Notes on HB Kim Flashcards
CPR norm
Dial 911 then start CPR
Compression30: ventilation2
100 per minute
Anatomical movements
Flex - shorten muscles eg: iliopsoas - hip flexor
Extend - lengthen muscles
Adduct - move toward body
Abduct- move away from body
Most common side effects of Ergotamine in treating migraine
Nausea and cold fingers and toes
Ergotamine works by constricting blood vessels to reduce pain
Side effects of drugs
Myalgia (pain in muscle/s) - Statins, which lower LDL
GI Bleeding - Ibuprofen/aspirin
Tinnitus, Reyes syndrome, asthma, peptic ulcers - Aspirin
Flush - Niacin/Vitamin B3 - lowers LDL and increases HDL
Nausea, cold fingers and toes - Ergotamine - treats migraines
Generic name example
Acetaminophen (generic) - tylenol / panadol
What significantly increases risk of life threatening hypotension with Sildenafil (viagra)
nitroglycerin
Triglyceridee
a type of fat found in blood to make energy. Normal - <150 Borderline high is 150-199 high is 20-499 V high is 500+
Fish oil helps bring down triglyceride levels
Elevation is associated with: Pancreatitis (levels over 1,000), Alcoholism, myocardial infraction, increased fat/sugar
Dermatome for parts of body
A dermatome is an area of skin in which sensory nerves derive from a single spinal nerve root (see the following image).
L5 - top foot st2-s4- perinemum s1 - bottom of foot T4- nopple c6 - thumb t10 - umbilicus
Efectiveness of iron therapy can be monitored by
Hemoglobin and reticulocyte levels (will become RBC)
RBC life span - 120 days
Thrombocyte WBC -
Platelets -5-10 days
Generic name for Aspirin and long term side effects
Salicylate
* can cause tinnitus and GI problems
COX 1 inhibited which protects GI and renal FX, platelets, incraase risk of hemorrhagic stroke and asthma (if you use too much)
If corticoseroids (treats inflammation) are stopped without taper can lead to
Adrenal insufficiency. - Adrenal cortex stops making enough
Adverse effects of corticosteroids:
Osteoporosis, exogenous Cushings, hyperglycemia, increased skin fragility, easy bruising
Sulfonamide is an
Antibiotic
- many people have sulfur allergy: skin rashes
Adverse affects of Pellagra
A disease that occurs when a person does not get enough niacin (b3)
4D Dermititus Diarrhea Dementia Death (untreated)
sympathetic nervous system involved in stimulation of
Bronchodilation
Increased HT rate
vasoconstriction
Parasympathetic - pupil constriction, urination
Point and shoot
Erection - parasympatahetic
Ejaculation: Sympathetic
NSAIDS inhibit formation of
Prostaglandins
HMG CoA reductase - Statin, lower cholesterol
Xanthine oxidase production - allopurinal (chronic gout) (enzyme converts Purines to Uric acid
PDE5 (an enzyme in the walls of blood vessels. It affects blood flow and how cells signal within the body. ) - viagra
Diazepam (valium) and Antihistimine together will cause
Together increase central depressive effect
Valium- central depressive effect
Antihitamine (1st gen - Benadryl) - Drowsiness/sedative effect
median nerve innervates
Palmar aspect - thumb, index, middle and half of 4th/ring
Dorsal Aspect- Distal thumb, distal of index, distal middle, distal and medial of 4th
Normal adult mouth has how many permanent teeth
Permanent: 32
Deciduous teeth: 20
Transient Ischemic Attack (mini-stroke) common SX
- Temp loss of vision (amarosis fugax)
- Difficulty speaking (aphasia)
- Weakness of one side of body (Hemiparesis)
- numbness and tingling (Paresthesia)
Cataracts
Clouded lens (about opacity)
Glaucoma - closed angle - more dangerous/med emergency and open
Retinal disorder- problem with nerve layer in back of eye
Macular degeneration - Disease that destroys sharp and central vision
Smoking tobacco can cause
Lung cancer
Bladder cancer (also, caused by anilon dye, parasite)
Coronary artery disease
spontaneous abortion
screening exam for female over 50
general checkup every year
mammogram every other year
pap smear every 3 years
SX of otitis externa (swimmers ear) inflamaation of outer ear
Ear pain
foul smelling discharge
itching and irritation around ear canal
Structure of inner ear
External ear - ear canal to eardrum
Structure of inner ear
Inner ear - semicircular canals and cochlea - pressbycusis (inner ear problem leading to hearing loss)
External ear - ear canal to eardrum
Middle ear - ear drum to 3 bones marlius, stapes and incas
Thoracic outlet Syndrome Test
Adson’s test - Lose the radial pulse in the arm by rotating head to ipsilateral side with extended neck, followed by deep inspiration.
