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536 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Which ligament runs vertically along the posterior aspect of the vertebral bodies?
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Posterior Longitudinal Ligament (Begins to narrow at lumbar region)
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https://o.quizlet.com/l-5SZUKQXDDJnjBL4pBYUw_m.jpg
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Why is the lumbar spine more susceptible to disc herniations?
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Narrowing of Posterior Longitudinal Ligament
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In the thoracic and lumbar regions, the nerve root exits where in relation to the corresponding vertebrae?
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Below
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https://o.quizlet.com/sD9NPPURSiQ93C4YM0nc7g_m.jpg
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Where does the spinal cord usually terminate?
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L1-L2
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https://o.quizlet.com/id2S.48pjByMcEbklqHU3w_m.jpg
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Due to the termination of the spinal cord, where do the lumbar nerve roots exit in relation to the intervertebral disc?
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Above
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A pelvic side shift usually indicates what?
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Iliopsoas dysfunction
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A positive Thomas test indicates what?
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Iliopsoas dysfunction
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https://o.quizlet.com/n7sQyy04Rn6D5doDvb.AyQ_m.jpg
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What landmark is used to locate the L4-L5 intervertebral disc?
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Iliac Crest
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https://o.quizlet.com/FM9VSMwlWrliHfdoeM.iIw_m.jpg
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What is the most common anomaly in the lumbar region?
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Zygopophyseal Facet Trophism (predisposes to early degenerative changes)
- asymmmetry of facet joint angles that are aligned in the coronal plane instead of the usual sagittal plane (BM) |
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What is it called when one or both transverse processes of L5 articulate with the sacrum?
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Sacralization
- can lead to early disc degeneration |
https://o.quizlet.com/VaMxBCGrNRAWvuZ.1BsQjA_m.png
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What is it called when there is a failure of S1 to fuse with the other sacral segments?
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Lumbarization
- less common than sacralization |
https://o.quizlet.com/rbUiYXQYJ36cG7y-4KDQDA_m.png
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A defect in the closure of the lamina of the vertebral segment is called?
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Spina Bifida
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No herniation through the defect, course patch of hair over site, rarely associated with neurological deficits:
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Spina Bifida Occulta
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https://o.quizlet.com/K9HH7Diy-YJqQx5mapzUfg_m.png
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Herniation of meninges through defect:
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Spina Bifida Meningocele
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https://o.quizlet.com/Cubs6RICU4ySoplLWOkEcQ_m.png
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Herniation of meninges and nerve roots through defect, associated with neurological deficits?
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Spina Bifida meningomyelocele
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https://o.quizlet.com/b--vu4dUf2stRjNGRkomnQ_m.png
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What is the major motion of the lumbar vertebrae?
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Flexion and Extension
- due to the alignment of facets (BM) |
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Sidebending of L5 will induce what in the sacrum?
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Oblique Axis on the same side
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Rotation of L5 will induce what in the sacrum?
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Rotation to opposite side
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What is another name for the lumbosacral angle?
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Ferguson's Angle
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https://o.quizlet.com/rYIyye5Yc1Uz9HZgat5rRw_m.png
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What is the intersection of a horizontal line and the line of inclination of the sacrum called?
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Lumbosacral Angle (Ferguson's Angle)
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What is a normal angle for the Lumbosacral (Ferguson's angle)?
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25-35 degrees
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https://o.quizlet.com/gk5S2mQVVluVKjCLpU-mCA_m.jpg
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An INC in Lumbosacral angle (Ferguson's angle) causes a shear stress placed on the lumbosacral junction often causing __.
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LBP
- excessive lordosis = INC in the angle |
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Where do 98% of herniations occur?
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L4-L5 or L5-S1
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A herniated lumbar disc will exert pressure on the nerve root of the vertebrae (above or below)?
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Below
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https://o.quizlet.com/B6y1s2LEvffe9repPo76bA_m.jpg
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Sharp, burning or shooting pain radiating down the leg which is worse with flexion is indicative of what?
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Herniated disc
- weakness + DEC reflexes associated with affected root - sensory deficit over corresponding dermatome (+) straight leg raise |
https://o.quizlet.com/CisYZNEZ5IQE95X3MoXw6w_m.png
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Tx Herniated disc?
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Most cases tx conservatively
- Bed rest for no more than 2 days - Indirect techniques OMT, followed by gentle direct - HVLA relatively contraindicated |
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What is the gold standard for the diagnosis of herniated disc?
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MRI
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https://o.quizlet.com/bD0P.Z0tEWT6sNfOTlx.XQ_m.jpg
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Increased pain when standing or walking indicates what?
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Psoas Syndrome
- due to sitting up suddenly after sitting for a long time since shortens the psoas |
https://o.quizlet.com/rOVLFFQShXVTlV2oHTU2VA_m.png
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Tender point medial to ASIS, nonneutral dysfunction of L1 or L2, positive pelvic shift test to the CL side, backward sacral torsion and CL piriformis spasm. Dx?
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Psoas syndrome
+ Thomas test |
https://o.quizlet.com/Cw8hp-gBjlMto5bFd8ZkTw_m.png
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Appendicitis, Sigmoid Colon dysfunction, ureteral calculi, ureter dysfunction, metastatic carcinoma of the prostate and salpingitis are all possible causes of what somatic dysfunction?
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Psoas Syndrome
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https://o.quizlet.com/i/Qo5GrG2R8J_3W_Wdm1kGTA_m.jpg
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Tx Psoas syndrome
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Acute spasm -> ice to DEC pain + edema
CS to anterior iliopsoas TP followed my MET or HVLA to the high lumbar dysfunction * Stretching an acute psoas spasm may cause it to further spasm, only stretch chronic |
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What is indicated if a patient has ipsilateral psoas syndrome and contralateral piriformis spasm?
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Sciatica
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A flexion contracture of the iliopsoas is often associated with what?
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Non-neutral dysfunction of L1 or L2
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Lower back pain that is worsened by extension (standing, walking or lying supine) is most likely what?
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Spinal Stenosis
- narrowing usually due to degenerative changes, causing pressure on nerve roots - visualized X-ray oblique view |
https://o.quizlet.com/vpEiYMO0VmlSnLo3S6cVLg_m.png
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Tx Spinal stenosis
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OMT DEC any restrictions, improve ROM
- additional conservative tx: PT, NSAIDs or low dose tapering steroids - epidural steroid injection if conservative tx not effective - laminectomy w/ decompression is indicated if all above tx options fail |
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INC pain with extension based activities. Tight Hams B/L. Stiffed-legged, short-stride, waddling type gate. No neuro deficits. Dx?
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Spondylolisthesis
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Anterior displacement of one vertebrae in relation to the one below is called due to fatigue fractures in pars interarticularis. Dx?
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*Spondylolisthesis*
*+ vertebral step-off sign* (palpating the spinous processes there is an obvious forward displacement at the area of the listhesis) |
https://o.quizlet.com/P16UjID.DYxAZRWTDwen-w_m.jpg
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Tx Spondylolithesis
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Conservative tx - goal reduce lumbar lordosis and SD
- HVLA contraindicated - Wt loss - Avoiding high heels - Avoid flexion based exercises - Lumbo-sacral orthotics for short term stability |
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Fatigue fractures in the pars interarticularis is a common cause of what?
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Spondylolisthesis
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A defect of the pars interarticularis without anterior displacement of the vertebral body is called?
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Spondylolysis
- 95% occur at L5 |
https://o.quizlet.com/Ugw99mM2qAri79IOFNnVbQ_m.png
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Oblique radiographs showing a Scotty Dog is indicative of what?
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Spondylolysis
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https://o.quizlet.com/M9FC8J7qg3oVM.3n0vV3wA_m.jpg
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Diagnose:
Spondylolisthesis ___ x-rays. Spondylolysis ___ x-rays. |
Spondylolisthesis - LATERAL x-rays
Spondylolysis - OBLIQUE x-ray |
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Grade 1 Spondylolisthesis is what percentage of displacement?
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0-25%
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https://o.quizlet.com/4cUVy5s6BsBaop4HT2eT-A_m.png
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Grade 2 Spondylolisthesis is what percentage of displacement?
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25-50%
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https://o.quizlet.com/4cUVy5s6BsBaop4HT2eT-A_m.png
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Grade 3 Spondylolisthesis is what percentage of displacement?
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50-75%
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https://o.quizlet.com/4cUVy5s6BsBaop4HT2eT-A_m.png
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Grade 4 Spondylolisthesis is what percentage of displacement?
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>75%
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https://o.quizlet.com/4cUVy5s6BsBaop4HT2eT-A_m.png
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What should you look for on radiographs if suspicious of Spondylolysis?
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Scotty Dog
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https://o.quizlet.com/qJZKJaKSADpn36JUoNzh7Q_m.jpg
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Forward displacement of one vertebrae on another seen on lateral films is indicative of what?
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Spondylolisthesis
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https://o.quizlet.com/Lhyc.u.2dX1.bO5WQTRUTQ_m.png
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Degenerative changes within the intervertebral disc and ankylosing of adjacent vertebral bodies is called what?
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Spondylosis
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https://o.quizlet.com/DpfZYDzAEF2XpdIIOo5AQw_m.png
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Saddle Anesthesia, DEC DTR, DEC rectal sphincter tone, loss of bowel and bladder control are indicative of what?
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Cauda Equina Syndrome (Surgical Emergency)
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https://o.quizlet.com/5vsWzZX0spYzWINRSMAZMQ_m.jpg
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What is the cause of Cauda Equina Syndrome?
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Massive Central Disc Herniation
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https://o.quizlet.com/5vsWzZX0spYzWINRSMAZMQ_m.jpg
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Tx Cauda Equina syndrome
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ER surgical decompression of cauda equine
-> if surgery delayed too long can have irreversible paralysis |
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The point at which a patient can actively move any given joint is called?
