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M1 Block 5 > Week 2 > Flashcards

Week 2 Flashcards

1
Q

List the basic steps of counterstrain technique

A
  1. Identify tender point
  2. Establish pain scale (10/10)
  3. Place in position of ease while monitoring
  4. Recheck tender point (0/10)
  5. Monitor and hold position for about 90 seconds
  6. Return to neutral passively
  7. Recheck tender point (at least 70% improvement)
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2
Q

List 4 upper extremity tender points of the anterior shoulder

A
  1. Pec Minor
  2. Biceps-long head
  3. Biceps-short head
  4. Subscapularis
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3
Q

What is the action of supraspinatus?

A

Abduction

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4
Q

What is the action of infraspinatus?

A
  • External rotator of the shoulder
  • Assist in shoulder extension and adduction
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5
Q

What is the action of Pec Minor?
What is its insertion?

A

Action: Stabilize scapula drawing it inferiorly and anteriorly
Elevate ribs when scapula is fixed
Assist protraction & downward rotation of scapula
Insertion: Medial border & superior surface of coracoid process of the scapula

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6
Q

What is the main action of biceps brachii:

A
  • Chief supinator
  • When arm is supine, some flexion
  • Short head resists dislocation of shoulder
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7
Q

What head of biceps brachii plays a more significant role in muscle action?

A
  • Short head performs ~90% of of biceps function
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8
Q

What is the action of supraspinatus?

A
  • Initiates shoulder abduction
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9
Q

What is the action of subscapularis?

A
  • Internal rotation of the humerus
  • Adduction of the arm
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10
Q

What is the counterstrain positioning for Pectoralis minor treatment?

A
  • Arm crossed over the chest
  • Shoulder flexion with adduction and inferomedial traction
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11
Q

What is the counterstain treatment position for long head of biceps brachii?

A
  • Wrist supinated
  • Elbow flexion and some shoulder flexion
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12
Q

Which head of the biceps is more lateral? Which is more medial?

A
  • Long head is more lateral, supraglenoid tubercle of scapula
  • Short head is more medial, tip of coracoid process of scapula
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13
Q

What is the counterstrain treatment position for short head of biceps brachii?

A
  • Arm cross over chest touching shoulder
  • Wrist supinated
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14
Q

What is the counterstrain positioning for subscapularis treatment?

A
  • Shoulder extension with internal rotation and slight adduction/abduction
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15
Q

What is the positioning for counterstrain treatment of supraspinatus?

A
  • Shoulder flexed with abduction and external rotation
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16
Q

What is the counterstrain positioning for treatment of infraspinatus

A
  • Shoulder flexion (90-120 degrees) with abduction and either internal or external rotation
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17
Q

What is the counterstrain positioning for levator scapulae?

A
  • Pt prone
  • Slight shoulder extension with internal rotation
  • Apply traction to rotate scapula spueriormedially
  • Pt neck and face towards the side being treated
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18
Q

What is the counterstrain treatment positioning for rhomboids?

A
  • Patient seated or prone
  • Shoulder extension with adduction by pulling arm posterior medially towards spine
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19
Q

What is the counterstrain treatment positioning for radial head?

A
  • Seated or supine
  • Elbow extension with slight abduction and forearm supination
  • Mild valgus at elbow
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20
Q

What is the counterstrain treatment positioning for medial epicondyle?

A
  • Pt seated or supine
  • Elbow flexion with slight adduction and marked forearm pronation with slight wrist flexion
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21
Q

What is the action of levator scapule?

A
  • Sidebends the head and neck
  • Elevates and rotates the scapula
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22
Q

What is the action of rhomboids?

A

Stabilization
Retraction
Elevation and internal rotation of scapula

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23
Q

What is the counterstrain treatment positioning for palmar wrist?

A

Flexion of wrist and elbow with slight ulnar or radial devation

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24
Q

What is the counterstrain treatment positioning for dorsal wrist?

A
  • Extension of wrist with slight ulnar or radial deviation of wrist as needed
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25
Q

What is the counterstrain treatment positioning for First carpometacarpal?

A
  • Lateral thumb
  • Flexion of wrist and abduction of thumb
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26
Q

What is the counterstrain treatment positioning for flexor pollicis brevis?

A

Flexion of wrist with flexion or adduction of thumb
Usually more medial

27
Q

List three suspected diagnotsis that might indicate ordering an Abdominal XR

A
  • Bowel obstruction
  • Bowel perforation
  • Kidney stones
28
Q

What is Rigler’s sign?

A
  • The Rigler sign, also known as the double-wall sign, indicates the presence of free air within the peritoneal cavity (pneumoperitoneum
  • seen on XR
29
Q

What is Steinstrasse?

A
  • Small calcifications lineraly arranged
  • Can be seen in the ureter as kidney stones are excreted
30
Q

What is a basic definition of Fluoroscopy?

A
  • Live XR performed during administration of contrast material
31
Q

Name 5 type of fluoroscopic studies

A
  1. Barium swallow
  2. Upper GI series
  3. Barium enema
  4. Small bowel follow through
  5. Urologic eval for bladder mass etc.
32
Q

When oral contrast is administered, how long to wait for CT to be performed for small bowel imaging?

