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FSBPT > Musculoskeletal System > Flashcards

Musculoskeletal System Flashcards

0
Q

What occurs during anaerobic glycolysis/lactic acid system?

A

Glycogen ->glucose ->pyruvic acic. Releases ATP and forms lactic acid. Good for 30 to 40 seconds

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1
Q

Which energy system is used for producing ATP at high intensity short duration exercise such as sprinting 100 meters?

A

ATP-PC/Phosphagen System-the most rapidly available source of ATP for use by muscle. Both ATP and PC are stored directly within the contractile mechanisms of the muscle.

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2
Q

Class 1 lever and example of muscle

A

Fulcrum (axis of rotation) is between the effort (force) and resistance (load) Triceps brachii, open chain elbow extensions

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3
Q

Class 2 lever and example of muscle/action

A

Load is between the axis and force, closed chain pushup: Wrist is the fulcrum, load is through the forearm, and triceps is the force

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4
Q

Class 3 lever, muscle example

A

The force is between the axis and the load. Eg shoulder abduction-hand is load, force is deltoid, axis glenohumeral joint

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5
Q

The 3 types of fibrous joints (synarthroses) and examples of each

A

1) Suture: Union of bones by ligament or membrane, skull sutures
2) Syndesmosis: Bone connected to bone by a dense fibrous membrane or cord, tibia/fibula with interosseous membrane
3) Gomphosis: Tooth in socket

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6
Q

The 2 types of cartilaginous joints (amphiarthroses)

A

1) Synchondrosis: Hyaline cartilage adjoins 2 ossifying centers of bone. Provides stability during growth and may ossify when growth is completed. Sternum and true rib articulation
2) Symphysis: Usually in the midline of body, bones covered with hyaline cartilage, connected with fibrocartilage. Pubic symphysis.

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7
Q

The 6 types of synovial joints (diarthroses) and if they are uni, bi, or multi-axial.

A 
Uniaxial:  
Hinge/ginglymus
Pivot/trochoid
Biaxial:
Condyloid (MP joint)
Saddle (CMC of thumb)
Multi-axial
Plane (carpals)
Ball and socket
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8
Q

Location
Sensitivity
Primary Distribution
of this nerve ending: Free Nerve Endings

A

Location: Joint capsules, ligaments, synovium, fat pads
Sensitivity: Mechanical stress, noxious mech/chem stimuli
Primary Distribution: All joints

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9
Q

Location
Sensitivity
Primary Distribution
of this Joint Receptor: Pacinian corpuscles

A

Location: Fibrous layer of the joint capsule
Sensitivity: High freq vibration, acceleration, high velocity changes in joint position
Primary Distribution: All joints

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10
Q

Location
Sensitivity
Primary Distribution
of this Joint Receptor: Golgi Ligament Endings

A

Location: Ligaments and their bony attachment
Sensitivity: Tension or stretch on ligaments
Primary Distribution: Majority of joints

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11
Q

Location
Sensitivity
Primary Distribution
of this Joint Receptor: Ruffini endings

A

Location: Fibrous layer of joint capsule
Sensitivity: Stretching of the capsule; amplitude and velocity of joint position
Primary Distribution: More in proximal joints

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12
Q

Location
Sensitivity
Primary Distribution
of this Joint Receptor: Golgi-Mazzoni Corpusces

A

Location: Joint capsule
Sensitivity: Compression of joint capsule
Primary Distribution: Knee joint, joint capsule

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13
Q

Temporomandibular joint:

3 muscles for depression

A

1) Lateral pterygoid
2) Suprahyoid
3) Infrahyoid

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14
Q

Temporomandibular joint:

3 muscles that elevate

A

1) Temporalis
2) Masseter
3) Medial pterygoid

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15
Q

Temporomandibular joint:

3 muscles for protrusion

A

1) Masseter
2) Lateral pterygoid
3) Medial pterygoid

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16
Q

Temporomandibular joint:

3 muscles for retrusion

A

1) Temporalis
2) Masseter
3) Digastric

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17
Q

Temporomandibular joint:

