Overall Review Flashcards
What are the qualifying conditions for Medicare coverage for FO/shoes?
-have diabetes
-neuropathy
-pre-ulcerative callusing (or history)
-ulceration (or history)
-compromised circulation
-foot deformity
-ampuation
T/F: scar tissues is as strong as normal tissue
-false
What are the fabrication requirements for OTS diabetic FOs?
-heated molded to PT’s anatomy 230* or higher
-multidensity with plastazote top cover
what is subtalar neutral?
-equal medial/lateral joint space of subtalar joint
What amount of navicular drop is considered excessie?
-10+mm
T/F: Patient education is not a requirement of third party payers:
-false
When is a spinal fracture considered unstable?
-affecting 2 adjacent colums
What is a Jefferson facture?
-anterior/posterior arch C1 facture due to flexion trauma
What is a Hangman’s fracture?
-bilateral pars interarticularis fracture C2 due to extension trauma
What vertebra is affected by an odontoid fracture?
-C2
What is spondylosysis?
-stress fracture in the pars interarticularis
What is spondylolisthesis?
-anterior slippage of the vertebral body secondary to spondylosis
What is scoliosis?
-lateral curvature of the spine >10 degrees with evidence of rotation deformity
When is scoliosis bracing typically indicated?
-history of progression
-curves at least 25 degrees
-skeletal immaturity
What is Buerger’s disease?
-chronic arterial condition resulting in distal extremity pain and inflammation
What is Raynaud’s sydrome?
-excessive vascular sensitivity to cold temperatures, resulting in numbness
Describe a stage 1 ulcer
-intact skin with blanchable erythema with signs of impending opening of the skin surface
Describe a stage 2 ulcer
-partial thickness loss of skin involving epidermis and dermis
Describe a stage 3 ulcer
-full thickness loss of skin extending into subcutaneous tissue
Describe a stage 4 ulcer
-full thickness loss extending into muscle, bone, tendon, and/or joint capsule
What is Legg-Calve-Perthes disease?
-avascular necrosis of the femoral head/neck
Legg-Calve-Perthes is more common in males or females
-males
What is the typical age of onset of Legg-Calve-Perthes disease?
-6 years old
What are clinical signs of Legg-Calve-Perthes?
-limp
-positive Trendelenberg
-limited abduction ROM
-pain in groin, hip, thigh, or knee
What position should be attained in conservative treatment of Legg-Calve-Perthes?
-hip abudction
What is pectus carinatum?
-deformity of the sternum/ribs caused by asymmetrical costal growth, which results in an extruding sternum
How is pectus carinatum treated?
-pectus brace restricts growth in the excessive direction
What is PFFD?
-proximal femoral focal deficiency
-inadequate development of the hip/femur
What are the classes of PFFD?
-femoral head present, normal acetabulum
-femoral head present, dysplastic acetabulum
-femoral head absent, dysplastic acetabulum
-femoral head absent, absent acetabulum
T/F: It is considered appropriate medical interaction to palpate the patient without seeking consent?
-false
What contractures might be expected from prolonged prone positioning?
-ankle PF
-GH extensors, adductors, rotators
-neck rotators
-hip extensors
What contractures might be expected from prolonged side lying positioning?
-knee flexors
-hip flexors, adductors, internal rotators
-should adductors, internal rotators
What contractures might be expected from prolonged supine positioning?
-ankle PF
-knee flexors
-hip flexors, external rotators
-shoulder extensors, adductors, internal rotators
What contractures might be expected from prolonged sitting positioning?
-knee flexors
-hip flexors, adductors, internal rotators
-shoulder extensors, adductors, internal rotators
What are key characteristics of muscular dystrophy?
-inherited progressive neuromuscular disorders
-progressive symmetric muscle wasting without neural or sensory deficits
What are the types of muscular dystrophy?
