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NPTE Study Practice > Foundational Sciences > Flashcards

Foundational Sciences Flashcards

1
Q

Define the foundational position

A
  • Same position as the anatomical position except the palms of the hands are facing the sides of the body
  • Used in discussing rotation of the UE
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2
Q

Define distal versus proximal

A
  • Distal means away from the trunk or a specific joint
  • Proximal means towards the trunk or a specific joint
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3
Q

Purpose of the clavicle

A
  • Connects the upper limb to the axial skeleton
  • 1st bone to ossify
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4
Q

Function of the clavicle

A
  • Holds the upper limb free from the trunk to allow freedom of movement
  • Provides attachment for muscles
  • Transmits forces from the upper limb to the axial skeleton at the sternum
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5
Q

Which ribs does the scapula cover

A
  • 2-7th ribs
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6
Q

What vertebrae level does the inferior angle of the scapula sit at

A
  • T7
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7
Q

Purpose of the coracoclavicular ligament

A
  • Stabilizes the AC joint and prevents upward displacement of the humeral head
  • Also prevents separation of the scapula from the clavicle
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8
Q

What 4 joints make up the shoulder joint

A
  • Glenohumeral joint
  • Acrominoclavicular joint
  • Sternoclavicular joint
  • Scapulothoracic articulation
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9
Q

What four muscles make up the rotator cuff

A
  • Supraspinatus
  • Infraspinatus
  • Teres minor
  • Subscapularis
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10
Q

How much ROM for abduction/flexion of the shoulder comes from the GHJ versus the scapula

A
  • 120º from GHJ
  • 60º from scapula
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11
Q

Biomechanics of the clavicle during shoulder elevation

A
  • During the first 90º of abduction the clavicle elevates 35-45º at the SC joint
  • For full elevate the clavicle requires 45-50º of clavicular backward rotation
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12
Q

How due the rotator cuff muscles stabilize/hold the humerus in the glenoid

A
  • Supraspinatus and coracoacrominal arch guard superiorly
  • Infraspinatus and tires minor guard posteriorly
  • Subscapularis guards anteriorly
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13
Q

What is the most commonly fractured part of the proximal humerus

A
  • Surgical neck
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14
Q

Normal carrying angles

A
  • Men 10-15º
  • Women 20-25º
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15
Q

Purpose of the interosseous membrane and oblique cord in the middle radioulnar joint

A
  • Interosseous membrane stabilizes during pushing movements
  • oblique cord resists distal displacement of radius during pulling movements
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16
Q

What is Volkmann’s ischemic contracture

A
  • Permanent flexion of the hand at the wrist
  • Passive finger extension is restricted and painful
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17
Q

Order of carpal bones from lateral to medial proximal and distal rows

A
  • Proximal row: Scaphoid, Lunate, Triquetrum, Pisiform
  • Distal row: Trapezium, Trapezoid, Capitate, Hamate
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18
Q

What carpal bones does the flexor retinaculum attach to

A
  • Scaphoid and Tripezium
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19
Q

Which carpal bones is most commonly fractured and most commonly dislocated

A
  • Fractured: Scaphoid; poor blood supply with likelihood of AVN
  • Dislocated: Lunate (anteriorly)
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20
Q

What is the load bearing ratio of radius to ulna

A
  • 60:40 radius:ulna
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21
Q

Which muscle is most active during grasping

A
  • Extensor carpi radialis brevis
  • Holds the wrist in extension
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22
Q

Which muscles radially deviate the wrist

A
  • Extensor carpi radialis longus/brevis
  • Flexor carpi radialis
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23
Q

Which muscles ulnarly deviate the wrist

A
  • Flexor carpi ulnaris
  • Extensor carpi ulnaris
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24
Q

How are the muscles of the forearm grouped into pronators, flexors, and finger flexors

A
  • Pronators: pronator teres and quadratus
  • Wrist flexors: FCR, FCU, and palmaris longus
  • Finger flexors: flexor digitorum superficialis/profundus and flexor pollicis longus
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25
Q

Which ligament (palmar, transverse, collateral) becomes tight during MCP flexion

A
  • Collateral ligaments
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26
Q

How much wrist extension is needed for optimal use of the hand

A
  • 20-30º
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27
Q

Describe power versus precision grips

A
  • Power: finger and wrist flexion with ulnar deviation
  • Precision (prehension): holding an object between the fingertips
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28
Q

What does the opponent digits minimi do

A
  • Hollows the palm for cupping the hand or for grasping a cylindrical object
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29
Q

Nerve damage and its effects on hand/wrist function

A
  • Radial: affects maintenance of functional wrist position & release of an object
  • Median: affects flexion of digits on radial side and precision grip
  • Ulnar: affects flexion of ulnar Sid digits and power grip
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30
Q

