EXAM 2 Flashcards

1
Q

What are the superior, medial, and lateral borders of the femoral triangle?

A

Superior: inguinal ligament
Medial: medial border of adductor longus m.
Lateral: medial border of sartorius m.

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2
Q

What are the flexors of the hip?

A

iliopsoas, sartorius, rectus femoris, and tensor fascia lata/IT band

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3
Q

What are the extensors of the hip?

A

gluteus maximus and hamstrings (biceps femoris, semitendinosus, semimembranosus)

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4
Q

What are the adductors of the hip?

A

adductor longus m.

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5
Q

What are the abductors of the hip?

A

gluteus medius and tensor fascia lata/IT band

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6
Q

Tight hamstrings lead to a decrease in hip flexion. What is the name of this dysfunction?

A

hip extension dysfunction

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7
Q

TO check for hip flexion how should the patient be laying?

A

Supine

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8
Q

To check for hip extension how should the patient be laying?

A

Prone

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9
Q

How do you check for hip external/internal rotation?

A

Patient supine or prone with knee flexed to 90 degrees

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10
Q

For hip adduction and abduction how do you set up the patient?

A

Supine

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11
Q

Iliotibial band restriction presents as:

A

lateral knee pain and restriction to hip adduction

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12
Q

What are the best ways to check for IT band restriction?

A

supine or lateral recumbent

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13
Q

ROM of hip flexion

A

90 degrees knee extended; 120-135 with knee flexed

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14
Q

ROM of hip extension

A

15-30 degrees

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15
Q

ROM of hip internal rotation

A

30-40 degrees

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16
Q

ROM of hip external rotation

A

40-60 degrees

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17
Q

ROM of hip abduction

A

45-50 degrees

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18
Q

ROM of hip adduction

A

20-30 degrees

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19
Q

Iliopsoas m. is innervated by what nerve?

A

femoral nerve (L1-L2)

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20
Q

Gluteus maximus is innervated by what nerve?

A

inferior gluteal nerve (L5, S1-S2)

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21
Q

Gluteus medius is innervated by what nerve?

A

superior gluteal nerve (L5, S1)

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22
Q

Adductor longus is innervated by what nerve?

A

obturator nerve (L2-L4)

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23
Q

What does 0/5 mean on Strength Scale?

A

no muscle contraction detected

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24
Q

What does 1/5 mean on Strength Scale?

A

barely detectable flicker/trace of muscle contraction

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25
Q

What does 2/5 mean on strength scale?

A

active muscle movement with gravity eliminated

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26
Q

What does 3/5 mean on strength scale?

A

active muscle movement against gravity

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27
Q

What does 4/5 mean on strength scale?

A

active muscle movement against gravity and some resistance

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28
Q

What does 5/5 mean on strength scale?

A

active muscle movement against gravity and resistance without signs of fatigue (NORMAL MUSCLE STRENGTH FINDING)

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29
Q

What are the contents of the central compartment?

A

Labrum, ligamentum teres, and articular surfaces

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30
Q

What pathology is associated with the central compartment?

A

Labral tears, ligamentum theres tears, osteochondral defects, chondromalacia/osteoarthritis, congenital hip dysplasia, loose bodies

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31
Q

What are the contents of the peripheral compartment?

A

femoral neck and synovial lining

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32
Q

What pathology is associated with the peripheral compartment?

A

loose bodies, impingement syndrome (CAM and Pincer types) and synovitis

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33
Q

what are the contents of the lateral compartment?

A

gluteus medius, gluteus minimus, piriformis, IT band and trochanteric bursae

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34
Q

What pathology is associated with the lateral compartment?

A

IT band syndrome, bursitis, rotator cuff tendinopathies (gluteus medium, gluteus minimum, piriformis)

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35
Q

What are the contents of the anterior compartment?

A

iliopsoas insertion and iliopsoas bursae

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36
Q

What is the pathology associated with the anterior compartment?

A

psoas tendonitis

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37
Q

Describe a flexion dysfunction.

A

ease of motion to flexion and a restriction of motion to extension

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38
Q

Describe a extension dysfunction.

A

ease of motion to extension and a restriction of motion to flexion n

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39
Q

Describe internal rotation dysfunction

A

ease of motion to internal rotation and restriction to external rotation

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40
Q

Describe external rotation dysfunction

A

ease of motion to external rotation and restriction to internal rotation

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41
Q

Describe abduction dysfunction.

