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Lower quarter > OCS > Flashcards

OCS Flashcards

1
Q

What is Boehlers angle? Normal?

A

Used for diagnosis of calcaneal fracture
30 is normal
< 20 indicates fracture

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2
Q

What is burkhart scapular or sick scapula classification?

A

I = inferior
II = Medial
III = Superior
IV = Lateral
(most to least common)

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3
Q

What is a hangman’s fracture

A

Spondylolisthesis of C2 and C3

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4
Q

What do beta blockers do?

A

Decrease HR
Decrease force of contraction
Will need to use borg exertion scale

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5
Q

MCL gapping
normal to very abnormal

A

Normal 1-2
Nearly normal 3-5
Abnormal 5-10
Very abnormal > 10

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6
Q

What’s grading on depression scale

A

0-2 none
3-5 mild
6-8 moderate
8-10 severe

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7
Q

What exercise should follow
Lumbar traction or cervical traction

A

Lumbar = prone press up
Cervical = DCF training

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8
Q

What is the brudzinski sign

A

Bilateral hips and knees will flex in response to cervical flexion
Common with meningitis

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9
Q

What is group I and Group II of TMJ?

A

Group I = muscle
Group II = Joint or disc

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10
Q

What motions does the clavicle do with OH reach?

A

Clavicle slides inferior and rolls posterior

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11
Q

What nerve is involved in scapular winging?
Flexion
Abduction

A

Flexion = long thoracic
Abduction = accessory nerve

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12
Q

What self mob to calcaneous is best to teach patients with plantar fascia?

A

Lateral self mob into eversion

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13
Q

What ligament is taut in
Supination
Pronation

A

Supination = palmar radioulnar
Pronation = dorsal radioulnar

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14
Q

What are end stage findings in OA

A

Osteophytes
Subchondral cysts
Sclerosis

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15
Q

What is the pain pattern of gait with posterolateral corner injury?

A

Sharp pain at terminal stance and with push off

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16
Q

What nerve innervates:
Obturator

A

Obterator

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17
Q

What nerve innervates:
Gracilis

A

Obterator

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18
Q

What nerve innervates:
Pectineus

A

Femoral

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19
Q

What nerve innervates:
Transverse Abs

A

Iliohypogastric

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20
Q

What nerve innervates:
quads/sartorius

A

Femoral

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21
Q

What nerve innervates:
Iliacus

A

Femoral

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22
Q

Clarks sign?

A

Patella PFPS

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23
Q

Sail sign

A

fat pad radical displacement

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24
Q

Galaezzi

A

Leg length discrepancy in babies with displasia

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25
Q

Jobes relocation

A

Anterior instability of the GHJ due to applying a posterior force on the shoulder with apprehensive test

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26
Q

Yocum test

A

SAPS test
Horizontal ADD and the examiner raises the elbow
(+) if pain present

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27
Q

Crank test

A

Labrum of the GHJ

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28
Q

What is stimson reduction for shoulder dislocation

A

Prone
Arm hangs off of the table

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29
Q

What portion of the patella has the most OA

A

Lateral

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30
Q

Whats a normal DCF result?
What about with neck pain?

A

38.95s normal
24.1s with pain

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31
Q

Painful arc range for:
A = SAI
B = ACdysfunction

A

SAI = 60/70 - 110/120
AC = 12-160

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32
Q

What position is best for strengthening the supraspinatus

A

full can
limits the action of the deltoid

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33
Q

What is cheralgia?

A

Paresthesia and burning on dorsal hand and wrist - finger tips are spared
Radial nerve
Wartenbergs syndrome

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34
Q

what is the most common elbow fx in pediatrics?

A

95% are extension
Supracondylar humeral fracture

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35
Q

What 2 ms can dynamically anterior translate the humeral head?

A

teres minor
Infraspinatus

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36
Q

How would you stretch the L levator scapula

A

Elevate the Left arm Sb the C/S to Right

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37
Q

Test cluster for ankylosing spondylitis

A

Night pain
AM stiffness for > 30 mins
Alternating buttock pain
improve with exercise
ESR,CRP are common in blood

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38
Q

2 anatomical features that may lead to myelopathy

A

Congenital narrow spinal canal
Large vertebrae body

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39
Q

nerve glide progression for CTS 1-6

A

Grasp
Extend fingers
Extend wrist
thumb extension
supinate
grab and stretch the thumb

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40
Q

Special test for posteromedial corner injury of the knee

A

Hughstons drawer sign
Anterior drawer position with ER to target medial

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41
Q

Valgus + Varus relationship to knee OA

A

Genu valgus - lateral OA
Genu varus - medial OA

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42
Q

What type of shoe wedge would offload medial knee OA

A

Lateral wedge - would put in valgus - would stress lateral and gap medial

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43
Q

What is MCID for NDI
Radiculopathy:
Mechanical:

A

7.5 radiculopathy
9.5 mechanical

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44
Q

What position should an orthotic for heel pain put patient into?

