NPTE ALL OF IT Flashcards
1
Q
Rotator Cuff Muscles “SITS”
A
Supraspinatus, infraspinatus, teres minor and Subscapularis
2
Q
How much elevation occurs at GH joint?
A
120 degrees
3
Q
How much elevation occurs at Scapulothoracic ?
A
60 degrees
4
Q
The ratio of scapular to humeral motion for elevation
A
1 to 2
5
Q
Upward rotation of Scapula with elevation?
A
traps and serratus anterior
6
Q
Downward rotation with purposeful extension
A
rhomboids, levator scap, pec minor
7
Q
Scapular protaction
A
serratus anterior and pec minor
8
Q
scapular retraction
A
rhomboids, middle and lower trap
9
Q
Depression of scapula
A
pectoralis minor and latissimus dorsi
10
Q
Long thoracic Nerve
A
C5, C6, C7
innervates the serratus anterior
injury can cause scap winging
11
Q
Dorsal scapular Nerve
A
C5, C6
innervates leavtor scapulae and rhomboids
Injury can affect scapular retraction and downward rotation
12
Q
What nerve roots pass through the first rib?
A
C8 and T1
13
Q
Suprascapular Nerve
A
C5, C6
innervates the supraspinatus and infraspinatus
if injured it will cause pain/ decreased shoulder abduction and ER limitations.
14
Q
Carrying angle for men vs women
A
men: 10-15 deg
women: 20-25 deg
15
Q
Axillary Nerve off the posterior cord
Supplies: Teres minor whats the action?
Supplies Deloid whats the action?
A
Nerve Root: C5-C6
Teres: shoulder ER, Extension, abduction and horizontal abduction
Deltoid: anterior: shoulder IR, flexion
Posterior: shoulder ER, extension, horizontal abduction
16
Q
Axillary nerve sensory
A
Upper lateral cutaneous nerve of arm supples the skin covering the lower half of deltoid and upper part of long head of triceps
17
Q
Axillary Nerve injury
A
Shoulder dislocation, fracture at the surgical neck
Square shoulder from deltoid atrophy
sensory loss over lower half of deltoid
18
Q
Radial nerve comes off the posterior cord
Supplies triceps tell me action
Supplies anconeus tell me action
Supplies brachioradialis tell me action
Supplies supinator tell me action
A
Nerve root: C5-T1
Triceps
- Elbow extension
Anconeus
- Weak elbow extensor
Brachioradialis
- Elbow Flexion especially
in mid-prone position
Supinator
- Supination of forearm
19
Q
Radial nerve Supplies all the extensors tell me actions
A
Extensor Carpi Radialis Longus
- Action: Wrist EXT, Radial Deviation
Extensor Carpi Radialis Brevis
- Action: Wrist EXT, Radial Deviation
Extensor Carpi Ulnaris
- Action: Wrist EXT, Ulnar Deviation
Extensor Digitorum
- Action: 2-5
th digits EXT a MCP, IP, Wrist
Extensor Digiti Minimi
- Action: 5th digit EXT at MCP, IP
20
Q
Radial nerve Supplies all the extensors tell me actions
A
Extensor Pollicis Longus
- Action: 1st digit EXT at CMC, IP
Extensor Pollicis Brevis
- Action: 1st digit EXT at MCP, IP
Extensor Indicis
- Action: 2nd digit EXT, wrist extension
Abductor Pollicis Longus
- Action: 1st digit ABD and extension at
CMC joint
21
Q
Radial Nerve Sensory supply
A
Skin of lower half of lateral side of arm
skin of back of arm
skin of back of forearm
skin of lateral half of dorsum of hand, lateral two and half digits including thumb
22
Q
Radia tunnel syndrome
A
Radial nerve is compressed at the tunnel. Pain 1/2 down arm under the supinator
23
Q
Posterior interosseous nerve syndrom
A
Radial nerve compression at the arcade of frohse
24
Q
Lateral epicondylitis
A
Inflammation of the extensors at the lateral epicondyle of the humerus. The main muscle affected is the extensor carpi radialis brevis
25
What motions provoke pain for lateral epicondylitis?
