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NPTE Study Flash Cards > Musculoskeletal Section > Flashcards

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)
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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.

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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
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4
Q

Joint Receptors: Golgi- Mazzoni Corpuscles

A

Location: Joint Capsule

Sensitivity: Compression of joint capsule

Distribution: Knee joint, joint capsule

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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

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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

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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.
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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
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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.
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10
Q

Anaerobic Glycolysis Facts

A
  • High intensity/short duration.
  • 30-40 seconds
  • 50% slower than ATP-PC system
  • only uses carbs (glycogen/glucose)
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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
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12
Q

Muscle Spindles

A
  • belly of muscle
  • muscle length/rate of change of length
  • helps control posture, and involuntary movements
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13
Q

Golgi Tendon Organ

A
  • muscle tendon
  • sensitive to tension
  • 10-15 muscle fibers per GTO
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14
Q

Heel walking tests?

A

L4-L5

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15
Q

Toe walking tests?

A

S1

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16
Q

SLR Tests

A

L4-S1

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17
Q

Patella Reflex tests?

A

L4

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18
Q

Achilles Reflex Tests?

A

S1

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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
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20
Q

Muscle Insufficiency: Active

A

when a two-joint muscle contracts across both joints simultaneously

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21
Q

Muscle Insufficiency: Passive

A

when a two joint muscle is lengthened over both joins simultaneously.

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22
Q

Hand Held Dynamometer

A
  • dominant is 5-10 lbs stronger than non-dominant
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23
Q

Gait: Stance Phase Standard Terminology

A
  1. Heel strike
  2. foot flat - entire foot makes contact
  3. Midstance - entire body weight
  4. heel off - heel leaves ground
  5. toe off - only toe is down
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24
Q

Gait: Swing Phase Standard Terminology

A
  1. Acceleration - after toe off complete
  2. Midswing - limb directly under body
  3. Deceleration - as limb extends
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25
Q

Gait: Stance Phase RLA Terminology

A
  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
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26
Q

Gait: Swing Phase RLA Terminology

A
  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.
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27
Q

def: cadence

A

the number of steps and individual will walk over a period of time. AVG: 110-120 per minute

28
Q

Double support phase

A
  • increases as the speed of gait decreases

- not present in running

29
Q

Special Tests: Dislocation

A

Apprehension test ant/post dislocation

30
Q

Special Tests: Biceps Tendon

A
  1. Ludington’s
  2. Speed’s
  3. Yergason’s
31
Q

Special Tests: Rotator Cuff/Impingement

A
  1. Drop arm test
  2. Hawkins-Kennedy impingement test
  3. Neer impingement test
  4. Supraspinatus test
32
Q

Special Tests: Thoracic Outlet Syndrome

A
  1. Adson Maneuver
  2. Allen Test
  3. Costoclavicular Syndrome Test
  4. Roos Test
  5. Wright Test (hyperabduction test)
33
Q

Special Test: Epicondylitis

A
  1. Cozen’s Test
  2. Lateral test
  3. Medial test
  4. Mill’s Test
34
Q

Special Test: Neurologic Dysfunction of Elbow

A
  1. Tinel’s Sign
35
Q

Special Test: Wrist/hand vascular insufficiency

A
  1. Allen Test

2. Capillary Refill Test

36
Q

Special Test Wrist/Hand contracture

A
  1. Bunnel-LIttler Test

2. Tight Retinacular Lig. Test

37
Q

Special Test: Wrist/Hand Neurological Dysfunction

A
  1. Froment’s sign
  2. Phalen’s Test
  3. Tinel’s Sign
38
Q

Special Test: Hip Contracture/Tightness

A
  1. Ely’s
  2. Ober’s
  3. Piriformis
  4. Thomas
  5. Tripod
  6. 90-90 SLR
39
Q

Pediatric Test of Hip Displacement

A
  1. Barlow’s Test

2. Ortolani’s test

40
Q

Special Test: Knee Meniscal

A
  • Apley’s compression
  • Bounce home
  • McMurray
41
Q

Special Test: Knee Swelling

A
  • Brush Test

- Patellar Tap Test

42
Q

Shoulder Apprehension Test

A

Ant: arm 90 deg of abduction, therapist lat. rotates arm

POST: Arm 90 deg flexion and medially rotated, apply post. force through humorous.

43
Q

Ludington’s Test

A
  • 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
Q

Speed’s Test

A
  • 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
Q

Yergason’s Test

A
  • 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
Q

Drop Arm Test

A
  • Rotator Cuff Tear
  • arm 90 deg abduction, pt slowly lowers arm to side.
    POSITIVE TEST: failing to slowly lower, severe pain.
47
Q

Hawkins-Kenedy Test

A
  • shoulder impingment involving supraspinatus tendon

- 90/90 shoulder/elbow flexion. therapist medially rotates arm.

48
Q

Neer Impingement

A
  • 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
Q

Supraspinatus Test

A
  • supraspinatous tendon, impingement, suprascap nerve involvement.
  • arm 90 deg abduction, 30 degree horiz. add. thumb down. resist abduction.
50
Q

Adson Maneuver

A
  • 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
Q

Allen Test

A
  • 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
Q

Costoclavicular syndrome

A
  • 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
Q

Roos Test

A
  • arms 90 degree abduction, lateral rotation, elbow flexion, open and close hands for 3 minutes.
  • thoracic outlet syndrome
54
Q

Wright Test (hyperabduction test)

A
  • therapist moves pts arm overhead in the frontal plane while monitoring radial pulse.
  • indicative of compression in the costoclavicular space, thoracic outlet syndrome.
55
Q

Elbow Lig Testing

A 
Varus = lateral
Valgus = Medial
56
Q

Cozen’s Test

A
  • elbow slight flexion
  • place thumb on lat. epicondyle.
  • pt makes fist, pronates, radially deviates, and extends wrist against resistance.
  • lateral epicondylitis
57
Q

Lateral Epicondylitis Test

A
  • 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
Q

Medial Epicondylitis Test

A

palpate medial epicondyle and supinate pts forearm, extend wrist, extend elbow.
- medial epicondylitis (on stretch)

59
Q

Mills Test

A
  • palpate lateral epicondyle
  • pronate forearm, flex wrist, extend elbow.
  • lateral epicondylitis (on stretch)
60
Q

Tinel’s Sign (elbow)

A

tap index finger between the olecranon process and the medial epicondyle.
- ulnar nerve compression

61
Q

Bunnel-Littler Test

A
  • metocarpophalangeal joint held in slight extension

- therapist attemtps to move proximal interphalangeal joint into flexion, tight intrinsic muscle or capsular tightness.

62
Q

Tight retinacular lig test

A
  • 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
Q

Froments sign

A

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
Q

Phalen’s Test

A
  • 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
Q

Finkelstein Test

A
  • 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
Q

Grind Test

A
  • apply compression and rotation through metacarpal

- dgenerative joint disease in CMCs

67
Q

Murphy Sign

A
  • make fist
  • third MC remaining level with second and fourth.
  • dislocated lunate

NPTE Study Flash Cards (13 decks)

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