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Old Ortho > Ortho Exam One > Flashcards

Ortho Exam One Flashcards

1
Q

When and how do we rule out the lumbar?

A

We rule out the hip when the client is presenting with pain in the pelvis/hip or leg and there has NOT been a history of injury to the hip

We rule out the lumbar with postural, joint play, close pack the joint, and myotome testing

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2
Q

What are the functions of the pelvis?

A
  • the SI joints along with the symphysis pubis help to transfer weight from the spine to the lower limbs
  • provide elasticity to the pelvic ring
  • acts to decrease force of impacts to the spine and upper body caused by contact of the lower limbs with the ground
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3
Q

Define contranutation.

A
  • the promontary moves superiorly and posteriorly

- the apex of the sacrum and the tip of the coccyx move inferiorly and anteriorly

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4
Q

Define nutation.

A
  • the promontary moves inferiorly and anteriorly, while the apex of the sacrum and the tip of the coccyx move posterior
  • the iliac bones approximate whereas the ischial tuberosities move apart
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5
Q

Define upslip.

A

-the sacrum and ilium move independantly, when the SI joint locks, the sacrum moves up on the ilium and they move dependantly

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6
Q

Why is it important to test for uplip?

A
  • pain may be on opposite side due to hypermobility
  • causes shift of pubic bones
  • iliums rotate
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7
Q

Why do we find anomalies so often at the hip?

A
  • the pelvis is a stabilizing unit, the center of our balance/weight transfer occurs here as well as imbalance
  • there are multiple muscles that act on the pelvis that can cause disarticulation or influence the position of the pelvis
  • our lifestyles require alot of sitting which can alter the position of the pelvis as muscles become short or weak
  • root chakra is located here, which speaks to who we are, as we struggle without identity it can show up as physiological dysfunction
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8
Q

What are the SI joint ligaments?

A
  • long posterior SI ligament
  • short posterior SI ligament
  • posterior interosseous ligament
  • anterior SI ligament
  • sacrospinous ligament
  • iliolumbar ligament
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9
Q

What is the function of the long posterior SI ligament?

A

limits contranutation

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10
Q

How do you perform sacral mobilization?

A

-compressing the sacrum anteriorly, medially, laterally, and compressing and rotating the sacrum right and left

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11
Q

What types of pain do you experience with sacral mobilization?

A
  • dull aching pain, if this is present hold the position of the sacrum until the pain subsides
  • if sharp, get out and ice the area
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12
Q

How do you test L1/L2 myotome?

A

resisted hip flexion

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13
Q

How do you test L3 myotome?

A

resisted knee extension

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14
Q

How do you test L4 myotome?

A

resisted ankle dorsiflexion

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15
Q

How do you test L5 myotome?

A

resisted great toe extension

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16
Q

How do you test S1 myotome?

A

resisted hip extension

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17
Q

How do you test S2 myotome?

A

resisted knee flexion

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18
Q

What is the dermatome referral for L1?

A

runs obliquely on upper anterior portion of the thigh, immediately below inguinal ligament

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19
Q

What is the dermatome referral for L2?

A

anterior aspect of mid thigh running obliquely, between L1 and L3

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20
Q

What is the dermatome referral for L3?

A

runs oblique on anterior thigh, immediately above the patella

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21
Q

What is the dermatome referral for L4?

A

medial side of leg, knee divides L3 above, L4 below, crest of tibia divides L4 medially and L5 laterally

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22
Q

What is the dermatome referral for L5?

A

lateral leg and dorsum of the foot, tibial crest divides L4 and L5

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23
Q

What is the dermatome referral for S1?

A

posterior lateral thigh and leg; lateral malleolus and lateral side of plantar surface of foot

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24
Q

What is the dermatome referral for S2?

A

outermost concentric ring around the anus

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25
Q

What is the normal ROM for hip extension?

A

20-30 degrees

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26
Q

What is the normal ROM for hip flexion?

