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OMM > Fall 2015 Final > Flashcards

Fall 2015 Final Flashcards

1
Q

hip flexors

A

iliacus*
psoas* (iliosoas)
rectus femoris
sartorius

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2
Q

rectus femoris origin/insert

A

AIIS

patella

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3
Q

sartorius origin/insert

A

ASIS

medial tibia

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4
Q

hip extensors

A

semimembranosus
semitendinosus
biceps femoris
gluteus maximus

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5
Q

adductors

A 
adductor magnus*
adductor brevis*
adductor longus*
gracilis 
pectineus
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6
Q

abductors

A

gluteus medius
gluteus minimus
tensor fascia lata

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7
Q

piriformis fxn

A

ext rotation*

abduction extension

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8
Q

what makes piriformis special

A

only rotator that connects to sacrum

only muscle on ant surface of sacrum

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9
Q

male pelvis

A 
narrow pubic arch
acute pubic angle
rounded iliac crest
heart shaped pelvic opening
sacral promontory not in line w/ pelvic brim
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10
Q

female pelvis

A 
broad pubic arch 
obtuse pubic angle
broad/flat iliac crest
oval shaped pelvic opening
sacral promontory in line w/ pelvic brim
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11
Q

innominate dysfunctions

A

rotational: ant or post
shear: sup or inf
flare: int or ext

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12
Q

steps of innominate dx

A 
ID dysfuntion side:standing flexion test 
(reset pelvis)
ASIS compression
ID dysfunction:ASIS/PSIS positions
(reset pelvis
)Leg lengths
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13
Q

standing flexion test findings

A

side that moves first/furthest is side of dysfunction (+)

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14
Q

ASIS compression test findings

A

side that’s harder to press in dysfunction side (+)

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15
Q

ASIS/PSIS position findings

A 
ASIS lo, PSIS hi --> ant rot
ASIS hi, PSIS lo --> post rot
ASIS hi, PSIS hi --> sup shear
ASIS lo PSIS lo --> inf shear
ASIS med, PSIS lat --> inflare
ASIS lat, PSIS med --> outflare
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16
Q

leg length findings

A

short –> post rotation or sup shear
long –> ant rot or inf shear
even –> in/outflare

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17
Q

ME innominate ant rot

A 
pt supine
flex hip/knee
monitor PSIS
3-5 x for 3-5 s
final stretch
return, RESET, reassess
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18
Q

ME innominate post rot

A 
pt supine, dysfunctional leg off table
stabilize opp ASIS
extend hip to barrier
3-5 x for 3-5 s
final stretch
return, RESET, reassess
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19
Q

ME innominate inflare

A 
pt supine
stabilize opp ASIS
flex hip 90
abduct to barrier
3-5 x for 3-5 s
final stretch
return, RESET, reassess
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20
Q

ME innominate outflare

A 
pt supine
monitor dysfunctional PSIS 
flex hip 90
adduct into barrier
pull PSIS lat during contraction
3-5 x for 3-5 s
final stretch
return, RESET, reassess
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21
Q

HVLA innominate superior shear

A 
pt supine
dr @ foot of table
grasp tib/fib, int rot
apply traction to barrier
thrust
return, RESET, reassess
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22
Q

sacrum fusion

A

5 unfused at birth
fusion begin @ 16
complete @ 26

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23
Q

muscles of sacrum (+fxns)

A

gluteus maximus (extend, abduct hip)
multifidus
piriformis (ext rotation, weak extension)

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24
Q

sacroiliac motion

A

nutation (~flexion)

counternutation (~extension)

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25
Q

primary axis of sacroiliac mvmt

A

sup transverse axis (respiratory axis)

permanent

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26
Q

sacroiliac mvmt w/ resp

A

nutation (flex) @ exhalation

counternutation (ext) @ inhalation

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27
Q

secondary axis of sacroiliac mvmt

A

oblique axis
temporary (when we walk)
axis = locked side = closed SI joint

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28
Q

L5 flex/extend –>

A

sacral extend/flex

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29
Q

L5 sidebend –>

A

axis on same side

sidebent L –> (?) on L

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30
Q

L5 rotate –>

A

motion to opposite side

rotated L –> R (on ?)

