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MSK Flashcards

1
Q

ULTT1

A

Median nerve bias
Abduct arm to 110 degrees, flex elbow to 90, externally rotate shoulder, extend elbow, wrist, and fingers

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2
Q

ULTT1 biases …

A

median nerve, roots C5-7, anterior interosseous nerve

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3
Q

ULTT2

A

same as the ULTT1 except that you only abduct the arm to 10°
Biases Median nerve + axillary nerve + musculocutaneous nerve

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4
Q

ULTT2 biases …

A

Median nerve + axillary nerve + musculocutaneous nerve

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5
Q

ULTT3

A

radial nerve
Depress the shoulder and bring the arm into 10° of abduction. Then flex your patient’s wrist and fingers, pronate the forearm and flex the elbow to 90°. Now slowly extend the elbow to lengthen the neurological structures

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6
Q

When can ULTT be determined positive

A

When 1 or more is present

greater than 10 degrees difference side to side
Reproduction of pain
Contralateral cervical side bending increases symptoms, or ipsilateral side bending decreases symptoms

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7
Q

ULTT4

A

ulnar nerve bias
Shoulder girdle depression
Shoulder abduction 110
Shoulder external rotation
Forearm PRONATION
Wrist and Finger extension
Elbow flexion

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8
Q

MMT clavicular head pec major

A

pure horizontal adduction

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9
Q

MMT sternal head pec major

A

pulling down adduction toward the opposite pocket

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10
Q

Palpation of extensor carpi radialis longus

A

In line with 2nd metacarpal

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11
Q

Palpation of extensor carpi radialis brevis

A

In line with third metacarpal

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12
Q

Psoas abcess

A

collection of pus in psoas muscle

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13
Q

Chondromalacia patella

A

“runners knee”

dull aching pain in front of knee and behind patella
irritation of the hyaline cartilage undersurface of the patella
typically see more pain with inactivity

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14
Q

Early muscle training should be ….

A

focus on isometric and eccentric contractions because muscle tension is better maintained than concentric

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15
Q

Increased hip retroversion produces

A

toe out during gait

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16
Q

Males tend to have more anteversion or retroversion

A

retroversion

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17
Q

Females tend to have more anteversion or retroversion

A

anteversion

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18
Q

If patient presents with toe in gait pattern they are most likely …

A

anteverted

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19
Q

If patient presents with toe out gait pattern they are most likely …

A

retroverted

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20
Q

If Craigs tests measures 8-15 degrees =

A

normal

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21
Q

If Craigs test measures greater than 15 degrees =

A

anteversion

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22
Q

If Craigs test measures less than 8 degrees =

A

retroversion

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23
Q

Egawa sign

A

indicative of ulnar nerve palsy

with patients hand flat on the table, have them lift the middle finger and radially/ulnar deviate it

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24
Q

Froments sign

A

Flexion of phalanx of thumb via FPL (median nerve) to compensate for weak adductor pollicis

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25
Q

Jeannes sign

A

ulnar nerve palsy

MCP hyperextension with thumb IP flexion

compensate for weak adductor pollicis

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26
Q

Main restraints to horizontal shear force in AC joint

A

superior and inferior AC ligaments

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27
Q

Coracoacromial ligament prevents

A

upward displacement of the humeral head

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28
Q

Ober vs Modified Ober Test

A

Ober - knee bent
Modified Ober - knee straight

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29
Q

TMJ Anterior disc displacement symtpoms

A

affected joint will have limited ROM. ipsilateral deviation, and a hard end-feel as the mandibular condyle jams against the displaced disk

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30
Q

Bruxism

A

clenching of jaw/grinding of teeth

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31
Q

Otitis

A

infection/inflammation of ear

think otolith

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32
Q

Epistaxis

A

nose bleed

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33
Q

Structural vs functional scoliosis

A

functional - easily corrected with postural correction/typical of musculature imbalance - no rib hump seen

structural scoliosis - fixed rib hump

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34
Q

Digital prehension grasp

A

same thing as 3 point chuck

ex holding a pencil

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35
Q

Tip pinch grip

A

picking a coin or marble up off the table with thumb and index finger only

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36
Q

Hook grasp

A

carrying a bucket handle

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37
Q

Deeper water w/ aquatic therapy is going to ….

