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MT Flashcards

1
Q

importance of pelvis

A

middle center of mass

locomotion

stability of masses above/below

base of vertebral column

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2
Q

function of pelvis w/ GI/GU

A

acts as a bowl supporting most of the systems

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3
Q

pelvis lymphatic/vascular importance

A

contains all vascular/lymphatic contents for below structures

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4
Q

important areas of pelvis for LE circulation

A

pelvic diaphragm and inguinal area

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5
Q

pelvis main functions

A
  • biomechanical function/balance
  • reproduction
  • elimination
  • vascular/lymphatics for the region and LE
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6
Q

basic anatomy of the innominate

A

composed of the ilium, pubis, and ischium

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7
Q

acetabulum structure

A

composed of 3 different ossifaciton centers (3 areas of innominate)

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8
Q

true vs accessory ligaments

A

true - bone to bone

accessory - attach at another ligament, tendon, or fascia

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9
Q

ligament functions

A
  • limit movement
  • permit motion
  • elastic quality
  • limit movement as part of reflex response
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10
Q

anterior pelvic ligaments

A

sacrospinous - sacrum to ischial spine

iliolumbar - from ilia to L5

anterior sacroiliac - covers sacroiliac joint

inguinal L - ASIS to superior pubic rami

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11
Q

posterior pelvic ligaments

A

sacrotuberous - sacrum to ischial tuberosity

posterior ascroiliac - covers sacroiliac joint

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12
Q

attachment of Gmax/biceps femoris

A

sacrotuberous L

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13
Q

attachement of coccygeus M

A

sacrospinous L

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14
Q

iliolumbar L function

A

stabilization of L5, prevents excessive anterior/rotary motion

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15
Q

origin of IOM and TAM

A

inguinal L

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16
Q

L preventing anterior displacement of sacrum

A

anterior sacroiliac L (thicker than PSL for this reason)

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17
Q

L filling irregular space posteriosuperior to sacroiliac joint

A

interosseous sacroiliac L

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18
Q

attachment points of PSL

A

3rd/4th sacral segments to PSIS and posteiror iliac crest

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19
Q

attachment points of ASL

A

3rd sacral segment to lateral pre-auricular sulcus

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20
Q

attachment points of inguinal L

A

pubic tubercle to ASIS

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21
Q

attachment points of sacrospinous L

A

ischial spine to lateral sacrum/sacrotuberous L

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22
Q

attachment points of sacrotuberous L

A

lower sacral tubercles to ischial tuberosity

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23
Q

Ls associated w/ pubic symphysis

A

superior pubic L (above) and inferior pubic L (below)

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24
Q

innominate w/ heel strike

A

right heel strike = right innominate rotates posterior due to iliopsoas contraction

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25
Q

innominate w/ toe off

A

right toe off = right innominate rotates anterior w/ iliopsoas relaxation and gmax/hamstring contraction

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26
Q

major/minor hip flexors

A

major = iliacus, psoas

minor = rectus femoris, sartorius

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27
Q

hip extensors

A

Gmax, hamstrings (biceps femoris, semitendonosis, semimembranosis)

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28
Q

hamstring tension effect on innominate

A

posterior rotation

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29
Q

rectus femoris, iliacus, or adductor tension effect on innominate

A

anterior rotation

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30
Q

major/minor hip adductors

A

major = ad magnus/brevis/longus

minor = gracilis, pectineus

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31
Q

hip abductors

A

Gmed, Gmin, TFL

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32
Q

trendelenburg sign

A

drop of pelvis when lifting leg opposite to a weak Gmed

+ sign = abductor strenght not adequate

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33
Q

causes of trendelenburg gait

A

weak abductor (Gmed/Gmin) or superior gluteal N (L5) issues

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34
Q

hip external rotators

A

piriformis, obturator externus/internus, superior/inferior gemilli, quadratus femoris

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35
Q

only hip rotator connected to sacrum

A

piriformis

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36
Q

quadratus lumborum effect on Ns

A

may product Sx of groin pull/hernia by irritating the ilioinguinal and iliohypogastric Ns as they pass anterior to it (L1)

