Exam Flashcards

Question

Glenohumeral Joint

Answer 1

- Synovial, ball and socket joint - Due to the loose joint capsule, and the relative size of the humeral head compared to the shallow glenoid fossa (4:1 ratio in surface area), it is one of the most mobile joints in the human body. - Most commonly dislocated joint

Answer 2

2:1 ratio Glenohumeral Joint (GHJ) :Scapulothoracic Joint (ST) - ST contributes 60° rotation - GHJ contributes 120° abduction - Combines for a total of abduction 180° - First 30 degrees of abduction largely occurs at GHJ. - 30° on, GHJ & ST joint move simultaneously

Answer 3

- Pectoralis Major - Coracobrachialis - Deltoid - Long head of biceps brachii

Answer 4

- Latissimus Dorsi - Long head of Triceps brachii - Deltoid - Teres Major

Answer 5

- Supraspinatus (initiates first 15*) - Deltoid (up to 90*)

Answer 6

- Pectoralis Major - Latissimus Dorsi - Coracobrachialis - Teres Major

Answer 7

- Subscapularis - Teres Major - Latissimus Dorsi - Pectoralis Major - Deltoid

Answer 8

- Infraspinatus - Teres Minor - Deltoid

Answer 9

- Only true joint connecting upper limb to trunk - Clavicle, manubrium, 1st costal cartilage - Joint incongruence - Structure = saddle - Function = ball and socket Movements: - Elevation/Depression (40°) - Protraction/Retraction (34°) - Axial rotation (20-40°)

Answer 10

- Articulation between humerus and ulnar - Synovial hinge joint - Uniaxial - Flexion/extension

Answer 11

- Biceps Brachii - Brachialis - Brachioradialis

Answer 12

- Triceps Brachii

Answer 13

- Synovial pivot joint = Uniaxial - Head of radius and radial notch of ulnar - Annular ligament = “collar” around head of radius Movements: - Pronation/supination

Answer 14

- Pronator Teres - Pronator Quadratus

Answer 15

- Supinator - Biceps Brachii

Answer 16

- Distal radius and ulna - A synovial pivot joint - Uniaxial joint - Pronation/supination

Answer 17

- Pronator Teres - Pronator Quadratus

Answer 18

- Supinator - Biceps Brachii

Answer 19

Consists of: - Radioulnar Joint - Midcarpal Joint

Answer 20

Distal radius articulates with: - Scaphoid - Lunate - Triquetrum

Answer 21

Flexion = 65-90° - Flexor carpi ulnaris - Flexor carpi radialis - Palmaris longus - Flexor digitorum superficialis - Flexor digitorum profundus

Answer 22

Extension = 60-85° - Extensor Carpi Radialis Longus & Brevis - Extensor Carpi Ulnaris - Extensor Digitorum

Answer 23

Radial Deviation = 15-20° - Extensor carpi radialis longus & brevis - Flexor carpi radialis - Abductor pollicis longus

Answer 24

Ulnar Deviation = 20-45° - Extensor carpi ulnaris - Flexor carpi ulnaris

Answer 25

Head of femur – acetabulum of ilium - Synovial ball and socket; multiaxial - Connects pelvic girdle to lower limb - Designed for weight bearing - Sacrifices mobility for stability - Entire body weight transmitted through joint when standing - Most stable joint in the body

Answer 26

- Depth of acetabulum - Femoral head coverage - Strong ligamentous structure/joint capsule (iliofemoral, pubofemoral, ischiofemoral ligaments)

Answer 27

- Taut in extreme extension, external rotation and adduction - Strongest ligament in the body

Answer 28

Taut in extreme abduction and extension

Answer 29

Taut in internal rotation and adduction

Answer 30

Flexion = 120-145° - Psoas - Iliacus -Rectus Femoris

Answer 31

Extension = 10-30° - Gluteus maximus - Hamstrings * Semimembranosus * Semitendinosus * Biceps Femoris - Adductor Magnus

Answer 32

Abduction = 45° - Gluteus medius - Gluteus minimus - Tensor Fascia Latae (TFL)

Answer 33

Adduction = 45-50° - Adductor magnus - Adductor longus - Adductor brevis

Answer 34

Internal Rotation = 35° - Gluteus medius - Gluteus minimus

Answer 35

External rotation = 45° - Piriformis - Gluteus maximus - Obturator internus - Gemelli superior & inferior - Quadratus femoris

Answer 36

Angle taken between the long axis of the femoral neck and the long axis of the femoral shaft: - Greater in infancy and childhood, decreases gradually to norma adults. - Greater in women to accommodate wider pelvis. - Coxa Vara angle < 110 -120 - Abduction and Int. rotation are restricted. - Coxa Valga angle > 130-135

