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Cram List for NPTE > MSK review > Flashcards

MSK review Flashcards

1
Q

Grade this ankle sprain:

mild joint instability, moderate intra- capsular swelling and tenderness, and some loss of ROM and joint function

A

Grade II lateral ankle sprain

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2
Q

Grade?

Complete rupture of the anterior talofibular ligament, calcaneofibular ligament, and capsule with mechanical joint instability; severe intra/extra-capsular swelling, ecchymosis, tenderness and inability to weight-bear.

A

a severe or Grade III lateral ak sprain

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3
Q

Grade?

Stretch of the lateral ligament complex with no macroscopic tear or joint instability, little swelling or tenderness

A

Grade I lateral ankle sprain (mild)

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4
Q

Syndesmosis sprain ankle sprain looks like?

A

inability to bear weight, severe ecchymosis (a discoloration of the skin resulting from bleeding underneath), mortise widening

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5
Q

medical term for a dark purple spot when blood leaks into top layer of skin.

A

ecchymosis - from greek “to pour out”

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6
Q

What test?

Lie the patient supine on the bed. Place the patient’s knee in about 20-30 degrees flexion. According to Bates’ Guide to Physical Examination, the leg should also be externally rotated slightly. The examiner should place one hand behind the tibia and the other on the patient’s thigh. It is important that the examiner’s thumb be on the tibial tuberosity.

A

Lachman’s test for ACL

Anterior translation of the tibia associated with a soft or a mushy end-feel indicates a positive test

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7
Q

Tibialis anterior weakness and sensory loss along the anterior leg below the knee are the most common signs of x nerve root entrapment.

A

L4

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8
Q

a childhood condition that occurs when blood supply to the ball part (femoral head) of the hip joint is temporarily interrupted and the bone begins to die.

A

Legg-Calvé-Perthes’ disease

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9
Q

Constant pain without any relation to position is a key indicator of

A

spinal cancer.

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10
Q

What deformity?

digit has a hyperextended metacarpophalangeal joint, flexed proximal interphalangeal joint, and a hyperextended distal interphalangeal joint.

A

Boutonniere deformity

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11
Q

Mallet finger involves

A

just flexion of the DIP joint

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12
Q

The O’Brien’s test is MOST indicative of

A

SLAP tears.

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13
Q

Extension activities will exacerbate any pain from

A

spondylolisthesis, stenosis of the spinal canal

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14
Q

for hypomobility of the neck, thrust manipulation of the x spine can provide short-term improvements in patients with mechanical neck pain.

A

thoracic

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15
Q

precautions to avoid dislocation with a THA that used a posterior surgical approach

A

flexion, medial rotation, and adduction.

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16
Q

Shoulder rotation, especially x, is the MOST helpful at strengthening the rotator cuff, which will be the MOST helpful at treating subacromial bursitis.

A

external rotation

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17
Q

Numerous studies indicate that maintaining x function after knee surgery speeds recovery.

A

quadricep

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18
Q

Forward head posture impacted by ___ tightness and ___ weakness

A

pec minor tightness

Sh retractor weakness

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19
Q

ligament located just inferior to the medial malleolus and is commonly injured in eversion sprains.

A

Deltoid

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20
Q

A patient reports pain in the knee while descending stairs. The pain increases with knee flexion, especially at approximately 30 degrees of flexion.

Which disorder likely present?

A

pain at approximately 30 degrees of flexion with eccentric loading, the point of the greatest compression of the patella into the femur = PFPS

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21
Q

Patrick’s Test (or the FABER Test) is used to test for

A

hip or SI joint pathology

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22
Q

Straight Leg Raising Tests for what?

A

Herniated discs

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23
Q

dark line is caused by increased melanocyte-stimulating hormone occurs in what?

A

Linea nigra, pregnancy

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24
Q

Supine; placing pillows under the x side of the body will help offload the inferior vena cava during treatment.

good for?

A

right

good for pregnancy

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25
Q

??, characterized by excessive collagen production and adhesions that result in restricted joint motion and pain, is the MOST common complication of surgical joint repair

List examples ^

A

Arthrofibrosis - characterized by excessive collagen production and adhesions that result in restricted joint motion and pain.

frozen shoulder, adhesive capsulitis,

joint contracture

stiff knee and stiff elbow.

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26
Q

anterior shoulder dislocation which creates a divot in the cortex of the humeral head.

what is this called?

A

Hill-Sach’s lesion

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27
Q

Difference between primary vs secondary shoulder impingement

A

secondary causes (2)= pinching of the rotator cuff in the shoulder joint itself; OR overuse d/t rotator cuff from attempting to stabilize an unstable GHJ

primary = pain in the shoulder is caused by direct (or primary) mechanical rubbing of the rotator cuff tendon by surrounding bony structures

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28
Q

MOST important consideration during rehab for meniscus repair? How long to limit?