A

Plantar flexion and inversion

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45
Q

Temportal arteritis vs optic neuritis

A

Temporal = sudden, significant eye pain with palpation
Optic = pain with eye movement

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46
Q

CPR for MT for ankle sprain

A

Navicular drop > 5mm
Symptoms worse in standing
symptoms worse in PM
Distal tib/fib hypomobile

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47
Q

What should ionto tx consist of when there are calcium deposits

A

Acetic acid

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48
Q

What is the acute conservative tx of syndesmotic ankle sprain

A

2 weeks
PRICE
NWB, crutches
Post splint slight PF

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49
Q

What motions are most limited with distal radial Fx

A

supination and pronation
Their movement is dependent on radius aligment

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50
Q

With radial head fractures what 2 motions should be limited in the beginning?

A

flexion
pronation

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51
Q

What resists varus and ER in posterolateral corner injury

A

Varus - LCL
Popliteus and popliteal ligament resist the ER

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52
Q

What fractures are likely with
High arch?
Flat foot?

A

high arch - tibia femur
Low arch - metatarsal

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53
Q

What fractures are common with leg length discrepancy?

A

Longer limb = tibia, METS, femur
Shorter = fibula

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54
Q

What make up the orders of the carpal tunnel?

A

Pisiform/hamate to scaphoid/trapezium
Carpals are floor
Flexor retinaculum roof

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55
Q

What is a:
Night stick fx
Monteggia fx

A

Night stick is mid ulna
Monteggia is proximal ulna fx with dislocation of radial head and needs Sx

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56
Q

Most common decompression Sx for lumbar spine?
Stenosis?

A

Decompression = discetomy
Stenosis = laminoplasty

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57
Q

Cervical traction guidelines

A

15-24 degrees of flexion
60s on | 20s off
50% pull
10-12 lbs, 40lbs max
15 mins, 6 sessions, 3 wks

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58
Q

Cluster for those likely to respond to cervical traction

A

> 55 y/o
+ ULTT
+ Shld AB
+ distraction
Peripheralize with PA

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59
Q

Qualifications to being an ACL coper

A

<2 episode of giving out
80% hop test
80% KOOS ADL
GRPS > 60%
>70% quad strength

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60
Q

Joint mechanics of lateral deviation at TMJ

A

Ipsilateral rotation
Contralateral translation
Ex = Right lateral deviation
Right rotation
Left translation into right

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61
Q

What happens to the disc as it becomes late stage displacement

A

The disc is more anterior in the late stage

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62
Q

What nerve entrapment may present like lateral epi?

A

Radial tunnel syndrome

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63
Q

What structure takes on more stress if the MCL is injured?

A

ACL

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64
Q

What artery supplies the posterolateral corner?

A

Popliteal artery

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65
Q

Biceps special test
A = most SN
B = most SP

A

SN = Bear hug/upper cut
SP = speeds

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66
Q

Differences btw men and females knee with OA

A

Females
- more OA pain
- disability
- more advanced imaging
- more PF OA
Men
- higher volume of cartilage

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67
Q

More knee OA facts

A

Night pain will increase as OA advances
QF strength has greatest effet on outcomes
Adductors; iliopsoas, and TFL should all be stretched

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68
Q

At what degree do the carpals start moving together?

A

45 extension

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69
Q

What muscle and posture are associated with TMJ hypermobility?

A

Lateral pterygoid
forward head posture

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70
Q

What 3 nerves may be injured with anterior dislocation of the shoulder?

A

Axillary
Long thoracic
suprascapular

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71
Q

LEFS MCID

A

Increase by 9 points

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72
Q

ODI MCID

A

Decrease by 12%

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73
Q

QuickDASH MCID

A

Decrease by 18 points

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74
Q

DHI MCID

A

Decrease by 18 points

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75
Q

NDI MCID

A

Decrease by 7.5 points

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76
Q

KOOS MDC pain

A

6.1

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77
Q

KOOS MDC symptoms

A

8.5

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78
Q

KOOS MDC ADL

A

8

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79
Q

KOOS MDC QoL

A

7.2

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80
Q

Acute LBP w/o LE pain would benefit from?

