MSK Flashcards
1
Q
Capsular Pattern of GH joint
A
ER> ABD> IR
2
Q
Thoracic and Lumbar spine capsular pattern
A
Limitation of side bending and rotation
3
Q
Hip capsular pattern
A
Limited in FLEX/IR, >ABD, no limitation in ER and Adduction
4
Q
Soft end feel =
A
Soft tissue approximation
5
Q
Firm end-feel
A
Capsular and ligamentous stretching
6
Q
Hard end-feel
A
Bone and/or cartilage meet
7
Q
When is an end-feel pathological
A
Boggy, firm too early, hard too early or firm too late, rubbery
8
Q
Empty end-feel
A
Loose and then very hard , associated with muscle guarding or patient avoiding painful part of range
9
Q
Boggy end feel
A
Edema/swelling
10
Q
Arthrokinematic of SC joint
A
Superior inferior= convex
A/P: concave
11
Q
Scapular elevation mm
A
Levator scapula, rhomboids
12
Q
Scapular downward rotators
A
Pectoralis minor, levator scapula, rhomboids
13
Q
Scapular upward rotators
A
Serratus anterior, upper trapezius,
14
Q
Rhomboids action
A
Scapular adduction, elevation and downward rotation
15
Q
Anterior interosseous nerve innervates what muscles
A
FPL, pronator teres, pronator quadratus
16
Q
Normal hip angle of inclination
A
115-125
17
Q
Normal torsion of the femoral head
A
10-15 degrees
18
Q
Antetorsion of the femoral head=
A
> 25-30 degrees
19
Q
Retrotorsion of the femoral head =
A
<10 degrees
20
Q
Where is the femur the weakest
A
Neck of the femur
21
Q
L2 myotome
A
Hip flexion
22
Q
L3 Myotome
A
Knee extension
23
Q
L4 reflex
A
Patellar reflex for knee extension
24
Q
L4 myotome
A
Ankle dorsiflexion
25
L5 myotome
Great-toe extension
26
S1 myotome
Eversion
27
S1 reflex
Achilles reflex
28
L5 reflex
Hip extension and knee flexion: semitendinosis
29
Medial plantar nerve innervation
Flexor digitorum brevis, flexor hallucinations brevis
30
Lateral plantar nerve
Toe adduction and abduction (DABs and PADS)
31
S3-S4 innervation
Pelvic floor
32
When are both bands of the iliofemoral ligament taut
In extension and ER of the hip
33
When may pain be felt with a deep trochanteric bursae
Flexion and internal rotation because gluteus Maximus is being compressed
34
function of the transverse humeral ligament
acts as a retinaculum for long biceps tendon
35
what is the function of the extensor expansion hood
helps the DIP and PIP joints extend with it's connection to extensor digitorum profundus
36
what is the function of the volar plates
gives the joint a larger articular surface during extension and to protect the volar side
37
normal angle of inclination
115-125
38
coxa valga=
>125
39
coxa vara
<115
40
normal anterior antetorsion angle
10-15 degrees
41
retrotorsion
<10 degrees
42
antetorsion=
>25-30 degrees
43
thickest part of hip labrum
superior
44
weakest part of the femur
femoral neck, decreased trabeculae
45
what fills/bridges the acetabular notch
labrum
46
L4 reflex
knee extension
47
L5 reflex
hip extension, knee flexion
48
S1 reflex
achilles `
49
L1-L3 anterior rami innervate
psoas major
50
femoral nerve L2-L3 innervate
sartorius
51
femoral nerve, L2-L4 innervates
quadriceps femoris
52
L2-L3 obturator nerve innervates
adductor magnus, brevis and longus
53
L2-L3 obturator nerve innervates
pectineus
54
L4-S1, superior gluteal innervates
glut minimus and medius and TFL
55
Function of the hip labrum`
deepen the acetabulum
56
when is the iliofemoral ligament taut
both bands taut in extension and ER, superior band taut with adduction, inferior band taut with abduction
57
when is the pubofemoral ligament taut
extension, ER and abduction
58
when is the ischiofemoral ligament taut
extension, medial rotation, abduction
59
L5-S1 nerve to obturator internus innervates
obturator internus
60
L5-S1
obturator internus nerve and nerve to piriformis
61
L5-S2 inferior gluteal nerve innervates
gluteus maximus
62
L5-S1 sacral plexus innervation
gemelli, quadratus femoris
63
L5-S2 tibial, common fibular nerve (sciatic) innervates
biceps femoris
64
Tibial nerve L5-S2 innervates
semitendinosis and simimembranosus
65
deep fibular nerve (L4-L5) innervates
tibialis anterior, extensor digitorum longus, extensor hallucis longus
66
superficial fibular nerve (L5-S2) innervates
fibularis longus and brevis
67
Tibial neve (L4-S1) innervates
popliteus and tibialis posterior
68
Tibial nerve L5-S2 innervates
flexor digitorum longus, flexor hallucis longus
69
tibial nerve S1-S2
gastrocnemius and soleus
70
S2-S3 medial plantar nerve innervates
flexor digitorum brevis, flexor hallicus brevis
71
S2-S3 lateral plantar nerve innervates
dorsal and plantar interossei
72
S3-S4 sacral plexus innervates
perineals and sphincters
73
what is the zona orbicularis
circular pattern around the femoral neck, no muscle attachments here but helps hold the femoral head in acetabulum
74
a deep trochanteric bursitis may cause pain during what motion
hip flexion and internal rotation (compression of glute max)
75
ischifemoral bursae may cause what type of pain
pain in the sciatic distribution
76
what artery supplies femoral head
small branch off obturator artery
77
acetabulum is supplied by what blood supply
superior and inferior gluteal arteries
78
function of knee MCL
prevents ER and provides stability against valgus (same direction of ACL)
79
function of the knee LCL
prevents external rotation of the tibia and provides stability against varus forces
80
total length of rehab for a sports hernia
8-12 weeks
81
positive camelback sign seen with
patella alta
