Study Guide Flashcards
Concentric Vs Eccentric Contraction
Supination to neutral
Neutral to pronation
Pronation to neutral
Neutral to supination
Supination to neutral = PRONATOR muscle(s) in a CONCENTRIC contraction
Neutral to pronation = SUPINATOR muscle(s) in an ECCENTRIC contraction
Pronation to neutral = SUPINATOR muscle(s) in a CONCENTRIC contraction
Neutral to supination = PRONATOR muscle(s) in an ECCENTRIC contraction
Intersection syndrome vs De Quervain’s
De Quervain’s: synovitis of 1st compartment tendons
Intersection syndrome: synovitis of the intersection of the 1st and 2nd compartment.
- This condition will hurt 2 inches more proximal from the wrist where 1st and 2nd compartment meet at the first hump of the wrist (dorsal forearm, 2 inches proximal to wrist)
What is in compartment 1 of the wrist?
What is in compartment 2 of the wrist?
Compartment 1: APL, EPB
Compartment 2: ECRL and ECRB
What is the test for intersection syndrome?
Test: Resisted wrist extension with fist
What is the test for De Quervains?
Finkelstein’s test: passive stretch of wrist, ulnar deviated + thumb flexion
What would you prescribe for treatment of de Quervain’s Syndrome?
- Isometrics
- thumb gliding
- wrist gliding
- add both: composite
What could you do for treatment of intersection syndrome?
- immobilize
- soft tissue
- tendon gliding
Deep Neck Flexors
- longus colli
- rectus capitis anterior and lateralis
- longus capitis.
These muscles generally ispilaterally rotate and flex.
Note: The rectus capitus anterior is our main chin tuck muscle
Suboccipitals
- rectus capitis posterior major and minor
- obliquus capitis superior and inferior
Rectus capitis posterior major: extension and ispilateral rotation
Rectus capitis posterior minor: extension
obliquus capitis superior: ipsilateral flexion of head, some extension
obliquus capitis inferior: ipsilateral rotation of atlas on axis
What is the normal resting scapula position
(Medial border, Superior border, Inferior border, Spine of scapula, Upward rotation , Anterior tipping)
- Medial border: 5 cm/3 fingers width from t-spine
- Superior border: at T2
- Inferior border: at T7
- Spine of scapula: T3
- 30-45 degrees angled from frontal plane
- Upward rotation 10-20 degrees
- Anterior tipping 10-20 degrees
NORMAL MOTION (SHR)
Humeral elevation and ER
ST upward rotation
SC elevation
AC posterior/upward rotation
Humeral elevation: 120
ST upward rotation: 60
Humeral ER: 30-45
SC elevation: 25
AC posterior/upward rotation: 35 (25 SC posterior rotation, 10 AC ER)
Normal Posture
Plum Line
Normal arm position
Plum line through:
- External auditory meatus
- AC joint
- Greater trochanter
- Anterior to knee joint
- Anterior to lateral malleolus
Normal arm position:
Humeral head ⅓ or less anterior to acromion
Cubital fossa faces anteriorly
Olecranon faces posteriorly
Hands face body
Describe Flatback Posture
- scapular winging
- Decreased expansion of posterior ribcage (upper 6 ribs)
- decreased lumbosacral angle
- decreased lumbar lordosis, posterior pelvic tilt
- Flat t-spine
- Head: neutral or protracted (moved forward)
- Neck: slightly extended
- Thoracic: upper flexed, lower flat
- Pelvis: neutral or PPT
- Hips: neutral or extension
- Knees: hyperextended or neutral
- Ankles: neutral
What is tight and what is long in flatback posture?
Tight:
Hamstrings
Abdominals
Long:
Hip flexors
Swayback (slouched)
- scapular winging
- Entire pelvis shifted anteriorly, thorax shifted posteriorly
- Forward head, thoracic kyphosis
- posterior/flat lumbar spine, hip extension
What is tight and what is long is swayback posture?
Tight:
- IO
- Hamstrings
- Lower back muscles: ES, QL
Long:
- Hip flexors
- EO
- Upper back extensors
- Neck flexors
kyphosis/lordosis posture
- more pressure on disc and joints
- increased lumbosacral angle
- increased lumbar lordosis
- increased anterior pelvic tilt, hip flexion
- Knee hyperextension
- Ankle PF
What is tight and what is long in kyphotic/lordotic posture?
Tight:
- Neck extensors
- Lower back
- Hip flexors
Long:
- Neck flexors
- Upper back
- hamstrings/glutes
abdominals
What posture is this?
- scapular winging
- Decreased expansion of posterior ribcage (upper 6 ribs)
- decreased lumbosacral angle
- decreased lumbar lordosis, posterior pelvic tilt
- Flat t-spine
- Head: neutral or protracted (moved forward)
- Neck: slightly extended
- Thoracic: upper flexed, lower flat
- Pelvis: neutral or PPT
- Hips: neutral or extension
- Knees: hyperextended or neutral
- Ankles: neutral
Flatback Posture
What posture is this?
- scapular winging
- Entire pelvis shifted anteriorly, thorax shifted posteriorly
- Forward head, thoracic kyphosis
- posterior/flat lumbar spine, hip extension
Swayback posture
What posture is this?
- more pressure on disc and joints
- increased lumbosacral angle
- increased lumbar lordosis
- increased anterior pelvic tilt, hip flexion
- Knee hyperextension
- Ankle PF
Kyphotic/lordotic posture
Review Pails/Rails
- Stretch 1-2 minutes
- PAILS: irradiate antagonist muscle: 10%, 20%,….100%
- hold max isometric 10-15 seconds
- RAILS: agonist max hold 5-10 seconds
slowly relax and stay/push into new ROM
benefits:
- bypass stretch reflex
- create cortical mapping
- cellular adaptation in tissue
- increase BF to both antagonist and agonist tissue
How would you do pails/rails to improve elbow extension?
- use a doorway or wall to complete this exercise
- rotate arm until elbow crease is facing wall and place L palm flat on wall; gently lean into the wall stretching the elbow out straight as tolerated – hold STRETCH for 1-2 minutes
- PAILS: in the same position press palm into the wall activating your bicep muscle; gradually intensify the amount you are pushing into wall from 20%-100%; at 100% hold for 10 seconds
- RAILS: lastly, activate triceps, actively try to straighten arm and hold for 10 seconds (hand may come away from wall
Rib expansion: what is considered normal and what is considered impaired?
Normal: Expand 5-10 cm with max inhalation
Impaired: Less than 3 cm (shortness of abdominal obliques)
