PTFE MSK Flashcards
1
Q
goniometry steps
A
- determine joints
- organize by body position
- educate pt
- stabilize proximal segment
- move joint through ROM and determine end feel
- make clinical estimate
- align goniometer, record starting position
- record end position
2
Q
empty end feels are d/t
A
pain
3
Q
boggy end feels are d/t
A
hemoarthrosis - blood in joint
4
Q
passive insufficiency
A
- inability of 2 joint muscle to passively extend across full ROM of both joints
- stretch - hamstrings w/ hip flexed and knee extended
5
Q
active insufficiency
A
- inability of 2 joint muscle to actively contract across full ROM of both joints
- can’t flex wrist AND flex fingers
6
Q
open-packed positions - arm
A
- GH: abd 55-70, abd 30, neutral rotation
- humeroulnar: 70 flexion, 10 supination
- humeroradial: full ext and supination
- prox radioulnar: 70 flexion, 35 supination
- distal radioulnar: 10 degrees supination
- radiocarpal: neutral
7
Q
vertebral open pack
A
midway between flexion and extension
8
Q
LE open-pack positions
A
- hip: 30 flexion, 30 abd, sligh ER
- knee: 25 flexion
- ankle: 10 PF
9
Q
hip closed pack
A
- ligamentous: full ext, abd, IR
- bony: 90 flex, slight abd, ER
10
Q
phases of healing
A
- hemostasis: day 1-3
- inflammation: day 3-20 - new BV growth
- proliferation/granulation: week 1-6 - scar tissue formation
- remodeling/maturation: week 6-2 years
11
Q
6/6/6 rule
A
- first 6 weeks: max protection - limit ROM, activation, & stretching
- second 6 weeks: mod protection - control loading
- 6 month: return to sport, ACL, RTC for hi-load and hi-velocity
12
Q
pancoast tumor
A
- tumor in apical segment
- like TOS but w/ lung symptoms
13
Q
osteosarcoma
A
- cancer in end of bone, metaphysis, M > F
- painful bump, sunburst X-ray
14
Q
ewing’s sarcoma
A
- in shaft, diaphysis
- painful lumps, sunburst patterns on x-ray
15
Q
convex on concave rules
A
- opposite direction
- shoulder, ankle, hip
- improve IR - post mob, ER - ant mob, flexion - post/inf, abd - inf
16
Q
concave on convex
A
- same direction
- fingers
17
Q
shoulder upward rotators
A
- SA: serratus anterior
- LT: lower trap
- UT: upper trap
18
Q
shoulder downward rotators
A
- Love: levator
- Rha: rhomboids
- Min: pec minor
19
Q
scapular dyskinesia
A
- needs coordination
- pt ABD alone, then w/ PT
- (+) is pt feel better
20
Q
TOS testing
A
- Adson: head toward PT
- ROOS: 3 minutes
- Allen: head away from PT
- Halstead: reverse adson
21
Q
shoulder impingement and testing
A
- primary: bony
- secondary: RTC
- Hawkin’s kennedy: arm 90, PT moves into IR
- Neer: arm near ear
- painful arc: abd 60-120
22
Q
RTC tear tests
A
- drop arm: supraspinatus
- lag: ER - supra or infra, IR - subscap
- empty can: supraspinatus
- hornblower/Patte: teres minor
23
Q
SLAP tests
A
- o’briens: “oh that’s better”
- speeds: speedily bring arm forward
- biceps load/kim: pt supine, activates bicep
- yergasons: turn palm over - strong supination, “why am i doing this”
- clunk test: pt supine
24
Q
bankart lesion
A
- inferior labrum
25
Q
apprehension test
A
- posterior or anterior
26
Q
adhesive capsulitis
A
- lose ER -> ABD -> IR - AROM and PROM
- F > M
- after immobilization, hypothyroidism
- protection - freezing, pendulum
- controlled - subacute, progress ROM, function, self-mob
- return to function - stretch and strengthen as tolerated
27
Q
midshaft humerus fracture results in damage to
A
radial nerve
28
Q
distal humerus fracture (supracondylar) results in damage to
