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Chap 4 MSK Flashcards

1
Q

What % of burn is it if just head and neck are burned

A

9%

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2
Q

what % of burn is it if only anterior trunk is burned

A

18%

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3
Q

what % of burn is it if only post trunk is burned

A

18%

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4
Q

what % of burn is it if both ant and post trunk are burnt

A

36%

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5
Q

if both arms and hands are burned ant only what % is it

A

9%

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6
Q

if both arms and hands are burned post only what % is it

A

9%

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7
Q

if both arms and hands are burned post and ant what % is it

A

18%

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8
Q

if both ant legs are burned what % is it

A

18%

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9
Q

if both post legs are burned what % is it

A

18%

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10
Q

ratio of quads to hams is

A

3 quads 2 hams

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11
Q

which energy sx is used for ATP production during high intensity, super short duration exercise like sprinting 100 meters (up to 15 sec).

A

ATP-PC (phosphocreatine decomposes)

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12
Q

ATP and PC are stored

A

within contractile tissue

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13
Q

anaerobic metabolism is aka

A

lactic acid sx

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14
Q

this energy sx is used for shorter duration higher intensity exercise like sprinting 500meters

A

anaerobic glycolosis

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15
Q

in this energy system, stored glycogen is split into glucose then glycolosis occurs creating pyruvic acid, then ATP.

A

anaerobic glycolosis (or lactic acid sx)

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16
Q

anaerobic glycolosis only uses what to make energy

A

carbs (glycogen and glucose)

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17
Q

which energy sx yields the most ATP

A

aerobic, but it requires many complex chemical rxns

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18
Q

which type of lever is when the load and effort are on either side of the fulcrum, and give ex

A

class 1, triceps

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19
Q

most common lever in the body

A

3

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20
Q

type of lever where the load is between fulcrum and effort, and the effort is always longer

A

2 (like a wheelbarrow)

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21
Q

biceps contraction, elbow flexion is what type of lever

A

3

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22
Q

with a type 3 lever, the effort is where

A

middle

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23
Q

type 1 what is in middle
type 2 “ “
type 3 “ “

A

1-Fulcrum in middle
2 load in middle
3- effort in middle

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24
Q

the tissue btwn tibia and fibula is what type of joint classification

A

syndesmosis (the interosseous membrane)

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25
Q

two boney surfaces connecting like a peg in a hole (like teeth in socket) is what type of joint

A

gomphosis

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26
Q

amphiarthritic joints are aka

A

cartilaginous

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27
Q

the sternum and the rib articulations are what type of joint

A

synchondrosis

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28
Q

if entire trunk, ant and post, is burnt what % is that

A

36%

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29
Q

what are diarthritic joints

A

true synovial joints (they have a capsule, membrane, fluid, cart)

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30
Q

role of golgi tendon organs

A

sense tension

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31
Q

ball and socket joints have ___ degrees of freedom

A

at least 3

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32
Q

what is closed packed position of shoulder

A

abd and ER

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33
Q

what is loose packed position of shoulder

A

55d abd, 30d hor add

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34
Q

what is capsular pattern of shoulder (GH)

A

ER, IR, ABD

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35
Q

normal ROM to GH shoulder joint

A 
flexion 0-165 (they say 180)
ext 0-60
abd 0-165 (they say 180)
IR 0-70
ER 0-90
hor add 0-40
hor abd 0-45
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36
Q

the SC joint is what type

A

saddle synovial

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37
Q

closed packed position of AC joint

A

arm abd to 90 d

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38
Q

shoulder flexors

A

ant delt, coracobrachialis, pec major, biceps

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39
Q

shoulder extensors

A

lats, post delt, teres major (PLT)

