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MSK Flashcards

1
Q

How do you treat hypomobility?

A

joint and soft tissue mobilization

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2
Q

What is treated with stabilization movements?

A

Hypermobility and instability

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3
Q

OA movement occipital condyles on atlas what movements occur here

A

movement include nodding (forward and backward bending) and side bending

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4
Q

AA atlas on axis, what is the primary motion and how much of it occurs at the AA?

A

primary motion: rotation

50% of cervical

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5
Q

What are principle movements?

A

upslides and downslides at facet joint

translatory movements at lateral inter-body articulations

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6
Q

What is the degree orientation for the mid cervical spine?

A

45 degrees

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7
Q

What is the degree orientation for the mid thoracic spine?

A

60 degrees

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8
Q

With forward nodding what happens arthrokinematically?

A
  • occiput rolls foward on atlas, glides posteriorly
  • atlas translates foward on axis
  • axis translate foward and up on C3
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9
Q

With backward nodding what happens arthrokinematically?

A

Occiput rolls back on atlas and glides anteriorly

  • Atlas translates backward on axis
  • Axis translates back and down on C3
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10
Q

With side bending what happens arthrokinematically?

A

Primarily at OA

Example of SBR:
• Occiput rolls Right on atlas and glides Left

Atlas translates Right

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11
Q

With rotation what happens arthrokinematically?

A

Primarily at AA

• Example of rotation Right:

Occiput and atlas rotate to Right on axis

Atlas translates to the Left

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12
Q

Physiological motion

A

combines sidebend and rotation to the same side

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13
Q

Non-physiological motion

A

SB - head is forward

Rotation - head remains upright

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14
Q

What is mid-cervical facet capsular restriction on left facet?

A

look at the lack of upslide restrictions at right rotation, right side bend, and forward bend limited with possible left deivation

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15
Q

subcranial facet capsular pattern for forward nodding?

A

deviate away from restriction

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16
Q

subcranial facet capsular pattern for backward nodding?

A

deviate towards the restriction

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17
Q

In mid cervical vs upper cervical involvement a limitation in side bend to right maybe b/c of limitation to what?

A

limitation in mid cervical right downslide or left upslide

limited right side glide of OA and left rotation of AA

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18
Q

PIVM graded as

A

normal, hypermobile, hypomobile

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19
Q

Cervical PAIVMS test for what

A

assess for resistance to motion and pain provocation

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20
Q

Patient is presented with hypertonicity and decreased ROM from an injury/trauma/dsyfunction…what are they presenting with?

A

involuntary muscle guarding

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21
Q

Patient is presented with pt apprehension and decreased AROM/PROM from fear of pain/pain…what are they presenting with?

A

voluntary muscle guarding

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22
Q

Patient is presented with loss of muscle bulk and weakness from lack of use/stiff joints?

A

muscle atrophy

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23
Q

Patient is presented with normal muscle tone and loss of flexibility/ROM and caused by muscle held in shortened posture and think posture?

A

adaptive shortening

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24
Q

facet restriction causes?

A

immobility and resolved joint synovitis and hemarthorsis

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25
Q

facet restriction signs and symptoms?

A

decreased ROM in facet capsular pattern

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26
Q

patient is presented to you with head held at angle away from midline and pain with DOWNSLIDE. Patient say she slept weird wtf is wrong with her?

A

Wry neck

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27
Q

Hypermobility instability shows this on x ray

A

osteophytes

28
Q

what are facets positioned at in the C Spine?

A

45 degree angle

29
Q

Pathway of the vertebral artery?

A

thru c6 and up

30
Q

A of ABCs

A

alignment

31
Q

B of ABCs

A

bone density

32
Q

C of ABCs

A

Cartilage

33
Q

s of ABCs

A

soft tissue

34
Q

What is the atlantodens interval?

A

radiolucent line anterior to the articular facet of dens

35
Q

ADI in adults, what is abnormal? (atlanto-axial dislocation)

A

more than 3 mm

36
Q

ADI in adults, what is abnormal? (atlanto-axial dislocation)

A

more than 5 mm

37
Q

How do you examine the Odotnoid AP view of c1/c2?

