Day 1 Flashcards by Stephen Barna

The spleen is located beneath ribs 9, 10, and 11 on the __ side of the body. It is in between the left __-diaphragm and __ cavity. If the __ is messed up, then the spleen can no longer move fluid throughout the body

left, hemi, peritoneal, diaphragm

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Which is not a function of the spleen?

1) Destroy damaged RBCs
2) Metabolizes drugs
3) Synthesizes immunoglobulins
3) Clearance site for antigens, micro-organisms, and poorly organized bacteria

2 (thats the liver)

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The __ is a major lymph channel for 3/4 of the body, back into circulation

Thoracic Duct

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The liver is a pressure sensitive organ, affected by the muscular action of the __ diaphragm

thoraco-abdominal

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The __ is largest and most active in an infant, and dies down (involutes) after puberty. It is the processing site for T-lymphocytes

Thymus

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Name the tonsil

1) Located on the posterior 1/3 of tongue
2) Located at the lateral pharynx
3) Located at the nasopharyngeal border

1) Lingual
2) Palatine
3) Pharyngeal

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__ is located at the medial surface of the cecum and presumed to offer support to the immune system

Apendix

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__ system aids in filtration of toxins from the lungs and the GI system also has visceral lymphoid tissue

In the GI system, __ are located in the distal ilium, __ are lymphatic capillaries in each vili in the small bowel, and fats are cleared out that have entered circulation via GI system

Respiratory

Peyers patches, lacteals

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__ nodes receive lymph from skin/deep tissues of upper and lower extremities/head and neck

They drain into three main groups, name them

Superficial

Cervical, axillary, and inguinal

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Cervical lymph nodes from the head/supraclavicular and upper extremity drain into __ nodes

Axillary lymph nodes from infraclvicular to umbilicus drain into axillary nodes and then __

Inguinal lymph nodes from caudal to umbilicus drain into inguinal nodes and then __

Jugular

Subclavian

Lumbar

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Lymph unites with one of which two ducts

Thoracic duct (75%) or right lymphatic duct (25%)

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You are in the left supraclavicular region on the left side of the body, what node is located there?

Also, what is this associated with

Virchow’s node

Intra-abdominal or thoracic cancer

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The thoracic duct starts off on the __ side of the body and then at the level of T-__ it moves __ of the midline and connects to the junction of the left subclavian and left brachiocephalic veins

Right side, 4, left

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Which of the two ducts drains the left side of the head and neck, left arm, left side of thorax, left and right lower body, and viscera of thoracic?

Which duct drains the right head and neck, right arm, and right chest?

Thoracic duct

Right lymphatic duct

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50% of plasma __ re-enter the system via lymph, so if you were to have a problem with lymph you could be malnourished

proteins

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One way to move lymph is by ___ fluid pressure which has a normal pressure of ___ mmHg and hits a ceiling at 0 mmHG (when vessels collapse and obstruct flow)

Interstitial, Negative 6.3 (negative is the important part)

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The __ pump works by using contraction forces to cause pressure gradients, which help move the fluid. However, when that fails, the __ pump is the only thing left which works by direct pressure on vessels to move lymph

Intrinsic

Extrinsic

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What kind of system is the lymphatic system

“passive”

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It is critical to start treatment at the level of the __ (thoracic inlet) which as said before, it at the junction of the duct and left subclavian vein/brachiocephalic vein

thoracic duct

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ALWAYS ALWAYS ALWAYS go back to the __ after you finish your treatment session

Name what area each treatment does

1) Upper extermity
2) Head and neck
3) Thoracic
4) Lower extremity
5) Abdomen

Thoracic duct

1) Area 3
2) Area 5
3) Area 1
4) Area 4
5) Area 2

**Note that area 3 and 4 can be reversed

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The lymph system is readily effected by external compression from your __

Diaphragm

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Name what region the superficial node is found in. Choose from: Head/neck, abdomen, upper extremity, lower extremity

1) Popliteal
2) Cisterna chyli
3) Cubital
4) Celiac
5) Submental
6) Superficial ingunial
7) Virchow’s
8) Deltopectorial
9) Axillary

1) Lower Ex
2) Abdomen
3) Upper Ex
4) Abdomen
5) Head/neck
6) Lower Ex
7) Head/neck
8) Upper Ex
9) Upper Ex

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Which one does the lymphatic system not do?