A

increase bouyancy
increase resistance/drag

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38
Q

Weak and pain free

A

total rupture

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39
Q

Weak and painful

A

partial rupture or fracture

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40
Q

Strong and painless

A

normal

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41
Q

strong and painful

A

grade 1 tear - minor muscle or tendon injury

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42
Q

Surgery for compression fracture

A

vertebroplasty or kyphoplasty

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43
Q

Common areas for compression fractures

A

T10-12

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44
Q

Surgery for spinal instability

A

spinal fusion

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45
Q

Measuring carpometacarpal abduction

A

fulcum at radial styloid

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46
Q

Normal knee flexion ROM

A

140 degrees

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47
Q

Can perform 75% of the task independently

A

minA

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48
Q

Can perform 50% of the task

A

modA

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49
Q

Can only perform 25% of the task

A

maxA

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50
Q

MMT grading 2- (poor-)

A

cannot complete ROM even in gravity eliminated

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51
Q

cannot complete ROM even in gravity eliminated

A

MMT grading 2- (poor-)

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52
Q

MMT grading 2 (poor)

A

Can complete full ROM in gravity eliminated

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53
Q

Can complete full ROM in gravity eliminated

A

MMT grading 2 (poor)

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54
Q

MMT grading 2+ (poor+)

A

Can only initiate movement against gravity

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55
Q

Can only initiate movement against gravity

A

MMT grading 2+ (poor+)

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56
Q

MMT grading 3- (fair-)

A

completes more than half of range against gravity, but cannot complete full

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57
Q

completes more than half of range against gravity, but cannot complete full

A

MMT grading 3- (fair-)

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58
Q

MMT grading 3 (fair)

A

full ROM against gravity, but no resisitance

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59
Q

full ROM against gravity, but no resistance

A

MMT grading 3 (fair)

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60
Q

MMT grading 3+ (fair+)

A

completes full ROM and holds min resistance

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61
Q

completes full ROM and holds min resistance

A

MMT grading 3+ (fair+)

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62
Q

Amount of knee flexion for

walking
stairs
bike

A

60 degrees
90-100?
90 degrees

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63
Q

What exercises are contraindicated for ankylosing spondylitis

A

Flexion
need to emphasize extension and rotation

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64
Q

Wider or narrower intracondylar notch = higher risk of ACL tear

A

narrower - think females are “skinner”

