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Ortho 1 > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

When doing a distraction its is limited, what is involved?

A

contracture of connective tissue

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2
Q

When doing a distraction it is painful, what is involved?

A

tear of connective tissue

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3
Q

When doing a distraction and it eases the pain, what is involved?

A

articular surfaces implicated

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4
Q

When doing compression and it eases the pain, what is involved?

A

joint capsule implicated

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5
Q

When doing compression and its painful, what is involved?

A

joint surface implication

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6
Q

SINSS

A

Severity: intensity and effect on functional ability
Irritability: Amt it takes to exacerbate/subside symptoms
Nature: structure involved
Stage: acute, subacute, chronic
Stability: getting better, worsening, staying the same

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7
Q

Subjective Asterisks

A

linked with functional activity, used to reasses/set goals

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8
Q

Objective Asterisks

A

used to set goals

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9
Q

Myostatic Contracture

A

adaptive muscle shortening w/ reductio int he number of sarcomere units in series, individual sarcomere lengths also shortened – easiest to gain length

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10
Q

Periarticular Contracture

A

loss of mobility in the connective tissues that cross or attach to a joint or join capsule (restriction of arthrokinematics) – manual therapy, mobs, distraction

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11
Q

Arthrogenic Contracture

A

result from intra-articular pathology (adhesions, synovial proliferation, joint effusion, irregularities in the articular cartilage or osteophyte formation – surgery

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12
Q

Pseudomyostatic Contracture

A

limited ROM due to hypertonicity (spasticity and rigidity) associated with CNS - nerves that go to muscle

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13
Q

Fibrotic and Irreversible Contracture

A

connective tissues are replaced by great amount of nonextensible tissue (fibrotic adhesions, scar tissue, heterotrophic bone)

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14
Q

Contract-Relax

A 
Autogenic Inhibition (Golgi, Ib). responds to force/m. tension
Restricted/stretched muscle is contracted for 6 sec after this time the muscle is passively stretched. muscle will relax after contraction
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15
Q

Hold-Relax

A 
Reciprocal Inhibition (Spindle Fibers, Ia). Stretch reflex' keep from over stretching, muscle fiber damage.
contracting isometrically the ANTAGONIST (opposite) of the restricted and stretched muscle/relaxing
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16
Q

Changes Affecting Flexibility

A 
Injury
Immobilization
Inactivity
Aging
Posture
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17
Q

Static Stretching

A

30-60 seconds 1-3 times

hold longer to gain ROM

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18
Q

Cyclic Stretching

A

5-10 seconds several times
low velocity/intensity
flexibility

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19
Q

Ballistic Stretching

A

quick, bouncing movements that create momentum to carry the body segment through ROM (precaution for old)

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20
Q

Manual Stretching

A

early stages, patient can not perform, stabilize compensations, applying proprioceptive techniques - to gain length/mobility

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21
Q

Self-Stretching

A

maintain or increase the ROM gained by the therapist (HEP)

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22
Q

Mechanical

A 
prolonged time (30 min - 10 hrs)
stretch casts, traction
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23
Q

Posterior Muscle Chain

A

erector spine, deep pelvic trochanteric muscles, hamstrings, triceps surae

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24
Q

Anterior Muscle Chain

A

SCM and scalenes, anterior fascial tissues of the thoracic spine, diaphragm, psoas, adductors, soleus

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25
Q

Factors for Unbalanced Muscular Chains

A

aging, pathological, environmental, psychological

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26
Q

Postural Exam

A

head/cervical, thoracic, lumbar, pelvis, knee, foot

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27
Q

Mechanisms for how manual therapy decreases pain:

A

Neurophysiological/Chemical: inhibit descending pain pathway, opiod release, gate control theory, change in reflex excitability
Mechanical
Placebo

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28
Q

Unrestricted joint glide but decreased motion due to:

A

contractile tissues

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29
Q

Excessive joint glide due to :

A

ligaments

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30
Q

Restricted joint glide due to:

A

joint surfaces/ capsule

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31
Q

Pain with traction:

A

connective tissue tear, decrease in pain with compression

ligaments/joint capsule

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32
Q

Restricted motion w/ traction:

A

connective tissue restriction

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33
Q

Relieve of pain with traction

A

joint surface problem

34
Q

Pain with compression:

A

articular surface problem

35
Q

Assessment/Documentation

A

Assess each grade and document
specify direction
quantity and quality of motion with each grade
reproduction of symptoms/relief of pain

36
Q

How can a PT change the volume of resistance exercise?

