Final Exam Flashcards
What action would you take if you noticed a Red Flag?
Immediately notify the supervising PT
What are the Cardiovascular Red Flags?
-Chest P!
-L UE P!
-Any Sx of MI
-Pulsating P!
-Constant/Severe LE P!
What are the Cancer Red Flags?
-Chronic night P!
-Constant P! unrelieved by position/activity
What are the Gastrointestinal Red Flags?
Frequent or severe abdominal P!
What are the Neurological Red Flags?
Frequent or severe headaches
What are the Cardinal signs of Inflammation?
-Heat
-Redness
-Swelling
-P!
-Decreased ROM
What is abnormal redness?
-Rash/Streaking
-With hardened tissue, may indicate thrombophlebitis
What are the risk factors for DVT?
-Immobility
-Trauma: Fx/Surgery
-Hx of DM, obesity, hormone changes
-Hypercoagulation
What are the signs and Sx of DVT?
-Peripheral edema
-Warmth
-Skin discoloration
-Prominent superficial veins
-Leg P!
-Tenderness
What are signs of Abnormal Edema?
-Bilateral (systemic)
This is a description of what diagnosis?
-Increased pressure in a muscle compartment (grouping of muscles, nerves and blood vessels) causing muscle and nerve damage along with pain.
Compartment Syndrome
Which area of the body is Compartment Syndrome most typically found?
The anterior compartment of the lower leg
Define Acute, Subacute, and Chronic Inflammation
-Acute Inflammation: P! before end ROM
-Subacute Inflammation: P! at end ROM
-Chronic Inflammation: P! with stretch past end ROM
What are the general guidelines for Vital Signs?
-O2 Saturation: 95-98%
>90% is typical Tx parameter
-HR w/ exercise: </= 20 bpm above RHR
-Return to RHR within 5’ post exercise
-BP: </= 250 systolic, 110 diastolicd
<20-30 mmHg systolic increase w/mod exercise
<10 mmHg diastolic increase w/mod exercise
What are the Signs and Sx of Tendonitis?
-Resisted movement
-P! with stretching
-TTP
-No P! with PROM
What are the Signs and Sx of a Fracture?
-Point tenderness
-Local edema
-Subjective report of instability
-Deep/grinding P!
What are the phases of bone healing?
-Inflammatory phase: bleeding
-Soft Callus phase: Granulation tissue
-Hard Callus phase: Osteoblasts form new bone
-Clinical Union: takes approximately 6-8 weeks to
What are the phases of Tissue Healing?
-Acute Stage: Inflammatory response
-Subacute Stage: Repair Sequence/Fibroplastic
-Chronic Stage: Remodeling/Connective tissue formation
Which stage of healing occurs approximately 5-21 days post injury?
The Subacute (Repair/Fibroplastic) Stage
Which stage of healing occurs approximately 2-3 weeks post injury?
The Chronic (Remodeling) Stage
What Grade Sprain is…
-Microscopic tearing
-No joint laxity
-No/minimal swelling
-Local tenderness
-(-) joint stress test
Grade 1
What Grade Sprain is…
-Incomplete tearing
-Moderate joint laxity
-Localized swelling
-P! with WB
-Ecchymosis (Bleeding)
-Mild (+) stress test
Grade 2
What Grade Sprain is…
-Complete tear/rupture
-Profound joint laxity and instability
-Unable to WB
-Significant P! and swelling/ecchymosis
-Mod/severe joint stress test
Drade 3
What is the ultimate tensile strength of an injured ligament?
50-70%
What Degree Strain is…
-Stretch or minor tear
-Minor weakness, P!, swelling
1st Degree
What Degree Strain is…
-Moderate tear (50%)
-Moderate weakness, P!, swelling/bruise
2nd Degree
What Degree Strain is…
-Complete tear
-Major weakness, swelling/bruise, LOF
-No P!
3rd Degree
In what joint position should all joint mobilizations be performed in?
The open-packed position
What are the characteristics of the closed-packed postition?
-Most congruent position of the joint
-Joint surfaces aligned
-Capsule and ligaments are most taut
What are the Contraindications for Joint Mobilizations?