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Physiologic Barrier ("A + P" = *A*ctive + *P *hysiologic)
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https://o.quizlet.com/JlIKQzOsFBNFpNaN8fmHJw_m.png
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The point at which a physician can passively move any given point (beyond would cause ligament, tendon or skeletal injury):
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*Anatomic Barrier* ( "A + P" = *A*natomic + *P*assive)
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The point caused by somatic dysfunction that prevents motion to the physiologic barrier:
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Restrictive Barrier
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Another name for restrictive barrier is:
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Pathologic Barrier
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What is the only subjective component of TART?
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Tenderness
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The painful sensation produced by palpation of tissues where it should not occur is called:
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Tenderness
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Edematous, erythematous, bogginess, increased moisture and hypertonicity are characteristic of what?
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Acute Tissue Texture Changes
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Cool dry skin, slight tension, decreased muscle tone, flaccid, and fibrotic are characteristic of what?
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Chronic Tissue Texture Changes
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Tenderness in acute somatic dysfunction are likely to be what?
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Severe or Sharp
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Tenderness in chronic somatic dysfunctino are likely to be what?
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Dull, achy or burning
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The rules that govern spinal motion are termed?
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Fryette's Laws
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In Type I somatic dysfunction, sidebending and rotation occur to what?
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Opposite sides
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In Type I somatic dysfunction, would you expect to see flexion, extension or neutral positioning?
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Neutral (N for neutral points opposite directions as do rotation and sidebending)
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In Type II somatic dysfunction, sidebending and rotation occur to what?
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Same side
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In Type II somatic dysfunction, would you expect to see flexion, extension, or neutral positioning?
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Flexed or Extended
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How many vertebrae does Type II SD affect?
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One
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How many vertebrae does Type I SD affect?
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Multiple
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In non-neutral (Type II) SD, which occurs first, Sidebending or Rotation?
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Rotation
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In neutral (Type I) SD, which occurs first, Sidebending or Rotation?
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Sidebending
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Initiating motion at any vertebral segment in any one plane of motion will modify the mobility in the other two planes is the definition of what?
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Freyette's Law III
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C1 is the 1st so it is number 1) - What is the principle SD of C1?
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Type I (with F, E, or N)
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C2-C7 come after C1 (so they are number 2) - What are the principle SD of C2?
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Type II (with F, E, or N?
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Somatic Dysfunction is always named for the direction of?
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Ease
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When naming a SD of a vertebral unit (2 vertebrae and the disc between) which should be used as your reference point?
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Superior Vertebra
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The orientation of the superior facts of the cervical vertebrae is:
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BUM (Backward, upward and medial)
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The orientation of the superior facts of the thoracic vertebrae is:
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BUL (Backward, upward and Lateral)
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The orientation of the superior facets of the Lumbar vertebrae is:
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BM (Backward and Medial)
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Flexion and extension occur around what axis?
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Transverse
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Flexion and extension occur in what plane?
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Sagittal associated (kyphosis/lordosis)
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Rotation occurs around what axis?
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Vertical
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Rotation occurs in what plane?
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Transverse
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Sidebending occurs around what axis?
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AP (Anterior/Posterior)
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Sidebending occurs in what plane?
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Coronal associated (scoliosis)
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Approximation of muscle's origin and insertion without a change in its tension is what?
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Isotonic Contraction (iso = same tonic = tensions)
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When the operator's force is less than the patient's force, this is what?
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Isotonic Contraction
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Increase in tension without an approximation of origin and insertion is what?
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Isometric Contraction (iso = same metric = length)
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https://o.quizlet.com/VSLkVytmf98ma885YAVlFQ_m.jpg
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When the operator's force is equal to the patient's force, this is what?
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Isometric Contraction
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Muscle contraction against resistance while forcing the muscle to lengthen is what?
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Isolytic Contraction ("lysis" break adhesions)
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When the operator's force is greater than the patient's force, this is what?
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Isolytic Contraction
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Approximation of the muscle's origin and insertion is what?
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Concentric Contraction - wt lifter contract + shorten
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https://o.quizlet.com/ngrKdb.g3g93TdmUHabWrQ_m.jpg
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Lengthening of muscle during contraction due to an external force is what?
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Eccentric Contraction
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https://o.quizlet.com/napL2l4Uym6HIqz6HHEzBw_m.jpg
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Engaging the restrictive barrier and eventually moving through it is an example of what?
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Direct Treatment
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Moving tissues or joints away from the restrictive barrier towards the direction of ease is an example of what?
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Indirect Treatment
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This type of treatment involves the assistance of the patient (Usually isometric or isotonic)
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Active Treatment
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This type of treatment only involves the practitioner?
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Passive Treatment
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In general where should you begin treatment and where should you work to?
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Centrally to Peripherally
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What patients typically respond better to indirect techniques or gentle direct techniques?
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Elderly and Hospitalized
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What cases should have shorter intervals between treatments?
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Acute Cases
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What is required to allow the patient's body to respond to the treatment?
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Time
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Who can be treated more often, Pediatric or Geriatric patients?
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Pediatric
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Myofascial Release is what type of treatment?
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Direct or Indirect, Active or Passive
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Counterstrain is what type of treatment?
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Indirect, Passive
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FPR (Facilitated Positional Release) is what type of treatment?
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Indirect, Passive
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Muscle Energy is what type of treatment?
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Direct, Active
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HVLA (High Velocity Low Amplitude) is what type of treatment?
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Direct, Passive
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Cranial is what type of treatment?
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Direct or Indirect, Passive
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Lymphatic techniques are what type of treatment?
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Direct, Passive
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Chapman's Points are what type of treatment?
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Direct, Passive
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Tissue Texture changes, Asymmetry, Restriction of motion and Tenderness is known as what?
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TART
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Which vertebra has no spinous process or vertebral body?
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C1
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https://o.quizlet.com/B1X12aX4XJx-p9398jG8.g_m.png
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The dens is on which vertebra?
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C2
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https://o.quizlet.com/9BCZj8ld.53Hx4QuSVj.oQ_m.jpg
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Which vertebrae have bifid spinous processes?
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C2-C6
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https://o.quizlet.com/bmipaU7ir3TFQ909LfCkzw_m.jpg
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What lies between the superior and inferior facets of cervical vertebrae?
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Articular Pillars (green = 2 articular pillars)
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https://o.quizlet.com/pwWQq9szs6sO5w9p5gtVGw_m.jpg
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What is the passageway for the vertebral artery through the cervical vertebrae called?
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Foramen Transversarium
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https://o.quizlet.com/nxQx84q95vyh-9BnYkNbzw_m.png
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Where does the anterior scalene insert?
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*Rib 1* "1 AM 2 Pee"
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https://o.quizlet.com/L5Uj18.lcPDCkvQP58kHKg_m.png
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Where does the middle scalene insert?
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*Rib 1* "1 AM 2 Pee"
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https://o.quizlet.com/L5Uj18.lcPDCkvQP58kHKg_m.png
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Where does the posterior scalene insert?
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*Rib 2* "1 AM 2 Pee"
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https://o.quizlet.com/L5Uj18.lcPDCkvQP58kHKg_m.png
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This muscle sidebends ipsilaterally and rotates contralaterally:
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Sternocleidomastoid
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https://o.quizlet.com/tgOF5Gk8W4izvn8E-WHy4w_m.png
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Pathologic shortening of the SCM is called what?
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Torticollis
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This ligament extends from the sides of the dens to the lateral margins of the foramen magnum:
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Alar Ligament
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https://o.quizlet.com/3vIk9W2ePscQG.sLoKJ91w_m.png
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This ligament attaches to the lateral masses of C1 to hold the dens in place
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Transverse Ligament
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https://o.quizlet.com/jWvRb9M5av3XX7q13CkvMw_m.png
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What are two common causes of atlanto-axial subluxation?
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Rheumatoid Arthritis and Down's Syndrome
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What is the articulation between the uncinate processes and the superadjacent vertebrae called?
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Joint of Luschka C3-C7 bodies
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https://o.quizlet.com/Mzrh0TABYq-TeAf2UzC3Hg_m.png
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What is the most common cause of cervical nerve root pressure (cervical foraminal stenosis)?
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Degeneration of the Joints of Luschka
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https://o.quizlet.com/LKfnybOI7SBJfoGUI6rZVw_m.png
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What is the second most common cause of cervical nerve root pressure (cervical foraminal stenosis)?
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Hypertrophic arthritis (osteoarthritis) of intervertebral synovial joints
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https://o.quizlet.com/wbttWKtuArlftyu6lK9Y5w_m.jpg
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Where does the nerve root C8 exit?
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Between C7 and T1 (hence why every nerve root after this point is below the named vertebrae
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there is a C8 nerve but no C8 vertebral body)
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D |
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Where do cervical nerve roots C1-C7 exit?
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Above named vertebrae
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https://o.quizlet.com/C5n1pgh875a.jT9gNor0jQ_m.jpg
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What cervical nerve roots make up the brachial plexus?
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C5-T1
Roots Trucks Divisions Cords Branches |
https://o.quizlet.com/IJAwDXtZLci2m9-EffcwZA_m.png
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The occipital condyles on the atlas (C1) make up what joint?
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OA
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What is the primary motion of OA?
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Flexion and Extension (OA = OK! ... as with the motion of a head nod)
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Sidebending and rotation occurring to opposite sides with either flexion or extension is characteristic of which cervical joint?
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OA (and AA)
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https://o.quizlet.com/fiwqpKjcP-4M2POEGzyCpQ_m.jpg
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What is the primary motion of the AA (Atlantoaxial joint)
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Rotation
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https://o.quizlet.com/.BKj-z-h2ZMQaO5xw4kEEw_m.png
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Sidebending and Rotation to the same side in Neutral, Flexion or Extension is characteristic of what vertebrae?
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C2-C7
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Right translation results in what?
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Left Sidebending
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What must you do before motion testing the AA?
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Flex to 45 degrees (to lock out C2-C7)
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What is the primary method to asses motion of C2-C7?
