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NPTE Final Frontier > MSK Basic Interventions > Flashcards

MSK Basic Interventions Flashcards

1
Q

Practice!
According to convex/concave rule, to inc R forearm SUP @ prox RU jt PT should perform what glide?

A

Roll POST and Glide ANT
- Sup is ANTERIOR
- PPP-> Posterior glide for Proximal RU jt for PRO

Remember ALL JTS ALTERNATE!!!!!

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2
Q

Stretch _ Strengthen

A

BEFORE!!!!

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3
Q

OKC vs CKC
Which better for strengthening?
And what else to remember?

A

CKC!!!
KNOW YOUR PLANE– what plane of mvmt is the question asking you about?–likely answer is mm that controls that plane of mvmt Ex. glute med and abduction if hip drop

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4
Q

Rule of 6–>

aka: 3 Phases of Rehab

A
  • First 6wks
  • Up to 12wks
  • Up to 6mos

**Major sx’s like rotator cuff **

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5
Q

Practice:
39yo comes into OPPT c/o neck probs. Which of following ex combos is MOST approp for pt who has FHP?

Remember Jandas Crossed Syndrome!!!

A
  • Strengthen DCFMs and Stretch SCM and Upper CS EXTs
  • Upper Crossed: Inhibited (Weak)–> DCFMs + Lower trpz/Serratus ant.; Facilitated (Tight)–> Upper trpz/Levator + Pec minor/SCM
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6
Q

TibioFemoral Jt and Screw-Home Mechanism

A
  • Lat femoral condyle is flatter, does not ext as far distally, projects further post vs medial condyle
  • Bc of this–> Tibia rotates LATERALLY (ER) ON FEMUR @ full EXT==Screw-Home
  • This is in OPEN CHAIN–> last 20-30deg EXT
  • Remember “Paper on Tibia trick”–It ERs!

NOTE: in CKC–Femur MEDIALLY rotates on TIBIA

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7
Q

Practice:
In order to UNLOCK knee from TKE in a CKC, what must occur?

A

LATERAL (ER) rotation of FEMUR on TIBIA

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8
Q

More on Screw-Home

A
  • TOLL: Tibia in Open chain rotates LAT for LOCK
  • CKC–> Femur moving on Tib
  • Screw-Home in CKC–> Femur MED rotates on tib, so to UNLOCK must LAT (ER) rotate!
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9
Q

More on Screw-Home

A

OKC:
- Tibia Lat Rot== Locks
- Tib Med Rot== Unlocks

CKC:
- Femur Med Rot== Locks
- Femur Lat Rot== Unlocks

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10
Q

Iso vs Ecc vs Conc

A

Isometric: SAME length, no JRF
Ecc: Load > force (torque)
Conc: Load < force (torque)

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11
Q

Which type of contraction do biceps (elbow flexor/shoulder flexor/supinator) undergo as shoulder moves 180-90deg of flex?

A

ECCENTRIC—> biceps move from more flexion to LESS, Triceps working conc.

Another example: Stand–> Sit== Rec fem (quads) ecc. work to SLOW US

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12
Q

Shoulder Rotators
Mnemonic to remember UPWARD ROTATION—->

A

SALUTE
- Serratus Ant
- Upper/Lower Trpz

Note: Force Couplebw Upper/Lower Trpz–> MUST AGREE W/ EA OTHER

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13
Q

Easy way to mimic Upward and DOWNward scapular rotation

A

USE HANDS!!!!
Upward we go into ABDUCTION
Downward we go into ADDuction
use hand and thumbs as scapulas!

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14
Q

UPward rotators of scapula
“SALUTE”

A
  • Serratus Ant
  • Upper trpz (force couple)
  • Lower trpz (force couple)
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15
Q

DOWNward rotators of scapula

A
  • Rhomboids
  • Pec Minor
  • Levator Scap
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16
Q

Upward/Downward Rotators of scapula
*Trick to remember

A

Remember which mm’s counter ea. other AND that Serratus ant HELPS w/ upward rot & Pec minor HELPS w/ downward rot
- Upper trpz (UPward) matches w/ Levator (Downward)
- Lower trpz (Upward) matches w/ Rhomboids (Downward)

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17
Q

Practice!
Excess upward rot of L. scap noted w/ shoulder ABD. Which mm MOST LIKELY contributing?

A

Weakness of Rhomboid major/minor
bc they are NOT pulling scapula back DOWN!!!!

Rhomboids must BALANCE OUT upward rot w/ downward rot

18
Q

What should you ABSOLUTELY REMEMBER about Active/Passive Insufficiency?

A

MAINLY due to Two/Multi-jt muscles!!!!

19
Q

Active Insuff.

A

Crossbridge too CLOSE

20
Q

Passive INsuff

A

Too lengthened

21
Q

Active Insuff.
Definition + Ex.

A
  • Inability of two-jt muscle to shorten simultaneously @ both jts
  • Ex. Bicep curl (elbow flex) THEN try to get into 180deg shoulder flex—> CANNOT bc biceps are FULLY contracted ==> Active Insuff
22
Q

Passive Insuff
Definition + Ex.

A
  • Inability of two-jt mm to lengthen simultaneously @ both jts
  • Ex. Ext knee fully & Flex trunk forward–> major stretch in HS’s and cannot lift leg up high bc HS can NO LONGER stretch over hip & knee anymore===> Passive Insuff
23
Q

Active and Passive Insuff. Rules:
Steps 1, 2, 3, 4

A
  • Step 1: Name mm
  • Step 2: Is it a 2jt mm?
  • End range? Function of mm?
  • Active or Passive Insuff?