-Duchene
-Becker
-Fascioscaphulohumeral
-Limb fridle
-myotonic
-congenital
-oculopharyngeal
-distal
-Emery-Dreifuss
What type is the most common for muscular dystrophy, and what does this type entail?
-Duchenne; lack of dystrophin
Duchenne MD primarily affects which gender?
-males
What are the clinical signs of Duchenne MD?
-onset early childhood
-Gower’s sign
-pseudohypertrophy
-muscle weakness starts proximal
-characteristic posture of hyperlordosis, ankle PF, knee extension, hip flexion
What is the Gowers sign?
-standing from floor, using hands to walk up legs
What is Becker MD?
-less severe than Duchenne
-partial functionality of dystrophin
What are the clinical signs of Becker MD?
-onset late childhood/adolescence
-muslce weakness starts proximal
What is myotonic MD?
-most common adult form
-onset from early childhood to adult hood
-inability to relax muscles at will
-distal muscles affected
What are the clinical signs of myotonic MD?
-prolonged muscle spasms
-cardiac abnormalities
What is limb girdle MD?
-onset childhood to adulthood
-proximal weakness of shoulder and hip muscles
What are the clinical signs of limb girdle MD?
-waddling gait
-cardiac issues
What is fascioscapulohumeral MD?
-adolescent onset
-muscles of face, shoulders, and upper arms most affected
What is Emery-Dreifuss MD?
onset by age 10
-slow progressive
-early onset contractures in elbows, neck, heels
-weakness of shoulders, upper arms, calf muscles
-conduction block cardiac issues
What is congenital MD?
-onset at birth
-global hypotonia
What is distal MD?
-distal muscles affected
-onset childhood to adulthood
What is oculopharyngeal MD?
-onset 40s-50s
-facial muscles affected, sometimes affecting ability to swallow
What is spinal muscular atrophy?
-hereditary disease affecting functional of motor neurons (voluntary)
-early to late onset, age at onset indicative of severity
What is Cerebral palsy?
-non-progressive brain disorders present at or before birth
-periventricular leukomalacia: damage to white matter
-intracranial hemorrhage brain bleeding
-hypoxic-ischemic encephalopathy: lack of oxygen to brain
-cerebral dysgenesis: malformation of brain
what are the types of CP?
-spastic
-athetoid/dyskinetic
-ataxic
Where can CP manifest in the extremities?
-monoplegia
-hemiplegia
-paraplegia/diplegia
-quadriplegia
What is monoplegia?
-affecting a single limb
What is hemiplegia?
-affecting ipsilateral limbs
What is paraplegia/diplegia?
-affecting bilateral limbs
What is quadriplegia?
-affecting 4 limbs
What are signs of spastic CP?
-hypertonicity
-contracture development
-hyperactive deep tendon reflex
-difficulty with fine motor movement
What characteristic gait pattern is seen with spastic CP?
-scissor gait
What are signs of athetoid/dyskinetic CP?
involuntary movements of limbs and face
-symptoms absent in sleeps
What are signs of ataxic CP?
-disturbed coordination
-lack of equilibrium
What is spina bifida?
-neural tube defect caused in first 6 weeks due to insufficient folic acid
-permanent, non-progressive spinal cord dysfunction
What are the types of spina bifida?
-occulta
-meningocele
-myelomeningocele
What is spina bifida occulta?
-bony deformity
-possible hair patch at level of occurrence
What is meningocele?
-posterior malformation resulting in skin sac
-CSF in sac only, not affecting cord and meninges
What deformities are associated with spina bifida?
-clubfoot
-scoliosis
-hydrocephalus
-Chiari malformation
What orthotic intervention and typical functional activity would be expected for spina bifida at level <T10?
-standing equipment; supported sitting
What orthotic intervention and typical functional activity would be expected for spina bifida at level T12?
-HKAFO; slide board transfers, good sitting balance, independent wheelchair mobility
What orthotic intervention and typical functional activity would be expected for spina bifida at level L1-2?
