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AT Exam > MSK Conditions (18-25) > Flashcards

MSK Conditions (18-25) Flashcards

1
Q

Why must foot act as shock absorber and as rigid lever?

A

Shock absorber - to dissipate GRF

Rigid lever to propel body

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2
Q

What is the role of sesamoids bone?

A
  • reduce pressure in WB
  • incr mechanical advantage of flexor tendons
  • sliding pulley for tendons (decreases friction)
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3
Q

What is function of 1st MT?

A

main WB support for walking/running

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4
Q

What are the tarsal bones

A
  • calcaneous
  • talus
  • navicular
  • cuboid
  • cuneiforms - medial, intermediate, lateral
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5
Q

What is role of arches of foot

A
  • support in WB
  • absorb shock
  • space for plantar nerves, blood vessels, muscles
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6
Q
  1. What is main supporting ligament for medial longitudinal arch?
  2. What does it do
  3. What muscle supports this ligament
A
  1. Plantar Calcaneonavicular Ligament (Spring)
  2. returns arch to normal position after stretch
  3. Tib Post
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7
Q

The talus position control ________

A

calcaneus and navicular

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8
Q

What bones form Lisfranc joint

A

base of MTs, cuboid, all 3 cuneiforms

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9
Q

What are combined movements of pronation in WB?

A

PF, Add, Calc Ev

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10
Q

What are combined movements of supination in WB?

A

DF, Abd, Calc Inv

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11
Q
  1. What joints make up Choparts Joint (midtarsal)

2. What is directly related to this joint?

A
  1. calcaneocuboid and talonavicular

2. Subtalar - if subtalar is pronated, midtarsal is hypermobile. if supinate - midtarsal is hypo

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12
Q

What muscles allow DF?

A

Tib Ant, EHL, EDL, Peroneus Tertius

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13
Q

What muscles allow PF?

A

Gastroc, Soleus, Plantaris, Peroneus Longus/Brevis, Tib Post, FDL, FHL

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14
Q

What muscles do Inversion, Adduction, Supination?

A

Muscles along medial mall
Behind - Tib Post, FDL, FHL
Infront - Tib Ant, EHL

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15
Q

What muscles do Eversion, Abduction, Pronation?

A

Muscles along lateral mall
Behind - Peronus Longus/Brevis, Peroneus Tertius
Infront - EDL

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16
Q

What is function of extensor retinculum?

A

Provides pulleys for tendons to maximize pull

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17
Q
  1. What is nerve supply of foot

2. What is blood supply

A
  1. Medial and Lateral Plantar nerves - branch of Tibial Nerve
  2. Anterior, Posterior Tib Art
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18
Q

What are 5 phases of Gait?

What happens during each phase

A
  1. Initial contact - ER Tibia, Sup
  2. Load response - IR tibia, Pro
  3. Midstance
  4. Terminal stance
  5. Pre Swing/Toe off - ER Tibia, Sup
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19
Q

What are 3 periods of swing phase

A

Initial Swing
Mid Swing
Terminal Swing

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20
Q

What is Forefoot varus?

What does it cause

A

Talus PF, Add, Calc Ev

causes deformities associated w/ excessive pronation

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21
Q

What is forefoot valgus?

What does it cause

A

Talus DF, Abd, Calc Inv

- causes deformities associated w/ excessive supination

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22
Q

Where is anatomical weakness of tibia?

A

Lower ⅓ of shaft

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23
Q

What movements occur at subtalar joint?

A

Pronation, supination, Inversion, Eversion

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24
Q

what movements occur at talocrural joint?

A

DF PF

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25
Q

What are the ankle lateral ligaments

A

ATFL - prevent ANT movt of talus
PTFL - prevent POST movt of talus
CFL - prevent inversion calcaneus

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26
Q

Name deltoid ligaments

What arch does it support?

A
  • anterior and posterior tibiotalar, talonavicular, tibiocalcaneal

Medial longtitudinal arch

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27
Q

What muscles make up anterior compartment of leg?

nerve and artery?

A

Dorsiflexors - Tib Ant, EHL, EDL, Peroneus tertius

Ant tibial N, Tibial artery

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28
Q

What muscles make up lateral compartment of ankle?

Nerves?

