MSK I Flashcards
Hip angle of inclination typically is..
115-125
coxavalgaof the hip is..
> 125 deg
anteversion is.. & is consideredexcessivewhen?
> 25-30 deg excessive; anteversion is when thefemoral neck angles too far anteriorly
the extensor hood assists with..
ext of PIP and DIP jts
the ACL limits..
ant glide of tibia and limits tibial IR during flex
LCL and MCL are taut when?
extension
hip ER/IR ROM is..
40-60/30-40 deg
1st MTP normal ROM
45-70 deg
T2 vs T1 weighted MRI?
T1 typically used to assess bony anatomy
T2 usually used to assess soft tissue structures
posterior internal impingement test IDs..
an impingement b/t RTC & greater tuberosity OR posterior glenoid & labrum
4 tests for thoracic outlet syndrome:
Adson’s, Roos , Wright (hyperabduction), costoclavicular syndrome test
pronator teres syndrome test tells you..
if there is entrapment of the median nerve in the pronator teres ms
Finkelstein;s tells you about.
deQuervein’s
Bunnel-Littler test IDs..
tightness in structures surrounding the MCP jt - differentiates b/t capsular and instrinsic tightness
–IF flexion is lmtd in BOTH stabilization of the MCP & flex MCP/flex PIP, then it’s a capsular issue
IF when performing the Bunnel Littler test, there is more PIP flexion with MCP flexion, then..
the intrinsic ms are tight (not the capsule)
what two tests are used to determine hip flexor tightness?
Thomas’s test THEN Ely’s used to differentiate rec fem vs iliopsoas
Phalen’s test is used for..
carpal tunnel
Froment’s sign indicates..
weakness of abductor pollicis 2/2 ulnar nerve dysfxn
Allen’s test is used to determine..
vascular compromise (distal ulnar and radial arteries)
Craig’s test tells you..
What are norms?
if hip is anteverted or retroverted
-norms: 8-15 deg of hip IR
Normal Q angle is..
13 for men
18 for women
Noble compression test tells you about..
IRB friction syndrome (distally)
anterior drawer test of the ankle indicates..
laxity of ligaments, specifically the ATFL
what special test is used to tell if there is laxity of the calcaneofibular or deltoid ligaments?
talar tilt
what test evals the integrity of the Achille’s
Thompson’s
How do you differentiate b/t vascular and vestibular causes of dizziness/vertigo?
Hautant’s test: palms up at 90 deg, close eyes, if wobbles - vestib
- -can add on head/neck ext to test for vascular compromise
- hold both for 30 sec
Lhermitte’s sign IDs..
dysfunction of SC or UMN lesion
-p/w pain down spine and into UE/LE
Lasegue’s test IDs..
dysfxn of neuro structures that supply the LE
-SLR –> shooting pain –> DF foot; IF pain reproduced with DF then it’s neurological
to test for IV foramen vs facet dysfunction in quadrant testing..
IV foramen: SB/Rot same side then ext
facet : SB/Rot opposite sides then ext
Stork standing test IDs:
spondylolisthesis : stand on 1 LE then go into trunk ext: LBP indicates spondy
McKenzie’s slide glide test differentiates.
b/t scoliosis & neurological dysfunction
-IF when shift is corrected, neuro sx reproduced = neuro dysfxn
Bicycle (van Gelderen’s test) differentiates b/t
spinal stenosis & intermittent vascular claudication
Goldthwait’s test differentiates b/t
dysfxn in lumbar spine vs SIJ
during stance phase of gait, when do the glute max & h/s begin to contract concentrically?
foot flat
what is the position of the knee from heel strike thru toe off?
HS: full ext, flexing as foot hits ground
foot flat: 20 deg flex
midst: 15 deg flex
Toe-off : full ext –> 40 deg flexion
what controls the rapid knee flexion during heel strike and prevents buckling?
quads contracting eccentrically
during foot flat, what are the quads doing?
concentrically contracting to bring femus over tibia
PF ms activity peaks at..
toe off
during push-off, what is the position of the foot?
supination (windlass effect)
when is max DF achieved during gait?
acceleration (initial Swing) to MidSwing (20 deg)
lumbar spinal flexion is coupled with what at the ilium?
posterior rotation
tibial ER is associated with what motion at the foot?
supination (and upward glide of the talus)
ankylosing spondylitis is..
progressive inflammatory disease affecting axial skeleton
typical onset of ankylosing spondylitis?
meds used for ankylosing spondylitis?
NSAIDs, corticosteroids, cytotoxic drugs, TNF inhibitors
what exercises should be emphasized for ankylosing spondylitis?
flexibility - especially to improve EXTENSION - aerobic exercise, respiratory exercises to improve FVC
gout pathology:
genetic ? elevated serum uric acid;
crystals deposited into peripheral jts & other tissues incl kidneys
gout usually found in..
knee and great toe
psoriatic arthritis is..
chronic erosive inflammatory disorder (erosion in jts of digits and axial skeleton)
what are DMARDs?
disease modifying antirheumatic drugs
characteristics of RA?
digis usually affected
-pannus formation (inflammatory granulation tissue), ulnar drift, volar subluxation, possible swan neck & boutinneire deformity
what will blood tests show for someone with RA?
Hgb & Hct = anemic; rheumatoid factor elevated; incr WBCs & ESR
postmenopausal osteoporosis directly related to..
decr estrogen
osteomalacia is..
decalcification of bones 2/2 vit D deficiency
-severe pain, fx, weakness & deformities
osteomyelitis is..
inflammatory response within bone typically caused by an infection
anthrogryposis is characterized by..
a limitation in jt motion & sausage like appearance of limbs; emphasis on flexibility exercises, AE, jt protection, adaptive devices, etc.
OI is characterized by..
abnormal collagen synthesis, leads to an imbalance b/t bone deposition & reabsorpotion;
BONES ARE VERY THIN, serious risk of fx & deformity of WBing bones
osteochondritis dissecans is..
-typically involves:
a separation of articular cartilage from underlying bone , typically involves the medial femoral condyle
MPS vs FMS
myofascial pain syndrome characterized by localized or regional pain in TPs, densensitization is key in tx via manual P, task performance training
tendinosis vs tendonitis
tendinosis NOT inflammatory
during the early stages of recovery from tendinosis, what strengthening shoudl be emphasized? q
ECCENTRIC
When do pts w bursitis c/o pain?
at REST, also during P/AROM but not in capsular pattern
myositis ossificans is..
-PRECAUTIONS:
abnormal calcification within a ms belly
-PRECAUTIONS include AVOIDANCE of being overly aggressive w ms flexibility exercises/STM, which could worsen condition
Paget’s disease involves..
caused by viral infection and/or enviornmental factors
-results in SPINAL STENOSIS, FACET ARTHROPATHY, POSSIBLE SPINAL FX
Structural vs functional scoliosis?
structural has a rotational component and is irreversible
when should conservative mgmt be used for a structural scoliosis?
less than 25 deg
when is surgery advised for structural scoliosis?
curves greater than 45 deg
