Exam 2 Flashcards
Action at AO joint
Flexion and extension (nodding)
5 Ds of vertebral artery test
Diplopia, dysphasia, dysarthria, dizziness, drop attack
Tectorial membrane
Covers dens and ligaments
Role of alar ligaments
Major stabilizers of C1 and C2 especially in flexion and rotation
Where is the alar ligament
Goes from dens to occipital condyles
Primary movement at AA joint
Rotation
Role of transverse ligament of the atlas
Holds dens in atlas
Role of facet joints
Facilitate flexion and extension
Rotation and slide flexion in cervical spine
C1+C2 and C7-T1 opposite
C2-C7 same direction
Where is greatest mobility in c spine
C5-C6
Resting position at c spine
Between flexion and extension. Neutral
Close packed position at c spine
Completely extended
Function of nucleus pulposus
Buffers axial compression
Function of annulus fibrosus
Withstands tension in disc
5 phases of Watkins severity scale neuro deficit
- One arm sensory
- Both UE sensory and motor
- Entire one side motor and sensory
- Sensation loss in all limbs
- Motor loss in all limbs
What are burners
Traction or compression of upper brachial plexus or C5,C6 nerve root
Bakodys sign
Decrease pain when place hand of affected side on top of head
Usually a C4, C5 problem
How patient looks with c spine injury
Head tilted and rotated away from affected side
Face tilts up
How a hysterical patient looks
Head tilted and rotated away from pain
Face tilted down
Cluster for thoracic outlet
Adson Allen Roos Wright Tinel over supraclavicular
Cluster for cervical radiculopathy
Upper limb tension test A
Spurlings
Distraction test
Rotation less than 60 degrees
Close packed position of GH joint
Full abduction and lateral rotation
Resting position of GH joint
40-55 degrees abduction and 30 degrees horizontal adduction
Capsular pattern of GH joint
ER, abd, IR
What makes up rotator interval
Superior GH ligament, coracohumeral ligament, joint capsule, tendons of supraspinatus and supraclavicular
Major stabilizers of GH joint
Superior, middle, and inferior GH ligament
Primary support of AC joint
Coracoclavicular ligament
Resting position of AC joint
Arm at the side
Close packed position of AC joint
90 degrees abduction
Capsular pattern of AC joint
Horizontal adduction and full elevation
Primary support of SC joint
Costoclavicular ligament and anterior and posterior SC ligament
Resting position of sc joint
Arm at side
Closed pack position of sc joint
Full elevation and protraction
Sprengels deformity
High undescended scapula
Shoulder abd rom decreases
GH painful arc
60-120
AC painful arc
170-180
Presentation of anterior shoulder instability
Drooping shoulder
Excessive ST movement in abduction
Presentation of posterior shoulder instability
Excessive ST movement in horizontal adduction
Limited motions with subacromial bursitis
Abduction and ER
Popeyes sign
Long head of biceps is ruptured. Bulge in biceps when muscle is flexed
Bankhart lesion
Anteroinferior labrum is torn. Occurs most common with anterior dislocation
SLAP lesion
Tear in superior labrum from anterior to posterior
Cluster for full thickness rotator cuff tear
Drop arm sign
Painful arc sign
Infraspinatus muscle test
Lag sign
Ulnohumeral resting position
70 elbow flexion and 10 supination
Ulnohumeral closed pack position
Extension with supination
Ulnohumeral Capsular pattern
Flexion then extension
Radiohumeral resting position
Full extension and full supination
Radiohumeral closed pack position
Elbow flexed to 90 and forearm supinated 5
Radiohumeral capsular pattern
Flexion, extension, pronation, supination
Superior radioulnar joint resting position
35 supination and 70 flexion
Superior radioulnar joint closed pack position
5 supination
Superior radioulnar capsular pattern
Equal limitation of supination and pronation
Distal radioulnar resting position
10 supination
Distal radioulnar close packed
5 supination
Distal radioulnar capsular pattern
Full ROM pain at extremes of rotation
Function of lateral collateral ligament
Posterolateral stability
Function of medial collateral ligament
Valgus instability
Characteristics of cubital tunnel
FCU, three ulnar collateral ligament
Ulnar nerve passes through
Gunstock deformity
Cubitus varus in extension because of fracture of supracondylar ridge on distal humerus
Functional ROM of elbow flexion
30-130 flexion
50 pronation
50 supination
Resting position of Radiocarpal
Neutral with slight ulnar deviation
Closed pack position of Radiocarpal joint
Extension with radial deviation
Capsular pattern of Radiocarpal joint
Flexion/extension equally limited
Resting position of intercarpal
Neutral or slight flexion
Closed pack position of intercarpal
Extension
Midcarpal joint resting position
Neutral or slight flexion with ulnar deviation
Midcarpal closed pack position
Extension with ulnar deviation
Swan neck
Flexion of mp and dip. Extension of pip
Boutonnière deformity
Extension of MCP and dip and flexion of pip
Ulnar drift
Ulnar deviation of digits due to weakening of capsuloligamentous structures of the MCP joint and bowstring of extensor communis tendon
Extensor plus deformity
Cannot simultaneously flex MCP and IP
Claw fingers
Loss of intrinsics and over action of extrinsics. MCP joints are hyperextended and pip and dip are flexed