A

Evertors: Peroneus longus and brevis

Peroneal N (superficial)

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29
Q

What makes up Superficial Posterior Compartment?

A

Plantarflexors: Gastroc, Soleus, Plantaris,

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30
Q

What makes up Deep Posterior Compartment?

A

Tib Post, FDL, FHL

Post Tib Artery

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31
Q

What ankle ROM required for normal gait?

A

DF 10 degrees

PF 20 degrees

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32
Q

What are Ottawa Ankle Rules

A
  1. Inability to WB 4 steps
  2. Tenderness distal fibula
  3. Tenderness medial mall
  4. Tenderness navicular
  5. Tenderness base of 5th
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33
Q

What is Potts #?

A

Bimalleloar # from inversion sprain

  • avulsion of lateral mall
  • fracture medial mall
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34
Q

What holds the peroneal tendon in place

A

Fibularis retinaculum

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35
Q

Name joint mobilizations to increase

  1. DF
  2. PF
  3. Inversion/Eversion
A

DF - Ant tibial glide or post talar glide
PF - Post tibial glide or ant talar glide
Inv/Ev - glide subtalar med / lat

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36
Q

What is shape of Medial Meniscus?

What attaches to it

A

C-shape
semiM, jt capsule
deep fibers of MCL

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37
Q

What is shape of Lateral Meniscus?

What attaches to it

A

O shaped

jt capsule, popliteal tendon

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38
Q

What is blood supply to meniscus?

what ⅓ is avascular

A

Medial Genicular Artery

inner ⅓ is the white zone

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39
Q

What is arcuate ligament?

A

thickened posterior jt capsule knee - attaches to the LCL popliteal fascia and lateral meniscus

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40
Q

what muscles stabilize knee laterally

A

ITB
popliteus
biceps femoris

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41
Q

What structures reinforce the 4 corners of the knee joint capsule

A

Postlat - ITB, biceps fem, popliteus, LCL, arcuate ligament
Postmed - SemiM, SemiT, MCL, post oblique ligament
Antlat - lateral retinaculum, patella tendon, ITB
Antmed - patella tendon, MCL

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42
Q

What muscles do Flx, Ext, ER and IR of knee

A

Flx - Biceps fem, SemiM, SemiT, sartorius, gracilis, gastroc, poplitus, plantaris
Ext - rectus femoris, vastus lat, intermedius, VMO

ER - biceps fem
IR - poplitues, semiT, semiM, sartorius, gracilis

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43
Q

Name the knee bursae

function?

A 
suprapatella
prepatellar
infrapatella
pretibial
gastroc 
- to reduce friction
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44
Q

What is name of knee fat pad

Function?

A

Infrapatellar

cushions front of knee, separates patellar tendon from capsule

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45
Q

Name the nerve inneverations

  • hamstrings and gastrocs
  • biceps femoris (short head)
  • quadriceps and sartorius
A
  1. Tibial N
  2. Peroneal N - exposed at head of fibula
  3. Femoral N
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46
Q

What is main blood supply to knee

A

Femoral artery –> popliteal artery

medial/lat sup/in genicualar artery

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47
Q

What is screw home mechanism

A

WB when extending - femur IR bc medial condyle is larger than lateral
last 15 degrees of extension - Tibia ER (CPP, lock knee, increase stability)
- popliteus contracts to ER femur to unlock knee

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48
Q

How to measure leg length discrepancy?

A

ASIS to med mall = structural

Navel to med mall = functional

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49
Q

What does Apleys distraction test identify

A

Meniscus tear vs Joint capsule/collateral ligament

Pain on traction/rotn = MCL/LCL joint capsule

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50
Q

What does a Slocum IR vs ER test

A

IR - ACL, post-lat

ER - ACL, post-med, MCL

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51
Q

What rotation does McMurray test

A

ER - medial

IR - Lateral

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52
Q

Name the 5 areas of girth measurement of knee

A

1) 8-10cm above jt line
2) 2cm above patella
3) Jt line
4) Tib tubercule
5) Gastrocs

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53
Q

What are normal Q angles for men and women

What does abnormal Q angle identify risk of

A

Males - 10
Females - 15

Q angle > 20 incr of improper patella femoral tracking

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54
Q 
What nerves supply.. 
Biceps Femoris
Quadriceps
SemiM
SemiT
Popliteus
Adductors
A 
Biceps fem - sciatic L5-S3
Quads -Femoral L2-L3
SemiM - tibial (branch of sciatic)
SemiT- tibial
Popliteus - Tibial
Adductors - obturator L3-L4
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55
Q

What arteries serve the thigh

A

Femoral Artery

Circumflex Artery - femur head

56
Q

How do you manage a Quad contusion?

