Musculoskeletal Flashcards
toe raises - nerves
S1, tibial n
Heel walking tests what nerves
L4, 5, deep fibular n
hip flexion - nerve
L1, 2; femoral n
knee extension - nerve
L3, 4; femoral n
dorsiflexion - nerve
L4, 5; deep fibular
big toe extension - nerve
L5; deep fibular n
ankle eversion - nerve
L5, S1; superficial fibular
Patellar Tendon DTR tests:
L3, 4
Achilles Tendon DTR tests:
S1, 2
C/S Rotation - nerve
C1
Shoulder elevation - nerve
C2, 3, 4
Shoulder abduction - nerve
C5
elbow flexion - nerve
C5-C6
Elbow extension - nerve
C7
wrist flexion - nerve
C7
Wrist extension - nerve
C6
thumb extension - nerve
C8
Finger abduction - nerve
T1
MMT grades (numbers v words)
5 - normal 4 - good 3 - fair 2 - poor 1 - trace
Biceps DTR tests:
C5
Brachioradialis DTR tests
C6
Triceps DTR tests:
C7
SLR c Tibial n bias
DF and Eversion
SLR c Fibular n bias
PF and Inversion
SLR c Sural n bias
DF and Inversion
forward flexion test for SIJ
palpate both PSISs, the one that moves first or farthest is the blocked or (+) side
Gillet’s test
Normal PSIS will move inferiorly
Long sitting test for rotated inominate: what will you see c anterior rotated? posterior rotated?
anterior rot inom: longer supine, shorter sitting
posterior rot inom: shorter supine, longer sitting
prone knee bend tests which n roots?
femoral n: L1-3
SLR tests which n roots?
sciatic: L4-S3
SIJ cluster
3/5 need to be positive. Distraction, thigh thrust, Gaenslen’s, sacral thrust, compression
Shoulder impingement tests
neer, hawkins kennedy, painful arc
RC special tests
drop arm test, ERLS, IR lag sign, lift off, belly press
Shoulder Instability special tests
Sulcus sign, anterior apprehension test, relocation test, anterior drawer test, jerk test for posterior instability
AC joint special tests
Horizontal adduction test, resisted horizontal extension test, o’brien’s sign, Paxinos sign, palp AC jt
Labrum shoulder special tests
Crank, biceps load I & II, pain provocation test, compression rotation, obrien’s active compression, resisted supination ER
Cubital tunnel special tests
pressure provocative test, flexion, tinel’s
MCL tears special tests
Valgus stress at diff degrees of elbow flexion, moving valgus test
Lateral Epicondylitis special tests
mmt, mill’s test
Ligamentous instability of hand special tests
thumb ulnar collateral lig test, lunatetriquetral ballottment test
osteochondritis dissecans - what is it?
separation of articular cartilage from bone
where does osteochondritis dissecans happen most frequently?
medial femoral condyle near intercondylar notch
Osteomalacia - what is it? what causes it?
decalcification of bones
vit D deficiency
Osteoporosis - what is it?
depleted BMD
Paget’s disease - what is it?
metabol bone disease: excessive bone reabsorption, then formation of fragile bone
Paget’s disease - where?
spine, pelvis, femur, skull
patellofemoral dysfunction tests?
Q angle >18 deg; (+) chondromalacia test
chondromalacia test - patellofemoral jt
compress patella, contract quadriceps mm
Tx for PFP?!?
McConnell’s taping, VMO strengthening :(, stretch ITB & TFL, shoe inserts, x-friction massage at lateral retinaculum, pat mobs
Scleroderma/progressive systemic sclerosis - what is it?
fibrosis and changes in organs & skin, sometimes c raynaud’s
Scleroderma - symptoms
polyarthralgia early, heartburn, dyspnea, RF, problems in skin, GI, cardioresp, kidneys
Scleroderma - Tx
ROM, meds, strengthening
Pronator Teres synd - what is it?
median n entrapment
Pronator Teres synd - test
resist pronation while elbow is extended
RA onset
30-40yo
RA - other manifestations
c/s (SC compression), cardio, pulm, GI, eye lesions, OP
JRA - onset & symptoms
before 16yo, 75% complete remission
fever & rash
scaphoid fx concern
poor vasc supply -> AVN
scoliosis is named for
area and convexity of curve
scoliosis sx considered c cobb angle
> 40-50 deg
Sjorgren’s syndrom - what is it?
rheumatoid like disorder c dry mucous membranes, jt inflam, and anemia
Smith’s Fx is what?
wrist, displaced ventrally (reverse colle’s)
Smith’s fx is caused by
falling on flexed wrist
Sprain - 1st degree
some fibers torn, stable joint
Sprain - 2nd degree
portion of lig is torn, mod hemorrhaging, some fn.al loss, stable joint
Sprain - 3rd degree
complete disruption/avulsion of lig, loss of fn, jt instability, pronounced hemorrhaging/swelling
SLE symptoms
malaise, fatigue, arthralgia, fever, arthritis, butterfly rash, photosensitivity, anemia, hair loss, raynaud’s , kidney issues, vasculitis
TMJ synovitis and capsulitis symptoms
Preauricular P, unable to close back teeth, <40mm opening bc of P, less P c rest
TMJ hypermobility symptoms
jaw goes out of place, noises, >40mm opening
March Fx of tibia - what is it? who gets it?
inferior 1/3, common in long walkers who aren’t used to long walks
Spiral Fx of tibia - what is it? who gets it?
at jn of middle and inferior 1/3s, tibial torsion, skiers
Compound Fx of tibia - how?
direct blow, bumper of car
THR - precautions
hip flexion, adduction, IR c posterior approach
ER c anterior apporoach
Severs disease
Sever’s disease (i.e., calcaneal apophysitis) is a painful bone disorder that results from inflammation of the growth plate in the heel. The disease MOST commonly occurs during adolescence and rarely occurs once an individual reaches skeletal maturity. The pain is typically located on the posterior surface of the calcaneus.
