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Kinesiology (OCTH 521) Lecture > Exam # 3 > Flashcards

Exam # 3 Flashcards

1
Q

What does the median nerve innervate?

A
  1. Thenar Eminence
  2. Lateral two lumbricals
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2
Q

What does the ulnar nerve innervate?

A
  1. Hypothenar
  2. Medial two lumbricals
  3. Adductor Pollicis
  4. Interosseus muscles
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3
Q

What does the radial nerve innervate?

A

Extensors of the Thumb
 EDC
 EDI
 EDM

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4
Q

What nerve passes through the carpal tunnel?

A

Median nerve

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5
Q

Extensor Hand Muscles:

A

Extensor Digitorum
 Extensor Indicis
 Extensor Digiti Minimi
 Ext. D moves together despite obscene gesture
 EI allows for isolated index extension

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6
Q

Where do the extensors originate from?

A

Lateral epicondyle

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7
Q

Extrinsic Thumb Extensors:

A

 Thumb
 Extensor Pollicis Longus
 Extensor Pollicis Brevis
 Abductor Pollicis Longu

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8
Q

flexor that can move in isolation. To test hold all but one digit in PIP, DIP extension

A

Flexor Digitorum superficialis

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9
Q

flexor that has isolated index flexion in majority of people. FDP 3rd -5th move in unison

A

Flexor Digitorum profundus

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10
Q

Extrinsic Flexor of the Thumb:

A

 Flexor Pollicis Longus
 Only muscle to flexThumb IP
 Texting has added new functional importance to thumb IP flexion

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11
Q

Which wrist muscle inserts in the palmar fascia or Aponeurosis?

A

Palmaris longus

  • Dupuytren’s contracture, thickening of the palmar fascia usually on ulnar side. Creates flexion deformity of ulnar 2 fingers
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12
Q

What is the function of the pulleys of the fingers?

A

Redirect force, keep flexor tendons against fingers

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13
Q

Soft Tissue of Hand(Extensor Expansion; Dorsal Hood):

A

 Complex aponeurosis over dorsum (primarily)from MCP to insert onto the distal phalanx
 Extensor digitorum inserts along middle of dorsum of digit  Interossei and lumbricals insert laterally

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14
Q

What bones articulate at the CMC joint?

A

Trapezium/ 1st metacarpal

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15
Q

What motions occur at the CMC joint?

A

Flexion/extension/abd/add/opposition

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16
Q

What type of joint is the CMC joint?

A

saddle joint

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17
Q

Which finger CMC has the most motion?

A

fifth

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18
Q

What are the motions of the fifth finger?

A

Flex/ext/Opposition(slight)

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19
Q

What other CMC has motion (minimal)?

A

fourth

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20
Q

What motions are allowed at the MCP of the thumb?

A

Flexion and Extension

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21
Q

What motions are allowed at the MCP of the fingers?

A

Flex/ext/abd/add

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22
Q

What is the significant ligament of the MCP joint?

A

collateral ligament
- close-packed
- flexion

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23
Q

What motions occur at the IP joint?

A

flexion and extension

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24
Q

How many IP joints in the fingers?

A
  • Two (PIP & DIP)
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25
Q

How many joints are in the thumb?

A

*One (IP)

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26
Q

Ligaments of the IP joints:

A
  1. “Volar” Plate: tough, ligamentous structure. When contracted, difficult to correct
  2. Collateral ligaments: Short, Prevent lateral movement
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27
Q

Hand Intrinsic Muscles:

A

 Thenar group: FPB,OP, AbdPB
 Hypothenar: FDM, AbdDM, ODM
 Deep Palm: D & P Interossei, Lumbricles, Add. Pollicis

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28
Q

Intrinsic “Plus” Position:

A

 Lippert says only the lumbricals flex MCP, extend IP’s
 Do a tip-to-tip pinch, palpate 1st dorsal interossei
holding spreaded cards in hand

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29
Q

Radial nerve injury:

A

(can person extend wrist, MCPs)

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30
Q

Median nerve injury:

A

(Can person oppose with thumb)

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31
Q

Ulnar nerve injury:

A

(Can person perform a strong lateral pinch – Froment’s Sign)

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32
Q

Grip and pinch :

A

 Power grip:
 Cylindrical, hook, spherical
 Lateral Pinch (pad to side)
 Three jaw chuck (pad to pad)
 Precision (tip to tip)

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33
Q

4th and 5th CMC functional significance:

A
  1. The motion of the fourth and fifth CMC allow for power grip in flexion
  2. Also, allows ulnar two fingers to “get out of the way” for precision tasks
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34
Q

Which is the“power” side of the hand?