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Lateral Translation
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What is the primary motion of C2-C4?
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Rotation (half closest to the AA behaves like the AA)
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What is the primary motion of C5-C7?
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Sidebending (half closest to the thoracics behaves like them)
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What is another name for Articular Pillars?
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Lateral Masses
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What portion of the cervical vertebrae is used to evaluate cervical motion?
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Articular Pillars
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What vertebrae have spinous processes located at the level of the corresponding transverse processes?
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T1-T3, T12
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What vertebrae have spinous processes located one half a segment below the corresponding transverse processes?
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T4-T6, T11
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What vertebrae have spinous processes located at the level of the transverse process of the vertebrae below?
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T7-T9, T10
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What level is the spine of the scapulae?
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T3
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What level is the inferior angle of the scapulae?
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T7
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What level is the sternal notch?
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T2
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https://o.quizlet.com/fxOyzvlShjpb4xhkwqz6wg_m.png
|
|
|
What level is the sternal angle (angle of Louis)?
|
T4
|
https://o.quizlet.com/xfbZ3lLdtfuDroZkq.CpGQ_m.jpg
|
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What dermatome is the nipple?
|
T4
|
https://o.quizlet.com/viJ2e68G5YIVm6c.Q0ez9Q_m.png
|
|
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What dermatome is the umbilicus?
|
T10
|
|
|
|
What is the main motion of the thoracic vertebrae?
|
Rotation (hence in nomenclature R precedes S)
|
|
|
|
What are the primary muscles of respiration?
|
Diaphragm and Intercostals
|
|
|
|
What portion of the rib articulates with the corresponding transverse process?
|
Tubercle
|
https://o.quizlet.com/nJlsMKl7hEh5mTgRAUcoFQ_m.jpg
|
|
|
What portion of the rib articulates with the corresponding vertebra and the vertebra above?
|
Head
|
https://o.quizlet.com/eEzw4VSQWjvNxElAoBtB0A_m.jpg
|
|
|
Which ribs are typical?
|
3-10 (10 is only sometimes considered atypical)
|
https://o.quizlet.com/D8VGypy0FhwUmufC1Z98Rw_m.jpg
|
|
|
All 1's and 2's - Which ribs are atypical (meaning they articulate in more or less places than typical)?
|
1, 2, 11, 12 (And sometimes 10)
|
|
|
|
Which ribs are True Ribs (Attach directly to the sternum)?
|
1-7
|
|
|
|
Which ribs are False Ribs (Do not attach directly to the sternum)?
|
8-12
|
|
|
|
Which ribs are Floating Ribs (Unattached anteriorly)?
|
11, 12
|
|
|
|
What is the primary motion of Ribs 1-5?
|
Pump Handle - transverse axis/sagittal plane
|
https://o.quizlet.com/u.b0JfeDGPlajpQT8g3B5A_m.png
|
|
|
What is the primary motion of Ribs 6-10
|
Bucket Handle - A/P axis/coronal plane
|
https://o.quizlet.com/gJp3hIKRG27qCwxfB7wi3A_m.png
|
|
|
What is the primary motion of Ribs 11 and 12?
|
Caliper Motion
|
https://o.quizlet.com/cr44koYSfwO0-46CF6SbxQ_m.png
|
|
|
If a pump handle rib (1-5) is held in inhalation, what edge of the posterior rib angle would you expect to be prominent?
|
Superior Edge
|
|
|
|
If a bucket handle rib (6-10) is held in inhalation, what edge of the rib shaft would you expect to be prominent?
|
Inferior Edge
|
|
|
|
If a pump handle rib (1-5) is held in exhalation, what edge of the posterior rib angle would you expect to be prominent?
|
Inferior Edge
|
|
|
|
Which rib is the key rib in an inhalation dysfunction?
|
*Lowest* Rib (*BI*TE)
|
|
|
|
Which rib is the key rib in an exhalation dysfunction?
|
*Uppermost* Rib (BI*TE*)
|
|
|
|
Treatment is directed at which rib in an inhalation or exhalation dysfunction?
|
Key Rib
|
|
|
|
Name the secondary muscles of respiration and corresponding ribs?
|
Scalenes: ribs 1 + 2
Pectoralis minor: ribs 3-5 Serratus anterior + posterior: ribs 4-9 Latissimus dorsi: ribs 10-12 Quadratus lumborum: rib 12 |
|
|
|
An appreciable lateral deviation of the spine from the normally straight vertical line is called what?
|
Rotoscoliosis
|
|
|
|
Who are most likely to have scoliosis?
|
Females
5% of school aged children dev. scoliosis by age 15 |
|
|
|
Scoliosis with the apex at the right is called what? (sidebent left)
|
Dextroscoliosis
- Curve SL with Scoliosis to R |
https://o.quizlet.com/AsPR8TZTRKidua99JVuK1Q_m.jpg
|
|
|
Scoliosis with the apex to the left is called what? (sidebent right)
|
Levoscoliosis
- Curve SR with Scoliosis to L |
https://o.quizlet.com/AsPR8TZTRKidua99JVuK1Q_m.jpg
|
|
|
A spinal curve that is relatively fixed and inflexible and will not resolve with sidebending the opposite direction is called what?
|
Structural Curve
|
|
|
|
A spinal curve that is flexible and can be partially or completely corrected with sidebending to the opposite side is called what?
|
Functional Curve
|
|
|
|
What age group should be screened for scoliosis?
|
10-15
|
|
|
|
If suspicious, what can be done to screen for scoliosis in addition to the physical exam?
|
Standing X-rays
|
|
|
|
What is used to measure the degree of scoliosis?
|
Cobb Angle
|
https://o.quizlet.com/cVEi3LeaOI4gGzbXPM3t.Q_m.png
|
|
|
What is described by perpendicular lines originating from horizontal lines from vertebral bodies of extreme ends of the curve?
|
Cobb Angle
|
https://o.quizlet.com/cVEi3LeaOI4gGzbXPM3t.Q_m.png
|
|
|
Mild scoliosis is what cobb angle?
|
5-15 degrees
|
|
|
|
Moderate scoliosis is what cobb angle?
|
20-45 degrees
|
|
|
|
Severe scoliosis is what cobb angle?
|
>50 degrees
|
|
|
|
Respiratory function is compromised if the thoracic curvature is of scoliosis is ___.
|
>50 degrees
|
|
|
|
Cardiovascular function is compromised if the thoracic curvature is of scoliosis is ___.
|
>75 degrees
|
|
|
|
Causes of scoliosis?
|
1. *Idiopathic* 80% some pts have FHx
2. *Congenital* - malformation vertebrae 3. *Neuromuscular* - muscular weakness/spasticity (poliomyelitis, cerebral palsy, Duchenne's, meningomyelocele) 4. *Acquired*- tumor, infection, osteomalacia, sciatic irritability, psoas syndrome, short left syndrome |
|
|
|
What is the treatment for mild scoliosis?
|
PT
*Konstancin Exercises* (series of specific exercises that have been proven to improve the pt with scoliotic postural decompensation) OMT - goal improve flexibility + strengthen trunk and abdominal musculature |
|
|
|
What is the treatment for moderate scoliosis?
|
Bracing with spinal orthotic
|
|
|
|
What is the treatment for severe scoliosis?
|
Surgery - if respiratory compromise or if scoliotic curve progresses quickly despite conservative tx
|
|
|
|
One leg appears shorter than the other.
|
Functional leg length discrepancy
|
|
|
|
What are the compensations in short leg syndrome?
|
1. *Sacral base unleveling* - base lower on side of short leg
2. *Anterior innominate* rotation on side of *short leg* 3. *Posterior innominate* rotation on the side of* long leg* 4. *Lumbar spine* will SA + RT side short leg 5. *Lumbosacral (Ferguson's) angle* will INC 2-3 deg. 6. First the iliolumbar *ligaments*, then the SI ligaments may become *stressed on the side of the short leg* |
|
|
|
What is the most common cause of anatomical leg length discrepancy?
|
Hip Replacement
|
|
|
|
In short leg syndrome, the sacral base will be lower on which side?
|
Short Leg
|
|
|
|
In short leg syndrome, the Anterior innominate rotation will be on which side?
|
Short Leg
|
|
|
|
In short leg syndrome, the Posterior innominate rotation will be on which side?
|
Long Leg
|
|
|
|
In short leg syndrome, the lumbar spine will sidebend away and rotate toward which side?
|
Short Leg
|
|
|
|
Tx Short leg syndrome
|
*OMT directed at spine + LE* done to remove or DEC as much SD as possible if leg length discrepancy is still present and short leg syndrome is suspected obtain postural x-rays to quantify differences in the heights of the femoral head
|
|
|
|
What is used to diagnose Short Leg Syndrome?
|
*Standing Postural X-rays*
- if femoral head > 5 mm consider a heel lift |
|
|
|
Unless the cause was recent and sudden, how much should the final heel lift height be?
|
*1/2 - 3/4 of the measured leg discrepancy*
- unless there was a sudden cause of the discrepancy (hip fracture/hip prosthesis) in that case lift the full amount that was lost |
|
|
|
In the "fragile"(elderly, arthritic, osteoporotic, or having acute pain), how often should you increase the heel lift in short leg syndrome?
|
1/16" heel lift and INC 1/16" (1.5 mm) every two weeks
|
|
|
|
In the "flexible", how often should you increase the heel lift in short leg syndrome?
|
1/8" heel lift and INC every two weeks
|
|
|
|
What is the maximum heel lift that can be placed inside the shoe?
|
1/4"
- if > 1/4 is needed then this must be applied to the outside of the shoe |
|
|
|
If more than 1/2" is needed in short leg syndrome, what should be used in place of a heel lift?
|
*Anterior Sole Lift*
- extending from the heel to toe used in order to keep the pelvis from rotating to the opposite side |
|
|
|
What percentage of school-age children develop scoliosis by age 15 ?
