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Flashcards in PT Rehab Final Deck (114):
1

The superior articular facet faces what direction?

Upward and anterolaterally
Is slightly concave

2

What direction does the inferior articular facet face?

Downward and posteriormedially
Is slightly convex

3

In what plane are the facets mostly oriented?

Sagittal plane
*allows for increased flexion and extension

4

What is a unique feature at the edge of each facet joint?

Meniscoid
*ticker at proximal and distal edges

5

T or F

The superficial extensor muscles are primary movers and force generators

True

6

What muscles act as position sensors?

Deep small rotators

7

What are the consequences of spinal muscle injury on function?

- takes longer to "turn on" and reach peak strength
- Impair stabilization during movement
- can become inhibited and have asymmetrical force production which can lead to lumbar dysfunction and pain

8

What has been the hypothesis for lumbopelvic rhythm?

The first 60 degrees of trunk flexion occurs at the lumbar spine before hip flexion is initiated to fully flex spine

9

What is the flexion-relaxation phenomenon?

Shutting down the back extensors during trunk flexion
- spinal extensors become inactive with full flexion of the lumbar spine.
- ligaments and passive tissues take up the stress which increases the shear force on the spine

10

T or F

Decreased lumbar spine flexibility may predispose an athlete to injury

False

Increased

11

Flexibility where in the body appears to have a profound affect on lumbar spine injury prevention?

Hip, knees and ankles

12

T or F

Strength is less important for sports performance than for injury prevention

False

More important

13

What are the seven exercises for William's Flexion Exercise?

1. Pelvic Tilt
2. Single knee to chest
3. Double knee to chest
4. hamstring stretch
5. partial sit-up
6. hip flexor stretch
7. Squat

14

What is the goal of the William's Flexion exercises?

- reduce pain
- provide lower trunk stability by actively strengthening the abs, glutes and hamstrings
- stretch the hip flexors and lower back muscles

15

What is the goal of the McKenzie extension exercises?

To centralize pain and restore full ROM in all directions

16

What does centralize pain mean?

Pain moves closer to the low back.

17

What is the McKenzie progression?

Prone lying
Prone on elbows
Prone press-ups
Standing backward bending

18

The muscles of the cervical spine provide what percent of stability?

80%

19

What structures stabilize the cervical spine at end ranges?

Ligaments

20

What are the 3 important functions of ligaments in the Cspine?

Provides stability to the joint
Absorb energy during trauma
Act as a joint position transducer during physiologic motions.

21

Nodding (Craniocervical Flexion) helps to strengthen what muscles?

Deep cervical flexors
- longus coli and longus capitis

22

How many times should cervical ROM exercises be performed?

5-15 times
** be implemented until full pain-free ROM is restored

23

What are the recommended reps and sets for Cspine stretching?

Be held 10-30 seconds and repeated 3-5 times

24

Strengthening of the cervical spine should follow this progression:

Isometric
Isotonic
Polymetric
Straight plane to multi-plane

25

What is the progression criteria for strengthening of the Cspine?

No pain during exercise
No pain in cervical muscles the day after
Pain-free ROM in all ranges

26

How do the thoracic spine facets vary from the lower cervical spine?

oriented at a 60 degree slope

27

What are the signs and symptoms of facet joint/ rib dysfunction?

- unilateral pinpoint thoracic pain
- brought on by deep breathing, sneezing or coughing
- may radiate beneath the scapula.

28

In the resting position what is the angle of the humeral head position?

25-30 degrees in a retroverted position

29

What are the static stabilizers of the GHJ?

Capsule, glenoid labrum and GH ligaments

30

What are the dynamic stabilizers of the GHJ?

Rotator cuff muscles

31

T or F

The AC joint is a amphiarthroidal joint

False

Diarthrodial

32

T or F

The AC ligaments provide for vertical stability

False

Horizontal

33

During shoulder elevation that clavicle must move how?

Elevate, rotate and retract to position the glenoid

34

GH to ST motion is what ratio?

