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OS year 2 > OS3 year 2 exam 1 -Hannah > Flashcards

OS3 year 2 exam 1 -Hannah Flashcards

1
Q

systemic causes of compression neuropathy

A

pregnancy
hypothyroidism
diabetes

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2
Q

three sites of radial nerve entrapment and associated symptoms

A
  1. high on the humerus
    sx: wrist drop, weak elbow flexion, tricep weakness
  2. radial tunnel
    sx: pain and tendernesss 5cm distal to lateral epicondyle , wrist drop , pain with resisted supination
  3. at the wrist
    sx: sensation changes over posterolasteral hand
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3
Q

what nerve causes pronator syndrome

sx: achy pain in the mid/proximal forearm, pain with resisted forearm pronation and cramping in the fingers

A

median N.

-compression by the pronator trees muscle

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4
Q

anterior interosseous syndrome

A
  • anterior interreouses N. from the MEDIAN N.
    sx: NO sensory symptoms, cannot make “OK” sign with thumb and index finger properly
  • weak flexion of the index finger DIP and thumbs IP
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5
Q

sx: parathesia to the 4th and 5th digits, medial elbow pain radiating to the hand with decreased intrinsic muscle strength (can’t turn a key in the door)
* + Tinel sign at elboww

A

ulnar nerve entrapment in cubital tunnel syndrome

*reproduction with elbow flexion, wrist extension

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6
Q

what is froments sign and when do you see it

A

patient must flex thumb in order to pinch paper between 1st and 2nd digit
seen in cubital turner syndrome of ulnar n. entrapment

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7
Q

what is the most common compression syndrome

A

median N entrapment at the CARPAL TUNNER SYNDROME

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8
Q

sx of carpal tunnel syndrome

A

nighttime numbness of lateral 3 1/2 digits, tingling, wrist pain, dropping things, thenar atrophy

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9
Q

dx gold standard for carpal tunnel syndrome

A

EMG

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10
Q

sx of thoracic outlet syndrome

A

weakness, parathesia of medial arm forearms and hand worsened by overhead activity

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11
Q

what causes a positive tinnels sign 1cm medial and inferior to ASIS

A

meralgia parasthetica (lat fem cutaneous n.)

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12
Q

what compression is caused by “strawberry pickers palsy” (time spent in squatting position), or leg hooked over a rail, or ANKLE SPRAINS

A

common fibular nerve compression
sx: pain along proximal third of lateral leg, steps make louder sound on affected side (foot drop) , pain worsened with plantar flexion and inversion of the foot

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13
Q

plantar flexion and foot inversion makes the fibular head go _____

A

posterior

*PIP

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14
Q

tarsal turner syndrome (assoc with autoimmune diseases and diabetes)

A

compression of the posterior tibial n. in the tarsal tunnel behind the medial malleolus and overlying flexor retinaculum
sx: affects motor to plantar (bottom) muscles of foot and sensation to plantar aspect of the foot and toes

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15
Q

anterior tarsal tunnel syndrome

A
  • compression of deep fibular nerve by the inferior extensor retinaculum
  • sx: pain over dorsomedial aspect of foot and worse at rest, weakness of extensor digitorum braves
  • caused by prolonged plantar flexion or compression from shoes, or soccer
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16
Q

cervical nerve root compression is caused by

A

2 degree to cervical disc disease
(herniated or bulging disc)
= radiculopathy

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17
Q

bulging disc vs herniated disc

A

bulging
-compresses every without tearing to cartilage rings

herniated
-tearing of cartilage rings
(protrusion- few tearing, no leakage)
(extrusion- torn in a small area, nucleus pulposus is able to flow out of disc space)

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18
Q

technique: extending and rotating the neck toward the symptomatic side, look for exacerbation of radicular pain
dx: cervical radiculopathy (herniated disc)

A

spurling test

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19
Q

technique: elevate patient chin (extend neck) and rotate head toward affected side while inspiring deeply, look for decrease in radial pulse on affected side
dx: thoracic outlet syndrome (plexopathy)

A

adsons test

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20
Q

technique: firmly grasp the middle finger and quickly snapping or flipping the dorsal surface, look for quick flexion of both the thumb and index finger
dx: cervical myelopathy (c-spine stenosis)

A

hoffmann tets

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21
Q

compression of the superficial radial N., (cheiralgia parathestica, wartenbergs syndrome, “HANDCUFF NEUROPATHY”)

A

numbness, pain, tingling in the posterolateral hand and distal forearm
-compression of the radian n. at the wrist between the ECRL, and brachioradialis M.

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22
Q

baseball players and dentist are likely to get what compression neuropathy

A

median n. entrapment as PRONATOR SYNDROME

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23
Q

what muscle is weak in anterior interrosseous syndrome as seen with with pts with forearm casts

A

flexion pollicus longus muscle and flexor digitorum M.