4 muscles for side-to-side

A

1) Medial pterygoid
2) Lateral pterygoid
3) Masseter
4) Temporalis

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18
Q

Loose packed position of the GH joint

A

55 abd, 30 horizontal add

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19
Q

Close packed position of the GH joint

A

EROM abd/ER

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20
Q

Capsular pattern of the GH joint

A

ER, abd, IR

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21
Q

Loose packed position of the SC joint

A

Arm resting by side

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22
Q

Close packed position of the SC joint

A

Maximum shoulder elevation

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23
Q

Capsular pattern of the SC joint

A

pain at EROM

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24
Q

Loose packed position of the AC joint

A

Arm resting by side

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25
Q

Close packed position of the AC joint

A

Arm abducted to 90

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26
Q

Capsular pattern of the AC joint

A

Pain at the EROM

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27
Q

Loose packed position of the Radiohumeral joint

A

Full extension, supination

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28
Q

Close packed position of the Radiohumeral joint

A

90 flexion, 5 sup

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29
Q

Capsular pattern of the Radiohumeral joint

A

Flexion, extension, supination, pronation

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30
Q

Loose packed position of the Ulnohumeral joint

A

70 flexion, 10 sup

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31
Q

Close packed position of the Ulnohumeral joint

A

Extension

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32
Q

Capsular pattern of the Ulnohumeral joint

A

flexion, extension

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33
Q

Loose packed position of the Proximal Radioulnar joint

A

70 flex, 35 sup

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34
Q

Loose packed position of the Radiocarpal joint

A

Neutral with slight ulnar deviation

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35
Q

Close packed position of the Radiocarpal joint

A

Extension with radial deviation

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36
Q

Capsular pattern of the Radiocarpal joint

A

Flexion and extension equally limited

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37
Q

Loose packed position of the Iliofemoral joint

A

30 flex, 30 abd, slight ER

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38
Q

Close packed position of the Iliofemoral joint

A

Full extension, medial rotation

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39
Q

Capsular pattern of the Iliofemoral joint

A

flex, abd, IR (sometimes IR is most limited)

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40
Q

Loose packed position of the Tibiofemoral joint

A

25 flex

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41
Q

Close packed position of the Tibiofemoral joint

A

full ext and ER of tibia

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42
Q

Capsular pattern of the Tibiofemoral joint

A

Flexion, extension

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43
Q

Which structures compose the Arcuate Ligament Complex? (5)

A

Arcuate ligament, oblique popliteal ligament, lateral collateral ligament, popliteus tendon, and the lateral head of the gastrocnemius

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44
Q

Loose packed position of the Talocrural joint

A

10 PF, midway between in/ev

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45
Q

Close packed position of the Talocrural joint

A

Maximum DF

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46
Q

Capsular pattern of the Talocrural joint

A

PF, DF

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47
Q

Loose packed position of the Subtalar joint

A

Midway between EROMs

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48
Q

Close packed position of the Subtalar joint

A

Supination

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49
Q

Capsular pattern of the Subtalar joint

A

Varus

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50
Q

Loose packed of the Midtarsal Joint

A

Midway between EROMs

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51
Q

Close packed of the Midtarsal Joint

A

Supination

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52
Q

Capsular pattern of the Midtarsal Joint (what do these joints consist of and what axis(es) of rotation)

A

DF, PF, Add, IR
This joint consists of the talocalcaneonavicular joint and the calcaneocuboid joint. One longitudinal and one oblique axis, each triplanar START ON P60, SPINE

53
Q

Capsular pattern of the spine

A

Lateral flexion and rotation equally limited

54
Q

Which ribs are attached to the sternum?

A

1-7, 8-10 costal cartilage, 11 and 12 vertebral bodies

55
Q

Type I vs type II fibers-which has larger fibers, which has high myoglobin content?

A

Type II has larger fibers, Type I has high myoglobin content.

56
Q

Isotonic vs isokinetic muscle activity

A

Isotonic-Constant load

Isokinetic-Tension in the muscle is the same throughout the entire range

57
Q

DeLorme vs Oxford for exercise protocols

A

DeLorme: 10 reps at 50% ten rep max, then 75, then 100.
Oxford: Opposite

58
Q

Review Dermatomes!

A

p65

59
Q

The 9 standard skinfold site for measurment

A

Abdominal, midaxillary, triceps, subscap, biceps, suprailiac, chest/pc, thigh, medial calf.

60
Q

Ideal plumb line alignment: 9 key points

A

1) Just posterior to the coronal suture
2) External Auditory Meatus
3) Odontoid Process (dens)
4) Tip of the shoulder
5) Bodies of the lumbar vertebrae
6) Slightly posterior to the hip joint
7) Slightly anterior to the knee joint
8) Slightly anterior to the lateral malleolus
9) Through the calcaneocuboid Joint

61
Q

What is the difference between active and passive muscle insufficiency?

A

Active: When a two joint muscle contracts across both joints simultaneously.
Passive: When it is lengthened over both joints

62
Q

What is a festinating gait?

A

Walks on toes as though pushed then eventually may have to grasp an object

63
Q

What is a tabetic gait pattern?