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40
Q

shoulder abductors

A

middle delt, supraspinatus

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41
Q

shoulder adductors

A

pec major, teres major, lats

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42
Q

shoulder ERs

A

infraspinatus, teres minor, post delt

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43
Q

shoulder IRs

A

subscapularis, lats, major major

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44
Q

scapular elevators

A

levator scap, upper trap

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45
Q

scap depressors

A

lower trap, lats, both pecs

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46
Q

scap protractors

A

serratus ant, pec minor

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47
Q

scap retractors

A

traps, rhomboids

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48
Q

scap upward rotators

A

traps, serratus

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49
Q

scap downward rotators

A

rhomboids, levator scap, pec minor

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50
Q

elbow flexors

A

biceps, brachioradialis, brachialis

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51
Q

2 main bursa in shoulder

A

subacromial and subscapular

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52
Q

capsular pattern of elbow joint

A

flexion and ext

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53
Q

closed packed of elbow joint

A

full ext

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54
Q

loose packed of elbow joint

A

70d flexion with slight supination

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55
Q

in the proximal radioulnar joint, what is concave and convex

A

concave radial notch of the ulna, and convex radial head

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56
Q

what motions come rom the proximal R/U joint

A

pronation and supination

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57
Q

capsular pattern of R/U joint

A

sup and pro

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58
Q

elbow extensors

A

triceps, anconeus

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59
Q

supinators

A

biceps, supinator

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60
Q

pronators

A

pronator teres and quadratus

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61
Q

the radial collateral ligg is aka

A

lateral collateral ligg

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62
Q

the LCL of elbow attaches where

A

lateral epicondyle of humerus to olecranon process of ulna and annular ligg

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63
Q

LCL of elbow prevents

A

adduction of elbow

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64
Q

the UCL is aka

A

medial collateral ligg

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65
Q

attachments of UCL

A

medial epicondyle of humerus to the ulna

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66
Q

UCL prevents what motion

A

excessive abd of elbow

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67
Q

where is the annular ligg

A

surrounding head of radius (allows rotation of head)

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68
Q

main joints in wrist

A

RC, mid carpal

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69
Q

loose packed of wrist joint

A

neutral and in ulnar deviation

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70
Q

closed packed wrist joint

A

full ext with radial deviation

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71
Q

wrist flexors

A

flexor carpi radialis, flexor carpi ulnaris, palmaris longus

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72
Q

shoulder scapular depressors

A

pecs, lats, lower traps

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73
Q

wrist extensors

A

extensor carpi radialis longus and brevis, extensor carpi ulnaris

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74
Q

only wrist ligg on dorsal side, it limits flexion

A

dorsal radiocarpal ligg

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75
Q

main ligg in wrist to limit ext

A

palmar radiocarpal ligg

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76
Q

ligg in wrist that limits ulnar deviation

A

radial collateral ligg

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77
Q

what nerve enters the carpal tunnel

A

median

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78
Q

what is the condition called when the retinaculum in the wrist becomes inflammed

A

tenosynovitis (it can press on median nerve causing carpal tunnel syndrome)

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79
Q

what 2 tendons run closely together on the thumb side of the wrist

A

extensor pollicus brevis and abd pollicus longus

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80
Q

loose packed position of hip

A

30d flexion and abd, slight ER

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81
Q

closed packed position of hip

A

full ext and IR

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82
Q

capsular pattern hip

A

flexion, abd, IR

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83
Q

hip flexors

A

iliopsoas, pectinineus, sartourious, rectus femoris

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84
Q

hip extensors

A

glut max and med, all 3 hamstrings

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85
Q

hip abductors

A

TFL, glut med and min, piriformis

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86
Q

hip adductors

A

adductor longus magnus and brevis, gracilis

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87
Q

hip IRs

A

TFL, glut med and min, pectinius, adductor longus

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88
Q

hip ERs

A

piriformis, glut max, obtoratur externus, sartourious

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89
Q

main axns glut med and min

A

hip abd and IR

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90
Q

main axns piriformis

A

hip abd and ER

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91
Q

ligg that reinforce the hip joint capsule

A

ileofemoral, pubofemoral, ischifemoral

92
Q

which hip ligg limits hip ext and excessive abd of femur

A

pubofemoral

93
Q

in the knee joint, what parts are convex/convace

A

femur condyles are convex, tibia is concave

94
Q

closed packed position of knee

A

full ext with tibia ER

95
Q

loose packed position of knee

A

25d flexion

96
Q

knee flexors

A

all hamstrings and sartorious

97
Q

sartorious axns

A

hip and knee flexion, ER

98
Q

knee extensors

A

rectus femoris, vastus lateralis and medialis

99
Q

3 main bursa in the knee

A

pre patellar (over the patella), superficial infrapatellar (at tendon and skin), deep infrapatellar (btwn tendon and bone)