Apley’s scratch test
Type of ROM test.
Frozen shoulder - problem with external rotation or abduction
Drop arm teset
Tests rotator cuff inury. Supposed to drop arm slowly but will drop fast because of pain.
Speed tests
Biceps tendinitis test.
ptaient supinates aram and tries to push up as physician pushes down
Empty Can Test
Tests for supraspinatous tear (most common in rotator cuff)
90degree shoulder, internal rotation of 30degrees, like your emptying cans. Dr. pushes down as client pushes up. Pain indicates
Supraspinatus
infraspinatus
subscapularis
teres Minor
Lift off test
Tests supraspinatus tear
adduction, internal rotation (broken wing), try to lift hand away from body.
De Quervain Syndrome Test
Blackberry thumb/texting/video games
Test with Finkelstein test. Put thumb inside fist, and physician pushes down
pain over abductor pollicus and extensor pollicus brevis
Lasegue’s Test
Test is used to evaluate sciatic nerve compression
Pain between 30-70 is considered positive
Lift leg straight. Normally a leg can extend to 70-80degrees of hip flexion.
`
Ober Test
Tests tightness of iliotibial band
Lachmens test
ACL test (more specific test) moves forward >6mm
Trendelenburg’s Test
Tests Weak Gluteus medius/mimimus are weak -
hips are uneven if positive
FABERE Test
Leg moved through FABERE motions Tests hip joint and SI joing F- Flexion AB - ABduction ER - External rotation E - Extension
Thomas Test
Problems: tests hip flexor contracture
Contralateral hip flexes
iliopsoas
Hip flexion
flex one hip, other leg will not be bale to stay straight, it will raise up
Posterior Drawer Test
PCL - moves posterior
Hamstring Muscles
Biceps femoris
semitendonisus
semimembranosus
Quadriceps muscles
Vustus medialis, intermeidus, lateralis
Quads lengthen
hamstring contracts
Most common fracture in a child
Greenstick torus or buckle fracture
Their bones are more likely to bend than break. - incomplete fracture (periosteum is stronger and thicker)
Treatment modality for allergic reaction or anaphylaxis
Epinephrine - adrenaline (Epi-pen)
Histamine blockade
Steroid (lowers inflammation)
- With Beta blocker, epi-pen won’t work
Best radiology modality for carotid stenosis and DVT
Duplex ultrasound - how blood moves through veins
*Regular Ultrasound - AAA (Abdominal aortic aneurysm), appendicitis, gallstones, scrotal pathology, pregnancy
Best radiology modality for esophageal obstruction
Barium swallow test- drink liquid barium and take pictures to see if going down properly
upper endoscopy
Radiology modality for head trauma, intracranial bleed, nephrolithiasis
CT without contrast
Ct with contrast (abdominal trauma, diverticulitis)
Weber and Rinne Test for
Hearing loss
differentiate Macule, papule, vesicle, pastule
Macules - flat,
What Reduces LDL and increases HDL
Nicotinic acid (Niacin)
Just Lower LDL - HMG-CoA reductase ihibitors (statis), choloestorol absorption inhibitors (ezetimbe)
Hypothermia is defined as temp of
< 35 deg C (95 deg F)
Risk factors for Gerd - Gastro-esophageal Reflux Disease
Due to LES - lower esophageal sphincter is weakened
- increased pressure - hiatal hernia, Obesity, collagen vascular disease, pregnancy
- Decreased tone - alcohol, caffeine, nicotine, choc, fatty food
HPV for genitala warts
HPV 6 and 11
HPV for Cervical cancer
HPV 16 and 18 ( smoking is a risk factor)
Eeting nonnutritive, non food substances (ice, clay, sand, chalk, soil, paper, metal)
PICA - over a period of >1 month - Cause can be def of vitamins and minerals or parasite, or psychiatric
Dissociative Fugue
Temporary amnesia for ones own identity, typically lasts hours to days + unexpected travel away from home.