1) Maintain homeostasis
2) Facilitate immune function
3) Transport fat from digestive system to blood
4) Aid in the movement of oxygen
5) Assist the body in removing interstitial fluids and plasma proteins

4) Aid in the movement of oxygen

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The right lower body is drained by ___

Thoracic duct

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Match the reason for increased interstitial fluid pressure with its cause 1) HTN 2) Hepatic cirrhosis 3) Starvation/plasma hypoalbuminemia 4) Rattlesnake poison and other toxins a) Increased interstitial fluid protein b) Increased capillary permeability c) Increased arterial capillary pressure d) Decreased plasma colloidal osmotic pressure

1) c 2) d 3) a 4) b

Abnormal feeling indicating Otitis Externa would be found palpating what structure?

Pre and Post Auriculars

The superior and inferior inguinal lymph nodes are found in what structure?

Femoral triangle

The goal of lymphatic treatment is to move lymph __

centrally

Patient with COPD, URI, LRI, swollen upper extremities or enhanced immune function can be treated with what technique?

Thoracic pump

How fast do you perform the thoracic pump?

110-120 x/min

In the abdominal pump zone 2 technique, how fast do you pump and also this indirectly affects pressure gradients and indirectly messages the thoracic duct at its origin in ___

20-30x/min Cisterna Chyli

How fast can you perform the pedal pump?

100x/min

What technique can be used when a patient has eustachain tube dysfunction, lymphatic congestion in ENT or submandibular region

Mandibular drainage

Name the path of virchows lymph

Abdomen drains to deep visceral -> Cisterna chili -> thoracic duct -> virchow

Name range of motions Hip 1) Flexion 2) Extension 3) Internal rotation 4) External rotation 5) Abduct 6) Adduct Knee 1) Internal rotation 2) External rotation 3) Flexion 4) Extension Ankle/foot 1) Dorsiflex 2) Plantarflex 3) Ankle Inversion 4) Ankle Eversion 5) Subtalar inversion 6) Subtalar eversion 7) Pronation 8) Supination

1) 90, or 120-135 2) 15-30 3) 30-40 4) 40-60 5) 45-50 6) 20-30 1) 10 2) 10 3) 145-150 4) 0 1) 15-20 2) 55-65 3) 35 4) 20 5) 10 6) 10 7) 5 8) 20

What are the borders of the femoral triangle?

Superiorly - Inguinal ligament Medially - Medial border of adductor Longus muscle Laterally - Medial border of sartorius muscle

What muscles make up the hamstring?

Biceps femoris, semitendinosus, semimembranosus

What is the function of the IT band/ tensor fascia lata?

Flexor, abductor

Name the grading scale for muscle strength 1) Active movement against gravity 2) Active movement against gravity and resistance 3) No muscular contraction detected 4) Active movement with gravity eliminated 5) Active movement against gravity and some resistance 6) Barley detectable flicker/trace of contraction

1) 3 2) 5 3) 0 4) 2 5) 4 6) 1

Name the nerve being tested Hip 1) Flexion - iliopsoas 2) Extension - glut max 3) Abduction - glut med 4) Adduction - adductor longus Knee 5) Flexion - Hamstrings 6) Extension - Quadriceps Ankle/foot 7) Dorsiflexion and inversion - Tibialis anterior 8) Dorsiflexion - Extensor hallucis longus 9) Dorsiflexion - Extensor digitorum longus 10) Plantarflexion - Gastroc/soleus 11) PLantarflexion - FHL 12) PLantarflexion - FDL 13) Plantarflexion and inversion - Tibialis posterior 14) Evert - FIbularis longus and brevis

1) Femoral n L1-L2 2) Inferior gluteal nerve L5, S1, S2 3) Superior gluteal nerve L5, S1 4) Obturator nerve L2-L4 5) Sciatic n L5-S1 6) Femoral n L2-L4 7) Deep fib nerve L4, L5 8) Deep fib nerve L5 9) Deep fib Nerve L5 10) Tibial nerve S1/2 11) Tib nerve L5 12) Tib nerve L5 13) Tib nerve L5 14) Superficial fibular nerve L5,S1

Name the compatment 1) Labrum ligamentum teres, articular surfaces 2) Femoral neck, synovial lining 3) Guteus medius, gluteus minimus, IT band, trochanteric bursae 4) Iliopsoas insertion, iliopsoas bursae

1) Central 2) Peripheral 3) Lateral 4) Anterior

Adduction of the knee is the same thing as applying a __ force Abduction of the knee is the same thing as applying a __ force Therefore, an ABduction dysfunction would have restriction to what?