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31
Q

type I vs II lumbar dysfunction –>

A

I –> ant rot

II –> post rot

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32
Q

ant torsions

A

physiologic (occur normally)
L on L
R on R

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33
Q

post torsions

A

non-physiologic (not normal)
L on R
R on L

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34
Q

tx for ant torsions

A

use gluteus maximus to pull dysfunctional base post

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35
Q

tx for post torsions

A

use piriformis to pull dysfunctional base ant

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36
Q

sacral shear dysfunctions

A

R/L unilateral flexion shear
R/L unilateral extension shear
bilateral flexion shear
bilateral extension shear

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37
Q

R/L unilateral flexion shear

A

R/L half of sacrum moves ant

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38
Q

R/L unilateral extension shear

A

R/L half of sacrum moves post

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39
Q

sacral dx steps

A

seated flexion test
spring test
sacral sulcus
inferior lateral angle(need 3/4)

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40
Q

seated flexion test findings

A

ID dysfunctional side
feet planted
first/furthest = + = dysfunctional
opp side = axis

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41
Q

spring test findings

A

compression in sphinx

no recoil = + = post displacement of base (extension –>. RoL, LoR, UniER/L, biE)

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42
Q

sacral sulcus (place)

A

medial to PSIS

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43
Q

inf lat angle (place)

A

inferior to PSIS by a few cm

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44
Q

SS/ILA findings (R axis)

A

deep SS L, deep ILA L (RoR)
deep SS R, deep ILA R (LoR)
deep SS L, deep ILA R (uniFL)
deep SS R, deep ILA L (uniEL)

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45
Q

SS/ILA findings (L axis)

A

deep SS L, deep ILA L (RoL)
deep SS R, deep ILA R (LoL)
deep SS L, deep ILA R (uniER)
deep SS R, deep ILA L (uniFR)

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46
Q

ME torsion directions

A

torso
axis
dr force

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47
Q

ME sacral ant torsion

A 
up up up - use gluteus maximus
pt in lat recumbent, chest up
flex hips
monitor base of dys side
lift legs
3-5 for 3-5
final stretch
return, reassess
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48
Q

ME sacral post torsion

A 
up down down - use piriformis
pt in lat recumbent, chest up
flex hips
monitor base of dys side
lower legs (or just top)
3-5 for 3-5
final stretch
return, reassess
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49
Q

ME sacral unilateral flexion shear

A 
pt prone
abduct/int rotate lower leg on dys side
contact ILA of dys side
push on INhalation
resist on EXhalation
return, reasses
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50
Q

ME sacral unilateral extension shear

A 
pt prone, sphinx
abduct/int rotate lower leg on dys side
contact base of dys side
push on EXhalation
resist on INhalation
return, reasses
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51
Q

ME sacral bilaterals

A

same as uni, but push on middle of base or ILA

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52
Q

pelvic floor make up

A

levator ani (puborectalis, pubococcygeous, iliococcygeous) transverse perineus muscleobturator fasciapiriformiscoccygeus ischial tuberocity

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53
Q

muscles attached closest to pubic symphysis

A

adductors

54
Q

pubis dx steps

A

ASIS compression pubic tubercle positionstenderness

55
Q

pubic tubercle position findings

A

symmetric, tender (compression)symmetric, widened (gapped)R/L superior (tender) –> R/L superior pubic shearR/L inferior (tender) –> R/L inferior pubic shear

56
Q

ME inferior pubic shear

A

(same as ant rot innominate)pt supinegap PS (dr force open)flex hip/kneemonitor PSIS3-5 x for 3-5 sfinal stretchclose PS (dr force close)return, RESET, reassess

57
Q

ME superior pubic shear

A

(same as post rot innominate)pt supine, dysfunctional leg off tablestabilize opp ASISextend hip to barrier3-5 x for 3-5 sfinal stretchgap PS (dr force open)return, RESET, reassess