A

Avoid full knee flexion - will shift the menisci posteriorly and disturb the repair site. Most protocols call for limited weight bearing and flexion for about 6-10 weeks.

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29
Q

The most dangerous point of rehabilitation is approximately x weeks when the graft is remodeling

A

6-8

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30
Q

Steps of gioniometric measurement

A

1) estimate
2) Locate landmarks
3) align
4) read

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31
Q

Joint Mob Grade X is large amplitude oscillation to the limits of available motion.

A

3

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32
Q

Grade X is large amplitude oscillations, but not to end of range.

A

2

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33
Q

Grade ?? is small amplitude oscillations at the end of range.

A

4

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34
Q

Grade ?? is high velocity, low amplitude thrust past the end of range.

A

5

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35
Q

correct landmarks for plumb line

A

posterior to the coronal suture

anterior of the lateral malleolus.

posterior to the iliofemoral joint

@ Vertebral bodies of the lumbar spine

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36
Q

A patient with an above knee prosthetic limb is displaying lateral trunk bending toward the involved lower extremity while ambulating. What is MOST likely cause of this gait abnormality?

A

Medial wall too high

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37
Q

If prosthetic is too long, what is likely?

A

Circumducted gt

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38
Q

Poor suspension leads to what type of gt?

A

vaulting in order to keep residual limb inside socket (approximate gap via gastroc)

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39
Q

When the capsule shrinks and sticks, the end-feel becomes

A

very firm.

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40
Q

Best test for anterior talofibular ligament integrity

A

Anterior drawer

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41
Q

Talar tilt test will indicate a torn x ligament.

A

calcaneofibular

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42
Q

x is a test for Achilles tendon rupture.

A

Thompson

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43
Q

Ottowa 2-step test rules out ?

A

fx

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44
Q

A patient is asked to flex their shoulder to 90 degrees with the forearm in full supination. The examiner places resistance downward against the flexed arm.

Name? Rules out?

A

Speed’s Test for bicep tendon pathology.

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45
Q

Rotator cuff pathology can be tested with resisted

A

external/internal rotation

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46
Q

Ratio of GH to scapulothoracic movement?

A

there is typically a 2:1 glenohumeral:scapulothoracic ratio of movement that will achieve full shoulder flexion.

120;60

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47
Q

Capsular pattern for T spine?

A

Equal lateral flexion and rotation inhibited, less so for extension

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48
Q

The TUG test is a timed test where less than x seconds is normal and higher than x seconds in community-dwelling elderly indicates a high fall risk.

A

10/30

49
Q

The tibial plateau rotates laterally during the final x degrees of extension.

A

20

50
Q

Having elbow flexion of approximately x degrees will allow optimal stability while ambulating on parallel bars

A

20

51
Q

degrees of plantarflexion is required for gait during the preswing phase.

A

20

52
Q

describe terminal stance

A

contralateral tibia is perpendicular to the ground w ispi knee in full extension

53
Q

Terminal swing is when

A

reference tibia slows for initial contact with the floor

54
Q

Midstance begins at what action of contralat foot

A

At the point of toe off of the contralateral foot.

55
Q

The x joint is a flexion/extension joint of the head

A

AO

56
Q

Atlanto-axial joint produces what motion

A

“no”

57
Q

Percentage of body weight offset with water levels at…

neck?

Chest?

Hips?

Knees?

A

90 - 75 - 50 -35

58
Q

is an appropriate weight-bearing activity for patients seeking to improve bone density.

A

Progressive leg press training

59
Q

What grades??

The patient is able to complete < ½ ROM with gravity eliminated

Pt is able to complete full ROM, gravity elim

Pt is able to complete full ROM in gravity elim position + slight resistance

Pt is able to complete <1/2 ROM against gravity

A

Poor- 2- Partial ROM, gravity eliminated

Poor 2 Full ROM, gravity eliminated

Poor+ 2+ Gravity eliminated/slight resistance or < 1/2 range against gravity

60
Q

patient is able to complete more than ½ of the available range of motion against gravity.

A

3-

61
Q

The patient is able to complete the range of motion against gravity, but NO resistance

A

3

62
Q

The patient is able to complete less than ½ of the available range of motion with gravity eliminated

A

2-

63
Q

A patient with a stroke affecting the right middle cerebral artery has difficulty walking, especially over uneven surfaces. Which of the following describes the MOST appropriate initial treatment?

A

SPC training on even surface

left LE weakness = counterbalance cane on R hand for STEP TO training

64
Q

Describe Brown Sequard Syndrome

A

Ipsilateral Sensory/Motor loss

Contralateral pain and temperature loss

65
Q

Squat pivot transfer requires what?

