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NPTE > MSK > Flashcards

MSK Flashcards

1
Q

Capsular Pattern of GH joint

A

ER> ABD> IR

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2
Q

Thoracic and Lumbar spine capsular pattern

A

Limitation of side bending and rotation

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3
Q

Hip capsular pattern

A

Limited in FLEX/IR, >ABD, no limitation in ER and Adduction

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4
Q

Soft end feel =

A

Soft tissue approximation

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5
Q

Firm end-feel

A

Capsular and ligamentous stretching

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6
Q

Hard end-feel

A

Bone and/or cartilage meet

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7
Q

When is an end-feel pathological

A

Boggy, firm too early, hard too early or firm too late, rubbery

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8
Q

Empty end-feel

A

Loose and then very hard , associated with muscle guarding or patient avoiding painful part of range

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9
Q

Boggy end feel

A

Edema/swelling

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10
Q

Arthrokinematic of SC joint

A

Superior inferior= convex
A/P: concave

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11
Q

Scapular elevation mm

A

Levator scapula, rhomboids

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12
Q

Scapular downward rotators

A

Pectoralis minor, levator scapula, rhomboids

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13
Q

Scapular upward rotators

A

Serratus anterior, upper trapezius,

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14
Q

Rhomboids action

A

Scapular adduction, elevation and downward rotation

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15
Q

Anterior interosseous nerve innervates what muscles

A

FPL, pronator teres, pronator quadratus

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16
Q

Normal hip angle of inclination

A

115-125

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17
Q

Normal torsion of the femoral head

A

10-15 degrees

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18
Q

Antetorsion of the femoral head=

A

> 25-30 degrees

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19
Q

Retrotorsion of the femoral head =

A

<10 degrees

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20
Q

Where is the femur the weakest

A

Neck of the femur

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21
Q

L2 myotome

A

Hip flexion

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22
Q

L3 Myotome

A

Knee extension

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23
Q

L4 reflex

A

Patellar reflex for knee extension

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24
Q

L4 myotome

A

Ankle dorsiflexion

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25
Q

L5 myotome

A

Great-toe extension

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26
Q

S1 myotome

A

Eversion

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27
Q

S1 reflex

A

Achilles reflex

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28
Q

L5 reflex

A

Hip extension and knee flexion: semitendinosis

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29
Q

Medial plantar nerve innervation

A

Flexor digitorum brevis, flexor hallucinations brevis

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30
Q

Lateral plantar nerve

A

Toe adduction and abduction (DABs and PADS)

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31
Q

S3-S4 innervation

A

Pelvic floor

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32
Q

When are both bands of the iliofemoral ligament taut

A

In extension and ER of the hip

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33
Q

When may pain be felt with a deep trochanteric bursae

A

Flexion and internal rotation because gluteus Maximus is being compressed

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34
Q

function of the transverse humeral ligament

A

acts as a retinaculum for long biceps tendon

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35
Q

what is the function of the extensor expansion hood

A

helps the DIP and PIP joints extend with it’s connection to extensor digitorum profundus

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36
Q

what is the function of the volar plates

A

gives the joint a larger articular surface during extension and to protect the volar side

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37
Q

normal angle of inclination

A

115-125

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38
Q

coxa valga=

A

> 125

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39
Q

coxa vara

A

<115

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40
Q

normal anterior antetorsion angle

A

10-15 degrees

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41
Q

retrotorsion

A

<10 degrees

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42
Q

antetorsion=

A

> 25-30 degrees

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43
Q

thickest part of hip labrum

A

superior

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44
Q

weakest part of the femur

A

femoral neck, decreased trabeculae

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45
Q

what fills/bridges the acetabular notch

A

labrum

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46
Q

L4 reflex

A

knee extension

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47
Q

L5 reflex

A

hip extension, knee flexion

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48
Q

S1 reflex

A

achilles `

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49
Q

L1-L3 anterior rami innervate

A

psoas major

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50
Q

femoral nerve L2-L3 innervate

A

sartorius

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51
Q

femoral nerve, L2-L4 innervates

A

quadriceps femoris

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52
Q

L2-L3 obturator nerve innervates

A

adductor magnus, brevis and longus

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53
Q

L2-L3 obturator nerve innervates

A

pectineus

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54
Q

L4-S1, superior gluteal innervates

A

glut minimus and medius and TFL

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55
Q

Function of the hip labrum`

A

deepen the acetabulum

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56
Q

when is the iliofemoral ligament taut

A

both bands taut in extension and ER, superior band taut with adduction, inferior band taut with abduction