NOTE: 1 jt mm’s will NOT display Active or Passive Insuff!!!!

24
Q

Mnemonic/Way to remember Active vs Passive Insuff

A
  • Active Insuff==SAME–> Active insuff will be SAME function of mm. Ex. HS= knee flex/hip ext
  • Passive Insuff==OPPOSITE–> Passive insuff will be OPP motion of mm function. Ex. HS will then be knee ext/hip flex
25
Q

Practice!
Active Insuff of R. Iliopsoas (hip flex, LF same side)

A

Hip flexion + R. LF of trunk

26
Q

Practice!
Pt c/o reduced mobility in R hip. PT notices pt has INCd hip flexion w/ knee flexion as compared to knee ext. What is most likely cause of **reduced hip flexion w/ knee extension? **

The motion they are asking about is OPPOSITE TO HS FUNCTION.

A

PASSIVE INSUFF== OPP motion of mm
A: Passive insuff of HS’s bc hip flexion and knee ext is OPP to HS function

27
Q

Practice!
Pt c/o reduced mobility in R hip. PT notices pt has INCd hip flexion w/ knee flexion as compared to knee ext. What is most likely cause of **reduced hip flexion w/ knee extension? **

The motion they are asking about is OPPOSITE TO HS FUNCTION.

A

PASSIVE INSUFF== OPP motion of mm
A: Passive insuff of HS’s bc hip flexion and knee ext is OPP to HS function

28
Q

Kinematic Chain ex.
Starting pt= Overpronation of foot

A
  1. Over PROnation of foot–> Leg IRs–> Knee moves INward (valgum)–> Coxa varus–> Pelvis tilits forward (APT)

Be familiar with how things move UP THE CHAIN

29
Q

Practice!
Pt presents w/ foot pain during running. PT notes excess foot PROnation and would like to provide orthotic to relieve pain. Which would beneift pt most?

A

Medial post under first MetHead
This will LIFT medial aspect of foot OFF ground

30
Q

Anteversion: What will you see w/ this?

Transverse plane

A

IN-toeing
- Normal= 15deg
- >15deg== Anteversion (IN-toe to fix)–to “put back in socket”—–note pic says 35degs Anteversion for In-toe
- <15deg==Retroversion (OUT-toe to fix)

31
Q

Hip Malalignments:
Table

THINK ABOUT WHAT HAPPENS UP THE CHAIN!

A

see pics (but most of this you already KNOW!)

32
Q

Excessive anteversion
Related posture?

A

In-toeing–> subtalar PRO–> lat patellar sublux–> med tibial torsion–> med femoral torsion

33
Q

Excessive RETROversion
Related posture?

A

OUT-toeing–> subtalar SUP–> Lat tibial torsion–> Lat femoral torsion

34
Q

Coxa VARA
Related posture?

A

Subtalar PRO–> Medial rotation of leg–> knee valgus–> Anterior pelvic tilt
SHORT I/L leg—- bc PRO makes leg SHORTER

35
Q

Coxa VALGA
Related posture ?

A

SUP subtalar–> Lateral rotation of leg–> knee varus–> POST pelvic tilt
**LONG ipsilat leg **— bc SUP makes leg LONGER

36
Q

Practice!
PT is treating peds pt w/ autism. Pt stans w/ IN-TOEing. Postural strategies?

A

Anteversion!
- Medial rotation of leg, knee valgum, coxa vara, APT
- A: Internal tibial torsion, Incd femoral ANTEversion

37
Q

ALL assocd w/ In-Toeing

A
  • PRO foot
  • Med tibial torsion
  • Metatarsus varus
  • Talipes varus or equinovarus
  • Tibial or genu varum
  • Medial femoral torsion
  • Excess femoral ANTEversion
  • Tight hip IRs
38
Q

Rule of 6
for Sx’s

A
  • First 6 weeks
  • Up to 12 weeks
  • Up to 6 mos

major Sx like RTC

39
Q

Rule of 6 and Training for ADL activities
Tips:

A
  • 1st priority ALWAYS SAFETY
  • 2nd priority should be placed on obeying the above (Rule of 6) while choosing MOST relevant exercise to desired task
40
Q

Practice!
Pt underwent sx repair of full thick RTC tear 6d ago. PT wants to perform passiveand assisted mvmt. Which pos MOST approp
THINK–6d ago???? == MAX PROTECTION

A

Pt in SUPINE w/ arm ABDd 45deg w/ slight flex
bc gravity eliminated!!!! Least amt of force on Jt or repair!!!

Rule of 6!!!!!

41
Q

Rule of 6 applied:
Post-op Achilles Tendon Repair or Reconstruction w/ Graft

A

See pics
NOTE: @ 6-8wks, and Beyond 12 wks

42
Q

Practice!
Pt underwent R. Achilles tendon repair 6 wks ago (Rule of 6) and now able to FWB. PT giving advice on shoe mods. Which is best?

A
  • Things to keep in mind: NO DF, want to keep heel in slight PF to keep Achilles shortened and protect repair
  • A: Shoes w/ 1-1.5cm heel lift (as per table)

NPTE Final Frontier (19 decks)

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