A

adequate upper extremity strength

66
Q

Rotator cuff strength is critical to x the humeral head during shoulder flexion.

A

depress

aka if RTF is weak, secondary impingement occurs

67
Q

is characterized by dizziness lasting about 1 minute following head position changes, such as stooping or turning

The Epley Maneuver is used to treat, primarily when the disturbance is in the posterior semicircular canal.

A

BPPV Benign paroxysmal positional vertigo

68
Q

x disease is a fluid imbalance in the inner ear; can cause persistent dizziness and lightheadedness.

A

Meniere’s

69
Q

neurological disorder characterized by the inability to perform learned (familiar) movements on command, even though the command is understood

Pt may try to APPROXIMATE the movement

A

Apraxia

70
Q

A positive x sign is one when leg pain is reproduced or pain in the gluteal region passive straight leg raising. The test has a high sensitivity (0.80-0.97) for a low lumbar disc protrusion but has a low specificity

A

Lasègue’s

71
Q

The tibia rotates ____ in Open chain terminal extension

In closed chain exercises, the Femur rotates _____ on the tibia

A

Tibia moving = Rotates Externally

Femur moving = Rotates Internally

72
Q

a painful condition that affects the ball of your foot, most commonly the area between your third and fourth toes; may feel as if you are standing on a pebble; may be caused by pressure or injury, such as from running or use of high heels

A

Mortons Neuroma

73
Q

How to distinguigh valgus vs varus forces?

example @ hip/knee

A

by PROXIMAL joint

ValGUS displaces distal shaft LATERALLY to the midline

Varus displaces distal shaft MEDIALLY to the midline

  • Lateral displacement to distal leg will produce valgus knee and varus hip/coxa
  • Medial displacement will produce varus knee and valgus coxa
74
Q

Mechanism of injury for PLC tear/sprain

A

Forced knee hyperflexion on planted foot

75
Q

Most common graft cite for ACL repair? Concequences?

A

Patellar tendon (Quads will be weakened)

76
Q

Cause: repetetive overhead motion

Deep ache in anterosuperior shoulder made worse with lifting objects

Resisted supination tests for positivity***

what pathology?

A

Bicipital tendontitis

77
Q

A ____ tear is most susceptible with anterior damage or subluxation (shoulder)

A

labral

78
Q

Avulsion of labral ligament complex from the inferior aspect of glenoid = what type of lesion?

A

Bankarts

79
Q

Primary stabilizer of medial knee against valgus force and lateral rotation of tibia

A

Medial Collateral Ligament

80
Q

Laxity with valgus testing

inability to fully extend knee

loss of strength, proprioception, antalgic gait

what pathology?

A

MCL Sprain (grade 2)

81
Q

this ligament attaches proximally on lateral femoral condyle to the distal posterior insert at the fibula

injury is far less common than to counterpart

A

Lateral Collateral Ligament of the knee

82
Q

Most common joint disease

A

Osteoarthritis

83
Q

Risk factors for secondary OA of young individuals?

A 
Obesity
repetitive micro trauma
inflammatory arthritis
neuromuscular disorders
metabolic disorders
84
Q

The Q-angle is the angle between what two cites

A

Patella v ASIS

drop a plumb-line through the tibial tubercle and middle of the patella and another from the ASIS to intersect with the first line at the mid-patella. The angle created by the intersecting lines is the Q angle.

85
Q

The XX is a region where the tibial nerve passes between the medial malleolus and the calcaneus. XX syndrome is characterized by pain in WB but not with direct palpation of patellar fascia. Numbness, burning pain, parasthesias at the heel with entrapmet and compression of posterior tibial nerve or plantar nerves; thickening of flexor retinaculum may be seen.

What pathology?

A

Tarsal Tunnel Syndrome

86
Q

Lateral shoulder pain with radiation into deltoid and upper arm

mild to severe pain and lack of functionality with Sh lateral rotation and ABD

Crepitus, night pain

what pathology

A

RTC tear

87
Q

Painful arc of motion at 60-120 degrees active ABD

difficulty dressing, overhead motions

what pathology?

A

Shoulder impingement, RTC tendonitis

88
Q

Since RTC mm are dependent on adequate blood supply and O2, it is essential that all ROM and strengthening exercises are __ ___

A

PAIN FREE

89
Q

Significant scoliosis can cause what type of insufficiency?

A

Pulmonary

90
Q

Conservative tx for torticollis

A

Stretching, massage, positioning, bracing, HEAT and TRACTION

91
Q

Over 50 yrs old

back pain that increases with getting out of car/bed, standing, walking up incline or stairs

pain may follow dermatomal distribution, myotomal weakness

what pathology?