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65
Q

PF and inversion most likely damages what ligament in the ankle

A

ATFL

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66
Q

DF and inversion most likely damages what ligament in the ankle

A

CF ligament

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67
Q

Joint mob for isolated ER deficit

A

anteiror glide

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68
Q

Joint mob for adhesive capsulitis ER deficit

A

posteiror glide

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69
Q

Normal shoulder ROM

A

160-180 total

120 GH
60 scapula

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70
Q

Normal shoulder extension ROM

A

60 degrees

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71
Q

Normal shoulder ER ROM

A

80-90

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72
Q

Normal shoulder IR ROM

A

60-70

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73
Q

Normal shoulder abduction ROM

A

170-180

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74
Q

Normal elbow flexion ROM

A

140-150

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75
Q

Normal elbow extension ROM

A

0

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76
Q

Normal forearm pronation/supination ROM

A

80 degrees

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77
Q

Normal wrist flexion ROM

A

80-90

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78
Q

Normal wrist extension ROM

A

70-80

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79
Q

Normal radial deviation ROM

A

20 degrees

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80
Q

Normal ulnar deviation ROM

A

30-40

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81
Q

Normal cervical flexion and extension

A

45 degrees

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82
Q

Normal cervical lateral flexion

A

45

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83
Q

Normal cervical rotation

A

60-90

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84
Q

Normal hip flexion ROM

A

120

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85
Q

Normal hip extension ROM

A

10-15

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86
Q

Normal hip IR ROM

A

30-45

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87
Q

Normal hip ER ROM

A

40-60

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88
Q

Normal hip abduction

A

30-50

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89
Q

Normal hip adduction

A

30

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90
Q

Normal knee flexion ROM

A

135-140

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91
Q

Normal MCP flexion

A

90

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92
Q

Normal PIP flexion

A

100-115

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93
Q

Normal DIP flexion

A

90

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94
Q

Normal ankle PF

A

40-65

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95
Q

Normal ankle inversion

A

40

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96
Q

Normal ankle eversion

A

15-30

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97
Q

Normal thoracic flexion

A

35

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98
Q

Normal thoracic extension

A

25

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99
Q

Normal thoracic lateral flexion

A

35

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100
Q

Normal thoracic rotation

A

45

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101
Q

Normal TMJ opening

A

40 mm

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102
Q

Normal TMJ lateral deviation

A

10-15 mm

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103
Q

Normal TMJ protrusion/retrusion

A

3-4 mm

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104
Q

TMJ arthrokinematics with mouth openeing

A

Anterior roll anterior glide

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105
Q

Muscles involved in mandibular elevation (closing mouth)

A

masseter
medial pterygoid
temporalis

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106
Q

Muscles involved in mandibular depression (opening mouth)

A

lateral pterygoid

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107
Q

Dorsal displacement of radius

A

Colles fracture

108
Q

Strong and painless

A

normal

109
Q

Strong and painful

A

tendonitis or small tear

110
Q

Weak and painful

A

grade 2 tear or mod to severe tendonitis

or bursitis

111
Q

Weak and painless

A

complete tear or nerve pathology

112
Q

Tendonitis vs bursitis

A

full PROM pain at end range = tendonitis

decreased AROM and PROM difficult = bursitis

113
Q

No pain with PROM
tendonitis or bursitis

A

tendonitis

114
Q

Achilles tendonitis vs plantar fasciitis

A

achilles - burning in heel, pain with activity, swelling, thickening, morning stiffness

PF - worse at rest or in morning, barefoot

115
Q

Cold intolerance

A

hypothyroidism

116
Q

Trigger finger

A

inflammation of tendon sheath - popping and clicking sensation
typically worse in the morning

117
Q

sign of buttock

A

perform SLR, then flex knee/hip - if it does not relieve pain = positive test

118
Q

dupentreyn contracture is most common in

A

4th//5th digit

119
Q

lisfranc injury

A

metatarsal fracture

difficulty pushing off
inability to bear weight

120
Q

lisfranc injury MOI

A

twisting on PF foot
brake pedal injury

121
Q

Turf toe MOI

A

forceful hyperextension of big toe - resulting in rupture or stretching of plantar complex

122
Q

Central tendon rupture / volar slippage

A

boutannire deformity

123
Q

First class lever

A

forces on either side of fulcrum

Effort is the force that causes movement
Resistance is the force that opposes movement

  • contraction of tricep at elbow
124
Q

Second class lever

A

Forces on same side of axis
Resistance is between the effort force and the axis of rotation

  • toe raises
125
Q

Third class lever

A

Forces on same side of axis

Effort force is closer to the axis than the resistance force

Ex: elbow flexion

126
Q

Diarthrodial joint

A

freely moving joint encased within a synovial membrane/joint capsule

examples

127
Q

Bilateral contraction of lateral pterygoid =

A

protrusion

P in pterygoid = Protrusion

128
Q

Unilateral contraction of lateral pterygoid =

A

contralateral lateral deviation

129
Q

Unilateral contraction of medial pterygoid

A

contralateral lateral deviation

130
Q

Bilateral contraction of medial pterygoid

A

Mandibular elevation and protrusion

P in pterygoid = Protrusion

131
Q

Aattachment site of temporalis

A

coronoid process of mandibel

132
Q

Bilateral contraction temporalis

A

elevation and retraction

133
Q

Unilateral contraction temporalis

A

ipsilateral lateral excursion

134
Q

Normal mandibular depression

A

40 mm

approx 4 finger width

135
Q

Lateral excursion normal ROM

A

1/4 of opening

aka 10 mm

136
Q

Normal protrusion ROM

A

6-9 mm

137
Q

Normal retrusion

A

3 mm

138
Q

Arthrokinemtics of TMJ depression

A

posterior roll anterior glide

139
Q

Muscles involved in mandibular protrusion

A

medial and lateral pterygoids + masseter

140
Q

Muscles involved in lateral excursion (opening mouth)