A
- lateral side: radial nerve
- medial side: median nerve
29
Q
lateral epicondylitis
A
- tennis elbow
- wrist extensors
- cozen’s test: resisted extension and radial deviation
- treatment: night immobilization, counter force brace, cross-friction, eccentric
30
Q
medial epicondylitis
A
- golfer’s elbow
- wrist flexors
- test w/ passive supination, elbow extension, wrist extension
- treatment: night immob, counterforce brace, cross-friction, eccentric
31
Q
de quervain’s tenosynovitis
A
- abductor pollicis longus and extensor pollicis brevis
- overuse w/ gripping and lifting
- finklestein’s: passive thumb flexion w/ ulnar deviation
- eichoff’s: thumb in clenched fist, active/passive ulnar dev
32
Q
bunnell-littler test
A
- test tightness of MCP intrinsics - MCP tight capsule vs tight intrinsics
- PT move finger to MCP ext to stretch lumbrical and flex PIP to further to further stretch
- then MCP flexion for slack
- if tight in both -> capsular
- if different -> muscle tightness
normally, lumbricals flex MCP and extend PIP
33
Q
elbow moves
A
- concave on convex
- distraction improves flexion and extension
- distal/hook improves flexion
34
Q
radioulnar joint
A
- PPP - at Proximal joint, to improve Pronation, do a Posterior/dorsal glide
- at distal, to improve pronation, do an anterior glide (opposite of proximal)
35
Q
radiocarpal joint
A
- convex on concave
- improve ext - volar/ant glide
- improve flex - dorsal/post glide
36
Q
fingers and toes move
A
- concave on convex
- improve extension - volar/ant glide
- improve flexion - dorsal/post glide
37
Q
thumb movement
A
- out/in is flexion/extension - concave on convex
- forward is abd/add - convex on concave
bc thumb is a saddle joint
38
Q
nutation
A
- anterior sacral tilt w/ posterior pelvic tilt
- apex at bottom of sacrum posterior and superior
39
Q
counter nutation
A
- post sacral tilt w/ anterior pelvic tilt
- apex anterior and inferior
40
Q
achilles tendonitis
A
- burning/aching in heel
- TTP
- pain w/ activity
- swelling
- thickening
- morning stiffness
- weakness d/t pain
41
Q
plantar fasciitis
A
- TTP at insertion
- heel spur
- pain worse in AM or after prolonged inactivity
- difficulty w/ prolonged standing
- pain w/ walking barefoot
42
Q
patellofemoral syndrome chondomalacia patella
A
- ant knee pain
- pain w/ prolonged sitting
- swelling
- crepitus
- pain w/ stairs
43
Q
osgood schlatter
A
- tenderness over patellar tendon and tibial tuberosity
- antalgic gait
- pain w/ increased activity
44
Q
leg-calve perthes vs slipped capital femoral epiphysis
A
- LCP
- 4-8 YO
- short child
- femoral head deformity
- conservative treatment
- achy dull pain - like OA
- SCFE
- 10-15 YO
- overweight
- displacement of femoral neck
- operative treatment
- groin pain
45
Q
dupuytrens
A
- abnormal thickening of tissues in palm of hand
46
Q
swan neck
A
- caused by damage to extensor mechanism of digit
47
Q
mallet finger
A
stretching or tearing of extensors mechanism
48
Q
boutonnieres deformity
A
- extensor tendon injury
49
Q
LE amputation levels
A
- chopart - below calcaenus
- syme’s - through ankle
50
Q
K levels
A
- K1: prosthesis for transfers
- K2: walk short distances
- K3: variable cadence
- K4: high level activities
51
Q
pressure w/ prosthetics
A
- bony areas are sensitive
- fleshier areas are more tolerant
52
Q
transfemoral sockets
A
- ischial containment
- subiscial containment - suction
53
Q
transfemoral suspension
A
- suction