A

place knee in 120 Knee flx to prevent shortening

57
Q

What are grades of quad contusion

A

Gr 1 - no ROM restriction
Gr 2 - cant flx knee more than 90
Gr 3 - cant flx between 45-90
Gr 4 - cant flex more than 45

58
Q

What position does femoral fracture show in

A

Hip will be ER, slightly add and shortened

59
Q

What ligaments reinforce hip joint

What does it restrict

A

Iliofemoral - prevent hyperext, restrain ER, Add
Pubofemoral - prevent Abd
Ischiofemoral - prevent IR and Add

60
Q

What does transverse ligament in hip cover

A

Covers acetabular notch

61
Q

What are direction of femur head

A

Ant, Med, Sup

62
Q

Name 6 deep external rotators of leg

What is the role?

A

Piriformis, Superior Gemellus, Inferior Gemellus, Oburtator Internus, Obturator Externus, Quadratus Femoris
- stabilize femur in acetabulum

63
Q
  1. Where does femoral nerve emerge from?

2. Where does sciatic nerve emerge from? What does it branch to?

A
  1. Lumbar plexus

2. Sacral plexus. Lead to Tibial and Peroneal N

64
Q

Name 2 bursa of hip

A
  1. Iliopsoas bursa

2. Deep trochanteric bursa

65
Q

Where are stress fractures in hip most common

A

inf pubic ramus
femur neck
subtrochanter femur

66
Q

What Hip ROM do these mobs increase

  • Inf Glide
  • Post Glide
  • Ant Glide
A
  1. Hip Flx, Abd
  2. Hip Flx
  3. Hip Ext
67
Q

Name 4 ligaments of Sternoclavicular joint

A

Anterior SC
Posterior SC
Interclavicular
Costoclavicular

68
Q

Where does subacromial bursa get compressed

A

coracoacromial arch in OH activity

69
Q

What is the brachial plexus nerve supply

A 
C5-6 Axillary
C5-6 Subscapular
C6-6 Suprascapular
C5-C7 Musculocutanous
C5 Dorsal Scapular
C5-T1 Pectoral
C5-T1 Radial
70
Q

What blood vessels serve the arm

A

Subclavian artery –> Axillary artery –> brachial artery

71
Q

What are the actions of RC in shoulder overhead movment

A

Supraspinatus compresses humeral head
Infraspinatus, Teres minor and Subscap depress humeral head with OH movement

  • RC and LH biceps are dynamic stabilizers of arm
72
Q

Describe ROM of scap during OH movement

A

0-30 - GH abd 30
30-90 - GH Abd 30, Scap UR 30
90-150 - GH Abd 30, Scap UR 30, GH ER 70-90
150-80 - GH Abd 30

73
Q

Name tests for GH Instability

A
  1. Load and Shift
  2. Anterior, Posterior Drawer Tests
  3. Sulcus Sign
  4. Clunk test - labral tear
  5. OBrien Test - SLAP lesion
  6. Apprehension and Relocation
74
Q

Name tests for Shoulder Impingement

A

Neers

Hawkins Kennedy

75
Q

Name tests for supraspinatus weakness

A

Drop Arm test

Empty Can

76
Q

Name tests for TOS

A
  1. Adson test - rotate head towards
  2. Hyperabuction Test - rotate head away
  3. Military Brace - rotate head away
77
Q

Where does the following TOS tests identify compression?