A

Ulnar side

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35
Q

Which is the precision side?

A

Radial side

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36
Q

What are the arches of the hand?

A
  • Distal Carpal
  • Proximal Carpal
  • Longitudinal
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37
Q

is a common nerve compression affecting the ulnar nerve as it passes through a tunnel in the wrist called Guyon’s canal. This problem is similar to carpal tunnel syndrome, but with the ulnar nerve

A

Guyon’s Canal Syndrome

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38
Q

Median Nerve Injury:

A

 Issues with the thenar muscles.
 Loss of ability to flex the thumb, index and middle fingers.

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39
Q

Intrinsic Minus:

A

Median Nerve
Thenar eminence
Lateral two lumbricals

Ulnar Nerve
Hypothenar
Medial two lumbricals
Adductor Pollicis
Interosseous muscles

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40
Q

Radial Nerve Palsy:

A
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41
Q

De quervain’s tenosynovitis:

A

Treatment
 Rest
 Thumb Spica Splint
 Gradual Strengthening as Pain Decreases

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42
Q

What 2 tendons are associated with De quervain’s Syndrome?

A

Abductor Pollicis Longus (ABD-PL)
Extensor Pollicis Brevis (EPB)

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43
Q

If someone’s hand is crushed from an injury where will you see swelling?

A

dorsal side of hand (intrinsic minus)

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44
Q

Boutonniere Deformity:

A

Trauma
 Lesion of the extensor tendon at the level of the proximal interphalangeal joint

Rheumatoid Arthritis
 The PIP is slowly forced into flexion by chronic synovitis of the joint, elongating the central slip and ultimately leading to rupture. Subsequent volar displacement of the lateral bands below the axis of the PIP rotation creates increased tension on the DIP extensor mechanism, leading to hyperextension and limited flexion of the DIP

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45
Q

Treatment of Boutonniere Deformity:

A

 Splinting
 AROM / PROM DIP

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46
Q

Swan Neck Deformity:

A

 RA causes chronic swelling of the PIP joint, which in turn loosens the volar plate

 Once loosened, this ligament tears easily, and when torn it leads to the hyperextension of the PIP joint.

 This hyperextension in turn causes the extensor tendon of the DIP joint to fall out of balance, and that joint then hyperflexes

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47
Q

Treatment for Swan Neck Deformity:

A

Splinting
ROM

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48
Q

Treatment for Flexor Tendon Lacerations:

A

Initial Phase
 Splinting
 PROM within limits of splint
 No Resistance
 No hand use for ADLs, One handed techniques
 Wound Care
 Scar Massage

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49
Q

Extensor Tendon Injuries:

A

*Treatment
1. Immobilization Method
Very Young
Non Compliant
2. Early Passive Motion
Method

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50
Q

What nerve innervates the hypothenar group?

A

Ulnar

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51
Q

What nerve innervates the lumbricles of the 4th/5th digits?

A

Ulnar

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52
Q

What nerve innervates the thenar group?

A

Median

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53
Q

What nerve innervates the adductor pollicis?

A

Ulnar

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54
Q

What nerve innervates the interossei?

A

Ulnar

55
Q

What nerve innervates the lumbricles of the 2nd/3rd digits innervate?

A

Median

56
Q

What nerve innervates the extensor pollicis B & L?

A

Radial

57
Q

What are the two bones of the Temporomandibular (TMJ)?

A

The two bones that form the TMJ are the mandible(jaw) located inferiorly, and the temporal bone of theskull (located more superiorly)

58
Q

Motions of TMJ:

A

 Depression (opening mouth)
 Elevation (Closing mouth)
 Lateral deviation (side-to-side motion)
 Protrusion (Protraction)
 Retrusion (Retraction)

59
Q

Muscles of TMJ:

A

Masseter
Temporalis

60
Q

What nerve is TMJ innervated by

A

CN V (Trigeminal)

61
Q

Motions of TMJ:

A

Depression (opening
mouth
 Elevation (Closing
mouth)
 Lateral deviation (side to
side motion)
 Protrusion (Protraction)
 Retrusion (Retraction)

62
Q

Temporomandibular Disorder:

A

 Causes:
* Teeth (malocclusion)
* Malocclusion is a problem in the way the upper and lower teeth fittogether in biting or chewing.
* muscle imbalances
* head, neck, & facial postural abnormalities
* Forward head posture,
* tongue positioning
* Removal of teeth to relieve crowded situations may lead to the forward posturing of the tongue, resulting in over functioning of the masseter muscle and jaw pain
* Stress
* Clenching and Grinding