A

ipsilateral temporalis and masseter

contralateral medial/lateral pterygoids

141
Q

ADDwR

A

at rest, the disk in sitting anterior to the condylar head while the mouth is closed

during opening, the disk reduces back - click/pop

142
Q

TMJ disk usually almost always displaces which direction

A

anteriorly

143
Q

ADDwoR

A

disk remains anteriorly throughout mandibular depression/elevation - no clicking

144
Q

C curve with opening TMJ

A

indicates capsular pattern

deviates to side of restriction

145
Q

S curve with opening TMJ

A

indicated motor control issue

146
Q

Total dislocation of condyle

A

lock jaw

147
Q

Most common cause of TMD

A

myofasical pain

basically the muscles are overworked and create referred pain

148
Q

Medications for dystonia

A

botox

149
Q

Referral pattern of Temporalis musle

A

maxillary (upper) teeth

150
Q

Referral pattern of Masseter musle

A

mandibular (lower) teeth

151
Q

Mandible deflection

A

when madible deviates to one side without returning to center

152
Q

Capsular pattern TMJ

A

limited mouth opening
deflection and protrusion to ipsilateral side
limited lateral excursion contralaterally (ipsi?)

153
Q

Scalloping of tongue =

A

parafunction or bruxism

154
Q

Is medial pterygoid or lateral pterygoid palpable

A

medial

155
Q

Behavioral modification technique

A

positive reinforcement only

negative reinforcement should be ignored

156
Q

If hypoglycemic in clinic - give

A

OJ to act fast

157
Q

If delayed onset hypoglycemia - give

A

crackers

158
Q

TMJ hypermobility

A

55 mm

159
Q

Biting down on cotton roll results in gapping on

A

ipsilateral TMJ

compression to contralateral

160
Q

Trigeminal nerve reflex normal

A

very slight or no movement at all

161
Q

Trismus

A

lockjaw

common after dental procedures - muscle spasms

162
Q

Most muscle complexes in the body operate with what type of lever

A

Second class

163
Q

Equinovarus

A

PF
inversion
adduction of forefoot

most commonly seen congenitally - SMA, etc

164
Q

Hindfoot varus places talus in more

A

externally rotated position

165
Q

Hindfoot valgus places talus in more

A

internally rotated position

166
Q

Closed chain pronation results in what motion at the
talus
calcanues

A

talus: PF, adduction, IR
calcanous: eversion

167
Q

Eichoff vs FInklestein

A

eichoff - make a fist, ulnar deviate (what you think is finklesteins)

finklestein test - passive flexion of thumb into palm

168
Q

Best special test to rule out Dequerveins

A

Wrist hyper abduction test

169
Q

Costophrenic angle

A

point where chest wall and diaphragm meet - should be sharp

blunting of this angle would indicate hyperinflated lungs

170
Q

Increased subcostal angle =

A

hyperinflation, blunted costophrenic angle

171
Q

Subcostal angle

A

angle between xiphoid and R/L costal margin

increased or flatter angle would be a result of hyperinflated lungs

172
Q

Which mucles are likely to be tight with spinal stenosis

A

hip flexors from forward flexed posture
anterior chest wall
plantarflexors

173
Q

Neurogenic claudication =

A

stenosis origin

174
Q

Caludication pain above knees

A

stenosis

below knees would be more vascular

175
Q

Gait considerations spinal stenosis

A

excessive trunk/hip flexion
excessive DF

176
Q

Will SLR be positive with spinal stenosis

A

No hip flexion makes them feel better

177
Q

Positive 2 stage treadmill test

If distance in time is greater with slouched position/increased incline on treadmill test =

A

stenosis

178
Q

Deliurium sympotms

A

fluctuating state of attention - worse at night
personality changes and hallucinations are only intermittent

179
Q

Normal AA ROM

A

35-45; think about how half of motion in cspine comes from AA joint

180
Q

SLAP repair early intervention

A

careful ROM of IR - does not stress repair as ER does

181
Q

Patients taking Lasix can experience what type of ion imbalance

A

hypokalemia (low potassium)

diuretics do not spare K - they get excreted with water

182
Q

Short acting vs long acting bronchodilator

A

short - emergency use
long - daily use - would be inappropriate to administer in acute episode