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37
Q

greater and lesser sciatic formaen are created by

A

sacrospinous L

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38
Q

gravitational line

A
  • auditory meatus
  • acromion process
  • greater trochanter
  • L3 body
  • anterior 1/3 of sacrum
  • lateral condyle of knee
  • lateral malleolus
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39
Q

innominate shear

A

superior/inferior motion of one innominate

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40
Q

innominate flare

A

flares out/in as measured by distance of ASIS to midline on both sides

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41
Q

lateralization tests

A

used to determine which side SD is on

standing flexion test and ASIS compression test

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42
Q

rib articulations w/ spine

A

articulates w/ superior costal facet of its own vertebra

articulates w/ inferior costal facet of above vertebra

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43
Q

rib tubercle articulation

A

articulates w/ transverse process of its own vertebra

44
Q

joints of ribs

A

costochondral and sternocostal

45
Q

rib articulation exceptions

A

1/10/11/12 - articulate only w/ their own vertebra

11/12 - dont have tubercles, dont articulate w/ TPs

46
Q

atypical/typical ribs

A

1, 2, 11, 12 (sometimes 10) are atypical

3-9 (sometimes 10) are typical (have all landmarks)

47
Q

true/false ribs

A

true = 1-7; cartilage attaches to sternum

false = 8-12;

  • 8-10 cartilage attaches to above ribs
  • 11-12 are floating
48
Q

rib at sternal angle (Louis)

A

rib 2 costal cartilage

49
Q

Ms of 1st/2nd ribs

A

i get up at 1 AM 2 P

Anterior scalene/Middle scalene - elevate 1
Posterior scalene - elevates 2

50
Q

pec minor action and correlation w/ ribs

A

stabilizes scapula drawing it inferior/anterior; inserts of ribs 3/4/5

51
Q

serratus anterior action and correlation w/ ribs

A

protracts scapula, ribs 2-8 insertion

52
Q

lat action and correlation w/ ribs

A

extends/adducts/med rotates humerus, lower 4 ribs origin

53
Q

quadratus lumborum action and correlation w/ ribs

A

fixes 12th rib in inhalation (insertion)

54
Q

external intercostals

A

from spine -> costal cartilage

elevates during forced inspriation

55
Q

internal intercostals

A

from rib angle -> sternum

depresses ribs

56
Q

innermost intercostals

A

from rib angle -> costal cartilage

depresses ribs

57
Q

origin of diaphragm

A

xiphoid process, lower 6 ribs, L1-L3

58
Q

vessels/nerves b/w ribs

A

VAN (vein most superior) b/w ribs found in b/w internal and innermost Ms

59
Q

bucket handle rib motion

ribs

A

superior/lateral motion, increase transverse diameter (AP axis)

ribs 1-2, 8-10

60
Q

pump handle rib motion

ribs

A

superior/anterior motion, increase AP diameter (transverse axis)

ribs 3-7

61
Q

caliper/pincer rib motion

ribs

A

downward/posterior in inspiration, upward/anterior in expiration

ribs 11/12

62
Q

torsional rib movement of rib

A

due to rotation of thoracic spine

T6 RL -> L 6th rib turns externally, R 6th rib internally; L 6th sharp/flat anteriorly, R 6th accentuated

63
Q

non-physiologic movement of rib

A

due to trauma -> ant/post subluxation

64
Q

inhalation SD

A

inhalation more free, exhalation restricted

exhalation SD opposite

65
Q

ribs in inhalation/exhalation SDs

A

inhalation SD = ribs 1-4 held up (key rib = 4)

exhalation SD = ribs 3-8 held down (key rib = 3)

66
Q

key ribs

A

BITE (bottom inhalation, top exhalation)

key rib maintains the group, treat key rib first

67
Q

ribs 11-12 inhalation SD cause

A

quadratus lumborum

68
Q

rib 1 ex SD cause

A

ant/med scalene Ms

69
Q

rib 2 ex SD cause

A

post scalene

70
Q

ribs 3-5 ex SD cause

A

pec minor

71
Q

ribs 6-8 ex SD cause

A

serratus anterior

72
Q

ribs 9-10 ex SD cause

A

lat

73
Q

ribs 11-12 ex SD cause

A

quadratus lumborum

74
Q

major cause of rib dysfunction

A

thoracic scoliosis/kyphosis

rib asymmetries (excavatum/carinatum)

osteoporosis/osteoarthritis (anteriorly depress ribs)

