MSK Flashcards
what are the UE myotomes?
C1-2: cervical flexion C3: side flexion C4: shrug C5: abduction C6: elbow flexion / wrist extension C7: elbow extension / wrist flexion C8: thumb extension T1: finger abduction
what are the LE myotomes?
L1-2: hip flexion L3: knee extension L4: dorsiflexion L5: big toe extension S1: eversion / PF / hip ext S2: knee flexion
what are the biceps, brachioradialis, and triceps reflex nerve roots?
biceps: C5-C6
brachioradialis: C5-C6
triceps: C7-C8
what are the patellar, achilles tendon, and hamstrings reflex nerve roots?
patellar: L2-L4
achilles tendon: S1-S2
hamstrings: L5-S2
what does a posterior glide of the shoulder improve when performed at 90 degrees of flexion?
horizontal adduction (think horizontal abduction would stress anterior capsule and it’s opposite)
what is the capsular pattern of the shoulder?
ER, abduction, IR
what is the capsular pattern of the elbow?
flexion > extension
what is the capsular pattern of the hip?
IR, flexion, abduction, (minimal extension loss)
what is the capsular pattern of the knee?
flexion > extension
what direction should mobilizations be performed in patients with frozen shoulder?
posterior / inferior
what muscles are tight in upper crossed syndrome? what muscles are weak?
Tight 1) SCM / pec minor 2) upper traps / levator scapulae Weak 1) deep cervical flexors 2) lower traps / serratus anterior
what muscles are tight in lower crossed syndrome? what muscles are weak?
Tight 1) hip flexors 2) erector spinae Weak 1) abdominals 2) glute med / max / min
what muscles upwardly rotate the shoulder? which ones downwardly rotate the shoulder?
upward rotation 1) serratus anterior 2) upper and lower traps downward rotation 1) rhomboids 2) levator scapulae 3) pec minor
what happens at the tibia and foot with knee valgus?
1) IR of tibia
2) overpronation at the forefoot
what happens with anteversion of the hip? what’s the compensation that occurs?
1) hip anteversion is when the femoral head moves too far anteriorly
2) to correct this, toeing in (IR of the femur) improves joint congruency
what position should the foot be placed in following achilles tendon repair surgery?
slight PF (to reduce stretch of the tendon)
what is Scheuermann’s disease? what are the most commonly affected levels? what is it also known as?
1) weakening of vertebral end plates leading to excessive kyphosis of the thoracic spine (must involve 3+ adjacent vertebrae)
2) T10-L2
3) juvenile scoliosis
what should be avoided with spondylolthesis?
hyper extension of the spine past neutral
a patient has trouble closing at the left C4-C5 segment, what are a couple mobilization options to improve closing at this joint?
1) PA glide of C5 on left side
2) PA glide of C4 on right side
what occurs during UNCOMPENSATED forefoot valgus and forefoot varus?
(1) forefoot valgus: no rearfoot (heel) deviation and a PRONATED forefoot
(2) forefoot varus: no rearfoot deviation and a SUPINATED forefoot
what occurs during COMPENSATED forefoot valgus and forefoot varus?
(1) forefoot valgus: a VARUS rearfoot to correct forefoot position
(2) forefoot varus: a VALGUS rearfoot to correct forefoot position
how is scoliosis named (concave or convex side of deformation)?
after the CONVEX side
which way do the vertebral bodies and spinous processes rotate with scoliosis?
(1) vertebral bodies rotate to the CONVEX side
(2) spinous processes and pedicles rotate towards the CONCAVE side
what happens on the convex side of the body with scoliosis?
Convex side (1) shoulder shrug (elevated) (2) scapula retracted (3) head tilted towards this side Concave Side (1) hip hike (2) arm is higher and elevated
what is legg calves perthes disease? what is it caused by? what are the main s/s?
(1) flattening of the femoral head
(2) avasular necrosis of the femoral head
(3) the patient will LIMP, trendelenburg sign
what is Slipped capital femoral epiphysis (SCFE)? what is it caused by? what are the main s/s? what postion of the leg do these patients walk?
(1) the femoral head slips backwards off the femur (usually in tens / preteens aged 8-17)
(2) initial traumatic episode (could be as minimal as turning over in bed)
(3) acute onset, unable to bear weight
(4) MAINTAINS leg in EXTERNAL ROTATION
how can you differentiate between SCFE and LCP?
