UQ Final Exam Flashcards

1
Q

Lordotic Posture

A

-lordotic with kyphosis
-increased lumbosacral angle

-forward head
-abducted scaps
-kyphotic thoracic
-hyperextended lumbar
-Hips flexed
-anterior pelvic tilt
-hyperextended knees

-Short/tight: low back, hip flexors, neck extensors
-Weak/lengthened: abs, erectors, upper back, hamstrings

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2
Q

Swayback Posture

A

-lordotic with kyphosis
-flat lumbar spine

-forward head
-winged scaps
-kyphotic thoracic
-flat lumbar
-Hips hyperextended
-posterior pelvic tilt
-hyperextended knees

-Weak/Lengthedt: upper back extensors, hip flexors, neck flexors, ex obliques
-Short/tight: internal oblique, erectors, low back, hamstrings

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3
Q

Flatback Posture

A

-decreased lumbosacral angle

-forward head
-flat thoracic
-flat lumbar
-Hips extended
-posterior pelvic tilt
-extended knees

-Short/tight: abs, hamstrings
-Weak/lengthened: hip flexors

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4
Q

Rib Quadrants

A
  1. Upper Chest and sternal ribs
  2. Lower chest annd Lower ribs
  3. Upper back and space btwn shoulders
  4. Lower back and lower ribcage
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5
Q

Shoulder ER at Side (<90)

A

-upper back evaluation

  1. Pt in supine w/ elbow at 90, shoulder at side
  2. Let arm go into ER

-Normal is 60, if can’t achieve, limited in upper back/ST joint

Tx:
-crime scene

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6
Q

Shoulder ER at 90

A

-lower chest evaluation

  1. Pt in supine at 90/90
  2. Let arm fall into ER

-Normal is 90, if can’t achieve, lower chest limited

Tx:
-swiss ball behind head

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7
Q

Reaching Behind Upper Back

A

-lower back
-GH: ABD, FLX, ER

  1. Pt looks straight ahead
  2. Tell to reach to contra scapula

-Can’t? Limited in low back or ribcage

Tx:
-crocodile breathinng

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8
Q

Reaching Behind Lower Back

A

-Upper chest
-GH: IR, EXT,

  1. Reach behind back to touch contra scapula

-Can’t? Limited in upper chest

Tx:
-swiss ball with hands down

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9
Q

Thoracic Extension AROM

A

-assess T5 and below (T1-T3 are functionally C-spine)
-Long sit w/ arms crosses above head

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10
Q

Thoracic Flexion AROM

A

-perform cervical flexion and have them slouch upper back

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11
Q

Thoracic Rotation AROM

A

-most rotation @ T5-T8

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12
Q

Thoracic Side-Bending AROM

A

-hands behind head and side bend

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13
Q

Large Infrasternal Angle

A

->100 deg
-tight IOb
-have more posterior expansion
-lumbar lordosis and thoracic kyphosis common

Tx:
-need anterior expansion in upper chest
-downward wall reach

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14
Q

Small Infrasternal Angle

A

-<90 deg
-tight ExOb
- have more anterior expansion
-flatback posture

Tx:
-need posterior rib expansion
-in quadruped

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15
Q

Rib Mobility during Breathing

A

-@ 4th intercostal space
-Shoulder increase 2-5 inches (5-12cm)

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16
Q

T-Spine and Arm Motion

A

Unilateral: T-spine ipsi rotation
Bilateral: T-spine Ext

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17
Q

T-Spine Stretching Exercises

A

-Extension over chair or Foam roller (foam roller to block L-spine)
-Prayer stretch (lats too, breathe into it)
-Cat/cow
-Thread the needle

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18
Q

Rib Expansion Exercises

A

-Crime scene pose (upper back restriction)
-Swiss Ball ext arms behind head (lower chest restriction/tight ExOb)
-Swiss ball ext arms down (upper chest restriction)
-Crocodile Breathing (lower back/ribs and front upper chest restriction)
-Sidelying Expansion (QL and lateral ribs)
-Anterior Rib Expansion