Answer 37

- Angle between the long axis of the femoral neck and a line touching the posterior borders of the femoral condyles - Varies between 10-15° - Femoral anteversion = pathological increase in angle of torsion * “Pigeon-toed” - Femoral retroversion = pathological decrease in angle of torsion

Answer 38

- Femur, tibia and patella - Synovial, hinge joint - Tibiofemoral joint & patellofemoral joint - Arguably the most stressed joint in the body

Answer 39

- Flexion (160°) - Extension (0°) * Because point of reference is from knee in full extension (anatomical position) - Medial/lateral rotation

Answer 40

Hamstrings: - Semimembranosus - Semitendinosus - Biceps femoris

Answer 41

Quadriceps Femoris: - Rectus Femoris - Vastus Medialis - Vastus Intermedialis - Vastus Lateralis

Answer 42

- Popliteus - Semimembranosus - Semitendinosus

Answer 43

Patella – femur - Saddle joint - Sesamoid bone - Provides a larger lever for the quadriceps muscles – increases its mechanical advantage

Answer 44

- Fibrocartilaginous crescent/moon shaped cups overlying the surface of the tibial plateau - Joint stability - Shock absorption - Weight distribution/load transmission - Proprioception * Position awareness

Answer 45

- Firmly adhered to the medial collateral ligament and tibial plateau - Anterior horn attaches to the anterior intercondylar area and may blend with the anterior cruciate ligament

Answer 46

- Not firmly adhered to the collateral ligament or tibial plateau

Answer 47

- Medial femoral condyle rotates medially during final stages of knee extension (due to its larger size) - Allows for stabilisation during weight bearing without active help from muscular tissue

Answer 48

Limits: - Anterior displacement of tibia under a fixed femur - Hyperextension - Internal femoral rotation on a fixed tibia

Answer 49

Limits: - Posterior displacement of tibia under a fixed femur - Hyperflexion - External femoral rotation on a fixed tibia

Answer 50

Limits: - Medial and Lateral translation of tibia under fixed femur - Valgus stress

Answer 51

Limits: - Medial and Lateral translation of tibia under fixed femur - Varus stress

Answer 52

- Changes in bone, mucles and joints. - On average a loss of 1cm 10 years after age 40, accelerating after 70 years. Pathological Causes: - Spondyloarthropathies (arthritic pathologies of the spine) - Osteoporosis Structural Causes: - Disc Pathologies (Herniation, dehydration) - Kyphosis

Answer 53

- Balance between bone remodelling and resorption changes with age resulting in loss of bone tissue and weakening of bone. - Trabecular bone density decreases Risk Factors Include: - Inactive lifestyle - Hormonal changes - Loss of calcium and either mineral in bone

Answer 54

- Physically dependent (debilitated) - Physically frail (Activities of daily living [ADL] affected) - Physically independent (Free from disease, however, don’t exercise regularly) - Physically fit (Physically active) - Physically elite (Masters athletes)

Answer 55

- Both aerobic and anaerobic power and capacity decrease with age - Exercise can decrease rate of decline - Aerobic fitness potential (measured by VO2) decreases after 20 years of age, by approx. 0.5%-1% per year After 75 years of age, rate of decline accelerates due to; - Loss of muscle mass - Decrease in maximum heart rate & cardiac output - Decline in oxidative capacity of skeletal muscle

Answer 56

- The ability of skeletal muscle to extract oxygen during exercise decreases with age - Caused by a decrease in number of capillaries in skeletal muscle. - Therefore, less delivery of oxygen to muscle + decreased capacity to produce ATP = less oxidative capacity

Answer 57

- 40% of muscle size lost between 20 – 80 yrs - Strength related to mass and/or cross- sectional area - Decreased number of fast twitch fibres - Slow twitch fibres preserved due to their activity during ADL such as postural control and walking

Answer 58

- 65 + - 30 minutes of moderate intensity physical activity preferably all days.

Answer 59

- Exercise prescription needs to be personalised to the unique medical history - Aerobic exercises have numerous cardiovascular and musculoskeletal benefits - Resistance exercise training is the only therapy known to consistently improve muscle mass, strength, power, and quality, as well as overall physical function in older adults. As a result, when prescribing exercise the following considerations are important: - Low-intensity exercise (40%-50% VO2max) - Gradual progression - Low intensity interval training to avoid early fatigue.

Answer 60

- Reduced joint flexibility makes dailt activities such as dressing challenging. - Stretching and flexibility exercises improve this.

Answer 61

- Balance and proprioception exercises should be performed regularly to prevent falls. - 2 hours per week and should be supervised at first. - wide stance/two feet/eyes open/even surface = easier - narrow stance/one foot/eyes closed/uneven surface = harder

Answer 62

- Head of the femur is supplied by the branches from medial and lateral circumflex femoral artery.

