Test questions Flashcards
upper cross syndrome signs
anterior head carriage
elevated, rounded shoulders, winging scapulae, shortened pectoralis, kyphotic upper thoracic spine, shortened upper trap/levator, weak serratus anterior and low/middle trap
lack of ____ will cause dysfunction within the joint and may cause pain
joint play
hydodynamics= essential for proper lubrication, transport of nutrients, and removal of waste material from he articular surfaces. Proper hydrodynamics occur during
weight bearing, intermittent muscle activity, full range of motion
over time, scapulas tend to migrate ___ and ____, making a shallow glenoid cavity more shallow leading to more shoulder complaints
superior, lateral
glenohumeral joint is most often affected by ____ or the tendon of the _____ of biceps
rotator cuff dysfunction (supraspinatus), long head
lateral epicondylitis= tennis elbow. most commong listing is ____ radius
posterior-lateral (PL)
an ____ muscle test is a good indicator of median nerve involvement
oppenens policies during supination
pronation-pronator teres syndrome
weakness of this muscle with arm in ____ usually indicates median nerve pressure at the wrist
supination
weakness with arm in pronation usually indicates median nerve irritation at the elbow or____
pronator teres syndrome
exercise for retraction of the scapula/glenohumeral joint
wall walks with hands oriented so fingers pointing upward/wall angels
initial motion upon____ occurs at the radoiocarpal joint and secondary motion at the mid carpal and carpal metacarpal joint
flexion
based on the above, if there is pain at the beginning of the ROM, check the
radiocarpal joint
which rib subluxations can cause intercostal neuritis
costo-vertebral
costo-transverse
costal angle
anterior dorsals
the two muscles involved in jaw protrustion
lateral pterygoid msucle
assisted by medial pterygoid
the four muscles involved in jaw retraction
posterior fibers of temporalis
deep part of master
geniohyoid
digastric
the three muscles involved in jaw elevation
medial pterygoid
masseter
temporalis
the three muscles involved jaw depression
digastric, geniohyoid, mylohyoid
assisted by gravity
most common s/c joint separation
superior and anterior
on xray- a space of more than ____ between the coracoid and clavicle indicates coracoclavicular ligamentous disruption
1.3 cm or 13 mm
with cross over maneuver, presence of superior pain or discomfort int he shoulder indicates
pathology of the a/c joint
on an AP thoracic x-ray, a height difference of ____ between the inferior tips of the scapula indicates an unstable shoudler
15 mm
most common reason for re-injury of a dislocated shoulder is
failure to properly condition the healed tissues
overuse is ___ in tendinitis but ___ in tendinosis
rare, common
tennis elbow can have a long healing time lasting up to as much as ___ weeks
72 weeks
rate of irritation greater than rate of recovery is the description of the ___ principle
specific adaptation to imposed demand
____ tears are inter capsular, whereas ____ tears are extracapsular
primary, secondary
which joint is likely the most responsible for the majority of the proprioceptive information for the upper extremity
s/c
the s/c articulation is the most overlooked region up the upper extremity what its he second most
scapulothoracic articulation
medial epicondylitis or golfers elbow typically produces a ___ ulna
posterior-medial
medial epicondylitis is observed when there is weakness of the __ muscle
flexor carpi ulanris
if wrist pain is reduced or range of motion enhanced by applying mild pressure approximation distal ulna and radius- a ____ may have occurred via hyperextension or hyper flexion insult to the wrist
spreading injury
to test this, you would perform this part IV orthopedic test
bracelet’s test—–> + increase pain= RA
the sphenoid bone articulates with___ other cranial bones
12
the TMJ is unique because it is a synovial joint, but the surfaces are covered by this type of cartilage
fibrocartilage
this source of pain and synovial effusion in a TMJ related issue consists of a venous plexus covered with a synovial membrane
retrodiscal tissue
if a patient complains of locking, he can’t open his mouth fully this is called a closed lock. In this case the disc is___ to the condyle
anterior
lateral epicondylitis or tennis elbow is observed when there is weakness of the ___ muscles
extensor carpi ulnaris
which direction of movement is more common in a costal angle subluxation
superior
at the 5th rib, the xosto-chondral junction is approximately located at the
mid-clavicular line
costo-sternal or chondro-sternal subluxations apply to which ribs
the upper 6 ribs
another name for anterior dorsal is
pottinger saucer
what else has a biconcave disc besides the s/d joint
TMJ
what is the condition regarding grinding of the teeth at night
buxism
ribs typically articulate with the disc and bodies of vertebrae above and below except
1st, 10th, 11th, and 12th
musculature that suspends the scapula are innervated by
lower cervicals
tirgger point type pain between the scapula and upper trapezius/levator scapula is evidence of
dysfunction and
symptomatic referred pain
what is the primary function of the shoulder
to place the upper extremity in space
list the dynamic stabilizers
levator scapula pec minor rhomboids serratus anterior trapezius
most dynamic stabilizers are ___ used
under
dynamic stabilizers attach ____ to ___
shoulder, spine
what are the compensatory stabilizers
biceps
supraspinatus
compensatory stabilizers are often ___ used
over
what do ligaments do
connect the chain– DO NOT CREATE STABILITY
what its he osseous pivot of the upper extremity
sc joint
the ac joint is ____ mobile than the sc joint. However, it is often ___ due to restrictions and fixations of the ____
less, hyperbole sc joint
what is the sulcus sign
inferior and anterior instability of the g/h joint
the g/h joint is most often affected by rotator cuff dysfunction the tendon of the long head of the biceps.
