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NPTE-PT > Musculoskeletal > Flashcards

Musculoskeletal Flashcards

1
Q

What are the 5 requirements of full shoulder elevation?

A
  1. scapular stabilization
  2. inferior glide of the humerus
  3. ER of humerus
  4. rotation of the clavicle at SC joint
  5. scapular abduction and lateral rotation of AC joint
  6. straightening of thoracic kyphosis
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2
Q

What arteries supply the elbow joint?

A

brachial artery, anterior ulnar recurrent artery, posterior ulnar recurrent artery, radial recurrent artery, and middle collateral branch of the deep brachial artery

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3
Q

What is the biomechanics of the elbow joint during flexion/extension?

A

During flexion, the ulnar externally rotates (supinates) and internally rotates (pronates) during extension.

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4
Q

Middle pillar of carpals

A

lunate and triquetrum with capitate and hamate

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5
Q

Lateral pillar of carpals

A

scaphoid with trapezium and trapezoid

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6
Q

What arteries supply the wrist/hand?

A

ulnar and radial arteries merge to form the palmar arch which sends digital branches up the medial/lateral aspect of each digit

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7
Q

Iliofemoral ligament

A
  • Comprised of two bands running from AIIS
  • The medial band runs to the distal intertrochanteric line
  • The lateral band runs to the proximal aspect of the intertrochanteric line
  • Both are taut with extension and ER. The superior band is taut with adduction, while the inferior band is taut with abduction
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8
Q

Pubofemoral ligament

A
  • Runs from the iliopectineal eminence, superior rami of the pubis, obturator crest, and obturator membrane, laterally blending with the capsule; inserts into the same point as the medial iliofemoral ligament
  • Taut with extension, ER, and abduction
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9
Q

Ischiofemoral ligament

A
  • Runs from the ischium and posterior acetabulum, superiorly, and laterally, blending with the zona articularis, and attaching to the greater trochanter
  • Taut with medial rotation, abduction, and extension
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10
Q

What arteries supply the hip joint?

A
  • medial and lateral femoral circumflex arteries supply the proximal femur
  • the femoral head is supplied by a small branch of the obturator artery
  • the acetabulum is supplied by branches from the superior and inferior gluteal arteries
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11
Q

Medical Collateral Ligament (knee)

A
  • runs anteriorly and inferiorly
  • taut in extension and slackened in flexion
  • prevents valgus forces and ER of the tibia
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12
Q

Lateral Collateral Ligament (knee)

A
  • runs inferiorly and posteriorly
  • taut in extension and slackened in flexion
  • prevents varus forces and ER of the tibia
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13
Q

Oblique popliteal ligament

A
  • inserts into expansion from the tendon of the semimembranosus; partially blending with capsule
  • forms the floor of the popliteal fossa and strengthens the posteriomedial capsule
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14
Q

Arcuate popliteal ligament

A
  • stem attaches to fibular head. Medial band attaches to posterior border of intercondylar area of tibia; lateral band extends to lateral epicondyle of femur.
  • Strengthens the posterolateral capsule
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15
Q

What arteries supply the knee joint?

A

descending branch from lateral circumflex femoral branch of the deep femoral artery, genicular branches of popliteal artery, and recurrent branches of anterior tibial artery

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16
Q

Biomechanics of the proximal tibiofibular joint during dorsiflexion/plantarflexion

A
  • During DF, the fibular head glides superiorly and posteriorly while the fibular shaft glides externally
  • During PF, the fibular head glides anteriorly and inferiorly while the fibular shaft glides internally
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17
Q

What arteries supply the ankle joint?

A

malleolar rami of anterior tibial and fibular arteries; articular innervation comes from the deep fibular and tibial nerves

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18
Q

Rule of 3

A
  • s.p. of T1-T3 are at the same level of the vertebral body;
  • s.p. of T4-T6 are one-half level below the vertebral body;
  • s.p of T7-T10 are one level below the vertebral body;
  • s.p of T11 is one-half level below the vertebral body;
  • s.p. of T12 is at the same level as the vertebral body
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19
Q