A

Spondylolysthesis (folowing DJD)

follow williams flexion exercsie protocols

92
Q

Posterolateral THA spares what mm group? - What containdicated movements?

Anterolateral approach contraindicated movements?

A

Post-Lat spares Hip ABDuctors; Contraindicated is flexion past 90, adduction, Medial rotation

Anterolateral = Hip flexion, Lateral rotation

93
Q

Cemented hip THA WB precautions?

Vs Noncemented?

A

Noncemented = TTWB for 6 weeks

Cemented = PWB

94
Q

Cemented TKA precautions vs Noncemented?

A

Cemented = PWB or WBAT

Noncemented = TTWB for 6 weeks

95
Q

TKA - what to avoid for several months after surgery?

A

Squatting

Sleeping with pillows under knees (contractions)

Quick pivoting

96
Q

Most common sites for osteosarcoma? (most common primary bone tumor)

A

Epiphiseal plates of long bones

distal femur
proximal tibia
proximal humerus
pelvis

97
Q

s/s of chemotherapy

A 
anemia 
abnormal bleeding
infection
kidney impairment
fatigue
diarrea
confusion
98
Q

_____ _____, also known as PAD, produces thickening and narrowing with eventual occlusion of the arteries; results in ____ of affected tissues; areas may become ____, ____, and require amputation

A

Arteriosclerosis Obliterans

Ischemia –> necrotic/necrosis, gangrenous

99
Q

Individual over 45 that smokes, presents with intermittent claudication in gastroc/soleus, decreased pulse and skin temperature.

Likely eventual candidate for what surgery?

A

Transtibial amputation

100
Q

The Neer shoulder protocol advocates initiating isometric shoulder exercises approximately ? weeks after TSA, and active shoulder exercises ? weeks after surgery.

What types of ROM are okay in first phase of rehab?

A

Isometric @ 3 wks, ACTIVE Sh exercise @ 6 wks

PROM,AAROM okay in first phase (pendulum, rod)

101
Q

Transverse fx of distal radius secondary to FOOSH

associated deformity?

A

Colle’s fx

dinner fork/bayonet deformity - hand/wrist shaped in zig-zag

102
Q

Infection of bone with staph = Osteo???

Calcification of mm post mm strain or contusion = ???

A

Infection = Osteomyelitis

Calcification = Myocitis Ossificans

103
Q

Compound vs communicated fx

A

compund - breaks skin

communicated = shattered

104
Q

What is a nonunion fx?

A

A fx that has failed to heal after 9-12 months

105
Q

RTC tear repair precautions after surgery

A

AROM, lifting, WB through arm for several weeks

106
Q

Precautions for shoulder stabilization surgeries (SLAP repair, capsular tightening, etc.)

remember lab!

A

External Rotation

Extension

Horizontal ABDuction

Resisted internal Rotation if subscap was detached during surgery

107
Q

After a SLAP repair, avoid contracting ?

A

biceps

108
Q

Common precautions for TSA

A

Avoid extension and external rotation to protect healing subscap and anterior capsule

avoid resisted internal rotation

109
Q

Signs of failure for hip ORIF following fx? (3)

What is more common with these fractures?

A

Leg length discrepency taht was not present initially

Trendelenburg sign that does not improve with strengthening

persistent thigh/groin pain

More common = nonunion and osteonecrosis d/t lack of blood @ femoral neck

110
Q

For external hip ORIF, early ___ is allowed but ____ _____ is postponed until mm have healed

what mm likely affected from surgery?

A

Early WB, isotonic strenghtening postmponed

TFL, Glute Med, Vasus Lateralis

111
Q

Graft tissue is most vulnerable when?

A

6-8 weeks post op

112
Q

ACL rehab = avoid what?

A

open chain ex @ o-45 deg (stresses graft site)

113
Q

Ulnohumeral resting position

vs

Radiohumeral resting position

A

Ulonhumeral = 70 deg ext + 10 supination

Raiohumeral - FULL ext, FULL sup

114
Q

Radioulnar jts connect the ends of the radius and ulna.

Proximal radioulnar resting position

vs Distal

A

Proximal = 70 deg flexion, 35 sup

Distal = 10 deg sup

115
Q

Most common carpal fractured?

A

Scaphoid @ base of Radius

116
Q

Name carpals in clockwise from SCaphoid

S

T

T

C

H

T

P

L

A

Scaphoid

Trapezius

Trapezoid

Capitate

Hamate

Triquetrum

Pisiform

Lunate

117
Q

Actions

Origin

Insertion

Lat Dorsi

A

Scapular depression

GH EXT + ADD + MR

Originates @ spinous process T7-L5
Inserts at intertubuercular groove

118
Q

Mm of scap upward rotation

A

Trap

Serratus

Cram List for NPTE (22 decks)

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