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Board Prep > COMLEX: general > Flashcards

COMLEX: general Flashcards

1
Q

Fryette’s law I

A

sidebending precedes rotation, sidebending and rotation occur to opposite sides; typically group dysfunctions. Ex: T4-T7 NSrRl

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2
Q

Fryette’s law II

A

rotation precedes sidebending, sidebending and rotation occur to the same side; typically single vertebra dysfunction. Ex: L2 FRrSr

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3
Q

superior facet orientation in the cervical spine

A

BUM: backward, upward, and medial

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4
Q

superior facet orientation in the thoracic spine

A

BUL: backward, upward, lateral

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5
Q

superior facet orientation in the lumbar spine

A

BM: backward, medial

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6
Q

name the axis and plane: flexion/extension

A

transverse axis, sagittal plane

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7
Q

name the axis and plane: rotation

A

vertical axis, transverse plane

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8
Q

name the axis and plane: sidebending

A

anterior-posterior axis, coronal plane

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9
Q

direct treatment

A

towards the barrier. ex: lymphatic treatment, Chapman’s reflexes

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10
Q

indirect treatment

A

away from the barrier. ex: counterstrain, facilitated positional release

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11
Q

what is the most common cause of cervical nerve root pressure symptoms?

A

degenerative changes within the joints of Luschka and hypertrophy of the intervertebral (facet) joints

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12
Q

which muscles help elevate the 1st rib during forced inhalation?

A

anterior and middle scalene

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13
Q

which muscle helps elevate the 2nd rib during forced inhalation?

A

posterior scalene

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14
Q

according to the rule of 3s, where is the spinous process from T1-T3?

A

the spinous process is located at the level of the corresponding transverse process; T12 follows this rule

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15
Q

according to the rule of 3s, where is the spinous process from T4-T6?

A

the spinous process is located 1/2 segment below the corresponding transverse process; T11 follows this rule.

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16
Q

according to the rule of 3s, where is the spinous process from T7-T9?

A

the spinous process is located at the level of the transverse process of the vertebrae below; T10 follows this rule

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17
Q

name the corresponding spinal level: spine of the scapula

A

T3

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18
Q

name the corresponding spinal level: inferior angle of the scapula

A

spinous process of T7

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19
Q

name the corresponding spinal level: sternal notch

A

T2

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20
Q

name the corresponding spinal level: sternal angle (angle of Louis)

A

T4; attaches to the 2nd rib

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21
Q

name the corresponding spinal level: nipple

A

T4 dermatome

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22
Q

name the corresponding spinal level: umbilicus

A

T10 dermatome

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23
Q

what are the atypical ribs?

A

ribs 1, 2, 11, and 12, sometimes 10

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24
Q

what are the true ribs?

A

ribs 1-7, attach to the sternum through costal cartilages

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25
Q

what are the false ribs?

A

ribs 8-12, do not attach directly to the sternum but instead connected by its costal cartilage to the cartilage of the rib superior.

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26
Q

what are the floating ribs?

A

ribs 11-12, unattached anteriorly

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27
Q

what is the primary motion of ribs 1-5?

A

pump-handle

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28
Q

what is the primary motion of ribs 6-10?

A

bucket-handle

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29
Q

what is the primary motions of ribs 11-12?

A

caliper

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30
Q

diagnostic findings for inhalation dysfunction of ribs 1-5

A

pump-handle ribs: rib elevated anteriorly. anterior part of the rib moves cephalad on inspiration and restricted on expiration. anterior narrowing of intercostal space above dysfunctional rib.

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31
Q

diagnostic findings for inhalation dysfunction of ribs 6-10

A

bucker-handle ribs: rib elevated laterally. lateral part (shaft) of rib moves slightly upward on inspiration and restricted on expiration. lateral narrowing of intercostal space above dysfunctional rib.

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32
Q

diagnostic findings for exhalation dysfunction of ribs 1-5

A

pump-handle ribs: rib depressed anteriorly. anterior part of rib moves caudad on expiration and restricted on inspiration. anterior narrowing of intercostal space below dysfunctional rib.

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33
Q

diagnostic findings for exhalation dysfunction of ribs 6-10

A

bucket-handle ribs: rib depressed laterally. lateral part (shaft) of rib moves slightly downward on expiration and restricted on inspiration. lateral narrowing of intercostal space below dysfunctional rib.