-HKAFO, KAFO, RGO; house hold ambulation
What orthotic intervention and typical functional activity would be expected for spina bifida at level L3-4?
-KAFO, floor reaction AFO; household ambulation, limited community ambulation
What orthotic intervention and typical functional activity would be expected for spina bifida at level L5?
-KAFO, floor reaction AFO; community ambulation
What orthotic intervention and typical functional activity would be expected for spina bifida at level >S1?
-usually none; community ambulation
What are characteristics of upper motor neuron lesions?
-weakness without atrophy
-increased tone
-increased reflexes
What are characteristics of lower motor neuron lesions?
-weakness with atrophy
-decreased tone
-decreased reflexes
What is the typical pattern of functionality returned in a CVA?
-LE first, then UE, then hand
-tone before voluntary
-proximal before distal
When does the majority of motor recovery take place following CVA?
-3 months
What is a complete SCI?
-total loss of sensory/motor below level
-loss of bowel/bladder
What is an incomplete SCI?
-partial loss of sensory and/or motor below level
-intact bowel/bladder
How is SCI level determined?
-the inferior-most point with intact function
What spinal level must be intact to maintain independent breathing?
-C3
What is the C1/C2 myotome?
-neck flexion/extension
What is the C3 myotome?
-neck lateral flexion
What is the C4 myotome?
-shoulder shrug
What is the C5 myotome?
-shoulder abduction
What is the C6 myotome?
-elbow flexion/wrist extension
What is the C7 myotome?
-elbow extension/wrist flexion
What is C8 myotome?
-finger flexion/thumb extension
What is T1 myotome?
-finger abduction
What is the L2 mytome?
-hip flexion
What is the L3 mytome?
-knee extension
What is the L4 myotome?
-ankle dorsiflexion
What is the L5 myotome?
-toe extension
What is the S1 myotome?
-Ankle plantarflexion
What spinal level is responsible for neck flexion/extension?
-C1-2
What spinal level is responsible for neck lateral flexion?
-C3
What spinal level is responsible for shoulder shrug?
-C4
What spinal level is responsible for shoulder abduction?
-C5
What spinal level is responsible for elbow flexion/wrist extension?
-C6
What spinal level is responsible for elbow extension/wrist flexion?
-C7
What spinal level is responsible for finger flexion/thumb extension?
-C8
What spinal level is responsible for finger abduction?
-T1
What spinal level is responsible for hip flexion
-L2
What spinal level is responsible for knee extension?
-L3
What spinal level is responsible for ankle dorsiflexion?
-L4
What spinal level is responsible for toe extensinon?
-L5
What spinal level is responsible for ankle plantarflexion?
-S1
What are the clinical signs of ALS?
-UMN affected, resulting spasticity
-extensors of UE and flexors LE affected
-LMN affected, resulting in asymmetric distal-proximal weakness
-aggressively progressive
What is multiple sclerosis?
-pathology wherein damage to myelin sheath results in slower, weaker transmission of nerve signals
-sclerotic plaques from in brain and spinal cord
What are the types of MS?
-clinically isolated
-relapsing-remitting
-secondary progressive
-primary progressive
-progressive-relapsing
What is transverse myelitis?
-inflammation of the spinal cord resulting in changes in nerve signals below affected level
What causes transverse myelitis?
-autoimmune
-viral infection
-bacterial infection
-fungal infection
-parasitic infection
-idiopathic
What is poliomyelitis?
-viral infection which causes typically asymmetrical nerve injury and resultant paralysis
What is post polio syndrome?
-overwork syndrome of motor neurons which were recruited to compensate for loss of function during initial viral infection
What are the signs of post polio syndrome?
- slow progressive muscle weakness
-muscle atrophy
-LLD
-increased fatigue
What is Guillan-Barre?
-autoimmune disorder in response to viral or bacterial infection, surgery, or vaccination
What are the signs of Guillan-Barre?
