Practice Exam 2 Flashcards

1
Q

SC joint, how many degrees of freedom and name them

A

3 degrees of freedom
1.elevation and depression
2. Protraction and retraction
3. Anterior and posterior rotation

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2
Q

What type of joint is the sc joint and what bones make it up?

A

Gliding joint, proximal part of clavicle and manubrium and part of 1st costal cartilage

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3
Q

What makes up the ac joint?

A

Acromion process of scapula and distal end of clavicle

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4
Q

AC joint is what type of joint? How many degrees of freedom and list the motions that occur at this joint.

A

Plane synovial joint, 3 degrees of freedom
1. Internal and external rotation
2. Upward and downward rotation
3. Anterior and posterior scapular tilting

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5
Q

Scapulothoracic articulation movement happens here in response to movement occuring at what joints? Give example

A

In response to ac and sc movement, example arm abducts scapulothoracic articulation upwardly rotates, externally rotates and posteriorly tilts

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6
Q

Glenohumeral joint is formed by?

A

Head of the humerus and glenoid fossa of the scapula

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7
Q

Glenohumeral joint is what type of joint and how many degrees of freedom occur here? List them

A

Ball and socket joint, 3 degree of freedom
1. Flex/ext
2. Add/abd
3. Int/ext rotation
(Not true anatomical motions but occur here: horizontal add/abd and circumduction)

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8
Q

Anoxia

A

Lack or absence of oxygen

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9
Q

What is postconcussion syndrome?

A

A condition that occurs following a concussion. Can occur in mild cases of head injury that dont involve LOC or in cases of severe concussions.

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10
Q

Postconcussion syndrome S&S, duration of S&S

A

-persistent headaches
-impaired memory
-lack of concentration
-anxiety and irritability
-giddiness
-fatigue
-depression
-visual disturbances
Symptoms can start immediately or w/in several days following the trauma and may last for weeks or months before resolving

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11
Q

Postconcussion syndrome management

A

Refer patients w/persistent symptoms
-factors such as previous concussions can complicate recovery time
(Sub-symptom aerobic exercise may improve outcomes for individuals w/persistent symptoms)

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12
Q

What is second-impact syndrome? Who is it more likely to occur in?

A

Rapid swelling and herniation of the brain after a second head injury that occurs before an initial head injury has resolved. Second impact can be minor, even a blow to the chest, anything that is enough to snap the patients head back and cause acceleration/deceleration forces to a brain thats already compromised.
-most likely to occur in individuals less than 20 years of age

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13
Q

Second-impact syndrome S&S

A

-patient doesnt usually lose consciousness, may look stunned.
-may be able to remove themselves off the field but within 15 seconds to several minutes they rapidly deteriorate: pupils dilate, loss of eye movement, loss of consciousness leading to coma, respiratory failure
(Second-impact syndrome is a life-threatening injury that has a 50% mortality rate)

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14
Q

Second-impact syndrome management

A

-life-threatening emergency that has to be addressed within 5 minutes by dramatic life saving efforts in an emergency care facility.
-best way for an AT to manage it, is to prevent it from happening, be careful when deciding to return an athlete to play after an initial head injury

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15
Q

Hypoxia

A

Insufficient oxygen delivery

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16
Q

What bones form the ankle joint? What is this joint aka?

A

Distal portion of fibula (lateral malleolus), distal portion of tibia (medial malleolus), and talus ( trochlea-superior articular surface of talus)
AKA-ankle mortise

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17
Q

What type of joint is the ankle joint? What movements occur here?

A

-hinge joint
-plantarflexion and dorsiflexion

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18
Q

Subtalar joint is the articulation between?

A

Talus and calcaneus

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19
Q

What movements occur at the subtalar joint?

A

Inversion, eversion, pronation, and supination

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20
Q

Axonotmesis

A

Group of more severe nerve injuries, where your nerves stretch and become damaged

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21
Q

Neurotmesis

A

Serious nerve injury in which your nerve is completely cut (severed)

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22
Q

Paresthesia

A

Tingling/prickling, “pins and needles” sensation

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23
Q

Neurodynia

A

Nerve pain; pain of a severe, throbbing, or stabbing nature along the course of distribution of a nerve

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24
Q

Neuropraxia

A

Mildest form of traumatic peripheral nerve injury. Nerve stays intact but results in blockage of nerve conduction results in temporary loss of motor and sensory function. transient weakness or paresthesia

