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NPTE Exam Study > Musculoskeletal > Flashcards

Musculoskeletal Flashcards

1
Q

ROM needed for gait

A

Hip flexion 30º; hip flexion 10º; knee flexion 60º; ankle DF 10º; ankle PF 20º

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2
Q

Shoulder flexion/extension ROM

A

flexion 180º, extension 60º

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3
Q

Shoulder IR/ER ROM

A

IR 70º, ER 90º

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4
Q

Wrist flexion/extension/UD/RD

A

flexion 80º, extension 70ª, RD 20º, UD 30º

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5
Q

Hip flexion/extension/ABD/ADD/IR/ER

A

flexion 120º, extension 30º, ABD 45º, ADD 30º, IR/ER 45º

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6
Q

Shoulder flexion muscles

A

anterior deltoid, coracobrachialis, pec major, biceps brachii

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7
Q

Shoulder extension muscles

A

lats, posterior deltoid, teres major

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8
Q

Shoulder ABD muscles

A

middle deltoid, supraspinatus

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9
Q

Shoulder ADD muscles

A

pec major, lats, teres major

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10
Q

Shoulder IR muscles

A

subscapularis, teres major, pec major, lats, anterior deltoid

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11
Q

Shoulder ER muscles

A

teres minor, infraspinatus, post deltoid

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12
Q

Scapular depression muscles

A

lats, pec major and minor, lower trap

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13
Q

Scapular protraction muscles

A

serratus anterior, pec minor

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14
Q

Scapular upward rotation muscles

A

upper+lower trap, serratus anterior

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15
Q

Scapular downward rotation muscles

A

rhomboids, levator scap, pec minor

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16
Q

Hip flexion muscles

A

iliopsoas, sartorius, rectus femoris, pectineus

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17
Q

Hip ABD muscles

A

glut med/min, piriformis, obturator internus

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18
Q

Hip IR muscles

A

TFL, glut med/min, pectineus, adductor longus

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19
Q

Hip ER muscles

A

glut max, obturator internus/externus, piriformis, gemilli inf/sup, sartorius

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20
Q

Knee flexion muscles

A

biceps femoris, semimem/tendinosus, sartorius

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21
Q

Plantarflexion muscles

A

tib posterior, gastroc, soleus, peroneus long/brev, plantaris, flexor hallicus

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22
Q

Dorsiflexion muscles

A

tib anterior, ext hallicus longus, ext digitorum longus, peroneus tertius

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23
Q

Ankle Inversion muscles

A

tib posterior and anterior, flex digitorum longus

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24
Q

Type I muscle fibers

A

aerobic, red, tonic, slow oxidative, low fatigue, high capillary, high myoglobin, high blood supply, high mitochondria

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25
Q

Type II muscles fibers

A

anaerobic, white, phasic, fast glycolytic, large fibers

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26
Q

Muscle spindle

A

in belly of muscle; muscle length and rate of change of length for postural control and involuntary movements

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27
Q

Golgi tendon organ

A

in tendons; tension from muscle contraction and rate of change in tension

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28
Q

Non-opioid agents

A

acetominophen, NSAIDs (naproxen, ibuprofen, aspirin)

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29
Q

Non-opioid agents effects

A

analgesia, anti-inflammatory and anti pyretic effects, reduce prostaglandin formation (decreases inflammation process and impulse formation of pain fibers)

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30
Q

Non-opioid agents side effects

A

N/V, vertigo, abdominal pain, GI distress or bleeding, ulcers

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31
Q

Opioid agents

A

morphine, meperidine, oxycodone, fentanyl, codeine

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32
Q

Opioid agent effects

A

analgesia for acute severe pain, stimulates opioid receptors in CNS to prevent pain impulses from reaching targets

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33
Q

Opioid agent side effects

A

Mood swings, sedation, confusion, vertigo, dulled cognitive fxn, orthostatic hypotension, constipation, incoordination, dependence, tolerance

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34
Q

Glucocorticoid agents (corticosteroids)

