Exam A Flashcards by Becca Fetter

metabolic abnormalities in adrenal insufficiency

dec cortisol
hyponatremia
hypoglycemia
hyperkalemia
possibly acidotic

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symptoms of hypothyroidism

proximal muscle weakness
myalgia
joint stiffness
prolonged deep tendon reflexes

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accessory motions of subtalar joint

concave navicular and cuneiform move on convex talus

convex cuboid and calcaneus move on concave talus

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typical symptoms of juvenile RA

swollen, stiff, painful joints, usually worse in morning
fatigue
fever
swollen lymph nodes
poor weight gain/slow growth

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cervical spine coupled motions

sidebend and rotate same direction

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dyssynergia

impairment in coordination

movements typically performed in component parts rather than single, smooth motions

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murphy’s sign

pain and tenderness over costovertebral angle

may indicate acute cholecystitis or pyelonephritis

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hiatal hernia referral pattern

pain usually sharp in lower esophagus/upper stomach

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hamstring/quad torque ratio

around 65-70%, closer to 100 at higher speeds

at 60 deg/sec: 65%
at 180 deg/sec: 69%
at 300 deg/sec: 71%

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thumb CMC accessory motions

metacarpal is convex in palmardorsal

concave mediallateral

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salter harris fracture types

type 1 - non displaced across growth plate
type 2 - angulated and displaced across growth plate, continuing up shaft (most common)
type 3 - starts through growth plate, turns and exits though end of bone
type 4 - fracture through metaphysis, growth plate, epiphysis, may impact growth.
type 5 - compression

SALTER - Straight cross, Above, Lower, Through (or Two), Rammed

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muscles that retrude jaw

middle and posterior temporalis, suprahyoid

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muscles that protrude jaw

temporalis, medial and lateral pterygoids

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muscles that close mouth

masseter, temporalis, both pterygoids

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muscles that open mouth

lateral pterygoid, anterior digastric, suprahyoid

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typical arterial ulcer locations

distal lower leg, lateral malleolus, anterior tibial area

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typical venous ulcer locations

distal lower leg, medial malleolus

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clinical prediction rule for lumbar manipulation

95% chance of benefit with 4/5 of the following:

no sxs distal to knee
pain duration <16 days
FABQ work subscore <19
at least 1 hypomobile segment in lumbar spine
at least 1 hip with >35 deg IR

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Treatment Based Classification criteria for abdominal stabilization

age <40
SLR >91 deg
aberrant motion present
positive prone instability test

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ulcer stage classifications

stage 1: non-blanchable erythema, skin intact
stage 2: partial thickness skin loss, abrasion, blister, shallow crater
stage 3: full thickness skin loss, damage to or necrosis of sub-cutaneous tissue, presents as deep crater
stage 4: extensive destruction, tissue necrosis, damage to muscle, bone, supporting structures. Undermining or sinus tracts present

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Duchenne’s muscular dystrophy

proximal muscle wasting
commonly have contractures of hips, knees, plantar flexors, ITB
scoliosis presenting around age 11-12.
treatment focus on preventing contractures, maintaining ADL’s, energy conservation, family education, positioning - no strengthening

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opisthotonos

posture of extreme hyperextension of neck and spine, both LE flexed and heels touching buttocks.

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pursed lip breathing

increases resistance to airways on exhalation, causes increased pressure to prevent airway collapse

APTA classification for hip OA diagnosis

hip pain and either:

IR< 15, flexion <115, age >50
IR<15, pain with IR, morning stiffness lasting <60 min, age >50

transfemoral prosthetic causes of circumduction

``` long prosthesis locked knee loose knee friction inadequate suspension ill fitting socket plantarflexed foot ```

AC sprain symptoms

``` usually traumatic injury shear test positive O'Brian test positive passive cross chest adduction painful pain at end ranges, especially full elevation and horizontal adduction ```

calcific supraspinatus tendinitis symptoms

can be asymptomatic - see only on imaging if symptomatic, either: chronic, mild pain if large deposit, may interfere with elevation pain can radiate to deltoid insertion, aggravated by elevation or laying on affected side

subacromial bursitis sxs

pain with rest PROM and AROM limited, but not in capsular pattern typically painful arc

non-fluent (expressive) aphasia

slow, hesitant awkward, interrupted speech, produced with effort, but produces meaningful words. pt's tend to have good awareness of deficit Broca's aphasia

fluent (receptive) aphasia

impaired auditory comprehension fluent speech that is normal rate and melody, but nonsense Wernicke's aphasia pt's often don't realize their speech has no meaning

LE neural tension biasing

SLR with... plantarflexion and inversion - fibular dorsiflexion and inversion - sural dorsiflexion and eversion - tibial

metabolic syndrome criteria

waist circumference > 40 men, >35 women triglycerides > 150 HDL < 40 men, <50 women fasting glucose > 110

dorsal column-medial lemniscal pathway

light touch 2 pt discrimination stereognosis barognosis

stereognosis

ability to tell what an object is via touch

barognosis

ability to differentiate objects of different weights

s&s of pneumonia

tachycardia signs of lung infection abnormal breath sounds dullness to percussion

thoracic outlet sxs

``` sometimes referred pain no change in sxs with neck motions possible spine stiffness possible paresthesias reflexes may be affected increased muscle guarding tension tests may be positive possible pallor and coolness in hands possible fatigue and muscle cramps muscle weakness in late stages ```

risk factors for osteoporosis

``` post menopause low body weight loss of height sedentary lifestyle tobacco use hyperthyroidism (Graves disease) ```

spine rotation rules in lumbar and thoracic spine

rotation and side bend occur opposite

dysdiadochokinesia

impaired ability to perform rapid alternating movements

dysmetria

inability to judge distance or ROM, can be over or underestimation

Lisfranc injury

one or all metatarsal bones displaced from tarsus

dyspraxia

impairment of skilled learned movement disconnect b/w the idea of movement and motor execution

effects of nitroglycerin

vasodilation of coronary arteries decreasing left ventricular end diastolic volume reduces myocardial O2 consumption

inversion sprain - what ligament most commonly injured

anterior talofibular

joint mobs to increase knee extension

tibial anterior glide and external rotation

semi-fowler position

supine, head and torso elevated to 30 deg

reliability coefficient cutoffs

good: >0.75 moderate b/w 0.5 and 0.75 poor < 0.5

dysarthria

motor speech disorder, can't talk because of musculoskeletal problem

spondylolisthesis

forward translation of vertebral body with respect to one below

spondylolysis

break in vertebra, typically in region of pars interarticularis. may or may not result in spondylolisthesis

turf toe

sprain of MTP joint due to hyperextension

naming scoliosis

named for convex side

spinothalamic pathway

lateral: pain and temperature anterior: crude touch

when to begin ROM following tendon repair

48-72 hours

McBurney's point

half distance b/w ASIS and umbilicus right lower abdominal quadrant tenderness associated with acute appendicitis