COMLEX Flashcards
1
Q
superior facets of cervicles
A
BUM - backwards, upwards, medial
2
Q
superior facets of thoracic
A
BUL - backwards upwards, lateral
3
Q
Lumbar superior facets
A
BM - backward medial
4
Q
muscle contraction that results in the approximation of the muscles origin and insertion without a change in its tension. the operators force is less than the patients force
A
isotonic contraction
5
Q
muscle contraction that results in the increase in tesnion without an approximation of origin and insertion. in such case the operators force and the patients force are equal
A
isometric contraction
6
Q
direct or indirect, active or passive?: Myofascial release
A
both, both
7
Q
direct or indirect, active or passive?: CS
A
indirect, passive
8
Q
direct or indirect, active or passive?: FPR
A
indirect, passive
9
Q
direct or indirect, active or passive?: ME
A
direct, active
10
Q
direct or indirect, active or passive?:HVLA
A
direct, passive
11
Q
direct or indirect, active or passive?: Cranial
A
both, passive
12
Q
direct or indirect, active or passive?: lymphatic
A
direct, passive
13
Q
direct or indirect, active or passive?: chapmans
A
direct, passive
14
Q
sequence: psoas syndrome
A
lumbar or thoracolumbar first
15
Q
sequence: before cervicals
A
ribs and upper thoracics first
16
Q
sequence:before ribs
A
thoracics first
17
Q
sequence: acute SD
A
treat peripheral area first
18
Q
sequence: cranial or other first?
A
cranial will help the patient to relax, making it easier to treat other areas
19
Q
sequence: for extremities
A
treat axial skeleton first (spine, sacrum, ribs)
20
Q
what are the O and I of the scalenes?
A
all O:posterior tubercle of cervicals
I: rib 1 (anterior and middle), rib 2 (posterior)
21
Q
ROM of SCM
A
unilateral contraction= SB towards and R away
bilateral contraction= flexion of the neck
22
Q
damage to the alar and transverse ligaments is common in what?
A
down syndrome and rheumatoid arthritis. can result in subluxation
23
Q
where are the joints of luschka?
A
the uncinate processes of C3-C7
24
Q
how to treat an acute cervical injury?
A
indirect fascial techniques or counterstrain first
25
primary motion of upper cervicals
rotation
26
primary motion of lower cervicals
SB
27
spine of scapula
T3
28
inferior angle of scapula
spinous process of T7, body of T8
29
sternal notch
T2
30
sternal angle of louis
Rib 2 and body of T4
31
nipples dermatone
T4
32
umbilicus dermatone
T10
33
main motion of the thorax
rotation
34
motions of upper thorax
rotation>F/E>SB
35
motions of lower thoracic
F/E>SB>rotation (like lumbars)
36
Diaphragm attachments
xiphoid process, ribs 6-12, bodies and discs of L1-3
37
primary mm of respiration
diaphragm and intercostals
38
typical ribs
T3-10 (atypicals have "1s" and "2s" - sometimes 10 is considered atypical)
39
false ribs
8-12 = do not attach to the sternum
40
motion of ribs 1-5
pump handle
41
motion of ribs 6-10
bucket handle
42
where is the dysfunction: costochondral junction or chondrosternal junction
pump handle rib problem
43
where is the dysfunction: intercostal muscles at midaxillary line
bucket handle ribs
44
O, I, and MOA of iliopsoas
O: T12-L5
I: lesser trochanter
MOA: primary hip flexor
45
umbilicus level
L3 and L4
46
main motion of the lumbar spine
F/E
47
what nerve comes out between L3 and L4
L3 nerve
48
what nerve is injured in a herniated disc between L3 and L4
L4 nerve is damaged
49
how to treat a herniated disc?
initially indirect techniques, then gentle direct techniques
50
How to treat psoas syndrome
must treat higher lumbar dysfunction
51
what is mostly associated with a flexion contracture of the iliopsoas?
F/E of L1 or L2
52
how to diagnosis spondylolisthesis? spondylolysis?