A

ease of motion to abduction and restriction to adduction

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42
Q

Describe adduction dysfunction.

A

ease of motion to adduction and restriction to abduction

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43
Q

When assessing for internal rotation/external rotation of the knee, how do you assess the patient?

A

patient is supine with hip and knee flexed to 90 degrees or prone with knee flexed to 90 degrees

put them on either side of tibial tuberosity

NOTE: these movements are in relation to the tibia on the distal femur

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44
Q

When assessing for adduction of the knee joint, what do you do and what is another word for adduction in this case?

A

VALGUS TEST: one hand contacts lateral aspect of distal femur and the other grabs the medial ankle
You apply a lateral to medial force on the distal femur and a medial to lateral force on the medial ankle

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45
Q

When assessing for abduction of the knee joint, what do you do and what is another word for abduction in this case?

A

VARUS TEST: one hand contacts MEDIAL aspect of distal femur and the other hand grabs the LATERAL aspect of the ankle
You apply a medial to lateral force on the distal femur and then push the ankle medially

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46
Q

Describe an adduction somatic dysfunction of the knee.

A

ease of motion with valgus force and a restriction of motion with varus force
EASE OF MEDIAL TRANSLATORY MOTION

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47
Q

Describe an abduction somatic dysfunction of the knee.

A

ease of motion with varus force and restriction of motion with valgus force
EASE OF LATERAL TRANSLATORY MOTION

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48
Q

Describe a posterior fibular head somatic dysfunction.

A

ease of posterior glide with anterior glide restriction

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49
Q

Describe an anterior fibular head somatic dysfunction

A

ease of anterior glide with posterior glide restriction

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50
Q

When assessing the proximal fibula of the knee joint what do you do?

A

patient is supine with knee flexed and foot flat on the table
student contacts head of the fibula with the thumb and index finger of one hand and slowly applies and anterior then posterior force to assess for gliding motion of the fibular head with the tibia

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51
Q

What is the normal Q angle?

A

15 degrees (females sometimes have increased Q-angle)

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52
Q

ROM of flexion of the knee

A

145-150 degrees

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53
Q

ROM of extension of the knee

A

0-5 degrees (Most of the time its 0)

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54
Q

ROM of internal rotation and external rotation of the knee

A

10 degrees

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55
Q

What muscles are involved in extension of the knee?

A

quadriceps (innervated by femoral nerve) (L2-L4)

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56
Q

What muscles are involved in flexion of the knee?

A

hamstrings (innervated by sciatic nerve) (L5-S1)

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57
Q

What nerve is subject to compression as it courses around the fibular head by either a fibular head fracture or a somatic dysfunction?

A

common fibular (peroneal) nerve

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58
Q

What makes up the medial longitudinal arch?

A

Calcaneus, Talus, Navicular, Cuneiforms 1-3 and Metatarsals 1-3

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59
Q

What makes up the lateral longitudinal arch?

A

Calcaneus, cuboid and metatarsals 4-5

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60
Q

What makes up the transverse distal tarsal arch?

A

navicular, cuboid, cuneiforms 1-3 & proximal metatarsals

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61
Q

What is the primary stabilizer of the medial ankle?

A

deltoid ligament

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62
Q

What ligaments make up the lateral ankle and which tears first?

A

Posterior talofibular ligament, anterior talofibular ligament (TEARS FIRST), and calcaneofibular ligament

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63
Q

What is a Jones Fracture?

A

inversion injury to forefoot causes avulsion fracture of 5th metatarsal head

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64
Q

When assessing the lateral malleolus, how would you perform the assessment?

A

patient is supine with knee flexed and foot flat on the table
pinch lateral malleolus and translate anterior and posterior

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65
Q

ROM of dorsiflexion of the foot

A

15-20 degrees

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66
Q

ROM of plantar flexion of the foot

A

50-65 degrees

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67
Q

ROM of ankle inversion (talocalcaneal)

A

35 degrees

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68
Q

ROM of ankle eversion (talocalcaneal)

A

20 degrees

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69
Q

ROM of forefoot adduction

A

20 degrees

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70
Q

ROM of forefoot abduction

A

10 degrees

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71
Q

ROM of metatarsophalangeal flexion

A

45 degrees

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72
Q

ROM of metatarsophalangeal extension

A

70-90 degrees

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73
Q

Pronation includes what movements of the foot

A

dorsiflexion, abduction & eversion of the calcaneus

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74
Q

Supination includes what movements of the foot

A

plantar flexion, adduction & inversion of the calcaneus

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75
Q

What innervates the dorsiflexors of the foot?