-fast progressive disorder resulting in peak impairment in 4 weeks or less
-flaccid paralysis
-ascending symmetric motor weakness and distal sensory impairment
What is the typical course of Guillan-Barre?
-onset to peak disability in 4 weeks
-static phase lasting 2-4 weeks
-recovery proximal-distal progression
What are the required diagnosing criteria for Guillan-Barre?
-progressive weakness in more than one extremity
-loss of deep tendon reflex
What are the supportive diagnosing criteria for Guillan-Barre?
-rapidly-developing weakness
-symmetric weakness
-facial weakness
-absence of fever
-recovery beginning 2-4 weeks after cessation of progression
What is Charcot-Marie-Tooth?
-hereditary motor and sensory neuropathy
What are the classic signs of CMT?
-foot drop with steppage gait
-difficulty with fine motor skills
-cavus foot deformity
-parasthesia
Carpal tunnel syndrome is classified as an injury to what nerve?
-medial
What is a Morton’s Neuroma typically found?
-between 3-4 met heads
What are clinical signs of PTTD?
-hindfoot valgus
-pain at medial ankle
-inability to perform heel rise
What is the difference between OA and RA?
-OA is mechanical overuse injury
-RA is a degenerative autoimmune condition
What is Erb’s Palsy?
-upper brachial plexus injury to roots C5-C6
-waiter’s tip deformity
What is Klumpke’s Palsy?
-lower brachial plexus injury to roots C8-T1
-claw hand deformity
Is Erb’s Palsy or Klumpke’s palsy more likely to resolve?
-Erb’s Palsy
What position should be maintained in treating carpal tunnel syndrome?
-neutral forearm/wrist (not in extension)
What is Blount’s disease?
-dysgenetic growth of medial proximal tibial epiphysis?
What are the clinical signs of Blount’s disease?
-unilateral genu varum
Hip flexors are typically innervated by what nerve(s)?
-lumbar plexus
-femoral
Hip extensors are typically innervated by what nerve(s)?
-gluteal
Hip abductors are typically innervated by what nerve(s)?
-gluteal
Hip adductors are typically innervated by what nerve(s)?
-obturator
Knee flexors are typically innervated by what nerve(s)?
-sciatic
-tibial
Knee extensors are typically innervated by what nerve(s)?
-femoral
Ankle dorsiflexors are typically innervated by what nerve(s)?
-peroneal
Ankle plantarflexors are typically innervated by what nerve(s)?
-tibial
Ankle inverters are typically innervated by what nerve(s)?
-tibial
Ankle everters are typically innervated by what nerve(s)?
-peroneal
Shoulder flexors are typically innervated by what nerve(s)?
-axillary
-lateral pectoral
Shoulder extensors are typically innervated by what nerve(s)?
-axillary
-thoracic nerve roots
Shoulder abductors are typically innervated by what nerve(s)?
-axillary
Elbow flexors are typically innervated by what nerve(s)?
-musculocutaneus
Elbow extensors are typically innervated by what nerve(s)?
-radial
Forearm pronators are typically innervated by what nerve(s)?
-median
Forearm supinators are typically innervated by what nerve(s)?
-radial
Wrist flexors are typically innervated by what nerve(s)?
-ulnar
Wrist extensors are typically innervated by what nerve(s)?
-radial
Thumb abductors are typically innervated by what nerve(s)?
-median
What are the major events of the gait cycle?
-initial contact
-opposite toe off
-heel rise
-opposite initial contact
-toe off
-feet adjacent
-tibial vertical
What are the major periods of the gait cycle?
-loading response
-midstance
-terminal stance
-pre-swing
-initial swing
-mid swing
-terminal swing
What percentage of the gait cycle is spent in stance?
-60%
What is cadence?
-steps in a given time (steps/minute)
What is a normal cadence?
-120 steps/minute
What are the determinants of gait?