Other Dissociative disorders:
Dissociative identity disorder - formerly know as Multiple personality disorder
When using lithium, you must monitor which two organs?
- Renal 2. Thyroid
(narrow therapeutic index) - side effects: Hypothyroidism and nephrotoxicity
Characteristic of barking cough
Croup (Laryngotracheobronchitis) - Wind pipe has swollen tissues and is narrowed (front view) - barking cough
Whooping cough *caused by - pertussis
Epiglottitis - life threatening airway obstruction (side/lateral view) - thumbprint sign - Epiglottis - CN10 (has some taste) Food goes to wind pipe instead of food pipe
Phagocytes for internal parasites
eosinophil (allergic rxn, parasite)
Granular - basophil, neutrophil, eosinophil (allergic rxn, parasite)
Agranular - lymphocyte, moncytes
The most common benign breast disorders
- Fibrocystic changes 30-60% women - mild to moderate pain, +/- lumps - hormonal
The most common tumor in menstruating women <25 yrs
Fibroadenoma - benign tumors - small, firm, unilateral, non-tender mass, freely movable and slow growing.
- Ultra-sound can differentiate from cyst
Normal hip flexion using passive ROM
120degrees
Loose connective tissue with elastic and adipose tissue. Lubricate joint cavities.
synovial membrane - join cavities
Serous membrane - closed body cavities (Pericardial, peritoneal, pleural)
mucous membrane - lining to cavities that are open to exterior (digestive)
Cutaneous membrane - covers outside of body (skin)
DEXA,DXA Test evaluates
Bone mineral density, t-score - determines osteoporosis
Low blood chloride levels are due to
severe vomiting and diarrhea (electrolyte disturbance)
Alpha beta blocker used to treat severe hypertension
Trandate (lavetalol)
Others:
Cardizem (Diltiazem)
Vesotec (Enalapril) -pril - ACE inhibitor for high blood pressure
Inderal (propranolol) –olol - just Beta blocker that treats hypertension
Hypertension drugs ACE Beta blocker Calcium Channel Blocker Diuretic
xanthoma
Irregular yellow patch nodule of the skin. Excess triglyceride fatty tissue under the skin.
Ligaments
Connect bone to bone
Tendons
Connect muscle to bone
Fasciae connects
muscle to muscle or muscle to other organs (plantar fasciitis)
Injury of muscle or tendon
Strain
Sprain - Joint out of position, overstretch or rupture of supporting ligament
<p>The most common injured ligament in the foot</p>
<p>Anterior talofibular ligament (around GB40_</p>
<p>Always</p>
<p>Tears</p>
<p>First</p>
<p>Erythropoietin (EPO) is</p>
<p>A hormone secreted by the kidneys that creates the rate of production of red blood cells in response to falling level of oxygen in the tissues (like at high altitude)</p>
<p></p>
<p>Gastrin (in walls of stomach)- stimulates pepsinogen (<span>secreted by the stomach) converts into pepsin, which </span><strong>breaks down proteins in food during digestion</strong><span>.</span></p>
<p>CCK - stimulates emptying of bile <span>Cholecystokinin (in small intestine) stimulates </span><strong>the gallbladder</strong><span> to contract and release stored bile into the intestine. Regulates digestion and appetite</span></p>
<p>hCG - production of embryo following implantation</p>
<p>AKA Human placental lactogen (hPl)</p>
<p>Human chorionic somatotropin (hCS)</p>
<p>hormone produced by placenta that develops during pregnancy to hepl feed the baby.</p>
<p></p>
<p>Treatment for infectious mono</p>
<p>EBV - Epstein Barr Virus</p>
<p>Rest during acute phase so as not to rupture spleen (Avoid heavy lifting and contact sports for 1 month)</p>
