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PT Examination > MMT notes > Flashcards

MMT notes Flashcards

1
Q

What type of strength does MMT cover?

A

Isometric

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2
Q

What strength scale does MMT cover (1-5)

A

Anything below 4

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3
Q

Is MMT viable for strength scales 4 and above?

A

No.

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4
Q

What is better used for scales of 4 and 5?

A

Submax rep, handheld dynamometer

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5
Q

MMT helps the Physical Therapist in..

A

-Diagnosis and prognosis by determing level of lesion

Planning treatment programs

Evaluating progress or regression

Basic starting point for developing an exercise test

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6
Q

Is gravity eliminated?

A

Never ; just lessened

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7
Q

Palpation is always done when

A

to confirm muscle activation even if there is no movement observed

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8
Q

Where is the resistance applied too?

A

Perpendicular to distal end of segment being tested

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9
Q

Make vs break test

A

Make: patient exerts max force through ROM

Break: Patient holds position against max resistance until limb starts to move

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10
Q

Common break test saying?

A

Don’t let me move your arm/leg

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11
Q

Which part of the muscle should be stabilized?

A

Proximal, or origin

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12
Q

What is substitution?

A

When muscle synergists try and compensate for agonist movement

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13
Q

Procedure for MMT:

A

1) Explain purpose of the procedure
2) Place patient in gravity resisted position
3) Stabilize proximal joint segment
4) Instruct patient in what movement will be performed

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14
Q

Which hand is used to apply pressure?

A

Hand used to palpate muscle in ONE MOTION

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15
Q

Ask patient to hold for how long?

A

Hold 4-5 seconds, then relax

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16
Q

If patient cannot complete full ROM against gravity?

A

Move to gravity lessened position

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17
Q

0

A

No movement, no contraction of muscle

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18
Q

1

A

Trace; contraction of muscle but no movement

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19
Q

2-

A

Movement through partial ROM in grav-lessened position

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20
Q

2

A

Movement through full ROM in grav-lessened position

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21
Q

2+

A

Movement through full ROM in grav-lessened position and up to 1/2 grav resisted

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22
Q

3-

A

Movement through full ROM in grav-lessened position and over 1/2 grav resisted

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23
Q

3+

A

Movement through full ROM in grav resisted and holds against minimal resist

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24
Q

4

A

Movement through full ROM in grav resisted with moderate resist applied

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25
Q

5

A

Movement through full ROM in grav resisted with max resist applied

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26
Q

Hip Flexors?

A

Iliopsoas and rectus femoris

27
Q

OIAN Rectus Femoris

A

O: AIIS
I: Patella through quadriceps tendon
A: Flexes hip, extends knee
N: Femoral Nerve L2-L4

28
Q

OAIN Iliopsoas

A

O: Transverse processes, vertebral bodies of L1-L5
I: Lesser trochanter of femur
A: Increase lumber lordosis, flexes hip

iliacus innervation: femoral nerve L2-L4
psoas major : Lumbar plexus L1-L4

29
Q

How to test the hip flexors? (iliopsoas and rectus femoris)

A

Patient at end of table. Raise knee to ceiling. One hand stabilizing lower back, other hand palpates the rectus femoris as it goes up, then push down at knee.

30
Q

OIAN Sartorius

A

O: ASIS
I: Superior part of medial tibia
A: Hip flexor, external rotation, hip abductor, knee flexor
N: Femoral Nerve L2-L4

31
Q

How to test sartorius?

A

Patient at end of bed. Bring knee up and slide the side of the inner foot against the opposite leg for me and hold.

Palpate with left hand and move hand to outside of knee. Other hand will press above ankle.

Pressure will go down, towards PT, and in.

32
Q

Hip internal rotators: 3

A

Gluteus Medius/Minimus/TFL

33
Q

OIAN of TFL

A

O:ASIS, iliac crest
I: iliotibial tract –> lateral condyle of tibia
A: Abducts, internally rotate, flexes hip, extends knee
N: Superior Gluteal L4-S1

34
Q

How to test TFL?

A

Patient lying sideline. Bottom leg under the patient is slightly flexed and slightly internally rotated.

Hand stabilizes pelvis @ iliac crest while other hand palpates. Then hand moves to above knee and presses.

35
Q

How to test all 3 internal rotators at once in sitting?

A

Patient sits, cloth under knee. Ask patient to move leg and swing it to the outside, while pelvis is stabilized. Palpated at TFL.

Hands on inside of knee and outside of ankle.

36
Q

OIAN of Glute Med

A

O: External surface of ilium between a/p glute lines
I: Lateral surface of greater trochanter
A: abduction of thigh. ANTERIOR FIBERS ROTATE IN. Lateral fibers rotate out.
N: Superior Glute l4-s1

37
Q

OIAN of glute min:

A

O: External surface of ilium between a/i glute lines
I: anterior surface greater torchanter
A: rotates thigh medially, steadies pelvis. abducts thigh
N: Superior Gluteal Nerve l4-s1

38
Q

Name hip external rotators

A 
Obturators
Gemeli
Quad Femoris
Piriformis
Glute med post fibers
Glute MAX
39
Q

How to test external rotators?