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25
Q

Legg-Calve-Perthes Disease

A

Avascular necrosis of the proximal femoral epiphysis
-occurs in ages 2-14, more common in males
-causes osteochondritis, reduce hip ROM especially abduction and internal rotation when hip is extended
-pain can be referred to the medial thigh (obturator nerve), buttock (sciatic nerve), or suprapatellar region (femoral nerve)
-positive trendelenburgs
-visible signs on radiographs: visible v on lateral epiphysis, calcification of lateral epiphysis, lateral subluxation of femoral head, coxa magna (assymetrical circumferential enlargement of the femoral head)

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26
Q

Legg-Calve-Perthes Disease intervention strategies

A

-maintaining good hip ROM
-making sure the femoral head stays in the acetabulum so that it ossifies into a round shape

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27
Q

Apophysitis

A

Apophysis is the location of a growth plate with a muscle attachment, inflammation of these areas is known as apophysitis

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28
Q

What is osgood-schlatter disease?

A

Apophysitis characterized by pain at the attachment of the patellar tendon to the tibial tubercle
-often represents an avulsion fx of tibial tubercle that is cartilaginous at first but hardens over time and then a bony callous forms and the tuberosity enlarges
-repeated avulsion of the patellar tendon at the apophysis of the tibial tubercle
-Usually resolves once the patient turns 18

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29
Q

Larsen-johansson disease

A

-apophysitis at the inferior pole of the patella
-caused by excessive repeated strain on the patellar tendon
-swelling, pain, and point tenderness

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30
Q

Osgood-Schlatters and Larsen-johansson disease S&S

A

Repeated irritation that causes swelling, gradual degeneration of apophysis and as a result impaired circulation
-patient complains of pain when kneeling, jumping, and running, point tenderness of proximal tubercle

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31
Q

Osgood-Schlatters and Larsen-johansson disease management

A

-decrease stressful activities until the epiphyseal union occurs, w/in 6 months. - 1yr
-ice knee before and after activities
-perform isometric strengthening of quads and hamstrings

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32
Q

What is jumpers knee?

A

Chronic inflammation at the superior pole of the patella (quadriceps tendinitis), the tibial tubercle, or most commonly at the distal pole of the patella (patellar tendinitis) due to overuse.
-usually develops in athletes that deal with mechanical overloading, quick acceleration/deceleration movements like jumping and landing
-Chronic inflammation of the tendon that persists for 3-6 weeks is known as patellar tendinosis

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33
Q

Jumpers knee S&S

A

-point tenderness at posterior aspect of the inferior pole of the patella (hallmark sign)
-patient complains of a dull aching pain after jumping/running following repetitive jumping activities
-may be thickening of the tendon but no effusion
-pain disappears with rest but returns w/activity
-also reports of pain w/stairs, squatting and feeling of giving out

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34
Q

Jumpers knee management

A

-decrease overall training volume rather than completely stopping activity to reduce the load on the tendon
-shockwave therapy and platelet rich plasma injections in combo with/eccentric exercise (performing eccentric sqauts w/25 degree decline board is most effective)
-patellar tendon brace/strap

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35
Q

What is Sever’s Disease?

A

Inflammation of the unfused apophysis in children. The most common source of heel pain in athletes aged 5-11.
-forefoot varus and a tight triceps surae are primary predispositions to this condition, repetitive tensile forces on the achilles tendon insertion on the calcaneus cause inflammation

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36
Q

Anisocoria

A

Anisocoria is unequal pupil size. The condition results from pressure on the oculomotor nerve (cranial nerve 3) or may be congenital.

37
Q

Emmetropia

A

20/20 vision,ability to read the letters on the 20-foot line of an eye chart while standing 20 feet away, indicates light rays are focused precisely on the retina

38
Q

Myopia

A

Nearsightedness, occurs when light rays are focused in front of the retina, making only objects very close to the eye distinguishable

39
Q

Hypermetropia (hyperopia)

A

Farsightedness, results when the light rays are focused at a point behind the retina

40
Q

What is decerebrate posturing and what does it indicate?

A

Extended arms and legs, lesion of the brainstem

41
Q

Decorticate posturing and what does it indicate?

A

Flexion of the elbows and wrists, extension of the legs, lesion above the brainstem

42
Q

Flexion contracture and what does it indicate?