|
5%
|
|
|
|
Of those who develop scoliosis, what percentage experience clinical symptoms?
|
10%
|
|
|
|
What is the most common etiology of Scoliosis?
|
Idiopathic
|
|
|
|
How much can the lumbosacral angle increase in short leg syndrome?
|
2-3 degrees
|
|
|
|
What two muscles make up the pelvic diaphragm?
|
Levator ani and Coccygeus (primary pelvic muscles)
|
https://o.quizlet.com/.qeC0clC8AVz-ewfR8L7.Q_m.png
|
|
|
Around what axis of the sacrum does respiratory motion occur?
|
Superior Transverse Axis
|
https://o.quizlet.com/7Qj8-95Y9oAChYIQXczv3Q_m.png
|
|
|
What level is the superior transverse axis of the sacrum?
|
S2
|
https://o.quizlet.com/7Qj8-95Y9oAChYIQXczv3Q_m.png
|
|
|
During inhalation, what direction does the sacral base move?
|
Posterior
|
|
|
|
Around what axis of the sacrum does Craniosacral (inherent) motion occur?
|
Superior Transverse Axis
|
https://o.quizlet.com/7Qj8-95Y9oAChYIQXczv3Q_m.png
|
|
|
During craniosacral flexion, what direction does the sacrum move?
|
Posterior or *Counternutation*
|
|
|
|
What is another name for the posterior movement of the sacral base?
|
Counternutation
|
|
|
|
During cransiosacral extension, what direction does the sacrum move?
|
Anterior or *Nutation*
|
|
|
|
What is another name for anterior movement of the sacral base?
|
Nutation (Nod forward)
|
|
|
|
Around what axis of the sacrum does postural motion occur?
|
Middle Transverse Axis
|
https://o.quizlet.com/7Qj8-95Y9oAChYIQXczv3Q_m.png
|
|
|
As a person begins to bend forward the sacral base move ___.
At terminal flexion, the sacrotuberous ligaments become taut and the sacral base will move ___. |
Anterior
Posterior |
|
|
|
What are the 4 physiologic axes of the sacrum and innominates?
|
*DRIP *
*D*ynamic *R*espiratory *I*nherent/*I*nnominate *P*ostural |
|
|
|
Around what sacral axes does dynamic motion occur during ambulation?
|
*2 Sacral Oblique Axes* are engaged when walking
|
|
|
|
When weight bearing on one leg, which oblique axis is engaged?
|
Same oblique axis
- wt bearing left leg (stepping forward with the right leg) will cause a left sacral axis to be engaged |
https://o.quizlet.com/7Qj8-95Y9oAChYIQXczv3Q_m.png
|
|
|
Around which sacral axis does innominate rotation occur?
|
Inferior Transverse Axis
|
https://o.quizlet.com/7Qj8-95Y9oAChYIQXczv3Q_m.png
|
|
|
What level is the inferior transverse axis at?
|
S4
|
|
|
|
What level is the middle transverse axis at?
|
S3
|
|
|
|
In innominate dysfunction, the side of the dysfunction is on the side of what?
|
Positive Standing Flexion Test
|
|
|
|
Anterior vs Posterior innominate rotation when does the leg appear shorter IL or longer IL?
|
Anterior innominate rotation = Short leg IL
Posterior innominate rotation = Long leg IL |
|
|
|
What is the cause of anterior innominate somatic dysfunction?
|
Tight Quadriceps
|
|
|
|
What is the cause of posterior innominate somatic dysfunction?
|
Tight Hamstrings
|
|
|
|
What are the 2 most common causes of superior innominate shear?
|
Fall IL buttock or mis-step
|
|
|
|
What are the 2 most common causes of superior pubic shear?
|
Trauma or Tight Rectus Abdominus
|
|
|
|
What are the 2 most common causes of inferior pubic shear?
|
Trauma or Tight Adductors
|
|
|
|
Standing Flexion Test indicates what?
|
Iliosacral Dysfunction
|
|
|
|
Seated Flexion Test indicates what?
|
Sacroiliac Dysfunction
|
|
|
|
Sacral oblique axes are named for what?
|
Superior Pole
|
|
|
|
When L5 is sidebent, which sacral oblique axis is engaged?
|
Same Side
|
|
|
|
When L5 is rotated, which direction is the sacrum rotated?
|
Opposite Side
|
|
|
|
When a positive seated flexion test is found, which side is the oblique axis engaged?
|
Opposite Oblique Axis
|
|
|
|
Negative spring test indicates which type of torsion?
|
Forward Torsion (or unilateral flexion)
|
|
|
|
Positive spring test indicates which type of torsion?
|
Backward Torsion (or unilateral extension)
|
|
|
|
In a forward torsion, rotation is on which side compared to the axis?
|
Same Side
|
|
|
|
In a backward torsion, rotation is on which side compared to the axis?
|
Opposite Side
|
|
|
|
Which has + backward bend test forward or backward torsion?
|
+ backward bend in backward (posterior torsion)
|
|
|
|
What is the most common dysfunction of the sacrum in post-partum patients?
|
Bilateral Sacral Flexion
- INC lumbar curve |
|
|
|
If L5 and Sacral dysfunction are both present (as is usually the case), which should be treated first?
|
L5 (Sacral dysfunction will often resolve with treatment of L5)
|
|
|
|
A psoas syndrome will often cause dysfunction where?
|
L1 or L2 (flexed, sidebent and rotated to the same side as the iliopsoas contracture)
|
|
|
|
What three bones make up the innominate?
|
Ilium, Ischium, Pubis
|
|
|
|
By what age does the innominate usually fuse?
|
20
|
|
|
|
What ligament divides the greater and lesser sciatic foramen?
|
Sacrospinous Ligament
|
https://o.quizlet.com/z3Mk9PBEfbQs9C8qnnS5mA_m.png
|
|
|
What is usually the first ligament to become painful in lumbosacral decompensation?
|
Iliolumbar Ligament
|
https://o.quizlet.com/TvQFQ7DTFzf2x-S8PbbhNA_m.png
|
|
|
What are the true pelvic ligaments (sacroiliac ligaments)?
|
Anterior, Posterior, and Interosseous
|
https://o.quizlet.com/m4T1HKLwUXWeSd7OQJ0pUw_m.jpg
|
|
|
What is the only bone connecting the upper extremity to the axial spine?
|
Clavicle
|
|
|
|
What are the 4 muscles that make up the rotator cuff?
|
*S*upraspinatus
*I*nfraspinatus *T*eres Minor *S*ubscapularis |
|
|
|
What is the primary motion of the supraspinatus?
|
Abduction
|
|
|
|
What is the primary motion of the infraspinatus?
|
External Rotation
|
|
|
|
What is the primary motion of the Teres Minor?
|
External Rotation
|
|
|
|
What is the primary motion of the subscapularis?
|
Internal Rotation
|
|
|
|
What is the primary motion of the Pectoralis Major?
|
Adduction
|
|
|
|
What is the primary motion of the Latissimus Dorsi?
|
Adduction and Extension
|
|
|
|
What is the primary motion of the Teres Major?
|
Extension
|
|
|
|
What is the primary motion of the posterior Deltoid?
|
Extension
|
|
|
|
What is the primary motion of the middle Deltoid?
|
Abduction
|
|
|
|
What is the primary motion of the anterior Deltoid?
|
Flexion
|
|
|
|
Where does the subclavian artery pass through the thoracic outlet?
|
Between Anterior and Middle Scalenes
|
https://o.quizlet.com/qwOlWQ8HcWfOGBzxBCFqJw_m.png
|
|
|
Where does the subclavian vein pass through the thoracic outlet?
|
Anterior to the Anterior Scalene
|
https://o.quizlet.com/9dB3CubsLY7-m10857m-bA_m.jpg
|
|
|
Where does the subclavian artery become the axillary artery?
|
Border of the first Rib
|
https://o.quizlet.com/ztrI3q45oWKw18fxsH3vyA_m.png
|
|
|
Where does the axillary artery become the brachial artery
|
Inferior Border of the Teres Minor
|
https://o.quizlet.com/ztrI3q45oWKw18fxsH3vyA_m.png
|
|
|
What is the first major branch of the brachial artery?
|
Profunda Brachial Artery
|
|
|
|
The profunda brachial artery accompanies the radial nerve in its posterior course where?
|
Radial Groove
|
https://o.quizlet.com/V8FNdYrSgk1a.xAm-a22Hw_m.png
|
|
|
Where does the brachial artery divide into the ulnar and radial arteries?
|
Under the bicipital aponeurosis
|
https://o.quizlet.com/m4bOcSAm4YxQB59tl-jNUA_m.png
|
|
|
What supplies blood to the elbow, wrist, dorsal aspect of hand and end in the deep palmar arterial arch?
|
Radial Artery
|
https://o.quizlet.com/Nyn9BInYYYdPHOJ0NAwmoQ_m.jpg
|
|
|
What is medial, supplies blood to the elbow, wrist, dorsal aspect of hand and forms most of the superficial palmar arterial arch?
|
Ulnar Artery
|
https://o.quizlet.com/3zn79DhwZbY12P35CxktLQ_m.jpg
|
|
|
With normal motion, how far can the arm actively abduct?
|
180 degrees (2/3 due to glenohumeral motion and 1/3 due to scapulothoracic motion)
* every 3 degrees abduction, the glenohumeral joint moves 2 degrees and scapulothoracic joint moves 1 |
|
|
|
What is the most common somatic dysfunction of the shoulder?
|
Internal and External Rotation
|
|
|
|
What is the 2nd most common somatic dysfunction of the shoulder?
|
Abduction
|
|
|
|
What is the least common somatic dysfunction of the shoulder?
|
Extension
|
|
|
|
What is the most common somatic dysfunction of the sternoclavicular joint?
|
Clavicle Anterior and Superior on Sternum
|
https://o.quizlet.com/fx8Ad5fBQk1GJmkcG6J0xA_m.png
|
|
|
What is the most common somatic dysfunction of the acromioclavicular joint?
|
Clavicle superior and lateral on the Acromion
|
https://o.quizlet.com/c4j1Jjx.xKErvj5tPbjzoA_m.png
|
|
|
What 3 ligaments stabilize the acriomioclavicular joint?
|
Acriomioclavicular, Coracoacromial, and Coracoclavicular
|
https://o.quizlet.com/rgcOdwQhQLoaz-q8A0-bvA_m.png
|
|
|
Compression of the neurovascular bundle as it exits the thoracic outlet is called:
|
Thoracic Outlet Syndrome
|
https://o.quizlet.com/xdLCRG0-XCH9npTcOEgi.w_m.png
|
|
|
A positive Adson's test indicates what type of thoracic outlet syndrome?
|
Compression between the scalenes
|
|
|
|
A positive Military Posture test indicates what type of thoracic outlet syndrome?
|
Compression between clavicle and rib 1
|
https://o.quizlet.com/i/pb2HwiFfozx5-dtAPiPnpA_m.jpg
|
|
|
A positive Hyperextension test indicates what type of thoracic outlet syndrome?
|
Compression under Pectoralis Minor
|
https://o.quizlet.com/-ci4O33jSuvvdj-PF4-ozA_m.jpg
|
|
|
Continuous impingement of the greater tuberosity against the acromion as the arm is flexed and internally rotated results in what?