63
Q

TMD Characteristics:

A

 Forward head posture
 Tight anterior chest wall
 High costal breathing
* diaphragm is pushed upward, and the abdomen drawn in. The ribs are raised somewhat, and the chest is partially expanded.
 Bruxism (teeth clenching and grinding)
 Headaches

64
Q

Mouth Considerations:

A

 Tongue, lips help with mouth closure
 Tongue must touch the hard palate for an efficient swallow
 Cerebral Palsy-malocclusion common due to abnormal tone in face & tongue

65
Q

Vertebrae:

A

 Four Segments
 First two cervicalvertebrae are called?
 Atlas and Axis

66
Q

Intervertebral Discs:

A

 Allow small motions in every direction =“shock absorbers”
 80% water, rest is cartilage
 Herniated disk causes extreme pain

67
Q

Motions of the spine:

A
  • Cervical:
     flexion/extension
     rotation (atlanto-axial joint)
     lateral flexion
  • Thoracic:
     lateral flexion
  • Lumbar:
     flexion/extension
     rotation
68
Q

Neck Muscles:

A
  • Sternocleidomastoid
     Unilateral contraction: lateral flexion of neck to the same side and rotation of head to opposite side
     Bilateral contraction: flexion of neck
  • Scalenes
     Unilateral: assist in lateral flexion to the same side
     Bilateral: raise first 2 ribs during forced inspiration; OR assistneck flexion
  • Upper Trapezius
69
Q

Thoracic Outlet Syndrome:

A

 Scalene muscle tightness (& other anatomical anomalies)
*Cervical Rib
 Impingement on brachial plexus and subclavian artery/vein
 Painful with a variety of symptoms

70
Q

Thoracic Outlet Syndrome Vascular Symptoms:

A

 Swelling or puffiness in the arm or hand
 Bluish discoloration of the hand
 Feeling of heaviness in the arm or hand
 Pulsating lump above the clavicle
 Deep, boring toothache-like pain in the neck and shoulder region which seems to increase at night
 Easily fatigued arms and hands
 Superficial vein distention in the hand

71
Q

Thoracic Outlet Syndrome Neurologic Symptoms:

A

 Paresthesia along the inside forearm and the palm (C8, T1 dermatome)
 Muscle weakness and atrophy of the gripping muscles (long finger flexors)and small muscles of the hand(thenar and intrinsic)
 Difficulty with fine motor tasks of the hand
 Cramps of the muscles on the inner forearm (long finger flexors)
 Pain in the arm and hand
 Tingling and numbness in the neck, shoulder region, arm and hand

72
Q

Provacative Tests for TOS:

A

East Test
Adson’s Maneuver

73
Q

point of stability for the body “core strength”

A

trunk

74
Q

Muscles of the trunk:

A
  • Rectus abdominis
     trunk flexion
  • External abdominal oblique
     Unilateral: lateral flexion, rotation to the opposite side
     Bilateral: trunk flexion
  • Internal abdominal oblique
     Unilateral: lateral flexion, rotation to the same side
     Bilateral: trunk flexion
  • Quadratus lumborum
     lateral trunk flexion
     through reverse action: hikes up hip
75
Q

ERECTOR SPINAE Muscles:

A
  • Spinalis mms. = closest to the spine
  • Longissimus mms. = in the middle
  • Iliocostalis mms. = farthest from spine
     Unilateral: lateral flexion of trunk
     Bilateral: trunk extension
76
Q

PELVIC TILT:

A

 Abdominal and gluteal muscles are important for maintaining pelvic tilt
 Some anterior pelvic tilt is normal, but if it is extreme there is increased lordosis and may lead to low back pain

77
Q

increase in posterior convexity of the thoracic curve (hunch back)

A

kyphosis

78
Q

SPINE ABNORMALITIES:

A

Kyphosis
Lordosis
Scoliosis

79
Q

increase in the forward curve of the lumbar spine (i.e. pregnant women)

A

lordosis

80
Q

lateral deviations in spine

A

scoliosis

81
Q

Things to Remember Abut The Trunk:

A

 Most trunk mms. exist in bilateral pairs but each can work independently
 All trunk mms. interact to maintain stabilization
 Trunk = point of stability for the body
 Neck and trunk mms. are also involved in forceful breathing & coughing (quadriplegia/ SCI at risk for pneumonia due to weak cough)