<p>sx: swollen lymph, Splenomegaly, fatigue</p>
<p></p>
<p>If you give mono patient penicillin - can get a rash</p>
<p>Menstrual cramps are due to</p>
<p>Prostaglandins</p>
<p>Uterus contracts to help expel lining.P Prostaglandin is involved in pain and inflammation trigger the uterine muscle contractions</p>
<p></p>
<p>Cox-2 inhibitor reduces</p>
<p>Cox 1 - protects</p>
<p>2- inflammation</p>
<p>1- GI</p>
<p>Drugs that are Cox-2 inhibitors: -oxib</p>
<p>Which part of medicare is for hospitalization coverage</p>
<p>Part A</p>
<p>Med insurance - B</p>
<p>Privately purchased supp insurances for additional services - C</p>
<p>Prescription drug - D</p>
<p>Bone, cartilage Blood, adipose tissue</p>
<p>Connective Tissue</p>
<p>Muscle tissues, Cardiac, smooth, skeletal (voluntary, multi-nucleated)</p>
<p>Which drug is associated with miosis (constriction of pupil)</p>
<p>Heroin, oxycodone → opioids (life threatening → respiratory depression)</p>
<p>Amphetamines - (yang) psychomotor agitation, tachycardia, high BP, pupillary dilation</p>
<p>Cocaine - cocaine bug (feel like bugs crawling under skin), chest pain, pupillary dilation, psychomotor agitation, impaired judgement</p>
<p>LSD - pupillary dilation, visual hallucination</p>
<p>PCP - psychosis/violent/impulsive/agitated/ tachycardia,</p>
<p>Scheduled drugs</p>
<p>I. Not accepted for medical use - high potential of abuse - ecstasy, heroine, LSD, PCP</p>
<p>II. Accepted medical use with severe restrictions with high potential of abuse - morphine</p>
<p>III. Accepted medical use with moderate to low potential for abuse - codeine, vicodin</p>
<p>IV. Accepted medical use with potential for abuse but less than schedule III - valium, ambient</p>
<p>V. Accepted medical use with low potential for abuse - Robitusin</p>
<p>Reduced norepinephrine causes</p>
<p>Depression (yin symptom because its reduced- and is a hormone to increase stress response, theres low arisal)</p>
<p>Comes from the adrenal gland</p>
<p></p>
<p>Erythasma</p>
<p>Brown, scaly skin patches</p>
<p>Can happen in diabetic patients</p>
<p>Folate (B9) deficiency and cobalamin (B12) deficiency are associated with</p>
<p>Homocysteine (HCY) (both)</p>
<p>B9 and B12 (hyper-segmented neutrophil)</p>
<p>More B12 - Neurological symptoms</p>
<p>Laparoscopy is used for</p>
<p>Endometriosis (tissue is supposed to be in lining of endometrium) but the tissue is elsewhere, like ovaries, outside uterus (endometrioma/chocolate cyst) , abdomen, fallopian tubes</p>
<p></p>
<p></p>
<p>Most common site of Ectopic pregnancy</p>
<p>Tubular, ampular area</p>
<p>Can do an ultrasound to see</p>
<p>May occur with another health problem, giant cell arthritis (large temporal artery)</p>
<p>Polymyalgia rheumatica (PMR) (<strong>disorder that causes muscle pain and stiffness</strong><span>, especially in the shoulders and hips.)</span></p>
<p>Treatment of BPH (benign prostatic hyperplasia) may be treated by</p>
<p>Tamsulosin (Flomax)*</p>
<p>Proscar (finasteride) *</p>
<p>Dutasteride (avodart)</p>
<p>ICD-10 codes are about</p>
<p>Diagnosis (international classification disease) by WHO</p>
<p>CPT- treatment (current procedural terminology) For US, American Medical Association AMA</p>
<p>CPT insurance code for acupuncture treatment without electro-stimulation</p>
<p>97810 - acu - initial 15 min</p>
<p>97811- acu - each additional 15</p>
<p>97813 -Electro acu initial 15</p>
<p>97814- Electro acu - each additional 15</p>
<p>97140 - myofascial release (Cupping)</p>
<p>Homan's sign</p>
