Final Flashcards
(178 cards)
1
Q
Essential hydrodynamics occur during which of teh following
A
Running
2
Q
Lack of joint play will cause dysfunction within the joint and may cause
A
Pain
3
Q
Correct proprioception is essential for proper position of ___ in the joint where stability is sacrificed for mtion
A
Gleno-humeral
4
Q
Over time the scapula tends to migrate which way in the shoulder complex
A
Superior and lateral, making the gelnoid cavirty more shallow
5
Q
Tennis elbow is usually considered which one of the following subluxations
A
Posterio-lateral radius
6
Q
Which of the following subluxations can mimic angina or neuritis symptoms
A
Costo-transverse subluxations
Posterior rib angles
7
Q
The structure within the TMJ that is the source for pain and synovial effusion is called
A
Retrodiscal tissue
8
Q
When using an AP thoracic x-ray, measuring from teh inferior tips of the scapula and comparing one to teh other a different of greater than ___ indicates an unstable shoulder complex
A
15mm
9
Q
A patient is muscle tested using opponens pollicis while pronating the forearm, which one of the following conditions is being tested
A
Pronator teres syndrome
10
Q
Normal opening of the jaw could be measured as 3 fingers wide, whic his equivalent to
A
50-65mm
11
Q
Initial motion in teh wrist during flexion occurs at which joint
A
Radius and scaphoid
12
Q
A great exercise used to attempt to re-establish scapulo-humeral rhythm adn strengthen the shoulder, focusing on scapular retractors is which of the following
A
Wall angels
13
Q
Loose packed posiiton can involve positions of travel away from the closed packed position and extreme movement in that direciton usualy results in which of teh following
A
Sprain
14
Q
Which of the following structures is a postural sign of upper cross syndrome
A
Anterior head carriage
15
Q
Which of the following muscles is a primary muscle responsible for protrusion of the mandible
A
Lateral pterygoid
16
Q
When vertical height of the tetth is lost, this can lead to which mal-position of the condyle
A
Superior/posterior
17
Q
The alleged part 4 NBCE extremity move that is known as the palmar-distal contact pull move requires which of the following SCP
A
Distal radius and ulna
18
Q
In a close lock of the mandible, the pt will complain of what
A
Inability to open mouth fully
19
Q
A measurement between the coracoid and the clavicle of more than ___ on an x-ray could indicate a coracoclavicular ligamentous disruption
A
1.3
20
Q
Which one of the following is not a dynamic stabilizer of teh scapulae
A
Biceps tendon
21
Q
The alleged part 4 extremity move that is known as the ulnohumeral extension move requires which one of the following SCP
A
Cubital fossa
22
Q
The GH joint is in flexion, adduction, and external rotation, the elbow is in extension; this describes the starting position for the RMT for what
A
Costo-angle
23
Q
after adjusting a PL radius, if the triceps muscle test with wrist extension does not lock out (weakr); which of the following subluxations is then corrected
A
AM radius
24
Q
The pec major inferior branch muscle test is useful to find which one fo teh following subluxations
A
Costo-chondral
25
The trigger point type pain between the scapula and upper trapezius/levator scap are evidence of which
Dysfunction and symptomatic referred pain
26
Biomechanically when the scapula drops inferior to give the appearance of a raised scapula this is called
Horizon sign
27
The segmental contact point for a posterior superior costovertebral rib is
Just lateral to the transverse process of the vertebrae on the involved rib
28
Loose packed position for the elbow is what position
Flexion and supination of the forearm
29
The 10th intercostal rib junction is found approx where
Lateral aspect of the abdomen
30
Which muscles listed are primarily responsible for retraction of the mandible
Temporalis, masseter, geniohyoid, dygastric
31
When a patient complains of biting the inside cheek of their mouth which subluxation listing is this complaint most ocmmonly associated with
Superior/posterior condyle
32
Pathologies, pain tolerance and dislocation are classified under which management criteria category
Safety
33
According to the lecture assessment notes of the wrist and hand. When there is decreased motion and pain in full wirst extenstion, your initial assessment is to
Check posterior to anterior restriction of the radio-lunate joint
34
A measurement between the SC joints of more than ____ mm on a AP thoracic x-ray could indicate an unstable shoulder
5
35
Which structure is compensatory stabilizer of the scapulae
Supraspinatus
36
Essential hydrodynamics in a joint occur during
Running
37
The goal for the GH distraction adjusting move is
To open up the joint stimulating the mechanoreceptors and improvign proprioception
38