183
Q

Salter Harris 1

A

straight across entire epiphysis
caused by shearing or torsion
immobilized with cast

184
Q

Cause of Salter Harris 1

A

shearing or torsion

185
Q

Treatment for Salter Harris 1

A

immobilized with cast

186
Q

Salter Harris II

A

affects metaphysis
most common
caused by shear or avulsion with angulation
good prognosis
treated with immobilization

187
Q

Salter Harris II affects

A

metaphysis

188
Q

SALTER acrynym

A

1 - S - Straight across
2 - A - above (metaphysis)
3 - L - Lower (epiphysis)
4 - TE - through everything (both)
5 - R - cRush

189
Q

Salter harris III affects

A

epiphysis

190
Q

Sharp purser test places the pt into

A

20-30 degrees flexion

stabilize C2 and shear forehead on C2

positive test = cranial movemnt or increase in sx

191
Q

Common VBI symptoms

A

dizziness
N and V
ataxia
CN V sensory abnormalities
nystagmus
PICA symptoms

192
Q

Flexor carpi radialis action and innervation

A

flexion/radial deviation

median n

193
Q

Flexor carpi ulnaris action and innervation

A

flexion and ulnar deviation

ulnar nerve

194
Q

FDS innervation and action

A

flexion of PIP

195
Q

FDP innervation and action

A

flexion of DIP

radial half (2nd and 3rd digits) - median n
ulnar half (4th and 5th) - ulnar n

196
Q

Forearm flexors that do not arise from medial epicondyle

A

flexor pollicis longus
FDP
pronator quadratus

197
Q

Thumb IP normal ROM

A

80 flex
0 ext

198
Q

Thumb MCP normal ROM

A

50 flex
0 ext

199
Q

Thumb CMC normal ROM

A

50 total arc abd/add

200
Q

Sural nerve tension test

A

knee extension
ankle DF
knee inversion

sural nerve goes down lateral side of leg

Eversion for tibial nerve

201
Q

Vasuclar portion of meniscus

A

Outside 1/3rd

inside is avascular

202
Q

Osgood Shlatters vs PFPS

A

Osgood - pain with more activity

PFPS - pain with rest, prolonged sitting

203
Q

Crank vs Clunk test

A

crank - supine arm abducted, add axial load through humerus with IR/ER

clunk - supine elevation + anteiror translation of GH joint + ER

204
Q

Biceps load 1 vs 2

A

1 - 90 abd
2 - 120 abd

both with contraction of biceps tension with max ER

205
Q

TOS special test - locate radial pulse + shoulder extension, cervical rotation/extension to ipsilateral side

A

Adsons

206
Q

Positive allens test

A

90/90 pitcher position

dissipation of radial pulse with contralateral head turn

207
Q

Wright test

A

hyperabduction to compress costoclavicular space

stretching the pic minor and occluding pulse

208
Q

locate radial pulse + shoulder extension, cervical rotation/extension to contralateral

A

Halstead

209
Q

Halstead vs Adsons

A

Adsons - ipsilateral head turn
Halstead - contralateral head turn

210
Q

Positive test for anterior/posterior drawer shoulder

A

increased translation of half or more of HH diameter

210
Q

Lateral pivot shift elbow

A

Tests for posterolateral instability

In supine, test arm overhead, extended elbow and forearm supinated.

Axial load + Flex elbow and apply a valgus stress

40 degrees of flexion = clunk

211
Q

In what range would you expect a positive lateral pivot shift test elbow

A

40 degrees

212
Q

Mills test

A

M= P

Mills = Passive
basically stretching of tendons at lateral eppicondyle

pronate, flex wrist

213
Q

Cozens test

A

C = A
Cozen = Active

resisted active wrist extension, radial deviation,

214
Q

Maudleys test

A

M = middle finger

resisted 3rd finger extension

215
Q

Hand of benediction can mean what

A

ulnar n injury - when attempting to open hand

median nerve injury - when attempting to close hand

216
Q

Mortons neuroma most commonly affects

A

bt 3rd and 4th toe

217
Q

Pinch grip test

A

AIN
if unable to perform tip to tip - will be pulp to pulp

218
Q

Posteiror hip precautions

A

flex past 90
hip adduction
IR past neutral

anterior approach is jsut the opposite

219
Q

Why is hip dislocation more common with post approach

A

labrum is thicker anteriorly/superiorly

220
Q

Normal angle of inclination

A

120-130 degrees

coxa vara - less than 120

coxa valga - more than 130

221
Q

Deviations seen with coxa valga

A

increased leg length
circumducted gait

222
Q

An anteverted femoral head lies more …

A

anteriorly

thus they have more observed femoral IR (bc they are starting in relative ER)