2:1

35

T or F

The scapula is stable for the first 20-40 degrees of motion

False

first 30-60 degrees

36

How does the scapula move when the arm is elevated overhead?

Upwardly rotates 50 degrees and the posterior tilts 30 degrees.

37

Abnormalities in scapulohumeral rhythm are caused by?

- weakness of the scapular stabilizers
- tightness and shortening of the scapulohumeral muscles
- involuntary adaptation to avoid painful arc
- postural changes

38

Proper scapular motion depends on?

1. muscle strength
2. muscle length
3. thoracic spine alignment
4. muscular attachments

39

T or F

Internal impingement is when the rotator cuff and bursar are impinged in the subacromial space

False

This is external

Internal = supraspinatus and infraspinatus compression in the posterior superior aspect of the glenoid

40

Causes of impingement

- Poor shoulder complex mechanics
- simple joint laxity
- prolonged overhead activities
- repeated throwing activities

41

Phase 1 of shoulder impingement tx

Flexibility
Stretches = sleeper, horizontal posterior, latissimus

42

T or F

Phase 3 of impingement tx is focused on strength

False

Endurance

43

What are some strengthening exercises for phase II shoulder impingement

Swiss ball
Push-ups
Quadruped stability
PNF and tubing
Scapular stability exercises

44

What are the 4 articulations in the elbow?

Humeroulnar
Humeroradial
Prox and Distal Radioulnar

45

What are some tx for lateral epicondylitis?

Exercises progressing with no pain
Ice, rest, NSAID
US
Iontophoresis with dexamethasone
Transverse friction massage

46

When treating medial epicondylitis what muscles should be focused on?

Flexors and pronators

47

Rehab for a UCL in phase 2 should include?

- increase AROM to 0-145 degrees
- hinged brace set at 10-120 degrees *add 5 degrees each week
- avoidance of placing any valgus force on the elbow
- submaximal isometrics and isotonic

48

Leg length discrepancies great than ___ can cause biomechanics changes?

7mm

49

Where might you see referred pain in an obturator nerve entrapment?

Pubic region

50

T or F

A obturator nerve entrapment can show a weak resisted abduction

False

Adduction

51

Tx for obturator nerve entrapment?

deep tissue massage
myofascial release to the groin
aggressive stretching
surgical intervention
surgical debridement *high success rate

52

Entrapment of the lateral femoral cutaneous nerve is called?

Meralgia Paresthetica

53

Where is the most common location of nerve entrapment for the lateral femoral cutaneous nerve?

Anterior to the ASIS and superficial to the origin of the sartorius 27%

54

T or F

There is no motor loss with Meralgia Paresthetica

True

55

What is the loose packed position of the hip

30 degrees flexion
30 degrees abduction
Slight ER

56

What is the normal angle of inclination of the hip?

125 degrees

57

Coxa valga is what angle of inclination?

> 125 degrees

58

Where will a lower abdominal strain refer pain to?

Groin

59

Herniated disc/nerve root pathology will have what site of referred pain?

Hip

60

What injury has a site of referred pain as the hip and buttock?

SI joint

61

Deep seated buttock pain
Point tenderness
Difficult to find a position of comfort
Passive IR = pain

These are the signs and symptoms of??

Piriformis syndrome

62

What percent of the population does the sciatic nerve pierce the piriformis muscle?

10%

63

What are some causes of Trochanteric Bursitis?

ITB tightness
training errors
improper footwear
lower extremity postural abnormalities
Abnormal gait biomechanics

64

Prolonged frequent sitting or trauma is the MOI for this condition?

Ischial Bursitis

65

What are the signs and symptoms of Ischial Bursitis?

Pain with sitting and palpation
Pain increased with full hip flexion
Pain increased with walking up stairs, running uphill

66

If the gluteals are unable to stabilize the pelvis what muscle must pick up the slack?

ITB

67

ITB is responsible for what three conditions?

Greater trochanteric bursitis
Lateral snapping hip syndrome
Patellofemoral pain syndrome

68

A click with active or passive hip IR/ER at 90 degrees flexion is indicative of what condition?