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57
Q

when is the pubofemoral ligament taut

A

extension, ER and abduction

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58
Q

when is the ischiofemoral ligament taut

A

extension, medial rotation, abduction

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59
Q

L5-S1 nerve to obturator internus innervates

A

obturator internus

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60
Q

L5-S1

A

obturator internus nerve and nerve to piriformis

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61
Q

L5-S2 inferior gluteal nerve innervates

A

gluteus maximus

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62
Q

L5-S1 sacral plexus innervation

A

gemelli, quadratus femoris

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63
Q

L5-S2 tibial, common fibular nerve (sciatic) innervates

A

biceps femoris

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64
Q

Tibial nerve L5-S2 innervates

A

semitendinosis and simimembranosus

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65
Q

deep fibular nerve (L4-L5) innervates

A

tibialis anterior, extensor digitorum longus, extensor hallucis longus

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66
Q

superficial fibular nerve (L5-S2) innervates

A

fibularis longus and brevis

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67
Q

Tibial neve (L4-S1) innervates

A

popliteus and tibialis posterior

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68
Q

Tibial nerve L5-S2 innervates

A

flexor digitorum longus, flexor hallucis longus

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69
Q

tibial nerve S1-S2

A

gastrocnemius and soleus

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70
Q

S2-S3 medial plantar nerve innervates

A

flexor digitorum brevis, flexor hallicus brevis

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71
Q

S2-S3 lateral plantar nerve innervates

A

dorsal and plantar interossei

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72
Q

S3-S4 sacral plexus innervates

A

perineals and sphincters

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73
Q

what is the zona orbicularis

A

circular pattern around the femoral neck, no muscle attachments here but helps hold the femoral head in acetabulum

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74
Q

a deep trochanteric bursitis may cause pain during what motion

A

hip flexion and internal rotation (compression of glute max)

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75
Q

ischifemoral bursae may cause what type of pain

A

pain in the sciatic distribution

76
Q

what artery supplies femoral head

A

small branch off obturator artery

77
Q

acetabulum is supplied by what blood supply

A

superior and inferior gluteal arteries

78
Q

function of knee MCL

A

prevents ER and provides stability against valgus (same direction of ACL)

79
Q

function of the knee LCL

A

prevents external rotation of the tibia and provides stability against varus forces

80
Q

total length of rehab for a sports hernia

A

8-12 weeks

81
Q

positive camelback sign seen with

A

patella alta

82
Q

patella baja results in restricted knee ____

A

extension

83
Q

percentage of stress fractures in lower limb

A

49% tibia, 10% fibula

84
Q

what tests should be used on examination for ligamentous ankle sprains

A

Star excursion balance test, objective measures of ROM, ankle swelling, talar translation and inversion, single-leg balance, weight-bearing lunge test, static single leg balance on firm surface with eyes closed

85
Q

tarsal tunnel syndrome is entrapment of

A

posterior tibial nerve

86
Q

symptoms are tarsal tunnel syndrome

A

pain, numbness and paresthesias along medial ankle to the plantar surface of foot

87
Q

what tendonopathy is seen with ballet performers commonly

A

flexor hallucis tendonopathy

88
Q

what is metatarsalgia

A

pain at first and second metatarsal heads after long periods of weight bearing, changes to transverse arch (possible neural or vascular changes) might be tight triceps surae or achilles tendon, short first ray or pronation of forefoot

89
Q

risk factors for plantar fasciitis

A

limited ankle dorsiflexion and high BMI , running or work-related activities in weight bearing with decreaed/poor shock absorption

90
Q

charcot-marie tooth diseas

A

peroneal muscular atrophy affecting motor and sensory nerves, initially affects LE muscles but progresses to muscles of hand and forearm
it is inherited

91
Q

which type of disc bulge might cause spinal cord compression

A

central posterior bulge/herniation

92
Q

why is anterior disc bulge rare

A

anterior intervertebral disc is thick

93
Q

loose packed of tibiofemoral joint

A

25 degrees of flexion

94
Q

tests for hip dysplasia

A

ortolani, barlow, limited hip abduction, galeazzi, klisic

95
Q

use of the pavlik harness has increased success if used for how long?