A

Arms flexed across the chest, spinal cord lesion at C5-C6

43
Q

Wolffs law

A

A bone remodels itself in response to the forces placed on it, this allows bones to adapt and become stronger. Bone develops an exostosis at the site of stress (can become painful and in some cases forms a mechanical block against movement)

44
Q

Exostosis

A

Growth of extraneous bone

45
Q

Salter-Harris Type 1 Fx

A

Fracture goes through the physis, separating the two segments. Common in infants

46
Q

Salter-Harris Type 2 Fx

A

Fx starts through the physis and ends on the shaft, creating a displaced wedge

47
Q

Salter-Harris Type 3 Fx

A

The fx line extends perpendicularly through the joint surface and then transversely across the physis, resulting in a partial displacement of a segment. Growth of the involved physis may be compromised

48
Q

Salter-Harris Type 4 Fx

A

Similar to a type 3 but the transverse fx line extends across the physis into the shaft. Surgical fixation is often required, and physeal growth may be affected

49
Q

Salter-Harris Type 5 Fx

A

W/this fx, a crushing injury compresses the physis. If undetected, avascular necrosis may occur, and growth may be inhibited.

50
Q

List the dermatomes for the upper quarter screen

A

C4-Superior Shoulder
C5-Lateral Upper arm
C6-Lateral lower arm and 1st digit
C7-Median hand and 3rd digit
C8- 5th digit and medial hand
T1- Mid medial arm
T2: Axillary region

51
Q

Myotome Testing for upper quarter screen

A

C4- Shoulder Elevation
C5-Shoulder Abduction
C6-Elbow flexion/wrist extension
C7-Elbow extension/wrist flexion
C8- Finger Flexion
T1- Finger abduction

52
Q

Deep tendon relfex grading

A
53
Q

Upper quarter screen reflexes and corresponding nerve root

A

C5-Biceps tendon (elbow flexion)
C6-Brachioradialis tendon (elbow flexion)
C7- Triceps tendon (elbow extension)

54
Q

Positive signs and implications for upper quarter screen

A

Positive signs
-decrease/absence in sensation
-decrease/absence in strength
-hypo/hyperreflexia
Implications
-NRI
-Peripheral nerve damage
-CNS trauma
-Disease

55
Q

When do you complete an UQS?

A

When patient complains of numbness, tingling, paresthesia, unexplained muscle weakness, pain of unexplained origin, and cervical and lumbar pathologies

56
Q

Dermatomes for LQS

A

L1-Lateral/anterior aspect of proximal thigh
L2-Lateral/anterior aspect of proximal/mid thigh
L3-Medial/anterior aspect of distal thigh
L4-Medial aspect of 1st metatarsal
L5-Dorsal aspect of 3rd metatarsal
S1-Base of 5th metatarsal
S2: Popliteal space

57
Q

Myotomes for LQS

A

L1/L2- hip flexion
L3- knee extension
L4- ankle dorsiflexion
L5- great toe extension
S1- ankle plantar flexion
-Break test at end ROM for each myotome, hold for 30 seconds

58
Q

Deep tendon reflexes for LQS and corresponding nerve roots

A

-Medial hamstring, Semimembranosus Tendon- L5, S1 (knee flexion
-Lateral hamstring, Biceps Femoris Tendon-S1,S2 (Knee flexion)
-Tibialis Posterior, Tendon behind medial malleolus- L4-L5
-Achilles tendon (plantarflexion)- S1-S2

59
Q

Describe the pivot shift test

A

-Patients leg flexed and abducted to 30 degrees
-grab patients calcaneus to internally rotate the tibia (some authors say add axial compression)
- w/other hand add valgus force with hand placed at the top of the fibula
-move the patients leg from extension to flexion

60
Q

Pivot shift tests for what pathology and whats a positive?

A

-tests for anterior cruciate ligament tear and anterolateral rotary instability
-positives: if the tibia reduces at 30-40 degrees of knee flx (due to IT band tightness), subluxed tibia anteriorly in extension (torn acl), patient feels clunk or giving out feeling

61
Q

Sensitivity and specificity of pivot shift test

A

Sensitivity: 24%
Specificity: 98%

62
Q

Describe the screw home mechanism

A

-occurs at the end of knee extension, between full extension (0 degrees) and 20 degrees of knee flexion.
-Tibia rotates internally during open chain movements (swing phase) and externally during closed chain movements (stance phase)
-external rotation occurs at terminal degrees of knee extension and results in tightening of both cruciate ligaments, which locks the knee. Tibia is maximally stabilized against femur.

63
Q

What does the sensitivity of a test tell you?

A

-it describes the tests ability to detect patients who actually have the disorder (true positive rate)

64
Q

How do you calculate sensitivity?

A

True positives/ true positives+false negatives

65
Q

What does the specificity of a test tell you?

A

Describes the tests ability to detect patients who don’t have the disorder (true negative rate)

66
Q

How do you calculate specificity?

