exam 3 Flashcards
Describe the kellgren/lawerence classification of knee OA
radiographic classification
0- no OA changes
1- doubtful narrowing and possible osteophytic lipping
2- definite osteophytes and possible joint space narrowing
3- multiple osteophytes, definite JSM, sclerosis, possible boney deformity
4. large osteophytes, marked JSN, severe sclerosis, definite bony deformity
Describe Neer impingement classification
I. typically less than 25 with minimal wont changes and irritation to shoulder soft tissues
II. typically 25-40, RTC fibrosis and tendonitis, partial thickness tear
III. greater than 40, bone spurs, tendon rupture or tear
IV. RTC tear arthopathy and progressive disability
which of the following will Manipulation inot cause HR change, muscle weakness, hypolagesia, improvement in depression score
muscle weakness
What is an appropriate time dosing of traction who have not received traction before and are in an acute or subacute stage
cameron 2013 static 5-10
describe the dermatomes for L4-S1
L4 - anterior medial shin region
L5- anterior lateral shin across the top of foot to the big toe
S1- Butt, posterior thigh, posterior lateral lower leg and lateral foot
Singh 2012 identified what risk factors for cervical myelopathy
- increasing age
- larger vertebral bodies
- smaller transverse and sagittal diameter of spinal canal
- Smaller Torg/Pavlov
what is the wrist ration index and what is the cut of for increased risk for CTS
- wrist AP diameter/wrist width
>0.67
what it is the CTS cpr
- shaking hands
- wirst ration >.67
- symptoms >1.9
- thumb sensation loss
- age >45
Describe Ibrahim 2012 stages fo CTS
- wake during the night with sensations of swollen, numb hands, hand shaking helps, staff hands in the morning
- symptoms persistent during the day, mostly with static positions, start dropping things
- muscle wasting in the thenar reign and surgical decompression is unlikely to help
What classic CTS test are have greater sensitivity for detecting tenosynovitis than CTS
tinel’s
phalen’s
Reverse phalan’s
carpal tunnel compression
what are the recommend nerve glide positions of the hand with CTS
- neutral fist arm out in front
- neutral wrist with fingers and thumb straight
- extend the wrist
- turn the wrist up
- passively extending the thumb
CTS tendon glides
- straight hand
- hook fist - no flexion of MCP - FDP dip FDS pip
- full fist - flexion of all joint - add lumbrical
- straight fist - extension of DIP - takeout FDP
- platform fist - extension of DIP and PIP - lumbricals only
what are the extensor compartments of the wrist
- EPB and AbD PL
- ECRB and ECRL
- EPL
- EI and EDCommunis
- EDM
- ECU
what part of the ACL plays the greatest role in rotational stability
Posterior lateral bundle with anterior medial a lessor role
what part of the ACL has the greatest role in anterior translation of the tibial during knee flexion
Posterior medial bundle
what is the Hughston drawer sign
posterior drawer of the knee with some tibial IR to assess posterior medial corner injury
what is lateral pivot shift test
The patient lies supine with legs relaxed. The examiner grasps the heel of the involved leg with examiners opposite hand placed laterally on the proximal tibia just distal to the knee. The examiner then applies a valgus stress and an axial load while internally rotating the tibia as the knee is moved into flexion from a fully extended position. [6] A positive test is indicated by subluxation of the tibia while the femur rotates externally followed by a reduction of the tibia at 30-40 degrees of flexion. lax ACL cause anterior glide and as the ITB tension increased the tibia is pulled back into place
Describe the different roles of the arcuate complex and popliteofibular ligament in knee stability
- arcuate - posterior lateral capsular thickening to the fibular styloid process (medial limb over the poplitesu muscle to the oblique popliteal ligament, lateral limb to blend with gastroc insertion)
- popliteofibular ligament - tibial ER stability and limitation
What is a ER lag test how is it deferent that drop arm
- Position patient in 90/90 shoulder ER
- inability to hold the position is positive suggestive of full thickness supra or infraspinatus tears
- not in CPR and is thought to have higher sensitivity
what is the horn blowers test
90/90 shoulder in front of body and resist ER
In cases of severe knee OA what role doe debirde surgery play
no added benefit use in connection with PT. So try PT first
What are the selection criteria according deyle et al 2000 what figuring out what joint to treatment with pollyarticular DJD
all of them particularly those in the involved region
does the medial or lateral pectoral nerve innervate both muscles
medial - minor and major
lateral major only
what cervical motions does C3 impact
extension - C1-2
flexion - C3
SB - C3
rotation - C3
Does strengthening or endurance exercise have better outcomes for chronic neck pain
at 12 months both has good outcome, there was no difference
Soft tissue imaging of WAD demonstrates what changes
fatty infiltration of the muscle and increased cross sectional area
how do the carpal row move during ulnar deviation
extension proximal, flexion distal
the median nerve innervatates the tips of which fingers
1-4 (1/2 of four)
what are the different upper limb tension test
1 - median nerve
2a- median with arm down and back wrist extended
2b- radial with arm down and back wrist flexed
3- ulnar
what type of arthritis is associated with joint nodules
RA
what type of arthritis is associated with tenosynovitis
RA
thumb adduction is influenced by what nerve
ulnar
pronator teres syndrome influences what muscles
weakness in the muscle of the anterior interosseous nerve - FPL, 1/2 FDP, PQ
what innervates more muscle the PIN or the AIN
PIN - 9 ECRB, ED, EDM, ECU, SUP, AbD PL, EPB, EPL, EI
AIN - 3 FPL, 1/2 FDP, PQ
what treatment modalities is likely of have the LEASE impact on PF pain (manual, education, physical agents, exercise)
all will help, but education has the least benefit
TMJ capsule problems will present with what type of opening aberrant motions
C for sure
S if there is any disc involvement
what type of headaches have the longest duration
tension type 30-7 days
cluster 15 minutes to 2 hours
migrane 4-72 hours
what is a normal amount of cervical extension and rotation
45 degree according to the AAOS
60 degrees of rotation
what is the ROM cut off for cervical radiculopathy
there isn’t one
- spurlings
- ULTT-a
- distraction
how would the sensory symptoms differ from a C8 and ulnar nerve injury
C8 entire 4th and 5th
ulnar nerve entire 5th, but only part of 4th
what muscles of the arm share c5
musculocutaneous - biceps, brachialis, brachioradialis
radial- supinator
