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MSK III > quiz 2 > Flashcards

quiz 2 Flashcards

1
Q

how much motion occurs at hip (degrees)

A

35 degrees flexion at heel strike
10-15 degrees Flexion at pre swing
AB/Add 10 degrees

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2
Q

greatest force of wb occurs during what activity (hip)

A

running

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3
Q

order of best exercises for glut med

A

LOW: good mornings, cable walk outs
Mod: bilateral bridge, clam
High: quadruped with a lift, wall squats
Very high: lateral band walk, or SL hib abd

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4
Q

what are the generals of femoral ant glide syndrome

A

limited post glide
Insufficient posterior glide during flexion
Stiff hip extensors, posterior hip capsule
Excessive flexibility of anterior capsule

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5
Q

what is dominant with femoral ant glide

A

TFL

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6
Q

what pathologies go with femoral ant glide

A

FAI
labrum tear
hip flexor issues (strain/pain)

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7
Q

what exercise is good for femoral ant glide issue

A

PASSIVE knee flexion (supine)

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8
Q

what muscles do you need to strengthen for someone with femoral ant glide

A

gluts

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9
Q

list some general info about femoral lateral glide syndrome

A

Dancers
femoral head is lateral
has hypermobility
They stand adducted (bc their abductors and ER are weak)

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10
Q

anatomic dx’s related to femoral lateral glide syndrome

A

Trochanteric bursitis
Snapping hip syndrome
Piriformis strain

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11
Q

for femoral lateral glide, do you do mobs

A

no - they are hypermobile

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12
Q

what mm to strengthen for femoral lateral glide

A

abd
ER
gluts

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13
Q

what really simple task can you teach a pt with femoral lateral glide syndrome for tx

A

sleep with pillow btwn knees to abd (since they are often stuck adducted) (femoral head is lateral but leg is adducted)

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14
Q

hip OA is aka

A

femoral hypomobility syndrome

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15
Q

what is the cascade of pathos for hip

A

FAI = labral tear = OA

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16
Q

cane goes with what leg

A

opp of impaired

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17
Q

good txs for OA

A

MT and EX

water aerobics/therapy
distraction (inf and lateral)
strengthen gluts

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18
Q

what 2 things cause hams strain

A

eccentric control

sprint take off

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19
Q

location of acute vs chronic hams strain

A

acute - in belly (bruises)

chronic - at mm tendon junction (px deep at isc. tub)

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20
Q

recovery time strain

A

6-8 wks

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21
Q

chronic hams strain occur where

A

proximally

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22
Q

slump stretching exercises are really good for

A

proximal (chronic) hams strain

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23
Q

PFPS - list some general ideas

A

Excessive pull laterally = patella pulls laterally
IR of femur – causes patella to track laterally
Pronation of foot (at subtalar jt) creates IR of tibia which creates IR of femur
Art cart underneath the patella wears down
Contributing factors: tight ITB

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24
Q

with PFPS the femur is often rotated

A

internally

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25
Q

what imbalance do you need to investigate for PFPS

A

quad vs gluts (which is dominant)

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26
Q

who are more apt to have quad dominance with PFPS

A

athletic males

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27
Q

If you notice a person medially drifting (at the knee) when they do a SL squat, how do you tx

A

work on abd and ER

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28
Q

what must you incorporate into tx for PFPS (strengthen what)

A

abd and ER

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29
Q

what can you do to “influence” the distal extremity of the knee for a person with PFPS

A

talocrural
do post joint mobs to increase dorsiflexion
remember, if one joint is hypomobile (ex at the ankle) the joint above or below is prob hypermobile

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30
Q

what tissue is the px generator with PFPS

A

cart

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31
Q

always look ___ and ___ the knee with any knee issue

A

above and below

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32
Q

tendonitis is aka

A

jumpers knee

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33
Q

itis vs osis

A

itis - acute, warm, inflammed

osis -collagen issue

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34
Q

patellar tendon issue, where you watch them squat and you think quads are too weak, what is a good exercise

A

put them on a wedge with small side towards toes and squat

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35
Q

purpose of tendons

A

store and release energy = power

plyo helps with this

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36
Q

3 insertions of ITB

A

Patella
Gerdy’s tubercle
Fibular head

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37
Q

the ITB decelerates ____ of tibia

A

IR

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38
Q

criteria of dx for knee OA

A 
•	Knee pain plus 3 of the following:
o	Age > 50 years
o	AM stiffness less than 30 min
o        Tenderness with no warmth
o         crepitus
o      osteophytes on imaging
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39
Q

generals of strength vs power vs endurance

A

strength and power are typically higher load lower rep

endurance is opp (low load high rep)

