NPTE ALL OF IT Flashcards

1
Q

Rotator Cuff Muscles “SITS”

A

Supraspinatus, infraspinatus, teres minor and Subscapularis

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2
Q

How much elevation occurs at GH joint?

A

120 degrees

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3
Q

How much elevation occurs at Scapulothoracic ?

A

60 degrees

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4
Q

The ratio of scapular to humeral motion for elevation

A

1 to 2

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5
Q

Upward rotation of Scapula with elevation?

A

traps and serratus anterior

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6
Q

Downward rotation with purposeful extension

A

rhomboids, levator scap, pec minor

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7
Q

Scapular protaction

A

serratus anterior and pec minor

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8
Q

scapular retraction

A

rhomboids, middle and lower trap

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9
Q

Depression of scapula

A

pectoralis minor and latissimus dorsi

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10
Q

Long thoracic Nerve

A

C5, C6, C7

innervates the serratus anterior

injury can cause scap winging

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11
Q

Dorsal scapular Nerve

A

C5, C6

innervates leavtor scapulae and rhomboids

Injury can affect scapular retraction and downward rotation

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12
Q

What nerve roots pass through the first rib?

A

C8 and T1

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13
Q

Suprascapular Nerve

A

C5, C6

innervates the supraspinatus and infraspinatus

if injured it will cause pain/ decreased shoulder abduction and ER limitations.

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14
Q

Carrying angle for men vs women

A

men: 10-15 deg
women: 20-25 deg

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15
Q

Axillary Nerve off the posterior cord

Supplies: Teres minor whats the action?

Supplies Deloid whats the action?

A

Nerve Root: C5-C6

Teres: shoulder ER, Extension, abduction and horizontal abduction

Deltoid: anterior: shoulder IR, flexion
Posterior: shoulder ER, extension, horizontal abduction

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16
Q

Axillary nerve sensory

A

Upper lateral cutaneous nerve of arm supples the skin covering the lower half of deltoid and upper part of long head of triceps

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17
Q

Axillary Nerve injury

A

Shoulder dislocation, fracture at the surgical neck

Square shoulder from deltoid atrophy

sensory loss over lower half of deltoid

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18
Q

Radial nerve comes off the posterior cord

Supplies triceps tell me action

Supplies anconeus tell me action

Supplies brachioradialis tell me action

Supplies supinator tell me action

A

Nerve root: C5-T1

Triceps
- Elbow extension

Anconeus
- Weak elbow extensor

Brachioradialis
- Elbow Flexion especially
in mid-prone position

Supinator
- Supination of forearm

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19
Q

Radial nerve Supplies all the extensors tell me actions

A

Extensor Carpi Radialis Longus
- Action: Wrist EXT, Radial Deviation

Extensor Carpi Radialis Brevis
- Action: Wrist EXT, Radial Deviation

Extensor Carpi Ulnaris
- Action: Wrist EXT, Ulnar Deviation

Extensor Digitorum
- Action: 2-5

th digits EXT a MCP, IP, Wrist

Extensor Digiti Minimi
- Action: 5th digit EXT at MCP, IP

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20
Q

Radial nerve Supplies all the extensors tell me actions

A

Extensor Pollicis Longus
- Action: 1st digit EXT at CMC, IP

Extensor Pollicis Brevis
- Action: 1st digit EXT at MCP, IP

Extensor Indicis
- Action: 2nd digit EXT, wrist extension

Abductor Pollicis Longus
- Action: 1st digit ABD and extension at
CMC joint

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21
Q

Radial Nerve Sensory supply

A

Skin of lower half of lateral side of arm

skin of back of arm

skin of back of forearm

skin of lateral half of dorsum of hand, lateral two and half digits including thumb

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22
Q

Radia tunnel syndrome

A

Radial nerve is compressed at the tunnel. Pain 1/2 down arm under the supinator

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23
Q

Posterior interosseous nerve syndrom

A

Radial nerve compression at the arcade of frohse

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24
Q

Lateral epicondylitis

A

Inflammation of the extensors at the lateral epicondyle of the humerus. The main muscle affected is the extensor carpi radialis brevis

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25
Q

What motions provoke pain for lateral epicondylitis?