82
patella baja results in restricted knee ____
extension
83
percentage of stress fractures in lower limb
49% tibia, 10% fibula
84
what tests should be used on examination for ligamentous ankle sprains
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
tarsal tunnel syndrome is entrapment of
posterior tibial nerve
86
symptoms are tarsal tunnel syndrome
pain, numbness and paresthesias along medial ankle to the plantar surface of foot
87
what tendonopathy is seen with ballet performers commonly
flexor hallucis tendonopathy
88
what is metatarsalgia
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
risk factors for plantar fasciitis
limited ankle dorsiflexion and high BMI , running or work-related activities in weight bearing with decreaed/poor shock absorption
90
charcot-marie tooth diseas
peroneal muscular atrophy affecting motor and sensory nerves, initially affects LE muscles but progresses to muscles of hand and forearm
it is inherited
91
which type of disc bulge might cause spinal cord compression
central posterior bulge/herniation
92
why is anterior disc bulge rare
anterior intervertebral disc is thick
93
loose packed of tibiofemoral joint
25 degrees of flexion
94
tests for hip dysplasia
ortolani, barlow, limited hip abduction, galeazzi, klisic
95
use of the pavlik harness has increased success if used for how long?
birth to 6 months
96
risk factors for hip dysplasia
female, breech position, family history of dysplasia, low levels of amniotic fluid, swaddling too tight
97
age of onset for transient synovitis in children
3-10
98
signs and symptoms of transient synovitis in children
unilateral hip or groin pain, crying at night, antalgic limp, recent history of upper respiratory tract infection
99
onset of legg-calve-perthes
2-13 years
100
what muscle is weak in legg-calve-perthes
iliopsoas/psoas major
101
signs and symptoms of legg-calve-perthes
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
slipped capital femoral epiphysis onset age
10-17 years (average 13 in male)
8-15 (average 11 in female)
103
at what age do you develop your foot arches
2-3 years old
104
treatment of sever's disease
temporary cessation of running and jumping, give heel lifts and heel cups, stretching and strengthening
105
what is the most common cause of heel pain in GROWING children
sever's disease
106
treatment for slipped capital femoral epiphysis
surgical internal fixation to prevent AVN
107
age of onset for benign nocturnal pains of childhood
3-5, 8-11
108
signs and symptoms of benign nocturnal pains of childhood
pain at night, typically bilateral leg pain, no redness, temperature swelling or tenderness
109
onset of osteochondritis dissecans
12-15
110
What is panner's disease
AVN of capitellum, children around 10 years old or younger
111
what is a nonstructural scoliotic curve
reversible lateral curvature of spine, no rotational component and straightens with spinal flexion
112
degree's of scoliosis for conservative management
less than 25 percent
113
degree's of scoliosis for bracing
25-45 degrees
114
degree's of scoliosis for surgical management
greater than 45 degrees
115
at what age would you splint a patient with congenital muscle torticollis
at 4 months old
116
treatment for plagiocephaly
repositioning techniques, parent education and use of helmet
117
what condition is characterized by nonprogressive contractures and sausage like appearance of the limbs
arthrogryposis multiple congenita
118
pathophysiology of osteogenesis imperfecta
abnormal collagen synthesis leading to imbalance between bone deposition and reabsoprtion, causing multiple bone fractures (cortical and cancellous bones)
119
medications for osteogenesis imperfecta
vitamin D, estrogen, calcium, biphosphonates
120
121
what type of therapy is great for children with OI
aquatic therapy
122
spondylolysis is fracture of what
pars interarticularis
123
clinical test for spondylolithesis
stork test
124
treatment for spondylolithesis
abdominal/spinal stabilization, NO MANIPULATION, avoid extension or stressful positions
125
post-op PCL reconstruction
immobilized in full extension for 6 weeks
126
post op lateral ankle ligament reconstruction
4-6 weeks in cast or rigid walking boot
127
finger flexor tendon post op
immobilized for 3-4 weeks, can do active extension and passive flexion within the splint, AROM starts within 4 weeks
128
distal tendon repairs typically immobilized for ____ weeks with active ___ occurring before ____
6-8 weeks, extension before flexion
129
wrist surgery post op
immobilized in wrist and digitial joints in extension for 4 weeks
130
full AROM in proximal (UE) repairs can occur at ___ weeks
6
131
immobilization following rotator cuff repair
4-6 weeks, with no WB through shoulder or AROM
132
position to avoid with knee meniscus repair
weight bearing with flexion
133
position to avoid with shoulder aterior-inferior labral repair
external rotation
134
position to avoid with hip labrum procedure
passive unilateral hip extension, excessive hip flexion, abduction and external rotation
135
following procedure for scoliosis (harrington rod) when do you start ambulating
between 4th and 7th days post-op
136
what are three tests for malingering
Hoover, burns and waddell signs
137
MCID for ODI
6
138
MCID for NDI
10
139
which foot and ankle outcome measure has a sport subscale? what other subscale is also included?