What artery can a fracture of the femoral head effect

A
  • Can disrupt the blood supply of the obturator artery to the head of the femur & cause aseptic necrosis (death in absence of infection)
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31
Q

What 3 ligaments cover the hip joint capsule and their function

A
  • Illiofemoral (“Y” ligament) resists extension
  • Ischiofemoral ligament resists extension and IR
  • Pubofemoral ligament resists abduction
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32
Q

How much anteversion is normal

A
  • Femoral neck is rotated 15º anterior to the long axis of the femur
  • Too much ante version causes IR and toe in gait pattern
  • Retroversion causes ER
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33
Q

What are the prime movers for IR and ER of the hip

A
  • IR: gluteus medius and minimus anterior fibers
  • ER: obturator externus and quadrates femoris
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34
Q

Importance of the Sciatic nerve

A
  • Largest nerve in the body
  • Passes under the Piriformis sometimes through it
  • Splints into the tibial and common fibular (perineal) nerves in the distal thigh
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35
Q

What artery is the chief blood supply for the LE

A
  • Femoral artery
  • Pulse can be palpated in the femoral triangle, 2-3 cm inferior to the midpoint of the inguinal ligament
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36
Q

The collateral ligaments of the knee primarily restrain varus and valgus stresses especially between

A
  • Full extension and 30º flexion
37
Q

Describe the screw home mechanism of the knee joint

A
  • Unlock: femur laterally rotates and tibia medially rotates in closed chain
38
Q

In weight bearing how much compression force does the menisci transmit

A
  • 50% in full extension
  • 85% in 90º flexion
39
Q

Which direction do the menisci move during flexion/extension

A
  • They move posteriorly in flexion and anteriorly in extension
40
Q

Which part of the menisci are partly vascular

A
  • Outer 1/3 are partly vascular while the inner 2/3 is avascular
41
Q

When is the ACL taut

A
  • Taut during knee extension
42
Q

What does the VMO (vastus medalis oblique) resist

A
  • Resists lateral displacement of the patella out of the trochlear groove during closed chain
43
Q

The most stress on the ACL from the quadriceps occurs from

A
  • 45-0º of extension
44
Q

Which hamstring muscles IR and ER the tibia

A
  • IR: semimembranousus
  • ER: biceps femoris
45
Q

What muscles attach at the pes anserine

A
  • Sartorius
  • Gracilis
  • Semitendinosus
46
Q

Does the tibia have poor/good blood supply

A
  • Relatively poor blood supply making even stable undisplayed fractures take up to 6 months to heal
47
Q

Which bone in the foot ossifies first

A
  • The calcaneous which is also the largest bone in the foot
48
Q

Movements of the distal tibiofibular joint

A
  • Fibula rotates laterally with DF to accommodate the wider portion of the talus
49
Q

Movements of the talocrual joint

A
  • DF and PF
50
Q

Movements of the subtalor joint

A
  • Triplanar motion
  • Pronation: eversion, DF, and ABD of calcaneus
  • Supination: inversion, PF, and ADD of calcaneus
51
Q

How does the tibia rotate with supination and pronation at the subtalar joint

A
  • Supination causes tibial ER
  • Pronation causes tibial IR
52
Q

Action of posterior tibialis in open chain

A
  • PF and ankle invertor
53
Q

Action of fibularis longus/brevis in open chain

A
  • Evert the foot and ankle
54
Q

Action of anterior tibialis, extensor digitorum longus (EDL), and extensor hallucinations longus (EHL)

A
  • In open chain EHL and EDL extend the toes and all muscles DF the ankle
55
Q

What structures support the arches of the foot

A
  • Longitudinal: long palmar ligament supports the lateral aspect
  • Medial: supported by the fibularis longus, posterior tibialis, and intrinsic muscles & the plantar calcaneonavicular ligament (Spring lig)
  • Transverse: supported by metatarsal heads & musculoligamentous complex preventing metatarsals from spreading out
56
Q

Regional characteristics of vertebrae

A
  • Cervical: foramina of transverse processes contain vertebral arteries
  • Thoracic: facets on vertebral bodies for articulation with ribs
  • Lumbar: massive bodies & sturdy laminae for support of the body weight
  • Sacrum: fused vertebrae with 4 foramina on each side
  • Coccygeal: tiny, incomplete, & fused vertebrae
57
Q

A teardrop fracture is the result of

A
  • Compression of the anterior aspect of the vertebral body in which a triangular fragment is split from the vertebral body anteriorly
58
Q

Function of the intrinsic and extrinic muscles of the back

A
  • Superficial: trapezius and latissimus dorsi conneting the upper limbs to the trunk & provide movement of the limbs
  • Intermediate: serratus posterior are respiratory muscles
  • Deep: erector spinae maintain the posture & move the vertebral column & head
59
Q

Function of the platysma

A
  • Assists in depressing the mandible
  • Draws mouth inferiorly & is one of the facial expression muscles
  • Superficial neck muscle
60
Q