A

Repeated extension and supination cause it. The pain will increase with wrist flexion with elbow extension, resisted extension and resisted radial deviation.

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26
Q

Medial epicondylitis affects what muscles?

A

Affects the flexor carpi radialis, humeral head of pronator teres

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27
Q

Medial epicondylitis increases in pain with what motions?

A

Pain with resisted wrist flexion and resisted pronation

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28
Q

Ulnar Nerve comes off the medial cord

Supplies the Doral interossei Tell me action

Supplies the Palmar interossei Tell me action

Supplies the adductor pollics Tell me action

Supplies the opponens digiti minimi and abductor digiti minimi

A

Nerve root: C8-T1

Doral interossei : DAB = abduction

Palmar interossei: PAD = adduction

Adductor pollicis: adduction of thumb

Opponens digiti mimini: opposition of 5th digit

Abductor digiti minimi: abduction of 5th finger

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29
Q

Ulnar nerve supplies

Flexor pollicis brevis

Flexor digitorum profundus

Flexor digiti minimi

Flexor carpi ulnaris

what are their actions?

A

Flexor Pollicis Brevis
- Action: Flexion of thumb

Flexor Digitorum Profundus (Medial half)
- Action: Flexion of DIP, Secondary –Flexion
of joints of digits, finger, wrist

Flexor Digiti Minimi
- Action: Flexion of little finger

Flexor Carpi Ulnaris
- Action: Wrist flexion, Ulnar Deviation

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30
Q

What is the sensory supply for the ulnar nerve?

A
  • Supplies medial 1⁄2 of palm

Supplies skin of dorsal aspect of medial
two and half fingers

Supplies 1⁄2 of 4th, 5th digit

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31
Q

Cubital tunnel syndrome

A

Compression at cubital tunnel at elbow
- Paralysis of Flexor Carpi Ulnaris, Flexor
Digitorum Profundus (Ulnar half), hypothenar eminence, interossei, and the
third and fourth lumbrical muscles
- All sensations affected
- Inability to grip paper

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32
Q

Guyon’s canal syndrome

A

Sensory changes and progressive
weakness of muscles innervated distal to
the site

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33
Q

Ulnar Claw hand

A
  • Hyperextension at 4th,5th MCP, Flexion at 4th, 5th IP due to Flexor Digitorum Profundus
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34
Q

Median Nerve comes from the medial and lateral cord

supplies the abductor pollicis brevis tell me action

supplies the opponens pollicis tell me action

supplies the lumbricals 1,2

A

Nerve roots: C5-T1

Abductor Pollicis Brevis
- Action: Abduction of thumb at MCP, CMC joint

Opponens Pollicis
- Action: Opposition of thumb

Lumbricals 1,2
- Action: Flexion of MCP and extension of IP

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35
Q

Median nerve supplies almost all of the flexors what are their actions?

Flexor digitorum profundus

Flexor pollicis longus

Flexor carpi radialis

Flexor digitorum superficialis

Flexor pollicis brevis

A

Flexor Digitorum Profundus (Radial half)
- Action: Flexion of DIP, Secondary –Flexion
of joints of digits, finger, wrist

Flexor Pollicis Longus
- Action: Flexion of distal phalanx of thumb

Flexor Carpi Radialis
- Action: Wrist flexion, Radial deviation

Flexor Digitorum Superficialis
- Action: Flexion of PIP joint

Flexor Pollicis Brevis
- Action: Flexion of thumb

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36
Q

Median nerve sensory supply

A

Palmar Cutaneous Branch
- Skin of lateral two-thirds of palm

Palmar Digital Branches
- Supplies dorsal tips of 1st, 2nd, & 3rd finger,
palmar skin of lateral three and half fingers

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37
Q

Pronator teres syndrome what nerve is affected and what is the issue?

A

Hypertrophy of pronator teres muscle can compress the median nerve. Pronator teres
remains normal, but the other muscles supplied
by the median nerve are affected, as is its
sensory distribution

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38
Q

Carpal tunnel syndrome

A

Median nerve is compressed under the flexor

retinaculum at the wrist

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39
Q

Ape Hand deformity

A

Wasting of the thenar eminence of the hand

occurs as a result of a median nerve palsy

40
Q

Musculocutaneous Nerve branches off lateral cord

Supplies the biceps, brachialis and coracobrachialis

A

Nerve Root: C5-C7

Biceps: elbow flexion, forearm supination

Brachialis: elbow flexion

Coracobrachialis: flexion of arm

41
Q

Musculocutaneous nerve sensory supply?