Answer 63

- The retinacular arteries (i.e. vascular supply) are not disturbed

Answer 64

Excess mortality after hip fracture may be linked to complications following the fracture, such as: - Pulmonary embolism - Infections - Heart failure

Answer 65

- Land- and aquatic-based physical activities help patients with knee or hip osteoarthritis to reduce pain and increase mobility, muscle strength, joint flexibility, and aerobic endurance. - The buoyancy of the water decreases joint loading, which can help decrease pain, and warm water may have a therapeutic effect. - Once patients become more mobile, they can transition to land-based exercises. - Land-based exercise improves pain and functional aerobic capacity more than aquatic activities

Answer 66

- Resistance exercises are effective for improving bone mineral density (BMD)

Answer 67

- Exercise appears to improve cognition and lower the risk of dementia.

Answer 68

- Injury/trauma to ligament caused by tearing of the fibers, ranging from partial to complete. - Micro-tear (grade 1) - complete rupture (grade 3)

Answer 69

Grade 1 (Mild): - Microtear to ligament - Mild tenderness and swelling around ankle Grade 2 (Moderate): - Partial tearing of ligament (some but not all of fibers torn) - Moderate tenderness and swelling - Moderate instability Grade 3 (Severe): - Complete tear/rupture - Significant tenderness - Significant instability

Answer 70

- Trauma to muscle and/or its tendon - Graded 1-3

Answer 71

Open Fracture: - A fracture in which the bone breaks through the skin and can be seen outside the leg. Or there is a deep wound that exposes the bone through the skin. This is also called a compound fracture. Closed Fracture: A fracture that does not break the skin. This is also called a simple fracture. Partial Fracture: - An incomplete break of the bone Complete Fracture: - A complete break of the bone causing it to be separated into two or more pieces Stable Fracture: - The broken ends of the bone line up and have not moved out of place. Displaced Fracture: - There is a gap between the broken ends of the bone. Repairing a displaced fracture may require surgery.

Answer 72

Transverse fractures: - Breaks that are in a straight line across the bone. Spiral fractures: - A kind of fracture that spirals around the bone. Usually in the femur, tibia, or fibula in the legs. Greenstick Fracture: - Bone bends and breaks but does not separate into two separate pieces Stress fractures: - This type of fracture looks like a crack. Caused by repetitive stress Compression fracture: - Occurs when a bone is crushed. The broken bone will be wider and flatter in appearance than it was before the injury. Oblique fracture: - When the break is diagonal across the bone Impacted fracture: - Occurs when the broken ends of the bone are driven together Segmental fracture: - The same bone is fractured in two places, leaving a “floating” segment of bone between the two breaks Comminuted fracture: - The bone is broken into 3 or more pieces Avulsion fracture: - Occurs when a fragment is pulled off the bone by a tendon or ligament Pathological Fracture: - Fracture secondary to pre-existing pathology/underlying disease

Answer 73

Grade 1: - Tear with a maximum diameter less than a muscle fascicle Grade 2: - Tear with a diameter greater than a fascicle Grade 3: - Tear involving the subtotal/complete muscle diameter/tendinous injury involving the enthesis (where tendon or ligament inserts into bone)

Answer 74

- Inflammatory phase: days 0-6 - Repair phase: days 4-24 (overlaps with inflammatory phase) - Remodeling phase: day 21 - 12 months

Answer 75

- Day 0-6 - Stops leakage: Hemostasis/blood clotting - Removal of damaged cells (WBC) - Removal of foreign bodies

Answer 76

- Days 4-24 - Granular Tissue (scaring) - Lay down scaffolding of new tissue - Mediated By Fibroblasts

Answer 77

- Day 21 - 12 months - Granular tissue becomes scar tissue - Scar tissue becomes avascular - Scar tissue retracts returning tissue to original form

Answer 78

- Acute phase 1-7 days -Subacute phase Day 3-3weeks - Remodeling phase 1-6 weeks - Most ‘typical’ soft tissue injuries can expect resolution within 6 weeks - This may be increased/decreased by complexity and severity of injury

Answer 79

- 1-7 days PRICE: - Protect * Prevent further injury - Rest * Prevent further injury - Ice * Anti-inflammatory + analgesic - Compression * Anti-inflammatory - Elevation * Anti-inflammatory

Answer 80

- Day 3-21 LOVE: - Load *Let pain guide your gradual return to normal activities, your body will tell you when its safe to increase load - Optimism * Condition your brain for optimal recovery by being confident and positive - Vascularisation * Choose pain-free cardiovascular activities to increase blood flow to repairing tissues - Exercise * Restore mobility, strength and proprioception by adopting an active approach to recovery