A

deep fibular nerve (L4-L5)

76
Q

What innervates the plantar flexors of the foot?

A

tibial nerve

77
Q

What innervates the evertors of the foot?

A

superficial fibular nerve

78
Q

What are the two invertors of the foot?

A

tibialis anterior and posterior

79
Q

For talus evaluation what motion is occurring?

A

motion is occurring between the talus and the tibia/fibula

80
Q

For calcaneus evaluation of the foot joint what is the set up to determine dysfunction?

A

patient is supine and the foot is placed with the ankle in a standing posture position (dorsiflexion to a 90 degree angle between the tibia and the foot) to avoid excess laxity in the subtalar joint

81
Q

if you are testing the talus, what two motions are you performing

A

dorsiflexion and plantar flexion

82
Q

if you are testing the calcaneus what two motions are you performing?

A

inversion and eversion

83
Q

For calcaneus evaluation what motion is occurring?

A

motion is occurring between the talus and the calcaneus (subtalar) joint

84
Q

For navicular evaluation what are you checking for?

A

plantar and dorsal glide

NOTE: plantar glide dysfunction is more common in both navicular and cuboid
NOTE: dorsal navicular is associated with tight plantar fascia

85
Q

plantar cuboid dysfunction is associated with

A

posterior fibular head

86
Q

What is the most mobile joint in the body?

A

the shoulder joint

87
Q

What 3 bones make up the shoulder girdle?

A

clavicle, humerus and scapula (coracoid and acromion)

88
Q

what are the 3 true synovial joints of the shoulder?

A

GH joint, SC joint, AC joint

89
Q

What are the 2 functional joints of the shoulder?

A

Suprahumeral and scapulothoracic joint

90
Q

What are the 2 accessory joints of the shoulder?

A

costosternal and costovertebral joints

91
Q

What level of vertebrae is the spine of the scapula?

A

T3

92
Q

What level of vertebrae is the inferior border of the scapula?

A

T7

93
Q

What joints are involved in early shoulder abduction?

A

GH joint and Suprahumeral joint

94
Q

What joints are involved in mid-late shoulder abduction?

A

scapulothoracic + sternoclavicular + acromioclavicular

95
Q

ROM of flexion of the shoulder

A

180 degrees (sagittal plane)

96
Q

ROM of extension of the shoulder

A

60 degrees

97
Q

ROM of abduction of the shoulder

A

180 degrees (coronal plane)

98
Q

ROM of adduction of the shoulder

A

40-50 degrees in the coronal and transverse planes

99
Q

ROM of internal rotation and external rotation of the shoulder

A

90 degrees

100
Q

ROM of horizontal abduction and horizontal adduction of the shoulder

A

40-50 horizontal abduction

130-145 horizontal adduction

101
Q

What muscles are used for shoulder flexion?

A

Anterior deltoid and coracobrachialis

102
Q

What muscles are used for shoulder extension?

A

latissimus dorsi and teres major

103
Q

What muscles are used for shoulder abduction?

A

supraspinatus (10-15) and mid-deltoid (remainder of 180)

104
Q

What muscles are used for shoulder adduction?

A

pectorals major and latissimus dorsi

105
Q

What muscles are used for internal rotation of the shoulder?

A

subscapularis and pectoralis major

USE LIFT OF TEST TO TEST THESE MUSCLES

106
Q

What muscles are used for external rotation of the shoulder?

A

infraspinatus and teres minor

107
Q

What muscles are used for the shoulder shrug?

A

trapezius and levator scapulae

108
Q

What muscles are used for scapular retraction?

A

rhomboid major and minor

109
Q

What muscles are used for scapular protraction?

A

serratus anterior

110
Q

anterior/inferior glide of the proximal humerus

A

towards the front and down

111
Q

posterior/superior glide of the proximal humerus

A

towards the back and up

112
Q

How do you assess the AC joint?