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34
Q

what is the key rib in an inhalation dysfunction?

A

the key rib is the lowest rib of the dysfunction

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35
Q

what is the key rib in an exhalation dysfunction?

A

the key rib is the uppermost rib of the dysfunction

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36
Q

what are the landmarks of a typical rib?

A

tubercle, head, neck, angle, shaft

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37
Q

what is the primary flexor of the hip?

A

iliopsoas

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38
Q

origin and insertion for iliopsoas

A

origin: T12-L5 vertebral bodies.
insertion: lesser trochanter of the femur.

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39
Q

diagnosis: contralateral pelvic side shift, positive Thomas test, somatic dysfunction of upper lumbar segment

A

iliopsoas dysfunction

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40
Q

what is spina bifida occulta?

A

no herniation through the defect. often a coarse patch of hair over the site. rarely associated with neuro deficits.

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41
Q

what is spina bifida meningocele?

A

herniation of the meninges through the defect

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42
Q

what is spina bifida meningomyelocele?

A

herniation of the meninges and the nerve roots through the defect. associated with neuro deficits.

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43
Q

what somatic dysfunction is commonly associated with flexion contracture of iliopsoas?

A

nonneutral dysfunction of L1 or L2

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44
Q

anterior displacement of one vertebrae in relation to the one below due to defect in the pars interarticularis, (+) vertebral step-off sign

A

spondylolisthesis, diagnose with lateral x-ray

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45
Q

defect of the pars interarticularis without anterior displacement of the vertebral body

A

spondylolysis, diagnose with oblique x-ray

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46
Q

oblique x-ray of spondylolysis

A

fracture of the pars interarticularis, often seen as a “collar” on the neck of the scotty dog

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47
Q

degenerative changes in the intervertebral disc and ankylosing of adjacent vertebral bodies

A

spondylosis

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48
Q

saddle anesthesia, decreased DTRs, decreased rectal sphincter tone, loss of bowel/bladder control

A

cauda equina syndrome

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49
Q

what ligament divides the greater and lesser sciatic foramen?

A

sacrospinous ligament

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50
Q

origin and insertion of piriformis

A

origin: inferior anterior aspect of the sacrum.
insertion: greater trochanter of the femur

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51
Q

externally rotates, extends thigh, and abducts thigh with hip flexed

A

piriformis

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52
Q

respiratory motion of the sacrum

A

motion occurs about the superior transverse axis of the sacrum. located approximately at S2. sacral base moves posterior on inhalation and anterior on exhalation.

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53
Q

inherent (craniosacral) motion of the sacrum

A

same axis as respiratory motion. sacral base rotates posteriorly (counternutates) on craniosacral flexion and anterior (nutates) on craniosacral extension.

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54
Q

postural motion of the sacrum

A

motion occurs about the middle transverse axis of the sacrum. sacral base moves anteriorly with forward bending and posteriorly with terminal flexion

55
Q

dynamic motion of the sacrum

A

weight bearing on the left leg (stepping forward with the right leg) will cause a left sacral axis to be engaged

56
Q

etiology of superior pubic shear

A

trauma or tight rectus abdominis muscle

57
Q

etiology of inferior pubic shear

A

trauma or tight adductors

58
Q

sacral torsion rules

A

1.) when L5 is sidebent, sacral oblique axis is engaged on the same side as the sidebending. 2.) when L5 is rotated, the sacrum rotates the opposite way on an oblique axis. 3.) the seated flexion test is found on the opposite side of the oblique axis.

59
Q

forward sacral torsion

A

rotation is on the same side of the axis, LoL or RoR

60
Q

backward sacral torsion

A

rotation is on the opposite side of the axis, RoL or LoR

61
Q

what is a common dysfunction in postpartum patient?

A

bilateral sacral flexion

62
Q

how does psoas syndrome affect L1 or L2?

A

may cause L1 or L2 to be flexed, sidebend, and rotated to the same side of the iliopsoas contracture

63
Q

name the functions of the rotator cuff muscles

A

supraspinatus = ABduct arm.
infraspinatus = ext rotate arm.
teres minor = ext rotate arm.
subscapularis = int rotate arm.

64
Q

what is the most common brachial plexus injury?

