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COMLEX Level 2 > Savarese > Flashcards

Savarese Flashcards

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1
Q

What does TART stand for?

A

T-Tissue texture changesA-AsymmetryR-RestrictionT-Tenderness

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2
Q

What is the Physiologic Barrier?

A

Point at which a PATIENT can ACTIVELY move any given joint

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3
Q

What is the Anatomic barrier?

A

Point at which a PHYSICIAN can PASSIVELY move any given joint

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4
Q

Findings of ACUTE Tissue texture changes.

A

-Edematous-Erythematous-Boggy w/ increase moisture-Hypertonic muscles

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5
Q

Findings of CHRONIC Tissue texture changes.

A

-Cool dry skin w/ slight tension-Decreased muscle tone (flaccid)-Ropy-Fibrotic-NO edema (or decreased)-NO erythema

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6
Q

What are the findings of Asymmetry in Acute & Chronic conditions?

A

Acute - PresentChronic - Present w/ COMPENSATION in other areas of body

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7
Q

Restriction findings in ACUTE condition.

A

Painful w/ movement

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8
Q

Restriction findings in CHRONIC condition.

A

Decreased or NO Pain

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9
Q

Tenderness findings in ACUTE condition.

A

Severe, Sharp

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10
Q

Tenderness findings in CHRONIC condition.

A

Dull, Achy, Burning

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11
Q

Orientation of Superior facets: -Cervical

A

“BUM”BackwardUpwardMedial

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12
Q

Orientation of Superior facets: -Thoracic

A

“BUL”BackwardUpwardLateral

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13
Q

Orientation of Superior facets: -Lumbar

A

“BM”BackwardMedial

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14
Q

Flexion/Extension: -Axis: -Plane:

A

Flexion/Extension: -Axis: Transverse -Plane: Saggital

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15
Q

Rotation: -Axis: -Plane:

A

Rotation: -Axis: Vertical -Plane: Transverse

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16
Q

Sidebending: -Axis: -Plane:

A

Sidebending: -Axis: Anterior-Posterior -Plane: Coronal

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17
Q

Describe DIRECT treatment.

A

Towards barrier

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18
Q

Describe INDIRECT treatment.

A

Away from barrier

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19
Q

Describe ACTIVE treatment.

A

Patient assists during treatment

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20
Q

Describe PASSIVE treatment.

A

Patient RELAXES during treatment

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21
Q

OA: -Main motion -Sidebending & Rotation

A

OA: -Main motion: Flexion/Extension -Sidebending & Rotation: Opposite

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22
Q

AA (C1): -Main motion -Sidebending & Rotation

A

AA: -Main motion: Rotation -Sidebending & Rotation: Opposite

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23
Q

C2-C4: -Main motion -Sidebending & Rotation

A

C2-C4: -Main motion: Rotation -Sidebending & Rotation: Same

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24
Q

C5-C7: -Main motion -Sidebending & Rotation

A

C5-C7: -Main motion: Sidebending -Sidebending & Rotation: Same

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25
Q

What is the main motion of the Thoracic spine?

A

Rotation

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26
Q

True Ribs.

A

-Ribs 1-7-Attach to the sternum through costal cartilages

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27
Q

False Ribs.

A

-Ribs 8-12-Do NOT attach directly to the sternum

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28
Q

Floating Ribs.

A

-Ribs 11-12-Unattached anteriorly

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29
Q

Describe the attachment of Ribs 8-10.

A

-Each are connected by its costal cartilage to the cartilage of the rib superior*Example: The costal cartilage of Rib 9 attaches to the costal cartilage of rib 8

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30
Q

What are the 3 types of rib movements?

A

-Pump-handle-Bucket-handle-Caliper

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31
Q

Pump-Handle motion.

A

Ribs 1-5

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32
Q

Bucket-handle.

A

Ribs 6-10

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33
Q

Caliper motion.

A

Ribs 11-12

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34
Q

Describe Inhalation dysfunction.

A

Dysfunctional rib will move Cephalad during Inhalation, but will NOT move Caudad during Exhalation -Rib will appear to be “Held Up”

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35
Q

Describe Exhalation dysfunction.