-pelvic rotation
-pelvic obliquity
-lateral displacement
-knee flexion in stance
-ankle mechanism/rocker
-foot mechanism/rocker
What is the benefit of the determinants of gait?
-reduces vertical displacement of COG by artificially lengthening limbs
What are the attributes of giat?
-stability in stance
-foot clearance in swing
-prepositioning for IC
-adequate step length
-conservation of energy
Where is the GRF acting in initial contact?
-posterior ankle, anterior knee, anterior hip
Where is the GRF acting in loading response?
-posterior ankle, posterior knee, anterior hip
Where is the GRF acting in midstance?
-anterior ankle, anterior knee, posterior hip
Where is the GRF acting in terminal swing?
-anterior ankle, posterior knee, posterior hip
What muscle activation is seen in initial contact/loading response?
-gluteus (concentric)
-hamstrings (isometric)
-quadriceps (eccentric)
-anterior tib (eccentric)
What muscle activation is seen in midstance?
-gluteus (isometric)
-quadriceps (concentric)
-gastroc (eccentric)
-anterior tib (isometric)
What muscle activation is seen in terminal stance?
-gastroc (isometric)
What muscle activation is seen in preswing?
-iliopsoas (concentric)
-quadriceps (isometric/concentric, depending on speed)
-gastroc (concentric)
What muscle activation is seen in initial swing?
-iliopsoas (concentric)
-anteriro tib (concentric)
What muscle activation is seen in midswing?
-anterior tib (concentric)
What muscle activation is seen in terminal swing?
-gluteus (concentric)
-hamstring (eccentric)
-quadriceps (concentric)
-anteriro tib (concentric)
What is the peak hip flexion angle seen in gait, and when?
-25 degrees; terminal swing/loading response
What is the peak hip extension angle seen in gait, and when?
-15-20 degrees; terminal stance
What is the peak knee flexion angle seen in gait, and when?
-60 degrees; initial swing
What is the peak ankle dorsiflexion angle seen in gait, and when?
-10 degrees; terminal stance
What is the peak plantar flexion angle seen in gait, and when?
-20 degrees; initial swing
How does the center of pressure travel along the plantar surface during gait?
-initial contact at lateral heel, push off at hallux
What are the functions of the foot in gait?
-shock absorption
-accommodation to walking surface
How much of the gait cycle is spent in double limb support?
-20%
As walking speed increases, what decreases?
-time spent in double limb support
Describe hammer toe deformity.
-PIP flexion
-DIP extension
Describe claw toe/curly toe deformity.
-PIP flexion
-DIP flexion
Describe mallet toe deformtiy.
-PIP extension
-DIP flexion
T/F: Supination is typically a flexible position of the foot/ankle.
-false
What is the functional ankle ROM required for normal gait?
-10 degrees DF
-20 degrees PF
What is the SVA during midstance?
-12 degrees inclined
When tuning an AFO, the bench alignment should be in what position?
-appropriate ankle angle
-5-8 inclined SVA
The proximal trimline of an AFO should be where?
-20mm below neck of fibula
What is the first rocker?
-heel rocker; lowering of the forefoot
What is the second rocker?
-ankle rocker; tibia declination into inclination
What is the third rocker?
-toe rocker; heel raise with extension of MTP
What muscles in the hand/wrist does the radial nerve innervate?
-extensor muscle groups
-abductor pollicis longus
What muscles in the hand/wrist does the median nerve innervate?
-radial flexors
-abductor pollicis brevis
-opponens pollics
-1-2 lumbricals
What muscles int he hand/wrist does the ulnar nerve innervate?
-ulnar flexors
-abductor digiti minimi
-opponens digiti minimi
-adductor pollicis
-3-4 lumbricals
Radial nerve receives fibers from what spinal level?
-C5-T1
Median nerve receives fibers from what spinal level?
-C6-T1
Ulnar nerve receives fibers from what spinal level?