Lateral view = spondylolisthesis
| Oblique view = spondylolysis - will see scotty dog
53
all the following may be seen in a patient with R sided psoas syndrome EXCEPT:
1. a +Thomas test
2. Tenderpoint medial to ASIS
3. Pelvis shifted to R
4. a non neutral SD of upper lumbar segments
5. sacral dysfunction on an oblique axis
Pelvis shifted to R
54
how to treat newborn suckling difficulties
condylar decompression of the occiput to improve PSNS function (XII), or treating dysfunctions of CN IX and X at the jugular foramen (occiput/temporal).
55
what can you treat to alleviate some labor pain caused by cervical dilation, dysmenorrhea, conspitation?
Sacral somatic dysfunctions to normalize hyperPSNS activity.
56
what should you treat if a person has thick secretions associated with an URI
Sphenopalatine Ganglion (CN VII)
57
what should you treat to treat ileus?
treat the paraspinals at L1 and L2
58
what should you treat if a person has dysmenorrhea to tone down the PSNS
sacral inhibition - apply deep pressure at the sacrum for 2 minutes
59
how can you treat tight paraspinals to enhance the cranial rhythmic impulse?
sacral rocking
60
best way to treat someone with decreased cranial rhythmic impulse and decreased amplitude
CV4
61
what are the 3 true pelvic (sacroiliac) ligaments
anterior, posterior, and interosseus sacroiliac ligaments
62
which ligament divides the greater and lesser sciatic foramen?
sacrospinous ligament
63
which ligament is painful in lumbosacral decompensation?
iliolumbar ligament
64
O, I, NN, and MOA of piriformis
O: inferior anterior aspect of sacrum
I: greater trochanter of femur
NN: S1 and S2
MOA: externally rotates, extends thigh, and abducts the thigh with hip flexed
65
where is the respiratory motion of the sacrum?
superior transverse axis of S2
66
what is a common sacral diagnosis in post partum patients?
Bilateral sacral flexion
67
what somatic dysfunction can you see in the lumbars for a person with R psoas syndrome?
L1 or L2 FRSR (flexed and SB to the same side as the syndrome)
68
primary upper arm external rotators? internal?
external - teres minor and infraspinatus
| internal - subscapularis
69
what is compromised in contracture of the anterior and middle scalenes?
subclavian aa. the subclavian vv runs anterior to the anterior scalene and so it is unaffected.
70
what nerves are usually injured in Erb-Duchenne's palsy (most common injury)
C5-6
71
saturday night palsy is an injury to which nerve?
chronic crutches use?
midshaft humoral fractures?
all answers are Radial nerve
72
what nerve is affected in tennis elbow
radial nerve
73
what nerve is affected in golfers elbow?
median nerve
74
what innervates the supinator?
radial nerve
75
what innervates the pronators?
median nerve
76
if you have an increased carrying angle of the elbow, you will have more of an (adduction/abduction) of the wrist?
increased carrying angle = abduction of the ulna = adduction of the wrist
77
falling foward on an outstretched arm causes what radial diagnosis? falling backwards?
posterior radial head, anterior radial head
78
what does the fibular head do when the ankle is dorsiflexed, everted, and abducted?
the fibular head is anterior
79
what makes up the lateral arch of the foot?
calcaneus, cuboid, and 4th and 5th metatarsals
80
what to treat to help induce delivery?
CV4 bulb decompression
81
where can CN X be restricted?
jugular foramen, OA, AA, C2
82
what force is used in DIRECT MFR? INDIRECT?
```
Direct = traction
Indirect = compression
```
83
where level innervates the cisterna chyli?
T11
84
where is the L5 tenderpoint located?
on the pubic rami
85
mm for ribs 1 and 2
```
1= anterior and middle scalene
2= posterior scalene
```
86
mm for ribs 3-5? 6-9?
```
3-5 = pec minor
6-9 = serratus anterior
```
87
mm for ribs 10-11? 12?