A

Dysfunction rib will move Caudad during Exhalation, but will NOT move Cephalad during Inspiration -Rib will appear to be “Held Down”

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36
Q

Grouped Rib INHALATION dysfunction KEY RIB?

A

Lowest Rib of dysfunction

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37
Q

Grouped Rib EXHALATION dysfunction KEY RIB?

A

Uppermost Rib of dysfunction

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38
Q

Spina bifida occurs when there is a defect in what?

A

Closure of the Lamina of the vertebral segment

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39
Q

Where does Spina Bifida usually occur?

A

Lumbar spine

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40
Q

Spina Bifida Occulta.

A

-No herniation through defect-Course patch of hair over site-Rarely associated with neurological deficits

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41
Q

Spina Bifida Meningocele.

A

-Herniation of the Meninges through the defect

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42
Q

Spina Bifida Meningomyelocele.

A

-Herniation of the Meninges & Nerve roots through defect-Associated with neurological deficits

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43
Q

What is the main motion of the lumbar spine?

A

Flexion/Extension

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44
Q

A flexion contracture of the Iliopsoas m. is often associated with what type of dysfunction?

A

Nonneutral dysfunction at L1 or L2

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45
Q

Describe Spondylolisthesis.

A

-ANTERIOR displacement of one vertebrae in relation to the one below-Often occurs at L4 or L5-Usually from fatigue fractures of the Pars Interarticularis*Grading: -1 = 0-25% -2 = 25-50% -3 = 50-75% -4 = 75-100%

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46
Q

Describe Spondyloysis.

A

-Defect of the Pars Interarticularis withOUT anterior displacement of the vertebral body-Scotty Dog fracture on OBLIQUE X-ray

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47
Q

Describe Spondylosis.

A

-Radiographical term for degenerative changes within the INTERVERTEBRAL DISC and ANKYLOSING of adjacent vertebral bodies-Anterior Lipping of vertebral bodies

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48
Q

X-ray Diagnosis: -Spondylolisthesis -Spondylolysis

A

X-ray Diagnosis: -Spondylolisthesis: LATERAL view -Spondylolysis: OBLIQUE view

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49
Q

What ligament divides the Greater and Lesser Sciatic Foramen?

A

Sacrospinous L.

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50
Q

Sacral Motion Axis: Respiration

A

-Superior Transverse axis at S2

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51
Q

Sacral Motion Axis: Inherent (Craniosacral) motion

A

-Superior Transverse axis

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52
Q

Sacral Motion Axis: Postural motion

A

-Middle Transverse axis

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53
Q

Sacral Motion Axis: Dynamic motion

A

Engages 2 Sacral OBLIQUE Axes: -Left Oblique axis - weight bearing on Left leg (stepping forward with right leg) -Right Oblique axis - weight bearing on Right leg (stepping forward with left leg)

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54
Q

During Inhalation, what is the motion of the Sacral Base?

A

Inhalation - Sacral Base moves POSTERIOR

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55
Q

During Exhalation, what is the motion of the Sacral Base?

A

Exhalation - Sacral Base moves ANTERIOR

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56
Q

During Craniosacral Flexion, what is the motion of the Sacral Base?

A

Sacral Base rotates Posteriorly (COUNTERNUTATION)

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57
Q

During Craniosacral Extension, what is the motion of the Sacral Base?

A

Sacral Base rotates Anteriorly (NUTATION)

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58
Q

As person begins to bend Forward, what is the motion of the sacral base?

A

Moves Anteriorly

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59
Q

What happens to the Sacral Base as a person reaches Terminal Flexion?

A

Sacrotuberous ligaments become taut and the Sacral Base moves POSTERIORLY

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60
Q

Sacral Torsion definition.

A

Sacral rotation about an OBLIQUE axis with Somatic Dysfunction at L5

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61
Q

What are the Sacral Torsion Rules?