A

A high stepping ataxic gait pattern

64
Q

The 12 steps of goniometric measurement

A

1) Place subject in position
2) Stabilize the proximal segment
3) Move distal segment through the available ROM
4) Estimate ROM
5) Return the distal joint segment to the starting position
6) Palpate the anatomical landmarks
7) Align the goniometer
8) Read the record the starting position. Remove goniometer
9) Stabilize the proximal segment
10) Move distal segment through the ROM
11) Replace the goni
12) Record ROM

65
Q

Ludington’s test

A

Pt is sitting, clasps hands behind head, asked to contract and relax the biceps, may indicate rupture of the biceps

66
Q

Adson maneuver

A

Pt is sitting or standing. PT monitors radial pulse and has pt rotate head to test shoulder. Pt then asked to extend head while PT extends pt’s shoulder.

67
Q

Allen Test

A

Arm at 90 deg abd, lat rot, elbow flex. Pt rotates head away from test shoulder, PT monitors radial pulse.

68
Q

Costoclavicular Syndrome Test

A

Pt assumes military position with hand, PT monitors radial pulse.

69
Q

Wright Test (hyperabduction test)

A

PT moves patient’s arm overhead in the frontal plane while monitoring the radial pulse.

70
Q

Cozen’s Test

A

Active, pt makes a fist, pronates, radially deviates, and extends wrist against resistance (elbow slightly flexed)

71
Q

Mill’s test

A

Passive: PT flexes the wrist and extends the elbow

72
Q

Lat Epicondylitis Test

A

Middle 3rd finger

73
Q

Medial Epicondylitis Test

A

Passive: PT passively extends wrist and elbow

74
Q

Allen test for vascular insufficiency

A

open and close hands several times while PT compresses the radial and ulnar arteries. Therapist releases one of the arteries

75
Q

Bunnel-Littler Test

A

MP joint in slight extension. PT moves PIP joint into flexion. If doesn’t flex might be capsular or muscular tightness.

76
Q

Tight retinacular ligament test

A

PIP held in neutral, PT flexes DIP. Retinacular or capsular may be tight. If can flex with the PIP in flexion, ligaments may be tight while capsule is normal.

77
Q

Froment’s sign

A

Pt to hold paper between thumb and index finger. Positive if pt flexes the DIP due to adductor pollicis paralysis

78
Q

Jeanne’s sign

A

Same test as Froment’s but at the same time pt hyperextends MP joint of the thumb, also indicating Ulnar nerve paralysis

79
Q

Phalen’s test

A

Pt flexes wrists maximally by pushing dorsal hands together. Carpal tunnel.

80
Q

Finkelstein test

A

Pt makes fist with thumb tucked inside fingers. PT ulnarly deviates the wrist. de Quervain’s Tenosynovitis.

81
Q

Which joint does the grind test examine for OA?

A

The CMC joint of the thumb.

82
Q

Murphy sign

A

Pt asked to make a fist. Positive if patient’s 3rd metacarpal remains level with the 2nd and 4th-possible dislocated lunate.

83
Q

Ely’s Test

A

Prone, knee flexion, tests for rec fem tightness

84
Q

Tripod sign

A

When sitting, extends back when extends knee

85
Q

90-90 SLR

A

Pt starts with hips flexed, tight hamstrings if knee remains 20 degrees or more flexed when asked to straighten it.

86
Q

Barlow’s Test

A

Pediatric: supine, hips flexed to 90, moves leg into abd and applies forward force. Positive if clunk/click, may indicate dislocation/relocation of hip, variation of Ortolani’s test.

87
Q

Ortolani’s Test

A

Supine, hips flexed to 90, PT abducts both hips and pressure applied to the greater trochanters until resistance is felt at approx 30 deg. Positive is click/clunk

88
Q

Craig’s Test

A

Prone, knees to 90, rotates hip until greater trochanter is parallel with table. Measure femoral anteversion. Should be 8-15 deg.

89
Q

What is FABER also known as?

A

Patick’s test.

90
Q

Slocum test

A

Supine, knee at 90, hip at 45, PT rotates foot 30 degrees medially, then anterior drawer. Tests anterolateral instability.

91
Q

Clarke’s sign

A

hold patella down, pt contracts quad

92
Q

Hughston’s Plica Test

A

Supine, PT flexes knee and medially rotates tibia, then medially glides the patella. Positive if popping sound over the medial plica.

93
Q

Noble compression test

A

Pressure over lat fem condyle-flexes and extends knee, ITB syndrome.

94
Q

Thompson Test

A

Prone, feet extended over table, squeeze calf, positive if no plantar flexion-achilles rupture.

