Final - Spring Flashcards
(66 cards)
1
Q
capitulum –>
A
radial head
2
Q
true joint of the elbow
A
humeroulnar joint
3
Q
what ligament stab the radial head
A
radial anular lig
4
Q
ROM of elbow and what it is limited by
A
flex: 145 - lim by muscles
ext: 5-10 - lim by olecranon fossa and tension of anterior lig
5
Q
main m of elbow flexion
A
brachialis
6
Q
main M of elbow extension
A
triceps
and anconeus
7
Q
carrying angle
A
>15: cubitus valgus –>
- ULNAR deviation of wrist
<5: cubitus varus: aka gunstock deformity
8
Q
supinators
A
biceps
supinator
9
Q
pronators
A
pronator quad
pronator teres
10
Q
pronation and supination: coupled motion
A
pronation: radial head –> posterior
* b/w distal radius crosses over ulna
supinator: radial head –> anterior
11
Q
the prox ulna has accessory motions of ____ with supination and _____ with pronation
A
adduction
abduction
12
Q
interosseous membrane
A
- tightens with supination
- transmits E from wrist to elbow to decrease strain
13
Q
nursemaids elbow
A
sublux of radial head –> flex and pronated
- tears anular ligament
tx:
- traction
- supination
- flex elbow to 90
14
Q
ulnar n compression
A
by FCU: arcuate ligament
- weakness of 4 and 5
- claw of 4 and 5
- hypothenar atrophy
15
Q
radial n compression
A
supinator –> pain @ lateral epicondyle
- WORSE with pronation
16
Q
median n compression
A
- struthers
- pronator teres: can pass b/w 2 heads of pronator
- FDS
- carpal tunnel
17
Q
lateral epicondylosis
A
degen and tearing of extensor tendons
- not inflammation so not -itis
MOA:
- neuro-M dysfx
- inability of antag M to relax with contraction of agonist
- results of breakdown of tendon as it attaches to periosteum
- lower c-spine dysfx
tx:
- ME
- traction of c-spine
- corticosteroid injection
18
Q
A
olecranon bursitis: P leaning on elbow
- gout
- RA
19
Q
medial adduction of the ulna–>
A
wrist ABduction –> superior radius –> lateral olecranon
- decreased carrying angle
20
Q
falling forward on outstretched hand
A
hand in pronation –> anterior distal radius –> ANTERIOR “disloc” of hand
- results in radial HEAD to be POSTERIOR
- b/c pronation –> posterior SD
21
Q
falling backwards on “backwards” hand
A
hand is SUPINATED –> posterior distal radius –> ANTERIOR slide of radial head
22
Q
true wrist joint =
A
radiocarpal
23
Q
fx joints of wrist
A
radiocarpal: F, E, ulnar and radial deviation
midcarpal: sliding b/w bones, radial deviation
ulnomeniscotriquetral: pesudojoint - ulnar deviation
24
Q
wrist range of motion
A
F: 80
E: 70
Ab: 20
Ad: 30
25
accessory motions of slide, rotation, traction are GREATEST @
radioscaphoid
radiolunate
26
muscles acting on wrist
FCU: flex, adduct
FCR, palmaris longus: flex, abduct
ECU: extend, adduct
ECRL/B: extend, abduct
27
role of wrist ligaments
partially closed packed by lig
carpal bones = fulcrum for complex wrist mvmts
respond to DISTAL M forces
28
wrist SD
extension --\> VENTRAL carpal bones
flexion --\> DORSAL carpal bones
29
what is in the carpal tunnel sheath
median N
FDS: 4
FDP: 4
flexor pollicus longus
30
carpal tunnel syndrome
fingers 1-4.5: numbness
symptoms worse @ night
weakness/atrophy of thenar
(+) tinel's
dx: nerve conduction studies
31
predisposing factors of CTS
1. repetitive strain
2. sleeping with wrist flexed
3. DM
4. RA
5. pregnancy
6. hypothryoid
7. obesity
8. low vit C and b6
32
osteopathic tx of CTS
1. cerv, thoracic spine
2. ribs
3. "double crush"
4. anterior lunate
33
tunnel of guyon
pisiform --\> ulnar N --\> hook of hamate
dysfx:
1. gang cyst
2. ulnar A aneurysm
3. handlebar neuropathy
4. rapid wt gain
5. preg
6. RA
34
anatomic snuffbox
ABductor PL --\> EPB --(radial A & scaphoid)--\> EPL
* fx of scaphoid --\> avasc necrosis
35
accesory motions of hand
what happens with their loss?