A

1-When L5 is Sidebent, a Sacral Oblique axis is engaged on the Same Side as the Sidebending#2-When L5 is Rotated, the sacrum Rotates the Opposite way on the Oblique axis3#-The seated flexion test is found on the Opposite side of the Oblique Axis

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62
Q

Sacral Torsion Example: L5 F RrSr -Seated Flexion: -Sacrum findings:

A

Sacral Torsion Example: L5 FRrSr -Seated Flexion: Positive on LEFT -Sacrum findings: Rotated to the Left on a Right Oblique axis (L on R)

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63
Q

Sacral Torsion Example: L5 N SlRr -Seated Flexion: -Sacrum findings:

A

Sacral Torsion Example: L5 N SlRr -Seated Flexion: Positive on RIGHT -Sacrum findings: Rotated to the Left on a Left oblique axis (L on L)

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64
Q

In sacral torsions, L5 will ALWAYS rotate in the (same or opposite) direction of the sacrum.

A

Opposite

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65
Q

Due to birth mechanics, what is the most common Sacral dysfunction in the post-partum patient?

A

Bilateral Sacral Flexion

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66
Q

What are the Rotator Cuff muscles?

A

SupraspinatusInfraspinatusTeres minorSubscapularis

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67
Q

What is the primary action of Supraspinatus m.?

A

Abduction of arm

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68
Q

What is the primary action of Infraspinatus m.?

A

External rotation of arm

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69
Q

What is the primary action of Teres minor m.?

A

External rotation of arm

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70
Q

What is the primary action of Subscapularis m.?

A

Internal rotation of arm

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71
Q

What is the most common type of Brachial Plexus injury?

A

Erb-Duchenne’s palsy -injury to C5&C6 nerve roots

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72
Q

Erb-Duchenne’s plasy can result in paralysis of what muscles?

A

-Deltoid-External rotators-Biceps-Brachioradialis-Supinator

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73
Q

INCREASED carrying angle of the elbow (>15˚). -is called: -ulna movement: -wrist movement:

A

Increased carrying angle of the elbow (>15˚). -is it called: Cubitus Valgus -ulna movement: ABduction -wrist movement: ADDuction

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74
Q

DECREASED carrying angle of the elbow (<3˚). -is called: -ulna movement: -wrist movement:

A

DECREASED carrying angle of the elbow (<3˚). -is called: Cubitus Varus -ulna movement: ADDuction -wrist movement: ABduction

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75
Q

Cubitus Valgus is associated with what Ulnar movement?

A

ABduction

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76
Q

Cubitus Varus is associated with what Ulnar movement?

A

ADDuction

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77
Q

Describe Pronation of the ankle.

A

-Dorsiflexion-Eversion-Abduction

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78
Q

Describe Supination of the ankle.

A

-Plantarflexion-Inversion-Adduction

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79
Q

Fibular head glide w/: -Pronation: -Supination:

A

Fibular head glide w/: -Pronation: Anterior glide -Supination: Posterior glide

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80
Q

The common peroneal nerve (common fibular n.) lies directly _________ to the proximal fibular head.

A

Posterior

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81
Q

What nerve would most likely be involved with a posterior fibular head dysfunction?

A

Peroneal n. (aka Common fibular n.)

82
Q

What structures are involved in O’Donahue’s traid (aka Terrible Triad)?

A

-ACL-MCL-Medial meniscus

83
Q

The ankle is more stable in Dorsiflexion or Plantarflexion?

A

Dorsiflexion

84
Q

What is the most common injured ligament in the foot?

A

Anterior Talofibular ligament

85
Q

What makes up the Primary Respiratory Mechanisms (PRM)? (5 things)

A

-CNS-CSF-Dural membranes-Cranlal bones-Sacrum

86
Q

Where along the skull/spinal does the Dura Mater attach? (4 places)

A

-Foramen magnum-C2-C3-S2

87
Q

What 4 things are associated with Craniosacral Flexion?

A

1-Flexion of the midline bones2-Sacral base Posterior (counternutation)3-Decreased AP diameter of the cranium4-External rotation of the paired bones

88
Q

What suture is present at birth till around 6 y/o and separates the frontal bone into 2 halves?

A

Metopic suture

89
Q

What is the Pterion?

A

Junction of these bones: -Temporal -Parietal -Spenhoid -Frontal

90
Q

What 4 things are associated with Craniosacral Extension?

A

1-Extension of the midline bones2-Sacral base Anterior (nutation)3-Increased AP diameter4-Internal rotation of the paired bones

91
Q

What is the result of a compression strain of the Sphenobasilar Synchondrosis (SBS)?

A

Severely DEcreased CRI*usually d/t trauma, especially to the back of the head

92
Q

Vagal somatic dysfunction can be due to what dysfunctions?