A

Erg-Duchenne’s palsy, upper arm paralysis due to injury of C5-C6 nerve roots.

65
Q

innervation of the primary flexors of the wrist and hand

A

median nerve, except flexor carpi ulnaris (ulnar nerve)

66
Q

innervation of primary extensors of the wrist and hand

A

radial nerve

67
Q

primary supinators of the forearm

A

biceps (musculocutaneous nerve) and supinator (radial nerve)

68
Q

primary pronators of the forearm

A

pronator teres and pronator quadratus, both median nerve innervation

69
Q

ulna and wrist movement with increased carrying angle (cubitus valgus)

A

ABduction of ulna, ADduction of wrist, medial glide of the olecranon

70
Q

ulna and wrist movement with decreased carrying angle (cubitus varus)

A

ADduction of ulna, ABduction of wrist, lateral glide of the olecranon

71
Q

radial head motion

A

pronation = posterior radial head. supination = anterior radial head

72
Q

primary extensor of the hip

A

gluteus maximus

73
Q

primary flexor of the hip

A

iliopsoas

74
Q

primary extensor of the knee

A

quadriceps: rectus femoris, vastus lateralis/medialis/intermedius

75
Q

primary flexor of the knee

A

hamstrings: semimembranosus and semitendinosus

76
Q

external rotation somatic dysfunction of the hip

A

piriformis or iliopsoas spasm

77
Q

internal rotation somatic dysfunction of the hip

A

spasm of internal rotators: gluteus minimus, hamstrings, TFL, adductor magnus/longus

78
Q

anterior cruciate ligament (ACL)

A

posterior aspect of the femur to anterior aspect of the tibia. prevents anterior translation of tibia on femur (hyperextension of the knee)

79
Q

posterior cruciate ligament (PCL)

A

anterior aspect of the femur to posterior aspect of the tibia. prevents posterior translation of the tibia on the femur

80
Q

motion of the fibular head

A

ankle pronation (foot eversion, dorsiflexion) = anterior fibular head. ankle supination (foot inversion, plantarflexion) = posterior fibular head.

81
Q

femoral nerve

A

L2-L4. motor to quadriceps, iliacus, sartorius, and pectineus. sensory to anterior thigh and medial leg.

82
Q

sciatic nerve

A

L4-S3. divides into tibial and peroneal nerves.

83
Q

tibial nerve

A

L4-S3. motor to hamstrings except short head biceps femoris, most plantar flexors, and toe flexors. sensory to lower leg and plantar aspect of foot.

84
Q

peroneal nerve

A

L4-S3. motor to short head biceps femoris, evertors and dorsiflexors of the foot, most extensors of the toes. sensory to lower leg and dorsum of foot.

85
Q

genu valgum

A

increased Q angle, knocked-kneed

86
Q

genu varum

A

decreased Q angle, bowlegged

87
Q

what nerve can be affected by posterior fibular head?

A

common peroneal (fibular) nerve, lies directly posterior to proximal fibular head

88
Q

unhappy triad

A

common knee injury resulting in injury to the ACL, MCL, and medial meniscus

89
Q

motions of the talus

A

plantarflexion = anterior glide. dorsiflexion = posterior glide.

90
Q

most commonly injured ligament in the foot?

A

anterior talofibular ligament

91
Q

coxa vara

A

decreased angle (

92
Q

coxa valga

A

increased angle (>135º) between the neck and shaft of the femur

93
Q

spinal cord level and corresponding nerve: upper GI tract (foregut)

A

T5-T9, greater splanchnic nerve and celiac ganglion

94
Q

spinal cord level and corresponding nerve: middle GI tract (midgut)

A

T10-T11, lesser splanchnic never and superior mesenteric ganglion

95
Q

spinal cord level and corresponding nerve: lower GI tract (hindgut)