A

Adsons - compress subclavian artery bw anterior and middle scalenes
Hyperabuction - compression pec minor
Military brace - costoclavicular compression

78
Q

What shoulder movement causes Anterior GH DL

A

ER, Abd. Ext

79
Q

What is Bankart lesion

A

avulsion ant-inf labrum @ inf GH ligament

1-5 pm

80
Q

What is Hill-Sachs Lesion

A

Defect posterior lateral humeral head #

81
Q

What is SLAP lesion

A

superior labrum anterior posterior

- LH biceps tendon attach

82
Q

What is Reverse Hill-Sachs lesion

A

ant-med humeral head #

from a posterior DL (forced Add and IR)

83
Q

What structures are compressed in Shoulder Impingement?

Where?

A

subacromial bursa
supraspinatus tendon
LH biceps tendon

coracoacromial arch

84
Q

What does SICK scapula stand for

A

Scapula malposition
Inferior Medial Scap winging
Coracoid tenderness
Kinesis abnormalities

85
Q

What ROM is painful for shoulder bursitis?

A

Abd,Flx, IR

+ impingement test

86
Q

Name 4 reasons for TOS

A
  1. Compression of nerves/BV bw 1st rib and clavicle (costoclavicular syndrome)
  2. Compression bw anterior and middle scalenes (Anterior Scalene syndrome)
  3. Compression bw pec minor and coracoid (hyperabduction test)
  4. Presence of cervical rib
87
Q

What is the capsular pattern of Adhesive capsulitis ROM lost

A

ER > Abd > IR

88
Q

What is the condition of a Linebacker Arm or Blocker Exotososi called?

A

myositis ossificans - contusion to humerus

89
Q 
What joint mobs increase the GH ranges
Abd
Flx
IR
ER
A

Abd - Inf Glide
Flx - Post glide
IR - post glide
ER - ant glide

90
Q

Which bones in the humerus articulate with in the radius/ulna?

A

Capitulum articulate with radial head

Trochlea articulate with trochlear notch (ulna)

91
Q

What does UCL elbow protect against

Which band is strongest

A
  1. valgus force

2. anterior

92
Q

What does lateral elbow stability depend on

A
  1. RCL ligament

2. annular ligament

93
Q

where does RCL elbow attach from

A

lateral epicondyle to annular ligament

94
Q

name 2 bursa in elbow

A
  1. olecranon

2. bicipital

95
Q

name nerves that serve elbow

A

musculucutaneous C5-6
median C6-7
radial C7-C8
ulnar C8-T1

96
Q

what is blood supply of elbow

A

Subclavian artery –> axillary artery –> brachial artery

97
Q

What are normal carrying angles for M and W

A

W 10-15 degrees

M 5-10 degrees

98
Q

what does pinch grip test?

A

anterior interosseous nerve entrapment (bw heads of pronator)

99
Q

What does Cozens test do?

A

lateral epicondylitis

resist wrist ext

100
Q

What muscles are over used in Lateral Epicondylitis

A

ECRB, extensor carpi radialis brevis

EDC extensor digitorum communis

101
Q

What muscles are over used in Medial Epicondylitis

A

Pronator teres
FCU - flexor carpi ulnaris
FCR - flexor carpi radialis
palmaris longus

102
Q

What is Panners disease?

A

avascular necrosis of radial head/capitulum in 10-15 year olds

103
Q

What is Little League Elbow

A

Avulsion UCL

104
Q

What are signs of Cubital Tunnel syndrome

A

tingling into 4th and 5th digit
worse with hyperflexion

ulnar N irritation or sublux from valgus load

105
Q

WHat is pronator teres syndrome

A

Median N entrapment in pronator

106
Q

What mobs increase elbow flexion? elbow extension?

A

Flexion - ant glide radial head

Extension - post glide radial head

107
Q

Where do Deep Flexors of wrist arise from?
Superficial flexors?
Extensors?

A

Deep Flexors- radial, ulna, interosseous anteriorly
Superficial - medial epicondyle
Extensors- lateral epicondyle

108
Q

Name wrist extensors

wrist flexors

A

WE: ECRB, ECRL, ECU
Flexors: FCR, FCU,

109
Q

What is Nerve supply to wrist muscles

Blood supply?

A

MEDIAN N - serves flexors (except FCU and flexor digitorum profundus)

RADIAL N - serve extensors

Brachial –> Radial, Ulnar artery

110
Q

What are forearm fractures at risk of

A

Volkman contracture

111
Q

What is MOI of Colles #?