<p>Dorsi flex the foot makes calf muscle pain - positive sign of possible DVT - Deep vein thrombosis -</p>
<p>embolism detaches and is more dangerous</p>
<p>Best diagnostic test and treatment for Bronchiectasis (<strong>long-term condition where the airways of the lungs become widened</strong><span>, leading to a build-up of excess mucus that can make the lungs more vulnerable to infection.)</span></p>
<p>X-Ray and CT of Chest</p>
<p>Treatment - antibiotic, bronchodilators (albuterol), tiotropium, O2 therapy</p>
<p>Tests for Bicipital tendon</p>
<p>Speed test - patient supinates arm while extended to 90 degrees while practitioner pushes down and patient resists - If there is pain→ positive test</p>
<p>Yergasons test - <span>The patient should be seated or standing in the anatomical position, with the humerus in a neutral position and the elbow in 90 degrees of flexion in a pronated position. The patient is asked to externally rotate and supinate their arm against the manual resistance of the therapist produced by wrapping the hand around the distal forearm (just above the wrist joint).</span><a>[2]</a><span> Yergason's Test is considered positive if the pain is reproduced in the bicipital groove and a biceps or a SLAP (</span><strong>tear of tissue that is located on top of the shoulder</strong><span>. SLAP stands for “Superior Labrum Anterior Posterior.) </span><span>lesion is suspected.</span></p>
<p>Which of the following is not a key in identifying Hashimoto Thyroiditis</p>
<ol><li>Anti - thyroid peroxidase antibodies</li><li>TSH</li><li>T4</li></ol>
<p>*T3 is not a crucial to test</p>
<p>Hoshimotos ( teenagers usually had hyperthyroidism as a teenager</p>
<p>Hypo - TSH and T4 is high</p>
<p>Hyper- TSH and T4 is low</p>
<p>What substance Increase the chance of liver toxicity from acetaminophen (Tylenol), or will worsen LV damage that acetaminophen can cause?</p>
<p>Alcohol</p>
<p>Forms of estrogen hormones</p>
<p>E2 - Estra<strong>dio</strong>l (most common type in women in childbearing age) - (Dios willing, I'll get pregnant)</p>
<p>E3- Estriol - (main during pregnancy) - (ol baby is in my belly)</p>
<p>E1 - Estr<strong>one</strong> (only one/estrogen produced after menopause)</p>
<p></p>
<p>Treatment of Gerd consists of lifestyle changes and</p>
<p>Proton Pump Inhibitor - suppress acid production by acid gland</p>
<p>Omeprazole (nexium, prilosec), protonix, prevacid</p>
<p></p>
<p>H2 receptor blockers - can help stop stomach acid - ranitidine (zantac) Famotidine (pepcid), Climetidine (Zantac)</p>
<p>Hematocrit is the proportion of your total blood volume composed of</p>
<p>Red blood cells (RBCs)</p>
<p>Mean corpuscular volume MCV is the avg volume of red cells. Possible MCV for pernicious anemia?</p>
<p><100fl - macrocytic *<strong>causes unusually large red blood cells)</strong></p>
<p><80fl - microcytic - b12 and folate deficiency</p>
<p>Normal - 80-95fl</p>
<p></p>
<p>Best diagnostic test for bronchectaasis</p>
<p>Xray and Ct chest scan</p>
Reflexes for knee
L4 - knee reflex (can also relatae to L2, L3)
s1 - heel reflex/achilles/bottom foot
L5 - dorsum of foot
Digestive enzyme for protein
Pepsin - peptides and aminos
Trypsin- enzyme that aids with digestion of proteins (too much leads to pancreatitis)
Lipase - breaks down fat into fatty acids
Enzymes for carbs is released
in the mouth and Small intestine
Inhibitory neurotransmitter
GABA - inhibitory
Glutamine - Excitatory
Dopamine - both
Diazepam (Valium) and alprazolam (Xanax) are what?