A

T12-L2, least splanchnic nerve, inferior mesenteric ganglion

96
Q

spinal cord level: appendix

A

T12

97
Q

spinal cord level and corresponding nerve: kidneys

A

T10-T11, superior mesenteric ganglion

98
Q

spinal cord level: adrenal medulla

A

T10

99
Q

spinal cord level and corresponding nerve: upper ureters

A

T10-T11, superior mesenteric ganglion

100
Q

spinal cord level and corresponding nerve: lower ureters

A

T12-L1, inferior mesenteric ganglion

101
Q

spinal cord level: bladder

A

T11-L2

102
Q

spinal cord level: gonads

A

T10-T11

103
Q

spinal cord level: uterus and cervix

A

T10-L2

104
Q

spinal cord level: prostate

A

T12-L2

105
Q

spinal cord level: arms

A

T2-T8

106
Q

spinal cord level: legs

A

T11-L2

107
Q

PS innervation of viscera above the diaphragm

A

vagus nerve

108
Q

PS innervation of GI tract

A

foregut and midgut = vagus. hindgut = pelvic splanchnic

109
Q

PS innervation of GU tract

A

kidneys and upper ureter = vagus.

lower ureter and bladder = pelvic splanchnic

110
Q

PS innervation of reproductive system

A

ovaries and testes = vagus.

everything else = pelvic splanchnic

111
Q

sympathetic innervation of head and neck

A

T1-T4

112
Q

sympathetic innervation of heart

A

T1-T5

113
Q

sympathetic innervation of lungs

A

T2-T7

114
Q

sympathetic innervation of GI tract

A

before ligament of Treitz (divides duodenum and jejunum) = T5-T9.
between ligament of Treitz and splenic flexure = T10-T11.
after splenic flexure = T12-L2

115
Q

sympathetic innervation of upper extremities

A

T2-T8

116
Q

anteriorly, smooth, firm discretely palpable nodules approximately 2-3mm in diameter, located within the deep fascia or on the periosteum of bone

A

Chapman’s points

117
Q

hypersensitive focus, usually within a taut band of skeletal muscle or in the muscle fascia. painful upon compression and can give rise to characteristic referred pain

A

trigger point

118
Q

small tense edematous areas of tenderness about the size of a fingertip; do not refer pain beyond the location compressed.

A

tenderpoints. typically located near bony attachments of tendons, ligaments, or in the belly of some muscles.

119
Q

4 physiologic diaphragms

A

tentorium cerebelli, thoracic inlet, abdominal diaphragm (most important), pelvic diaphragm

120
Q

where does the left (major) duct drain?

A

into the junction of the left internal jugular and subclavian veins

121
Q

what structures drain into the right (minor) lymphatic duct?

A

right upper extremity, right hemicranium (including head and face), heart and lobes of the lung (except left upper lobe)

122
Q

which tissues bypass lymphoid tissue and drain directly into the thoracic duct?

A

thyroid, esophagus, coronary and triangular ligaments of the liver

123
Q

sympathetic innervation of cisterna chylli

A

T11

124
Q

true or false: Sibson’s fascia is traversed by both the left and right lymphatic ducts.

A

true

125
Q

sympathetic control to the lymphatic duct

A

topographically innervated by the intercostal nerves

126
Q

narrowing of the neural foramina can cause referred pain into the ipsilateral arm upon compression of the cervical spine, due to nerve root compression

A

spurling test (compression test)

127
Q

physician flexes patient’s neck, holding it for 10 sec, then extend the neck holding it for 10 sec. same is done for head and neck rotation to the R and L, head and neck rotation R and L with the neck in extended position, and in positions that the physician would attempt to mobilize the C-spine.

A

Wallenberg’s test for vertebral artery insufficiency. (+) = dizziness, visual changes, lightheadedness, nystagmus

128
Q

purpose of the hip-drop test

A

evaluate sidebending (lateral flexion) of the lumbar spine

129
Q

lumbosacral spring test

A

will be positive in all dysfunctions in which the sacral base moves posterior

130
Q

valgus and varus stress tests

A

pushing the knee medial (with a lateral force) is the valgus stress test. pushing the knee lateral (with medial force) is the varus stress test.

131
Q

trendelenberg test

A

assesses the hip abductors (strength of gluteus medius). (+) = pelvis falls, indicates weakness of contralateral gluteus medius.

132
Q

thomas test

A

assesses possibility of flexion contracture of the hip, usually of iliopsoas origin.

133
Q

most commonly injured ligament in the ankle

A

anterior talofibular ligament

134
Q

what nerve can be impinged with posterior fibular head dysfunction?

A

common fibular (peroneal) nerve, dysfunction of eversion and dorsiflexion

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