95
Q

Peak incidence of adhesive capsulitis is between ___ and ___ years

A

40 and 60

96
Q

Adhesive capsulitis is more common in which gender?

A

women

97
Q

What is the difference between a longitudinal and transverse limb deficiency?

A

Longitudinal: Reduction or absence of an element/s within the long axis of the bone.
Transverse: Limb has developed to a particular level beyond which no skeletal elements exist.

98
Q

How is subluxation different than dislocation of the humeral head?

A

Subluxation is allowing >50% of humeral head to translate over the glenoid rim without dislocation

99
Q

The 3 types of JRA

A

Systemic, polyarticular, oligoarticular

100
Q

Systemic JRA: % of JRA cases, symptoms

A

10-20%, fever, rash, enlargement of spleen and liver, inflammation of the lungs and heart

101
Q

Oligoarticular vs Polyarticular JRA

A

Oligo: Also known as pauciarticular. 40-60% of cases, less than 5 joints, asymmetrical .
Poly: 30 to 40%, significant rheumatoid factor, more than 4 joints, symmetrical involvement

102
Q

This disease is characterized by degeneration of the femoral head due to avascular necrosis, and has these 4 stages:

A

Legg-Calve-Perthes disease.

1) condensation
2) fragmentation
3) re-ossification
4) remodeling

103
Q

Which knee meniscus is most often injured and why?

A

Medial, because attached to joint capsule, so less mobile

104
Q

Which types of osteogenesis imperfecta are autosomal dominant and which are recessive?

A

I and IV are dominant, II and III recessive

105
Q

The most common age of onset for RA is between ___ and ___ and is most common in which gender?

A

40 and 60

women affected 3 times more than men

106
Q

Which gender is more likely to develop and scoliosis curve of 10 degrees or less? Which greater than 30 degrees?

A

Both genders for mild curve, females for significant curve.

107
Q

A spinal orthosis is often warranted with a spinal curve between ___ and ___ degrees

A

25 and 40, >40 surgery

108
Q

Best THA approach for non-compliant patients

A

Direct lateral approach. Longitudinal division of the TFL and vastus lateralis and anterior glut med. Minimizes posterior dislocation

109
Q

What is Roxanol?

A

Morphine

110
Q

What is Demerol

A

Meperidine (opioid)

111
Q

What is Sublimaze?

A

Fentanyl

112
Q

What is Paveral?

A

Codeine

113
Q

What is Oxycontin?

A

Oxycodone

114
Q

What are DMARDs? Side effects? Major implication for PTs?

A

Diease-modifying antiheumatic drugs-halt the progression of rheumatic disease. Nausea, headache, joint pain/swelling, GI distress, sore throat, fever, liver dysfunction, hair loss, sepsis, retinal damage. High incidence of toxicity.

115
Q

Which KAFO is specifically designed for paraplegics so they can stand with a posterior lean?

A

Craig-Scott KAFO

116
Q

What is a parapodium?

A

Standing frame that allows gait and sitting when necessary. Used primarily by the pediatric population.

117
Q

What type of orthosis is designed to promote realignment of the spine due to scoliotic curvature?

A

Milwaukee

118
Q

What TLSO limits flexion/extension through a 3 point control design?

A

Taylor Brace

119
Q

What is a shoulder girdle and UE amputation called?

A

Forequarter

120
Q

What is a pelvis and bilateral LE amputation called?

A

Hemicorporectomy

121
Q

What is a Syme’s amputation?

A

Foot at the ankle joint with removal of the malleoli

122
Q

What is a midtarsal joint amputation called?

A

Chopart’s

123
Q

Prosthetic causes of lateral bending gait deviation

A

Too short, improperly shaped lateral wall, high medial wall, aligned in abduction.

124
Q

Prosthetic causes of abducted gait deviation

A

Too long, high medial wall, poorly shaped lateral wall, positioned in abd, inadequate suspension, excessive knee friction

125
Q

Prosthetic causes of excessive knee flexion during stance

A

Socket set forward in relation to the foot
Foot set in excessive DF
Stiff heel
Prosthesis too long

126
Q

Prosthetic causes of vaulting

A

Too long, inadequate socket suspension, excessive alignment stability, excessive PF

127
Q

Prosthetic causes of rotation of forefoot at heel strike

A

Excessive toe-out build in
Loose socket
Inadequate suspension
Rigid SACH heel cushion

128
Q

Prosthetic causes of forward trunk flexion

A

Socket too big, poor suspension, knee instability

129
Q

Prosthetic causes of medial/lateral whip

A

Excessive rotation of the knee
Tight socket fit
valgus
improperly aligned toe break

FSBPT (7 decks)

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