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NPTE Final Frontier > MSK Basic Interventions > Flashcards

MSK Basic Interventions Flashcards

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1
Q

Practice!
According to convex/concave rule, to inc R forearm SUP @ prox RU jt PT should perform what glide?

A

Roll POST and Glide ANT
- Sup is ANTERIOR
- PPP-> Posterior glide for Proximal RU jt for PRO

Remember ALL JTS ALTERNATE!!!!!

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2
Q

Stretch _ Strengthen

A

BEFORE!!!!

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3
Q

OKC vs CKC
Which better for strengthening?
And what else to remember?

A

CKC!!!
KNOW YOUR PLANE– what plane of mvmt is the question asking you about?–likely answer is mm that controls that plane of mvmt Ex. glute med and abduction if hip drop

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4
Q

Rule of 6–>

aka: 3 Phases of Rehab

A
  • First 6wks
  • Up to 12wks
  • Up to 6mos

**Major sx’s like rotator cuff **

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5
Q

Practice:
39yo comes into OPPT c/o neck probs. Which of following ex combos is MOST approp for pt who has FHP?

Remember Jandas Crossed Syndrome!!!

A
  • Strengthen DCFMs and Stretch SCM and Upper CS EXTs
  • Upper Crossed: Inhibited (Weak)–> DCFMs + Lower trpz/Serratus ant.; Facilitated (Tight)–> Upper trpz/Levator + Pec minor/SCM
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6
Q

TibioFemoral Jt and Screw-Home Mechanism

A
  • Lat femoral condyle is flatter, does not ext as far distally, projects further post vs medial condyle
  • Bc of this–> Tibia rotates LATERALLY (ER) ON FEMUR @ full EXT==Screw-Home
  • This is in OPEN CHAIN–> last 20-30deg EXT
  • Remember “Paper on Tibia trick”–It ERs!

NOTE: in CKC–Femur MEDIALLY rotates on TIBIA

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7
Q

Practice:
In order to UNLOCK knee from TKE in a CKC, what must occur?

A

LATERAL (ER) rotation of FEMUR on TIBIA

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8
Q

More on Screw-Home

A
  • TOLL: Tibia in Open chain rotates LAT for LOCK
  • CKC–> Femur moving on Tib
  • Screw-Home in CKC–> Femur MED rotates on tib, so to UNLOCK must LAT (ER) rotate!
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9
Q

More on Screw-Home

A

OKC:
- Tibia Lat Rot== Locks
- Tib Med Rot== Unlocks

CKC:
- Femur Med Rot== Locks
- Femur Lat Rot== Unlocks

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10
Q

Iso vs Ecc vs Conc

A

Isometric: SAME length, no JRF
Ecc: Load > force (torque)
Conc: Load < force (torque)

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11
Q

Which type of contraction do biceps (elbow flexor/shoulder flexor/supinator) undergo as shoulder moves 180-90deg of flex?

A

ECCENTRIC—> biceps move from more flexion to LESS, Triceps working conc.

Another example: Stand–> Sit== Rec fem (quads) ecc. work to SLOW US

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12
Q

Shoulder Rotators
Mnemonic to remember UPWARD ROTATION—->

A

SALUTE
- Serratus Ant
- Upper/Lower Trpz

Note: Force Couplebw Upper/Lower Trpz–> MUST AGREE W/ EA OTHER

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13
Q

Easy way to mimic Upward and DOWNward scapular rotation

A

USE HANDS!!!!
Upward we go into ABDUCTION
Downward we go into ADDuction
use hand and thumbs as scapulas!

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14
Q

UPward rotators of scapula
“SALUTE”

A
  • Serratus Ant
  • Upper trpz (force couple)
  • Lower trpz (force couple)
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15
Q

DOWNward rotators of scapula

A
  • Rhomboids
  • Pec Minor
  • Levator Scap
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16
Q

Upward/Downward Rotators of scapula
*Trick to remember

A

Remember which mm’s counter ea. other AND that Serratus ant HELPS w/ upward rot & Pec minor HELPS w/ downward rot
- Upper trpz (UPward) matches w/ Levator (Downward)
- Lower trpz (Upward) matches w/ Rhomboids (Downward)

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17
Q

Practice!
Excess upward rot of L. scap noted w/ shoulder ABD. Which mm MOST LIKELY contributing?

Study These Flashcards
A

Weakness of Rhomboid major/minor
bc they are NOT pulling scapula back DOWN!!!!

Rhomboids must BALANCE OUT upward rot w/ downward rot

18
Q

What should you ABSOLUTELY REMEMBER about Active/Passive Insufficiency?

Study These Flashcards
A

MAINLY due to Two/Multi-jt muscles!!!!

19
Q

Active Insuff.

Study These Flashcards
A

Crossbridge too CLOSE

20
Q

Passive INsuff

Study These Flashcards
A

Too lengthened

21
Q

Active Insuff.
Definition + Ex.

Study These Flashcards
A
  • Inability of two-jt muscle to shorten simultaneously @ both jts
  • Ex. Bicep curl (elbow flex) THEN try to get into 180deg shoulder flex—> CANNOT bc biceps are FULLY contracted ==> Active Insuff
22
Q

Passive Insuff
Definition + Ex.