```
10-11 = lats dorsi
12 = QL
```
88
what are the absolute contraindications of HVLA?
osteoporosis, osteomyelitis, fractures, bone mets, rheumatoid arthritis, down syndrome
89
what are the relative contraindication of HVLA?
acute whiplash, pregnancy, post-surgical conditions, herniated disc, anticoagulants or hemophilia, vertebral aa ischemia
90
wallernbergs test test for what?
vertebral artery insufficiency
91
Military posture test tests for what?
neurovascular compromised between the clavicle and first rib
92
Yagason's test tests for what?
stability of the biceps tendon in the bicipital grove
93
Allens test
blood supply to the hand by the radial and ulnar aa
94
finkelsteins
de quervain's disease
95
Hip drop test
evaluate sidebending (lateral flexion) of the lumbar spine
96
seated flexion test
sacroiliac motion
97
standing flexion test
iliosacral motion
98
pelvic side shift
tight iliopsoas (a tight R iliopsoas will allow for a L + pelvic shift)
99
spring test
posterior sacral base
100
Ober's test
a tight IT band and TFL
101
bounce home test
full knee extension - meniscal tears or joint effusions
102
nerve distribution: C1, C2, C3, C4
C1-vertex of the skull
C2- temple and occipital area
C3- supraclavicular fossa
C4- superior aspect of the shoulder
103
nerve distribution AND motor: C5, T1
C5- lateral aspect of elbow, elbow flexors
| T1- medial elbow, finger abduction
104
nerve MOTOR function: C6, C7, C8
C6- wrist extensors
C7- elbow extensors
C8- deep finger and wrist flexors
105
what nerve controls the following reflexes: biceps, brachioradialis, triceps,
C5, C6, C7
106
innervation: deltoid, supraspinatus, infraspinatus, subscapularis
Axillary, suprascapular, suprascapular, subscapular
107
Innervation: teres minor, teres major, lat dorsi
lower subscap nerve, axillary nerve, thoracodorsal nerve
108
innervation: coracobrachialis, biceps brachii, brachialis
all musculocutaneous
109
innervation: triceps, anconeus
all radial nerve
110
what muscles of the anterior forearm are innervated by ulnar nerve?
flexor carpi ulnaris only
111
what innervates the supinator?
radial nerve
112
nerve distribution: L4, L5, S1
medial malleolus, dorsal aspect of foot and big toe, lateral malleolus
113
nerve motor functions: L4, L5, S1
ankle dorsiflexors, toe extendors, ankle planter flexors
114
what nerves are associatd with the following reflexes: patellar, achilles
L4, S1
115
obturator nerve innervates which muscles?
Adductors
116
what innervates the gluteus maximus? minimus?
inferior gluteal, superior gluteal
117
what innervates gastrocnemius and soleus?
tibial nerve
118
what innervates the muscles of the distal leg: extensors, flexors?
extensors - deep peroneal
| flexors- tibial
119
what innervates abductor hallucis longus?
medial plantar nerve
120
what innervates the flexors of the foot (except digiti minimi?)
medial plantar nerve
121
guyon's canal problem, which nerve?
ulnar nerve
122
suboccipital or paravertebral muscle spasms are usually associated with...
upper rib problems on the same side
123
mnemonic for L5 on S1
ROSS
124
what can cause supraspinitis tendonitis?
Chronic NSAID use
125
injury to which nerve can occur with shoulder dislocation?
axillary nerve
126
which direction does the fibular head glide with foot supination?
posterior
127
the Primary Respiratory mechanism is made up of which 5 things?
1. CNS
2. CSF
3. Dural Membranes
4. Cranial bones
5. sacrum
128
what is the inherent motility of the brain and spinal cord?
the brain and spinal cord lengthens and thens during exhalation and shortens and thins during inhalation
129
what is the rate of Cranial Rhythmic Impulse (CRI?)
10-14 cycles per minute
130
what will decrease the CRI? Increase?
decrease-stress, depression, chronic fatigue, chronic infections
increase- physical exercise, systemic fever, following OMT
131
what are the dural attachements?
Foramen Magnum, C2, C3, and S2
132
vagal SD can be due to problems at which locations?
Jugular foramen (tempora/occiput), OA, AA, or C2
133
how to induce labor in post dates gravid women
CV4
134
ganglion of the parotid gland
otic (receives CN IX from the medulla)
135
ganglion of lacrimal and nasal glands
sphenopalantine (receives CN VII from the pons)
136
chapmans point of the appendix
tip of the 12th rib (T11 transverse process posteriorly)
137
trigger point vs. tenderpoint?
Trigger points may refer pain when pressed, tenderpoints do NOT