A

birth to 6 months

96
Q

risk factors for hip dysplasia

A

female, breech position, family history of dysplasia, low levels of amniotic fluid, swaddling too tight

97
Q

age of onset for transient synovitis in children

A

3-10

98
Q

signs and symptoms of transient synovitis in children

A

unilateral hip or groin pain, crying at night, antalgic limp, recent history of upper respiratory tract infection

99
Q

onset of legg-calve-perthes

A

2-13 years

100
Q

what muscle is weak in legg-calve-perthes

A

iliopsoas/psoas major

101
Q

signs and symptoms of legg-calve-perthes

A

AROM limited in abduction and extension (collapse of subchondral bone at femoral neck/head), graduat onset of aching pain at hip/thigh and knee, males greater than female, gait in ER, flex and adduction

102
Q

slipped capital femoral epiphysis onset age

A

10-17 years (average 13 in male)
8-15 (average 11 in female)

103
Q

at what age do you develop your foot arches

A

2-3 years old

104
Q

treatment of sever’s disease

A

temporary cessation of running and jumping, give heel lifts and heel cups, stretching and strengthening

105
Q

what is the most common cause of heel pain in GROWING children

A

sever’s disease

106
Q

treatment for slipped capital femoral epiphysis

A

surgical internal fixation to prevent AVN

107
Q

age of onset for benign nocturnal pains of childhood

A

3-5, 8-11

108
Q

signs and symptoms of benign nocturnal pains of childhood

A

pain at night, typically bilateral leg pain, no redness, temperature swelling or tenderness

109
Q

onset of osteochondritis dissecans

A

12-15

110
Q

What is panner’s disease

A

AVN of capitellum, children around 10 years old or younger

111
Q

what is a nonstructural scoliotic curve

A

reversible lateral curvature of spine, no rotational component and straightens with spinal flexion

112
Q

degree’s of scoliosis for conservative management

A

less than 25 percent

113
Q

degree’s of scoliosis for bracing

A

25-45 degrees

114
Q

degree’s of scoliosis for surgical management

A

greater than 45 degrees

115
Q

at what age would you splint a patient with congenital muscle torticollis

A

at 4 months old

116
Q

treatment for plagiocephaly

A

repositioning techniques, parent education and use of helmet

117
Q

what condition is characterized by nonprogressive contractures and sausage like appearance of the limbs

A

arthrogryposis multiple congenita

118
Q

pathophysiology of osteogenesis imperfecta

A

abnormal collagen synthesis leading to imbalance between bone deposition and reabsoprtion, causing multiple bone fractures (cortical and cancellous bones)

119
Q

medications for osteogenesis imperfecta

A

vitamin D, estrogen, calcium, biphosphonates

120
Q
A
121
Q

what type of therapy is great for children with OI

A

aquatic therapy

122
Q

spondylolysis is fracture of what

A

pars interarticularis

123
Q

clinical test for spondylolithesis

A

stork test

124
Q

treatment for spondylolithesis

A

abdominal/spinal stabilization, NO MANIPULATION, avoid extension or stressful positions

125
Q

post-op PCL reconstruction

A

immobilized in full extension for 6 weeks

126
Q

post op lateral ankle ligament reconstruction

A

4-6 weeks in cast or rigid walking boot

127
Q

finger flexor tendon post op

A

immobilized for 3-4 weeks, can do active extension and passive flexion within the splint, AROM starts within 4 weeks

128
Q

distal tendon repairs typically immobilized for ____ weeks with active ___ occurring before ____

A

6-8 weeks, extension before flexion

129
Q

wrist surgery post op

A

immobilized in wrist and digitial joints in extension for 4 weeks

130
Q

full AROM in proximal (UE) repairs can occur at ___ weeks

A

6

131
Q

immobilization following rotator cuff repair

A

4-6 weeks, with no WB through shoulder or AROM

132
Q

position to avoid with knee meniscus repair

A

weight bearing with flexion

133
Q

position to avoid with shoulder aterior-inferior labral repair

A

external rotation

134
Q

position to avoid with hip labrum procedure

A

passive unilateral hip extension, excessive hip flexion, abduction and external rotation

135
Q

following procedure for scoliosis (harrington rod) when do you start ambulating

A

between 4th and 7th days post-op

136
Q

what are three tests for malingering

A

Hoover, burns and waddell signs

137
Q

MCID for ODI

A

6

138
Q

MCID for NDI

A

10

139
Q

which foot and ankle outcome measure has a sport subscale? what other subscale is also included?