Study These Flashcards
A
  • Inability of two-jt mm to lengthen simultaneously @ both jts
  • Ex. Ext knee fully & Flex trunk forward–> major stretch in HS’s and cannot lift leg up high bc HS can NO LONGER stretch over hip & knee anymore===> Passive Insuff
23
Q

Active and Passive Insuff. Rules:
Steps 1, 2, 3, 4

Study These Flashcards
A
  • Step 1: Name mm
  • Step 2: Is it a 2jt mm?
  • End range? Function of mm?
  • Active or Passive Insuff?

NOTE: 1 jt mm’s will NOT display Active or Passive Insuff!!!!

24
Q

Mnemonic/Way to remember Active vs Passive Insuff

Study These Flashcards
A
  • Active Insuff==SAME–> Active insuff will be SAME function of mm. Ex. HS= knee flex/hip ext
  • Passive Insuff==OPPOSITE–> Passive insuff will be OPP motion of mm function. Ex. HS will then be knee ext/hip flex
25
Practice! Active Insuff of R. Iliopsoas (hip flex, LF same side)
Hip flexion + R. LF of trunk
26
Practice! Pt c/o reduced mobility in R hip. PT notices pt has INCd hip flexion w/ knee flexion as compared to knee ext. What is most likely cause of **reduced hip flexion w/ knee extension? ** | The motion they are asking about is OPPOSITE TO HS FUNCTION.
PASSIVE INSUFF== OPP motion of mm A: Passive insuff of HS's bc hip flexion and knee ext is OPP to HS function
27
Practice! Pt c/o reduced mobility in R hip. PT notices pt has INCd hip flexion w/ knee flexion as compared to knee ext. What is most likely cause of **reduced hip flexion w/ knee extension? ** | The motion they are asking about is OPPOSITE TO HS FUNCTION.
PASSIVE INSUFF== OPP motion of mm A: Passive insuff of HS's bc hip flexion and knee ext is OPP to HS function
28
Kinematic Chain ex. **Starting pt= Overpronation of foot**
1. Over PROnation of foot--> Leg IRs--> Knee moves INward (valgum)--> Coxa varus--> Pelvis tilits forward (APT) ## Footnote *Be familiar with how things move UP THE CHAIN*
29
Practice! Pt presents w/ foot pain during running. PT notes excess foot PROnation and would like to provide orthotic to relieve pain. Which would beneift pt most?
Medial post under first MetHead **This will LIFT medial aspect of foot OFF ground**
30
Anteversion: What will you see w/ this? | **Transverse plane**
IN-toeing - **Normal= 15deg** - >15deg== Anteversion (IN-toe to fix)--to "put back in socket"-----note pic says 35degs Anteversion for In-toe - <15deg==Retroversion (OUT-toe to fix)
31
Hip Malalignments: Table | THINK ABOUT WHAT HAPPENS UP THE CHAIN!
see pics (but most of this you already KNOW!)
32
Excessive **anteversion** Related posture?
In-toeing--> subtalar PRO--> lat patellar sublux--> med tibial torsion--> med femoral torsion
33
Excessive **RETROversion** Related posture?
OUT-toeing--> subtalar SUP--> Lat tibial torsion--> Lat femoral torsion
34
Coxa VARA Related posture?
Subtalar PRO--> Medial rotation of leg--> knee valgus--> Anterior pelvic tilt **SHORT I/L leg**---- bc PRO makes leg SHORTER
35
Coxa VALGA Related posture ?
SUP subtalar--> Lateral rotation of leg--> knee varus--> POST pelvic tilt **LONG ipsilat leg **--- bc SUP makes leg LONGER
36
Practice! PT is treating peds pt w/ autism. Pt stans w/ IN-TOEing. Postural strategies?
Anteversion! - Medial rotation of leg, knee valgum, coxa vara, APT - A: Internal tibial torsion, Incd femoral ANTEversion
37
ALL assocd w/ **In-Toeing**
- PRO foot - Med tibial torsion - Metatarsus varus - Talipes varus or equinovarus - Tibial or genu varum - Medial femoral torsion - Excess femoral ANTEversion - Tight hip IRs
38
Rule of 6 *for Sx's*
- First 6 weeks - Up to 12 weeks - Up to 6 mos *major Sx like RTC*
39
Rule of 6 and Training for ADL activities Tips:
- 1st priority ALWAYS **SAFETY** - 2nd priority should be placed on **obeying the above (Rule of 6) while choosing MOST relevant exercise to desired task**
40
Practice! Pt underwent sx repair of full thick RTC tear **6d ago.** PT wants to perform passiveand assisted mvmt. Which pos MOST approp **THINK--6d ago???? == MAX PROTECTION**
Pt in SUPINE w/ arm ABDd 45deg w/ slight flex **bc gravity eliminated!!!!** Least amt of force on Jt or repair!!! | Rule of 6!!!!!
41
Rule of 6 applied: **Post-op Achilles Tendon Repair or Reconstruction w/ Graft**
See pics **NOTE: @ 6-8wks, and Beyond 12 wks**
42
Practice! Pt underwent R. Achilles tendon repair **6 wks ago (Rule of 6)** and now able to FWB. PT giving advice on shoe mods. Which is best?
- Things to keep in mind: NO DF, want to keep heel in slight PF to keep Achilles shortened and protect repair - A: Shoes w/ 1-1.5cm heel lift (as per table)

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