- lanyard
54
Q
transtibial sockets
A
- patella tendon bearing (PTB)
- supracondylar patella tendon (PTS)
- supcondylar suprapatellar socket (SC-SP)
55
Q
transtibial suspension
A
- sleeve
- pin
- suction
56
Q
types of prosthetic knees
A
- locked knee: no movement
- mechanical: can lock or unlock, swings through w/ gait
- piston: can control speed of swing, can lower slower (for downhill)
- micro-processor: piston w/ computer
57
Q
A
58
Q
prosthetic feet
A
- solid ankle cushion heel (SACH): starter
- stationary attachment flexible endoskeleton (SAFE)
- single axis: PF and DF
- multi axis: all axes of movement
59
Q
lateral bending with prosthetic
A
- prosthetic causes: too short, bad fit, high medial wall, prosthesis aligned in ABD
60
Q
excess knee flexion in stance with prosthetic
A
- prosthetic socket forward in relation to foot
- foot in excess DF
- stiff heel
- prosthetic too long
- pt causes: flexion contractures, decr quad strength
61
Q
circumduction with prosthetic
A
- prosthetic too long, too much knee friction, socket too small, excess PF of foot
62
Q
vaulting with prosthetic
A
- prosthetic too long
- bad socket suspension
- excessive alignment stability
- foot in excess PF
63
Q
forefoot rotation at heel strike with prosthetic
A
- excessive toe out/in build
- loose socket
- inadequate suspension
- rigid SACH
64
Q
lateral/medial whip with prosthetic
A
- if it’s above knee, it’s a prosthetic issue: excess knee rotation, valgus in knee, improper alignment of toe
- if it’s below knee, it’s a patient issue: weak, improper training, knee instability
65
Q
ely’s test
A
- for hip flexion contracture
- pt prone
66
Q
ober’s test
A
- test for IT band tightness
- pt sidelying w/ hip extended
- modified - knee extended for rec fem slack
67
Q
thomas test
A
- hip flexor tightness
- pt supine, single KTC
68
Q
FABER also called
A
patrick’s test
69
Q
craig’s test
A
- femoral anteversion test
- pt prone
- normal is 8-15 degrees
- retrOversion: < 8, toe-Out
- inversion: > 15, toe- In
70
Q
barlow’s test
A
- “bad guy”
- dislocating - developmental dysplasia of hip w/ shallow, underdeveloped acetabulum
- hip begins reduced, PT dislocated
71
Q
ortolani’s sign
A
- “gOOd guy”
- (+) is clunk as hip relocates onto acetabulum
- hold knees and abduct hip while lifting on greater trochanter
72
Q
slipped capital femoral epiphysis
A
- “teenagers love skippy PB”
- usually at puberty
- groin, medial thigh pain, dull, aching, decreased ROM (esp IR)
73
Q
legg-calve-perthes disease
A
- “limping child problem”
- in young children who are small for their age
- avascular necrosis of femoral head
- goals: matinain femur in acetabulum, WBAT
74
Q
iliopsoas bursitis
A
- pain/snapping in medial groin, thigh
75
Q
with open chain movement at knee, follow _ rule
A
- concave
76
Q
knee ROM requirements
A
77
Q
popliteus
A
- function: IR and flexion
- unlocks knee
- OKC - internal rotation of tibia, for initiation of flexus
- CKC - external rotation of femur
77
Q
apex of patella
A
- at bottom
78
Q
slocum’s test
A
- for ACL
- pt supine, knee flexed to 90
- medial 30 IR, 15 ER
- excessive tibial movement in relation to sound knee
79
Q
ottowa & pittsburgh knee rules
A
- for after trauma
- inability to walk 2 WB steps on affected leg at time of injury and in ED
- inability to flex knee to 90
- tenderness over fibular head
- isolated patellar tenderness
- age > 55 (<12 or >50)
80
Q
for talocrural joint, follow _ rule
A
convex
81
Q