A

Manipulation or exercise

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81
Q

vascular claudification relief?

A

Seen with standing alone due to calf pain

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82
Q

Neurogenic claudification relief?

A

Seen with sitting and have a shopping cart sign and pain above the knees.

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83
Q

Flank pain and reasoning for it

A

Nonmuscloskeletal and pain that doesn’t worsen w/ mvmt

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84
Q

1 predictor of cancer?

A

PMH of cancer

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85
Q

Sciatic pain risk factors

A

HTN
Smoking
Overweight
Cardiovascular issues

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86
Q

Lumbar traction is beneficial in those with?

A

(+) crossed leg syndrome
Nerve root compression
Peripheralization of symptoms

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87
Q

Acute LBP w/ mobility deficits have?

A

Restricted spinal ROM
symptom reproduction w/ provocation at involved segments

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88
Q

Acute LBP w/ mvmt coordination impairments and aLBP w/ radiating pain have?

A

Symptom reproduction at initial/midrange AROM or PROM
Focus on mvmts that limit pain or increase pain-free mvmt in mid-rage

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89
Q

Subacute LBP w/ mobility, mvmt coordination impairments, radiating pain will benefit from?

A

Mvmts to target mid to end range w/in pain

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90
Q

Chronic LBP w/ mvmt coordination impairments, radiating pain will benefit from?

A

An increase to tolerance to end range sustainability

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91
Q

ALBP w/ related (referred) LE pain will benefit from?

A

Centralizing symptoms while overcoming high irritability with interventions

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92
Q

A or sub LBP w/ cognitive and affective tendencies and chronic LBP w/ generalized pain are?

A

Not a common pain path of mvmt
Therefore rely on education and counseling rather than normalizing the mvmt

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93
Q

Chronic LBP w/ mvmt coordination have?

A

LE pain
Presence of 1 or more symptoms

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94
Q

Chronic LBP w/ mvmt coordination symptoms

A

Pain worsens with sustained postures
L/S hyper-mobility
T/S and pelvic deficits of mobility
Decreased pelvic and trunk ms endurance
Mvmt impairments while performing work tasks

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95
Q

Flat back syndrome or lumbago due to disc displacement symptoms

A

worsens with flexion
pain in buttock, thigh or leg
pain centralized w/ repeated mvmts
lateral trunk shift, reduced lumbar lordosis and limited extension

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96
Q

LBP or strain w/ cognitive or affective tendencies symptoms

A

2+ responses to primary care evaluation of mental disorders for depressive symptoms
High score on FABQ
High score on pain

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97
Q

When to order imaging for LBP?

A

If lasting 1 month or less and no red flags then imaging is not required.

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98
Q

Aberrant mvmts

A

Painful arc w/ flexion or return from flexion
Instability catch
Grower’s sign
Reversal of lumbopelvic rhythm

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99
Q

What is reversal of lumbopelvic rhythm?

A

Return from flexion they bend knees and use hip extension for anterior pelvic tilt to full stand

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100
Q

When to SLR test?

A

Best results on those w/ pain inferior to gluteal fold
good to identify pain below 45 degrees

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101
Q

Trunk flexors strength test and endurance test

A

Bilateral SLR
If low back does not maintain contact on the table while lowering the legs then pt has a higher risk of LBP and chronic LBP

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102
Q

Trunk extensors test

A

Prone with hands to the side and pt extends low back to elevate the chest off of table by 30 degrees
Timed test and cut off is 31 sec for males and 33 for females

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103
Q

TrA test

A

Prone over a cuff inflated to 70mmHg
Draw in the stomach w/o pelvic motion and breathe normally for 10 seconds
Max decrease in pressure recorded
4mmHg change is normal while a 2mmHg is indicative fo LBP

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104
Q

Hip extensor testing

A

Bridge position and maintain it for 76.7 sec w/ LBP and 127.9 w/o LBP

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105
Q

Hip OA CPG

A

Lateral or anterior hip pain w/ weight bearing
24 degrees of hip IR and 15 degrees of hip flexion difference compared to opposite side
< 1 hour morning stiffness
> 50 years of age

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106
Q

30s sit to stand MDC and ICC

A

3.5
.88 (intrarater reliability)