A

Lateral cutaneous nerve of forearm: supply

the skin on lateral side of forearm

42
Q

Suprascapular Nerve comes from superior trunk

Supplies: infraspinatus and supraspinatus

A

Nerve root: C5-C6

Infraspinatus
- Action: Lateral rotation and abduction of
arm

Supraspinatus
- Action: Shoulder Abduction up to 15
degrees

43
Q

Subscapular Nerve Comes from posterior cord

Supplies the teres major from lower branch

Supplies subscapularis with both branches

A

Nerve root C5-C6

Teres Major (Lower Subscapular Nerve)
- Action: Shoulder medial rotation,
extension, adduction

Subscapularis (Both Upper & Lower Subscapular Nerve)
- Action: Shoulder medial rotation(when
arm is by side), adduction

44
Q

Lateral pectoral nerve comes from lateral cord

supplies the pec major

A

Nerve root: C5-C7

Pectoralis Major
- Action: Medial rotation, adduction,
horizontal adduction,
Scapular Protraction, Depression

45
Q

Medial Pectoral Nerve comes from the medial cord

supplies: Pec Minor

A

Nerve Roots: C8, T1

Pectoralis Minor
- Action: Downward Rotation of scapula,
Scapular Protraction, Depression

46
Q

Long Thoracic Nerve comes from the roots of brachial plexus

supplies serratus anterior

A

Nerve Roots: C5,C6,C7

Serratus Anterior
- Action: Upward Rotation of scapula,
Scapular Protraction, Depression,

Injury can cause:
- Winged Scapula

47
Q

Thoracodorsal nerve comes from the posterior cord

Supplies the latissimus Dorsi

A

Nerve Roots: C6-C8

Latissimus Dorsi
- Action: Shoulder extension, adduction,
medial rotation.
Depression and protraction of scapula

48
Q

Doral scapular nerve comes from the root of the brachial plexus

supplies rhomboids and levator scapulae

A

Nerve root: C5

Rhomboid Minor
- Action: Scapular Elevation, Retraction, Downward Rotation

Rhomboid Major
- Action: Scapular Elevation, Retraction, Downward Rotation

Levator Scapulae
- Action: Scapular Elevation, Downward Rotation

49
Q

Nerve to subclavius comes from upper trunk

Subclavius

A

Nerve root C5-C6

Subclavius
- Action: Depress & stabilize clavicle

50
Q

What muscles perform scapular elevation?

A

upper trap, levator scap, rhomboids

51
Q

What muscles perform scapular protraction?

A

serratus anterior, pectoralis minor/major, latissimus dorsi

52
Q

What muscles perform scapular depression?

A

Serratus anterior, pec minor and major, lower trap, latissimus dorsi

53
Q

What muscles perform scapular retraction?

A

Trap and rhomboids

54
Q

What muscles perform scapular downward rotation?

A

levator scapular, rhomboids, pec minor

55
Q

What muscles perform scapular upward rotation?

A

Serratus anterior, trap upper and lower fibers

56
Q

Spinal Accessory Nerve

supplies : traps and SCM

A

Trapezius
- Action: Upper fibers- scapula elevation,
Middle fibers- Retraction, Lower fibers- depression,
Upper and lower fibers-Upward rotation

Sternocleidomastoid
- Action: Cervical lateral flexion and Opposite side
rotation

57
Q

Superior Gluteal Nerve

supplies gluteus medius, minimus and TFL

A

Nerve Roots: L4-S1

Gluteus Minimus
- Action: Abduction and medial rotation of hip

Gluteus Medius
- Action: Abduction and medial rotation of hip

Tensor Fascia Latae
- Action: Flexion, abduction, medial rotation of hip

58
Q

Inferior Gluteal Nerve

Supplies: glute max

A

Nerve Roots: L5-S2

Gluteus Maximus
- Action: Hip extension
Secondary action: Hip Lateral rotation, abduction