A

125 degrees

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27
Q

What is the normal ROM for hip adduction in flexion?

A

35 degrees

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28
Q

What is the normal ROM for hip adduction in extension?

A

30-35 degrees

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29
Q

What is the normal ROM for hip lateral rotation?

A

60 degrees

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30
Q

What is the normal ROM for hip medial rotation?

A

45 degrees

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31
Q

What is the normal ROM for hip abduction with the kneww flexed?

A

30 degrees

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32
Q

What is the normal ROM for hip abduction with the knee extended?

A

60 degrees

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33
Q

Which nerve innervates psoas?

A

L1-L3

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34
Q

What are the ligaments of the hip?

A
  • iliofemoral
  • pubofemoral
  • ischiofemoral
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35
Q

What is the function of the ligaments of the hip?

A

Iliofemoral: prevents excessive extension
Pubofemoral: supports medial and inferior joint, prevents excessive abduction of femur, limits extension and medial rotation
Ischiofemoral: winds tightly during extension helping hip during extension, supports posterior and superior region of joint, limits flexion

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36
Q

What are the bursa of the hip?

A
  • greater trochanteric
  • iliopectineal
  • ischiogluteal
37
Q

What is the purpose of the bursa of the hip?

A
  • lie between tendon and joint, flat and full of synovial fluid
  • reduce friction
  • tend to become inflamed
38
Q

Which bursa are being compressed and which ligaments are being stretched in hip extension?

A

iliofemoral ligament is stretched

iliopectineal bursa compressed

39
Q

Which bursa are being compressed and which ligaments are being stretched in hip flexion?

A

ischiofemoral ligament stretched

ischiogluteal bursa compressed

40
Q

Which bursa are being compressed and which ligaments are being stretched in hip adduction?

A

iliofemoral ligament stretched

greater trochanteric bursa compressed

41
Q

Which bursa are being compressed and which ligaments are being stretched in hip lateral rotation?

A

pubofemoral ligament stretched

no bursa compressed

42
Q

Which bursa are being compressed and which ligaments are being stretched in hip medial rotation?

A

iliofemoral ligament stretched

greater trochanteric bursa compressed

43
Q

Which bursa are being compressed and which ligaments are being stretched in hip abduction?

A

pubofemoral ligament stretched (slight)

no bursa compressed

44
Q

Why do we test peripheral muscles in three ROM?

A
  • makes inert tissue taut and puts more stress on contractile tissue
  • locate smaller lesions
  • may determine positional weakness
45
Q

What is Q angle?

A

the angle between the quads muscle and the patellar tendon, represents the angle of quads muscle force

46
Q

What are the ligaments of the knee?

A
  • anterior cruciate
  • posterior cruciate
  • lateral collateral
  • medial collateral
47
Q

What movements/forces stress the ligaments of the knee?

A

Anterior cruciate: anterior movement on the tibia
Posterior cruciate: posterior movement on the tibia
Lateral Collateral: varus force
Medial Collateral: vulgus force

48
Q

What are the functions of the meniscus?

A
  • aid in lubrication and nutrition of the joint
  • act as shock absorbers by spreading stress/weight through increased surface area over articular cartilage
  • make joint surfaces more congruent
  • reduce friction and wear during movement
  • prevent hyperextension
49
Q

What are the bursa of the knee?

A
  • suprapatellar
  • prepatellar
  • superficial infrapatellar
  • deep infrapatellar
  • pes anserine bursa
50
Q

Where are the bursa of the knee located?

A

Suprapatellar: above the patella
Prepatellar: on top of the patella
Superficial Infrapatellar: inferior to the patella closer to the surface of the skin
Deep infrapatellar: deep to the superficial infrapatellar
Pes anserine bursa: underneath the pes anserine tendons, close to the attachment

51
Q

What is the importance of tibial rotation?

A

-there may be tibial torsion present

52
Q

Which structures are being tested with tibial rotation?

A

medial: both cruciate ligaments are taut
lateral: both collateral ligaments are taut

53
Q

What are some knee injuries and their causes?