A

you bring GH joint into 60 degrees coronal abduction and 60 degrees horizontal abduction to maximize AC joint motion

Normal AC rotation is 10 degrees both ways

113
Q

To test SC joint flexion/extension:

A

patient lies supine and you place fingers bilaterally on the SC joints and have them reach towards the ceiling (flexion) and come back down (extension)

MOST COMMON IS HORIZONTAL EXTENSION DYSFUNCTION

FLEXION: proximal clavicle moves posterior and distal moves anterior
EXTENSION: proximal clavicle moves anterior and distal posterior

114
Q

To test SC joint ab/adduction:

A

patient supine and we place hands on the superior aspect of the head of both clavicles and have patient shrug their shoulders

ABDUCTION: proximal end of clavicle moves inferiorly/distal end moves superiorly
ADDUCTION: proximal end of clavicle moves superiorly/distal end moves inferiorly

115
Q

Best way to test ST joint:

A

have patient lay lateral recumbent with student facing the patient’s anterior aspect contacting the inferior angle of the scapula with their ciudad hand the acromion with their cephalad hand

116
Q

Scapular elevation ms.

A

upper trapezius and levator scapulae

117
Q

Scapular depression ms.

A

lower trapezius and lower rhomboids

118
Q

Scapular protraction ms.

A

serratus anterior

119
Q

Scapular retraction ms.

A

rhomboids and middle trapezius

120
Q

Scapular upward rotation ms.

A

serratus anterior and upper trapezius

121
Q

Scapular downward rotation ms.

A

levator scapulae, rhomboid major and minor, and latissimus dorsi

122
Q

Typical cervical segments C2-C7:

A

type II spinal mechanics with rotation and side bending to the same side

123
Q

Type II Mechanics

A

non neutral side bending and rotation to the same side (in single segment)

124
Q

Type II Modified Mechanics

A

N RrSr (same side in the neutral position)

125
Q

Translation (moving the segment laterally)

A

translation to the right means side bending to the left SB L
translation to the left means side bending to the right SB R

126
Q

ROM of flexion of the C spine

A

45-90 degrees

127
Q

ROM of extension of the C spine

A

45-90 degrees

128
Q

ROM of side bending of the C spine

A

45 degrees

129
Q

ROM of rotation of the C spine

A

70-90 degrees

130
Q

OA JOINT

A

major motions: flexion and extension

MODIFIED TYPE I MECHANICS: Sidebending and rotation to opposite sides even when in flexion and extension

131
Q

Type I Mechanics

A

Sidebending and rotation to opposite sides when in N for groups of vertebrae

132
Q

Type I Modified mechanics

A

Sidebending and rotation to opposite sides when non neutral

133
Q

AA JOINT

A

C1-2 joint
primary motion is rotation
YOU MUST: fully flex the head and neck to take out the rotation of the vertebrae below AA

134
Q

What part of elbow do flexor muscles attach to?

A

medial epicondyle

135
Q

What part of elbow do extensor muscles attach to?

A

lateral epicondyle

136
Q

What is the carrying angle?

A

normal range: 5 for men and 10-15 for women

allows forearms and hands to clear hips when swinging during walking

small degree of cubital valgus formed between the radially deviated forearm and axis of the humerus

137
Q

What muscles are involved in elbow flexion; extension; supination; and pronation?

A

FLEXION: biceps, brachial, brachioradialis
EXTENSION: triceps
SUPINATION: supinator and biceps
PRONATION: pronator teres and pronator quadratus

138
Q

ROM of elbow flexion

A

140-150 degrees

139
Q

ROM of elbow extension

A

0 to -5 degrees

140
Q

ROM of elbow supination and pronation

A

90 degrees

141
Q

Somatic dysfunction is primarily in what joint of the elbow?

A

ulnohumeral joint

142
Q

Ulnar abduction and ulnar adduction

A

ULNAR ABDUCTION = VALGUS
push medial on elbow and lateral on wrist
coupled with wrist adduction (ulnar deviation) think of the lateral push on the wrist
ULNAR ADDUCTION = VARUS
push lateral on elbow and medial on wrist
coupled with wrist abduction (radial deviation) think of the medial push on the wrist

143
Q

describe a posterior radial head dysfunction

A

ease of motion to posterior glide and forearm pronation and restriction of motion to anterior glide and supination

144
Q

describe an anterior radial head dysfunction

A

ease of motion to anterior glide and forearm supination and restriction of motion to posterior glide and pronation

145
Q

ROM of flexion of the wrist

A

80-90 degrees

146
Q

ROM of extension of the wrist

A

70 degrees

147
Q

ROM of adduction of the wrist (ulnar deviation)

A

30-40 degrees

148
Q

ROM of abduction of the wrist (radial deviation)

A

20-30 degrees

149
Q

Wrist flexion and wrist extension are coupled with:

A

Wrist flexion is coupled with dorsal/posterior glide

Wrist extension is coupled with ventral/anterior glide

150
Q

If you fall on an outstretched hand while pronated (forward fall) what type of dysfunction could this cause?