Repeated extension and supination cause it. The pain will increase with wrist flexion with elbow extension, resisted extension and resisted radial deviation.
26
Medial epicondylitis affects what muscles?
Affects the flexor carpi radialis, humeral head of pronator teres
27
Medial epicondylitis increases in pain with what motions?
Pain with resisted wrist flexion and resisted pronation
28
Ulnar Nerve comes off the medial cord
Supplies the Doral interossei Tell me action
Supplies the Palmar interossei Tell me action
Supplies the adductor pollics Tell me action
Supplies the opponens digiti minimi and abductor digiti minimi
Nerve root: C8-T1
Doral interossei : DAB = abduction
Palmar interossei: PAD = adduction
Adductor pollicis: adduction of thumb
Opponens digiti mimini: opposition of 5th digit
Abductor digiti minimi: abduction of 5th finger
29
Ulnar nerve supplies
Flexor pollicis brevis
Flexor digitorum profundus
Flexor digiti minimi
Flexor carpi ulnaris
what are their actions?
Flexor Pollicis Brevis
- Action: Flexion of thumb
Flexor Digitorum Profundus (Medial half)
- Action: Flexion of DIP, Secondary –Flexion
of joints of digits, finger, wrist
Flexor Digiti Minimi
- Action: Flexion of little finger
Flexor Carpi Ulnaris
- Action: Wrist flexion, Ulnar Deviation
30
What is the sensory supply for the ulnar nerve?
- Supplies medial 1⁄2 of palm
Supplies skin of dorsal aspect of medial
two and half fingers
Supplies 1⁄2 of 4th, 5th digit
31
Cubital tunnel syndrome
Compression at cubital tunnel at elbow
- Paralysis of Flexor Carpi Ulnaris, Flexor
Digitorum Profundus (Ulnar half), hypothenar eminence, interossei, and the
third and fourth lumbrical muscles
- All sensations affected
- Inability to grip paper
32
Guyon's canal syndrome
Sensory changes and progressive
weakness of muscles innervated distal to
the site
33
Ulnar Claw hand
- Hyperextension at 4th,5th MCP, Flexion at 4th, 5th IP due to Flexor Digitorum Profundus
34
Median Nerve comes from the medial and lateral cord
supplies the abductor pollicis brevis tell me action
supplies the opponens pollicis tell me action
supplies the lumbricals 1,2
Nerve roots: C5-T1
Abductor Pollicis Brevis
- Action: Abduction of thumb at MCP, CMC joint
Opponens Pollicis
- Action: Opposition of thumb
Lumbricals 1,2
- Action: Flexion of MCP and extension of IP
35
Median nerve supplies almost all of the flexors what are their actions?
Flexor digitorum profundus
Flexor pollicis longus
Flexor carpi radialis
Flexor digitorum superficialis
Flexor pollicis brevis
Flexor Digitorum Profundus (Radial half)
- Action: Flexion of DIP, Secondary –Flexion
of joints of digits, finger, wrist
Flexor Pollicis Longus
- Action: Flexion of distal phalanx of thumb
Flexor Carpi Radialis
- Action: Wrist flexion, Radial deviation
Flexor Digitorum Superficialis
- Action: Flexion of PIP joint
Flexor Pollicis Brevis
- Action: Flexion of thumb
36
Median nerve sensory supply
Palmar Cutaneous Branch
- Skin of lateral two-thirds of palm
Palmar Digital Branches
- Supplies dorsal tips of 1st, 2nd, & 3rd finger,
palmar skin of lateral three and half fingers
37
Pronator teres syndrome what nerve is affected and what is the issue?