A 
# of reps/set
#of sets/ exercises
# of exercises/ session
37
Q

GH Passive (static) Stability

A 
bones
cartilage
capsule
labrum
ligaments
38
Q

GH Active (dynamic) Stability

A 
deep muscles (RTC)
neuromuscular balance between deep and superficial muscles (scap m work with GH m)
39
Q

Superficial Muscles of Shoulder

A 
for MOVEMENT
deltoid
pecs
biceps
serrates ant
traps
lats
40
Q

Recruitment Order of Shoulder Muscles

A

Activation of agonist – movement – activation of antagonist – stop movement

41
Q

Deep Muscles of the Shoulder (RTC)

A 
STABILITY
pull humerus against glenoid fossa and down - increase subacromial space
infraspinatus
supraspinatus
teres minor
subscapularis
42
Q

Impingement Syndrome Symptoms

A

pain in anterosuperior part of shoulder
weakness
stiffness

43
Q

Compressed Structures in Impingement Syndrome

A

bursa (first)
supraspinatus (most common)
ER tendons (infraspinatus, teres minor)

44
Q

Outlet Impingement Syndrome

A

abrasion of soft tissue structures (RC) located between head of humerus and roof of shoulder during elevation (90-95%)
Painful arc

45
Q

Non outlet Impingement Syndrome

A

normal subacromial space
impingement of RC against post superior glenoid labrum and humeral head
young patients performing repetitive overhead movments

46
Q

Outlet Space Components

A

coraco-acromial ligament
coracoid process
anterior acromion
AC joint

47
Q

Primary Impingement

A 
related to tendon
chronic disorders of RC
RC weakness
RC compression (overuse)
degenerative tendinopathy
*35-40y/o does a lot of overhead activities
48
Q

Secondary Impingement

A 
related to surrounding structures
coracoid impingement
lesser tuberosity pinches coracoid process
instability (classic) 
Os acromiale/shape of acromion
*young athletes
49
Q

Stage I Impingement

A

edema and hemorrhage of the bursa and cuff
less than 25
trauma, active

50
Q

Stage II Impingement

A

irreversible changes
fibrosis and tendinitis of RC
25-40

51
Q

Stage III Impingement

A

chronic stages
partial or complete tears of the RC
>40

52
Q

Traumatic Shoulder Instability

A 
Bankart lesion
fall on extended arm
complain shoulder is going out
recurrent shoulder dislocation (chronic phase)
\+ apprehension test
53
Q

Atraumatic Shoulder Instability

A

GH ligaments (IGHL/AGHL)
tendinitis, sensation of instability and laxity
not afraid shoulder will pop out
- apprehension test

54
Q

SLAP Lesion

A

injury to glenoid labrum
Superior labral tear form anterior to posterior
starts in biceps and goes to capsule
pain most common symptom w feeling of instability as well as abducted ER positions

55
Q

Frozen Shoulder Stage I

A

duration of symptoms 0-3

painful, dont notice big loss of ROM

56
Q

Frozen Shoulder Stage II (freezing)

A

3-9 months

drastically lose ROM in all directions

57
Q

Frozen Shoulder Stage III (frozen)

A

8-15 months

minimum pain, stiff movement

58
Q

Frozen Shoulder Stage IV (thawing)

A

15-24 months
minimal pain
progressive ROM improvement
WILL improve w/o treatment - PT makes it faster

59
Q

Colles Fracture

A 
Most common fracture to wrist
fx of distal radius - dorsal displacement
extension + compression
dinner fork deformity
surgery
60
Q

Smiths Fracture

A

fx of distal radius - solar displacement
flexion + compression
surgery

61
Q

Scaphoid Fracture

A 
fall w/ extension/radial deviation 
pain in anatomical snuff box
painful/limited wrist movement
painful compression/load 
conservative treatment
62
Q

Boxer’s Fracture

A

fracture of neck of 5th MC
boxing or punching
swelling, pain with MMT
surgery or splint