100
Q

deep fibers of the MCL attach where

A

medial meniscus

101
Q

where is the arcuate ligg complex

A

lateral, post knee (comprised of lateral structures)

102
Q

what bones comprise the talocrural jt and what motions occur at it

A

talus, tibia, fibula (PF, DF)

103
Q

how many degrees of freedom does ankle have (talocrural)

A

1

104
Q

how many degrees of freedom does knee have

A

2

105
Q

normal ROM of knee

A

0-145

106
Q

ROM of hip, flexion

A

120

107
Q

ROM hip ext

A

30

108
Q

ROM hip add

A

30

109
Q

ROM hip abd

A

45

110
Q

ROM hip ER and IR

A

ER 45

IR 45

111
Q

subtalar joint articulations and axns

A

talus and calcaneous (inversion and eversion)

112
Q

liggs in ankle

A 
ATF (ant talofib)
CF (calcaneal fib)
PTF (post talofib)
deltoid
interosseous membrane
113
Q

these ligg resists inversion of ankle

A

ATF, CF

114
Q

this ankle ligg resists eversion

A

deltiod

115
Q

medial to lateral, list the hamstrings

A

semi membranosis, tendinosis, biceps femoris

116
Q

C1-C2 are aka

A

atlas, axis

117
Q

atlanto occipital joint is where

A

C1 facet joints

118
Q

what motions occur at atlanto occiptial joint

A

head flexion/ext (yes)

119
Q

rotation of cspine occurs from what joint

A

atlantoaxial

120
Q

what joints are formed from facets in cspine

A

zygoapophaseal

121
Q

muscles that flex neck

A

SCM, longus colli, scalenes

122
Q

muscles that extend neck

A

ILS cervicis’s (iliocostalis, longismus, semispinalis), multifidi, traps

123
Q

muscles that rotate and lateral bend neck

A

scm, scalenes, ILS, levator scap, multifidi

124
Q

ILS muscles in cspine motions

A

extension, rotation and lateral bend

125
Q

longus colli vs longismus cervicis

A

longus colli is ant neck, longismus cervicis is part of ILS and is post neck

126
Q

3 ILS muscles

A

ileocostalis, longismus cervicis, semispinalis

127
Q

this ligg resists cervical flexion

A

post longitudinal lig

128
Q

this ligg resists cervical ext

A

ant longitudinal lig

129
Q

spinal nerves exit via the

A

vertebral foramina

130
Q

foramina open with what motion

A

flexion and contra side bend (they close with ext and ipsi side bend)

131
Q

muscles that flex thoracolumbar region (trunk forward)

A

rectus abdominus, both obliques

132
Q

muscles that extend thoracolumbar region (trunk back)

A

erector spinae, QL

133
Q

ribs that are attached

A

1-10 (attach at costovertebral and costotransverse joints)

134
Q

type 1 muscle fibers are aka

A

aerobic, red, slow twitch

135
Q

type 2 muscle fibers are aka

A

anaerobic, white, fast twitch

136
Q

these receptors have to do with muscle LENGTH or rate of LENGTH change or POSTURE

A

spindles

137
Q

types of muscle contractions

A

isotonic (eccentric, concentric)
isometric
isokinetic (constant speed-machine)

138
Q

pt marks on a diagram to indicate area of pain, pt chooses 1 word to describe the pain, pt describes pattern of pain including agg/ease factors, pt rates intensity 0-5. This all describes what

A

McGill pain questionaire (remember McGill is 0-5)

139
Q

describe VAS

A

a line pts rate pain on

140
Q

myotomes upper body

A 
C1- cervical rotation 
C2-C4 shoulder elevation
C5- shoulder abd
C5-C6 elbow flexion
C6 only - wrist ext
C7-elbow ext and wrist flexion
C8- thumb ext
T1-finger adduction
141
Q

glut max does what type of rotation at hip

A

ER

142
Q

shoulder abd is what myotome

A

C5

143
Q

list reflexes UE

A

C5-biceps
C6 -brachioradialis
C7-triceps

144
Q

C6 only myotome test

A

wrist ext

145
Q

C7 myotome test

A

elbow ext and wrist flexion

146
Q

dermatomes for Upper body (remember, dearmatomes for upper are individual, not like myotomes)