-C7-8
Hand of benediction is typically associated with what nerve injury?
-median
Wrist drop is typically associated with what nerve injury?
-radial
Claw hand is typically associated with what nerve injury?
-ulnar
What is normal ROM in GH extension?
-45 degrees
What is normal ROM in GH flexion?
-180 degrees
What is normal ROM in GH abduction?
-180 degrees
What is normal ROM in GH adduction?
-0 degrees
What is normal ROM in GH horizontal abduction?
-90 degrees
What is normal ROM in GH adduction?
-30 degrees
What is normal ROM in GH external rotation?
-90 degrees
What is normal ROM in GH internal rotation?
-70 degrees
What is normal ROM in elbow flexion?
-154 degrees
What are the muscles of the rotator cuff?
-supraspinatus
-infraspinatus
-teres minor
-subscapularis
What are the power grips of the hand?
-cylindrical
-spherical
-hook
What are the precision grips of the hand?
-lateral (key)
-lumbrical (plate)
-pinch (tip/tip or pad/pad)
-3 jaw chuck
What is the functional position of the wrist/hand?
-20-30 degrees wrist extension
-45 degrees MCP flexion
-15 degrees PIP/DIP flexion
-45 degrees thumb abduction
What is the safe position of the wrist/hand?
-10-45 degrees wrist extension
-60-90 degrees MP flexion
-full extension PIP/DIP
What is a boutonniere deformity?
-PIP flexion, DIP hyperextension
What is a swan neck deformity?
-PIP hyperextension, DIP flexion
What is a colles fracture?
-distal radius fracture with radial dislocation
What is a Monteggia fracture?
-proximal radius fracture with dislocation of radial head
What is a Galeazzi fracture?
-distal radial fracture with ulnar dislocation
What spinal region is most mobile?
-cervical
Where does the most rotation occur?
-C1-2
How much rotation occurs at C1-2?
-50%
What is the greatest motion available in the thoracic spine?
-rotation
What is the greatest motion available in the lumbar spine?
-flexion/extension
What are the appropriate trim lines for a TLSO?
-25 mm below sternal notch
-20mm above thigh when seated on firm chair
-38 mm from axilla
-20mm above spine of scapula
-25mm from sitting surface (posterior)
What spinal level is roughly attributable to the base of the mandible?
-C2-3
What spinal level is roughly attributable to the sternal notch?
-T2-3
What spinal level is roughly attributable to the inferior angle of the scapula?
-T7
What spinal level is roughly attributable to the xyphoid process?
-T9-10
What spinal level is roughly attributable to the waist?
-L2
What spinal level is roughly attributable to the umbillicus?
-L3
What spinal level is roughly attributable to the iliac crests?
-L4
What spinal level is roughly attributable to the ASIS?
-S1
What motions does a chairback LSO control?
-AP (flexion/extension)
What motions does a Knight type LSO control?
-AP/ML (flexion/extension/lateral flexion?
What motions does a Taylor type TLSO control?
-AP (flexion/extension?
What motions does a Knight Taylor type TLSO control?
-AP/ML (flexion/extension/lateral flexion?
What motions does a Cowhorn type TLSO control?
-AP/ML + rotation (triplanar)
What motions does a does a Jewett/CASH type TLSO control?
-flexion
ow are hyperextension TLSO’s measured?
-distance sternal notch to pubis
-subtract 72mm (3”)
What is Torticollis?
-shortening of the sternocleidomastoid muscle
Torticollis is commonly associated with what other condition?
-plagiocephaly
Torticollis affecting the right side will be associated with what area of flattening?
-left (plagiocephaly/asymmetric brachy)
When is a SOMI traditionally indicated?
-post Halo intervention
What does SOMI stand for?
-sternal occipital mandibular immobilizer
What type of cervical orthosis provides end-point control?
-Halo
How is infantile idiopathic scoliosis defined?
