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NPTE Prep > Musculoskeletal review - end feels, gait, orthoses, ROM, and prosthetics > Flashcards

Musculoskeletal review - end feels, gait, orthoses, ROM, and prosthetics Flashcards

1
Q

Normal End Feel types

A

Firm, Hard, Soft

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2
Q

Abnormal End Feel Types

A

Empty, firm, hard, soft, boggy

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3
Q

Firm end feels

A

Should feel like a stretch
Normal examples: DF, finger extension, hip medial rotation, forearm supination
Abnormal examples: increased tone, tightening of the capsule, ligament shortening

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4
Q

Hard end feels

A

Bone to bone
Normal: elbow extension
Abnormal examples: fracture, osteoarthritis, osteophyte formation, HO, MO

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5
Q

Soft

A

Soft tissue approximation - normal
Normal examples: elbow and knee flexion
Abnormal examples: edema, synovitis, ligament instability/tear

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6
Q

Emty:

A

Due to pain: joint inflammation, fracture, bursitis

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7
Q

Standard Terminology for Gait (not RANCHO)

A

Stance:Heel strike, foot flat, midstance, heel off, toe off
Swing: acceleration, midswing, deceleration

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8
Q

Peak muscle activity of tibialis anterior during gait

A

After heel strike - eccentric lowering of the foot (1st rocker)

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9
Q

Peak muscle activity of the gastroc-soleus during gait

A

During late stance phase, responsible for concentric raising of the heel during toe off (terminal stance)

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10
Q

Peak muscle activity of the quadriceps group

A

Two periods: in periods of single support during early stance phase and just before toe off to initiate swing phase

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11
Q

Peak activity of the hamstrings group during gait

A

During late swing phase for decceleration of the swing limb

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12
Q

Average BOS

A

2-4 inches for an adult. Decreases as speed increases

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13
Q

Cadence

A

110-120

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14
Q

Degrees of toe out

A

Angle formed by intersecting heel and second toe. 7 degrees

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15
Q

Step length

A

13-16 inches

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16
Q

Stride length

A

24-32 inches likely (56 inches?)

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17
Q

Shoulder medial and lateral rotation ROM

A

Medial - 70

Lateral - 90

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18
Q

Supination/Pronation ROM

A

0-80

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19
Q

Wrist ROM

A

Flexion - 80
Extension - 70
Radial deviation - 20
Ulnar deviation - 30

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20
Q

Metacarpophalangeal motion

A

Flexion - 90

Hyperextension - 45

21
Q

Thumb motion

A

MCP flexion - 50

IP flexion - 80

22
Q

Hip ROM

A 
Flexion - 120
Extension - 30
Abduction - 45
Adduction - 30 
MR/LR - 45
23
Q

Ankle ROM

A

DF - 20
PF - 50
IV - 35
EV - 15

24
Q

Cervical ROM

A

Flexion - 45
Extension - 45
Lateral flexion - 45
Rotation - 60

25
Thoracic and lumbar spine ROM
Flexion - 80 Extension - 25 Lateral flexion - 35 Rotation - 45
26
Q angle
13 degrees in males and 18 degrees in females
27
Solid ankle foot orthoses
Control DF/PF and IV/EV. Can be articulating or not. Articulation allows the tibia to advance over the foot. Trim line is anterior to the medial malleolus
28
Posterior leaf spring AFO
Plastic AFO with trim line posterior to the malleoli. Assists with DF and prevents foot drop. Requires adequate medial/lateral control by the patient.
29
Floor reaction AFO
Assists with knee extension during stance through positioning of calf band and or positioning of ankle
30
Corset
Spine orthosis - constructed of fabric. Abdominal compression and support. Utilized to provide pressure and relieve pain associated with mid and low back pathologies
31
Milwaukee Orthosis
For realignment of spine due to scoliotic curvature. Pelvis to upper chest with corrective padding
32
TLSO
Prevents all trunk motions - common for post-surgical stabilization
33
Symes amputaton
surgical removal of the foot and the ankle joint including the malleoli
34
Chopart disarticulation
Disarticulation at the midtarsal joint
35
Prosthetics: Causes of lateral bending
Prothesis too short, improperly shaped lateral wall, high medial wall, prothesis aligned in abduction Poor balance, abduction conracture, short residual limb, weak hip abductors, hypersnsitive and painful residual limb
36
Prosthetics: Causes of abducted gait
Prothesis too short, high medial wall, poorly shaped lateral wall, prothesis positionined into abduction, inadequate suspension, excessive knee friction Abduction contracture, adductor roll, weak hip flexors and adductors, pain over lateral residual limb
37
Prothetics: Causes of circumducted gait
Prothesis too long, too much friction in the knee, socket too small, excessive PF of foot Abduction contracture, weak hip flexors, difficulty flexing knee, painful anterior distal residual limb
38
Prosthetics: Causes of excessive knee flexion during stance
Socket set forward in relation to foot, foot set in excessive DF, stiff heel, prothesis too long Knee or hip flexion contracture, pain anteriorly in residual limb, decreased quad strength, poor balance
39
Prosthetics: Causes of vaulting
Prothesis too long, inadequate socket suspension, excessive alignment stability, foot in increased PF Residual limb discomfort fear of stubbing toe, short residual limb, painful hip/residual limb
40
Rotation of forefoot at heel strike
Excessive toe-out buitl in, loose fitting socket, inadequate suspension, rigid SACH heel cushion Poor muscle control, weak medial rotators, short residual limb
41
Forward trunk flexion
Socket to big, poor suspension, knee instability Hip flexion contracture, weak hip extensors, pain with ischial weight baring, inability to initiate prosthetic knee flexion
42
Medial or lateral whip
Excessive roation of the knee, tight socket fit, valgus in the prosthetic knee, improper alginment of toe break weak hip rotators, knee instability
43
A long prothesis can cause:
Circumduction, abducted gait, excessive knee flexion during stance, contralateral vaulting
44
A short prothesis can cause:
Lateral bending
45
A stiff heel can cause:
Excessive knee flexion during stance
46
A high medial wall can cause:
Lateral bending or abducted gait
47
Inadequate suspension can cause
Abducted gait, rotation of forefoot at heel strike, vaulting, forward trunk flexon
48
A poorly shaped lateral wall may cause:
Lateral bending, abducted gait
49
Pain in the residual limb (based on location) may cause: Ant vs lateral vs overall hypersensitivity
Hypersensitive limb/overall pain: lateral bending or vaulting Lateral pain: abducted gait Anterior pain: Circumducted or excessive knee flexion during stance

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