(The pain exacerbated by abduction especially 60-120 deg "painful arc".) |
*Supraspinatus Tendinitis*
- tenderness tip of the acromion - chronic tendinitis may lead to calcification of the supraspinatus tendon |
https://o.quizlet.com/ExfJ66hIidXFiX20IOYyZQ_m.png
|
|
|
Overuse leading to adhesions that bind the tendon to the bicipital groove causes what?
|
Bicipital Tenosynovitis
- pain: anterior portion of the shoulder may radiate to biceps - tenderness bicipital groove |
https://o.quizlet.com/-Ub2L04Ezziy1V7KZt1dqg_m.png
|
|
|
Tenderness over the bicipital groove (aggravated by resisted flexion or supination) is likely due to what?
|
Bicipital Tenosynovitis
|
|
|
|
Pain with abduction (especially 60-120 degrees) is most likely due to what?
|
Supraspinatus Tendinitis
|
|
|
|
Positive drop arm test is indicative of what?
|
Rotator Cuff Tear
|
|
|
|
Progressive pain and restriction of shoulder motion is what?
|
Adhesive Capsulitis (Frozen Shoulder Syndrome)
- that INC gets worse over course 1 year - tenderness anterior shoulder |
https://o.quizlet.com/flFQxu8MhO5qTXxwowKlug_m.png
|
|
|
What is the most common cause of Adhesive Capsulitis?
|
Prolonged Immobility (of the shoulder)
|
|
|
|
What OMT treatment can be used to treat Adhesive Capsulitis?
|
Spencer Technique
|
|
|
|
What should be done to prevent Adhesive Capsulitis following shoulder surgery?
|
Early Mobilization
|
|
|
|
What is the most common cause of shoulder dislocation?
|
Trauma
|
|
|
|
What are the 2 most common directions of shoulder dislocation?
|
Anterior and Inferior
|
|
|
|
When can posterior shoulder dislocations happen?
|
Seizures
Electrocution Falling outstretched hand |
|
|
|
Injury to what nerve can occur from shoulder dislocation?
|
Axillary Nerve - deltoid
|
|
|
|
What muscle weakness results in Scapula Winging?
|
Serratus Anterior
|
|
|
|
What nerve injury results in Winged Scapula?
|
Long Thoracic
|
https://o.quizlet.com/PuYJb9u3CCZkXR69p29kIA_m.png
|
|
|
What is the most common brachial plexus injury?
|
Erb-Duchenne's Palsy
|
https://o.quizlet.com/0Hc-jaSdn-vs1dUqjUL52w_m.png
|
|
|
Damage to what nerve roots causes Erb-Duchenne's Palsy?
|
C5 and C6
|
|
|
|
What type of injury most commonly causes Erb-Duchenne's Palsy?
|
Traction injury during childbirth (shoulder dystocia)
|
https://o.quizlet.com/vYy-3wb1xdjAT2vZM4T--g_m.png
|
|
|
Damage to what nerve roots causes Klumpke's Palsy?
|
C8 and T1
- hyperextension, hyperabduction injury during fall or child birth |
|
|
|
Paralysis of what muscles results from Klumpke's Palsy?
|
Intrinsic Muscles of Hand
|
https://o.quizlet.com/OyRdaZXo-apBurDlzZNVEA_m.png
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Crutch palsy is due to direct pressure on what nerve?
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Radial Nerve
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What is the result of radial nerve injury?
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Wrist drop and Triceps Weakness
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What is the most common nerve injured in the upper extremity due to direct trauma?
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Radial nerve
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Compression of the radial nerve against the humerus while the arm is draped over the back of a chair during intoxication or deep sleep is called what?
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Saturday Night Palsy
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https://o.quizlet.com/ZmWfdKaiFPsV45GUbSXWqg_m.png
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How many phalanges are there?
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Fourteen
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What are the 4 carpal bones of the proximal row (lateral to medial)?
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Scaphoid, Lunate, Triquetral, Pisiform
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What are the 4 carpal bones of the distal row (lateral to medial)?
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Trapezium, Trapezoid, Capate, Hamate
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Where do the primary flexors of the wrist originate?
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Medial Epicondyle
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What nerve innervates the primary flexors of the wrist?
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*Median Nerve* (Except flexor carpi ulnaris which is innervated by the Ulnar nerve)
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Where do the primary extensors of the wrist originate?
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Lateral Epicondyle
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What nerve innervates the primary extensors of the wrist?
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Radial nerve
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What are the two primary supinators of the forearm?
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Biceps (musculocutaneous nerve) and Supinator (Radial Nerve)
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What are the two primary pronators of the forearm?
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Pronator Teres and Pronator Quadratus (Both innervated by median nerve)
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What innervates the muscles of the thenar eminence?
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Median Nerve (Except Adductor policis brevis which is innervated by the ulnar nerve)
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https://o.quizlet.com/I9KODQQ8yfRF6roRDBYSPQ_m.png
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What innervates the muscles of the hypothenar eminence +interossi?
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Ulnar nerve
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https://o.quizlet.com/Au3O0GDrwWAKIGl4T.RI7w_m.png
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Formed by the intersection of two lines. The first line is the longitudinal axis of the humerus. The second line starts at the distal radial-ulna joint, and passes through the proximal ulna joint.
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Carrying angle
normal Men: 5 deg. normal Women: 10-12 deg. |
https://o.quizlet.com/ygu8UWOBDT6Y7rwnbrmemA_m.png
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A carrying angle > 15 degrees is called cubitus valgus or ___ if SD is present.
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Abduction of the ulna
- Adduction of the wrist |
https://o.quizlet.com/HQDcluPieVwgA9PeO2aoew_m.png
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A carrying angle < 3 degrees is called cubitis varus or ___ if SD is present.
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Adduction of the ulna
- Abduction of the wrist |
https://o.quizlet.com/YOK0L7oN7hOom1rsl52NqA_m.png
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When the forearm is pronated the radial head will glide ___.
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*P*OSTERIOR = *P*ronated
- falling forward on a pronated forearm cause posterior radial head injury |
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When the forearm is supinated the radial head will glide ___.
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ANTERIOR
- can result from falling backward on a supinated arm (anterior dislocation radial head) |
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Pt complains of paresthesias on the thumb and the first 2 1/2 digits.
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*Carpal tunnel syndrome*
- entrapment of the *median nerve* at the wrist - tx: splints, NSAIDs, steroid injections, OMT (direct release technique to INC space in the carpal tunnel) surgery if medical tx fails |
https://o.quizlet.com/k0OkcwofmcyMCG59U3KtSg_m.png
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Dx Carpal tunnel syndrome gold standard?
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Nerve conduction studies/electromyography
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Commonly results from overuse of the extensors + supinators.
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Lateral epicondylitis (tennis elbow)
- NSAIDs, rest, ice |
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Commonly results from overuse of flexors and pronators.
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Medial epicondylitis (golder's elbow)
- NSAIDs, rest, ice |
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Flexion contraction MCP + DIP, Extension contraction PIP. Contraction of the intrinsic muscles of the hand and associated with?
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RA - Swan-neck deformity
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https://o.quizlet.com/TZJndRtcRwaop8O5gRBBTw_m.png
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Extension contraction of MCP + DIP. Flexion contraction PIP. Results from a rupture of the hood of the extensor tender at the PIP and associated with?
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RA - Boutonniere deformity
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https://o.quizlet.com/L2AzP2u.eI5rtogP2FIffA_m.png
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Extension of MCP. Flexion PIP + DIP. what can cause this?
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Claw hand
- injury to median + ulnar nerve (loss of intrinsic muscles + overactivity of the extensor muscles) |
https://o.quizlet.com/9.fF1aWUw-5J1F6Ve4EvlA_m.png
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What can cause Ape hand deformity?
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- Claw hand deformity + wasting of the thenar eminence and thumb adducted
- Median n. damage |
https://o.quizlet.com/JaGwqc5h7VhIq1PRyr7cAA_m.png
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Contracture of the last two digits with atrophy of the hypothenar eminence due to __ damage.
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ULNAR - Bishops deformity
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https://o.quizlet.com/fojMBh19r39HKSF19VblAQ_m.png
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Flexion contraction of MCP + PIP usually seen with contracture of the last two digits. Due to contraction of the palmar fascia.
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*Dupuytren's contraction*
- associated liver cirrhosis |
https://o.quizlet.com/Oegm-ZFYrWwubEUFTUWc.w_m.png
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Name the primary extensor and flexor of the hip.