COPD

M strain

trauma

slumping (depression, desk work, etc)

75
Q

SI joint after puberty

A

males: well developed and strong
females: less developed for childbirth

76
Q

males SI joint degeneration

A

begin in sacral side in 4th-5th decade of life

77
Q

SI joint type

A

diarthrodial joint - contains synovial fluid

is unique b/c 1 side is hyaline cartilage and other is fibrocartilage (sacral hyaline, iliac fibro)

78
Q

SI ligaments

A

posterior - thicker, blends w/ STL and thoracolumbar fascia

anterior - blends w/ iliolumbar L

79
Q

long dorsal SI ligament

A

stretches w/ pregnancy/aging, connects to PSIS

80
Q

form/force closure of the sacrum

A

form - due to how the joints fit together

force - due to gravity/loading forces/Ms/etc

81
Q

axes of the sacrum

A

Superior Transverse (respiratory) - parallel and through S2

Middle Transverse (postural) - through S2 parallel to the ground not the vertebrae

Inferior Transverse (pelvic) - through S3 upwards

82
Q

lumbar/sacrum relationship

A

lumbar flexion -> sacral extension

lumbar extension -> sacral flexion

83
Q

sacrum movement relationship w/ base/apex

A

extension -> base posterior, apex anterior

flexion -> base anterior, apex posterior

84
Q

Tender vs Trigger points

A

Tender - in Ms/Ts/Ls/fascia, twitch response not present

Trigger - in Ms, has radiating pain pattern, present in a taut band of tissue, elicits twitch response

85
Q

Tender vs Trigger points Tx

A

tender - spontaneous release by positioning (counterstrain)

trigger - spray and stretch

86
Q

nociceptive model of counterstrain

A

tissue is strained recruiting nociceptors within that tissue -> reflexive contraction occurs within tissue -> contraction becomes the new neutral

87
Q

proprioceptive model of counterstrain

A

muscle is strained (w/o nocicpetor recruitment) -> antagonist M shortens via antagonist gamma neuron system -> antagonist contraction new neutral

seen in whiplash: posterior neck Ms strained, so anterior shorten in new neutral

88
Q

nociceptive/proprioceptive models similarity

A

constriction -> decreased circulation causing localized edema and back up of products of metabolism

89
Q

4 phases of counterstrain

A
  • relaxation
  • reset of spindle fibers/nociceptors
  • washout
  • slow return to neutral
90
Q

counterstrain vs MET targets

A

counterstrain - muscle spindle fibers

MET - golgi tendon organs

91
Q

washout in counterstrain

A

washing out of waste products

begins 10-15 seconds, peaks at 1 min

92
Q

time for counterstrain holding

A

90 seconds for most

120 seconds for ribs

93
Q

anatomical reasoning for tender point

A

where motor N pierces investing fascia and enters M

94
Q

position of comfort

A

70% of tenderness alleviated

95
Q

position of optimal comfort

A

100% of tenderness alleviated

96
Q

maverick

A

tender point that does not respond to typical positioning, usually requires opposite position from standard

97
Q

counterstrain founder

A

Lawrence Jones 1955/1980 published

98
Q

sacral Dx

A

review notes and sacral review ppt

99
Q

L5 movement w/ sacral torsion

A

rotates opposite = compensated
rotates same = uncompensated
SB towards the axis

flexed sacrum -> neutral L5 (T1)
extended sacrum -> flexed/extended L5 (T2)

100
Q

Ms elevating ribs 1/2

A

woke up at 1am 2P

1 - anterior and middle scalenes
2 - posterior scalenes

101
Q

pec Ms contraction leads to what rib SD

A

contraction -> inhalation SD

this is why exhalation dysfunctions contract it

102
Q

M elevating ribs 3-5

A

pec minor

103
Q

M elevating ribs 6-8

A

serratus anterior

104
Q

M elevating ribs 9-10

A

lat

105
Q

M elevating ribs 11-12

A

quadratus lumborum

OS2 (4 decks)

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