What is the articular disc of the TMJ made of

A
  • Made of dense fibrous connective tissue & fibrocartilage & is largely avascular & aneural
61
Q

Movements of the TMJ

A
  • Mandible elevation: temporalis, masseter, & medial pterygoid
  • Protrusion: Lateral/Medial pterygoids protrude and posterior fibers of temporals muscles retrude mandible
62
Q

Define coxa vara

A
  • femoral neck shaft angled inward (angle of inclination <125º)
63
Q

Define coxa valga

A
  • femoral neck shaft angled outward (angle of inclination >125º)
64
Q

Define anteversion

A
  • femoral torsion markedly >15º
65
Q

Define retroversion

A
  • femoral neck torsion markedly <15º
66
Q

Define internal tibial torsion

A
  • distal aspect of tibia rotated or twisted medially as compared to its proximal end
67
Q

Define genu varum

A
  • knees are lateral in relation to the ankle (“bowlegged”)
68
Q

Define genu valgum

A
  • knees come together or almost touch (“knock-kneed)”)
69
Q

Define equinus

A
  • the toe is in a down position, DF limitation of the ankle
70
Q

Define talipes equinovarus

A
  • ankle & foot are down and in (“club foot”)
71
Q

Define valgus heel

A
  • the rear foot is deviated toward the outside resulting in a pronated heel
72
Q

Describe the different levers in the body

A
  • First class: fulcrum is located b/w the force and the resistance (seesaw on playground)
  • Second class: fulcrum is at one end, the resistance is in the middle, and the force is at the other end (wheelbarrow)
  • Third class: fulcrum is at one end, the force is in the middle, and the resistance is at the other end (most common lever in the body, advantage for ROM)
73
Q

Describe the plumb line through the body in the sagittal plane

A
  • Through the external meatus of the ear, acromion process & the hip joint
  • Posterior to patella
  • Anterior to the lateral malleolus
74
Q

In perfect static posture which muscle is most active

A
  • Soleus
  • Maintains the body’s balance
75
Q

Define arthrokinematics versus osteokinematics

A
  • Arthro: movements that occur from one joint surface to another
  • Osteo: movements that occur between 2 bones
76
Q

What percentage of gait does stance and swing phase make up

A
  • Stance phase: 60%
  • Swing phase: 40%
77
Q

When are the abdominals and trunk muscles active during gait

A
  • Abdominals are active throughout
  • Trunk extensors & rotators active during foot flat
  • Ipsilateral erector spinae are active during toe off as the contralateral limb is loaded
78
Q

Define isometric exercise

A
  • A static contraction at a particular point in the ROM
  • Precaution: Valsalva’s maneuver should be avoided; in pts with vascular/cardiac disease & concerns of causing sharp increase in BP
79
Q

Define isotonic exercise

A
  • Exercise occurs throughout the ROM with the same resistance & variable speed of movement
  • Precautions: Increased force and subsequent muscle soreness may occur with eccentric contractions
80
Q

Define isokinetic exercise

A
  • Occurs at a constant, preset speed in which the resistance is variable & accommodates as the force of contraction varies throughout the ROM
81
Q

Define aerobic exercise

A
  • Exercise that promotes circulation & efficient use of oxygen in the vascular & cardiopulmonary systems
  • Performed at target HR for at least 20 min & involving large muscles groups in rhythmical movements
82
Q

Training effects of aerobic exercise

A
  • Cardiac: decreased resting/submaximal HR, BP at rest; increased cardiac output & stroke volume during sub maximal exercise
  • Pulmonary: Increased tidal volume, oxygen extraction from the blood; decreased ventilation
83
Q

What temperature should a pool be for intense training versus rehabilitation

A
  • Intense training: 27-28ºC (81-83ºF)
  • Rehabilitation: 33-34ºC (91-93ºF)
84
Q

Cardiopulmonary responses to water immersion

A
  • SV & CO increase while HR stays the same or slightly decreases
  • Hydrostatic pressure on chest can decrease IRV & may reduce FVC
  • Target HR should be established in the pool due to lower HR during deep-water exercise compared to land-based exercise
85
Q

Cardiac changes with aging

A
  • Sedentary individuals have 2x the rate of VO2 max decline
  • Age predicted max HR decreases
  • CO may decline unless there in an increase in SV
86
Q

Muscular changes with aging

A
  • > 65 muscle strength decreases from 24% to 45%
  • Muscle mass reduces
  • Fiber size decreases
87
Q

Neurological changes with aging

A
  • Nerve conduction velocity declines 10%
  • # of spinal cord axons declines & reduces reaction time
88
Q

Pulmonary changes with aging

A
  • Static & dynamic pulmonary functions decline with age
89
Q

Skeletal changes with aging

A
  • > 60 bone mass may reduce by 30-50% which could result in osteoporosis

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