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24
Q

three test to dx carpal tunnel syndrome

A

tinels, phalens, 2 point discrimintion

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25
Q

lumbosacral radiculopathy (sciatica) vs piriformi syndrome sx

A

sciatica travels down to foot, and low back pain, and caused by herniated disc most often at the left of L5-S1 (affects L5 nerve)

piriformis syndrome - pain stops at or above kneee and radiates from the gluteal region, contralateral sacroiliac pain (SI JOINT PAIN) can have gait problems (foot drop) and weakness in ipsilateral LE

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26
Q

lat fem cutaneous comes from what lumbosacral nerve roots

A

L2 -L3

and nerve is compressed by inguinal ligament

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27
Q

common fibular N. lumbosacral nerve roots

A

L4-S2

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28
Q

tx for tarsal turner syndrome (posterior tibial N.)

A

gastrocnemius counterstain , calcaneal HVLA, talar tug HVLA, ankle figure 8

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29
Q

if there is a thoracic and rib TP, which do you treat first?

A

thoracic

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30
Q

2 cm lateral to medial end of the clavicle

A

AC 7
(clavicular head of the SCM)
(F StRa)

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31
Q

medial end of the clavicle

A

AC 8
(sternal head of SCM at the sternal notch )
(F SaRa)

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32
Q

inferior tip of xiphoid or 1/4 of the way between the xiphoid tip and umbilicus

A

AT 7

tx: patient sitting- knee on opposite side of TP, FSTRA

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33
Q

3/4 way between xiphoid and umbilicus

A

AT 9

tx: patient sitting- knee on opposite side of TP, FSTRA

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34
Q

1/4 way between unblicius and pubic symphysis

A

AT 10

tx: F STRT
- patient supine; same side as TP, pull ankles and knees toward you

35
Q

halfway between umbilicus and pubic symphysis

A

AT 11

tx: F STRT
- patient supine; same side as TP, pull ankles and knees toward you

36
Q

anterior superior surface of the iliac crest at the midaxillary line

A

AT 12

tx: F STRT
- patient supine; same side as TP, pull ankles and knees toward you

37
Q

medial ASIS

A

AL1
-F STRT
(stand same side pull ankles and knees toward you )

1 = STaRT

38
Q

medial, lateral and inferior AIIS

A 
medial ( AL 2) 
lateral AL3
inferior AL 4 
tx= F SARA
(stand opposite side and pull ankles and needs to you/away from TP)
39
Q

superior aspect of pubic ramus just lateral to the pubic syphysis

A

AL 5
tx= F-SART
stand same side and push ankles away and rotate knees towards you/TP

40
Q

lower quadrant, medial to ASIS, deep in iliac fossa

1/3 from ASIS to midline

A

iliacus Tender point

tx: “frog leg” [ F-ER ]
- same side and flex hips and knees to 90 crossing ankles over doc knee and inducing marked ER

“FrogER”

41
Q

superior pubic ramus where psoas muscle crosses the pelvic rim
(superior surface of iliopubic/iliopectineal eminence)

A

low ilium tender point

tx= same side and flex hip and knee to 90

42
Q

lateral pubic tubercle

A

inguinal ligament tender point
-tx= “cross good over bad” and pull ankles toward
[internal rotation of dysfunctional hip]
-associated with inguinal L. and pectineus M.

43
Q

2/3 distance from ASIS to midline, pressing deep

A

psoas major tender point
tx: F STRT
(same side, flex and pull ankles and feet towards you/TP)

44
Q

on the inferior nuchal line, lateral to the inion

A

PC1 inion

tx= F.STRA

45
Q

on the inferior nuchal line, 1/2 way between the inion and mastoid process (splenius Capitis M. )

A

PC1 occiput

tx: E-Sara

46
Q

on the inferior nuchal line , in the semispinalis capitis M.

A

PC2 occiput

tx: E-SARA

47
Q

on the inferior or inferolateral aspect/tip of the spinous process of C2

A

PC3
tx: F-sara
(C2 has 2 tender points)

48
Q

is seated or standing flexion test for the sacrum

A

seated flexion test

49
Q

for sacral torsion, what is the relationship between the axis and the seated flexion test

A

the axis is opposite to the positive side of the seated flexion test (dysfunctional side)

50
Q

when is pedal pump ABSOLUTELY contraindicated in a surgical patient

A

if DVT, lower extremity fracture, recent abdominal surgery

51
Q

facilitated segments are often a result of ____ ___ ____ and reproduction of dysfunction occurs rapidly therefore frequency of treatment is ____

A

acute visceral processes

-very frequent, often more than once daily until the process improves and the frequency can decrease

52
Q

tx of ____ may have greater effect in segmental facilitation vs ____ because of the high concentration of nociceptors in the joint capsules vs muscle bodies

A

articular tissues treatments vs soft tissue techniques (MFR or counterstain)

53
Q

rule of W’s

A

in post op fever

  1. wind (Lungs)
  2. water (kidneys)
  3. walking (DVT, PE)
  4. wound
  5. wonder drug
54
Q

thoracic duct is under SNS control and therefore hyper sympathetic tone may ____ lymphatic flow