FAAM, foot and ankle ability measure, also has ADL subscale
140
MCID for LEFS
9
141
WOMAC MCID for improvement
6.7%
142
WOMAC MCID for worsening
12.9%
143
which outcome measure for low back pain has psychosocial and disability questions
the subgroups for targeted treatment STarT
144
outcome measure for the hand
michigan hand outcomes questionnaire
145
outcome measure for TMJ
mandibular function impairment questionnaire
146
what is a maisonneuve fracture
Maisonneuve fracture refers to a combination of a fracture of the proximal fibula together with an unstable ankle injury
147
LPP of the elbow (HU)
70 degrees of elbow flexion, 10 degrees of supination
148
CPP of the HU
Full extension with full supination
149
Resting position of the HR joint
Full extension and full supination
150
CPP of the HR joint
Elbow flexed to 90 degrees with forearm supinated to 5 degrees
151
Capsular pattern of humeroradial joint
Flexion>extension>supination>pronation
152
What structures protect the elbow from rotary stability
Extensor muscles, annular ligament, radial collateral ligament and the accessory lateral collateral ligament and the lateral ulnar collateral ligament
153
LPP of prox radial ulnar ligament
35 supination, 70 elbow flexion
154
CPP of the proximal RU joint
5 degrees of supination
155
Age of tennis elbow (lateral epicondylitis), patient presentation
35 years or older, those with great deal of wrist flexion and extension in occupations
156
Case: patient is a 5 year old who presents with lateral elbow pain and lacks supination. What might be wrong?
Dislocation of the radial head
157
Typical age of osteochondritis dissecans
15-20 y/o
158
A foosh typically leads to what type of forces at the elbow joint
Lateral compressive force and medial traction force
159
Cubital valgus degrees
>15
160
Cubital varus degrees
5-10 degrees
161
What is gunstock deformity
Cubital varus of -15 degrees
162
A patient with olecranon bursitis may present to the clinic with
Flexion of elbow at 70 degrees of flexion (10 degrees of supination) as it is the resting position
163
What should you test with suspected lateral epicondylitis
Length of the long wrist extensors
164
What should you test with expected medial epicondylitis
Length of the long wrist flexors
165
What muscles does the posterior interosseous nerve innervate
Extensor Digitorum, Extensor digiti minimi, abductor policis longus, extensor pollicis brevis and longus, extensor indicus, extensor carpi ulnar is
166
_____ ligament provides restraint to inferior translation and external rotation of humeral head
Coracohumeral ligament
167
_______ ligament is a static restraint to excessive anterior translation of the humeral head
Superior/middle/inferior glenohumeral
168
_______ ligament provides superior stability to the AC joint
Acriomioclavicular joint
169
Suprascapular nerve can get impinged by what…
Superior transverse scapular ligament
170
Normal carrying angle in women
20-25q
171
Normal carrying angle in men
10-15
172
Function of the oblique cord (elbow)
Resist distal displacement of the radius during pulling movements
173
What structure stabilizes the elbow during pushing movements
Interosseous membrane
174
Secondary muscles of elbow flexion
Flexor carpi ulnaris and pronator teres
175
What muscle may assist with forearm pronation
Flexor carpi radialis
176
Injured with Volkmann’s fracture
Brachial artery
177
Most important muscle for grasp:
Extensor carpi radialis brevis
178
Muscles that provide dynamic wrist stability
Extensor carpi ulnaris, extensor pollicis brevis, abductor pollicis longus
179
Effect of wrist/hand function with peripheral nerve injury
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
Ischiofemoral ligament resists
Extension and internal rotation
181
Iliofemoral ligament resists
Extension and some adduction/abduction
182
Main restriction of the pubofemoral ligament
Abduction
183
What ligaments support the calcaneocuboid and talonavicular joints
Deltoid, dorsal talonavicular, calcaneonavicular and calcaneocuboid ligaments
184
Role of fibularis longus in closed chain
Support transverse and longitudinal arches and stabilize the first metatarsal during push off
185
Role of the fibularis brevis in closed chain
Stabilize the mid tarsal joints
186
Role of the posterior tibialis during closed chain
Help of flexor digitorum longus and flexor hallucinogen longus to control forward motion of tibia on the ankle during midstance