A 
C2 - post head
C3- lateral post neck
C4- AC joint
C5-lateral elbow area
C6-lateral thumb and forearm
C7-palm side of middle finger
C8-lateral pinky and ulnar side of hand
T1-medial elbow area
147
Q

having a pt walk on their heels would test what segments

A

L4-L5

148
Q

having a pt up on toes would test what segments

A

S1

149
Q

active SLR tests what segments

A

L4-S1

150
Q

myotomes lower body

A 
hip flexion L1-L2
knee ext L3-L4
dorsiflexion L4-L5
big toe ext L5
plantar flexion S1
151
Q

patellar reflex is what segment

A

L4

152
Q

achilles reflex is what segment

A

S1

153
Q

L4 dermatome location

A

patella to medial malleolus

154
Q

fibular head and dorsum of foot is what dermatome

A

L5

155
Q

perianal area is what dermatome

A

S3-S5

156
Q

lateral foot is what dermatome

A

S1

157
Q

to be consistant, all skin fold measurements should always be taken on what side

A

R

158
Q

skinfold measurement sites

A

abs, triceps, chest, calf, biceps

159
Q

formula used in bioelectrical impedence testing

A

ht squared/resistance

160
Q

in good standing posture, palms face

A

towards body

161
Q

in good standing posture, scapulas should be approx how far appart

A

4 inches

162
Q

plumb line in posture, note main points

A

through auditory meatus, through shoulder joint, post to hip, ant to knee, ant to lateral maleolous

163
Q

loose packed position of GH joint

A

55d abd, 30d hor adduction

164
Q

closed packed position of GH joint

A

abd with ER

165
Q

loose packed position of elbow

A

70d flexion 10d supination

166
Q

closed packed position of elbow

A

full ext

167
Q

loose packed wrist joint

A

neutral with slight ulnar deviation

168
Q

closed packed wrist joint

A

extension and radial deviation

169
Q

loose packed hip joint

A

30/30
flexion and abd

ER

170
Q

closed pack hip joint

A

full ext with IR

171
Q

loose packed knee joint

A

25d fleion

172
Q

closed pack knee joint

A

full ext

173
Q

loose packed ankle joint (talocrural)

A

10d plantarflexion

174
Q

closed packed ankle joint

A

full dorsi

175
Q

what is loose packed vs closed packed

A

stress on the joint (max or min). So in closed packed the liggs and structures are being stressed and compressed.

176
Q

good BMI %s

A

males is 12-18 females is 18-23

177
Q

capsular pattern of hip

A

flexion, abduction, IR

178
Q

capsular pattern means what

A

limitation due to the joint itself (capsular restriction occurs during these motions)

179
Q

firm end feel (describe and list example)

A

stretching, like dorsiflexion or finger ext

180
Q

hard end feel (describe and list example)

A

bone to bone, elbow ext

181
Q

soft end feel (describe and list example)

A

tissue to tissue, elbow flexion

182
Q

4 examples of abnormal end feels

A

empty-cant reach endp bc of ain
firm-increased tone, tight capsule
hard-arthritis or fx
soft - edema or ligg sprain

183
Q

L4 dermatome location

A

patella and medial malleolus

184
Q

L5 dermatome location

A

fibular head and dorsum of foot

185
Q

how to test L4 with a functional test (muscle)

A

L4 toes off the floor, heel walking

186
Q

how to test S1 with a functional muscle test

A

toe walking

187
Q

to test all L4-S1 functionally do what

A

have them do active SLR

188
Q

spacticity would cause what type of abnormal end feel

A

firm

189
Q

list grades of MMT

A

0 no contraction felt
1 contraction felt but no movement
2- movement initiated but cannot do in gravity elim
2 (COMPLETES in gravity elimitated)
2+ can do against gravity some movement
3- can do some against gravity (more than half)
3 can do full motion in gravity (no resistance)
3+ can take some resistance against gravity
4- can take min-mon resistance againt gravity
4 can take mod resistance against gravity
4+ can take mod to almost max against gravity
5 normal (max)