(1) SCFE: limited IR, abduction and FLEXION
(2) LCP: limited IR, abduction and EXTENSION
how is W sitting characterized?
INTERNAL rotation of the femur and lateral tibial torsion
what are the most common MOIs for an ACL tear?
(1) hyperextension of the knee
2) twisting of the knee (when foot is planted
should open chain interventions be used during early phases of post-ACL rehab? why?
no; increased shear forces
what is the roll and and glide of the mandibula when the mouth opens? which way does the disc glide?
both roll and glide are anterior; the disc also glides anteriorly to maintain congruent surface with the fossa
what is normal ROM at the TMJ? how much ROM is considered functional?
Normal: 35-55mm
Functional: 40mm
how far should the TMJ protrude? how far should it retract? how far should it laterally deviate?
(1) protrusion: 7mm
(2) retraction: 3-4mm
(3) lateral deviation: 10-15mm
what muscles are responsible for opening of the mouth? (1)
(1) lateral pterygoid
what muscles are responsible for closing the mouth? (3)
(1) medial pterygoid
(2) temporalis
(3) massester
what muscles are responsible for lateral deviation of the mouth? (2)
(1) ipsilateral lateral pterygoid
(2) contralateral medial pterygoid
what muscles are responsible for protrusion of the mandible? (2) which ones retract the mandible? (1)
Protrusion (1) medial pterygoid (2) lateral pterygoid Retraction (1) temporalis (posterior fibers)
how does a hypomobile TMJ present?
hypomobile (NO pain)
how does a TMJ disc displacement with reduction present?
clicking sound
how do TMJ synovitis and capsulitis differ with clinical presentation?
(1) synovitis: decreased opening with NO deviations
(2) capsulitis: decreased opening WITH deviations
what is froment’s sign? what does it indicate?
(1) when a patient attempts to grasp a piece of paper between their thumb and index finger and the PT tries to pull the paper away
(2) if they can’t, it indicates ulnar nerve paralysis
what is a Warternger sign? what does it indicate?
(1) patient sits with hands on table and fingers spread out; the pt. is then asked to bring the fingers together
(2) inability to bring little finger to rest of the hand indicates ulnar nerve injury
what is Jeanne’s sign?
(1) hyperextension of MCP when trying to grab a piece of paper with thumb and index finger (usually with IP flexion)
(2) ulnar nerve injury
what is a positive Hoffman’s sign?
(1) when the middle distal phalanx is flicked and the IP joint of the same hand flexes / adducts (fingers may also flex)
what is Murphy’s sign (of the hand)? what does it indicate?
(1) the patient makes a fist and if their 3rd MCP head is level with the 2nd and 4th it’s positive
(2) indicates lunate dislocation
what is the normal ROM at the hip for Craig’s test? what do greater than and less than normal ROM values indicate?
(1) 8-15 degrees of IR is normal
(2) >15 degrees IR = Hip Anteversion
(3) <8 degrees IR = Hip Retroversion
how are the medial and lateral meniscus tested with McMurray’s test?
(1) medial meniscus: ER of the tibia before being taken into extension
(2) lateral menicus: IR of the tibia before being taken into extension
what is the normal Q-angle for males and females with the knee extended?
(1) males: 13 degrees
(2) females: 18 degrees
what ligament does the anterior drawer test assess for?
anterior TALOfibular ligament
what ligaments does the talar tilt test assess for?
(1) inversion stresses calcaneofibular ligament
(2) eversion stresses deltoid ligament
what is Lhermitte sign? what does it indicate if positive?
(1) simultaneously passively flex the head and one hip with the knee extended
(2) sharp, electric shock pain down the spine indicates spinal cord / UMN lesion
what does a positive stork test indicate?
spondylolisthesis
how is the Van Gelderen’s test interpreted?
to determine if the issues is spinal stenosis or intermittent claudication; if the sx decrease while biking in a trunk flexed position this indicates stenosis; if the sx are the same regardless of position, it indicates claudication
what COMBINED motions at the hip should be avoided following an anterior approach total hip replacement?
FABER (flexion, abduction, ER)