*Benzodiazepines - Facilitates GABA action by increasing the frequency of CL channel opening
Barbituate: Facilitates GABA action by increasing duration of CL channel opening
what is added to ergotamine (used for migraines/cluster headaches) in order to facilitate GI absorption and synergetic effect
Caffeine
Trichomoniasis
STD -
Trichomoniasis - Protozoa, increased yellow-green-frothy discharge, malodorous, PH > 4.5, causes strawberry petechia, Rx: metronidazole - Treat partners
Provides. wealth of helpful info, size and shape of heart (internal chamber size quantification), pumping capacity, and location and extent of tissue damage
*Echocardiogram - Echo
Electroencephalography - EEG - seizure (brain recording)
Electrocardiography ECG - heart rhythm, fainting
Electromyography - EMG - nerve issues/skeletal muscle issues issues (ALS, myasthenia gravis, MS etc.)
Diagnostic test for bells palsy
- Physical exam
- Electromyography
- MRI by using contrast agent for CN VII (some cases)
- swelling -> corticosteroids
Heterophile antibody tests
EBV
for monospot test
Ace inhibitor , drug ends in wht letters
-pril
April
- side effect of ACE inhibitor is cough
- Statin - reduce LDL
Lisinopril inhibits the production of
Angitensin II
-pril is n ACE inhibitor. Angiotensin converting enzyme converts angiotensin I to angiotensin II
Plays. central role of regulation of blood pressure by increasing reabsorption of sodium and water in kidneys
Aldosterone
light colored white or clay colored stool indicates
lack of bile in stool
excess ft in stool - steatorrhea - malabsorption of fat (like celiacs)
Parietal cells of stomach secrete
HCL and intrinsic factor
Gastritis and autoimmune damage parietal cells - can’t produce intrinsic factor, which binds to B12 (in ilium) - can lead to pernicious anemia
Another term for illness
Morbidity
Incidence - newly
prevalence - whole number/snap shot
The potent clot-busting drug needs to be given with how many hours after stroke sx begin?
3 hours
tPA- Clot buster (tPA - toilet paper amazing - for cleaning clots)
2 Kinds of strokes:
1. Ischemic - Thrombosis - tPA clot buster
2 Hemorrhagic stroke
For an ischemic stroke as an immediate treatment given in the emergency rooms to reduce likelihood fo another stroke
Aspirin (prevent clots from forming)
Ischemic stroke: Hemorrhagic stroke (blood vessel ruptures)
80%:20%
CT scan will show if its a hemorrhagic stroke
The first like drug choice for strep throat (streptococcal pharyngitis)
Penicillin
Penicillin given to EBV patient -> rash
Strep- throat is normally grayish
Innervates the dorsal aspect of the index, middle and distal thumb
Radial nerve
medial nerve - palmar side side - full thumb, index, middle, half of 4th
- Distal on dorsal
Which of the following hormones is associated with hypothalamic-pituitary-adrenal axis
Corticotropin releasing hormone (CHR)
Adrenocorticotropic hormone (ACTH)
Cortisol
Negative feedback loop
which types of join are the Shoulder and hip joints?
*ball and socket joints
Can move freely in all directions
Hinged: allow small ROM in Elbow or knee
Pivot: allow a wide ROM, but not as much freedom as ball and socket joints (between atlas and axis)
Gliding - allow sliding motion between two bones (wrist & ankle)
What does FABERE (Patrick’s test) test stand for? What does it test?
Flexion, Abduction, External Rotation, Extension (figure four)
pain in the SI joint is possible - indicates hip or SI joint dysfunction
What tests checks for contraction of iliotibial band (combo of Tensor fascia latae + gluteus maximus)
Ober test.