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107
Q

4 square step test MDC

A

1.8-2.0s

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108
Q

Step test 6” tap test 15s MDC

A

3s

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109
Q

Timed single leg stance MDC

A

8.08 and in 2 attempts

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110
Q

Non-arthritic hip CPG

A

HOS
Copenhagen hip and groin outcome score
International hip outcome tool

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111
Q

HOS (hip outcome score)

A

9 points higher is MCID

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112
Q

Copenhagen hip and groin outcome score (HAGOS)

A

higher is better
5.2 MCID

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113
Q

International hip outcome tool (iHOT - 33)

A

Higher is better
6 point MCID

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114
Q

Trendelenburg sign

A

Performs SLS w/ leg flexed 30 degrees and held for 30s
Then the pt raises flexed hip pelvis
Positive if unable to hold for 30s
Positive if no elevation on the non-stance leg
Positive if stance leg ADDs to drop below non-stance leg

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115
Q

Lumbar plexus pneumonic

A

I Irregularly Get Lunch On Fridays

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116
Q

I Irregularly Get Lunch On Fridays

A

Iliohypogastric
Ilioinguinal
Gentiofemoral
Lateral Femoral cutaneous
Obturator
Femoral

117
Q

Iliohypogastic info

A

T12-L1
Sensory) lateral gluteal
M) Internal Oblique & transverse abs

118
Q

Ilioingunial info

A

L1
S) Anterior & medial thigh scrotum and labia
M) Internal Oblique TrA

119
Q

Gentiofemoral L1-2 info

A

S) scrotum and Labia
M) cremaster

120
Q

Lateral Femoral cutaneous Info

A

L2-3
S) lateral thigh

121
Q

Obturator info

A

L2-4
M) Adductors

122
Q

Obturator info

A

L2-4
M) Adductors

123
Q

Femoral info

A

S) anterior thigh w/ branch into saphenous nerve for patella sensation
M) quad, sartorius, articularis genu

124
Q

Lumbar stenosis therapy approach

A

Manual,
exercises,
Body weight supported TM

125
Q

Medial aspect of the LE/LQ has

A

Saphenous vein and nerve

126
Q

Saphenous nerve dynamic test

A

Place the hip in flexion, knee extension, dorsiflexion, and eversion

127
Q

When will you see a acetabalar labral cyst?

A

W/ positive FADIR,
Limited hip flexion/IR and extension
Pain with sitting

128
Q

What view will see a scotty dog?

A

Oblique view

129
Q

What is Isthmic II A?

A

Pars interarticularis Fx that is caused by fatigue failure

130
Q

What is Isthmic II B?

A

Pars interarticularis Fx due to it being elongated

131
Q

Dysplastic?

A

Spondylolisthesis due to contgenital defect

132
Q

What grade will spondylolisthesis surgery respond to?

A

Grade 3-4
Grade 3 = 51-75%

133
Q

How long can Whiplash last?

A

2 years but not beyond that

134
Q

Describe Lhermitte’s sign

A

Electrical sensation that radiates into the back and extremities w/ cervical flexion
Suggestive of spinal cord pathology

135
Q

What is the best view to see cauda equina?

A

MRI

136
Q

Morel - Lavallee lesion

A

Post traumatic hemolymphatic collection of fluid,
Separation of subcutaneous tissue from the deep fascia due to blunt force trauma.

137
Q

What is transverse myelitis?

A

Demyelinating pathology not acute

138
Q

When is an epidural abscess seen with?

A

Infection

139
Q

Schmorl’s node

A

Protrusion of the nucleus pulposus through a vertebral body and end plate.

140
Q

Disc herniation

A

Nucleus pulposus extrudes through the annulus fibrosus and when annulus fibrosus fragment into the epidural space.

141
Q

Spondylolisis

A

Fx of the pars interarticularis resulting in scotty dog sign w/ the Fx being the neck of the dog

142
Q

Stabilization criteria

A

< 40 years
SLR > 91 degrees
Aberrant motion present
Positive prone instability test

143
Q

CPR for Cervicothoracic manipulation and shoulder pain

A

Pain free shoulder flexion < 120
Shoulder IR < 53 @ 90 ABD
(-) Neer’s
No medication
Symptoms < 90 days

144
Q

Specificity for CPR of Cervical radiculopathy 2/3/4

A

2 = .56
3 = .94
4 = .99

145
Q

CPR for lumbar manipulation

A

FABQ < 19
Symptoms < 16 days
No symptoms past the knee
1 hypomobile lumbar spine segment
1 hip with > 35 degrees of IR