A

FAAM, foot and ankle ability measure, also has ADL subscale

140
Q

MCID for LEFS

A

9

141
Q

WOMAC MCID for improvement

A

6.7%

142
Q

WOMAC MCID for worsening

A

12.9%

143
Q

which outcome measure for low back pain has psychosocial and disability questions

A

the subgroups for targeted treatment STarT

144
Q

outcome measure for the hand

A

michigan hand outcomes questionnaire

145
Q

outcome measure for TMJ

A

mandibular function impairment questionnaire

146
Q

what is a maisonneuve fracture

A

Maisonneuve fracture refers to a combination of a fracture of the proximal fibula together with an unstable ankle injury

147
Q

LPP of the elbow (HU)

A

70 degrees of elbow flexion, 10 degrees of supination

148
Q

CPP of the HU

A

Full extension with full supination

149
Q

Resting position of the HR joint

A

Full extension and full supination

150
Q

CPP of the HR joint

A

Elbow flexed to 90 degrees with forearm supinated to 5 degrees

151
Q

Capsular pattern of humeroradial joint

A

Flexion>extension>supination>pronation

152
Q

What structures protect the elbow from rotary stability

A

Extensor muscles, annular ligament, radial collateral ligament and the accessory lateral collateral ligament and the lateral ulnar collateral ligament

153
Q

LPP of prox radial ulnar ligament

A

35 supination, 70 elbow flexion

154
Q

CPP of the proximal RU joint

A

5 degrees of supination

155
Q

Age of tennis elbow (lateral epicondylitis), patient presentation

A

35 years or older, those with great deal of wrist flexion and extension in occupations

156
Q

Case: patient is a 5 year old who presents with lateral elbow pain and lacks supination. What might be wrong?

A

Dislocation of the radial head

157
Q

Typical age of osteochondritis dissecans

A

15-20 y/o

158
Q

A foosh typically leads to what type of forces at the elbow joint

A

Lateral compressive force and medial traction force

159
Q

Cubital valgus degrees

A

> 15

160
Q

Cubital varus degrees

A

5-10 degrees

161
Q

What is gunstock deformity

A

Cubital varus of -15 degrees

162
Q

A patient with olecranon bursitis may present to the clinic with

A

Flexion of elbow at 70 degrees of flexion (10 degrees of supination) as it is the resting position

163
Q

What should you test with suspected lateral epicondylitis

A

Length of the long wrist extensors

164
Q

What should you test with expected medial epicondylitis

A

Length of the long wrist flexors

165
Q

What muscles does the posterior interosseous nerve innervate

A

Extensor Digitorum, Extensor digiti minimi, abductor policis longus, extensor pollicis brevis and longus, extensor indicus, extensor carpi ulnar is

166
Q

_____ ligament provides restraint to inferior translation and external rotation of humeral head

A

Coracohumeral ligament

167
Q

_______ ligament is a static restraint to excessive anterior translation of the humeral head

A

Superior/middle/inferior glenohumeral

168
Q

_______ ligament provides superior stability to the AC joint

A

Acriomioclavicular joint

169
Q

Suprascapular nerve can get impinged by what…

A

Superior transverse scapular ligament

170
Q

Normal carrying angle in women

A

20-25q

171
Q

Normal carrying angle in men

A

10-15

172
Q

Function of the oblique cord (elbow)

A

Resist distal displacement of the radius during pulling movements

173
Q

What structure stabilizes the elbow during pushing movements

A

Interosseous membrane

174
Q

Secondary muscles of elbow flexion

A

Flexor carpi ulnaris and pronator teres

175
Q

What muscle may assist with forearm pronation

A

Flexor carpi radialis

176
Q

Injured with Volkmann’s fracture

A

Brachial artery

177
Q

Most important muscle for grasp:

A

Extensor carpi radialis brevis

178
Q

Muscles that provide dynamic wrist stability

A

Extensor carpi ulnaris, extensor pollicis brevis, abductor pollicis longus

179
Q

Effect of wrist/hand function with peripheral nerve injury

A

Radial nerve=decreased ability to maintain functional wrist position (extension) and to release grip
Median nerve= decreased flexion of digits and radial side of the hand/precision grip is dysfunctional
Ulnar nerve= affects flexion of ulnar side digits and power grip

180
Q

Ischiofemoral ligament resists

A

Extension and internal rotation

181
Q

Iliofemoral ligament resists

A

Extension and some adduction/abduction

182
Q

Main restriction of the pubofemoral ligament

A

Abduction

183
Q

What ligaments support the calcaneocuboid and talonavicular joints

A

Deltoid, dorsal talonavicular, calcaneonavicular and calcaneocuboid ligaments

184
Q

Role of fibularis longus in closed chain

A

Support transverse and longitudinal arches and stabilize the first metatarsal during push off

185
Q

Role of the fibularis brevis in closed chain

A

Stabilize the mid tarsal joints

186
Q

Role of the posterior tibialis during closed chain

A

Help of flexor digitorum longus and flexor hallucinogen longus to control forward motion of tibia on the ankle during midstance

NPTE (7 decks)

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