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40
Q

there is an impingement zone with the ITB at 20-30 degrees of flexion as the ITB rubs the lateral femoral condyle, what test mimics this

A

noble compression

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41
Q

ant vs post portion of ITB

A 
ant = TFL
post = glut max
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42
Q

what (that is under the IT band) can often get irritated and inflamed and need injections

A

fat pad

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43
Q

4 biomechanical factors that can cause ITB syndrome

A

Prominent LFC (lateral condyle)
Weak hip abductors
ITB tightness
Genu varum

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44
Q

what 2 surgeries are common for serious ITB issues

A

shaving the lateral femoral condyle

clipping the band itself

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45
Q

what strengthening is essential for knee OA

A

quad

46
Q

would you use open or closed ex for knee oa

A

both

open isolates quad better though

47
Q

what part of knee is often most affected with OA (lateral or medial)

A

medial

48
Q

general ideas for OA activities (knee)

A

closed chain or water good
some open chain for experienced
no jumpy/plyo activities

49
Q

order of muscle firing with glut med test

A

glut med first
TFL
QL later (after full abd of 45)

50
Q

for testing of glut max, how to differentiate what might be weak/strong

A
  1. If the patient is unable to tolerate maximal resistance anywhere = glut max is weak.
  2. If the patient tests weak in the standard position, but tests strong when the hip is allowed to move forward 10º-15º, the gluteus maximus is long.
  3. If the hip rolls into medial rotation and/or flexion upon resistance, the TFL is dominant.
  4. if pelvis hikes QL is dominate
51
Q

proper firing pattern of hip ext should be

A

(1) gluteus maximus
(2) hamstrings,
(3) contralateral paraspinals,
(4) ipsilateral paraspinals.

max, ham, contra, ipsi

52
Q

prone quadriceps length test

A

prone foot to buttock

if pelvic motion is detected there is an imbalance
if you can lock down pelvis and take foot all way to buttock then abs are weak

if you lock down pelvis and cannot take foot to buttock quads are tight

53
Q

TA and multifidus are ___ stabalizers

A

local

54
Q

RA, the obliques, thoracis’s and QL are ___ stabalizers

A

global

TORQ

55
Q

T or F, even if the forces generated by global muscles were adequate, the spine was unstable if local muscles were not sufficient.

A

T

56
Q

these stabalizers stabalize the spinal SEGMENT

A

local

57
Q

these stabalizers have to do with the entire vertebrae and trunk movement

A

global

58
Q

The main function of the global muscles is to balance ______to the trunk so that the local muscles can handle the residual forces transferred to the spine (primarily lumbar).

A

external loads

59
Q

if iliacus is tight, it can do what to pelvis

A

Iliacus
Although this muscle is a hip flexor, by reverse pull it can create anterior pelvic tilt if tight.

It is often tight, as with an ilial inflare.

60
Q

psoas major can cause ___ tilt

A

anterior

61
Q

TFL can cause ___ tilt

A

ant (in full knee ext)

62
Q

primary goal of dry needling

A

• The Primary goal of Dry Needling is to desensitize supersensitive structures and restore motion and function.

63
Q

goal of dry needling is to ilicit a

A

local twitch response

64
Q

active vs latent trigger point (dry needling)

A

active -feels like “my pain”

latent-not familiar to the pt

65
Q

ART is for ___ tissue

A

soft

66
Q

ART tension is applied in what direction

A

Tension is usually applied longitudinal to the mm and with venous flow.

67
Q

principles of ART

A

soft tissue is taken in position from short to long

68
Q

ART formula

A

Insult to tissue = Number of reps x Force of rep/ Amplitude x Relaxation time between reps

NF/ARt
meaning, large reps large force without relaxation = injury

69
Q

professions that can do ART

A 
ATCs
OTs
PT
MD
Massage
70
Q

trigger pts produce ___ px

A

referred

71
Q

Anchor the tape to the coracoid process and pull posteriorly, caudally, and medially (pull away from pec minor)

This is what scapular tape job

A

post tilt

72
Q

similiar to post tilt tape but start at clavicle, and extended posteriorly, caudally, and medially (perpendicular to the course of the upper trapezius) to the area just distal to the spine of the scapula.