ROM of Shoulder

A

Flex/ext: 160˚-180˚/50˚-60˚
Abd/add: 170˚-180˚/50˚-75˚
ER/IR: 80˚-90˚/60˚-100˚

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20
Q

ROM of Elbow

A

Flex/ext: 140˚-150˚/0-10˚

Pronation/supination: 90˚/80˚-90˚

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21
Q

ROM of Wrist

A

Flex/ext: 80˚-90˚/70˚-90˚

Radial/ulnar deviation: 15˚/30˚-45˚

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22
Q

ROM of MCP

A

Flex/ext: 85˚-90˚/30˚-45˚

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23
Q

ROM of PIP

A

Flex/ext: 100˚-115˚/0

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24
Q

ROM of DIP

A

Flex/ext: 80˚-90˚/20˚

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25
Q

ROM of 1st CMC

A

Flex/ext: 45˚-50˚

Abd/add: 60˚-70˚/30˚

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26
Q

ROM of 1st MCP

A

Flex/ext: 50˚-55˚/0

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27
Q

ROM of 1st IP

A

Flex/ext: 85˚-90˚/0-5˚

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28
Q

ROM of Hip

A

Flex/ext: 110˚-120˚/10˚-15˚
Abd/add: 30˚-50˚/30˚
ER/IR: 40˚-60˚/30˚-40˚

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29
Q

ROM of Knee

A

Flex/ext: 135˚/0-15˚

ER/IR: 30˚-40˚/20˚-30˚

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30
Q

ROM of Ankle

A

Supination/pronation: 45˚-60˚/15˚-30˚

PF/DF: 50˚/20˚

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31
Q

ROM of 2nd-5th MTP

A

Flex/ext: 40˚/40˚

32
Q

ROM of 1st MTP

A

Flex/ext: 45˚/70˚

33
Q

ROM of 1st IP

A

Flex/ext: 90˚/0

34
Q

ROM of 2nd-5th PIP

A

Flex/ext: 35˚/0

35
Q

ROM of 2nd-5th DIP

A

Flex/ext: 60˚/30˚

36
Q

What are the best special tests for a SLAP tear?

A
  • Crank test

- Biceps load II

37
Q

What are the best special tests for cubital tunnel syndrome?

A
  • Elbow flexion test
38
Q

What are the best special tests for cubital tunnel syndrome?

A
  • Elbow flexion test

- Pressure provocation test

39
Q

Gout

A
  • A genetic disorder of purine metabolism, characterized by elevated serum uric acid
  • Medications: NSAIDs, COX-2 inhibitors, colchicine, corticosteroids, adrenocorticotropic hormone (ACTH), allopurinol, probenecid, and sulfinpyrazone
  • Lab tests identify monosodium urate crystals in synovial fluid and/or connective tissue samples
40
Q

Rheumatoid Arthritis

A
  • Plain film radiographs demonstrating symmetrical involvement within joints
  • Positive test findings include increased WBC count and erythrocyte sedimentation rate
  • Hemoglobin and hematocrit tests will show anemia and rheumatoid factor will be elevated
41
Q

Osteomalacia

A
  • Characterized by decalcification of bones due to vitamin D deficiency
  • Sx include severe pain, fractures, weakness, and deformities
  • Meds: calcitonin, vitamin D, and vitamin D injections
42
Q

Osteomalacia

A
  • Characterized by decalcification of bones due to vitamin D deficiency
  • Sx include severe pain, fractures, weakness, and deformities
  • Meds: calcitonin, vitamin D, and vitamin D injections
43
Q

What are the two types of CRPS?

A

1) CRPS I is frequently triggered by tissue injury; term describes all patients with the above symptoms, but with no underlying nerve injury
2) Patients with CRPS II experience the same symptoms but their cases are clearly associated with a nerve injury

44
Q

Paget’s Disease

A
  • Considered to be a metabolic bone disease involving abnormal osteoclastic and osteoblastic activity
  • Results in spinal stenosis, facet arthropathy, and possible spinal fracture
  • Meds: acetaminophen for pain control; calcitonin and etidronate disodium may also be beneficial
  • Dx tests: Plain film radiography; lab tests showing increased levels of serum alkaline phosphatase and urinary hydroxyproline
45
Q

TUBS

A
  • Traumatic
  • Unidirectional
  • Bankart lesion
  • Surgery is indicated in 75% of patients
46
Q

AMBRI

A
  • Atraumatic
  • Multidirectional
  • Bilateral
  • Rehabilitation is the treatment of choice
  • Inferior capsule shift

(75% do well with conservative treatment)

47
Q

What are the common sites of compression during TOS?

A
  • superior thoracic outlet
  • scalene triangle
  • between the clavicle and the first fib
  • between the pectoralis minor and the thoracic wall
48
Q

What is the capsular pattern of the GH joint?

A

ER>abd>flex>IR

49
Q

Lateral epicondylosis involves which muscle?

A

extensor carpi radialis brevis

50
Q

Medial epicondylosis involves which muscle?

A

pronator teres and flexor carpi radialis

51
Q

Panner’s Disease

A

localize avascular necrosis of capitellum leading to loss of subchondral bone, with fissuring and softening of articular surfaces of radiocapitellar joint; usually occurs in children 10 years and younger

52
Q

Differential diagnosis of carpal tunnel syndrome

A
  • cervical spine dysfunction
  • TOS
  • peripheral nerve entrapment
53
Q

Differential diagnosis of carpal tunnel syndrome

A
  • cervical spine dysfunction
  • TOS
  • peripheral nerve entrapment
54
Q

What is the clinical pattern of Dupuytren’s contracture?