Abduct the involved leg as far as possible with the knee flexed to 90 degrees and the hip extended to 0. The leg is lowered. If the leg remains abducted = positive -> IT band is tight
Thompson Test
Tests achilles tendon is ruptured
Squeeze calf produces plantar flexion of foot when cord is intact. If foot doesn’t go up, achilles tendon is ruptured
Painful Arc
Tests impingement of supraspinatus muscle
When you make an arc with arm, if there is pain from 60-120 degrees, if it is painful
Yergason’s test
Tests biceps tendinitis
Elbow is flexed to 90degrees with thumbs up
grasp hand (hand shake)
patient supinates against resistances. Pain = positive test.
How do you measure for leg length discrepancy?
ASIS to Medial malleolus
Piriformis syndrome
the Piriformis is one of the causes of sciatica. When its tight, it can pinch sciatic nerve and manifest like sciatica.
Leg will be abducted.
Sometimes pain from sciatica is from back (radiclopathy) - nerve pinched.
FAIR test -
Tests piriformis Flex hip, Adduction Internal Rotation Pain = positive
What is true about hip dislocation
There can be posterior and anterior dislocations
90% of hip dislocations are posterior
Transcervical fracture - neck of bone
Intertrochanteric fracture - doesn’t interrupt blood supply
Subtrochanteric fracture - below inter.
Anterior bursa of the knee
4 anterior knee bursas
- prepattelar - behind
- Suprapatellar -above
- infrapatellar bursa - below - 2 of these: Superficial (subcutaneous), and deep infrapatellar bursa)
- Pes Anserine Bursa- goose foot (medial side) - attachment of sartorius, gracilis, semitendinosus
Housemaid knee is the condition also known as
prepatellar bursitis (down on knees)
Baker’s cyst
A type of fluid collection behind the knee. Too much synovial fluid leads to Bakers cyst.
- Inflammation o knee - arthrits
- A knee injury, like cartiledge tear
What forms the medial malleolus
Distal tibia
Tibia (Tom) - big - leads to medial malleolus
Fibula (friend) - smaller - leads to lateral malleolus
Which ligaments is weakest of ankle ligaments?
Anterior talofibular ligament
Which ligament stabilizes medial ankle
Deltoid ligament
Patellar tendon reflex radiates to
L4 - Patellar tendon L1 - L5 - top of foot S1 - heel, achilles C5- biceps C6- brachoradialis C7- Triceps
How many cervical nerves are there?
8
Even though there are 8 cervical vertabrae
Normal ROM for hip flexion
120 degrees
Standing is neutral
what are the joints of the pelvic girdle
SI joint
Femoroacetabular (hip) joint
Pubic symphasis
(Lumbosacral joint is NOT)
Signs of a positive trendelenburg test?
Test Gluteus medius weakness (on side of buttocks) abducts the hips. If there is weekness, they have difficult abducting.
When you lift L leg, the left hip should be just a little bit higher. When glute medius is weak on the supported side, your unsupported side will drop down.
Standing leg is above the bent leg = positive - weak gluteus medius
Weak on Left - Drop on right
What is the pathology behind avascular necrosis of the femoral head?
Interruption of vascular supply
most common cause steroid or alcohol abuse
women are more likely to suffer from hip fracture.
Most common cause of hip fracture is osteoporosis. Approx. 25% of patients over 50 with hip fractures die within 1 year.
Most common hip fracture - intertrochanteric fracture
DEXA scan is for?
Testing bone density - osteoporosis - Dual energy xray absorptionmetry - minimal xray - measures t-score
What is normal Bone Denisty? For Osteoporosis?
+1- -1
Osteopenia -1 - -2.5
Osteoporosis
which ligament of the spine resists extension?
Anterior longitudinal ligament
Apley’s compression test
tests for meniscus tear
leg at knee, press down and rotate the leg in both directions. If pain, test is positive
Characteristics of plantar fassciitis
- F more than M
- Tenderness over medial foot
- worse pain in morning
- heel spurs may contribute
Most common site for Morton’s neuroma?
between the 3rd and 4th metatarsal bone, the 3rd metatarsal space
Its a nerve tumor that feels like a pebble.
structures that pass through the carpal tunnel into the hand include:
- Five finger flexor tendons
- median nerve