The injured GH joint is complicated due to the anatomical configuration of the joint. When the joint swells it can contain a tremendous amount of fluid within the joint and still display very little evidence of joint effusion. What is the maximum amount of fluid the joint can containt
30cc
39
Scapular stabilizer exercises will help the scapulae with which way
Posterior and medial, making the glenoid cavity deeper
40
Secondary rotator cuff tears are differentiated from primary tears by
The tear is found extracapsular
41
Which subluxation can mimic angina or neuritis symptoms
Posterior rib angles
42
Within the TMJ a pt that has problems where they are unable to close the mouth is known as a
Open lock
43
When a patient under the age of 25 years has a previous GH joint dislocation, the chance of having another dislocation is greater than
96%
44
Pronating teh forearm while testing opponens pollicis RMT, could uncover a pronator teres syndrome, which subluxation should you check or recheck on your pt
PM ulna
45
Normal opening of the jaw could be measure as ___ fingers wide, which is equivalent to
3; 50-65mm
46
Full recovery in a tendinitis issue is how long
4 weeks
47
The GH joint is in 90d shoulder flexion, 90 horizontal adduction and full radio-ulnar pronation, the elbow is in extenstion, this describes the starting position for the muscle test for which misalignment
Costo-sternal
48
Cervicobrachial compression syndrome, represents a scapula that is ___ which contributes to shoulder instaiblity
High on the side of involvement measured at the inferior angle
49
In lecture we had Emily show us an excellent exercise called the ____ used to help weakness of which muscle
Pushup plus
| Serratus anterior
50
Which description is correct for the order of the evaluation procedure, when addressing carpal issues
```
Motion
Pinch/distract/shear
Opponens pollicis RMT
Palpation to compare bilaterally
Adjust
```
51
Which RMT is used to test for the costal chondral rib subluxation
Pec major sternal division
52
After adjusting a costosternal, chondrosternal rib subluxation, how long may the pt continue to feel pain upon palpation
48 hours
53
When assessing extremity injuries in the chiro office, most injuries will require a medical referral at which minimum ghrade
2
54
If on assessment you find a posterior SC joint what is your initial management step
Call 911
55
Following the adjusting protocals improve the neurolgocail and biomechanical components of the VSC and associated extra spinal articular misalignments
Yes
56
Normally the GH capsule contains .5-1.5cc of fluid. How much fluid can it contain before seeig it
30 cc
57
What move is contraindicated for someone who has subacromial bursisits
AI humerus
58
Recruitment
1st
59
Abandonment
2nd
60
What are the dynamic stabilizers
Pec minor
61
Lack of joint play will cause dysfunction and
Pain
62
After clearing the SC joint, AC joint, GH joint and biceps, next chekc
Scapulothoracic articulation
63
The most common reason for re-injury is a
Failure to properly condition the healed tissues
64
The concept of extraspinal management within the chiro paradigm must include integration of extraspinal areas to the spine. First one must consider the ___ connection, then the ___
Neurological
| Muscles
65
If multiple extermities are subluxated, how do you determine which one to adjust
Use the pain scale - adjust extremity with hgihest pain level
66
What are benefits of bracing vs. using tape
Brace can be washed
| No dermatitis from the brace - tape can cause this
67
Forces of injury, position of joint, and time of episode fall under which category
Safety
68
A sprain with no separation
Grade 1
69
The end of travel in a joint whereby the surfaces are at maximal congruency, the ligaments are taut, and no further movement in that direction of travel may result in
Dislocation/fracture
70
The most common sublux for SC joint is
Inferior, anterior, medial
71
Ligamentous disruption of ___ mm is a SC separation and the direciton is most commonly separates is __ and ___
5
| Anterior and superior
72
Theory that states amsucel functioning across a misaligned joint will be inhibited by a reflex signal originating from ___ surrounding that joint
Mechanoreceptors
73
Trauma, if acute, check for
Patient safety
Joint stability
Then subluxation
74
The most common injuries seen in the office are
Grade 1 or mild grade 2
75
Over time the scapulars tend to migrate
Superior and lateral
76
SC joint is probably responsible for most of the ___ info for the upper extremity
Proprioception
77
Elbow in closed pack position
Full extension - taut ligaments at max confruency dislocation or fracture
78
Medial epicondylitis - golfers elbow is typically from a
PM ulna
79
Can mimic carpal tunnel syndrome
| Pt is tested by pronation against resistance; symptoms follow a median nerve distribution
Pronator teres syndrome
80