146
Q

CPR for Full thickness rotator cuff tear

A

Drop arm sign
Painful arc sign
Infraspinatus muscle test

147
Q

CPR for carpal tunnel

A

Shaking hands to relieve symptoms
Wrist ratio > .67
Symptom severity scale > 1.9
Diminished sensation in median sensory field 1 thumb
> 45 years old

148
Q

When to seek MD assist with Peds cases

A

Radicular symptoms involving anterior or anterior medial thigh

149
Q

Exa of when to seek MD attention

A

Chronic smoker w/ LBP and with non mechanical factors such as inability to achieve a comfy position

150
Q

Cauda equina syndrome

A

Progressive neurological deficits
Bilateral LE radiculopathy
Urinary retention
Hypo-reflexive
Ms stretch reflexes
Decreased sphincter tone
Surgery needed within 72 hours is max.

151
Q

Most common level for disc herniation

A

L4-5
L5-S1

152
Q

Anterior branch of obturator Nerve

A

Innervates adductor longus and gracillis
Sensation to medial thigh

153
Q

Posterior branch of Obturator Nerve

A

Innervates obturator externus Adductor magnus

154
Q

Ankylosing Spondylitis

A

Morning stiffness
Better with movement
Gross limitation of side bending

155
Q

Septic arthritis

A

No symptom relief after a week and elevated WBC > 1200mm and ESR > 39mm/hr

156
Q

Gilmore groin pain

A

Type of athletic pubalgia and seen with ingional ligament
Known as slap shot gut or sports hernia

157
Q

Patella pubic test

A

Ruling out a femoral neck Fx
Seen in females, amenorrhea and insidious onset

158
Q

Extension base injury of the cervical spine in youth

A

Causes spondylolysis of the pars interarticularis and then can progress to spondylolisthesis

159
Q

SCFE patients have?

A

Increased ER due to slippage
Decreased IR

160
Q

What innervates the facet joints?

A

Medial branch of dorsal rami

161
Q

Centralization occurance from least to most

A

Lumbar flexion
Extension
Side glides

162
Q

What is used to diagnose spinal stenosis?

A

Myelography

163
Q

What is considered absolute spinal stenosis?

A

AP diameter of <10mm

164
Q

Criteria for 86% of failing core stability exercises

A

Negative prone instability test
absence of abberrant movement
9 or greater score on FABQ

165
Q

What to think of when no change with repeated motion testing?

A

SI dysfunction
Other diagnosis

166
Q

LBP and work return

A

6 months of LBP = 40% of return to work
1 year of LBP = 20% of return to work
2 years of LBP = 0% of return to work

167
Q

Lumbar stenosis CPG

A

Bilateral symptoms
Pain w/ walking and standing
Relief w/ sitting
Leg pain greater than back pain
> 48 years old

168
Q

Hip capsular pattern

A

IR - ABD - flexion

169
Q

“Sign of the buttock”

A

Buttock large and swollen and TTP
SLR limited and painful
Limited trunk flexion
Hip flexion with knee flexion is painful
Empty end feel on hip flexion
Non-capsular patter of the hip
Weak and painful hip MMTs

170
Q

Present “Sign of the buttock” what could be seen?

A

Osteomyelitis, Neoplasm and sacral Fx
Never L4-5 disc extrusion

171
Q

Best test for radiographic instability at the lumbar spine

A

Passive lumbar extension test

172
Q

Passive lumbar extension test

A

Prone patient where the examiner raises the legs passively and then the patient should feel increased pain/back is about to come off/ or increased pressure in the back.

173
Q

Trunk flexion stabilizer endurance ratio to trunk extension

A

1 for young men
.79 for young women

174
Q

What to do next if symptoms are increased with flexion or extension

A

Sideglides

175
Q

Is urinary retention or incontinence a symptom of cauda equina?

A

Urinary retention is a symptoms Incontinence is NOT

176
Q

Cauda equina is commonly seen w/?

A

Sacral plexus injury

177
Q

What causes slackening of the posterior SI ligament?