A

-OA-AA-C2

93
Q

Dysfunction of CN VIII can cause what symptoms?

A

-Tinnitus-Vertigo-Hearing loss

94
Q

What dysfunctions can cause suckling dysfunctions in newborns?

A

-CN XII (condylar compression)-CN IX & CN X (at the jugular foramen)

95
Q

What effect does the CV4 treatment have on CRI?

A

Increase amplitude

96
Q

What midline bones of the cranium?

A

-Sphenoid-Occiput-Ethmoid-Vomer

97
Q

A condylar compression in a newborn might cause difficulty in what?

A

Suckling

98
Q

Where is the appendix chapman’s point?

A

Tip of the Right 12th Rib

99
Q

Do Tenderpoints or Trigger points refer pain when pressed?

A

Trigger points

100
Q

What is the myofascial release procedure?

A

1-Palpate restriction2-Apply compression (indirect) or traction (direct)3-Add twisting or transverse forces4-Use enhancers5-Await release

101
Q

Where is the anterior tenderpoint for L5?

A

1 cm lateral to pubic symphysis on the superior ramus

102
Q

What are the ABSOLUTE contraindications to HVLA? (6)

A

-Osteoporosis-Osteomyelitis (+ Pott’s dz)-Fractures in the area of thrust-Bone metastasis-Severe Rheumatoid Arthritis-Down’s syndrome

103
Q

What are the RELATIVE contraindications to HVLA? (6)

A

-Acute whiplash-Pregnancy-Post-surgical -Herniated nucleus pulposus-Pts on Anticoagulation therapy or Hemophiliacs-Vertebral artery ischemia (+ Wallenbergs’s test)

104
Q

Pupil: -Parasympathetic: -Sympathetic:

A

Pupil: -Parasympathetic: Constricts (miosis) -Sympathetic: Dilates (mydriasis)

105
Q

Lens: -Parasympathetic: -Sympathetic:

A

Lens: -Parasympathetic: Contracts for Near vision -Sympathetic: Relaxation for Far vision

106
Q

Glands: -Parasympathetic: -Sympathetic:

A

Glands: -Parasympathetic: Stimulates Secretion (copious) -Sympathetic: Vasoconstriction for slight secretion

107
Q

Sweat glands: -Parasympathetic: -Sympathetic:

A

Sweat glands: -Parasympathetic: Sweating on palms of hands -Sympathetic: Copious sweating (cholinergic)

108
Q

Heart: -Parasympathetic: -Sympathetic:

A

Heart: -Parasympathetic: Decreases contractility & conduction velocity -Sympathetic: Increases contractility & conduction velocity

109
Q

Bronchiolar smooth muscle: -Parasympathetic: -Sympathetic:

A

Bronchiolar smooth muscle: -Parasympathetic: Contracts -Sympathetic: Relaxes

110
Q

Respiratory epithelium: -Parasympathetic: -Sympathetic:

A

Respiratory epithelium: -Parasympathetic: Decreases # of goblet cells to Enhance THIN secretions -Sympathetic: Increase # of goblet cells to produce THICK secretions

111
Q

GI-Smooth muscle-Lumen: -Parasympathetic: -Sympathetic:

A

GI-Smooth muscle-Lumen: -Parasympathetic: Contracts -Sympathetic: Relaxes

112
Q

GI-Smooth muscle-Sphincters: -Parasympathetic: -Sympathetic:

A

GI-Smooth muscle-Sphincters: -Parasympathetic: Relaxes -Sympathetic: Contracts

113
Q

GI-Secretion & Motility: -Parasympathetic: -Sympathetic:

A

GI-Secretion & Motility: -Parasympathetic: -Sympathetic:

114
Q

Systemic arterioles-Skin & Visceral vessels: -Parasympathetic: -Sympathetic:

A

Systemic arterioles-Skin & Visceral vessles: -Parasympathetic: None -Sympathetic: Contracts

115
Q

Systemic arterioles-Skeletal muscle: -Parasympathetic: -Sympathetic:

A

Systemic arterioles-Skeletal muscle: -Parasympathetic: None -Sympathetic: Relaxes

116
Q

Bladder wall (detrusor): -Parasympathetic: -Sympathetic:

