MSK-Essentials Flashcards
Body’s 3 sources of ATP
AKA Energy Systems
- ATP-PC (Phosphagen) System
- Anaerobic Glycolysis (Lactic Acid) System
- Aerobic (Oxygen) System
ATP-PC System
Think HIGH int, SHORT duration
- ATP prod during HIGH int, SHORT duration ex.
- Time= 15s
Ex. Sprinting 100m
Anaerobic Glycolysis System
Think HIGH int, SHORT duration, but longer vs ATP-PC
- ATP during HIGH int, SHORT duration acts
- Time= 30-40s
Ex. Sprinting 400 or 800m
Aerobic System
Think LOW int, LOOOONG duration
- ATP during LOW int, LOONG duration acts
- ATP production FAR greater, BUT reqs complicated series of chem rxns
Ex. Running a marathon
Motion occurs in 3 Cardinal Planes: Name them
Around 3 Axes: Name them
- Frontal, Sagittal, Transverse
- A-P (frontal), Med-Lat (sagittal), Vertical (transverse)
Common Jt Receptors?
(5)
- Free nerve endings
- Golgi lig endings
- Golgi-Mazzoni corpuscles
- Pacinian corpuscles
- Ruffini endings
LOOK THESE UP!!!
Golgi Tendon Organs
(GTOs)
Remember Tendons sensitive to Tension
- Encapsulated sensory receptors (in tendons) sensitive to TENSION
- esp when produced by active mm contracts****
- Transmit info about TENSION or RATE of CHANGE of tension w/in mm
Type I MM Fibers
*Endurance fibers
- Aerobic
- Red
- Tonic
- SLOW-Twitch
- SLOW-oxidative
endurance
Type II MM Fibers
2-Fast, POWER
- Anaerobic
- White
- Phasic
- FAST-Twitch
- FAST-Glycolytic
MM Spindles
IN MUSCLE BELLY….think LENGTH
- T/o belly of mm
- Send info to NS about MM LENGTH or RATE of CHANGE of length
UE
Shoulder Complex
Joints?
- GH
- SC
- AC
- Scapulothoracic (not true jt)
UE
Elbow Complex
Joints?
- Radiohumeral
- Ulnohumeral
- Proximal Radioulnar
LE consists of: (4)
Hip, Knee, Ankle/foot
Knee Jt
Tibiofem
Patellofem
Hip Jt
Synovial jt: head of femur + acetabulum
Ankle/Foot formed by:
Distal tibiofibular, talocrural, subtalar, midtarsal, forefoot
CS/TS/LS vertebrae
CS= 7
TS= 12
LS=5
UQS/LQS consists of: @min…
- posture
- ROM
- resistive testing (myos)
- reflexes
- dermatomes
Body composition: and ranges
- relative %of bw comprised of fat
- Men= 12-18%
- Women= 18-23%
Common methods to assess body comp:
- hydrostatic (GOLD STD.) (water)
- plethysmography (air)
- skinfold
- BMI (ht/wt)
- bioelectric imp.
LOOSE-packed pos of jt:
MIN stress on jt, MIN jt congruency, MIN lig laxity.
CLOSE-pack pos of jt:
MAX stress, FULL jt congruency, MAX lig tightness
End-Feel
Type of resist felt when PASSIVELY moving jt thru END-ROM
-Firm, Hard, or soft can all be normal OR abnormal depending on the joint
- Empty==ALWAYS abnormal
Active Insuff vs Passive Insuff
- Active== when 2-jt mm contracts across BOTH jts simultaneously (MAX shortened)
- Passive== when 2 jt mm LENGTHENED over both jts simultaneously (MAX lengthened)
Standard gait term:
- Heel Strike-> Foot Flat-> Midstance-> Heel off-> Toe off-> Accel-> Midswing-> Decel
RLA Gait terms:
I Love Many Types of Pussy In My Tesla*
ISw-> LR-> MSt-> TSt-> PSw-> ISw-> MSw-> TSw
Gait: Stance vs Swing
St= 60%
Sw= 40%
STEP length vs STRIDE length
- STEP= Dist bw Rt heel strike and Left heel strike
- STRIDE= Dist bw Rt heel strike and the next Rt heel strike
Special Tests
Biceps Tendon Patho
- Ludingtons (arms behind head one)
- Speeds
- Yergason’s (You’re OUT)
Special Tests
RTC patho/impairs/Impingement
- Drop Arm Test
- ER lag
- Belly Press, Lift off test
- Empty can/Full can
- Hawkins-Kennedy (impinge)
- Neer’s (Impinge)
- Supraspinatus test?