A

hydrocortisone, cortisol, prednisone, prednisolone, dexamethasone

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35
Q

Glucocorticoid agents effects

A

provide hormonal anti-inflammatory and metabolic effects for suppression of articular and systemic diseases, reduces inflammation in chronic conditions that can damage healthy tissues

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36
Q

Glucocorticoid (corticosteroid) side effects

A

muscle atrophy, GI distress, weakening/breakdown of tissues (bone, lig, tendon, skin), at risk of osteoporosis, hypertension, modd changes, drug induced cushings, immune system is weakened

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37
Q

Disease modifying anti-rheumatic agents (DMARDs) effects

A

slow/halt progression of rheumatic disease, used in early stages to prevent widespread damage of affected joints, induces remission by modifying pathology and inhibiting immune response responsible

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38
Q

DMARD side effects

A

nausea, HA, joint pain/swelling, toxicity, GI distress, sore throat, fever, liver dysfunction, hair loss, retinal damage, potential for sepsis

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39
Q

Plastic AFO

A

for tone reduction (not flexible for swelling)

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40
Q

Metal AFO

A

to allow for swelling

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41
Q

Leaf spring AFO

A

plastic AFO with trim line posterior to malleoli to assist DF and prevent foot drop - requires adequate medial/lateral ankle control

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42
Q

floor reaction AFO

A

assists knee extension during stance by positioning of a calf band or at the ankle

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43
Q

HKAFO

A

for hip/knee/ankle/foot weakness, control rotation at hip, heavy and restricts patients to swing thru/to gait

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44
Q

Milwaukee orthosis

A

promote realignment of spine due to scoliotic curvature

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45
Q

Good posture plumb line

A

through external auditory meatus, through middle of shoulder, posterior to hip, anterior to knee, anterior to lateral malleolus, through calcaneocuboid joint

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46
Q

Upper Quarter screen myotomes

A

C1 cervical rotation, C2-4 shoulder elevation, C5 shoulder ABD, C5-6 elbow flex, C6 wrist ext, C7 elbow ext and wrist flex, C8 thumb ext, T1 finger ADD

47
Q

Upper quarter screen dermatome

A

C2 post head, C3 post lateral neck, C4 AC joint, C5 lateral arm, C6 lateral forearm/thumb, C7 palmar DIP, C8 little finger and ulnar hand, T1 medial forearm

48
Q

Lower quarter screen functional

A

L4-5 heel walking, S1 toe walking, L4-S1 SLR

49
Q

lower quarter screen myotomes

A

L1-2 hip flex, L3-4 knee ext, L4-5 ankle DF, L5 great toe ext, S1 ankle PF

50
Q

Lower quarter screen dermatome

A

L2 anterior thigh, L3 middle 1/2 anterior thigh, L4 patella and medial malleolus, L5 fib head and dorsum of foot, S1 lateral/planter foot, S2 medial posterior thigh, S3-5 perianal area

51
Q

SI joint tests

A

FABER, SI joint compression/distraction tests, thigh thrust, sacral thrust, Gaenslen’s test (hyperext hip in off table hip flexor stretch)

52
Q

Knee Anterior drawer test

A

high false negative for ACL - knee capsule is primary restraint while knee is flexed at 90ºnot the ACL

53
Q

hammer toes

A

hyperextension at MTP and DIP and flexion at PIP (boutinniere of toes)

54
Q

morton’s toe

A

looks like 2nd toe is longer than 1st, but it is first metatarsal shorter than 2nd metatarsal

55
Q

Feiss line for navicular drop

A

apex of medial malleolus and plantar aspect of 1st MTP joint

56
Q

Tinel’s sign for tarsal tunnel syndrome

A

posterior tibial nerve tapping (medial ankle)

57
Q

Ankle tests

A

anterior drawer, talar tilt, kleiger’s ER test, squeeze test for fx/syndesmotic sprain, bump test for fx, thompson’s for achilles rupture

58
Q

Lateral pivot shift test

A

anterolateral knee instability; 20 deg tibial IR starting in complete extension, then increase force of IR while applying a valgus force while slowly flexing knee (positive = tibia’s position on femur reduces as leg is flexed at 30-40º, during extension the anterior subluxation is felt = ACL, posterolateral capsule, or IT band)