A

Tight latissmus Dorsi and glute max

178
Q

Nutation

A

Sacrum rotates anteriorly and ilium rotates posteriorly

179
Q

Counternutation

A

Sacrum rotates posteriorly while Ilium rotates anteriorly

180
Q

Collagen fibers and their types

A

Type I = Common exa is scar tissue
Type II = Resists compressive forces exa. nuclear matrix/pulposus
Type III = Not common but seen w/ type I in muscles and other visceral structures
Type IV = bones cells membranes and skin

181
Q

Primary stabilizers of the spine are?

A

TrA and Multifidus

182
Q

FABQ score shows?

A

That a higher score is indicative of fear

183
Q

FABQ > 34

A

Increased risk of prolonged work restictions by 20-58%

184
Q

Proximal hamstring tendinopathy presents as

A

Deep localized pain at IT and pain with hip flexion and ADD activities

185
Q

SIJ Distraction

A

Sn = .6
Sp = .81

186
Q

SIJ Compression

A

Sn = .69
Sp = .69

187
Q

SIJ Thigh Thrust

A

Sn = .88
Sp = .69

188
Q

SIJ Gaenslen’s

A

Sn = .50
Sp = .77

189
Q

SIJ sacral Thrust

A

Sn = .63
Sp = .75

190
Q

3/5 SIJ tests completed

A

Sn = .91
Sp = .78

191
Q

2/4 SIJ tests completed

A

Sn = .88
Sp = .78

192
Q

What are observational studies

A

Cohort and case control

193
Q

Case control studies

A

Retrospective and subjects already of interest looking for risk factors

194
Q

Levels of evidence for Interventional studies Level 1

A

High quality RCT with or without statistically significant difference with narrow confidence intervals

195
Q

Levels of evidence for Interventional studies Level 2

A

Less quality RCT with < 80% follow up, no blinding or improper randomization

196
Q

Levels of evidence for Interventional studies Level 3

A

Case control studies, retrospective comparative study, a systematic review of level 3 studies

197
Q

Signs of upper cervical ligamentous instability

A

Headaches, feeling of heaviness, age, clumsy gait

198
Q

When to use anti-pronation taping?

A

Acute phase of plantar heel pain for 3 weeks

199
Q

When to use night splints for plantar heel pain?

A

Best used for those that have pain for greater than 6 months

200
Q

Define ratio

A

Highest level of measurement in which there are equal intervals between score units and true zero point (Height and weight)
Cannot be negative

201
Q

Define interval

A

Level of measurement in which values have equal intervals but no true zero point (Temperature)
Can be negative

202
Q

Define Ordinal

A

Level of measurement where scores are ranked (functional scales, educational degree, work status)

203
Q

Define nominal

A

Level of measurement for classification variables.
Variables are mutually exclusive with no inherent rank order (yes/no, resident/non-resident, smoker/nonsmoker)

204
Q

Define parametric tests

A

Used for ratio and interval data

205
Q

Define non-parametric tests

A

Used for ordinal or nominal data

206
Q

What is a Mann Whitney U Test

A

Test whether 2 groups are likely to derive from the same population
Ordinal data (Full duty, light duty, not working)

207
Q

Define the Wilcoxin test

A

Nonparametric test that compares 2 groups to see if they are statistically different from each other.
Ordinal

208
Q

Define Kruskal Wallis test

A

Compares 3 or more groups to assess if 3 variables are the same or provide a different structure

209
Q

Define an Independent variable

A

Variable that is presumed to cause, explain or influence a dependent variable; controlled or manipulated by researcher

210
Q

Define Dependent variable

A

A response variable that is assumed to depend on or be caused by another variable

211
Q

Define independent t-test

A

Is there a difference between males and females for shoulder AROM using Goniometer?
2 groups and continuous data

212
Q

Define dependent/Paired t-test

A

Is there a difference in lumbar AROM pre and post lumbar manipulation for 200 subjects
2 tests and continuous data

213
Q

Define Chi Squared test

A

Categorical data (yes/no) Association
Typically displayed in a 2 by 2 table
Is there an association between being diabetic (yes/no) and having a neuropathy (yes/no)

214
Q

What is a type 1 error?

A

States that there is a difference and to reject the null hypothesis when there is no difference

215
Q

What is a type 2 error?

A

States that there is no difference and to accept the null hypothesis when there is actually a difference.

216
Q

What does it mean if a special test has Sn = 92% and Sp = 24%

A

Low risk of false negative and high risk for false positive

217
Q

What is type of special test is best for screening?

A

A high sensitive test

218
Q

High sensitivity means

A

Few false negatives

219
Q

High specificity means

A

Few false positives

220
Q

Low sensitivity means

A

High false negatives

221
Q

Low specificity means

A

High false positives

222
Q

What is the cognitive stage?