Special Tests
Hip
Contractures, Tightness,
- Ely’s (He LIES prone)
- Ober (TFL/ITB)
- Piriformis (S/L one)
- Thomas Test (rec fem, iliopsoas, ITB)
- Tripod sign look up
- 90-90 SLR test
Special Tests
ACL (knee)
- Anterior Drawer
- Lachman (30deg knee flex and 0)
- Lateral Pivot
Special Tests
Meniscus (knee)
- Apley’s compression/distraction
- Bounce home test?
- McMurray
- 5 part cluster: click/pop, pain flex, pain ext, pain w/ palpation, +McMurray
Joint Mobs
- Grade I (pain) and Grade IV (ROM)= Small amp
- Grade II (pain) and Grade III (ROM)= Lare amp
Grade V manipulation (thrust)
SMALL amp, HIGH velocity thrust performed to snap adhesions at the limit of ROM
Convex/Concave Rule:
VEX moving on CAVE
- Roll and Slide (Glide) in OPPOSITE directions
NOTE: ROLL always goes in direction of long bone
Convex/Concave Rule
CAVE moving on VEX
Roll and Slide (Glide) SAME direction
NOTE: Roll always goes w/ long bone direction
ROM Ex’s
Purpose
Improve mobility of single joint
Includes PROM, AROM, AAROM
ROM Ex’s typical progression:
- BEGIN PROM bc does not req muscle contraction
- PROGRESS to AROM (mm contract stress joint)
Stretching Ex’s
Purpose
- Improve mm flexibility by INC’ing extensibility of musculotendinous unit and connective tissues
STATIC stretching
Explain
SAFEST form of stretching
- LOW int, LONG duration
- Greatest gains in extensibility
Proprioceptive Neuromuscular Facilitation Stretching
Purpose
- Designed to improve mm flexibility
Ballistic and Dynamic stretching
More often warm-up prior to initiating activity
A Muscle is made up of what?
Several muscle fibers and the connective tissue layers that surround it (LOOK UP!)
Resistive training programs
3 types of mvmts/types
- Isometric (no jt stress)
- Isotonic (conc/ecc)
- Isokinetic (conc/conc)
Open Chain vs Closed Chain
- Open chain== Dist segment moves freely in space
- Closed chain== Body moving over a fixed distal segment
Strength training parameters: Vol, Freq, Duration, Intensity vary according to _____
Desired goal of program (strength, endurance, power)
1-3= power, 3-5= strength, 8-12= hypertrophy, 15+= endurance
Hip Precautions THA
PosteroLateral Approach
See MSK!!!
AVOID:
- hip flexion >90deg
- Adduction
- IR
Common types of Fx’s
- Avulsion
- Closed
- Comminuted
- Compound
- Greenstick
- Non-union
- Stress
- Spiral
Common Pharma agents for MSK Disorders:
LOOK UP!
- Opioid
- Non-opioids
- Glucocorticoids
- Disease modifying anti-rheumatic drugs (DMARDs)
Kyphosis vs Lordosis
- Kyphosis== Excessive TS curvature (posterior direction)
- Lordosis== Excessive CS/LS curvature (anterior direction)
Orthotics
LOOK UP and KNOW IT!!!
- EXT. device
- provides support OR stabilization,
- improves function,
- corrects deformities,
- distributes pressure from one area to another
LE amputations more/less common vs UE amps?
MORE!!!
PERIPHERAL VASCULAR DISEASE== PRIMARY ETIOLOGY
Components of UE Prosthetic
KNOW ALL!!!
- Socket
- Suspension
- Elbow Unit
- Wrist Unit
- Terminal Device
Diff amongst each
Components of LE Prosthetic
KNOW ALL!!!
- Socket
- Suspension
- Knee
- Shank
- Foot
K-lvls and Rx!!!
Pot complications s/p amputation
- Contractures
- DVTs
- Hypersensitivity
- Neuroma
- Phantom limb/Phantom pain
- Psycho. impact
- Wound infx
Common Gait Deviations w/ Prosthesis
- Lateral Bending
- Vaulting
- Forwrd trun flexion
- Med/Lat whip
- Abducted or Circumducted gait
- Excess knee flex during stance
- Rotation of forefoot @ heel strike
See Table P. 144-145