Hypertrophy of pronator teres muscle can compress the median nerve. Pronator teres
remains normal, but the other muscles supplied
by the median nerve are affected, as is its
sensory distribution
38
Carpal tunnel syndrome
Median nerve is compressed under the flexor
| retinaculum at the wrist
39
Ape Hand deformity
Wasting of the thenar eminence of the hand
| occurs as a result of a median nerve palsy
40
Musculocutaneous Nerve branches off lateral cord
Supplies the biceps, brachialis and coracobrachialis
Nerve Root: C5-C7
Biceps: elbow flexion, forearm supination
Brachialis: elbow flexion
Coracobrachialis: flexion of arm
41
Musculocutaneous nerve sensory supply?
Lateral cutaneous nerve of forearm: supply
| the skin on lateral side of forearm
42
Suprascapular Nerve comes from superior trunk
Supplies: infraspinatus and supraspinatus
Nerve root: C5-C6
Infraspinatus
- Action: Lateral rotation and abduction of
arm
Supraspinatus
- Action: Shoulder Abduction up to 15
degrees
43
Subscapular Nerve Comes from posterior cord
Supplies the teres major from lower branch
Supplies subscapularis with both branches
Nerve root C5-C6
Teres Major (Lower Subscapular Nerve)
- Action: Shoulder medial rotation,
extension, adduction
Subscapularis (Both Upper & Lower Subscapular Nerve)
- Action: Shoulder medial rotation(when
arm is by side), adduction
44
Lateral pectoral nerve comes from lateral cord
supplies the pec major
Nerve root: C5-C7
Pectoralis Major
- Action: Medial rotation, adduction,
horizontal adduction,
Scapular Protraction, Depression
45
Medial Pectoral Nerve comes from the medial cord
supplies: Pec Minor
Nerve Roots: C8, T1
Pectoralis Minor
- Action: Downward Rotation of scapula,
Scapular Protraction, Depression
46
Long Thoracic Nerve comes from the roots of brachial plexus
supplies serratus anterior
Nerve Roots: C5,C6,C7
Serratus Anterior
- Action: Upward Rotation of scapula,
Scapular Protraction, Depression,
Injury can cause:
- Winged Scapula
47
Thoracodorsal nerve comes from the posterior cord
Supplies the latissimus Dorsi
Nerve Roots: C6-C8
Latissimus Dorsi
- Action: Shoulder extension, adduction,
medial rotation.
Depression and protraction of scapula
48
Doral scapular nerve comes from the root of the brachial plexus
supplies rhomboids and levator scapulae
Nerve root: C5
Rhomboid Minor
- Action: Scapular Elevation, Retraction, Downward Rotation
Rhomboid Major
- Action: Scapular Elevation, Retraction, Downward Rotation
Levator Scapulae
- Action: Scapular Elevation, Downward Rotation
49
Nerve to subclavius comes from upper trunk
Subclavius
Nerve root C5-C6
Subclavius
- Action: Depress & stabilize clavicle
50
What muscles perform scapular elevation?
upper trap, levator scap, rhomboids
51
What muscles perform scapular protraction?
serratus anterior, pectoralis minor/major, latissimus dorsi
52
What muscles perform scapular depression?
Serratus anterior, pec minor and major, lower trap, latissimus dorsi
53
What muscles perform scapular retraction?
Trap and rhomboids
54
What muscles perform scapular downward rotation?
levator scapular, rhomboids, pec minor
55
What muscles perform scapular upward rotation?