223
Q

Normal toe in/out angle

A

10 degrees

224
Q

Dysplasia results in medial or lateralized joint center

A

lateral

225
Q

Sensation loss between 1nd and 2nd toe

A

deep peroneal nerve

226
Q

Deep peroneal nerve muscles

A

tibA
extensor digitorum longus/brevis
EHL/EHB

227
Q

Tunnel 1

A

APL EPB

228
Q

Tunnel 2

A

ECRB - attaches to 2nd metacarpal
ECRL - attaches to 3rd metacarpal

229
Q

Tunnel 3

A

EPL

230
Q

Tunnel 4

A

ED
EI

231
Q

Tunnel 5

A

Extensor digiti minimum

232
Q

Tunnel 6

A

ECU

233
Q

Swan neck deformity cause

A

contracture of instrinsic muscles
laceration of extensor mechanism
volar plate rupture - unopposed extensor mechanism

234
Q

Trigger finger

A

thickened pulley mechanism of finger

stuck in flexion - manually extend

more freq in women

235
Q

Trigger finger interventions

A

orthosis or surgery

236
Q

Bunnel littler test

A

start with MCP extension, flex PIP and measure

with MCP flexion - flex PIP and should get more motion

237
Q

Jersey finger

A

ring finger FDP avulsion

238
Q

Forefoot valgus =

A

PF first toe

239
Q

Forefoot varus =

A

DF first toe

240
Q

Wedge vs post

A

wedge is on outside of foot
post on inside - sole

241
Q

When to use medial wedge

A

flexible rearfoot valgus
rigid rearfoot varus

242
Q

If forefoot or rearfoot deformity is fixed.. where does wedge go

A

in gap

rigid forefoot varus - medial
rigid forefoot valgus - lateral

243
Q

Anteversion at the hip results in

at the tibia
at the femur

A

medial tibial torsion
medial femoral torsion

244
Q

Retroversion at the hip results in

at the tibia
at the femur

A

lateral tibial torsion
lateral femoral torsion

245
Q

Coxa vara = genu valgum =

A

femoral anteversion

246
Q

Coxa valga = genu varum =

A

femoral retroversion

247
Q

Radial glide of CMC on trapezium =

A

for thumb extension

248
Q

Upper crossed syndrome

A

Weak cervical flexors
Weak lower trap/serratus

Tight SCM/pec
Tight upper trap levator

249
Q

PWB in boot for achilles until

A

6 weeks or so

progressively wean from boot

250
Q

How to prevent deformities w boutannire

A

flexion of DIP (which is hyperextendede)

251
Q

Sensory. of medial calf

A

saphenous nerve

252
Q

Sensory of lateral calf

A

sural

L in sural = latearl

253
Q

What does the obturaetor externus/internus do?

A

externally rotate

254
Q

Athetoid CP

A

slow writhing movments - mixed tone

255
Q

Which form of CP presents with slow writhing movements - mixed tone

A

Athetoid

256
Q

Optimal screening time fro scoliosis

A

9-11 females
11-13 males

257
Q

Provide anterior-directed resistance to the right PSIS during swing.

A

Promotes increased stp length on opposite side

258
Q

constipation referred pain

A

anterior hip groin or thigh region.

259
Q

NOrmal EKG changes with exercise

A

P wave increases
everything else decrease
depression of ST with upsloping

260
Q

Innervation of all the foot PF

A

tibial nerve - gastgroc/soleuos, FDL, FHL, post tib

261
Q

Deep peroneal nerve sensory

A

1st webspace of foot

262
Q

Increased or decreased hct after burn

A

increased because of relative fluid/plasma loss

263
Q

Elevated BUN =

A

dehydration

264
Q

Is cerebellum impaored with SCI?

A

no

MY NPTE (22 decks)

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