58
Q

piriformis dx steps

A

internal rotationFAIR (flexion, adduction, internal rotation)

59
Q

piriformis internal rotation findings

A

more difficult to IR –> piriformis dysfunction

60
Q

FAIR findings

A

pain –> + –> piriformis dysfunction

61
Q

piriformis counterstrain

A

spot: midpoint btwn sacrum and greater trochanter pt prone, dys leg off tablehip/knee flex/abductfine tune w/ ER

62
Q

psoas dx steps

A

Thomas test

63
Q

psoas major counterstrain

A

spot: 2/3 from ASIS to midlinept supinehip knee flexST

64
Q

tibiofibular dx steps

A

seesaw lateral malleolus and fibular head

65
Q

tibiofibular dysfunctions

A

foot supination/inversion –> posterior fibular head

foot pronation/eversion –> ant fibular head

66
Q

posterior fibular head ease

A

(supination)
plantarflexion
inversion
adductions

67
Q

anterior fibular head ease

A

(pronation)
dorsiflexion
eversion
abduction

68
Q

ME post fibular head

A 
pt supine, knee bent
monitor post aspect of fibular head
dr force EXternal rotation 
3-5 x for 3-5 s
final stretch
return, reassess
69
Q

ME ant fibular head

A 
pt supine, knee bent
monitor ant aspect of fibular head
dr force INternal rotation
3-5 x for 3-5 s
final stretch
return, reassess
70
Q

HVLA post fibular head

A 
pt prone
pronate foot (barrier)
MCP behind fibular head
flex knee into barrier
thrust with MCP
return, reassess
71
Q

HVLA ant fibular head

A 
pt supine, pillow under knee
supinate foot (barrier)
heel of hand over fibular head
thrust into fibula (valgus)
return, reassess
72
Q

knee ROM angles

A

flexion: 120 - 150
extension: 5 - 10
IR: 10
ER: 30 - 40

73
Q

MCL test

A

valgus stress test

74
Q

LCL test

A

varus stress test

75
Q

ACL test

A

anterior drawer test

lachman’s test

76
Q

PCL test

A

posterior drawer test

lachman’s test

77
Q

meniscus test

A

McMurray’s test
Apley’s test
(bounce home test)

78
Q

medial hamstring CS

A 
spot: medial popiliteal fossa
pt supine
hip flex (cptn)
knee: F, IR, Add
(can add compressive @ calcaneous)
return, reassess
79
Q

lateral hamstring CS

A

spot: lateral popliteal fossa
pt supine, leg off table
knee: F, ER, Ab
return, reassess

80
Q

gastrocnemius CS

A

spot: med/lateral head of gastroc
pt prone
knee flex, plantarflex (capt)
return, reassess

81
Q

fibularis CS

A

spot: post to lateral malleolus pt supine
plantarflex, evert
return, reassess

82
Q

tibialis ant CS

A

spot: inf to med malleolus
pt supine
invert, dorsiflex
return, reassess

83
Q

tibialis post CS

A

spot: post to med malleolus plantarflex, invert

return, reassess

84
Q

types of ankle sprain

A

lateral (inversion) - 80%

medial (eversion) - 20%

85
Q

types of lateral ankle sprains

A

1st degree: ATFL (ant talofibular lig)
2nd degree: TC (calcaneofibular)
3rd degree: PTFL (post talofibular lig)

86
Q

why medial less common?

A

deltoid lig very stable

87
Q

talocrural joint mvmt

A

dorsiflexion

plantar flexion

88
Q

subtalar joint mvmt

A

inversion

eversion

89
Q

supination mvmts

A

plantarflexion
inversion
adduction
(spadi)

90
Q

pronation mvmts

A

dorsiflexion
eversion
abduction
(pabED)

91
Q

ankle-knee-hip relationships

A

supination - ER tibia, post fibular head - IR hip

pronation - IR tibia, ant fibular head - ER hip

92
Q

gait energy conservation

A

architecture recycles energy
absorbs natural shocks
designed to navigate uneven or run