Serratus anterior, trap upper and lower fibers
56
Spinal Accessory Nerve
supplies : traps and SCM
Trapezius
- Action: Upper fibers- scapula elevation,
Middle fibers- Retraction, Lower fibers- depression,
Upper and lower fibers-Upward rotation
Sternocleidomastoid
- Action: Cervical lateral flexion and Opposite side
rotation
57
Superior Gluteal Nerve
supplies gluteus medius, minimus and TFL
Nerve Roots: L4-S1
Gluteus Minimus
- Action: Abduction and medial rotation of hip
Gluteus Medius
- Action: Abduction and medial rotation of hip
Tensor Fascia Latae
- Action: Flexion, abduction, medial rotation of hip
58
Inferior Gluteal Nerve
Supplies: glute max
Nerve Roots: L5-S2
Gluteus Maximus
- Action: Hip extension
Secondary action: Hip Lateral rotation, abduction
59
Nerve to piriformis
Supplies piriformis
Ventral rami Nerve Roots: S1-S2
Piriformis
- Action: Abduction and lateral rotation of
hip
60
Obturator Nerve bifuractes to anterior and posterior the anterior division supplies:
adductor longus, brevis and gracilis
Nerve Roots: L2-L4
Adductor Longus
- Action: Hip adduction, flexion, medial
rotation
Adductor Brevis
- Action: Hip adduction, flexion, medial
rotation
Gracilis
- Action: Hip flexion, medial rotation,
adduction
61
Obturator Nerve bifuractes to anterior and posterior the posterior division supplies:
obturator externus and adductor magnus
Nerve Roots: L2-L4
Obturator Externus
- Action: Hip lateral rotation, adduction
Adductor Magnus
- Action: Hip adduction, extension,
medial rotation
62
Obturator sensory supply
obturator nerve
| supplies skin of middle part of medial thigh
63
Nerve to quadratus Femoris
supplies the gemellus inferior and quadratus femoris
Nerve Roots: L4-S1
Gemellus inferior
- Action: Lateral rotation of hip
Quadratus Femoris
- Action: Lateral rotation of hip
64
Nerve to Obturator Internus supplies the:
Gemellus superior and obturator internus
Nerve Roots: L5-S2
Gemellus superior
- Action: Lateral rotation of hip
Obturator Internus
- Action: Lateral rotation of hip
65
Sciatic nerve supplies:
Bicep femoris, semitendinosus and semimembranosus and adductor magnus
Nerve Roots: L4-S3
Biceps Femoris
- Action: Knee flexion, hip extension, lateral
rotation of flexed leg in non–weightbearing
Semitendinosus
- Action: Knee flexion, hip extension,
medial rotation of flexed leg in non-weight bearing
Semimembranosus
- Action: Knee flexion, hip extension,
medial rotation of flexed leg in non–
weight-bearing
Adductor Magnus
- Action: Hip adduction, extension,
medial rotation
66
Femoral Nerve supplies the iliacus, pectineus, sartorius, rectus femoris and vastus medialis/intermedius and lateralis
Nerve Root: L2-L4
Iliacus
- Action: Hip flexion
- Works with Psoas Major & Psoas Minor
Pectineus
- Action: Hip flexion, adduction, medial
rotation
Sartorius
- Action: Hip flexion, abduction, lateral
rotation, Knee flexion
Rectus Femoris
- Action: Hip flexion, Knee extension, Assists
in Hip flexion
Vastus Medialis/Intermedius/Lateralis
- Action: Knee extension
67
Femoral nerve sensory
medial cutaneous of nerve of thigh
Branch of anterior division of femoral
nerve. Supplies the skin on medial side of
lower two third of thigh
68
Femoral nerve sensory
intermediate cutaneous of nerve of thigh
Branch of anterior division of femoral
| nerve. Supplies the skin on front of thigh
69
Femoral nerve sensory
Saphenous nerve
Branch of posterior division of femoral
nerve. Supplies the skin on the medial side
of leg
70
Tibial nerve
Supplies:
gastroc, soelus, plantaris
Nerve root: L4-S3
Gastrocnemius
- Action: Plantar flexion, Knee flexion
Soleus
- Action: Plantar flexion
Plantaris
- Action: Slight Knee flexion, Plantarflexion
71
Tibial nerve
Supplies:
poplieus, tibialis posterior, flexor hallucis longus, flexor digitorum longus
Nerve root: L4-S3
Popliteus
- Action: Knee flexion, unlocks the knee
during initial flexion by laterally rotating
femur
Tibialis Posterior
- Action: Plantarflexion, Inversion
Flexor Hallucis Longus
- Action: Flexion of great toe, Plantar
flexion, Inversion
Flexor Digitorum Longus
- Action: 2-5 toes flexion, PF and inversion
72
Tarsal Tunnel Sydrome
Tom, dick and harry
Tibial artery, nerve and vein compression
Tibialis posterior, flexor hallucis longus and flexor digitorum longus
73
Tibial nerve sensory
supplies over the heal, medial side of sole from the medial plantar and lateral side of the sole from lateral plantar
74
Common peroneal nerve
Nerve root: L4-S2
75
Deep Peroneal nerve supplies the: tibialis anterior, extensor hallucis longus, extensor digitorum longus and extensor digitorum brevis
Nerve Roots: L4-S1
Tibialis Anterior
- Dorsiflexion, inversion
Extensor Hallucis Longus
- Action: 1st toe extension, Ankle
dorsiflexion, inversion
Extensor Digitorum Longus
- Action: Toe extension, ankle DF, eversion
Extensor Digitorum Brevis
- Action: Toes extension
76
Injury to the deep peroneal nerve can result in what gait deviations?