59
Q

Nerve to piriformis

Supplies piriformis

A

Ventral rami Nerve Roots: S1-S2

Piriformis
- Action: Abduction and lateral rotation of
hip

60
Q

Obturator Nerve bifuractes to anterior and posterior the anterior division supplies:

adductor longus, brevis and gracilis

A

Nerve Roots: L2-L4

Adductor Longus
- Action: Hip adduction, flexion, medial
rotation

Adductor Brevis
- Action: Hip adduction, flexion, medial
rotation

Gracilis
- Action: Hip flexion, medial rotation,
adduction

61
Q

Obturator Nerve bifuractes to anterior and posterior the posterior division supplies:

obturator externus and adductor magnus

A

Nerve Roots: L2-L4

Obturator Externus
- Action: Hip lateral rotation, adduction

Adductor Magnus
- Action: Hip adduction, extension,
medial rotation

62
Q

Obturator sensory supply

A

obturator nerve

supplies skin of middle part of medial thigh

63
Q

Nerve to quadratus Femoris

supplies the gemellus inferior and quadratus femoris

A

Nerve Roots: L4-S1

Gemellus inferior
- Action: Lateral rotation of hip

Quadratus Femoris
- Action: Lateral rotation of hip

64
Q

Nerve to Obturator Internus supplies the:

Gemellus superior and obturator internus

A

Nerve Roots: L5-S2

Gemellus superior
- Action: Lateral rotation of hip

Obturator Internus
- Action: Lateral rotation of hip

65
Q

Sciatic nerve supplies:

Bicep femoris, semitendinosus and semimembranosus and adductor magnus

A

Nerve Roots: L4-S3
Biceps Femoris
- Action: Knee flexion, hip extension, lateral
rotation of flexed leg in non–weightbearing

Semitendinosus
- Action: Knee flexion, hip extension,
medial rotation of flexed leg in non-weight bearing

Semimembranosus
- Action: Knee flexion, hip extension,
medial rotation of flexed leg in non–
weight-bearing

Adductor Magnus
- Action: Hip adduction, extension,
medial rotation

66
Q

Femoral Nerve supplies the iliacus, pectineus, sartorius, rectus femoris and vastus medialis/intermedius and lateralis

A

Nerve Root: L2-L4

Iliacus

  • Action: Hip flexion
  • Works with Psoas Major & Psoas Minor

Pectineus
- Action: Hip flexion, adduction, medial
rotation

Sartorius
- Action: Hip flexion, abduction, lateral
rotation, Knee flexion

Rectus Femoris
- Action: Hip flexion, Knee extension, Assists
in Hip flexion

Vastus Medialis/Intermedius/Lateralis
- Action: Knee extension

67
Q

Femoral nerve sensory

medial cutaneous of nerve of thigh

A

Branch of anterior division of femoral
nerve. Supplies the skin on medial side of
lower two third of thigh

68
Q

Femoral nerve sensory

intermediate cutaneous of nerve of thigh

A

Branch of anterior division of femoral

nerve. Supplies the skin on front of thigh

69
Q

Femoral nerve sensory

Saphenous nerve

A

Branch of posterior division of femoral
nerve. Supplies the skin on the medial side
of leg

70
Q

Tibial nerve

Supplies:

gastroc, soelus, plantaris

A

Nerve root: L4-S3

Gastrocnemius
- Action: Plantar flexion, Knee flexion

Soleus
- Action: Plantar flexion

Plantaris
- Action: Slight Knee flexion, Plantarflexion

71
Q

Tibial nerve

Supplies:

poplieus, tibialis posterior, flexor hallucis longus, flexor digitorum longus

A

Nerve root: L4-S3

Popliteus
- Action: Knee flexion, unlocks the knee
during initial flexion by laterally rotating
femur

Tibialis Posterior
- Action: Plantarflexion, Inversion

Flexor Hallucis Longus
- Action: Flexion of great toe, Plantar
flexion, Inversion

Flexor Digitorum Longus
- Action: 2-5 toes flexion, PF and inversion

72
Q

Tarsal Tunnel Sydrome

Tom, dick and harry

A

Tibial artery, nerve and vein compression

Tibialis posterior, flexor hallucis longus and flexor digitorum longus

73
Q

Tibial nerve sensory

A

supplies over the heal, medial side of sole from the medial plantar and lateral side of the sole from lateral plantar