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19
Q

Thoracic Flexion Exercises

A

-Assisted (Theraband)
-Segmental Flexion

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20
Q

Thoracic Rotation Exercises

A

-Open Books
-Thread the needle
-Wall Windmill

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21
Q

Rule of 3s

A

T1-T3: SP at same level
T4-T6: SP 1/2 level under
T7-T9: SP 1 level under
T10-T12: Same Level

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22
Q

Sternum

A

-Sternal notch at T2/T3
-Xiphoid process T9-T10

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23
Q

Ribs

A

-1-7 true ribs, 8-10 false ribs, 11-12 floating ribs
-Superior rib facets attached to superior vertebral body
-1, 10, 11, 12 atypical with only 1 facet
-T1 and T2 attach to 2nd rib

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24
Q

Facet Joints

A

-60 degrees
-allows rotation

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25
Costovertebral Joints
-ribs + Vertebral bodies
26
Costotransverse Joints
-Rib tubercles + transverse processes -Upper T-spine: convex TP and concave rib -Lower T-spine: planar joints
27
LC/ER
-90/90 -Low chest/ ER
28
UB/ER
-at side ER (hitchhike) -Upper back/ER
29
Functional Movement: Over Head
-Lower Back
30
Functional Movement: Behind Back
-Upper Chest
31
TOS Anatomical Sites
-Interscalene triangle -Costoclavicular space -Subcoracoid space
32
C5-C7 Compression Referred Pain
-rhomboid -ant clavicle -deltoid and traps
33
C8-T1 Compression Referred Pain
-anterior shoulder and down the arm
34
Thoracic Outlet Syndrome Tests Positive Findings
(+): disappearance of pulse (+): Reproduction of neuro s/s
35
Thoracic Outlet Syndrome
-aim of test to dec pulse or reproduce neurologic s/s -4 tests
36
Adson's Vascular Test
-TOS 1. Pt seated 2. Pt hold arm into 15deg of abduction 3. Pt asked to inhale and hold breath 4. Then extend head and rotate away 5. Check for dimished pulse or increased s/s
37
Costo-Clavicular Test
-TOS 1. Pt seated w/ arms at side 2. Pt retracts arms/shoulders and protrudes chest and hold for 60s 3. Check for dimished pulse or increased s/s
38
Hyperabuction Test
-TOS 1. Pt seated 2. Pt asked to turn away from tesing side 3. Pt asked to raise arm into hyperabd/ext for 1-2min 4. Check for diminished pulse or increased s/s
39
Roo's Test
-TOS 1. Pt seated w/ both arms in 90/90 2. Asked to open and close fingers for 3 min 3. Check for diminished pulse or inc s/s *stop test if s/s present*
40
Atlas: C1
Forms atlanto occipital joint (OA). -Flexion -lacks spinous process -Transverse Ligament attaches here
41
Axis: C2
-Forms atlantoaxial joint (AA). -Rotation (60%) -Possesses dens/odontoid process -Links CV to C-spine
42
Cervical vertebrae
-Seven, bifid spinous process, flat facet joints. -C3-C7 have uncinate process limitations SB
43
Upper Cervical Spine Biomechanics: OA Joint
C0-C1 -Lateral flexion: with contralateral rotation coupling (mostly at (CO-C1) -lots of congruency due to lack of disc OA joint: convex (C0) on concave (C1) (opposite) -no disk -20-25 degrees -Flexion: rolls ant, slides pos (5 deg) -Extension: rolls pos, slides ant (10 deg) -LSB: (5 deg)
44
Lower Cervical Spine