foot drop and unopposed eversion
77
Superficial peroneal nerve supplies the peroneus longus and peroneus brevis
Nerve Roots: L4-S2
Peroneus Longus
- Action: Plantarflexion, eversion
Peroneus Brevis
- Action: Plantarflexion, eversion
78
Deep peroneal sensory supply:
Webbing between 1 and 2 toes on the dorsum of the foot
79
Superficial peroneal sensory supply:
Dorsum of the foot and anterolateral part of lower leg
80
General contraindications for electrical stimulation
healing fractures, active bleeding, malignancies, superficial metal implants, pharyneal/laryngeal muscles, pacemaker, cardiac issues
81
Iontophoresis: what is salicylate used for and what is the charge?
negative, pain relief
82
Iontophoresis: what is acetate used for and what is the charge?
negative, calcium deposits
83
Iontophoresis: what is dexamethasone used for and what is the charge?
negative, anti-inflammation
84
Iontophoresis: what is iodine used for and what is the charge?
negative, softens scars
85
Iontophoresis: what is hydrocortisone used for and what is the charge?
positive, anti-inflammation
86
Iontophoresis: what is lidocaine used for and what is the charge?
positive, pain relief
87
Iontophoresis: what is calcium/magnesium used for and what is the charge?
positive, muscle spasm
88
Iontophoresis: what is lithium used for and what is the charge?
positive, gout
89
Iontophoresis: what is zinc used for and what is the charge?
positive, dermal ulcers
90
Iontophoresis: what is copper used for and what is the charge?
positive, fungal infections
91
Conventional TENS: frequency, pulse width, intensity, purpose, and duration?
high frequency: 75-120
very short pulse width (50-100 microseconds)
low intensity
Provides temporary relief of pain treatment can last 20-60min
92
Acupuncture-like TENS: frequency, pulse width, intensity and purpose?
Low frequency: 1-4pps
wide pulse width (150-300 microseconds)
high intensity
Used for more chronic conditions with long lasting pain relief, treatment can take between 30-40 min
93
Brief intense TENS: frequency, pulse width, intensity and purpose?
```
High pulse rate: 150pps
Long pulse width (300 microseconds)
short term pain relief
Pain relief with wound debridement, deep friction massage, passive stretching
Total time 15 min
```
94
High voltage pulsed monophasic stimulation: frequency, pulse width, intensity and purpose?
strong used for denervated muscles
pulse rate: 50-200pps
pulse duration: 20-100 msec
continuous waveform
95
Muscle contraction: frequency, pulse width, intensity and purpose?
Pulse rate 35-80pps
Pulse duration: 150-200 msec for small 200-350 msec for large
On/ off time: 10-20 reps in about 10-20 min
96
Muscle strength: frequency, pulse width, intensity and purpose?
Pulse rate 35-50pps
Pulse duration: 150-200 msec for small 200-350 msec for large
On/ off time: 1 to 5 so 6-10 seconds or 50-120 seconds
97
Muscle spasm/ edema: frequency, pulse width, intensity and purpose?
Pulse rate 35-50pps
Pulse duration: 150-200 msec for small 200-350 msec for large
On/ off time: 1 to 1 ratio