-Closed Pack position
-CA in area
-CNS disorder
-Vertebral artery disorder
-Joint infection
-Joint hypermobility
-Bone disease
-Osteoporosis
-RA
-Acute inflammation
What are the characteristics that predispose someone to arthritis?
-Obesity
-Age
-Gender
-Inactivity
Are men or women more affected by OA?
Women
What are Heberden’s nodes?
OA in the DIPs
What are Bouchard’s nodes?
OA in the PIPs
Definition: A chronic inflammatory systemic disease with gradual destruction of joint tissues resulting in deformity and disability.
RA
Is RA more prevalent in men or women?
Women
Which diagnosis causes MCP ulnar deviation?
RA
Which deformity caused by RA results in hyperextension of the PIPs and hyperflexion of the DIPs?
Swan Neck Deformity
Which deformity caused by RA results in hyperflexion of the PIPs and hyperextension of the DIPs
Boutonniere Deformity
What is Ankylosing Spondylitis also known as?
Fusing Spine
Are males or females more affected by Ankylosing Spondylitis?
Males
What term is used to describe the x-rayed spine of a patient with ankylosing spondilitis?
Bamboo Spine
What does SLE stand for?
Systemic Lupus Erythematosus
What kind of disease is SLE?
Autoimmune
Are females or males more affected by SLE?
Females
What is typically the biggest sign a patient has Lupus?
A Butterfly Rash across the bridge of their nose and cheeks
What are the Static Stabilizers of the shoulder?
Things like the bony geometry of the joint, the capsule, ligaments, intraarticular pressure, and the glenoid labrum
What are the Dynamic Stabilizers of the shoulder?
Muscles
-Primary active stabilizers
-Rotator cuff muscles
-Deltoids
-Long head of biceps brachii
-Secondary active stabilizers
-Teres Major
-Lattisimus Dorsi
-Pectoralis Major
How much smaller is the glenoid than the head of the humerus?
3-4 times smaller
How much of the humeral head is in contact with the glenoid?
25-30%
At what degree of elevation does the shoulder have the most articular contact?
60-120 degrees
What is the purpose of the glenoid labrum?
Stability- it doubles the depth of the glenoid fossa from 2.5 to 5mm
Which muscle inserts into the superior portion of the glenoid labrum?
The biceps brachii
What are the rotator cuff muscles?
-Supraspinatus
-Infraspinatus
-Subscapularis
-Teres Minor
When is shoulder surgery needed?
-If there is no improvement of Sx in 4-6 months
-Pt. <50 yo, full thickness tear
What does SAD stand for?
Subacromial Decompression (Shoulder Arthroscopy)
How is a SAD performed and for what reason?
-by releasing the tight ligament of the coracoacromial arch and shaving away some of the under surface of the acromion
-This raises the roof of the shoulder and allows relief of impingement symptoms
What are the top goals post SAD?
-Restore PROM quickly
-Restore normal glenohumeral and scapulothoracic mechanics
What are the goals for non-surgical treatment of Shoulder Impingement and Rotator Cuff Tears?
-Control Inflammation
-Activity Modification
-Restore ROM
-Scapular Stabilization
-Strengthening
-Restore functional motion
How is a Bankart Repair performed?
The labrum is sutured directly back to the bone
What does SLAP stand for
Superior Labrum Anterior Posterior
What is the most common reason for TSA?
Uncontrolled P! secondary to arthritis in the shoulder?
Why are Reverse TSAs usually performed?
When there is an inability to repair the rotator cuff tear
Which muscles Flex the elbow?
-Biceps Brachii
-Brachialis
-Brachioradialis
Which muscles Extend the elbow?
-Triceps
-Anconeus
What is the difference between Tendonitis and Tendonosis?
-Tendonitis (tendon inflammation) is more short-term lasting <2 wks and has a 99% chance of full recovery
-Tendonosis (collagen degeneration) is more long-term lasting 6-10 weeks and only has an 80% chance of full recovery
What is the most common elbow fracture in adults?
Radial head fracture
Which Type Radial Head Fractures require surgery?
Types I-IV
What travels through the Carpel Tunnel?
-9 Tendons
-The median nerve
What travels through the Tunnel of Guyon
-Then ulnar nerve
What are the Flexors of the Wrist?