63
Q

Mallet Finger

A

avulsion of ext tendon (or bone) from DIP - sports injury
direct force causing forced flexion
deformity of DIP, can’t straighten DIP
volar splint, surgical fixation, exercises

64
Q

Scaphoid-Lunate Dissociation

A

injury to scaphoid, lunate ligament
fall or trauma
localized pain, swelling, clicking, pain w/ ext
xray, palpation, limited wrist ROM, increase glide, + Watson test
immobilization, modalities, surgery

65
Q

Lunate Dislocation

A 
more than 1 ligament compromised
volar dislocation of lunate
pain w/ palpation, limited/painful ROM, positive X-ray, N/T median nerve distribution 
Surgery
immobilization (3-4 weeks) 
limit wrist ext ~2mths
66
Q

Kienbocks Disease

A

osteonecrosis/AVN of lunate (any carpal bones) following fx
FOOSH, compression fracture
local tenderness, swelling, limited wrist motion
GOAL: restore blood supply/vascularization
initial immobilization (fracture)
thermal modality (US if no pain)
ROM/glide
surgery: bone graph

67
Q

Triangular Fibrocartilage Disc Injury

A

trauma/FOOSH, overuse injury (repetitive pronation & gripping w/ load though the wrist)
Ulnar pain (ONLY condition w/ ulnar pain), crepitus
edema, tender, weak, instable, loading wrist into UD & ext
Conservative: steroid injection, PT, education, US, splint/cast 4-6 weeks
Surgery

68
Q

Raynaud’s Phenomenon

A

Constriction of small blood vessels of hands/toes (vasospasm)
Location: defuse pain, cold, numbness
Idiopathic, trauma, cold, emotional stress
Blanching of fingers + Allens test (potency of the radial/ulnar arteries)
Skin changes
Vasodilatory drugs, education (stress management, smoking)

69
Q

Carpal Tunnel Syndrome

A

median n compression in carpal tunnel
leads to: ischemia, edema, reduced nerve gliding, fibrosis
trauma, overuse of flexor muscles/posture of hands
Pain and paresthesia, numbness, nocturnal pain, hand falling asleep, thenar atrophy
Tinels test/Phalens/Reverse

70
Q

Cubital Angle

A

male: 11-14
female: 13-16

71
Q

Lateral Epicondylitis (tennis elbow)

A

inflammation in the insertion of the extensor carpi radial braves (ECRB) and extensor carpi radials longs (ECRL
35-50 y/o, young athletes
lat elbow pain w/ insidious onset, pain w/ wrist extension, weekend grip strength
stretching, strength training, eccentric muscle training
deep transverse friction w/ mills manip, radial head/cervical mobs
brace: compresses before tendon, release tension on tendon

72
Q

Medial Epicondylitis (golfers/throwers elbow)

A

inflammation in the insertion of the flexor carp radials (FCR) and pronator teres
medial elbow pain, pain w/ wrist flexion and pronation
resisted wrist flexion, passive stretch
deep transverse massage, lateral glides

73
Q

Stage I Lateral Epicondylitis

A

inflammation without alteration in the tendons

74
Q

Stage II Lateral Epicondylitis

A

associated w/ pathological changes int eh tendon (tendinosis) or angiofibroblastic degeneration - some change in tendon

75
Q

Stage III Lateral Epicondylitis

A

pathological changes in tendon and rupture of tendon

76
Q

Stage IV Lateral Epicondylitis

A

characteristics of the stage 2 and 3 plus fibrosis, soft matrix calcifications and faint calcifications along the epicondylar margins

77
Q

Special tests for lateral epicondylitis

A

chari, mills, finger extension, cozens

78
Q

Pulled Elbow

A

sublation of radial head
arm is extended and pronated
reduction maneuver

79
Q

Osteochondritis Dissecans

A

> 12
clicking/locking
Lateral or central portion of capitellum
Repetitive loading (overuse)
lesion to the subchondral bone of capitellum
conservative vs. operative - depended on lesion
prognosis dependent on pt age and characteristics of lesion

80
Q

Panners Disease

A 
6-12
entire capitellum
repetitive loading (overuse)
ischemic necrosis of capitellum
conservative management (rest, activity modification)
excellent prognosis

Ortho 1 (1 decks)

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