A

Wrist hyperextension

- radius is posteriorly displaced

112
Q

Name Carpal bones

A

Scaphoid - Lunate - Triquetrum - Pisiform

Trapezium - Trapezoid - Capitate - Hamate

113
Q

Where is TFCC located

A

between ulna and triquetrum

114
Q

Name ligaments of wrist and where they attch

A

UCL - styloid of ulna to pisiform/triquetral
RCL - styloid radius to scaphoid
Transverse Carpal Ligament - across anterior carpal. forms roof of carpal tunnel

115
Q

What nerves are injured in the following hand conditions

  1. Bishops Deformity
  2. Clawhand deformity
  3. Drop Wrist
  4. Ape hand
A
  1. ulnar N , hypothenar and intrinsic muscles of 4th,5th finger
  2. Median and Ulnar
  3. Radial
  4. Median N
116
Q

What is Presiers disease

A

AVN scaphoid

117
Q

What are the following fingernail deformities a sign of?

  • Clubbing and cyanosis
  • Scaling/ridging
  • Spooning/depression
  • vertical ridges
A
  1. Congenital heart disorder, Respiratory disease
  2. Psoriasis
  3. thyroid problems, iron deficiency. anemia
  4. nutritional deficiency
118
Q

Why does C2 (axis) have increased mobility in rotation?

A

Articular facets are flat. SP is horizontal

119
Q

What is the projection in C2 called?

A

Dens - odontoid process

120
Q

Directions of articular facets?

A

Superior face medial

Inferior face lateral

121
Q

What are components of disc?

A

Annulus fibrosus

Nucleus pulposus

122
Q

Name the spinal ligaments and what movements they restrict

A

ALL - restrict extension
PLL - restrict flexion
Supraspinous - attach to SPs , called Ligamentun Nuchae in cervical
Interspinous - bw SP - limits rotation and flexion

123
Q

What are the sacral ligaments called

A

Sacrotuberous

Sacrospinous

124
Q

Name superficial erector groups

A

Iliocostalis - longissimus, thoracis, cervicis
Longissimus - thoracic, cervicus, capitus
Spinalis - thoracic, cervicus

125
Q

Name Deep erector muscles

A 
Interspinales
Multifidus
Rotators
Semispinalis - thoracic, cervicus, capitus
Splenius - capitus and cervicus
126
Q

Each nerve has anterior and posterior root join to form spinal Nerve. Where does ant vs post root lead to

A

Anterior - motor

Posterior - sensory

127
Q

What are the 5 nerve plexuses

A 
Cervical - C1-C4
Brachial - C5-T1
Lumbar L1-L4
Sacral - L4-S4
Coccygeal S4-S5
128
Q

what are positive signs of Vertebral Artery test?

A

Dizzy
Nystagmus
Nausea

means VA is occluded

129
Q

What does pain at different ranges mean for SLR

A

30 - nerve, disc
30-60 - Sciatic N
with DF - L3-L4, S1-S3
70-90 - SI jt

130
Q

What is Central Cord Syndrome?

A

bleeding or ischemia in central portion of cord

- causes quadriplegia, sensory loss, loss of sexual and bowel/bladder

131
Q

What is Brown-Sequard cord Syndrome

A

injury to one side of spinal cord

- loss of motor function, touch, vibration, pain, temp on OTHER side of body

132
Q

What is Anterior Cord Syndrome?

A

injury to anterior 2/3 cord

  • loss motor function, pain, temperature
  • sexual and bowel/bladder present
133
Q

What is Posterior Cord Syndrome

A

injury to posterior cord

  • difficulty coordinating limb movement
  • good strength, pain, temp
134
Q

What is Schuermans DIsease

A

wedge # of 5 degrees or more in 3+ Vertebral bodies
- incr in kyphosis

injury to epiphysis can cause AVN

135
Q

What is the difference between

  1. Prolapse disc
  2. Extruded
  3. Sequestered
A

Prolapse - nucleus moves through annulus
Extruded - nucleus into spinal canal, contact with NR
Sequesterd - nucleus migrate from disc

136
Q

What is difference between Spondylolysis and Spondylolisthesis

A

Spondylolysis - stress # to pars interarticularis in LS

Spondylolyisthesis - slipped vertebrae, step deformity

AT Exam (5 decks)

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