MSK Misc Flashcards by Kyle Murray

Hill Sachs Lesion

Being hit fro P-A in closed pack (Abduction and ER) overhead causes ant dislocation and damage to posterolateral HUMERAL HEAD H goes with H. SO ant dislocation damaged post HH

Could be reverse and impact posterior capusle and ant hum head if hit from A-P

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Bankart Lesion

Tear in LABRUM, the usually lower part. Due to disloaction

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What happens to cadence and step length with age

Cadence decreases b/c less steps required due to incincreased reased step length

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Extensor tendon repairs

Early intervention
Active flexion of MCP and passive extension of wrist allowed

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Flexor tendon repairs

Active extension, passive flexion

Active in opposite

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Free nerve endings (Joint receptors)

All joints (think pain)

Noxious and non noxious mechanical and biochemical stimuli to capsule, ligaments, synovium, fat pad

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Pacinian corpuscles (joint receptors)

All joints (think velocity, accel joint position)

detects different joint position changes in the fibrous layer of capsule

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Golgi ligament endings

Ligaments specific, detect the amount of stretch

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Ruffini Endings

Detects stretch of entire joint capsule (rather than ligament specific)

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Golgi-Mazzoni corpuscles

Mazzoni compression of joint capsule

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Synovial joints

All major joints we address in PT. Have free movement
1. joint cavity (fluid filled part)
2. Articular cartilage
3. Synovial membrane
4. Synovial fluid
5. Fibrous capsule

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Cartilaginous joints

Have hyaline or fibrocartilage
Slight mobility
e.g sternum articulation w/ true rib

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Fibrous joint

Barely oves
e.g bones in skull
syndesmosis of tibia and fibula

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Type 1 fibers

Slow
Smaller
Slow oxidative
Less fatiguing/fatiguability
More mitochondria
e.g marathon, swim
Recruited first in natural contraction

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Type 2 fibers

Recruited first with E STIM
Larger
faster
More fatigable
Lower capillary, mitochondria,
high jump, sprint

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Muscle spindle

Muscle belly, send info about muscle length or rate of change

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Golgi tendon organs

Detect tension especially with active contraction3

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Levator Scap action and innervation

ELEVATES SCAP but dowanrdly roates it as well
Anterior rami
Dorsal scap nerve, Rhomboids too

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What muscles do upward rotation

Lower and UT, SA

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What muscles do doward ro

Rhomboids, levator scap, pec minor

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Extensor carpi ulnar innervation

Posterior interosseous nerve (b/c starts more dorsal than medial)

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Flexor carpi ulnaris innervation

Ulnar nerve

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Extensor policis brevis and longus innervation

Posterior interosseous nerve (both deep muscles)

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Abductor policis brevis innervation

median nerve, recurrent branch

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Abductor policis longus innervation

Posterior interosseous nerve (b/c on dorsal side) deep

Flexor pollicis brevis innervation (superficial vs deep head)

Superficial (median recurrent) Deep (ulnar)

Flexor pollicis longus innervation

Anterior interosseous nerve b/c deep

Adductor pollicis innervation

Ulnar nerve

Oponens pollicis innervation

Median nerve

Pad and Dab (interossei muscles)

Palmar, adduction Dorsal abduction All innervated by ulnar nerve

Lumbricles action and innervation

MCP flexion and IP extension Ulnar vs median nerve side

Main hip IR

TFL then glute med

Main glute ER

Glute max Obturator bros Gemelli bros

Tib ant vs tib post distinction

both invert but df and pf rerspectively

Boxers fracture

fx pinkey finger

Toe flexion vs extension

Think the same as hand

If unsure of capuslar pattern, think about what goes first

e.g Cervical sb and rot goes first typically and that is capuslar pattern. Extension is next SAME FOR all of spine

C8 myotome

Thumb ext ( makes sense b/c radial)

T1 myotome

Finger abduction (ulnar)

Patella deep tendon reflex

R hand dominant

R shoulder lower and R hip higher is normal and vice versa="They come towards eachother because used more"

Normal lumbar curves

Lordosis of neck and low back Kyphosis of thoracic spine and sacrum (sacrum is nonflexible)

Protruded tummy is normal in kids up to 10 yo

Scapula 4 inches apart is norm

Head should be erect

Normal Plumb line order

Post to coronal suture Through external auditory meatus Through axis of odontoid process Midway through tip of shoulder Through bodies of lumbar vertebrae Slight Post to hip Slight Ant to axis of knee Slight ant to lat malleolus Through calcaneocuboid joint

Capsular patterns (in order starting with most restricted

Shoulder ER ABD IR Knee Flex EXT Spine ROT AND SB equal, then ext TMJ mouth cant open as well AO Ext, side flex equal At elbow flex then ext (then sup then pron for rh) talocrural PF then DF Hip Flexion abd, IR (sometimes IR most limited)

Empty endfeel

Cant reach due to pain

Boggy end feel

Mushy due to edema, hemarthrosis

MMT 3-

partial ROM against gravity

MMt 2+

Able to initiate against gravity

MMT 2

Full ROM in gravity min

MMt 2 -

Partial in gravity min

MMT 1

palpable contraction

MMT 0

No contraction

Pronation is linked with what LE alignment

Tibial Internal rotation causing knee valgus (tilting ankle inward focres tibia to move inward which causes knee valgus at top of tibia

Gout locations

Knee, big toe joint, MP joints of fingers ankle, medial foot, elbow

Scoliosis

25-45 orthosis 45 and up spinal fusion surgery should not occur unless kid is about 12 years old Stretching is not plan A but if so should focus on iliopsoas, low back extensors, lateral trunk flexors of concave side

Tendinopathies

painful with contraction e.g supraspinatus abd to 90 and IR b/c supraspinatus abducts

Always consider tissue healing phase

6week 6week 6 months rule for but inflammatory phase 1-5 proliferative phase 5-30 days Maturation 30 days to years Disorganized tissue cannot withstand tensile forces. Collagen formation and granulation tissue develops in subacute proliferative phase Collagen fibers reoritent to stresses in chronic stage of maturation and remodeling acute - pain w/ movement in general subacute - pain in relation to tissue resistance

Consider the type of contraction with MSK interventions. Example why are wall sits good for someone struggling with stair descension

Isometric but eccentric contraction Quadriceps need eccentric strength going down steps b/c knees bent and gravity is opposing force on knee extension

Pec major actions

Power grip requires

wrist extension and ulnar deviation

For chronically inflamed muscles

Eccentric contraction is pain free range. Eccentric contractions put less stress on contractile units at same level of ork

Anteversion vs retroversion

Antevesrion (causes toe in) because femur is internally rotated and tibia is as well. Retroversion is opposite (LESS than 8)

Whiplash

Mobs, patient education, submaximal exercise

MSK Misc Flashcards

(65 cards)