can test
222
TOS special tests
Adsons: arm down, look towards ipsi side (scalenes)
Allens: arm in L, look away (pec minor) (or compress radial and ulnar arteries and observe for flushing)
Roos: pinchy pinchy (only non pulse one)
Costoclavicular: scap depression, chest protrusion, pulse
223
normal elbow flexion
150
224
how to remember hip ROM norms
it's hip to be the same
120 (flexion)
45 (IR, ER, abd)
30 (ext, add)
225
4 tests for epicondylitis
Mills (lateral)
Cozen: pt makes fist, pronates, radially deviates and extends wrist with resistance as you palpate lateral epicondyle
lat epic: resist 3rd finger ext
medial epic: supinate and ext elbow/wrist with resistance
226
the 2 major majors are
IRs, adductor