82
Q

Joints of the Pelvis:

A

 Lumbosacral- allows motion
 Sacroiliac (non-axial)
* Instability with pain common here
* Sacrum and ilium are held together by ligaments
 Symphysis pubis (non-axial)
* Must stretch for childbirth

83
Q

Bones of the Pelvis:

A

 Ilium
 Ischium (ischial tuberosities are your“sit bones”)
 Pubis
 Acetabulum (the hip“socket”) is made up of all three bones of the pelvis
 The three pelvic bones (I, I & P) are fused to each other

84
Q

Pelvic tilt and effects on biomechanics:

A
  • Anterior – ASIS is forward of pubic symphysis
  • Posterior – ASIS is behind pubic symphysis
     Cause changes in curves of spine and position of shoulder girdle
  • Lateral – iliac crests are not even
     Causes changes in curves of spine
85
Q

ASIS as important reference point:

A

 Important reference point for visualizing pelvic tilt in all planes of movement.
 Pelvis is “key point of control” in seating/positioning
 Seat belts should reston ASIS

86
Q

Pelvic Rotation:
(seen in people with Cerebral Palsy)

A

*In pelvic rotation the“axis” is weight-bearing hip joint on opposite side
*Forward rotation refers to one ASIS moving forward relative to the fixed hip position(which is in medial hip rotation)
*Backward rotation opposite

87
Q

During an anterior tilt what is the vertebral column (L) and hip doing?

A

hyperextending; flexing

88
Q

During an posterior tilt what is the vertebral column (L) and hip doing?

A
89
Q

During an lateral tilt what is the vertebral column (L) doing?

A
  • Lateral bend to the supported side
  • Rotation forward: vertebrae rotate to the opposite side
  • Hip: medial rotation on weight-bearing side
90
Q

The incredible human hip:

A

 Allows for walking upright
 Stable AND Mobile(triaxial)
 The “fulcrum” of the locomotion system
* Must sustain more than 2x the body weight with each step
* Helps elevate and lower the body

91
Q

Hip muscle general actions/location
one-joint muscles:

A

Posterior:
1. Gluteus maximus & deep rotators
(Extend, hyperextend, and/or laterally
rotate)
2. Hamstrings (Extend)

Anterior:
1. Iliopoas (Flex)
2. Rectus femoris, sartorius (Flex)

Medial:
1. Pectineus
(some flexion and adductors)
 Adduct hip
2. Gracilis (adduction)

Lateral:
1. Gluteus medius and minimus
Hip Abduction (min. internal/medial rotation)
2. Tensor Fascia Lata (Abducts and flexion)

92
Q

Knee Muscles:

A

Quadriceps (extend)
 Hamstrings (flex)
 Gastrocnimeius (flex)
 Popliteus (deep
flexor)
 Which muscle is
exclusively a one-
joint muscle?
 Popliteus

93
Q

Hamstring muscles:

A

biceps femoris long and short head
semitendinosus
semimembranosus.

94
Q

Quadriceps muscles:

A

rectus femoris
vastus lateralis
vastus intermedius
vastus medialis

95
Q

Compression/irritation to the sciatic nerve
 Tightness in the piriformis muscle (one of the“deep rotators”) often impinges on the sciatic nerve.

A

sciatica

96
Q

“knee cap” that protects the knee

A

patella

97
Q

Soft area, posterior knee
 Important landmark when fitting for seating

A

popliteal space (fossa)

98
Q

Terrible Triad:

A

Medial collateral, Anterior cruciate, Medial meniscus are all torn from a blow to the knee when the foot is planted

99
Q

Angle decreases between the shaft of the femur and the tibia

A

Genu Valgum (knock knees)

100
Q

Angle increases between the shaft of the femur and the tibia

A

Genu Valrum (bowleg)

101
Q

Excessive hyperextension at the knee joint

A

Genu Recurvatum

102
Q

Total hip replacement restrictions (anterior approach):

A

No Hip Extension
No Hip Abduction
No External Rotation
+ or – Weight Bearing Restriction

103
Q

Total hip replacement restrictions (posterior approach):

A

No Hip Flexion
Limited to 70 – 90 degrees as defined by MD
No Internal Rotation
No Hip Adduction
+ or – Weight Bearing Restriction

104
Q

Foot Drop:

A

Caused by damage to the dorsiflexors
 Results in difficulty with ambulation
 Utilization of an AFO for ambulation to increase safety