A

Flexion with posterior translation: involves PCL
Hyperextension: involves ACL and meniscus tears
Acceleration & Twisting: Involves menisicus
Deceleration: involved cruciate ligaments
Constant speed with cutting: ACL

54
Q

What nerve innervates plantaris?

A

Tibial nerve

55
Q

Why are quick tests perfomed?

A

tests many joints and/or muscles to determine what area is contributing to pain and dysfunction

56
Q

Why is it necessary to MET a short muscle prior to PROM?

A

-prevent spasm, to get end feel

57
Q

What limits contranutation?

A

-the long and short sacroiliac ligaments

58
Q

What limits nutation?

A

-sacrotuberous, sacrospinous and anterior SI ligaments

59
Q

What is the function of the short posterior SI ligament?

A

limits all pelvic and sacral movement

60
Q

What is the function of the posterior interosseous ligament?

A

limits nutation

61
Q

What is the function of the anterior SI ligament?

A

limits nutation

62
Q

What is the function of the sacrotuberous ligament?

A

limits nutation

63
Q

What is the function of the sacrospinous ligament?

A

limits nutation

64
Q

What is the function of the iliolumbar ligament?

A

stabilizes L5 on the ilium

65
Q

Which nerve innervates rectus femoris?

A

femoral nerve

66
Q

Which nerve innervates sartorius?

A

femoral nerve

67
Q

Which nerve innervates pectineus?

A

femoral nerve

68
Q

Which nerve innervates adductor longus?

A

obturator nerve

69
Q

Which nerve innervates adductor brevis?

A

obturator nerve

70
Q

Which nerve innervates gracilis?

A

obturator nerve

71
Q

Which nerve innervates adductor magnus?

A

sciatic nerve

72
Q

Which nerve innervates biceps femoris?

A

sciatic nerve

73
Q

Which nerve innervates semitendinosis?

A

sciatic nerve

74
Q

Which nerve innervates semimembranosus?

A

sciatic nerve

75
Q

Which nerve innervates gluteus medius?

A

superior gluteal nerve

76
Q

Which nerve innervates TFL?

A

superior gluteal nerve

77
Q

Which nerve innervates gastrocnemius?

A

tibial nerve

78
Q

Which nerve innervates vastus lateralis?

A

femoral nerve

79
Q

Which nerve innervates vastus intermedius?

A

femoral nerve

80
Q

Which nerve innervates vastus medialis?

A

femoral nerve

81
Q

What muscles are short with genu varum?

A

vastus medialis, semitendinosus, semimembranosus, gracilis, sartorius

82
Q

What muscles are short with genu valgum?

A
  • TFL/ITB
  • vastus lateralis
  • biceps femoris
83
Q

What muscles are short with patella alta?

A

rectus femoris

84
Q

What muscles are short with patella baja?

A

weak rectus femoris

85
Q

What muscles are short with patella squinty eyes?

A

vastus medialis, adductor fascia

86
Q

What muscles are short with patella frog eyes?

A

vastus lateralis, ITB fascia

87
Q

What movements stress the SI joint or pubic symphysis actively?

A
  • trunk flexion and contralateral rotation (SI)
  • hip flexion (SI)
  • abduction and medial rotation (PS)
  • lumbar extension (PS)
88
Q

How do you perform sacral ligament tests?

A
  • client prone with feet over the table
  • therapist palpates the PSIS on one side and abducts the hip until the movement is felt, repeat this on the other side
  • place one hand over the sternum with the heel at the sacral base and support with the other hand
  • apply a steady firm pressure down on the sacrum (this is stretching ligaments) and make note of any lack of movement or pain
89
Q

What movements would stress the SI joint or pubic symphysis in RROM?

A
  • trunk extension (SI)
  • hip extension (SI)
  • lateral flexion and rotation (SI)
  • adduction (PS)
  • flexion (PS)

Old Ortho (2 decks)

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