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ORTHO TX I > FINAL EXAM > Flashcards

FINAL EXAM Flashcards

1
Q

T/F - nodding of the cervical spine occurs in the lower cervical spine, whereas flexion occurs in the upper C spine

A

FALSE

during flexion, nodding occurs in upper C-spine, flexion occurs in lower C-spine

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2
Q

T/F - rotation in the atlanto-occipital joint is negligible

A

TRUE

-principle motion of these two joints is flexion-extension (15°-20°) or nodding of head
-side flexion is ~10°

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3
Q

T/F - the atlas has a vertebral body

A

FALSE

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4
Q

T/F - the odontoid process of C2 has evolved from the vertebral body of C1

A

TRUE

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5
Q

T/F - the atlanto-axial joint is the least mobile articulation of the spine

A

FALSE

= MOST mobile articulations of the spine, they are ellipsoid & act in unison

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6
Q

T/F - rotation is the primary movement of the joints between C1-C2

A

TRUE

rotation is the primary movement of atlanto-axial joints (C1-C2)

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7
Q

T/F - the atlanto-axial joint is the articulation between C1 and C2

A

TRUE

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8
Q

T/F - the first palpable spinous process below the external occipital protuberance is the spinous process of C1

A

FALSE

first palpable vertebra descending from the EOP = SP of C2

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9
Q

what are the joints of Luschka? (costal/ uncovertebral processes/ uncinate joints)

A

-uncovertebral processes of inferior vertebrae
-pseudo - joint formed by weakness in annulus fibrosus

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10
Q

greatest stresses placed on the vertebral artery

A

-where it enters TVP of C6
-within bony canals of vertebral TVPs
-between C1 & C2
-between C1 & occiput

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11
Q

in shoulder/upper crossed syndrome, which muscles would be short & tight?

A

pectorals, upper traps, suboccipitals, levator scapula

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12
Q

in shoulder/upper crossed syndrome, which muscles would be long & taut?

A

deep neck flexors, rhomboids, serratus anterior, lower traps

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13
Q

a group of inherited disorders characterized by joint hypermobility, skin hyper-extensibility and increased bruising is called…

A

Ehler’s Danlos Syndrome

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14
Q

an autoimmune disorder characterized by inflammation and destruction of connective tissue resulting in hypermobility of the affected joints is called…

A

Rheumatoid Arthritis

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15
Q

inherited disorder with fragmentation of elastin, leading to joint hypermobility, elongated bones, aortal widening, mitral valve prolapse and changes in the eye is called…

A

Marfan’s Syndrome

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16
Q

to test for nerve root compression in the C spine, what would be the best special test to perform?

A

Spurling’s

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17
Q

to differentiate dizziness or vertigo, what would be the best special test to perform?

A

Hautant’s

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18
Q

which special test is to assess for nerve root compression in C spine by alleviating symptoms?

A

distraction

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19
Q

what trigger point referral pattern refers pain around the ear?

A

suboccipitals

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20
Q

which trigger point referral pattern refers pain to the top of the head?

A

splenius capitis

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21
Q

which trigger point referral pattern refers pain to the temple?

A

splenius cervicis
temporalis
semispinalis capitis

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22
Q

T/F - tension headaches are a muscle contraction type headache

A

TRUE

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23
Q

T/F - tension headaches cannot be the condition or secondary because of an underlying pathology

A

FALSE

primary: headache is the condition

secondary: result of an underlying pathology, such as hypertension or head trauma

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24
Q

T/F - predisposing factors of tension headaches can be TP stimuli or TMJ dysfunction

A

TRUE

trauma, acute mm overload, infection, fatigue, chilling of mm, referred pain, emotional stress, sleep disturbance, postural imbalances (hyperkyphosis, head-forward posture)

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25
Q

T/F - a ‘common migraine’ is a migraine with an aura

A

FALSE

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26
Q

T/F - a ‘classic’ migraine is a migraine with an aura

A

TRUE

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27
Q

T/F - a migraine without aura is more common than a migraine with aura

A

TRUE

(85%)

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28
Q

T/F - auditory stimuli and weather changes are not considered trigger factors for migraine

A

FALSE

stress, foodstuffs & food additives, hunger, meds, visual stimuli, olfactory stimuli, sleeping, hormonal shifts, allergies

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29
Q

T/F - ’Postdrome’ is when the person may feel fatigued and drained 24 - 48 hours post migraine

A

TRUE

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30
Q

T/F - the frequency of migraines is usually weekly

A

FALSE

= daily

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31
Q

Pseudo-torticollis is which type of torticollis?

