Musculoskeletal Section Flashcards
1
Q
Joint Classification: Fibrous Joints (synarthroses)
A
- bones that are united by fibrosous tissue - nonsynovial
- little to no movement/ movement dependent on length of fibers
TYPES
(1) Suture (skull) , (2) syndesmosis (tibia and fibula connected with interosseous membrane) , (3) Gomphosis (tooth in socket)
2
Q
Joint Receptors: Ruffini Endings
A
Location: Fibrous layer of joint capsule
Sensitivity: - Stretching of joint capsule
- Velocity of joint position
Distribution: greater density in proximal joints, particularly in capsular
regions.
3
Q
Joint Receptor: Pacinian Corpuscles
A
Location: fibrous layer of joint capsule
Sensitivity: - high frequency vibrations
- acceleration
- high velocity changes in joint position
Distribution: all joints
4
Q
Joint Receptors: Golgi- Mazzoni Corpuscles
A
Location: Joint Capsule
Sensitivity: Compression of joint capsule
Distribution: Knee joint, joint capsule
5
Q
Joint Receptors: Golgi Ligament Endings
A
Location: ligaments, adjacent to ligament’s bony attatchment
Sensitivity: Tension or stretch on ligaments
Distribution: majority of joints
6
Q
Joint Receptors: Free Nerve Endings
A
Location: joint capsule, ligaments, synovium, fat pads
Sensitivity: one type is sensitive to non-noxious mechanical stress and another type is sensitive to noxious mechanical/biochemical stress.
Distribution: all Joints
7
Q
Joint Classification: Synovial Joints (Diarthroses)
A
- provide free movement / are complex and vulnerable
- 5 characteristics including (1) joint cavity (2) articular cartilage (3) synovial membrane (4) synovial fluid (5) fibrous capsule.
TYPE - Uniaxial, biaxial, and multi-axial joints.
8
Q
Joint Classification: Cartilaginous Joints (Amphiarthroses)
A
- Hyaline cartilage or fibrocartilage
- slightly moveable
TYPE - Synchondrosis: EX: sternum and true rib, stability during growth
- Symphysis: Ex: pubic symphysis, covered hyaline, connected fibro
9
Q
Facts about ATP-PC System
A
- high intensity/short duration
- phosphocreatine decomposes and releases a large amount of energy that is sued to construct ATP
- 2-3x more PC in cells of muscles than ATP
- 15 seconds
- long string of chemical reactions/ no O2 needed.
10
Q
Anaerobic Glycolysis Facts
A
- High intensity/short duration.
- 30-40 seconds
- 50% slower than ATP-PC system
- only uses carbs (glycogen/glucose)
11
Q
Aerobic Metabolism Facts
A
- OXYGEN
- low intensity/long duration
- yields MOST ATP, after several series of complex chemical reactions
- oxidation of food
- fatty acids, amino acids, glucose, and oxygen are needed
12
Q
Muscle Spindles
A
- belly of muscle
- muscle length/rate of change of length
- helps control posture, and involuntary movements
13
Q
Golgi Tendon Organ
A
- muscle tendon
- sensitive to tension
- 10-15 muscle fibers per GTO
14
Q
Heel walking tests?
A
L4-L5
15
Q
Toe walking tests?
A
S1
16
Q
SLR Tests
A
L4-S1
17
Q
Patella Reflex tests?
A
L4
18
Q
Achilles Reflex Tests?
A
S1
19
Q
Resistive Testing for LE screen?
A
Hip flexion - L1-2 Knee Extension - L3-4 Ankle DF - L4-5 Great Toe Extension - L5 Ankle PF - S1
20
Q
Muscle Insufficiency: Active
A
when a two-joint muscle contracts across both joints simultaneously
21
Q
Muscle Insufficiency: Passive
A
when a two joint muscle is lengthened over both joins simultaneously.