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Extensor: Gluteus max
Flexor: Iliopsoas |
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Name the primary extensor and flexor of the knee.
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Extensor: Quads (rectus femoris, vastus lateralis, medialis, and intermedius)
Flexor: Semimebranosus + semitendinosus (hams) |
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What ligaments make up the femoroacetabular joint?
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Hip joint - ball + socket held by
1. Iliofemoral ligament 2. Ischiofemoral ligament 3. Pubofemoral ligament 4. Capitis femoral ligament - ligament at the head of the femur attaching to the acetabular fossa |
https://o.quizlet.com/287.p4BYVvMUeYqqF6iGcw_m.png
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The head of the femur will glide anteriorly with __ rotation of the hip.
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External
- External rotation SD can be due to piriformis or iliopsoas spasm |
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The head of the femur will glide posteriorly with __ rotation of the hip.
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Internal
- Internal rotation SD can be due to spasm of (gluteus minimus, semimembranosus, semitendinosus, TFL, adductor magnus, adductor longus) |
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Fibular head glides ___ with pronation of the foot.
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ANTERIORLY
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https://o.quizlet.com/Ar8chTrPoKZdcofFpgG23g_m.png
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Fibular head glides __ with supination of the foot.
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POSTERIORLY
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https://o.quizlet.com/uUBo.AHHCCgq5qvCOP7CPg_m.png
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Dorsiflexion, eversion, and abduction = ___ of the ankle.
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PRONATION
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Plantarflexion, inversion, and adduction = ___ of the ankle.
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SUPINATION
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Femoral n. which level?
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L2-L4
- anterior thigh, medial leg - quads, iliacus, satorius, pectinus |
https://o.quizlet.com/i/RZUdgjo5jjdNoKstIbe9og_m.jpg
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Sciatic n. which level?
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L4-S3
- greater sciatic foramen -85% population sciatic n. is inferior to the piriformis muscle |
https://o.quizlet.com/9vado2dZwIUh8PeQyFrHoQ_m.png
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What does L3-L4 disc herniation affect?
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L4 nerve root
Medial leg sensation Foot inversion Tested by the patellar DTR |
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What does L4-L5 disc herniation affect?
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L5 nerve root
Anterior leg + foot sensation Foot dorsiflexion NO DTR associated with it |
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What does L5-S1 disc herniation affect?
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S1 nerve root
Lateral leg sensation Foot eversion Tested by the Achilles DTR |
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Normal angle between the neck and shaft of the femur is ___ def.
IF this angle < 120 deg this is called ___. IF > 135 deg ___. |
normal = 120-135
< 120 = coxa vara > 135 = coxa valga |
https://o.quizlet.com/tWeZJZMlcyQdj5Kz.KCnfA_m.png
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Q angle what is it and what does it mean when there is an INC or DEC Q angle?
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Intersection of a line from the ASIS through middle of the patella and line tibial tubercle through middle patella (normal 10-12 deg)
INC Q = genu valgum DEC Q = genu varum |
https://o.quizlet.com/sIBWztZ96x5BeXkQpxVaCA_m.png
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Talus internally rotated causing foot to invert and plantarflex. What is the position of the fibular head?
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Posterior fibular head
- foot is supinated |
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Talus externally rotated causing foot to evert and dorsiflex. What is the position of the fibular head?
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Anterior fibular head
- foot is pronated |
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Deep knee pain especially when climbing stairs. Atrophy vastus medals and have patellar crepitus. More common in women due to large Q angle. Dx?
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*Patello-femoral syndrome*
- strong vastus laterals and weak vestus medals -> patella deviates laterally + excess wearing on posterior patella tx: strengthen vastus medialis |
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First degree sprain?
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No tear resulting in good tensile strength and no laxity
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Second degree sprain?
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Partial tear resulting in DEC tensile strength with mild to moderate laxity
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Third degree sprain?
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Complete tear resulting in no tensile strength and severe laxity
- usually require surgery |
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Severe unrelenting pain after and during exercise the anterior tibialis muscle is hard and tender to palpation, pulses are present and stretching the muscle causes extreme pain. Dx? Tx?
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Compartment syndrome (most common Anterior)
Tx: ice + MFR to INC venous lymph return ER: Muscle necrosis can occur w/in 4-8 hours if intracompartmental remains elevated surgical fasciotomy is indicated |
https://o.quizlet.com/yuFFSRM37jOOMOryYEv6kA_m.jpg
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O'Donahue's triad
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MCL
ACL MM |
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Associated with large baby female first born breach delivery femoral head posterior and superior. Dx.
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Congenital hip dysplasia
- Barlow + Ortolani test in newborn - Pavlik harness tx |
https://o.quizlet.com/iofTq88uX2vN-UdOjjJw3A_m.png
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Osteonecrosis femoral capital epiphysis with painless limp male between 4-10 years old.
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Legg-Calve-Perthes Dz
- self limiting management |
https://o.quizlet.com/Rd5vzPNaAYo3FRh6Hj57Fg_m.jpg
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Displacement of the femoral head on the femoral neck. Presents with progressive painful limp pain may be in the knee. Loss of abduction and internal rotation. Overweight 14 year old boy who develop limp with pain. Dx?
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Slipped Capital Femoral Epiphysis (SCFE)
- surgical intervention |
https://o.quizlet.com/i/618QDDxMIb8FzK842Yv6kw_m.jpg
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Compression of the lateral femoral cutaneous nerve called?
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Meralgia Paresthetica
- pass under the inguinal ligament - pain lateral leg |
https://o.quizlet.com/7btUcdlGKMg.28MR-QTzUA_m.jpg
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Painful swelling over the tibial tuberosity in children 10-15 yo. seperation of new bone growth tibial tuberosity.
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Osgood-Schlatter Dz
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https://o.quizlet.com/i/LAaaqBqHZAYSyymBi7HcnQ_m.jpg
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Bones of the foot
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D |
https://o.quizlet.com/LaSb9yzeMyJbHhm13vvYCw_m.png
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___ glide of the talus with plantaflexion.
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Anterior
- > posterior glide with dorsiflexion |
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The ankle is most stable in___.
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DORSIFLEXION
- thus most ankle sprains occur in plantar flexion |
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SD of the foot of the arch usually?
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Transverse arch (NICE)
-> *N*avicular *I*nverted -> Cuneiforms down -> *C*uboid *E*verted = flatten arch of the foot seen in long distance runners |
https://o.quizlet.com/tphmV4KtZr-5KYeVuyIcUw_m.png
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Type I sprain ankle involves?
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*ATFL*
"Always Tears First" |
https://o.quizlet.com/JqWW7D9HlxIKNBcEV3EUKQ_m.png
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Type II sprain ankle involves?
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ATFL + CFL (calcaneofibular ligament)
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https://o.quizlet.com/JqWW7D9HlxIKNBcEV3EUKQ_m.png
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Type III sprain ankle involves?
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ATFL + CFL + PTFL (posterior talofibular ligament)
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https://o.quizlet.com/JqWW7D9HlxIKNBcEV3EUKQ_m.png
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This ligament extends from the sides of the dens to the lateral margins of the forament magnum:
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Alar Ligament
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https://o.quizlet.com/T-eagInKwCd1gtY5oEaVgQ_m.png
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What is the primary method to asses motion at the OA?
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Check Neck
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Sidebending and rotation occurring to opposite sides with either flexion or extension is characteristic of which joint?
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OA
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Head + Neck
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T1-4
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Heart
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T1-5
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Lungs
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T2-7
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Esophagus
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T2-8
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Upper GI (Anything before ligament of Treitz)
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T5-9
- stomach - liver - gallbladder - spleen - portions of the pancreas and duodenum |
https://o.quizlet.com/3rp5Ht7mMMObY6KCmvldeg_m.png
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Middle GI (Anything between ligament of Treitz and splenic flexure)
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T10-11
- portions of the pancreas + duodenum - jejunum - ilium - ascending colon & proximal 2/3 transverse color (aka right colon) |
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Lower GI (Anything below Splenic flexure)
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T12-L2
- distal 1/3 transverse colon - descending colon + sigmoid (aka left colon) - rectum |
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Appendix sympathetic spinal levels
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T12
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Kidneys sympathetic spinal levels
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T10-11
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Adrenal Medulla sympathetic spinal levels
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T10
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Upper Ureters sympathetic spinal levels
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T10-11
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Bladder
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T11-L2
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Gonads sympathetic spinal levels
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T10-11
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Uterus and Cervix sympathetic spinal levels.
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T10-L2
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Prostate sympathetic spinal levels.
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T12-L2
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Erectile tissue of Penis and Clitoris sympathetic spinal levels
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T11-L2
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Lower Ureters sympathetic spinal levels.