A

Not intuitive
requires instruction and guidance
Inconsistent
Movements are slow and inefficient

223
Q

What is the associative stage?

A

Individual is moving towards independence
Movements are more fluid
Can make adjustments based on environmental factors

224
Q

Best interventions for gluteal tendinopathy

A

Isometrics on Hip ABDs and avoiding ITB standing stretch

225
Q

Cervicogenic HAs reproduction

A

Cervical rotation and do not involve an aura or vision changes

226
Q

Migraine symptoms

A

Pulsating/pounding HA, unilateral in nature, 4-72 hours of a headache
Nausea w/ HA
4/5 of these = +LR of 24

227
Q

C1 - 2 cavitation will produce?

A

Multiple audible pop bilaterally 3-4 pops

228
Q

Sharp Purser test

A

Transverse ligament test
Validated in those with RA and Down syndrome
Dangerous to use after a traumatic mechanism

229
Q

Cervical flexion rotation test

A

High Sp and Sn for cervical joint dysfunction in neck pain and cervicogenic HA

230
Q

Who has increased risk for upper cervical instability?

A

RA, DS history of cervical spine trauma

231
Q

Internal Carotid artery dissection is common with?

A

Hypoglossal cranial nerve dissected

232
Q

How to test for alar ligament instability

A

Neck tongue syndrome
Rotate head and if there is numbness along half of their tongue then it is positive

233
Q

What is horner’s syndrome?

A

Disrupted nerve pathway on one side from the brain to the face and eye
Common with carotid artery dissection

234
Q

When should you use premanipulative holds?

A

For assessing pt’s comfort levels

235
Q

When not to use Sharp purser test

A

When pt has paresthesia in hands with cervical flexion

236
Q

Purpose of transverse ligament

A

Preventing the dens of the atlas from pressing on the spinal cord with cervical flexion

237
Q

Where are the joints of luschka?

A

C3-7

238
Q

Characteristic of cervical intervertebral disc

A

Thick anteriorly and thin posteriorly

239
Q

Vertebral artery gets compressed when?

A

PROM cervical rotation to the right the artery is compressed b/w 1st and 2nd cervical vertebra on the left

240
Q

Absolute contraindications of manual

A

Osteomyelitis
Nerve root compression w/ increased neuro deficits
Influenza and fever

241
Q

Relative contraindications to manual are?

A

Pregnancy

242
Q

Radiculopathy past the elbow will benefit from?

A

Centralization than manipulation

243
Q

Cervical manipulation CPR

A

Symptoms < 38 days
Side to side difference of > 10 degrees rotation
Positive outlook on manipulation
Pain with PA on mid cervical

244
Q

Lowest risk of cervical manipulation is at?

A

Mid to lower cervical

245
Q

What is involved with a cervical artery dissection?

A

Vertebrobasilar artery resulting in posterior arterial system perfusing the hindbrain
Internal carotid artery which is the anterior arterial system perfusing the cerebral hemispheres and eyes

246
Q

Cervical artery dissection reproduces symptoms with

A

Cervical rotation and trunk rotation while the head is stable causing dizziness

247
Q

Vestibular is positive with what rotation

A

cervical rotation but not with trunk rotation

248
Q

Hindbrain ischemia will affect?

A

CN I & II

249
Q

Internal carotid artery dysfunction will involve?

A

CN XII Hypoglossal
CN IX Glossopharyngeal
CN X Vagus
CN XI Spinal accessory

250
Q

Common S/S of Horner’s syndrome

A

Drooping eyelid
Sunken eye
Small constricted pupil
Facial dryness

251
Q

Pancost tumor is?

A

Lung cancer at the superior aspect of the lung and compresses C8-T1 nerve root
Seen in 50 y/o
Smoking history
Shld pain

252
Q

What is the best intervention for nerve root irritation?

