FINAL EXAM

Question 1

what are the four variables of stabilization?

Answer 1

joint integrity
passive stiffness
neural input
muscle function

Question 2

what are the four possible causes of inhibited and/or dysfunctional muscles?

Answer 2

P!
swelling
disuse/immobilization
joint laxity
NOT a damaged nerve

Question 3

pain phenotyping

Answer 3

set of observable pain characteristics of an individual that results from body + environment interaction

Question 4

nociceptive P!

Answer 4

injury or damage to an individual tissue at a particular location that is a non-nervous tissue
(MSK + spondylogenic and viscerogenic)

Question 5

neuropathic P!

Answer 5

nervous tissue is compromised and causes paresthesias and/or numbness (radicular + radiculopathy + peripheral)

Question 6

nociplastic P!

Answer 6

altered/mismatched/heightened pain perception without evidence of actual/threatened tissue compromise

Question 7

spondylogenic P!

Answer 7

common, from the spine
local and/or referred spinal P! from noxious stimulation of spine structures
CANNOT cause visceral dysfunction
NON-segmental P! because it is not from a spinal nerve
vague, deep, achy P!

Question 8

somatic convergence

Answer 8

sensory afferents converge on and share the same innervation therefore symptoms are felt away from the source

Question 9

viscerogenic P!

Answer 9

referred pain from an organ
vague, deep, achy, and boring P!
neuro scan WNL
not mechanically reproduced

Question 10

viscerosomatic convergence

Answer 10

viscera and somatic (body) sensory afferents converge and share the same innervation

Question 11

radicular P!

Answer 11

NOT common
HIGHLY INFLAMED spinal nerve (dorsal root)
electric shock like pain
+ dural mobility tests

Question 12

radiculopathy P!

Answer 12

decreased conduction of spinal nerve due to compression and/or inflammation
often constant and long duration
may exist with radicular P!
segmental paresthesias from a spinal nerve
follows a dermatomal pattern
+ neuro scan for spinal nerve hypoactivity

Question 13

peripheral nerve P!

Answer 13

decreased conduction of nerve branch
short numbness duration (temporary)
non-segmental paresthesias (not from a spinal nerve)
often intermittent and short duration
dermatomes, DTRs, myotomes WNL
decreased sensation along peripheral nerve distribution
+ dural mobility tests due to inflammation

Question 14

imaging: better at ruling in or out?

Answer 14

better at ruling OUT!

Question 15

4 diagnosis categories and classifications of neck P!

Answer 15

neck P! with mobility deficits (hypomobility)
neck P! with movement coordination impairments (whiplash + hypermobility)
neck P! with headaches
neck P! with radiating P!

Question 16

4 neck P! Rx regions

Answer 16

cervical
shoulder girdle
thoracic
shoulder region

Question 17

type I collagen

Answer 17

resists tension
greater in outer annulus
fibrocartilage and bone

Question 18

type II collagen

Answer 18

resists compression
greater in the nucleus
articular cartilage

Question 19

protrusion (bulge)

Answer 19

MOST COMMON herniation
nucleus migrates but remains contained in the annulus

Question 20

extrusion

Answer 20

nucleus migrates through the outer annulus

Question 21

free sequestration

Answer 21

nucleus migrates and breaks away from the annulus

Question 22

most common type of herniation

Answer 22

protrusion (bulge)

Question 23

covers ends of long bones and facets
frictionless/resistant to wear
type II collagen
resists compression
neural/alymphatic/avascular
depends on diffusion

Answer 23

articular cartilage

Question 24

3 primary types of headaches

Answer 24

tension
migraine
cluster

Question 25

secondary type of headache

Answer 25

cervicogenic

Question 26

tension headache acronym

Answer 26

BAND

Question 27

migraine headache acronym

Answer 27

POUNDS

Question 28

cluster headache acronym

Answer 28

CRUSHING

Question 29

tendon structure

Answer 29

dense regular connective tissue type I collagen parallel fibers (for more unidirectional loads)

Question 30

tendon function

Answer 30

resists tension and releases energy with muscle actions more stiffness = better force transmission or storing of potential energy

Question 31

scapular motions before 150 degrees

Answer 31

elevation upward rotation protraction

Question 32

scapular motions after 150 degrees

Answer 32

depression retraction posterior tilt

Question 33

mid portion of tendon

Answer 33

hypovascular hyponeural

Question 34

insertion of tendon

Answer 34

hypervascular hyperneural

Question 35

regional interdependence

Answer 35

differing body regions are biomechanically and neurophysiologically interdependent so impairment in one region can contribute to impairment in another, particularly if persistent

Question 36

most common segment of joint dysfunction + etiology for regional interdependence

Answer 36

C5-C6

Question 37

C5-C6 regional interdependence

Answer 37

IMBALANCE WITH OVERHEAD REACHING = excessively recruited internal rotators + external rotators get inhibited, humeral head gets pulled anteriorly and into IR which creates excess tension and compression underneath long head of biceps tendon (can lead to impingement + tendinopathy)

Question 38

C2-C3 regional interdependence

Answer 38

IMBALANCE WITH OVERHEAD REACHING = excessively recruited scapular elevators, elevation compensation creates excess tension and compression underneath supraspinatus tendon (tendinopathy) + scapular depressors are inhibited (impingement especially if > 150 degrees), supraspinatus and long head of biceps tendons will impinge and can lead to tendinoapthy and GH or AC joint hypermobility/instability (due to hypomobility in the scapulothoracic joint)

Question 39

SLAP tear

Answer 39

long head of biceps excessively contracts and tears labrum in the anterior-posterior direction (may have to surgically fixate bicep's tendon aka tenodesis)

Question 40

precautions for the first 6 weeks post op total shoulder arthroplasty

Answer 40

no pushing, pulling, or lifting avoid hyperextension position/motion because it stresses the prosthetic too much ROM 2x/day

Question 41

primary etiology of frozen shoulder contracture syndrome

Answer 41

due to pathology, particularly autoimmune conditions

Question 42

secondary etiology of frozen shoulder contracture syndrome

Answer 42

concomitant injury and period of immobilization

Question 43

pathogenesis of frozen shoulder contracture syndrome

Answer 43

more often inflammation of GH capsule and ligaments (persistent inflammation, fibrosis, contracture) + reduced joint volume = leads to impingement due to hypomobility