-occurring before age 3
How is juvenile idiopathic scoliosis defined?
-occurring between ages 3-9
How is adolescent idiopathic scoliosis defined?
-occurring at age 10 or later (up to skeletal maturity)
What AIS curve patterns tend to progress the least?
-single lumbar
-single thoracolumbar
What are the risk factors for AIS curve progression?
-curve pattern
-curve magnitude
-age
-gender
-Risser
-menarche
How is a structural curve defined via X-ray?
-non-resolving in lateral bending
Describe how to take a Cobb angle
-angle between the lines made perpendicular to the superior endplate of the superior-most tilted vertebra and the inferior endplate of the inferior-most tilted vertebra
What direction does the spinous process rotate to in AIS?
-towards concavity
What direction does the body of the vertebra rotate to in AIS?
-towards convexity
What is the Adam’s forward bend test?
-visual inspection of thoracic rotation, by bending forward at the hips 90 degrees
What possible deformities in AIS can be seen in the frontal plane?
-C7 decompensation
-arm gap
-pelvic obliquity
-lateral curvature
-unequal shoulder height
-LLD
What possible deformities in AIS can be seen in the sagittal plane?
-hyperlordosis
-hypolordosis
-hyperkyphosis
-hypokyphosis
What possible deformities in AIS can be seen in the transverse plane?
-rib hump
What are the mechanisms of corrective action in AIS bracing?
-end point control
-three point pressure system
-coupled de-rotation
-active muscle component
What does end point control refer to in AIS bracing?
-reduction of pelvic deformity
-C7 compensation
What does three point pressure system refer to in AIS bracing?
-reduction of lateral curvature
-aiding in C7 compensation
-restoration of normal sagittal curve profile
What does coupled de-rotation refer to in AIS bracing?
-anteriolateral and posteromedial directed forces to reduce rotation
What does active muscle component refer to in AIS bracing?
-space allowed for movement of tissue during correction/breathing
When is a Milwaukee CTLSO indicated for AIS?
-apex above T7-8
-T1 tilt
What is the indications for treatment in AIS?
-Risser 0-1, curve <20 degrees: observe
-Risser 0-1, curve 20-40 degrees: brace
-Risser 2-3, curve 0-30 degrees: observe
-Risser 2-3, curve 30-40 degrees: brace
-Risser any, curve 40-50 degrees: brace (possible surgery)
-Risser any, curve >50 degrees: surgery
What is the difference between positional plagiocephaly and craniosynostotic plagiocephaly?
-craniosynostotic results in asymmetrical growth due to premature fusion of sutures
What is the cephalic index?
-ratio of head length to head width
What is cranial vault asymmetry?
-difference between diagonal measurements, frontozygomatic to bossing/flattening
What is brachycephaly?
-high cephalic ratio
What is scaphocephaly?
-low cephalic ratio
When are CROs most effective?
-4-8 months
What typically needs to be documented for insurance coverage?
-2 months of repositional therapy (and age of at least 3 months)
-age 6-18 months
-cephalic index +/- 2SD from normal
-10+ cranial vault asymmetry
-OR craniosynostosis
What is the normal femur angle of inclination?
-125 degrees
Femoral inclination angle of greater than 125 degrees is called what and results in what?
-coxa valga; knee varum
Femoral inclination angle of less than 125 degrees is called what and results in what?
-coxa vara knee valgum
What is the normal angle of femoral torsion?
-10-15 degrees anterior
Femoral torsion of greater than 15 degrees is called what and results in what?
-(excessive) anteversion; in-toeing
Femoral torsion of less than 15 degrees is called what and results in what?
-retroversion; out-toeing
The anatomical hip joint is oriented how compared to the greater trochanter?
-1” proximal
-1/2” anterior
What is the Ober test, how is it performed, and what is positive?
-tensor fascia latae tightness
-sidelying, passive abduction and extension
-positive test if upper leg stays in the air and does not contact table
What is the Thomas test, how is it performed, and what is positive?