-Flexor Carpi Ulnaris
-Flexor Carpi Radialis
What are the Extensors of the Wrist?
-Extensor Carpi Radialis Longus
-Extensor Carpi Radialis Brevis
-Extensor Carpi Ulnaris
What is the surgery performed for Carpel Tunnel Syndrome?
Retinaculum Release
What is a Colles’ Fracture
(AKA Dinner Fork Deformity) Fx of distal radius with displacement in the dorsal direction
-Most common in females middle aged to elderly
What is a Smith Fracture
A reverse Colles’ Fracture
-Distal radius displaced in the volar direction
What is the most common Carpal Fracture?
Scaphoid Fracture
Which diagnosis results in P! and edema in the snuff box or radial styloid
DeQuervain’s Tenosynovitis
Which diagnosis results in a contracture of the finger flexors (most commonly the 4th and 5th)
Duyputren’s Contracture
At what point is surgery needed for a Duyputren’s Contracture?
When the MCP is flexed >30 degrees
What is the term used to describe a sprain to the ulnar collateral ligament of the thumb which is caused by hyperextension and a valgus stress to the thumb?
Skier’s Thumb
What are the Flexors of the Hip?
-Iliopsoas
-Rectus Femoris
-Pectineus
-TFL
-Sartorius
What are the Abductors of the hip?
-Glute Med
-Glute Min
-TFL
-Sartorius
What are the Adductors of the Hip?
-Gracilis
-Pectineus
-Quadratus Femoris
-Adductor Brevis
-Adductor Longus
-Adductor Magnus
What are the Extensors of the Hip?
-Glute Max
-Semitendinosus
-Semimembranosus
-Biceps Femoris
What are the Internal Rotators of the Hip?
-Glute Min
-Glute Med
-TFL
What are the External Rotators of the Hip?
-Piriformis
-Quadratus Femoris
-Glute Max
-Gemellus Superior
-Obturator Internus
-Gemellus Inferior
-Obturator Externus
What is the Pediatric form of AVN called?
Legg-Calve Perthes
What is done for patients with Legg-Calve Perthes?
They usually have to wear a hip abduction brace for up to 2 years
What is the difference between a THA and a hemiarthroplasty?
THA: replaces both the femoral head and acetabulum
Hemiarthroplasty: Only replaces the femoral head
What are the THA precautions for the posterior approach?
-No flexion >90 degrees
-No internal rotation
-No adduction
Which exercises should a THA patient not perform in the Max protection phase of recovery?
SLR or bridges
Can THA patients in the Max protection phase perform AAROM exercises?
Yes, because tendons are not involved
What is the capsular pattern of the hip?
Flexion > Abduction > IR
Which diagnosis is caused by compression of the sciatic nerve as it pierces through the piriformis muscle?
Piriformis Syndrome
Symptoms of which diagnosis: hip flexion and internal rotation often reproduce this pain, as does palpation of the sciatic nerve and gluteal region.
Piriformis Syndrome
Which knee meniscus makes a C shape?
The Medial Meniscus
Which movements result in an ACL injury?
-Hyperextension with a valgus stretch
-Quick change of direction while running, jumping, or turning
What usually causes a PCL injury?
Posterior directed force on a flexed knee
What are the ACL stability special tests?
-Lachmans’s
-Anterior Drawer
What is the PCL stability special test?
Posterior Drawer
Which exercises should you not give to an ACL patient in the max protection phase?
LAQs and SAQs
What are the special tests for Meniscus Tears?
-McMurry’s
-Aply’s
What kind of knee surgery is typically done for a meniscus repair?
Knee Arthroscopy
What type of surgery is done for a HNP?
A Laminectomy
Which movements are contraindicated for Max protection phase post laminectomy?
Bending
Lifting
Twisting
What are the 4 stages of disc herniation?
-Degeneration
-Bulge or Prolapse
-Extruded Nucleus
-Sequestrated Nucleus
What is Stenosis
Narrowing of the spinal canal
What is Spondylosis?
OA of the spine
What is Spondylolysis?
Stress fracture of the spine
What is Spondylolisthesis?
Forward slippage of a vertebrae
What type of exercises are best for spinal stenosis?
Flexion based