A

open patients mouth and assess and ask about trauma

38
Q

what is the purpose of the candian C spine rule?

A

determines if the patient with acute trauma do not require imaging

39
Q

Canadian C spine: Step 1-If YES to any then radiograph needed:

A

ge >/= 65
• Dangerous MOI
• Fall >/+ 3 feet or 5 stairs
• Axial load to head
• High-speed MVA (>100 km/62 mph) or with rollover or ejection
• Motorized recreational vehicle accident
• Bicycle struck or collision

  • paresthesias in extremities
40
Q

Canadian C spine: if NO to any of these, pt needs radiograph

A
  • Simple rear-end MVA
  • Able to sit in ED
  • Ambulatory
  • Delayed onset of neck pain
  • Absence of midline cervical tenderness
41
Q

Canadian C spine: if NO pt needs radiograph

A

Able to actively rotate neck 45 degrees to right and left

42
Q

Nerve root compression symptoms

A
  • Diminished or absent DTRs
  • Diminished or absent sensation to light touch in dermatomal pattern
  • Muscle weakness along a specific myotome
43
Q

Causes of cervical spondylosis

A

osteoarthritis, DDD, DJD

44
Q

Cervical stenosis: what is lateral cervical stenosis

A

unilateral UE symptom, LMN signs, usually 1 segment

45
Q

Cervical stenosis: what is central cervical stenosis

A

B/L UE symptoms, multi-segmental, UMN signs

46
Q

Cervical myelopahty signs:

A 
Sensory disturbance of 1 or both hands and/or feet
• Muscle wasting of hand intrinsics 
• Unsteady gait
• (+) Hoffman’s Reflex
• (+) Babinski sign
• Hyperreflexia of UE & LE
• Clonus at ankle
• Bowel & bladder disturbances
• Multi-segmental weakness and/or sensory changes below level of compression
47
Q

In cervical radiculopathy DTRs are ?

A

hyporeflexive

48
Q

In cervical Myelopathy DTRs are?

A

hyper-reflexive

49
Q

Cervical instability hyperflexion injuries:

A

sprain posterior ligamentous structures & possible fx

50
Q

Cervical instability hyperextension injuries:

A

sprain anterior ligamentous structures and soft tissue

51
Q

Cervical instability: atlanto-axial dislocation

A

Distance between the anterior surface of dens and posterior surface of anterior arch on C1

52
Q

vertebral artery supplies how much blood to the brain?

A

20 percent

53
Q

80 % of blood supply brain is from what?

A

carotid artery system

54
Q

vertebral artery proximal:

A

origin to entry to cervical spine

55
Q

vertebral artery transverse:

A

entry to cervical spine to C2 transverse foramen

56
Q

vertebral artery suboccipital:

A

Exit from C2 to entry to foramen magnum

57
Q

vertebral artery intracranial:

A

entry to foramen magnum to formation of basilar artery

58
Q

Where is the vertebral artery most vulnerable?

A

suboccipital portion

59
Q

During rotation which side of the Vertebral artery is most vulnerable?

A

contralateral side

60
Q

What are the 5 Ds?

A
  • Dizziness
  • Drop attacks
  • Diplopia
  • Dysarthria
  • Dysphagia
61
Q

What are the 3 Ns?

A
  • Numbness
  • Nausea
  • Nystagmus
62
Q

what is the average time between event and onset of symptoms for CAD and stroke?

A

2-3 days

63
Q

IFOMPT decision making red light?

A
  • high number/ severe nature of RF, low predicted benefits for therapy, avoid treatment
64
Q

IFOMPT decision making yellow light?

A

Moderate number and nature of RF, moderate predicted benefits of PT, avoid or delay tx then reassess and monitor

65
Q

IFOMPT decision making green light?

A

low number and low RF, low to high predicted benefit and treat with care, monitor and make sure new symptoms do not arise

MSK (5 decks)

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