Compensatory stabilizers for scapula
Biceps and supraspinatus
81
Shoulder sulcus sign is ___ instaiblity of GH joint
Inferior and anterior
82
TMJ intra-articular involvement = syovitis and capsulitis with the focus on the disc which is considered displaced or degenerated. Studies show that ___% of individuals will show some TMJ related sypmtom in their lifetime
85-90
83
Upper cross syndrome signs
```
Anterior head carriage
Elevated rounded shoulders
Winging scapulae
Shortened pectoralis
Dyphotic upper T spine
Shortened upper trap/levator
Weak serratus anterior
Low/middle trap weakness
```
84
Lack of ___ will cause dysfunciton within the joint and may cause pain
Joint play
85
Hydrodynamics = essential for proper lubrication, transport of nutrients, and removal fo waste materal from the articular surfaces. Proper hydrodynamic occur during
Weight bearing, intermittenet muscle activity, full ROM
| Running, sleeping, sitting, grade 2 muscle
86
Over time, scapulas tend to migrate ___ making a shallow glenoid cavity more shallow leading to more shoulder complaints
Superior
| Lateral
87
GH joint is most often affected by ____ or the tendon of the ___ of biceps
Rotator cuff dysfunction (supraspinatus)
Long head
Stability sacrificed for meovment
88
Lateral epicondylitis = tennis elvboy. Most common listing is
PL radius
89
A ___ muscle test is a good indicator of median nerve involvement
Opponens pollicis
90
Weakness of this muslce with arm in ___ usually indicates median nerve pressure at the wrist (carpal tunnel)
Supination
91
Weakness with arm in pronation usually indicates median nerve irritation at the elbow or
Pronator teres syndrome
92
Exercise for retraction of the scapula/GH joint
Wall walks with hands oriented so fingers pointing upward
| Wall angels
93
Initial motion upon ____ occurs at the radiocarpal joint and secondary motion at the mid carpal and carpal metacarpal joint
Flexion
94
Based on the above, if there is pain at the beginning of ROM, check the
Radiocarpal joint
95
Which rib subluxations can cause intercostal neurtisi
Costo-vertebral
Costo-transverse
Costal angle
Anterior dorsals
96
The 2 muscles involved in jaw protrusion
Lateral pterygoid muscle
| Assisted by medial pterygoid
97
4 muscles involved in jaw retraction
Posterior fibers of temporalis
Deep part of masseter
Geniohyoid
Digastric
98
3 muscles involved in jaw elevation
Medial pterygoid
Masseter
Temporalis
99
3 muscles invovled in jaw depression
Digastric
Geniohyoid
Mylohyoid - assisted by gravity
100
Most common SC joint separation
Superior and anterior
101
On x-ray a space of more than ____ between the coracoid and clavicle indicates coracoclavicular ligamentous disruption
1.3cm or 13mm
102
With cross over maneuver, presence of superior pain or discomfort in the shoulder indicates
Pathology of the AC joint
103
On an AP thoracic x-ray a height difference of ___ between the inferior tips of the scapula indicates an unstable shoulder
More than 15mm
104
Most common reason for re-injury of a dislocated shoulder is
Failure to properly condition the healed tissues
105
Overuse is ___ in tenditis but ___ in tendinosis
Rare
| Common
106
Tennis elbow can have a long healing time lasting up to as much as __ weeks
72
107
Rate of irritation is greater than rate of recovery is the description of the
Specific adaptation to imposed demand principle (SAID)
108
___ tears are intercapsular, whereas ___ tears are extracapsular
Primary
| Secondary
109
Which joint is likely the most responsible for the majority of the proprioceptive information for the upper extremity
SC
110
The SC articulation is the most overlooked region of the upper extremity. What is the second most
Scapulothoracic articulation
111
Medial epicondylitis or golfers elbow typically produces a ___ ulna
PM
112
Medial epicondylitis is observed when there is weakness of the
Flexor carpi ulnaris muscle
113
Lateral epicondylitis or tennis elbow is observed when there is weakness of the
Extensor carpi radialis brevis muscle
114
If wrist pain is reduced or ROM enhanced by applying mild pressure approximating distal ulna and radius - a ____ may have occurred via hyperextension or hyperflexion insult to the wrist
Spreading injury
115
To test this, you would perform this part 4 orho test
Bracelets test
116
The sphenoid bone articulates with ___ other cranial bones
12
117
The TMJ is unique because it is a synovial joint, but the surfaces are covered by this type of cartilage
Fibrocartilage
118
This source for pain and synovial effusion in a TMJ related issue consists of a venous plexus covered with a synovial membrane
Retrodiscal tissue
119
If a pt complains of locking, he can’t open his mouth fully, this is called a closed lock. In this case the disc is __ to the condyle
Anterior
120
Which direciton of movement is more common in a costal angle subluxation