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T12-L1
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Upper Extremities
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T2-8
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Lower Extremities
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T11-L2
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What nerve innervates upper GI tract?
|
Greater Splanchnic Nerve
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What ganglion supplies upper GI tract?
|
Celiac Ganglion
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What nerve innervates middle GI tract?
|
Lesser Splanchnic Nerve
|
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What ganglion supplies middle GI tract?
|
Superior Mesenteric Ganglion
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What nerve innervates lower GI tract?
|
Least Splanchnic Nerve
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What ganglion supplies lower GI tract?
|
Inferior Mesenteric Ganglion
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What ganglion supplies Kidneys?
|
Superior Mesenteric Ganglion
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What ganglion supplies Lower Ureters?
|
Inferior Mesenteric Ganglion
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What ganglion supplies Upper Ureters?
|
Superior Mesenteric Ganglion
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What provides parasympathetic innervation to the Pupils?
|
CN III (midbrain)
|
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What provides parasympathetic innervation to the Lacrimal glands
|
CN VII (pons)
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What provides parasympathetic innervation to the Nasal Glands?
|
CN VII (pons)
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What provides parasympathetic innervation to the Submandibular Glands?
|
CN VII (pons)
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What provides parasympathetic innervation to the Sublingual Glands?
|
CN VII (pons)
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What provides parasympathetic innervation to the Parotid Glands?
|
CN IX (medulla)
|
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What provides parasympathetic innervation to the Heart
|
CN X (medulla)
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What provides parasympathetic innervation to the Bronchial Tree?
|
CN X
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What provides parasympathetic innervation to the lower 2/3 of the Esophagus?
|
CN X
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What provides parasympathetic innervation to the Stomach?
|
CN X
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What provides parasympathetic innervation to the Small Intestine?
|
CN X
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What provides parasympathetic innervation to the Liver
|
CN X
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What provides parasympathetic innervation to the Gallbladder?
|
CN X
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What provides parasympathetic innervation to the Pancreas?
|
CN X
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What provides parasympathetic innervation to the Kidney
|
CN X
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What provides parasympathetic innervation to the Upper Ureter?
|
CN X
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What provides parasympathetic innervation to the Ovaries?
|
CN X
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What provides parasympathetic innervation to the Testes?
|
CN X
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What provides parasympathetic innervation to the Ascending Colon
|
CN X
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What provides parasympathetic innervation to the Transverse Colon?
|
CN X
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What provides parasympathetic innervation to the Lower Ureter?
|
S2,3,4
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What provides parasympathetic innervation to the Bladder?
|
S2,3,4
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What provides parasympathetic innervation to the Uterus?
|
S2,3,4
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What provides parasympathetic innervation to the Prostate?
|
S2,3,4
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What provides parasympathetic innervation to the Genitalia?
|
S2,3,4
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What provides parasympathetic innervation to the descending Colon?
|
S2,3,4
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What provides parasympathetic innervation to the Sigmoid colon?
|
S2,3,4
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What provides parasympathetic innervation to the rectum?
|
S2,3,4
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What contributes to the Ciliary Ganglion?
|
CN III (midbrain)
|
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What contributes to the Sphenopalatine Ganglion?
|
CN VII (pons)
|
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What contributes to the Submandibular Ganglion?
|
CN VII (pons)
|
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What contributes to the Otic Ganglion?
|
CN IX (medulla)
|
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What contributes to the Pelvic splanchnic Nerves?
|
S2,3,4
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Where does CN III originate?
|
Midbrain
|
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Where does CN VII originate?
|
Pons
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Where does CN IX originate?
|
Medulla
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Where does CN X originate?
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Medulla
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What 4 CN have parasympathetic fibers?
|
III, VII, IX, X
|
|
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What 3 Sacral Nerve roots have parasympathetic fibers?
|
S2,3,4
|
|
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|
By what age does the innominate usually fuse?
|
20
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Due to the termination of the spinal cord, where do the lumbar nerve roots exit in relation to the intervertebral disc?
|
Above
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What is the most common anomaly in the lumbar region?
|
Zygopophyseal Facet Trophism (predisposes to early degenerative changes)
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Appendicitis, Sigmoid Colon dysfunction, ureteral calculi, ureter dysfunction, metastatic carcinoma of the prostate and salpingitis are all possible causes of what somatic dysfunction?
|
Psoas Syndrome
|
|
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What vertebrae have spinous processes located at the level of the transverse process of the vertebrae below?
|
T7-T9, T12
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C1 is the 1st (so it is number 1) - What is the principle SD of C1?
|
Type I (with F, E, or N)
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|
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Flexion and extension occur in what plane?
|
Sagittal
|
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Suboccipital or paravertebral muscle spasms are usually associated with ___ problems so treat these areas first.
|
Upper thoracic or rib problems on the same side
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|
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Spurling test what does it mean when there is pain radiating down the arm? IL localized pain? CL pain?
|
Pain radiation down the arm = Foraminal stenosis
IL localized pain = Facet atrophy CL pain = Muscle spasm |
https://o.quizlet.com/UEwRIhpaj8SM2HAwtgMRHQ_m.png
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Whiplash injury can cause injury to the ___ ligament.
|
Anterior longitudinal ligament
|
https://o.quizlet.com/TNBNBHOaSivqQdhTzzHkEQ_m.png
|
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Muscles of the erector spinae group?
|
*SILO*
*S*pinalis *I*liocostalis *LO*ngissimus |
https://o.quizlet.com/i/3en2Perjce4ivgAnVC2UGg_m.jpg
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Externally rotates, extends thigh, and abducts thigh with hip flexed.
|
Piriformis
- S1 + S2 nerve roots - inferior anterior aspect sacrum -> greater trochanter |
https://o.quizlet.com/z8YkAkbBpx8ZEhY36eMpkA_m.png
|
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If you have sacral torsion but the L5 is not following the rules of rotation this is called?
|
Sacral rotation on an oblique axis -> L5 is rotate to the same side as the sacrum
|
|
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|
___ hypertonicity can cause buttock pain that radiates down the thigh, but not usually below the knee with the IL leg slightly externally rotated.
|
Piriformis
-> 11% population will have either the entire or peroneal (fibular) portion of the sciatic nerve running through belly of the periformis thus pain only to the knee not past it |
https://o.quizlet.com/z8YkAkbBpx8ZEhY36eMpkA_m.png
|
|
|
Wolf's Law
|
Bone remodeling occurs along lines of stress
|
|
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|
What structure prevents hyperextension of the knee?
|
ACL
|
|
|
|
PRM what are the 5 anatomical-physiological elements?
|
1. The inherent motility of the brain and spinal cord
2. Fluctuation in CSF 3. The movement of the intracranial and intraspinal membranes 4. The articular mobility of the cranial bones 4. Involuntary mobility of sacrum between the ilia *PRM = CNS + CSF + Dural membranes + Cranial bones + Sacrum* |
|
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|
Factors that DEC the rate and quality of C.R.I. (cranial rhythmic impulse)
|
1. Stress (emo, physical)
2. Depression 3. Chronic fatigue 4. Chronic infections |
|
|
|
Factors that INC the rate and quality of C.R.I.
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1. Vigorous physical exercise
2. Systemic fever 3. Following OMT to the craniosacral mechanism |
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The dura mater is the outermost membrane and it is thick, inelastic, and forms the falx cerebri and tentorium cerebelli. The dura projects caudally down the spinal canal with firm attachment ___, __, __, and __.
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FORAMEN magnum
C2 C3 S2 |
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CRI is ___ cycles per minute.
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10-14 cycles/minute
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Craniosacral Flexion:
1. ___ (F/E) midline bones 2. Sacral base will move ___(A/P) 3. ___(INC/DEC) AP diameter of the cranium 4. __ (INT/EXT) rotation of paired bones. |
1. Flexion midline bones
2. Sacral base will move Posterior (counternutation) 3. DEC AP diameter of the cranium 3. External rotation of paired bones |
https://o.quizlet.com/IOXr8p.5dv34rBxL3KzzDg_m.png
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Craniosacral Extension:
1. ___ (F/E) midline bones 2. Sacral base will move ___(A/P) 3. ___(INC/DEC) AP diameter of the cranium 4. __ (INT/EXT) rotation of paired bones. |
1. Extension midline bones
2. Sacral base will move Anterior (nutation) 3. INC AP diameter of the cranium 4. Internal rotation of paired bones |
https://o.quizlet.com/fQMdw0pfJ9Hjddl2sNDCZA_m.png
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Main midline bones?
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Sphenoid
Occiput Vomer Ethmoid |
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Main paired bones?
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Temporal
Parietal Frontal |
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Finger placement for the vault hold?
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1. Index finger - greater wing sphenoid
2. Middle finger - temporal bone in front of the ear 3. Ring finger - mastoid region of temporal bone 4. Little finger - squamous portion of the occiput |
https://o.quizlet.com/zmzv8K-L8NmOub5SKJSXGA_m.png
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Physiologic Strain Patterns?
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Torsions
SB/R Flexion/Extension Opposite dxn |
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Non-Physiologic Strain Patterns?
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Lateral
Vertical Compession "LV" is all the Same |
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Torsion what is the axis?
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A/P axis opposite dxn rotation
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Sidebending/rotation what is the axis?
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Rotation: A/P axis
SB : 2 vertical axis (one through center sphenoid, other foramen magnum) |
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Vertical strain what is the axis?
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2 transverse axis (center of sphenoid, other superior to base occiput) - > rotation
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Lateral stain what is the axis?
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2 vertical axis (center of sphenoid, other, foramen magnum) rotation
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Compression strain of the SBS can result in severely decreased CRI it is usually due to trauma especially to the ___ of the head.
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BACK - no motion
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Diplopia, ptosis or accommodation problems which CN?
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CN III dysfunction
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Tic douloureux which CN?
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V2
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Diplopia, esotropia which CN?
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CN VI
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HA, arrhythmia, GI upset, respiratory problems which CN?
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CN X
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Dysphagia which CN?
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CN XII
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Vagal somatic dysfunction can be due to __, __, and ___ dysfunction.
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OA
AA C2 |
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Occipital condylar compression due to CN __ can result in poor suckling in the newborn.
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XII
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Dysfunction of CN __ and CN_ at the jugular foramen can cause suckling dysfunction in the newborn.
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CN IX + CN X
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The ___ technique will INC the amplitude of C.R.I.
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CV4: Bulb decompression
- resist flexion phase and encourage extension phase of CRI until "still point" then allow restoration normal flexion + extension - help fluid homeostasis, induce uterine contractions in post-date gravid women |
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Indications for craniosacral tx?
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1. After birth of a child
- trauma in delivery -> bones overlap can lead to synostosis 2. Trauma to PRM 3. Dentistry |
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Flexion/Extension Axis
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2 transverse axis (sphenoid, other superior to foramen magnum)
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Conditions associated with temporal bone dysfunction?
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Dizziness
Tinnitus Otitis media TMJ HA Bell's palsy Neuralgia |
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Absolute contraindications for cranial tx?
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Acute intracranial bleed
INC ICP Skull fracture |
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Relative contraindications for cranial tx?