A

acute acquired

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32
Q

trauma may be a predisposing factor, head & NK in typical torticollis position, aggravated by stress, C-spine bent toward & rotated away from affected side

A

torticollis

acute acquired
congenital
spasmodic

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33
Q

results from localized dystonia, idiopathic, painful movements, spasmodic mm, CNS lesion, malformation C0-C1, caused by postural dysfunction

A

spasmodic torticollis

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34
Q

idiopathic, tissue ischemia & cranial bone/ memebrane dysfunction may be predisposing factor, lifetime unless corrected, increase possibility of degenerative disc disease, present from infancy, contracture ipsilateral SCM, SCM thick, pain-free contracture

A

congenital torticollis

35
Q

painful movements, spasmodic mm, suddent onset, may have tinnitus/ nausea/ tearing of eye, increase possibility of degenerative disc disease, woke up with it, caused by postural dysfunction, activation of latent TPs, subluxation C1/C2, facet joint irritation, infection, disc related P

A

acute acquired torticollis

36
Q

what other conditions could lead to a patient presenting with TOS?

A

-carpal tunnel syndrome
-common flexor tendonitis
-compression of Guyon’s canal

-C-spine spondylosis, cervical radiculopathy, cervical tumors
-Raynaud’s disease (phenomenon)
-ulnar nerve compression
-osteoarthritis (OA)

37
Q

Adson’s maneuver tests for what?

A

TOS

38
Q

Tx for TOS

A

-main goal is to reduce cause of compression
-when treating subclavius, address pec major first
-when addressing anterior TVP for scalenes, SCM treated first
-when addressing pec minor, pec major treated first
-for all syndromes, address fascia of anterior NK, chest & SH

39
Q

if a patient comes in presenting with TOS symptoms and they tell you they sleep with their arm above their head, what type of TOS would you suspect?

A

pectoralis minor

40
Q

if a patient comes in presenting with TOS symptoms and they tell you the pain is activated by heavy lifting, what type of TOS would you suspect?

A

anterior scalene

41
Q

if a patient comes in presenting with TOS symptoms and they tell you the pain is activated by carrying a heavy bag over their shoulder, what type of TOS would you suspect?

A

costoclavicular, pectoralis minor

42
Q

anterior scalene syndrome can be caused by what?

A

-extra wide insertion of anterior scalene
-HT in anterior scalenes that is activated by heavy lifting
-anatomical anomalies such as a cervical rib

43
Q

CIs for treating TOS

A

-avoid aggressive mobilizations if a cervical rib is present
-moist heat over neck if clt has hypertension

44
Q

what factors might affect a rear-impact whiplash?

A

head position, air bags, seat belts, headrest position

45
Q

whiplash can result in…

A

facet joint irritation
nerve root compression
ligamentous injury
mm injury
vertebral injury
intervertebral disc injury
joint capsule injury
blood vessel injury
fascial injury

46
Q

full peak acceleration occurs at what phase of whiplash?

A

phase II

(vehicle & torso)

47
Q

head & neck are now at their peak forward acceleration while the vehicle and torso are slowing down

A

phase III

48
Q

head & torso are now at full deceleration

A

phase IV

49
Q

T/F - grade 1 classification of whiplash indicates no physical neck/upper back signs

A

TRUE

50
Q

T/F - grade 2 classification of whiplash indicates neck/upper back musculoskeletal signs

A

TRUE

51
Q

T/F - grade 3 classification of whiplash indicates neck/upper back neurological signs

A

TRUE

52
Q

T/F - grade 4 classification of whiplash indicates neck/ upper back fracture or dislocation

A

TRUE

53
Q

recommended self-care for a patient with acute or early subacute whiplash includes…