A

Bladder wall (detrusor): -Parasympathetic: Contracts -Sympathetic: Relaxes

117
Q

Bladder sphincter (trigone): -Parasympathetic: -Sympathetic:

A

Bladder sphincter (trigone): -Parasympathetic: Relaxes -Sympathetic: Contracts

118
Q

Penis: -Parasympathetic: -Sympathetic:

A

Penis: -Parasympathetic: Erection -Sympathetic: Ejaculation

119
Q

Kidneys: -Parasympathetic: -Sympathetic:

A

Kidneys: -Parasympathetic: Unknown -Sympathetic: Vasoconstriction of afferent arteriole > DEcreased GFR > DEcreased urine volume

120
Q

Ureters: -Parasympathetic: -Sympathetic:

A

Ureters: -Parasympathetic: Maintains normal peristalsis -Sympathetic: Uterospasm

121
Q

Liver: -Parasympathetic: -Sympathetic:

A

Liver: -Parasympathetic: Slight glycogen synthesis -Sympathetic: Glycogenolysis (release glucose into bloodstream)

122
Q

Uterus-Body (Fundus): -Parasympathetic: -Sympathetic:

A

Uterus-Body (Fundus): -Parasympathetic: Relaxation -Sympathetic: Constricts

123
Q

Uterus-Cervix: -Parasympathetic: -Sympathetic:

A

Uterus-Cervix: -Parasympathetic: Constricts -Sympathetic: Relaxes

124
Q

What are the CNS components of the Parasympathetic Nervous system?

A

-CN III (midbrain)-CN VII (pons)-CN IX (medulla)-CN X (medulla)-Pelvic Splanchnic (S2-S4)

125
Q

Parasympathetic Innervation: -CN III (midbrain)

A

Pupils -Ciliary ganglion

126
Q

Parasympathetic Innervation: -CN VII (pons)

A

Lacrimal & Nasal glands -Sphenopalatine ganglionSubmandibular & Sublingual glands -Submandibular ganglion

127
Q

Parasympathetic Innervation: -CN IX (medulla)

A

Parotid gland -Otic ganglion

128
Q

Parasympathetic Innervation: -CN X (medulla)

A

HeartBronchial treeGI System-Esophagus (lower 2/3)-Stomach-Sm. intestine-Liver-Gallbladder-Pancreas-Ascending colon-Transverse colonReproductive system-Ovaries-TestesUrinary system-Kidney-Upper ureter

129
Q

Parasympathetic Innervation: -Pelvic Splanchnic (S2-S4)

A

GI system-Descending colong-Sigmoid colon-RectumReproductive system-Uterus-Prostate-GenitaliaUrinary System-Lower ureter-Bladder

130
Q

Ascending & Transverse Colon.

A

CN X

131
Q

Descending colon, sigmoid, rectum.

A

Pelvic splanchnic

132
Q

Uterus

A

Pelvic splanchnic (S2-S4)

133
Q

Ovaries/Testes

A

CN X

134
Q

Kidney

A

CN X

135
Q

Bladder

A

Pelvic splanchnic (S2-S4)

136
Q

Lower ureter

A

Pelvic splanchnic (S2-S4)

137
Q

Pancreas

A

CN X

138
Q

Pupils

A

CN III (ciliary ganglion)

139
Q

Parotid gland

A

CN IX (otic ganglion)

140
Q

Lacrimal & Nasal glands

A

CN VII (sphenopalatine ganglion)

141
Q

Small intestines

A

CN X

142
Q

Bronchial tree

A

CN X

143
Q

Genitalia

A

Pelvic splanchnic (S2-S4)

144
Q

Heart

A

CN X

145
Q

Head & Neck

A

T1 -T4

146
Q

Heart

A

T1 - T5

147
Q

Respiratory System

A

T2 - T7

148
Q

Esophagus

A

T2 - T8

149
Q

Upper GI Tract:-Stomach-Liver-Gallbladder-Spleen-Portions of Pancreas & Duodenum

A

T5 - T9*Before ligament of Treitz

150
Q

Middle GI Tract:-Portions of Pancreas & Duodenum-Jejunum-Ilium-Ascending colon-Transverse colon (proximal 2/3)