A

True negatives/ (true negatives + false positives)

67
Q

Describe the SnNout and SpPin rule

A

-SnNout: tests w/high sensitivity, a negative finding, rule out the condition.
-SpPin: tests w/high specificity, a positive finding, rule in the condition

68
Q

Whats information does a positive likelihood ratio tell you?

A

Expresses the change in our confidence that a condition is present when the test is positive. The higher the LR+, the more a positive test enhances the probability that the pathology is present.

69
Q

How do you calculate positive likelihood ratio?

A

Sensitivity/ (1 - specificity)

70
Q

What does the negative likelihood ratio tell you?

A

Expresses the probability that the pathology is still present even though the test was negative. Closer to 1 means less significant, lower the LR- is the lower probability the disease exists.

71
Q

How do you calculate negative likelihood ratio?

A

(1-sensitivity)/specificity

72
Q

Knee hyperextension results in what pathology?

A

-anterior cruciate ligament sprain
-posterior cruciate ligament sprain

73
Q

Describe Rennes test

A

-patient stands on involved leg, and holds onto examiners shoulder for support
-palpate lateral femoral epicondyle while patient flexes knee to 30-40 degrees (squats)
-first palpate lat femoral epicondyle, 2nd time add pressure

74
Q

What is a positive for rennes test and what pathology does it indicate?

A

Positive signs: Pain/crepitus over the lateral femoral epicondyle
Pathology: IT band syndrome

75
Q

Function of the IT band when going from 20-30 degrees of flexion to full extension? Position of IT band?

A

-active knee extensor
-ITB lays anterior to the lateral femoral epicondyle

76
Q

Function of IT band when going from 20-30 degrees of flexion to full flexion? Position of IT band?

A

-Active knee flexor
-ITB lies posterior relative to lateral femoral epicondyle

77
Q

Arthrodial joint

A

A synovial joint that only allows for gliding movement

78
Q

Function of the cerebrum(cortex)?

A

-Coordinate all voluntary muscle activities
-Interprets sensory impulses
-controls higher mental functioning: memory, reasoning, intelligence, learning, judgement, and emotions

79
Q

Function of the cerebellum?

A

-controls synergistic movements of skeletal muscle
-coordination of voluntary muscular movements

80
Q

Function of the pons?

A

Controls sleep, respiration, posture, swallowing, and the bladder

81
Q

Function of the medulla oblongata?

A

(Lowest part of the brain stem)
-regulates heart rate, breathing, blood pressure as well as coughing, sneezing, and vomiting

82
Q

What is herpes simplex virus? Difference between type 1 and 2?

A

Strain/virus that is associated with/skin and mucous membrane infections.
-cant tell the difference between type 1 and type 2 lesions, hsv 1 typically found not on the genitalia while hsv 2 is typically found on the genitalia (both can be found anywhere on the skin)

83
Q

How is herpes simplex type 1 and type 2 transmitted?

A

-Type 1 spread through direct contact with/contaminated saliva or other infected secretions
-Type 2 spread primarily by sexual contact
-after initial outbreak it lies dormant in a sensory nerves ganglion. Recurrent attacks can be triggered by sunlight, emotional disturbances, illness, fatigue, infection, or stress. (Sunlight wont affect reactivation rate if SPF 15 is worn).

84
Q

Herpes simplex virus signs and symptoms

A

-early sign is tingling/hypersensitivity in the area 24 hrs before its about to appear
-local swelling followed by appearance of vesicles
-General feeling of illness: sore throat, lymph gland swelling and pain in area of lesions.
-Vesicles may rupture in 1-3 days and spill out a serous material that will form into a yellowish crust. Heal within 10-14 days

85
Q

Herpes labialis and herpes simplex gladiatorum are what type?

A

Type 1, herpes labialis is a cold sore

86
Q

What herpes virus is common among wrestlers and how does it present?

A

-herpes simplex gladiatorum occurs in wrestlers on the side of the face, neck or shoulders.

87
Q

What is herpes zoster?

A

Shingles, it is chicken pox that lies dormant for years
-appears in a specific pattern on the body in an area that is innervated by a specific nerve root
-zoster vaccines licensed in us to prevent shingles in people ages 50-59

88
Q

Management of herpes simplex virus

A

-new active lesions treated with antiviral drugs like valacyclovir, used to shorten course, reduce recurrence of outbreaks, and reduce transmission
-antiviral medications are useless when lesions are crusty
-athletes can return to play after no symptoms like fever/malaise persist, no new blisters for 72 hours, lesions have crusted over, theres been 5 days if systemic antiviral treatment, and lesions are covered