A

P-free active range of motion of cervical spine

54
Q

rib springing should be performed bilaterally at all times to…

A

hypomobile ribs

55
Q

a localized, sharp posterior angulation from vertebral wedging is called…

A

Gibbus deformity

(Pott’s disease)

56
Q

to eliminate compensation during AROM of the thoracic spine, the examiner can…

A

ask the patient to sit

57
Q

the primary muscles of inspiration is/are…

A

diaphragm
subclavius
levator costorum
external & internal intercostals

58
Q

T/F - if a rib stops moving relative to the other ribs on exhalation, it is classified as a(n) elevated rib

A

TRUE

59
Q

T/F - if a rib stops moving relative to the other ribs on inhalation, it is classified as a(n) deranged rib

A

FALSE

= depressed rib

60
Q

what direction does the pump handle action of ribs 1-6 move the ribs most?

A

superior-inferiorly

increase the anteroposterior dimension

61
Q

what direction does the bucket handle action of ribs 7-10 move?

A

upward, backward, medially

downward, forward, laterally

= bucket-handle action

62
Q

to locate the TVP of T9, what SP would be at the same level to landmark?

A

T8

63
Q

an increase in thoracic kyphosis can cause…

A

int.R GH joint
restricted rib mobility
TOS
inefficient breathing

64
Q

the purpose of using the passive scapular approximation test is to assess for what nerve root problem?

A

T1-T2

65
Q

when performing the slump test, what would be the next step in the test after getting the patient to “slump” or flex the spine forward?

A
  1. patient seated
  2. patient flexes spine & shoulders sag forward
  3. patient moves neck into flexion
  4. patient extends one knee
  5. patient dorsiflexes their foot
66
Q

which pathology leads to hyperkyphosis in juvenile males?

A

Scheuermann’s disease

67
Q

T/F - your patient presents with a hyperkyphotic posture, with AROM testing for the thoracic spine, the movement you would expect to see the most limited would be flexion

A

FALSE

= extension

68
Q

resisted muscle testing for someone with hyperkyphosis would reveal taut, weak muscles…

A

middle trapezius & rhomboid major

infrahyoids & suprahyoids

69
Q

what is CI’d for hyperkyphosis?

A

-mm stripping techniques to lengthened tissues
-fascial techniques to overstretched tissues

70
Q

T/F - lateral flexion of the spine towards the convexity is increased

A

FALSE

= decreased

71
Q

T/F - the ribs on the convex side are more posterior in scoliosis

A

TRUE

72
Q

T/F - the vertebral bodies are rotated toward the concavity

A

FALSE

= toward convexity

73
Q

T/F - the paraspinals are lengthened on the convex side

A

TRUE

74
Q

when charting information about scoliosis, you should list…

A

span of scoliosis
apex of the curve
direction of concavity
S or C shaped curve
transitional vertebra

75
Q

how can the therapist evaluate/confirm a structural scoliosis from a functional scoliosis?

A

-determine whether a small hemi-pelvis exists
-have them flex forward to see if spine straightens
-test to see if there is a leg length discrepancy

76
Q

what is the best way to locate the lateral pterygoids internally?

A

place finger against last upper molars & slide superiorly and posteriorly between maxilla & coronoid process of mandible

77
Q

what is the best way to locate the medial pterygoids internally?

A

place finger on last lower molar, then slide around to medial surface of molar & inferiorly past gum towards floor of mouth

78
Q

which muscle bilaterally depresses and retracts the mandible and unilaterally moves the mandible to the same side?

A

lateral pterygoid, digastric ??

79
Q

T/F - the resting position for the TMJs is the mouth slightly open, the lips together and the teeth not in contact

A

TRUE

80
Q

T/F - on mandibular depression, normally gliding occurs before rotation

A

FALSE

rotation = first

81
Q

T/F - the temporomandibular ligament restrains movement of the lower part of the jaw

A

TRUE

82
Q

T/F - the TMJ is a synovial, condylar, modified ovoid hinge joint

A

TRUE

83
Q

which muscles close the jaw?

A

masseter
medial pterygoid
temporalis

lateral pterygoid = opens jaw

ORTHO TX I (5 decks)

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