Superior
121
At the 5 rib, the costo-chondral junction is approx
Mid-clavicular line
122
Costo-sternal or chondro-sternal sublux apply to whcih ribs
The upper 6 ribs
123
Another name for anterior dorsals
Pottinger saucer
124
What else has a biconcave disc besides the SC joint
TMJ
125
What is the condition regarding grinding of the teeth at night
Bruxism
126
Ribs typically articulate with the disc and bodies of vertebrae above and below except
1,10,11,12
127
Do alll the middle eastern 7-11s have americnas working in them
Noone really knows
128
Musculature that suspends the scapula are innervated by
Lower cervic als
129
Trigger point type pain betwen the scapula and upper trapexius/levator scapula is evidence of
Dysfunction and symptomatic referred pain
130
What is the primary function of the shoulder
To place the upper extermity in space
131
List the dynamic stabilizers
```
Levator scap
Pec minor
Rhomboids
Serratus anterior
Trapezius
```
132
Most dynamic stabilizers are
Underused
133
Dynamic stabilizers attach
Shoulder to spine
134
What are the compensatory stabilizers
Biceps and supraspinatus
135
Compensatory stabilizers are often
Overused
136
What to ligaments do
Connect the chain - DO NOT Create stability
137
What is the osseous pivot of the upper extremity
SC joint
138
The AC joint is ___ mobile than the SC joint. However, it is often ___ due to restrictions and fixations of the ___
Less
Hypermobile
SC joint
139
What is the sulcus sign
Inferior and anterior instability of GH joint
140
When doing apley’s scracth inferior to check ST articulation what is the measurement to demonstrate an unstable shoulder
Greater than 1.5cm or 15mm
141
The most commonly overlooked subluxation
1. SC joint
| 2. Scapulothoracic
142
How should one place their arms for scaption
Roos/allens position
143
The 3rd way to check for scapulothoracic subluxation is
Internal rotation of at least 70 deg supine
144
When adjusting the inferior scapula, the goal is to break up adhesions of the
Subscpularis, bursae and serratus anterior
145
What is the ratio to determine GH efficacy
2deg of GH movement vs 1 deg of scapula movement
146
Which joint is the intersection of forces with little force dissipation option
Elbow
147
The biomechnical responder is the
Wrist
148
Positive ortho tests provide what info
Stability
149
Muscle tests are used to check for
Subluxation
150
What is hilton’s law
The same trunks of nerves whose branches supply the groups of muscles moving a joint furnish a distribution of nerves to the skin over the insertion of the same muscles, and the interior of the joint receives its nerves from the same source
151
The ortho test for any joint in the body is
O’donoghue
152
Serious grade 2-3 require
Medical referral
153
Except in teh case of ___ the spine is always considered first
Direct trauma
154
What is the CP for GH distrcation
Interlocking fingers
155
As we age, the scapula migrate _____ and the ____ flal forward with ____
Superior and lateral
Shoulders
Anterior head carriage
156
Where is joint play found
At the end of passive ROM
157
Based on the mechanoreceptor theory, muscles functioning across a misaligned joint are ___ due to ___ originating from mechanoreceptors surrounding a joint.
Inhibited
| Reflex signals
158
What is the most common subluxation of the GH jiont
AI 95% of the time
159
What is the challenge for the aC joint
Dugas
160
What is the SCP for biceps tendon
2 inches inferior to the bicipital tubercle
161
If chornic injury, chekc for
Instability then subluxation
162
What is the msot common ulnar subluxation
PM 80% of teh time
163
What is the SCP for PM ulna
Medial ridge of ulna 1” distal to the joint
164
Which ulna sublux occurs 20% of the time
PL ulna
165
The more common radius sublux is
PL radius
166
SCP for PL radius
Lateral rige of radius 1/4” distal to joint
167
How do you adjust a carpal bone
With reinforced thumbas - PA glide push
168
What is tennis elbow and what is the sublux commonly associated with it
Lateral epicondylitis
| PL radius
169
What is golfer’s elbow and what is the sublux associated with it
Medial epicondylitis
| PM ulna
170
PM ulna and PL radius both commonly occur after a __ injury. This may be the underlying problem in ___ which may mimic ____
Hyperextension
Pronator teres syndrome
Carpal tunnel syndrome
171
Pronator teres syndrome affects the ___ nerve distribution and is tested by ____
Meidan
| Pronation against resistance
172
Retraction of the scapula is called
Winging
173
Winging of scap is due to
Weak serratus anterior
174
Exercises used to strengthen serratus anterior are
Wall walks, wall angles, push-ups on all fours or full pushups
175
We tend to overuse
Flexor muscels
176
We tend to underuse
Extensor muscles
177
Upon extention of the wrist, carpals move
Diagonal and anterior
178
Upon flexion of the wrist carpals move
Posterior