(C2/3-C7/T1) -uncinate process limit lat flexion -more mobility -bifids til C6 Flexion: ant tilt and slide coupled with upward shift of facets (35-70 deg) Extension: pos tilt and slide coupled with downward shift of facets (55-60 deg) Lateral Flexion: coupled with ipsilateral rotation (15-40 deg) -downward slide of ipsilateral facet joints -upward slide of contralateral facet joints Rotation: coupled with ipsilateral lateral rotation (30-45 deg)
45
Upper Cervical Spine Biomechanics: AA Joint
C1-C2 -Lateral flexion: with contralateral rotation coupling -Convex on Convex -Flexion: 5deg -Extension: 10deg Rotation: 40-45 deg AA Joint: Biconvex -rotation -Coupled with contralateral lat flexion -contralateral move of C2 SP -60% of rotation -Biconvex (flx lower cerv, ext upp ext)
46
Trapezius Muscle Length
-only check if motion IS limited *must check length if you prescribe stretch later* 1. Pt supine 2. Flex head > contra SB > ipsi rotation 3. PT depresses ipsi shoulder Normal: 45deg of rot w/ soft end range Decreased:<45 or hard end range
47
Levator/Post Scalene Muscle Length
-only check if motion IS limited *must check length if you prescribe stretch later* 1. Pt supine 2. Flex head > contra SB and contra rotation 3. PT depresses ipsi shoulder Normal: 45deg of rot w/ soft end range Decreased:<45 or hard end range or TTP
48
Scalenes Muscle Length
-only check if motion ISN'T limited *must check length if you prescribe stretch later* 1. Pt supine w/ head off plinth 2. Extend and contra SB and ipsi rotation (ant) - Flexion and contra SB and contra rotation (posterior) 3. PT stabilizes ipsi shoulder Normal: 45deg of SB Decreased:<45 of SB
49
Humero-Ulnar Joint
-FLX/EXT: 5-145 Normal; 30-130 Functional -SUP/PRO: 75-85 Normal; 50 Functional -Uniaxial hinge -OPP: 70 deg FLX and 10 deg SUP -CPP: full EXT; full SUP -Convex medial lip of trochlea of Humerus and concave ulnar notch -FLX/EXT
50
Humero-Radial Joint
-FLX/EXT: 5-145 Normal; 30-130 Functional -SUP/PRO: 75-85 Normal; 50 Functional -OPP: full ext; full sup -CPP: 90 FLX; 5 SUP -flx/ext/spin -Capsular Pattern: equal sup and pro -Concave radial head and convex capitulum of humerus -Radial head: resists valgus stress
51
Proximal Radio-Ulnar Joint
-FLX/EXT: 5-145 Normal; 30-130 Functional -SUP/PRO: 75-85 Normal; 50 Functional -70 PRO; 80 SUP -OPP: 70 deg FLX; 35 def SUP -Radial head, annular ligament, radial fossa of ulna -interosseous membrane
52
Functional Motion of Elbow
Flx: 130 Ext: 30 Sup/Pro: 50
53
Carrying Angle
-valgus angulation at elbow Males: 11-14 Females: 13-16
54
Medial Ligament Complex
-Ulnar Collateral Ligament/UCL -fan shaped -resists valgus stess, especially 20-130 deg flx Anterior: strongest and stiffest Oblique/Transverse: little stability Posterior: taut btwn 60-90 flx
55
Lateral Ligament Complex
Lateral Collateral Ligament -varus stabiliy -primary restrain to posterio-lateral instability -taut in full SUP 2 Parts: -Lateral UCL: Humerus + Ulna -RCL: Humerus + Radius
56
Interosseous Membrane
-collagen that binds ulna and radius -finbers directed away from radius -assists in force transfer from radius to ulna -peak strain: neutral forearm -central band determines stability -dorsal oblique, accessory cord: limits supination passively
57
ICF Model: Neck Pain w/ Mobility Deficits
-hypomobility S/s: -Pain in central (older stenosis) or Unilateral (younger foramena) -limited ROM that constantly reproduces s/s -possible referred pain Exam: -Dec ROM -Neck pain at end ranges -Restricted mobility in c and t-spine -referred pain reproduced w/ provocation -deficits in cervico-scapulo-thoracic strength Treatment: -T-spine manips -C-spine manual -Cervical ROM: segmental motion -Strengthening