Trigger finger
Patient attempts to flex fingers, the tendon sticks, and finger lets go with a snap
Results from thickening of flexor tendon sheath
Ape hand deformity
Wasting of thenar eminence and the thumb falls back in line with fingers as a result of the pull of the extensor tendons
Bishops hand
Wasting of hypothenar muscles of the hand and flexion of 4 and 5 digit
Drop wrist
Extensor wrist muscles are paralyzed and fingers cannot be actively extended
Z deformity of the thumb
Flexed CMC and hyperextended MCP, partially flexed IP
Dupuytrens contracture
Contracture of palmar fascia. Fixed flexion of MCP and pip joint
Mallet finger
Result of rupture or avulsion of the extensor tendon where it inserts into distal phalanx resulting in flexed position
Green filament marking
Normal 1.65 to 2.83
Blue filament marking
Diminished light touch 3.22-3.61
Purple filament marking
Diminished protective sensation 3.84-4.31
Red filament marking
Loss of protective sensation 4.56-6.65
Red-lined filament marking
Above 6.65
Resting position of tmj
Teeth slightly apart with lips together
Closed pack of tmj
Teeth clenched
Capsular pattern of tmj
Limit mouth opening
Innervation of tmj disc
Auriculotemporal and masseteric branch of mandibular
Function of temporomandibular and lateral ligaments
Restrains lower jaw movement and prevents compression of tissue behind condyle
Sphenomandibular and stylomandibular ligaments
Guiding restraints
What is central occlusion
Max teeth contact
Upper cavity tmj movement
Gliding / sliding
Lower cavity tmj movement
Rotation
First phase of tmj movement
Roll/ rotation from beginning to midrange
Second phase of tmj movement
Glide of mandible and disc
Pain on opening of mouth
Extra articular
Pain when biting
Intra articular
Early click mouth opening
Developing dysfunction
Late click mouth opening
More chronic development
Disc displacement with reduction
Disk started anterior and when you open mouth it slid into place. Usually one click
Reciprocal clicking
Second click is closing of mouth
Hard click in jaw
Joint pathology
Soft click when closing mouth
Muscles not coordinated
What happens when jaw locks
Disc displacement
Buccoversion
Underbite
Class 1 occlusion
Normal
Class 2 malocclusion
Overbite ( horizontal overlap and vertical overlap)
Class 3 malocclusion
Underbite
Orthognathic
Normal, straight jawed
Retrognathic
Receding chin
Prognathic
Strong chin in front of vertical line
Cranial nerve 1 testing
Olfactory - smell coffee with eyes closed
Cranial nerve 2 testing
Optic look at eye chart
Cranial nerve 3, 4, 6 testing
Oculomotor
Trochlear
Abducens
Track finger with eyes
Cranial nerve 5 testing
Trigeminal
Clench teeth
Cranial nerve 7 testing
Facial
Make a facial expression
Cranial nerve 8 testing
Vestibulocochlear
Close eyes and repeat what you are saying
Cranial nerve 9 and 10 testing
Glossopharyngeal and vagus
Swallowing
Cranial nerve 11 testing
Spinal accessory
Shrug shoulders
Cranial nerve 12 testing
Hypoglossal
Stick tongue out
Type of joint for distal radioulnar
Pivot 1 dof
Type of joint Radiocarpal
Ellipsoid
Type of joint are both mid carpal
Sellar (saddle) types
Type of joint CMC thumb
Sellar joint with 3 dof
Type of joint CMC digits 2-5
Plane
Capsular pattern of CMC of thumb
Abduction then extension
Capsular pattern of CMC fingers
Equal in all directions
Resting position of CMC thumb
Between flexion/extension and adduction and adduction
Resting position CMC fingers
Between flexion and extension
Closed pack position CMC thumb
Full opposition
Closed pack CMC fingers
Full flexion
Type of joint MCP
Condyloid
Resting position MCP
Slight flexion
Closed pack position Mcp thumb
Full opposition
Closed pack position MCP fingers
Full flexion
Capsular pattern MCP
Flexion, then extension
Distal transverse arch
Passes through MCP joint and has greater mobility than proximal
Longitudinal arch
Runs from carpals to CMC joints
Type of joint IP
Hinge joint with 1 dof
Closed pack IP
Full extension
Resting position IP
Slight flexion
Capsular pattern
Flexion then extension
Heberdens nodes
Dorsal surface of distal dip
Bouchards nodes
Dorsal surface of pip
Functional position of wrist
20-35 extension
10-15 ulnar deviation
Power grip
Used whenever strength or force is primary consideration
Hook grasp
All of 2nd and 3rd finger are used as a hook controlled by forearm
Cylinder grasp
Thumb is used and entire hand wraps around object. Holding a cup
Fist grip
Hand moves around narrow object. Holding a tennis racket
Spherical grasp
More opposition and hand moves around sphere. Holding a baseball
Characteristics of anatomical snuff box
Bordered by epb and epl. Scaphoid inside
Where does radial pulse lie
Between fcr and apl
Tunnels of dorsal side of forearm
Tunnel 1: apl and epb Tunnel 2: ecrl and ecrb Tunnel 3: epl Tunnel 4: ed and ei Tunnel 5: edm Tunnel 6: ecu
Proximal skin crease
Upper limit of synovial sheaths of flexor tendons
Middle skin crease
Radiocarpal wrist joint
Distal skin crease
Upper margin of flexor retinaculum
Radial longitudinal skin crease
Encircles thenar eminence
Proximal transverse carpal arch
Runs across shaft of metacarpals indicating superficial palmar arch
Distal transverse arch
Heads of metacarpals