22
Q
Hand Held Dynamometer
A
- dominant is 5-10 lbs stronger than non-dominant
23
Q
Gait: Stance Phase Standard Terminology
A
- Heel strike
- foot flat - entire foot makes contact
- Midstance - entire body weight
- heel off - heel leaves ground
- toe off - only toe is down
24
Q
Gait: Swing Phase Standard Terminology
A
- Acceleration - after toe off complete
- Midswing - limb directly under body
- Deceleration - as limb extends
25
Gait: Stance Phase RLA Terminology
1. Initial Contact - foot touches ground
2. Loading Response - time between initial contact and swing phase for other limb
3. Midstance - other foot off floor until body directly over limb
4. Terminal Stance - begins when heel raises, ends when other foot touches
5. Pre-swing - other foot touches and stance foot reaches toe off
26
Gait: Swing Phase RLA Terminology
1. Initial Swing - lifts from floor, ends with max knee flexion
2. Midswing - begins max knee flexion, ends when tibia is perpendicular to the ground.
3. Terminal Swing - begins tibia is perpendicular, ends when foot touches ground.
27
def: cadence
the number of steps and individual will walk over a period of time. AVG: 110-120 per minute
28
Double support phase
- increases as the speed of gait decreases
| - not present in running
29
Special Tests: Dislocation
Apprehension test ant/post dislocation
30
Special Tests: Biceps Tendon
1. Ludington's
2. Speed's
3. Yergason's
31
Special Tests: Rotator Cuff/Impingement
1. Drop arm test
2. Hawkins-Kennedy impingement test
3. Neer impingement test
4. Supraspinatus test
32
Special Tests: Thoracic Outlet Syndrome
1. Adson Maneuver
2. Allen Test
3. Costoclavicular Syndrome Test
4. Roos Test
5. Wright Test (hyperabduction test)
33
Special Test: Epicondylitis
1. Cozen's Test
2. Lateral test
3. Medial test
4. Mill's Test
34
Special Test: Neurologic Dysfunction of Elbow
1. Tinel's Sign
35
Special Test: Wrist/hand vascular insufficiency
1. Allen Test
| 2. Capillary Refill Test
36
Special Test Wrist/Hand contracture
1. Bunnel-LIttler Test
| 2. Tight Retinacular Lig. Test
37
Special Test: Wrist/Hand Neurological Dysfunction
1. Froment's sign
2. Phalen's Test
3. Tinel's Sign
38
Special Test: Hip Contracture/Tightness
1. Ely's
2. Ober's
3. Piriformis
4. Thomas
5. Tripod
6. 90-90 SLR
39
Pediatric Test of Hip Displacement
1. Barlow's Test
| 2. Ortolani's test
40
Special Test: Knee Meniscal
- Apley's compression
- Bounce home
- McMurray
41
Special Test: Knee Swelling
- Brush Test
| - Patellar Tap Test
42
Shoulder Apprehension Test
Ant: arm 90 deg of abduction, therapist lat. rotates arm
POST: Arm 90 deg flexion and medially rotated, apply post. force through humorous.
43
Ludington's Test
- Biceps Tendon
- Pt sitting, clasp both hands behind head with fingers interlocked, alternate contracting and relaxing biceps.
- POSITIVE TEST: absence of movement - rupture of long head.
44
Speed's Test
- Biceps Tendon
- Elbow extended, palm up, arm in front. Place one hand over groove, the other on forearm. Resist active shoulder flexion.
POSITIVE TEST: pain or tenderness, bicipital tendonitis
45
Yergason's Test
- Bicep
- 90 degrees elbow flex, forearm pronated. Humerus stabilized against thorax. One hand on forearm and other on groove. Pt actively supinate and laterally rotate against resistance
POSITIVE TEST: pain/tenderness, bicipital tendonitis.
46
Drop Arm Test
- Rotator Cuff Tear
- arm 90 deg abduction, pt slowly lowers arm to side.
POSITIVE TEST: failing to slowly lower, severe pain.
47
Hawkins-Kenedy Test
- shoulder impingment involving supraspinatus tendon
| - 90/90 shoulder/elbow flexion. therapist medially rotates arm.
48
Neer Impingement
- impingement involving the supraspinatus tendon
- therapist has one hand on post. aspect of scale and the other stabilizing the elbow. then elevate arm through flexion passively.
49
Supraspinatus Test
- supraspinatous tendon, impingement, suprascap nerve involvement.
- arm 90 deg abduction, 30 degree horiz. add. thumb down. resist abduction.
50
Adson Maneuver
- monitor radial pulse
- pt rotates head TOWARD shoulder being checked, as pt to extend head while therapist laterally rotates and extends shoulder.
- POSITIVE: diminished radial pulse.
- thoracic outlet syndrome
51
Allen Test
- test arm in 90 degree abduction, lat rotation, elbow flexion.
- pt rotates away while PT monitors radial pulse.
- diminished radial pulse
- thoracic outlet syndrome
52
Costoclavicular syndrome
- monitor radial pulse
- assume military posture
- diminished pulse caused by compression of the subclavian artery between the first rib and the clavicle.
- thoracic outlet syndrome
53
Roos Test
- arms 90 degree abduction, lateral rotation, elbow flexion, open and close hands for 3 minutes.
- thoracic outlet syndrome
54
Wright Test (hyperabduction test)
- therapist moves pts arm overhead in the frontal plane while monitoring radial pulse.
- indicative of compression in the costoclavicular space, thoracic outlet syndrome.
55
Elbow Lig Testing
```
Varus = lateral
Valgus = Medial
```
56
Cozen's Test
- elbow slight flexion
- place thumb on lat. epicondyle.
- pt makes fist, pronates, radially deviates, and extends wrist against resistance.
- lateral epicondylitis
57
Lateral Epicondylitis Test
- stabilize elbow with one hand, pace other hand on dorsal aspect of patients hand distal to the proximal interphalangeal joint.
- extend third digit against resistance.
58
Medial Epicondylitis Test
palpate medial epicondyle and supinate pts forearm, extend wrist, extend elbow.
- medial epicondylitis (on stretch)
59
Mills Test
- palpate lateral epicondyle
- pronate forearm, flex wrist, extend elbow.
- lateral epicondylitis (on stretch)
60
Tinel's Sign (elbow)
tap index finger between the olecranon process and the medial epicondyle.
- ulnar nerve compression
61
Bunnel-Littler Test
- metocarpophalangeal joint held in slight extension
| - therapist attemtps to move proximal interphalangeal joint into flexion, tight intrinsic muscle or capsular tightness.
62
Tight retinacular lig test
- PIP held in neutral, therapist flexes DIP.
- unable to flex DIP, retinacular tight/capsule tight
- if can flex DIP with PIP flexed, retinacular lig tight, capsule normal.
63
Froments sign
hold paper between thumb and index finger.
POSITIVE: pt flexing DIP of thumb (adductor pollicis muscle paralysis) - ULNAR NERVE
- Jeanne's sign = hyperextend MCP at the same time.
64
Phalen's Test
- hands back to back with wrist flexed max.
- hold for 60 seconds
- CTS/median nerve - tingling thumb, index finger, middle finger, lat half of ring finger.
65
Finkelstein Test
- fist with thumb tucked inside fingers
- ulnar deviate wrist, pain over abductor pollicis longs and extensor pollicis brevis tendons.
- tenosynovitis in the thumb
de Quievain's Disease!
66
Grind Test
- apply compression and rotation through metacarpal
| - dgenerative joint disease in CMCs
67
Murphy Sign
- make fist
- third MC remaining level with second and fourth.
- dislocated lunate