59
Q

Valgus/varus tests at 0 and 30 deg

A

at 0º = collateral ligament and joint capsule, at 30º, just collateral ligament

60
Q

Slocum’s drawer test

A

rotational instability: anterolateral = ACL, anterolateral/posterolateral capsule, LCL, ITB, popliteus; anteromedial = ACL, MCL, anteromedial/posteromedial capsule

61
Q

McMurray’s test

A

full flexion for isolation of posterior meniscal horns

62
Q

Wilson’s test

A

osteochondral defect of knee; actively extends knee in tibial IR until pain, then ER at that same level of extension (positive = relieved pain at ER)

63
Q

Noble’s compression test

A

ITB; supine with knee flexed, thumb over lateral femoral condyle while passively ext/flex knee (positive = pain under thumb, commonly at 30º)

64
Q

patellar pain findings

A

diffuse, mostly anterior, catching without locking, stiffness and pain from sitting, pain going downstairs, pain with patellar compression and rising from a squat

65
Q

Clarke’s sign

A

chondromalacia patellae; supine knee extended, contract quads while pressure is maintained on patella (positive = pain and inability to hold contraction)

66
Q

Hip scouring test

A

for oscheochondral defects or arthritis, possibly a labral tear

67
Q

Milgram’s test

A

bilateral SLR 2-4” off table - lumbar nerve root impingement

68
Q

Kernig’s test

A

unilateral active SLR until pain, then flex knee (if alleviated then positive) - bulging disc, irritation of dural sheath or meninges causing nerve root impingement

69
Q

SLR test

A

passive hip flexion until pain, then ext till no pain, then passive DF - sciatic nerve

70
Q

Well SLR test

A

passive SLR of unaffected side - herniated disc

71
Q

Quadrant test

A

extend, sidebend and rotate to one side, then overpressure on shoulders - radicular pain (compression of intervertebral foramina on lumbar nerve roots), local pain (facet joint), PSIS (SI joint)

72
Q

Slump test

A

slumps, rounds shoulders, flex neck, knee ext, ankle DF

73
Q

Long sit test

A

alignment; if painful side goes longer to shorter (anterior rotation of that side), if painful side goes shorter to longer (posterior rotation of that side)

74
Q

Spurling’s test

A

extend neck, lateral bend then compression on top of head - nerve root impingement

75
Q

Vertebral artery test

A

passively ext and laterally flexes neck, rotated towards laterally flexed side and held for 30 seconds (positive = dizzy, confusion, nystagmus, unilateral pupil changes, nausea = occlusion of cervical vertebral arteries)

76
Q

Neer impingement test

A

elbow extended, humerus IR and forearm pronated, forward flexion with resistance

77
Q

Yergason’s test

A

biceps tendon subluxation; elbow flexed to 90º at side in neutral position, resist ER force and supination force

78
Q

O’Brien’s test/active compression test

A

SLAP; shoulder at 90º flexion and 15º horiz ADD, full IR with resistance (pain), then full ER (should decrease pain) - pain/clicking (labral tear), pain at AC joint (AC pathology)

79
Q

Adson’s test

A

TOS; shoulder ER and ABD 30º, elbow extended thumb up, palpate radial pulse and ER and ext shoulder while face is rotated towards that side and in neck ext, inhale and hold breath (positive = radial pulse decreases/absent = subclavian artery occluded between anterior/middle scalenes and pec minor)

80
Q

Allen’s test

A

TOS; elbow 90º flexed with shoulder ABD 90º, palpate radial pulse and passively horiz ABD and ER with patient head rotates to opposite shoulder - pec minor compressing neurovascular bundle

81
Q

posterior rotatory instability test

A

supine, elbow and shoulder flexed 90º, forearm fully supinated; apply valgus stress and axial compression and extend elbow with forearm still in supination (positive = elbow subluxes as it extends and relocates when flexed)

82
Q

Dupuytren’s contracture

A

flexion contracture of MCP and PIP joints due to shortening/adhesion of palmar fascia - mostly 4th and 5th fingers