74
Q

Common peroneal nerve

A

Nerve root: L4-S2

75
Q

Deep Peroneal nerve supplies the: tibialis anterior, extensor hallucis longus, extensor digitorum longus and extensor digitorum brevis

A

Nerve Roots: L4-S1

Tibialis Anterior
- Dorsiflexion, inversion

Extensor Hallucis Longus
- Action: 1st toe extension, Ankle
dorsiflexion, inversion

Extensor Digitorum Longus
- Action: Toe extension, ankle DF, eversion

Extensor Digitorum Brevis
- Action: Toes extension

76
Q

Injury to the deep peroneal nerve can result in what gait deviations?

A

foot drop and unopposed eversion

77
Q

Superficial peroneal nerve supplies the peroneus longus and peroneus brevis

A

Nerve Roots: L4-S2

Peroneus Longus
- Action: Plantarflexion, eversion

Peroneus Brevis
- Action: Plantarflexion, eversion

78
Q

Deep peroneal sensory supply:

A

Webbing between 1 and 2 toes on the dorsum of the foot

79
Q

Superficial peroneal sensory supply:

A

Dorsum of the foot and anterolateral part of lower leg

80
Q

General contraindications for electrical stimulation

A

healing fractures, active bleeding, malignancies, superficial metal implants, pharyneal/laryngeal muscles, pacemaker, cardiac issues

81
Q

Iontophoresis: what is salicylate used for and what is the charge?

A

negative, pain relief

82
Q

Iontophoresis: what is acetate used for and what is the charge?

A

negative, calcium deposits

83
Q

Iontophoresis: what is dexamethasone used for and what is the charge?

A

negative, anti-inflammation

84
Q

Iontophoresis: what is iodine used for and what is the charge?

A

negative, softens scars

85
Q

Iontophoresis: what is hydrocortisone used for and what is the charge?

A

positive, anti-inflammation

86
Q

Iontophoresis: what is lidocaine used for and what is the charge?

A

positive, pain relief

87
Q

Iontophoresis: what is calcium/magnesium used for and what is the charge?

A

positive, muscle spasm

88
Q

Iontophoresis: what is lithium used for and what is the charge?

A

positive, gout

89
Q

Iontophoresis: what is zinc used for and what is the charge?

A

positive, dermal ulcers

90
Q

Iontophoresis: what is copper used for and what is the charge?

A

positive, fungal infections

91
Q

Conventional TENS: frequency, pulse width, intensity, purpose, and duration?

A

high frequency: 75-120
very short pulse width (50-100 microseconds)
low intensity
Provides temporary relief of pain treatment can last 20-60min

92
Q

Acupuncture-like TENS: frequency, pulse width, intensity and purpose?

A

Low frequency: 1-4pps
wide pulse width (150-300 microseconds)
high intensity
Used for more chronic conditions with long lasting pain relief, treatment can take between 30-40 min

93
Q

Brief intense TENS: frequency, pulse width, intensity and purpose?

A
High pulse rate: 150pps
Long pulse width (300 microseconds)
short term pain relief
Pain relief with wound debridement, deep friction massage, passive stretching
Total time 15 min
94
Q

High voltage pulsed monophasic stimulation: frequency, pulse width, intensity and purpose?

A

strong used for denervated muscles
pulse rate: 50-200pps
pulse duration: 20-100 msec
continuous waveform

95
Q

Muscle contraction: frequency, pulse width, intensity and purpose?

A

Pulse rate 35-80pps
Pulse duration: 150-200 msec for small 200-350 msec for large
On/ off time: 10-20 reps in about 10-20 min

96
Q

Muscle strength: frequency, pulse width, intensity and purpose?

A

Pulse rate 35-50pps
Pulse duration: 150-200 msec for small 200-350 msec for large
On/ off time: 1 to 5 so 6-10 seconds or 50-120 seconds

97
Q

Muscle spasm/ edema: frequency, pulse width, intensity and purpose?

A

Pulse rate 35-50pps
Pulse duration: 150-200 msec for small 200-350 msec for large
On/ off time: 1 to 1 ratio