Parafin melting point and specific heat
Paraffin has a low melting point that can be lowered further by adding mineral oil. As a result, paraffin can provide a more even distribution of heat to areas such as the fingers and toes. Paraffin also has a low specific heat which enhances a patient’s ability to tolerate heat from paraffin compared to heat from water at the same temperature.
normal adult cadence
110-120 steps per min
syme’s amputation
removal of foot with malleoli
chapart’s amputation
disarticulation at mid tarsal
golgi tendon is sensitive to
tension
comminuted fracture
breaks into pieces
greenstick fracture
breaks on one side, no damage to periosteum
X-ray
screen for bone and joint injuries, lung and heart disease, foreign objects
MRI
visualization of soft tissues
CT
imaging of bone and most soft tissues
bone scan or bone scintigraphy
radionucleotide injected intravenously to visualize areas of increased metabolic activity. identifies stress fractures and tumors not detected on X-Ray
what happens with hypertrophy
6-8 weeks
fibers enlarge
more actin and myosin
more and larger myofibrils
Bells palsy symptoms
facial nerve 7
motor weakness of the muscles of facial expression, taste to anterior tounge, tearing, salvation
Cold pack temp
A cold bath requires water temperature ranging from 55 to 64 degrees Fahrenheit.
Hot pack temp
158-167
Cervical traction initial starting weight
A force between 10 and 15 pounds is often used to initiate mechanical cervical traction. Seven percent of the patient’s body weight may be necessary for separation of the vertebrae.
Dermatome testing: anterior thigh
L2
Dermatome testing: middle third of anterior thigh, medial knee
L3
Dermatome testing: patella and medial malleolus
L4
Dermatome testing: Fibular head and dorsum of foot, dorsal aspect for great toe
L5
Dermatome testing: Lateral and plantar aspect of foot
S1
Dermatome testing: medial aspect of posterior thigh, popliteal fossa
S2
Dermatome testing: Perianal area
S3-S5
Dermatome testing: Posterior head
C2
Dermatome testing: Posterior lateral neck
C3
Dermatome testing: ACJ
C4
Dermatome testing: Lateral arm
C5
Dermatome testing: lateral forearm and thumb
C6
Dermatome testing: Palmar distal phalanx-middle finger
C7
Dermatome testing: Little finger and ulnar border of hand
C8
Dermatome testing: medial forearm
T1
resistance training for muscular endurance
< 70 % 1RM
12-20 reps
1-3 sets
20-30 seconds between sets
resistance training for hypertrophy and strength
70-80% 1RM
8-12 reps
1-6 sets
30-120 seconds between sets
resistance training for max strength
80-100% 1RM
1-8 reps
1-5+ sets
2-5 minutes between sets
ISAD- negative ions used in ionto
iodine, salicylate, acetic acid/acetate, dexamethasone
home adjustments for: ramp rise, toilet seat height, doorway clearance, handlebar placement
1:12 rise
raise toilet to 17-19 inches
32 inches doorway clearance (36 is ideal)
handle bar height should be 33-36 inches
forces for traction of the lumbar spine
minimum initial: 25%
25% for split table, 50% for non-split table
biofeedback electrode placement and sensitivity settings`
For WEAK MUSCLES: place electrodes widely apart and use high sensitivity settings to increase detection (for single weak muscle place them close together for more precise signal detection). As motor recruitment improves decrease sensitivity, making it more difficult to produce an audiovisual signal.
For OVER ACTIVE MUSCLES: place electrodes close together with low sensitivity to minimize cross-talk. Progress from low to high sensitivity.
Isokinetic exercise
provides maximum resistance throughout all points of ROM as muscle contracts. Has speed control
Isotonic exercise
can have constant (free weights) or variable (machines) load as the muscle lengthens/shortens through ROM. Speed can be variable
breathing L/min
6 at rest
max exercise 200 L/min
muscle spindle
monitors velocity an length changes in muscle
alpha motor neurons
stimulated by a quick stretch and facilitates muscle contraction via monosynaptic stretch reflex (can increase tension in muscle to be stretched)
GTO
inhibits contraction of muscle when exercise tension develops (inhibits alpha motor neurons via autogenic inhabition) allowing muscle to lengthen (stretch protection reflex)
supine to long sit test
the leg at the side of the posterior rotation will be shorter in supine position and longer in sitting position
how to stretch lumbricals
The lumbricals contract to a shortened position of metacarpophalangeal flexion and interphalangeal extension. Thus, metacarpophalangeal extension and interphalangeal flexion would best stretch the muscles.