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Traumatic brain injury
In pt w/ known seizure history or dystonia, greater care must be used in order to not exacerbate any neuro symptoms |
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When a group of neurons remain in state of subthreshold excitation or activation threshold has lowered.
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Facilitation
- less afferent stimulation is required to trigger the discharge of impulses - once receptor changed occur, facilitation can remain even when initial insult has been removed |
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What is the facilitated state?
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Lower threshold + exaggerated output w/ or w/o the offending stimulus
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Right Pectorals Major trigger point between ribs 5-6 medial to the nipple can cause ___.
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Supraventricular tachyarrhythmias (Somato-visceral reflex)
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Rib raising will normalized (DEC) ___ activity.
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SYMPATHETIC
+ improve lymphatic return + encourage maximal inhalation/exhalation + provokes a more effective negative intrathoracic pressure |
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Soft tissue paraspinal inhibition will normalize (DEC) ___ activity.
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SYMPATHETIC (ileus prevention)
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Celiac ganglion, superior mesenteric ganglion, inferior mesenteric ganglion will normalize (DEC) ___ activity.
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SYMPATHETIC
- GI/pelvic dysfunction tx |
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Chapman reflexes will DEC ___ tone to associated visceral tissues.
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SYMPATHETIC
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Sphenopalatine ganglion technique enhanced ___ activity will encourage thin watery secretions through short intermittent manual finger pressure intraorally to the sphenopalatine ganglion.
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PARASYMPATHETIC
- indicated tx when have thick nasal secretions |
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Tx of sacral SD can normalize hyper parasympathetic activity in the ___ and ___.
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Left colon
Pelvis - can also reduce labor pain caused by cervical dilation |
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Indications for tx sacral SD
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- Dysmenorrhea
- Labor pain from cervical dilation - Constipation |
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Thick bronchial secretions is it PARA/SYMP cause?
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SYMPATHETIC = thick bronchial secretions
- dilate bronchioles |
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Chapman pt
Appendix |
*Anterior: At tip right 12th rib*
Posterior: at the transverse process T11 |
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Chapman pt
Adrenals |
*Anterior: 2" superior and 1" lateral to umbilicus*
Posterior: btw spinous and transverse processes T11 and T12 |
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Chapman pt
Kidneys |
*Anterior: 1" superior and 1" lateral to umbilicus*
Posterior: btw spinous process and transverse processes T12 and L1 |
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Chapman pt
Bladder |
Periumbilical region
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Chapman pt
Colon |
On the lateral thigh w/in the IT band from the greater trochanter to just above the knee
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https://o.quizlet.com/iwpDCu9YRdxpdt1pX-7GjA_m.png
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What does a trigger point represent?
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Somatic manifestation of a viscero-somatic, somato-viscero, or somato-somatic reflex
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Difference between a trigger point vs tender point?
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*Trigger points* may *refer pain when pressed* (tx purpose, taut myofascial bands)
*Tenderpoints DO NOT refer pain* when pressed |
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Tx trigger points?
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1. Spray + stretch using vapocoolant spray
2. Injection with local anesthetic or dry needling 3. MET, MFT, US, reciprocal inhibition, or ischemic compression |
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Goal MFR
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1. Restore functional balance to all integrative tissues in the MSK system
2. *Improve lymphatic flow* by removing myofascial restrictions |
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Four diaphragms that play a role in lymphatic return?
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1. Tentorium cerebelli
2. Thoracic inlet 3. Abdominal diaphragm 4. Pelvic diaphragm |
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Common compensatory pattern (80%) rotation.
OA junction __ (R/L) Cervicothoracic _(R/L) Thoracolumbar _(R/L) Lumbosacral __ (R/L) |
AO: Left
CT: Right TL: Left LS : Right LRLR (marching) |
https://o.quizlet.com/23Td-bcO.BgMNvos2sFAYg_m.png
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Uncommon compensatory pattern (20%) rotation.
OA junction _(R/L) Cervicothoracic _(R/L) Thoracolumbar _(R/L) Lumbosacral _(R/L) |
OA: Right
CT: Left TL: Right LS: Left RLRL |
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The Right UE, R hemicranium, the heart, lobes of the lung (except the ___lobe) drain into the right (minor) lymphatic duct.
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LEFT UPPER lobe
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The Left (major) duct where does it enter the venous system?
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Btw left IVJ + left Subclavian vein
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https://o.quizlet.com/S75nlpkF6kw37NH3Jx500A_m.png
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Innervation of the cisterna chyli is predominantly from ___.
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T11
- lymph is under sympathetic control chronic hypersympathetic tone can DEC flow - thoracic duct (intercostal nerves) |
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Relative contraindications to lymphatic tx.
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1. Osseous fracture
2. Bacterial infection > 102 degrees 3. Abscess or localized infection 4. Advanced stage carcinoma |
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Anterior rib counterstrain tx position? Posterior?
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Anterior = FSTRT
Posterior = ESARA ~120 seconds |
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Anterior tenderpoint for L5 is located?
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1 cm lateral to pubic symphysis on the superior ramus
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Procedure FPR
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1. *Neutralize the spine AP curve*
2. Apply the *facilitating force* (compression/torsion) 3. *Shorten the muscle* or place vertebra into indirect position 4. *Hold 3-5 sec* 5. *Move to neutral + re-evaluate* - Indirect MFR tx using activating force (compression or torsion) used to tx: superficial muscles, deep intervertebral muscles to influence vertebral motion |
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What is a Maverick Point?
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Approx. *5% of tender points* will not improve with the expected tx even with careful fine tuning. These are tx with positioning the patient in a position opposite of what would be used typically.
- *Cervical CS has the most Maverick points* |
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Which form type of MET contracts the antagonistic muscles as tx?
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Reciprocal inhibition
- direct/indirect - contracting the antagonistic muscle signals are transmitted to the spinal cord and through reciprocal inhibition reflex arc, the agonist muscle is then forced to relax |
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Absolute Contraindications HVLA
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1. Osteoporosis
2. Osteomyelitis + Potts dz 3. Fracture 4. Bone Metastases 5. RA 6. Down syndrome |
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Relative Contraindications HVLA
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1. Acute whiplash
2. Pregnancy 3. Post-surgical conditions 4. Herniated nucleus propulsus 5. Pt on anticoagulation tx or hemophiliacs should be tx w/ greater caution to prevent bleeding 6. Vertebral artery ischemia (+ Wallenberg's test) |
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The most common major complication HVLA?
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Vertebral injury
-> use cervical rotatory forces w/ the neck in the Extended position |
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The most common major complication HVLA in the low back?
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Cauda equina syndrome (very rare)
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Wallenberg's Test
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*Test vertebral artery insufficiency*
- supine position flexion pts neck, holding it for 10 sec. then extends the neck holding it for 10 sec. (+) test = pt complains of dizziness, visual changes, lightheadedness, or eye nystagmus occurs *Underberg's test: same thing neck backward bent w/ head fully rotated to either side, if pt has neuro/vascular symptoms then HVLA contraindicated |
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Underberg test
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Variation of Wallenberg's test
- neck full extension w/ head fully rotated to either side, if pt has neuro/vascular symptoms then in this pt HVLA is contraindicated |
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Adson's test
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Monitor pts pulse the arm extended pt asked to breathe in and turn head toward IL arm
(+) Test = severely DEC/absent radial pulse * indicates compression btw anterior + middle scale of the neurovascular bundle |
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Wright's Test
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Monitor radial pulse and hyperabducting the arm above the head w/ some extension
(+) Test = indicates compression of the neuromuscular bundle as it passes under the PECtoralis minor noted when there is severely DEC/absent radial pulse |
https://o.quizlet.com/bEstpFfmJtivOZqZWY3akQ_m.jpg
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Costoclavicular syndrome test (Military posture test)
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Palpate radial pulse while depressing + extending the shoulder
(+) Test = indicates compression of neuromuscular bundle between the clavicle and first rib when radial pulse absent/severely DEC |
https://o.quizlet.com/7FnIX0QMAflOXZu97hDElw_m.jpg
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Speeds Test
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Access tendon of long head of biceps
- pt fully extends elbow flex shoulder and supinated forearm, physician resists flexion of the shoulder (+) Test = pain in the bicipital groove |
https://o.quizlet.com/6-1gMsTK-21eG32vjgyEGw_m.png
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Yergason's Test
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Assess the stability of biceps tendon in bicipital groove
- pt flexes elbow to 90 while physician grasps elbow w/ one hand and wrist other pull and physician resists supination of forearm + external rotation of shoulder (+) Test = pain as biceps tendon pops out of bicipital groove |
https://o.quizlet.com/NmoCWqYVnuD1ZWGOYXKznQ_m.png
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Allen's Test
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Assess adequacy of radial + ulnar blood supply to hand
- can be done with arm extended or above pts head access the arterial supply with pt open and close the hand occluding one or the other artery check for slow or not at all flush of blood |
https://o.quizlet.com/.X-0Yw4sszoP7lx1hg.BjA_m.jpg
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Hip drop test
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Asses the sidebending (lateral flexion) ability of the lumbar spine
- alerts physician to SD of the lumbar spine |
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Braggard's Test
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After (+) straight leg raise this test can confirm sciatic origin of pain by dorsiflexing the flexed hip and (+) if pain is felt all the way down the leg
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https://o.quizlet.com/E1Cw3.pztVH8ndo38TTPPQ_m.png
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Apley's distraction test assesses?
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medial/lateral *Collateral Ligament* injury
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https://o.quizlet.com/eerPSptSZDotoivdwQix4g_m.png
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Apley's compression test assesses?
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medial/lateral *Menisci Injury*
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https://o.quizlet.com/1v5Y-ieloRkvW8LHHoyefg_m.png
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De Quervain's dz is due to an inflammation of ___?
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Abductor pollicis longus and/or Extensor pollicis brevis
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https://o.quizlet.com/h9MP4ZI2BXaAGX5VJfYCuQ_m.png
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