93
Q

components of gait energy conservation

A

spring lig
achilles tendon
inertia

94
Q

spring lig

A

absorb energy when arch flattens

rebound fuels toe off

95
Q

achilles tendon

A

absorb potential energy btwn stance and toe off

convert to kinetic for toe off

96
Q

talocrural joint dx steps

A

ant drawer test
sulcus (static landmark)
plantar/dorsiflexion (motion test)

97
Q

anterior tibia on talus signs

A

easy post translation (drawer)
deep sulcus
prefer dorsiflexion

98
Q

post tibia on talus signs

A

easy ant translation (drawer)
shallow sulcus
prefer plantarflexion

99
Q

HVLA ant tibia on talus

A

pt supine
cup calcaneous contact tibia @ distal
dr force down into tibia
return, reassess

100
Q

HVLA post tibia on talus

A 
pt supine
fingers woven over dorsum, thumbs @ ball of foot
bring to dorsiflexion barrier
thrust thru
return, reassess
101
Q

subtalar (talocalcaneous) joint dx

A

inversion vs eversion

102
Q

MFR subtalar

A

pt supine
hold calcaneous and forefoot
in/direct for 30 s

103
Q

HVLA subtalar (ankle decompression)

A 
pt supine
hold calc and forefoot
traction into in/eversion barrier
thrust
return, reassess
104
Q

midfoot HVLA

A

pt prone, leg off table
thumb contact inf bone
whip
return, reassess

105
Q

midfoot MFR

A

plantar fasciitis
pt supine
fascia into planes of resistance/ease
30-60 s

106
Q

midfoot CS

A

plantar flex, push inferior

107
Q

HVLA plantar styloid process

A

plantar force @ 5th head w/ thumb

dorsal force w/ MCP

108
Q

HVLA phalanges

A

traction

use flex/extend too

109
Q

sacrum true ligs

A

ant SI
interosseous SI
post SI

110
Q

sacrum accessory lig

A

sacrotuberous
sacrospinous
iliolumbar

111
Q

rotator cuff muscles

A 
SITS
supraspinatus
infraspinatus
teres major
subscapularis
112
Q

gait phases

A

stance phase

swing phase

113
Q

stance phase steps

A 
initial contact
loading response
midstance
terminal stance
preswing
114
Q

swing phase steps

A

initial swing
midswing
terminal swing

115
Q

6 determinants of gait

A 
pelvic rotation (4)
pelvic tilt (4-5)
lat pelvic displacement 
knee flexion in stance
knee mechanisms
foot mechanisms
116
Q

gluteus medius gait

A

shift toward deficient side (weak glute med)

+ trandelenburg sign in upright position

117
Q

gluteus maximus gait

A

trunk/pelvis hyperextended over both hips

COG behind involved hip

118
Q

short lower extremity

A

pelvis and trunk depress in stance phase

119
Q

elevated pelvis gait

A

hike up pelvis on swing side if that hip/knee has limited motion

120
Q

congenital hip dislocation

A

waddling gait

121
Q

osteoarthrosis gait

A

scissors gait

122
Q

hemiplegic gait

A

affected leg is stiff, less flexion @ hip/knee
lean to affected side, throw whole leg out (circumduction)
shoe dragged against floor
1 arm doesnt swing also

123
Q

high steppage gait (1st pattern)

A

toe touches floor first
foot drop
leg raised high
foot slaps floor

124
Q

high steppage (2nd pattern)

A

hell touch first
ataxia and side to side reeling
stomp of foot
rombergs sign

125
Q

shuffling gait

A

small, flat foot, shuffling

trunk flexion

126
Q

ataxic gait

A

reeling, unsteady gait

fall toward lesion

127
Q

scissors gait

A

legs adducted

128
Q

BLT technique components

A

disengagement
exaggeration
balance

129
Q

spondylolisthesis

A

ant displacement of 1 vert on vert below it

lat x ray

130
Q

spondylolysis

A

defect of pars interarticularis w/o ant displacement

oblique xray

OMM (10 decks)

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