stability is often sacrificed for movement
when doing applies scratch test inferior to check scapulothoracic articulation, what its he measurement to demonstrate an unstable shoulder
1.5 cm or 15 mm
the most commonly overlooked subluxation its he ___ followed by the ___
#1 sc joint #2 scapulothoracic
how should one place their arms for scaption
roo’s/allens position
the third way to check for scapulothoracic subluxation is
internal rotation of atlas 70 degrees supine
when adjusting the inferior scapula, the goal is to break up adhesions of the
subscapularis, bursae, and serratus anterior
what its he ratio to determine glenohumeral efficacy
2 degrees of g/h movement vs 1 degree of scapula movement
which joint is the intersection of forces with little force dissipation option
elbow
the biomechanical responder is the
wrist
positive orthopedic tests provide
stabilty information
muscle tests are used to check for
subluxation
a sign of upper crossed syndrome is
anterior head carriage
rounded shoulders
elevated shoulders
winging of the scapulas
what is hiltons law
the same turns of nerves whose branches supply the groups of muscles moving a joint, furnish a distribution of nerves to the skin over the insertion of the same muscles, and the interior of the joint receives its nerves from the same source
the orthopedic test for any joint in the body is
o’donoghues
the most common injuries seen in the chiropractic offices are
grade 1 or mild grade 2
serious grade 2 and grade 3 require
medical referral
except in the case of ____ the spine is always considered first
direct trauma
proper hydrodynamics occurs during
weight bearing
intermittent muscle activity
full ROM of joint and capsule
what its he contact point for glenohumeral distraction
interolocking fingers
as we age, the scapula migrate ___ and ___ and the ___ fall forward with ____
superior and lateral, shoulders, anterior head carriage
where is joint play found
at the end of passive ROM
based on the mechanoreceptor theory, muscles functioning across a misaligned joint are____ due to____ originating from mechanoreceptors surrounding a joint
inhibitied, reflex signals
what its he most common subluxation of the g/h joint
a/1 90%
what is the challenge for ac joint
dugas
what its he scope for biceps tendon
2 inches inferior to the bicipital tubercle
if chronic injury, check for
instability then subluxation
what is the most common ulnar subluxation
pm 80% of the time
what its he SCP for PM ulna
medial ridge of ulna 1” distal to the joint
which ulna subluxation occurs 20% of the time
PL ulna
the more common radius subluxations is
PL radius
what is the scope for PL radius
lateral ridge of radius 1/4” distal to joint
how do you adjust a carpal bone
with reinforced thumbs pa glide push
what is tennis elbow and what is the subluxation commonly associated with tennis elbow
lateral epicondylitis, PL radius
what is golfers elbow and what is the subluxation commonly associated with it
medial epicondylitis, PM ulna
PM ulna and PL radius both commonly occur after a ___ injury and this may be the underlying problem in ____ which may mimic_____
hyperextension
pronator teres syndrome
carpal tunnel syndrome
pronator teres syndrome affects the _____ nerve distribution and is tested by____
median
pronation against resistance
retraction of the scapula is called _____ and is due to a ____
winging
serratus anterior
what are exercises to strengthen the serrates anterior
wall walks, wall angels, push ups
we tend to ____ our flexors and ____ or extensors
over use
under use
upon _____ of the wrist, carpals move diagonal and anteiror
extension
upon____ of the wrist, the carpals move
posterior
normally the g/h capsule contains .5-1.5 cc of fluid. how much fluid can the g/h capsule contain before seeing it
30 cc
what move is contraindicated for someone how has subacromial bursitis
a/i humerus
recruitment is __ and abandonment is ___
1st
2nd
what are the dynamic stabilizers
pec minor rhomboids levator scapula serratus anterior trapezius
what are the compensatory stabilizers
biceps and supraspinatus
lack of joint play will cause dysfunction and
pain
after clearing the sc joint, ac joint, g/h joint, and biceps, next
scapulothoracic articulation
the most common reason for re-injury is a
failure to properly condition the healed tissues
the concept of extra spinal management within the chiropractic paradigm must include integration of extra spinal areas to the spine first one must consider the _____ connection, then the ____
neruological
muscles
if multiple extremities are sublimated, how do you determine which one to adjsut
use the pain scale
what are the benefits of bracing vs using tape
brace can be washed
no dermatitis from the brace
forces of injury, position of joint, and time episode fall under which category
safety
a sprain with no separation is
grade one
the end of travel in a joint whereby the surfaces are at maximal congruency, the ligaments are taut, and no further movement int hat direction of travel may result in
dislocation/fracture
the most common subluxation for the sc joint is
inferior
anterior medial
ligamentous disruption of ____ mm is a sc separation and the direction is most common separates is ___ and _____
5
anterior
superior
theory that states a muscle functioning across a misaligned joint will be inhibited by a reflex signal originating from_____ surrounding that joint
mechanoreceptors
trama, if acute, check for ______
patient safety, joint stability, then subluxation
the most common injuries seen in the office are ____ or _____
grade 1 or mild grade 2
over time the scapulas tend to migrate ___ and ____
superior and lateral
sc joint is probably responsible for most of the _____ information for the upper extremity
proprioception
elbow in closed packed position is in_____
full extension (taut ligaments and at max. congruency dislocation or fracture)
medial epicondylitis (golfers elbow) is typically from a
PM ulna
_____ can mimic carpal tunnel syndrome. Patient is tested by pronation against resistance; symptoms follow a median nerve distribution
pronator teres syndrome
___ and ___ are compensatory stabilizers for scapula
biceps and supraspinatus
shoulder sulcus sign is ____ an ____ instability of GH joint
inferior and anterior
TMJ intra-articular involvement= synovitis and capsulitis with the focus on the disc which is considered displaced or degenerated. studies show that ___ % of all individuals will show some TMJ related symptom in their lifetime
85-90%