1. dorsal ventral slide
2. long axis traction
3. axial rotation
loss --\> arthritis
36
very common Jones CS TP found in...
abductor pollicis brevis
37
M of hand: extrinsic and intrinsic
extrinsic: F, E
* forearm
* tendons that CROSS wrist into hand
intrinsic:
* thenar:
* opponens pollicis
* APB
* FPB
* hypothenar:
* FDM
* Abductor DM
* ODM
* inteross
* lumbricles
38
prehension
skin over palm = thicker than dorsum
* attached to fascia @ palmar creases
* GRASP objects securely
* conforms to shape well
39
finkelsteins:
inflammation of tendon sheaths of :
* EPB
* Abductor PL
40
ER of hip --\>
glide of fem head ANTERIOR in acetabulum
disengages fem head from acetabulum
41
flex/end of hip and relationship to pelvis
sup/int pelvis in sagittal plane
42
abduc/adduc of hip and relationship to pelvis
lateral pelvis in frontal plane motion around A/P axis
43
true hip pain refers to...
groin
44
ligaments of hip
anterior lig = iliofemoral (thickened) --\> gives stabilitiy
* RELAX with flexion
* increased tension and limits in extension
* reinforced by ILIOPSOAS
pelvis normally rotated forward
* seats hip joint
* forms sacral base of lumbar spine
45
hip flexors
iliopsoas: PRIMARY
r. femoris
sartoris
pectineus: also ADDuctor
TFL: also ABductor
\* all innerv by fem N: L2-4
46
hip extensors
g. max: inferior glut: L5-S2
hams: sciatic N: L4-S2
Add mag (post portion):
* sciatic and obturator (L2-S3)
47
obturator N:
articular branch: medial portion of capsule
sciatic: posterior capsule
48
hip abductors
sup. gluteal (L4-S1)
* g. med
* g. min
* TFL: also flexor
* also gives branhces to superiorlateral capsule
piriformis: when thigh is flexed: n to piriformis (s1-s2)
49
cut branches of hip origin at _____ lvl than motor and capsular N
higher
* lateral fem cut: anterolateral by L2
* anterior: con't of fem N by L2-L4
50
unilateral and bilateral trendelenburg = what gait?
lurch
waddling: common in polio
51
troch bursitis
radiates down lateral leg and mimics neuritis
pain with wt bear and walking
tx: TFL
52
hip OA
fixed external rotation: piriformis
fixed ADDuction of hip in SEVERE arthritis of hip joint
tx:
* lymph drainage
* traction
* block obturator N
* hip extension exercises to stretch anterior hip capsule and str extensor M
53
knee joint
hinge:
* stab in complete extension
* flex:
* relaxed collateral lig
* allows lat-med motion and tibial rotation
sacrifices stability for mobility
54
fem-tib joints
lat condyles reach phys end ROM 1st
* uneven surf b/w fem condyles and tib plateau
* med condyle con't mvmt
* _full ext = post-lat glide of condyles on plateau_
55
fem-patellar joint
vertical ridge of patella --. central groove of femur
patellar surf projects laterally
56
ROM of knee
flex:
* ant-med glide: tibia on femur
* int-rotation by poplitius @ initiation
extention
* post-lat glide: tibia on femur
* ext-rot by quads
abd/add: tibia on femur
57
fib head
attachment for biceps femoris
int-rot = post fib head
ext-rot = ant fib head
58
lig of knee
ACL: prevents hyperextension
PCL: assists flexion
medial and collateral lig: med attaches to med meniscus
59
terrible triad
o'donahue's
* MCL
* MM
* ACL
force: lateral --\> medial with knee extended and foot fixed
60
ant/posterior drawer
(+) = 5mm or more mvmt
61
varus and valgus
leg fulled extended = PCL for medial-lat stability
* put knee @ 30deg of flexion takes PCL out of play
* allows MCL to be tested
62
menisci
medial: larger, oral
lateral: circular
63
knee arthritis
valgus/varus: more prone to OA changes
* stiffness with prolonged sitting
* pain with wt bearing
* crepitation: loss of ROM - hyperextension
* no end range spring
tx:
* wt loss
* avoid deep bending and going down stairs
64
condromalacia patella
degen of patella cartilage articulation
* excessive load
* crepitation:
* most common in YOUNG WOMEN
* weakness/tightness of quads
* knock-knee/bowleg
* obesity
65
osgood-schlatter lesion
repetitive stress on tib tuberosity --\> superior avulsion
* late childhood, early adol
* more common in BOYS
* pain in extension
66
baker's cyst
* comun with synovial cav of knee
* RA/OA
* mensical tear
sx is not tx: correct joint disorder