talipes equinovarus
clubfoot
A
- congenital
- PF, supination, adduction, inversion, cavus, varus
- flexible: can be treated with bracing and stretching
- rigid: requires surgical intervention
82
Q
metatarsus adductus (hooked forefoot)
A
- most common foot deviation in children
- adducted and supinated
- hindfoot spared
- 90% causes resolve spontaneously
83
Q
subtalar joint mobilization
posterior compartment
A
- convex calcaneus, concave talus
- LIME
- medial glide - increase eversion
- lateral glide - increase inversion
84
Q
intertarsal and tarsometatarsal joints
A
- proximal segment (fixed segment) - convex
- distal segment (mobile segment) - concave
85
Q
kleiger test
A
- ankle ER of talus in mortise
- for syndesmosis/high ankle sprain
86
Q
ottowa ankle rules
A
- fibular tenderness
- tibial tenderness
- navicular tenderness
- 5th metatarsal tenderness
- inability to WB immediately after and in ED
87
Q
cervical ROM
A
- 80-90 flexion
- 70 extension
- 45 sidebending
- 90 rotation
88
Q
vertebral artery test
A
- turn L to test R
- dizziness
- diplopia
- dysarthria
- dysphagia
- drop attacks
- numbness
- nystagmus
- nausea
- ataxia
89
Q
lhermitte’s sign
A
- MS, cervical myelopathy, trauma
- pt seated w/ full neck flexion in long sitting
- electric shock-like sensation radiating down spine
90
Q
alar ligament test
A
- seated, examiner side bends head
- alar ligament should move immediately
- laxity if C2 does not move w/ rotation or SB
91
Q
sharp purser
A
- for transverse ligament test
- not down syndrome, ehlers danlos, pregnancy, marfan, RA
92
Q
spondylosis
A
- agre related changes to vertebral discs
- DDD
- arthritic changes
93
Q
spondylolysis
A
- bony defect/fx in pars interarticularis (scotty dog fx)
94
Q
spondylolisthesis
A
- anterior slippage of vertebral segment d/t pars defect
- usually in L5-S1
95
Q
ankylosing spondylitis
A
- chronic rheumatoid disorders, autoimmune
- bamboo spine
- M > F, 15-30 YO
96
Q
degenerative disc disease
A
- loss of intervertebral disk height and substance
- prefer flexion
- L4-L5, L5-S1
97
Q
herniated nucleus pulposus
A
- prefer extension
- SC s/s: weak ankle DF, impaired ankle reflexes, positive crossed SLR test
98
Q
radiculopathy
A
- nerve root impingement
- cervical, thoracic, or lumbar
99
Q
supine to long sit test for rotated innominate
A
- ALS: anteriorly rotated innominate - longer in supine, shorter in sitting
- PSL: posteriorly rotated innominate - shorter in supine, longer in sitting
100
Q
SLR nerve biases
A
- basic: sciatic and tibial nerves
- TED: tibial nerve - eversion, DF
- SID: sural - inversion, DF
- PIP: peroneal - inversion, PF
101
Q
upglide is like _ and _ facets; downglide is like _ and _ facets
A
- upglide - like flexion, opens facets
- downglide - like etension, closes facets
102
Q
sidebending and rotation coupled motion in spine
A
- C1/C2 - opposite
- cervical and thoracic - same
- lumbar - opposite
103
Q
pool water temperature should be
A
76-95 degrees F
104
Q
precautions for pool therapy
A
- fear of water
- ataxia
- seizures
- cardiac dysfunction
- small wounds (covered)
105
Q
contraindications for pool therapy
A
- cardiac failure/unstable angina
- vital capacity < 1 L (restrictive diseases)
- severe peripheral disease
- bleeding/hemorrhages
- severe kidney disease
- open wounds
- uncontrolled b/b
- infectious disease
- uncontrolled seizures
106
Q
WB changes in pool therapy
A
- C7: 10% WB
- xiphoid process: 33% WB
- ASIS: 50% WB