A

~ 2-3 hours for contrast to reach the small bowel

33
Q

Where does a barium swallow study stop?

A

At the gastroesophageal junction

34
Q

Where does an upper GI study stop?

A

At the ligament of Treitz

35
Q

What is the ligament of Treitz?

A
  • a thin band of tissue (peritoneum) that connects and supports the end of the duodenum and beginning of the jejunum in the small intestine
  • Forms boundary of upper GI vs Lower GI
36
Q

What is a Schatzki’s ring?

A
  • Narrowing of GE junction
  • A Schatzki’s ring is a ring of tissue that forms inside the esophagus, the tube that carries food and liquid to your stomach.
  • This ring makes the esophagus narrow in one area, close to where it meets the stomach
37
Q

Chronic stricture of terminal ileum + Mucosal wall thickening =

A

Chron’s disease

38
Q

What are the primary targets for Abdominal U/S?

A
  1. Gallbladder
  2. Liver
  3. Kidneys
  4. Spleen
    *5. Pancreas but not normally well viewed
39
Q

What are some common indications for ordering RUQ U/S?

A
  1. Epigastric pain
  2. Abnormal liver enzymes
  3. Renal failure
40
Q

Why is the pancreas not well viewed on abdominal U/S?

A

Pancreas often obscured by gas in the stomach
Remember sound waves do not readily transmit through air

41
Q

When is CT not an optimal indication for abdomen exam?

A
  • Not optimal evaluation for solid abdominal organ or bowel pathology except kidney stone
42
Q

What is the idea patient parameter for CT with Oral contrast

A

When patient has BMI < 25

43
Q

What is ACR appropriateness criteria?

A

Website providing indications for various radiologic studies

44
Q

What is the indication for ordering CT with & without contrast?

A
  • When trying to characterize specific known pathologies such as liver mass, renal mass, adrenal mass
45
Q

The density of liver and spleen should be about equal on CT. What might cause the liver to not match the spleen?

A
  • If the density of the liver changes
  • I.e. if there is fatty infiltrate of the liver will change density of image on CT b/c fat is less dense
46
Q

T/F: There should be mild dilation of the pancreatic duct after meal visible on CT

A

False, dilation of the pancreatic duct should not be visible on CT

47
Q

What can cause formation of calcifications in the pancreas?

A

Repeat acute pancreatitis can cause formation of calcifications

48
Q

On imaging, what would you expect the appendix to measure?

A

Appendix should be > 8 mm

49
Q

When there is stool impaction, what can this induce regarding the rectum?

A
  • Causes perirectal inflammation
  • Can cause ischemia of the rectum due to pressure on the bowel wall
50
Q

Both the flexor carpi radialis and flexor carpi ulnaris originate from the medial epicondyle and flex the hand. What are their other actions

A

Flexor carpi ulnaris: adducts hand

Flexor carpi radialis: abducts hand

51
Q

What is the action of flexor pollicis brevis?

A

Flex and adduct the thumb

52
Q

What is the counterstrain treatment positioning for lateral trochanter (_______________________)

A
  • IT band
  • Abduction of the leg with slight flexion
  • Patient prone
53
Q

What is the counterstrain treatment position for the medial meniscus?

A
  • Patient seated
  • Knee flexed with internal rotation
  • Adduction of tibia and ankle plantar flexion and inversion
54
Q

What is the counterstrain treatment position for the lateral meniscus?

A
  • Patient seated
  • Knee flexed with external rotation
  • Abduction of tibia and ankle eversion & dorsiflexion
55
Q

What counterstrain technique has 2 locations for treatment?

A

Hamstring can have lateral or medial treatments

56
Q

What is the counterstrain treatment position for the medial hamstring?

A
  1. Patient prone
  2. Marked knee flexion with internal rotation and slight adduction of tibia
57
Q

What is the counterstrain treatment position for the lateral hamstring?

A
  1. Patient prone
  2. Knee flexion with external rotation and slight abduction of the tibia
58
Q

What is the counterstrain treatment position for extension for gastrocnemius tenderpoint?

A
  1. Pt prone
  2. Knee flexion & Planter flexion
  3. Pressure of calcaneus towards knee
59
Q

What is the origin of quadratus plantae?

A

Calcaneus

60
Q

What is the counterstrain treatment position for quadratus plantae tenderpoint?

A
  1. Prone
  2. Plantar flexion with translation of calcaneus towards the forefoot
61
Q

What is the counterstrain treatment position for lateral ankle tenderpoint?

A
  1. Pt prone
  2. Ankle eversion with slight plantar flexion
62
Q

What is the counterstrain treatment position for medial ankle tenderpoint?

A
  1. Pt prone
  2. Subtalar inversion
63
Q

What is the counterstrain treatment position for navicular tenderpoint?

A
  1. Pt prone
  2. Plantar flexion of talotibial joint
  3. Inversion of subtalar joint
  4. Supination of forefoot

M1 Block 5 (3 decks)

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