Answer 81

- Use of tobacco or nicotine - Older age - Severe anaemia - Diabetes - Low vitamin D - Hypothyroidism - Poor nutrition - Infection - Complicated fracture that is open or compound - Medications

Answer 82

Pain management: - Reduce pain and inflammation through modalities, manual therapy, and therapeutic exercises. Restore range of motion: - Improve joint mobility and flexibility through stretching, mobilization, and manipulation. Increase strength and endurance: - Enhance muscle function and capacity through progressive resistance exercises and functional training. Improve proprioception and balance: - Enhance neuromuscular control and stability through specific exercises and activities. Restore functional capacity: - Enable patients to perform daily activities and return to work or sport safely and effectively. Prevent re-injury: - Educate patients on proper body mechanics, injury prevention strategies, and long-term self-management.

Answer 83

Therapeutic Exercise: Range of motion exercises: Passive, active-assisted, and active exercises to improve joint mobility. Strengthening exercises: Isometric, isotonic, and isokinetic exercises to improve muscle strength and endurance. Proprioceptive exercises: Balance and coordination exercises to enhance neuromuscular control. Functional exercises: Task-specific exercises to simulate real-life activities and improve functional capacity. Manual Therapy: - Soft tissue mobilization: Massage, myofascial release, and trigger point therapy to address muscle tension and pain. - Joint mobilisation and manipulation: Techniques to restore joint mechanics and improve range of motion. Modalities: - Heat and cold therapy: To reduce pain and inflammation. - Electrical stimulation: To manage pain, reduce muscle spasms, and promote healing. - Ultrasound: To promote tissue healing and reduce inflammation. Patient Education: - Provide information about the injury, healing process, and rehabilitation plan. - Teach proper body mechanics and injury prevention strategies. - Empower patients to actively participate in their recovery and long-term self- management.

Answer 84

- Sports injuries - Post-surgical Rehabilitation - Work-related injuries - Chronic Conditions - Geriatric Rehabilitation

Answer 85

- Severity of injury - Chronic conditions (ongoing management and may not be fully resolved) - Patient compliance - Access to resources - Psychosocial factors

Answer 86

- Reduce the impact of health conditions - Important part of a larger management plan - Minimize effects of chronic illness - Can ease financial burden on healthcare system

Answer 87

- Orthopaedic/Musculoskeletal - Neurological - Cardiac - Pulmonary - Geriatric - Burns - Addiction

Answer 88

- Address symptomatology - Protect against further tissue damage - Facilitate healing - Pain management - Prevent muscle atrophy

Answer 89

- Obtain normal ROM (passive and active) - Improve muscular control - Restore muscle balance - Restore proprioception

Answer 90

- Increase strength and endurance - Incorporate function movements – entire kinetic chain Prior to returning to full activity, patient should achieve: - Full pain free ROM - Normal strength - Correction of muscle imbalance

Answer 91

Personalised program to restore function following: - Spinal cord injury - Stroke - MS - Parkinson’s disease and - Other acquired or congenital neurological disorders.

Answer 92

Personalised program to restore function following: - Cardiovascular disease - Myocardial infarction - Congenital heart conditions - Pulmonary rehabilitation = COPD and other respiratory diseases

Answer 93

Personalised program to assist/retard the effects of: - Effects of ageing - Fall prevention - Independent living

Answer 94

Personalised program to restore function following - Chronic kidney disease - Pre-dialysis

Answer 95

Personalised program to restore function following: - Chemical and thermal burns

Answer 96

Personalised program to assist in the recovery from addiction(s) such as: - Drugs - Alcohol other substances of addiction, - Gambling, - Risk taking behaviours.

Answer 97

- The ability of an organism to adjust to changes in its environment. - This can involve short-term adjustments (like sweating when it's hot) or long-term changes (like developing greater lung capacity at high altitude). - Essential for survival and optimal performance in any environment, from the cellular level to the whole organism - Athletic Performance - Rehabilitation - Disease Prevention - Environmental Adaptation - Occupational Adaptation - Aging

Answer 98

- Type of stress - Intensity and duration - Individual factors - Previous training - Environmental factors

Answer 99

Sleep: - Essential for tissue repair, hormone regulation and cognitive function. Active Recovery: - Low-intensity exercise to promote blood flow, reduce muscle soreness and enhance recovery. Stress Management: - Techniques to reduce stress hormone (cortisol) and promote relaxation, such as meditation, deep breathing and yoga. Nutrition: - Proper nutrition is essential for providing the body with the nutrients it needs to repair and rebuild. Hydrotherapy: - Steam saunas and cold-water immersion can help to promote recovery and adaptation