A

Sit on edge of bed. Palpate greater trochanter as patient slides foot inwards along opposite leg without raising knee.

Hand will be on inside of knee and outside of ankle.

40
Q

How to test hip abductors lying?

A

Patient lies down on side with bottom leg partially flexed.

Hand stabilizes pelvis. Leg is asked to raise in line with trunk.

41
Q

OIAN Glute Max

A

O: external surface of ilium, iliac creast, dorsal surface of sacrum and coccyx
I: iliotibial tract –> lateral tibial condyle
gluteal tuberosity on femur
A: Extends thigh, lateral rotation
N: Inferior gluteal nerve L5-s2

42
Q

Name adductors:

A

adductor longus,brevis,magnus, gracilis, pectineus

43
Q

How to test adductors side lying?

A

Patient lying on side with both knees straight. hold patients leg while it is limp. palpate bottom adductor on leg and ask to raise. press and hold above that knee.

44
Q

What are the hip extensors?

A

Glute Max and hamstrings

45
Q

How to test for general hip extensors

A

Prone, one hand on iliac crest. Other hand palpates the glutes and hamstrings. that hand will slide down above knee is the leg is straightened and raised.

46
Q

Gluteus maximus how to test?

A

Ask patient to bend knee to 90 degrees. hold down by iliac crest. ask them to kick and bring foot to touch ceiling. palpation hand of glute max slides down to above knee.

watch out for extension of lumbar spine

47
Q

OIAN of Semimembranosus

A

O: Ischial Tube
I: posterior part of medial tibial condyle
A: flexes leg, extends thigh, medially rotates
N: tibial part of sciatic nerve l5-s2

48
Q

OIAN Semitendinosus

A

O: Ischial tube
I: medial superior part of tibia
A: extends thigh, flexes leg, medially rotates
N: tibial sciatic l5-s2

49
Q

OIAN Biceps femoris

A 
O: Long head: ischial tube
Short head: lateral lip of linea aspera
I: Lateral side of head of fibula
A: flexes leg, extends thigh and lat rotates
N: Long head: tibial sciatic l5-s2
short head: common peroneal l5-s2
50
Q

How to test hamstrings?

A

Patient lying down.
Ask to bring hamstrings through full ROM THEN bring it to 90 degrees.

Place hand on pelvis to stabilize, palpate hamstrings then with other hand press away on achilles.

51
Q

Quadriceps testing?

A

Sit at edge of bed. cloth under knee. keep out of closed pack position before resistance is applied.
Hand on pelvis to stabilize. Hand on quads to palpate it. Then move and press against ankle.

52
Q

OIAN of quadriceps?

A

O: varying surfaces of linea aspera and surface of femur
I: base of patella via quad tendon
A: Extends leg
N: femoral nerve l2-l4

53
Q

Testing of the tibialis anterior?

A

Sitting position. Ask patient to bring foot IN and UP. Apply pressure down and out. hand below knee. palpate as well.

54
Q

What other muscles aid in dorsiflexion?

A

Extensor digitorum longus and extensor hallucis longus

55
Q

OIAN Tibialis anterior

A

O: lateral condyle of tibia
I: medial cuneiform and 1st metatarsal
A: dorsiflexes and inverts foot
N: L4-L5 deep peroneal/fibular

56
Q

Can test foot muscles sitting or long sitting?

A

Both.

57
Q

Extensor Hallucis Longus

A

Longsitting.

Get patient to raise toe up and put pressure against large toe.

58
Q

Flexor Digitorum Longus

A

Longsitting

Get patient to flex toe and go against resistance

59
Q

Extensor Digitorum Longus/Brevis

A

Longsitting.

Extend all toes. Place fingers on each of toes and pull against resistance.

60
Q

What is tested in the lateral compartment of the leg?

A

Peroneus Longus and Peroneus Brevis

61
Q

How to test peroneals?

A

Side lying with top leg tested. Feet off table.
Hand under leg to stabilize.

Plantarflex and evert. Longus is upper half. Brevis is lower half of fibular surface.

Place hand on foot and press up and in.

62
Q

How to test the tib posterior?

A

side lying. use bottom leg. leg affected will be leg you are lying on. have patient plantarflex and invert. down and in.

Hold under leg, and press down and evert

63
Q

OIAN tib poster?

A

O: posterior surface tibia and interossues membrane under soleal ine.
I: cuboid, tuberosity of navicular, all 3 cuneiform bones, 2nd,3rd,4th metatarsals.
A:Plantar flex and invert
N: tibial L4-L5

64
Q

How to test the gastroc/soleus?

A

Gastroc: make patient do one legged calf raises straight leg

soleus: make patient do one legged calf raises bent leg

4-5 reps is normal 5
2-3 reps is good
1 rep is fair

PT Examination (8 decks)

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