105
Q

Trapezius (Upper, Middle, Lower):

A

Origin:
Superior nuchal line
External occipital
protuberance
Nuchal ligament
C7-T12 spinous processes

Insertion:
Lateral third of clavicle
Acromion
Spine of scapula

106
Q

Rhomboid Minor:

A

Origin:
Nuchal ligament
Spinous processes C7-T1

Insertion:
Medial end of spine of
scapula

107
Q

Rhomboid Major:

A

Origin:
Spinous processes of T2-T5

Insertion:
Medial border of the scapula

108
Q

Subscapularis:

A

Origin:
Subscapular fossa of scapula

Insertion:
Lesser tubercle of humerus

109
Q

Infraspinatus:

A

Origin:
Infraspinous fossa of the
scapula

Insertion:
Greater tubercle of the
humerus

110
Q

Supraspinatus:

A

Origin:
Supraspinous fossa of scapula

Insertion:
Greater tubercle of humerus

111
Q

Teres Minor:

A

Origin:
Lateral border of the Scapula

Insertion:
Greater tubercle of humerus

112
Q

Deltoid:

A

Origin:
Lateral ⅓ of the clavicle, acromion, spine of scapula

Insertion:
Deltoid tuberosity of the humerus

113
Q

Pectoralis Major:

A

Origin:
Anterior half of medial clavicle, anterior surface of
sternum, costal cartilages 1-6, aponeurosis of external
oblique

Insertion:
Crest of Greater Tubercle of humerus

114
Q

Levator Scapulae:

A

Origin:
Transverse process of axis and atlas
C3 and C4 posterior tubercles

Insertion:
Superior part of medial aspect of scapula (Posterior)

115
Q

Coracobrachialis:

A

Origin:
Coracoid process of the scapula

Insertion:
Anteromedial surface of the humerus

116
Q

Latissimus Dorsi:

A

Origin:
T7-L5 Spinous Processes, sacrum, iliac crest, ribs (X-
XI)

Insertion:
Intertubercular groove of humerus

117
Q

a contraction that occurs when there is joint movement, the muscles shorten and move toward each other (ex. Flexion)

A

Concentric contraction

118
Q

a contraction occurs when there is joint motion but the muscle appears to lengthen (ex. Extension)

A

Eccentric contraction

119
Q

What nerve goes through the carpal tunnel?

A

median nerve

120
Q

Quick peripheral nerve tests:

A

Radial- can person extend wrist, MCP
Median- can a person oppose with a thumb
Ulnar- can the person perform a strong lateral pinch- Froment’s sign

121
Q

Example of an opened kinetic chain applied to a person:

A

when you rise from a sitting position your knees extend, causing your hips and ankles to move as well

122
Q

Example of a closed kinetic chain applied to a person:

A

when you remain seated and extend your knee, your hip, and ankle will not move

123
Q

The three phases of stance include:

A

loading response
mid-stance
terminal stance

124
Q

The four phases of swing in the gait cycle are:

A

pre-swing
initial swing
mid-swing
terminal swing

125
Q

Flexor Digitorum superficialis
versus profundus:

A

 FDS can move in
isolation. To test hold all
but one digit in PIP, DIP
extension
 FDP has isolated index
flexion in majority of
people. FDP 3rd -5th
move in unison

126
Q

Extrinsic Flexor of the Thumb:

A

 Flexor Pollicis Longus
 Only muscle to flex
Thumb IP
 Texting has added new
functional importance to
thumb IP flexion

127
Q

Intrinsic plus vs Intrinsic minus:

A

holding a sandwich and claw hand (ape hand)

128
Q

Short, Prevent lateral movement

A

collateral ligaments

129
Q

Effects of Radial Nerve Lesions:

A

loss of triceps
 Elbow flexion and extension are performed by
concentric and eccentric contractions of the biceps
 Loss of wrist extension

130
Q

Effects of Median Nerve Lesions:

A

loss of pronator teres and pronator quadratus
 Loss of pronation so can’t turn things like keys,
etc.

131
Q

Effects of Musculocutaneous Nerve Lesions:

A

loss of biceps and brachialis
 Elbow flexion is accomplished by brachioradialis,
pronator teres, extensor carpi radialis longus and
brevis
 A person uses momentum to get flexion started
 Can only lift light objects

132
Q

Gait Sequence:

A

Walker, weak leg, strong leg

133
Q

Platform Weight Bearing:

A

Weight may go through the forearm but not the wrist or
hand

Kinesiology (OCTH 521) Lecture (5 decks)

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