A

T10 - T11*Btwn L. of Treitz and Splenic flexure

151
Q

Lower GI Tract:-Transverse colon (distal 1/3)-Descending colon-Sigmoid colon-Rectum

A

T12 - L2*After Splenic flexure of large intestine

152
Q

Appendix

A

T12

153
Q

Kidneys

A

T10 - T11 -Superior Mesenteric Ganglion

154
Q

Adrenal medulla

A

T10

155
Q

Upper ureters

A

T10 - T11 -Superior Mesenteric Ganglion

156
Q

Lower ureters

A

T12 - L1 -Inferior Mesenteric Ganglion

157
Q

Bladder

A

T11 - L2

158
Q

Gonads

A

T10 - T11

159
Q

Uterus & Cervix

A

T10 - L2

160
Q

Erectile tissue of penis & clitoris

A

T11 - L2

161
Q

Prostate

A

T12 - L2

162
Q

Arms

A

T2 - T8

163
Q

Legs

A

T11 - L2

164
Q

Upper GI tract: -Nerve & Ganglion

A

Greater Splanchnic N. -Celiac ganglion

165
Q

Middle GI tract: -Nerve & Ganglion

A

Lesser Splanchnic N. -Superior Mesenteric ganglion

166
Q

Lower GI tract: -Nerve & Ganglion

A

Least Splanchnic N. -Inferior Mesenteric ganglion

167
Q

What divides the duodenum & jejunum?

A

Ligament of Treitz

168
Q

What divides the transverse colon and descending colon?

A

Splenic flexure of large intestines

169
Q

Appendix: -Anterior

A

Tip of Right 12th rib

170
Q

Appendix: -Posterior

A

Transverse process of T11**this point directs differential diagnosis more toward ACUTE APPENDICITIS

171
Q

Adrenals: -Anterior

A

2” superior and 1” lateral to the Umbilicus

172
Q

Adrenals: -Posterior

A

Bwtn the Spinous and Transverse process of T11 and T12

173
Q

Kidney: -Anterior

A

1” Superior and 1” Lateral to the umbilicus

174
Q

Kidney: -Posterior

A

Btwn the Spinous and Transverse process of T12 and L1

175
Q

Bladder: -Anterior

A

Periumbilical region

176
Q

Colon

A

Lateral thigh within the Iliotibial band from Greater Trochanter to just above the Knee

177
Q

Pancreas: -Anterior

A

Lateral to costal cartilage btwn Ribs 7 and 8 on the RIGHT

178
Q

Asthma (acute)

A

T2 on Left

179
Q

Prostate

A

Posterior margin of Iliotibial band

180
Q

2nd Intercostal space

A

ThyroidEsophagusMyocardiumBronchi

181
Q

1st Intercostal space

A

Tonsils

182
Q

4th Intercostal space

A

Lung disease

183
Q

6th Intercostal space on Left

A

Stomach Peristalsis

184
Q

6th Intercostal space on the Right

A

LiverGallbladder

185
Q

5th Intercostal space on Left

A

Stomach Hyperacidity

186
Q

5th Intercostal space on the Right

A

Liver

187
Q

7th Intercostal space on the Left

A

Spleen

188
Q

7th Intercostal space on the Right

A

Pancreas

189
Q

Periumbilical

A

Bladder

190
Q

8-10 Intercostal

A

Small Intestines

191
Q

Middle Ear Chapman point

A

1st Rib & Clavicles, Lateral to where they cross the 1st rib

192
Q

Between the Spinous and Transverse process of:- T7-8 on Right

A

Pancreas

193
Q

Between the Spinous and Transverse process of:- T11-12

A

Adrenals

194
Q

Between the Spinous and Transverse process of:- T12-L1

A

Kidney

195
Q

Superior edge of L2 Transverse process

A

Bladder

196
Q

Eyes (anterior point)

A

Surgical neck of the Right Humerus

197
Q

Tonsils

A

1st Intercostal space

198
Q

Esophagus, Bronchi, Thyroid, Myocardium

A

2nd Intercostal space

199
Q

Upper lung and Upper Extremities

A

Third Intercostal space

200
Q

Middle ear (otitis media)

A

First rib and Clavicles, lateral to where they cross first rib

COMLEX Level 2 (8 decks)

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