A

decrease

55
Q

what is the caution with CHF patients

A

do not overwhelm the circulatory system and exacerbate symptoms

56
Q

neurologic tx for CHF patient

A

paraspinal inhibition at T1-T6 (decrease SNS)
sub occipital release (increase PNS tone)
chapmans points (2 ICS anteriorly, 2-3 TP posteriorly)

57
Q

scoliosis grading

A

mild : 5-15

moderate: 20-45
severe: >50
* cobb angle measurement

58
Q

measure of the angle between a line parallel to the superior end plate of the most cephlad vertebrae in a particular curve and a line parallel to the inferior end plate of the most caused vertebra of the curve

A

Cobb angle

59
Q

in FPR the activating force is applied ___ in pelvic tx, and ____ in rib tx ; what is the one exception

A

after in pelvic, before in rib

except in INH/EX seated FPR you add activation force after position indirectly

60
Q

FPR of sacral SD (restriction in cephalad motion on one side)

A

neutralize the curve, flex hip off table, knee extended abduct and add activation force by pushing cephalad on the ILA

61
Q

FPR of piriformis TP/hypertonicty (associated with sacral torsion)

A

neutralize the curve, flex hip off table, knee bent, and adduct duct, add activation axial compression through the palm at the kneee to shorten the muscle

62
Q

FPR of gluteus maximus TP/hypertonicty

A

neutralize the curve, flex hip off table, bend knee to 90 degree, extend hip with doctors knee until motion is felt at the TP, add TORSIONAL force by external rotating the hip by contact at the ankle and knee as fulcrum

63
Q

FPR of hamstring TP/hypertonicity

A

neutralize the curve, extend hip off table on top of doctors knee, flex knee until relaxation of the hamstring, induce IR/ER rotation with distally placed hand, add axial compression or traction with proximal hand as activating force

64
Q

FPR for quads (left vests lateraled hypertonicity SD)

A

neutralize the curve (with pillow under head in supine position) flex hip with knee maximally extended and calf of patient on doctors thigh. direct patella towards the monitoring hand, and induce IR/ER and AB/ADuct of hip as needed, add axial compression or traction activating force using the Dr.s thigh

65
Q

seated FPR of costochondral SD

A

neutralize curve, add compression at shoulders, rotate towards until motion felt or TP releases

66
Q

seated FPR of posterior rib SD

A

neutralize curve, add compression at shoulders, Flex, sideband towards, rotate towards (F STRT)

67
Q

where do you start and end in a stills technique

A

start at the shifted neutral position of ease, end at the ANATOMIC barrier or the direct position (not restrictive barrier)

68
Q

Stills technique for posterior rib

A

monitor costotransvere segment (posteriorly) abduct arms, add compression through elbows to the rib, and adduct the arm across the body

69
Q

tensor fascia lata TP ( at lateral trochanter)

A

F- AB (maybe IR)

70
Q

ITB TP

A

F-AB

71
Q

medial vs lateral hamstring TP

A

Lateral - F-AB-ER of tibia

medial - F-AD-IR of tibia

*follows same for menisci

72
Q

popliteus TP

A

F-IR (flex knee and IR tibia)

73
Q

gastrocnemius TP

A

flex knee and place dorsal of foot on doc thigh, add compression through calcaneous

74
Q

medial ankle (tibialis anterior) vs lateral ankle (fibularis m.s) TP

A

medial ankle= inversion
lateral ankle = eversion
(pt is lateral recumbent with pillow underneath for both)

75
Q

navicular TP

A

knee flex, dorsum of foot on doc thigh, plantarflexsion and supination (inversion) of foot

76
Q

supra spinatus, and upper and lowe infrapsinatus TP

A

all are FABER
supra- 45 degree
upper infra- 90-120
lower infra- >135

77
Q

levator scapula tp

A

rotate head away,

IR AB and traction on shoulder

78
Q

subscapulris TP

A

E and IR shoulder (maybe traction)

79
Q

biceps brachi TP short and long head

A

F-AB-IR
(flex should and elbow, min abduct, and IR)

**SHORT HEAD MIGHT BE FADDIR

80
Q

medial epicondyle (pronator teres) TP

A

Flex elbow, pronate, adduct forearm

81
Q

abductor policus brevis TP

A

flex wrist Abduct thumb

FAB

82
Q

when is an ankle series indicated according to the ottawa rules

A

if there is pain in the malleolar zone, and
1. tenderness at the posterior edge or tip of the medial or lateral malleolus
or
2. can not bear weight immediately after injury or for 4 steps in ER

83
Q

when is an foot series indicated according to the ottawa rules

A

if there is pain in the mid foot zone, and
1. bone tenderness at the base of the 5th metatarsal (pinky toe) or navicular
or
2. can not bear weight immediately after injury or for 4 steps in ER

OS year 2 (2 decks)

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