A

affects men more than women; constracture usually affects the MCP and PIP joints of the fourth and fifth digits in nondiabetics, and affects the third and fourth digits in diabetics

55
Q

Boutonnière deformity

A

rupture of the central tendinous slip of the extensor hood; observed deformity is extension of the MCP and DIP joints and flexion of the PIP joint

56
Q

Swan neck deformity

A

contracture of intrinsic muscles with dorsal subluxation of lateral extensor tendons; flexion of MCP and DIP joints and extension of the PIP joint

57
Q

Swan neck deformity

A

contracture of intrinsic muscles with dorsal subluxation of lateral extensor tendons; flexion of MCP and DIP joints and extension of the PIP joint

58
Q

Signs & symptoms of TRUE piriformis syndrome

A
  • restriction in IR
  • pain with palpation of the piriformis muscle
  • referral of pain to the posterior thigh
  • weakness in ER, positive piriformis test
  • uneven sacral base
59
Q

What is the function of the piriformis?

A

Functions as an ER at less than 60˚ of hip flexion and can become overworked with excessive pronation of foot, causing abnormal femoral IR. At 90˚ of hip flexion, the piriformis becomes an IR and abductor of the hip.

60
Q

What clinical tests are useful to diagnose a meniscal injury?

A
  • Thessaly’s test
  • McMurray’s test
  • Apley’s test
61
Q

Which clinical tests are used to diagnose a meniscal injury?

A
  • Thessaly’s test
  • McMurray’s test
  • Apley’s test
62
Q

T/F: You should not use quad sets, single-leg raise, and isolated quadriceps exercises for PFPS

A

True

63
Q

What is the difference in weight bearing torsional stresses between adolescents and adults?

A

In adults, torsional stress in weight-bearing often results in an ACL injury, while the same stress results in a fracture of the epiphyseal plate in adolescents

64
Q

What are the three common etiologies of anterior tibial periostitis?

A
  1. abnormal biomechanical alignment
  2. poor conditioning
  3. improper training methods
65
Q

Anterior tibial periostitis is thought to result from overuse of:

A

anterior tibialis and extensor hallucis longus

66
Q

Medial tibial stress syndrome is thought to result from overuse of:

A

posterior tibialis and medial soleus

67
Q

Grading of lateral ankle sprains

A

Grade I: no loss of function, with minimal tearing of the anterior talofibular ligament
Grade II: some loss of function, with partial disruption of the anterior talofibular and calcaneofibular ligaments
Grade III: complete loss of function, with complete tearing of the anterior talofibular and calcaneofibular ligaments, and partial disruption of the posterior talofibular ligament

68
Q

Trimalleolar fracture involves:

A

medial and lateral malleoli and the posterior tubercle of the tibia

69
Q

S/Sx of tarsal tunnel syndrome

A

pain, numbness, and paresthesias along the medial ankle to the plantar surface of the foot

70
Q

What are the potential mechanisms of plantar fascia?

A
  1. chronic irritation of plantar fascia from excessive pronation
  2. limited ROM of first MTP and talocrural joint
  3. tight triceps surae
  4. acute injury from excessive loading of the foot
  5. rigid cavus foot
71
Q

What position should the patient’s neck be in for optimal IV foraminal opening during cervical traction?

A

15˚ of cervical flexion

72
Q

Dysfunctions of the TMJ fall into what 3 categories?

A
  1. DJD
  2. Myofascial pain syndrome
  3. Internal derangement
73
Q

What is the treatment for congenital hip dysplasia?

A
  • Birth - 6 months: Pavlik harness to maintain hip flexion and abduction position
  • 6 months - 2 years: closed reduction under anesthesia followed by spica cast for 12 weeks
  • 2 years and older: open reduction under anesthesia followed by spica cast for 6-12 weeks
74
Q

What are the phases of ACL/PCL rehabilitation?

A
  1. CPM is utilized with PROM from 0˚-70˚ of flexion
  2. Motion is increased 0˚-120˚ by the sixth week
  3. Reconstruction is usually protected with a hinged brace set at 20˚-70˚ of flexion initially
  4. Pt. is non-weight bearing for approximately one week
  5. Weight-bearing progresses as tolerated to full weight bearing
  6. Pt. is weaned from brace between the second and fourth week
    * ACL/PCL rehabilitation is generally the same, except the hinged knee brace is set at 0˚ during ambulation
75
Q

What are the tests to assess for malingering?

A
  • Hoover test: the therapist evaluates the amount of pressure the patient’s heels place on the therapist’s hands when the patient is asked to raise one lower extremity while in a supine position
  • Burn’s test: requires the patient to kneel and bend over a chair to touch the floor
  • Waddell’s signs

NPTE-PT (9 decks)

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