A

inhibit upper trap

73
Q

put arm in scaption
anchor the tape slightly medial to the spine of scapula. Passively elevate the shoulder into full “flexion” (scaption) to fully upwardly rotate the scapula. Pull the tape medially and caudally toward the lower thoracic spine. Remember the lower trapezius attaches at T12

A

taping for UR

74
Q

if you ever tape scap for elevation it must be done

A

B

75
Q

Apply the tape to the lateral edge of the acromion process and passively elevate the scapula, making sure the acromial end rotates upward. Pull the tape medially toward the cervical spine in the suprascapular space, following the direction of the upper trapezius. Apply a piece without forceful elevation to the opposite side. Tape to – but not over – the spinous processes.

A

scap elevation

76
Q

Begin at the spinous process of the upper segment and pull the tape in the opposite direction you want the vertebral body to rotate. Anchor the next strip at the lower segment and pull it in the opposite direction of the first strip.

(This might be a technique you use after performing manual joint mobilization. The tape is useful in maintaining the corrected position.)

A

tape for rotated segment

77
Q

what pathologies go with lat femoral glide syndrome

A

bursitis
snappy hip
piriformis syndrome

78
Q

with femoral lateral glide syndrome, is it more capsular or ligg issue

A

capsular

79
Q

different outcomes for thomas test

A

bent knee is iliopsoas tight,
straight knee is RF
if they IR = tight TFL
if they ext rotate then tight sartourious

80
Q

what is difference in 30 vs 5 degrees when do MCL/LCL valgus/varus test

A

5 degrees and pos it tells you other structures are involved = more serious
if pos only at 30 it’s just the MCL or LCL

81
Q

Mcmurrays tests for

A

meniscus
IR -tests ext fibers
ER -tests internal fibers

82
Q

Thessaly’s tests for what

A

meniscus (twist)

83
Q

aply’s is for

A

meniscus

prone as you grind

84
Q

hx of clicking, locking, joint line px is prob

A

meniscus

85
Q

explain Clarke’s test

A

clark is uncomfortable

they do quad set as you push on sup aspect of patella

86
Q

explain noble compression

A

find lat fem condyle and push as they ext knee

87
Q

kleigers is for the ___ lig

A

deltoid

push laterally

88
Q

talar tilt tests

A

CF and ATF

89
Q

ant drawer (ankle) tests

A

ATF

90
Q

what should you do before doing taping of knee

A

do a medial mob of the patella first. You should be able to expose the lateral femoral condyle: if you can’t, it suggests that the lateral retinacular structures are too tight. so Mobilize the retinaculum first before considering taping.

91
Q

when forward bending, men typically do what and women do what

A

men bend at lumbar and women bend with hips

92
Q

good exercise for QL

A

side plank

93
Q

most support to the spine is the ___ sx

A

the ligamentous structures (PASSIVE) provide the most support to the spine at the end ranges of motion where they check excessive mobility

94
Q

ligg are ___ sx

A

passive

95
Q

the active sx is the

A

myo/fascia

96
Q

what is the control sx

A

feedback (proprioception)

97
Q

taping of the scap into UR looks

A

backwards from what you would think

98
Q

diff btwn scap taping for taping into post tilt vs taping to inhibit upper traps

A

post tilt - it goes ant to post and stops at the spine of scap
inhibit upper traps goes past the spine of scap and distal some.

99
Q

bakers cyst is where

A

popliteal fossa

100
Q

doing stairs and feeling like their knee will buckle or give out is a sign of

A

meniscus

101
Q

this hip pathology is Commonly felt in the anterior superior region of the hip; c/o of anterior hip pain;

A

FAI

102
Q 
Medial wrist pain distal to the ulna
Think what (pronation and supination hurt)
A

TFCC

disc btwn carpals and ulna

103
Q

structures in the carpal tunnel

A

4 FDP tendons, 4 FDS tendons, Median N, FPL tendon.

104
Q

if short, the psoas major causes

A

inc lumbar lordosis, ant translation/ant issues of the hip

105
Q

often times if the hip medially rotates what is tight

A

TFL

106
Q

if QL is tight what might occur

A

hip hike

107
Q

what posture accompanies tight hip flexors

A

ant pelvic tilt

108
Q

what posture accompanies tight hams

A

post pelvic tilt

and will have stretched hip flexors

109
Q

what posture accompanies genu recurvatum

A

post pelvic tilt

110
Q

explain RF, VL, VM functions other than knee extension

A

The rectus femoris also flexes the hip. The vastus lateralis pulls the patella more laterally; the vastus medialis pulls the patella more medially

111
Q

why would weak abductors contribute to ITBS

A

if other abductors are weak ITB will try to take over but it’s not meant to be the primary abductor

MSK III (8 decks)

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