190
Q

with MMT what numbers only have 1 level

A

0, 1, 5

191
Q

what grade of MMT is can complete motion in gravity eliminated

A

2

192
Q

what grade of MMT is: can complete against gravity but without resistance

A

3

193
Q

what muscles must be tested in side lying

A

glut min and med
lateral abdominals
hip adductors

194
Q

teres major aids in shoulder _____ (flexion or ext)

A

shoulder ext

195
Q

3 shoulder IRs

A

subscap, x2 major, lats

196
Q

2 scap retractors

A

traps, rhomboids

197
Q

4 hip ERs

A

piriformis, glut max, obtoratur externus, sartourious

198
Q

to mmt lats, pt must be

A

prone

199
Q

what is active and passive insufficiency

A

active- when a 2 joint muscle shortens (contracts) over both joints at same time

passive- when a 2 joint muscle lengthens over the joints at the same time

200
Q

why use a dynomometer on dominate hand side

A

dominant hand is usually 10 lbs stronger

201
Q

2 main phases of gait

A

stance

swing

202
Q

what are the phases of stance phase of gait (all about the planted foot)

A 
heel strike
flat foot
mid stance
heel off
toe off
203
Q

what are the phases of swing phase of gait (this is about the moving limb)

A

acceleration
midswing
deceleration

204
Q

explain acceleration phase

A

when toe off occurs on LE and leg is behind rest of body

205
Q

stance phase is what % of gait, swing phase is what %

A

stance 60

swing 40

206
Q

how much motion at each joint is required for gait

A

30d hip flexion
10d hip ext

60d knee flexion
0d knee ext

10d ankle dorsi
20d ankle PF

207
Q

what is the number os steps over a period of time

A

cadence (normal is 120/min)

208
Q

diff btwn step length and stride length

A

step is 2 diff feet

stride is same foot

209
Q

what is equine gait

A

high steps, lots of PF activity

210
Q

with festination, pt is usually on their

A

toes

211
Q

what is steppage gait pattern

A

dorsiflexors are weak, pt flops or drops foot to ground, hip and knee flexion is excessive to compensate

212
Q

normal ROM elbow

A

0-150

213
Q

normal ROM pronation and supination

A

80

214
Q

normal ROM wrist

A

flexion 80
ext 70
UD 30
RD 20

215
Q

how much hip flexion and ext is needed for gait

A

30 flexion

10 ext

216
Q

hip ROM norms

A

120d flexion
45d IR, ER, abd
30d ext and add

217
Q

normal DF/PF ROM

A

20d DF

50d PF

218
Q

normal cervical ROM

A

flexion 45
ext 45
lateral SB 45
rotation 60

219
Q

normal thoracolumbar ROM

A

80 flexion
25 ext
35 SB
45 Rotation

220
Q

biceps tendon pathology special tests

A

Ludingtons (hands on head alternating bicep contractions)

Speeds

Yergasons-yer resisting them supinating, elbow at 90

221
Q

RC special tests

A

drop arm- PROM to abd and see if they can hold
hawkins kennedy-
neers-thumb down and PROM raise full shoulder flexion
supraspinatus test- full can test

222
Q

TOS special tests

A

Adsons: arm down, look towards ipsi side (scalenes)
Allens: arm in L, look away (pec minor) (or compress radial and ulnar arteries and observe for flushing)
Roos: pinchy pinchy (only non pulse one)
Costoclavicular: scap depression, chest protrusion, pulse

223
Q

normal elbow flexion

A

150

224
Q

how to remember hip ROM norms

A

it’s hip to be the same

120 (flexion)
45 (IR, ER, abd)
30 (ext, add)

225
Q

4 tests for epicondylitis

A

Mills (lateral)

Cozen: pt makes fist, pronates, radially deviates and extends wrist with resistance as you palpate lateral epicondyle

lat epic: resist 3rd finger ext

medial epic: supinate and ext elbow/wrist with resistance

226
Q

the 2 major majors are

A

IRs, adductor

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