58
ICF Model: Neck Pain w/ Movement Coordination Impairments
-Instability S/s: -MOI linked to trauma/whiplash or hypermobility -referred shoulder pain -HA, concussion, confusion, hypersensitivity Exam: -(+): cranial cervical flexion test -(+): Neck flexor muscle endurance test -(+): Pressure algometry -Neck pain at midposition to end -Dec strength -Point tenderness Treatment: -Pt education and prognosis -Increase ROM -Manual or exercise: chin tucks -Pain science
59
ICF Model: Neck Pain w/ Headaches
S/s: -non-continuous, unilateral neck pain (facet joint) and referred HA -HA precipitated or aggravated by neck movements or positions Exam: -(+): Cervical flexion rotation test -HA reproduced w/ provocation -Limited ROM -Strength and endurance deficits Treatment: -Mobility -Self SNAGs to AA joint -Manual therapy c and t-spine: subocc release
60
ICF Model: Neck Pain w/ Radiating Pain
-Radiculopathy S/s: -neck pain w/ UE radiating pain -UE neruological signs Exam: -(+): Cervical radiculopathy CPR -UE sensory, strength deficits Treatment: -Exercise and MT: nerve glides -Cervical collar for short term -Intermittent traction -Pt education
61
DeQuervain's
-synovitis of 1s extensor comparment -APL, EPB Test: -Finkeltein's
62
Intersection Syndrome
-synovitis of intersection of 1st and 2nd extensor copaprtment Test: -resisted wrist ext in fist
63
Deep Neck Flexors
-longus colli -longis capitus -rectus capitus anterior -rectus capitus lateralis
64
Suboccipital Muscles
-rectus capitus posterior major/minor -oblique capitus superior/inferior
65
PAILS/RAILS
1. Long duration stretch of target muscle 1-2 mins 2. Active isometric contraction of antagoist 10% intervals 3. Max hold for 10-20s 4. Active isometric contraction of agonist 100% 5. Max hold for 10s 6. Use new ROM
66
Trigger Finger
-A1 pulley -finger stuck in flx; can feel nodule -reports pain on dorsal side
67
TMJ MET: Opening Agonist
-push open 10% for 8s
68
TMJ MET: Protrusion Agonist
-protrude 10s for 8%
69
TMJ MET: Lateral Excursion Agonist
-activate ipsi masseter and temporalis and contra pterygoid L Excursion: -push left to right
70
TMJ MET: Lateral Excursion Antagonist
-activate contra masseter and temporalis and ipsi pterygoid L Excursion: -push right to left
71
TMJ Closing Muscles
-masseter -temporalis -med pterygoid
72
TMJ Opening Muscles
-inferior lateral terygoid -suprahyoids
73
TMJ Protrusion Muscles
-masseter -pterygoids
74
TMJ Retrusion Muscles
-masseter -temporalis
75
TMJ Lateral Excursion Muscles
-ipsi temporalis and masseter -contra pterygoids
76
TUTALC Opening
-just open with TUTALC
77
TUTALC Tongue Roll Opening
-opening and suprahyoids -roll tongue along palatte in TUTALC
78
TUTALC N Exercise
-suprahyoids -make N sounds while depressing jaw in TUTALC
79
TUTALC Tongue Clucking
-supprahyoids -whip tongue in TUTALC
80
AC Joint Motion
Arm elevation: posterior spin Arm Extension: anterior spin Scapula upward rot: posterior rotation Arm ABD: inferior glide CPP: 90 abd OPP: arm at side
81
SC Joint
-Anterior to posterior: concave clavicle on convex sternum -sup to inf: convex clavicle on concave sternum Flexion: inf glide Extension: sup glide Horizontal abd/protraction: anterior Horizontal add/retraction: posterior OPP: arm at side CPP: full elevation