A

Intermittent mechanical traction

253
Q

Heart referral

A

Over the left anterior chest wall and the left arm into the finger
Posterior along the CT junction

254
Q

Pulmonary referral

A

Located anteriorly and posteriorly over the throat and cervical spine and into the left upper trap and lateral aspect of the left shoulder

255
Q

Kidney referral

A

Around the circumference of the waist, greater Trochanter, groin and proximal medial thigh bilaterally.
Posteriorly lateral thigh and to the buttock towards the lateral leg but not the medial butt or posterior thigh

256
Q

Bladder referral

A

Posteriorly gluteal cleft
Posteriorly medial thigh
Anteriorly midline to the umbilicus and distal to the AIIS

257
Q

Ovaries referral

A

Lateral to the umbilicus

258
Q

Liver and gallbladder referral

A

Right side of the neck and the lateral right shoulder
Posterior pain to the right scapula
Inferior angle of the right scapula and posteriorly right lateral truck on T9-12

259
Q

Gallbladder referral

A

Right upper quadrant
Typically after eating

260
Q

Stomach referral

A

Anterior along the midline and distally to the sternum medially from the right upper quadrant.
Superior to the umbilicus
Posterior midline of the t/s spine

261
Q

Colon referral

A

Anterior pain midline and inferior to the umbilicus

262
Q

Pancreas referral

A

Anterior pain left of the midline and posterior to the left side of the lumbar paraspinals above the belt line

263
Q

Sciatic nerve entrapment

A

Piriformis - Ischial femoral impingement syndrome
Proximal hamstring muscle = Ischial tunnel syndrome

264
Q

Sciatic and gluteal pain causes

A

Trauma to the glute and only able to sit for 30 mins

265
Q

Ischial femoral impingement syndrome symptoms

A

Pain with gait from mid stance to terminal stance

266
Q

Ischial tunnel syndrome

A

Pain radiating down the posterior thigh and the popliteal fossa with aggravating during running for knee flexion and hip flexion with heel strike

267
Q

Ischial tunnel syndrome causes

A

Thickening of the hamstring or partial avulsion of the hamstring tendon

268
Q

Modified Thomas test indicates decreased muscle length

A

Inability to extend the thigh below horizontal (Iliopsoas)
Knee flexion angle is less than 90 (Rectus Femoris)
Hip moves into an ABD position (TFL/ITB)

269
Q

Ober test indicator of decreased muscle length

A

Hip remains in ABD position and does not fall below horizontal

270
Q

Straight leg raise indicator of decreased muscle length

A

Inability to flex the hip beyond 70
Pain or neurologic symptoms from 30-70 of hip flexion is indicative of radiculopathy

271
Q

Popliteal angle measurement

A

Knee flexion angle is greater than 20

272
Q

Passive hip ABD 0 degrees muscle length test

A

Inability to ABD hip to at lease 40 (tight hip ADD)

273
Q

Passive hip ABD at 90 hip flexion muscle length test

A

Inability to ABD hip to at least 40 (tight hip ADD)

274
Q

MMT of Iliopsoas

A

Seated with hip flexion at end range and patient holds onto the edge of the table to stabilize trunk

275
Q

Psoas major MMT

A

Supine with hip in 30 degrees of flexion and slight ABD/ER

276
Q

Lachman SN and SP

A

85% Sn
94% Sp

277
Q

Anterior drawer test Sn & Sp

A

49% Sn
58% Sp

278
Q

Pivot shift test Sn & Sp

A

24% Sn
98% Sp

279
Q

Pivot Shift test under anesthesia Sn & Sp

A

81.8% Sn
98.4% Sp

280
Q

Pivot shift test technique

A
281
Q

Carotid artery (artherosclerosis, stenosis, thrombosis, aneurysm, dissection) Symptoms?

A

Neck pain
Facial pain
HA
Cranial nerve signs,
TIA,
CVA

282
Q

Carotid artery hypoplasia symptoms?

A

Frequently asymptomatic

283
Q

Vertebral artery dissection symptoms?

A

Neck pain,
possible headache,
TIA,
CVA
Ataxia

284
Q

Adhesive capsulitis primary S/S

A

Anterior lateral shoulder pain
Inability to sleep
Gradual loss of ROM due to pain
Female 40-65 years old
Diabetes or hypothyroidism

285
Q

Primary OA of GHJ s/s

A

60 or older
Loss of motion and pain
crepitus with End range
Stiffness worse in the morning

286
Q

SAPS s/s

A

Anterior/lateral should pain
pain at mid should range
pain worse at night

287
Q

RTC tear s/s

A

Loss of strength
Pain that wakes pt up in the night
Worse at night
> 40 years old

288
Q

AC joint arthropathy/ injury s/s

A

Pain on the top of the shoulder
Increased pain with end range shoulder elevation and add
History of weight lifting
Visible deformity at the top of the shoulder

289
Q
A

Lower quarter (4 decks)

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