83
Q

swan neck deformity

A

flexion of MCP and DIP and hyperextension of PIP - volar plate injuries, malunion fx of middle phalanx, trauma to finger flex/ext muscles, or rheumatoid arthritis

84
Q

volkmann’s ischemic contracture

A

flexion contracture of wrist and fingers - can occur after forearm fx, fx or dislocation of elbow, or forearm compartment syndrome

85
Q

Jersey finger

A

avulsion of flexor digitorum profundus tendon - cannot actively flex DIP

86
Q

Mallet finger

A

avulsion of extensor digitorum longus tendon - cannot actively extend distal phalanx

87
Q

Boutinniere deformity

A

rupture of central extensor tendon - Ext of MCP and DIP and flexion of PIP joint

88
Q

Handicap ramp ratio

A

1:12

89
Q

Ely’s test

A

rectus femoris length; prone, PROM knee flexion (positive = hip flexion with knee flexion)

90
Q

Knee OA clinical prediction

A

> 50 years old, stiff >30 minutes, crepitus, bony tenderness, bony enlargement, no palpable warmth

91
Q

Palpate supraspinatus tendon

A

shoulder 30º extension, fall off acromion to humerus

92
Q

palpate infraspinatus and teres minor tendons

A

shoulder 90º flexion, 10º ADD, 20º ER

93
Q

Legg Calve Perthes

A

M>F, age 3-12, degeneration of femoral head 2/2 avascular necrosis; limited hip IR/ADD, pain in groin area radiates to medial thigh and knee; bracing 8years old

94
Q

CAM labral lesions

A

abrasion of acetabular cartilage with avulsion from labrum and bone due to non-spherical femoral head/neck contact with acetabular rim

95
Q

Pincer labral lesions

A

labral degeneration, ossification of acetabular rim and deepening of acetabulum from repeated contact with femoral head

96
Q

Slipped capital femoral epiphysis (SCFE)

A

youths, decreased hip flexion, IR ABD; positive drehmanns (ER and ABD with passive hip flexion); NWB and immobilization for 1-4 months post op

97
Q

Achilles Tendinopathy Intervention Recommendations

A 
A - eccentric loading
B - low level laser, ionto dexa
C - orthoses, night splints
D - heel lift
F - manual therapy, taping
98
Q

Plantar fasciitis intervention recommendations

A

A - orthotics
B - modalities (dexa/acetic ionto), stretching, night splints
C - taping
E - manual therapy

99
Q

Knee ligament sprains intervention recommendations

A

A - ther-ex
B - immediate mobilization for ROM, Neuromuscular re-ed, NMES, early ROM and weight bearing, eccentric strengthening
C - CPM, early WB, cryotherapy

100
Q

Ankle DF and inversion muscles

A

extensor hallicus longus and tibialis anterior

101
Q

ankle DF and eversion muscles

A

extensor digitorum longus and peroneus tertius

102
Q

ankle PF and inversion muscles

A

tib posterior, flexor digitorum longus, flexor hallicus longus, gastroc, soleus

103
Q

ankle PF and eversion muscles

A

peroneus brevis, peroneus longus

104
Q

DF muscles in gait

A

initial swing and loading response (eccentrically)

105
Q

PF muscles in gait

A

midstance, terminal stance, off in pre-swing

106
Q

inversion muscles in gait

A

during swing and midstance

107
Q

eversion muscles in gait

A

midstance and terminal stance

108
Q

THA precautions anterior

A

hip flexion < 90º, ER < 45º, and extension < 10º

109
Q

THA precautions posterior

A

hip flexion < 90º, no IR or ADD

110
Q

Carpal tunnel (what runs through)

A

4 flexor digitorum superficialis tendons
4 flexor digitorum profundus tendons
1 flexor pollicis longus tendon
1 median nerve

111
Q

Cubital Tunnel syndrome

A

ulnar nerve compression; decreased sensation along ulnar nerve, decreased strength hand intrinsics, decreased grip strength, impaired ADD of 5th digit

112
Q

Shoulder capsular pattern

A

ER, ABD, IR

113
Q

Hip capsular pattern

A

flexion, ADD, IR

NPTE Exam Study (6 decks)

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