A

radial head posterior somatic dysfunction

151
Q

If you fall back on an outstretched hand while supinated what is the dysfunction called?

A

radial head anterior somatic dysfunction

152
Q

Diaphragm

A

deeply invaginated inferiorly by abdominal viscera
domed superiorly because the liver and spleen are pushing it up
innervated by the phrenic nerve

153
Q

Manubrium articulates with what:

A

clavicles and 1st rib

154
Q

bilateral costal facets on vertebral bodies

A

articulate with rib head
inferior costal facet on superior vertebrae
superior costal facet on inferior vertebrae (IV disc)

155
Q

Transverse costal facets on transverse processes

A

articulate with rib tubercle

156
Q

T1-T3

A

spinous process located at the level of the corresponding transverse process. SAME LEVEL

157
Q

T4-T6:

A

spinous process located 1/2 segment below the corresponding transverse process

158
Q

T7-T9:

A

spinous process is located at the level of the transverse process of the vertebrae below

159
Q

T10:
T11:
T12:

A

T10: follows T7-T9
T11: follows T4-T6
T12: follows T1-T3

160
Q

What is the main motion of the thorax?

A

Rotation

more similar to lumbar region in the lower thorax

161
Q

What are the sympathetics to the head and neck?

A

T1-T4

162
Q

What are the sympathetics to the heart?

A

T1-T5

163
Q

What are the sympathetics to the lungs?

A

T2-T7

164
Q

What are the sympathetics to the upper abdominal viscera?

A

T5-T9

165
Q

What are these sympathetics to the lower abdominal viscera?

A

T10-T11

166
Q

What are the sympathetics to the distal 1/3 of transverse colon?

A

T12-L2

167
Q

What are the true ribs?

A

1-7

attach directly to the sternum through their own costal cartilages

168
Q

What are the false ribs?

A

8-10
cartilages are connected to the cartilage of the rib above them
connection with sternum is indirect

169
Q

What are the floating ribs?

A

11 & 12

cartilages do not even connect indirectly to the sternum

170
Q

Where are the intercostal nerves and vessels located?

A

costal groove on inferior border

171
Q

Describe pump handle motion.

A
analogous to flexion/extension 
ribs moves anteriorly 
increases in A/P diameter 
Rib 1 has 50%
Ribs 2-6 are primarily pump handle
172
Q

Describe bucket handle motion.

A
analogous to abduction/adduction 
ribs move laterally 
increase in transverse diameter 
rib 1 is 50% bucket handle 
ribs 7-10 are primarily bucket handle
173
Q

Describe caliper motion.

A
analogous to internal and external rotation 
pivoting motion (due to no anterior attachment) 
ribs 11 and 12 only
174
Q

Inhalation dysfunction: what is the key rib responsible

A

key rib is lowest rib in the dysfunction

175
Q

Exhalation dysfunction: what is the key rib responsible?

A

key rib is the uppermost rib in dysfunction

176
Q

Costochondritis

A

inflammation of costochondral junction
unable to put area to rest
pain increased with large inhalation

177
Q

Pneumonia

A

cough (productive or non-productive)

rib, thoracic, lumbar dysfunction

178
Q

Flexion dysfunction

A

if the motion improves/becomes more symmetric during flexion; restricted to/becomes more asymmetric in extension

179
Q

Extension dysfunction

A

if the motion improves/becomes more symmetric during extension; restricted to/becomes more asymmetric in flexion

180
Q

What is an accessory muscle of inhalation?

A

Sternocleidomastoid m.

181
Q

Woke up at 1AM 2P

A

Anterior and middle scalene move rib 1

posterior scalene moves rib 2

182
Q

what is an accessory muscle of inhalation when scapula is fixed in place?

A

serratus anterior (you’d see this in COPD patients)

183
Q

restriction of motion of ribs 11 and 12 is influenced by:

A

quadratus lumborum

184
Q

if a rib is prominent, painful, and has less spring on downward pressure, it is called:

A

elevated (or superior) rib dysfunction

185
Q

if one rib stops moving before the other rib during exhalation, that rib has an exhalation restriction and therefore an INHALATION DYSFUNCTION

A

so you’d target the inferior or bottom rib in a group of ribs

186
Q

if one rib stops moving before the other rib during inhalation, that rib has an inhalation restriction, therefore an EXHALATION DYSFUNCTION

A

so you’d target the most superior or top rib in a group of ribs