Valgus Varus Valgus

What nerve is subject to compression by the fibular head fracture or SD around the fibular head?

Common fibular (old term is peroneal) nerve

The __ angle is between the patella and tibial tuberosity and then the patella and ASIS to give an angle of __. It's also large in women

Q, 15

If the fibula or tibia lateral? Also which one has the lateral malleolus and which one has the medial malleolus?

Fibula is lateral and has lateral malleolus

Inversion of the ankle and eversion checks for what kind of dysfunction? What about plantarflexion and dorsiflexion. What about dorsal and ventral glide? What about dorsi/planta/abduct/adduct/internal/external motions?

Calcanus, Talus, (Navicular, cuboid, cuneiform, metatarsa) Metatarso-phalangeal

What makes up the trasnverse distal tarsal arch, lateral longitudinal arch, and medial longitudinal arch?

Transverse = Cuboid, navicular, 1-3 cuneiforms, metatarsals (proximal part) Lateral longitudinal arch = Calcaneus, talus, cuboid, metatarsals 4-5 Medial longitudinal arch = Calcaneus, talus, navicular, cuneiforms 1-3, and metatarsals 1-3

What ligament is the primary stabilizer of the medial ankle?

Deltoid ligament

Which ligament is always the one to sprain first? (AKA if you get a sprained ankle what have you most likely injured?)

ATFL (Anterior talofibular ligament)

What injury is due to the unhappy triad (in the knee)

ACL, TCL, Lateral meniscus

Calcaneal inversion occurs between the __ and __ and the __ joint

Talus and calcaneus, subtalar

Are plantar or dorsiflexion injuries more common? Also what can a plantar navicular dysfunction be due to?

Plantar Tight plantar fascia

What make up the deltoid ligament?

Anterior tibiotalar ligament, tibiocalcaneal ligament, posterior tibiotalar ligament, and tibionavicular ligament ** Note it's on the medial side, which is another reason why most ankle sprains occur on the lateral side

When checking for glenohumeral dysfunction what two areas are you most concerned about and what do you contact when assessing this problem

Anterior/inferior and posterior/superior and you contact the proximal humerus

What position maximizes AC joint motion?

60 degree coronal abduction and 60 degree horizontal abduction

The spine of the scapula is at the level of T__ and the inferior border of the scapula is at the level of __

T3, T7

Normal AC rotation is estimated to be __ degree each way

You place your fingers __ for SC flex and extend and on __ for SC abduction and adduction

Anteriorly, superior

Is adduction or abduction somatic dysfunction more common?

Adduction

Name the muscles that do the function for the scapula 1) Elevation 2) Depression 3) Protraction 4) Retraction 5) Upward rotation 6) Downward rotation Name the muscles that do the function for the shoulder girlde 1) Flexion 2) Extension 3) Abduction 4) ADDuction 5) Internal rotation 6) External rotation

1) Upper traps and levator scapulae 2) Lower traps and rhomboid major 3) Serratus anterior 4) Both rhomboids and middle traps 5) Serratus anterior and upper traps 6) Levator scapulae, both rhomboids, and latissimus dorsi (LRRL) 1) CD (coracobrachialis and deltoids) 2) LT (Latissimus Dorsi and Teres Major) 3) Supraspinatus and mid delotid 4) Pec major and latissimus dorsi 5) Subscapularis and pec major 6) Infraspinatus and teres minor

What three bones make up the shoulder joint?

CLavicle, humerus, and scapula

What are the 2 accessory joints?

Costosternal and costovertebral

What mobile characteristics are seen in abnormal vs normal lymph

``` Normal = mobile Abnormal = Fixed, Discrete, Matted ```

Which lymph nodes drain the occipital and back of pharynx (throat)?

Posterior cervical

Day 1 Flashcards

(64 cards)