-hip flexor tightness
-supine, unilateral hip flexion to chest
-positive test if extended thigh does not contact table
What is the Lachman test, how is it performed, and what is positive?
-ACL rupture
-supine, 30 degrees flexion with external rotation, anterior translation force
-positive test with soft end feel and/or anterior translation 3 mm greater than intact leg
What is the Anterior drawer test, how is it performed, and what is positive?
-ACL rupture
-supine, hip flexion 45 degrees, knee flexion 90 degrees, anterior force on proximal tibia
-positive test with soft feel and/or anterior translation greater than 6mm
What is the Posterior drawer test, how is it performed, and what is positive?
-PCL rupture
-supine, hip flexion 45 degrees, knee flexion 90 degrees, posterior force on proximal tibia
-positive test with soft end feel and/or posterior translation greater than 6mm
What ist he posterior sag test (Gottfried test), how is it performed, and what is postive?
-PCL rupture
-supine, hip flexion, knee flexion
-positive test if posterior sag of tibia noted
What is the McMurray test, how is it performed, and what is positive?
-meniscus tears
-supine, hip flexion, knee flexion, compressive force between tibia and femur, with foot rotation
-positive test with pain or click
Describe against gravity and gravity eliminated MMT positions for shoulder abduction.
-AG: sitting
-GE: supine
Describe against gravity and gravity eliminated MMT positions for shoulder flexion.
-AG: sitting
-GE: sidelying, testing side up
Describe against gravity and gravity eliminated MMT positions for shoulder extension.
-AG: sitting
-GE: sidelying, testing side up
Describe against gravity and gravity eliminated MMT positions for elbow flexion.
-AG: sitting
-GE: sidelying, testing side up
Describe against gravity and gravity eliminated MMT positions for elbow extension.
-AG: prone, shoulder abducted to 90 degrees and off table OR supine, shoulder flexed to 90 degrees
-GE: sitting, shoulder abducted to 90 degrees
Describe against gravity and gravity eliminated MMT positions for wrist extension.
-AG: sitting, pronated
-GE: sidelying, testing side up
Describe against gravity and gravity eliminated MMT positions for wrist flexion.
-AG: sitting, supinated
-GE: sidelying, testing side up
Describe against gravity and gravity eliminated MMT positions for hip flexion.
-AG: sitting, arms crossed over chest
-GE: sidelying, testing side up
Describe against gravity and gravity eliminated MMT positions for hip extension.
-AG: prone
-GE: sidelying, testing side up
Describe against gravity and gravity eliminated MMT positions for hip abduction.
-AG: sidelying, testing side up
-GE: supine
Describe against gravity and gravity eliminated MMT positions for hip adduction.
-AG: sidelying, testing side down
-GE: supine
Describe against gravity and gravity eliminated MMT positions for hip internal rotation.
-AG: sitting
-GE: supine
Describe against gravity and gravity eliminated MMT positions for hip external rotation.
-AG: sitting
-GE: supine
Describe against gravity and gravity eliminated MMT positions for knee extension.
-AG: sitting
-GE: sidelying, testing side up
Describe against gravity and gravity eliminated MMT positions for knee flexion.
-AG: prone
-GE: sidelying, testing side up
Describe against gravity and gravity eliminated MMT positions for ankle dorsiflexion.
-AG: sitting
-sidelying, testing side up
Describe against gravity and gravity eliminated MMT positions for ankle plantar flexion.
-AG: single limb standing, heel raise (1-5 quality repetitions (1=grade 3, 5=grade 5))
-GE: sidelying, testing side up, 90 degrees knee flexion
Describe against gravity and gravity eliminated MMT positions for ankle inversion.
-AG: sitting
-GE: supine
Describe against gravity and gravity eliminated MMT positions for ankle eversion.
-AG: sitting
-GE: supine