Labral Tear

69

What is the sulcus angle of the knee?

The angle formed by the height of the medial and lateral femoral condyles and the depth of the patellar groove.

70

What is the normal range of the sulcus angle?

130-150 degrees
* >150 predisposes the patient to patellar instability.

71

Normal range of the Q angle?

10-15 degrees
>20 = abnormal

72

T or F

The transverse stabilizers are active stabilizers of the patellar tracking system

False

Transverse is passive
Longitudinal is active

73

T or F

IR = squinting patellae

True

74

T or F

Genu Valgum = decreased oblique pull of quads

False

Increased pull = increased lateral forces on patella

75

T or F

Pes planes can cause a decrease IR of tibia/femur

False

Increased IR
* increases lateral forces on patella

76

What type of joint is the tibiofemoral joint?

Condyloid
* allowing 2 degree of motion

77

What is the normal ROM for flexion of the tibiofemoral joint?

0-145 degrees

78

What are the arthokinematic motions of the tibiofemoral joint?

roll, glide, spin

79

Describe the screw-home mechanism

Tibial ER causes a medial shift and locks the joint in full extension
*closed packed position

80

What is the functional ROM with a walk at the tibiofemoral joint?

0-67 degrees

81

T or F
When we run/stair climb the functional ROM of the knee joint is 0-117 degrees

False

0-90

0-117 is lifting

82

The tibiofemoral joint is the referral zone for what conditions?

Lumbosacral spine, hip and LE

83

T or F

Sciatic nerve will cause posterior knee pain

True

84

Anterior thigh and knee, medial lower leg pain is a referral zone for what nerve root level?

L3

85

What is the referral zone for and S1 S2 nerve root

Posterior thigh to lower leg

86

Medial thigh to knee is a referral zone for what nerve root?

S3

87

MOI for a posteromedial rotary instability

Hyperextension with valgus force

88

MOI = rotational forces, cutting to same side, wear and tear from ACL deficient knee will cause instability where?

Anterolateral rotary

89

What is the MOI for an anteromedial rotary instability?

Same as that for ACL

90

More than half the fibres torn is what grade of strain?

2

91

Pain in passive ROM is seen with what grade of strain?

1 and 2

92

What muscles will be weak with a peroneal nerve palsy?

Tib Anterior and peroneal muscles

93

What is a Baker's Cyst?

Often a painless swelling of the gastroc and semimebranous bursa

94

What motions are involved in pronation?

Dorsiflexion, abduction, eversion

95

What motions are involved in supination?

Plantarflexion, adduction, inversion

96

what joint serves as the link between the upper and lower functional units of the foot?

Subtalar joints

97

T or F

The subtalar joint is multiracial

False uniaxial

98

What ligaments are part of the subtalar joint?

interosseous talocrural ligament
Cervical ligament

99

What is the open chain motion of the calcaneus on the talus?

Calcaneus moves on the talus

100

The closed chain motion of the calcaneus on the talus is accomplished by a combo of motions in what planes?

Sagittal
Frontal
Transverse

101

T or F

The lateral mid tarsal joint is a ball and socket type joint

False

Saddle-like joint between calcaneus and cuboid

102

T or F

Midtarsal and subtalar joints can function independently of one another

False

103

The medial mid tarsal joint is between what bones?

Talus and navicular

104

What ligaments are in the mid tarsal joint complex?

Plantar calcaneonavicular
Bifurcate ligament
long and short plantar ligaments

105

What motion occurs on the longitudinal axis of the mid tarsal joint?

Eversion and inversion

106

On what axis does abduction and adduction of the mid tarsal joint occur?

Oblique

107

How does the calcaneus strike the ground on the contact phase?

Slightly inverted, slightly supinated

108

What does the calcaneus do immediately after contact?

Everts immediately after contact

109

What is the result of subtalar pronation on the contact phase?

Unlocks the midtarsal joints and the foot becomes mobile adaptor.

110

T or F

During the contact phase the lower leg externally rotates

False

Internally

111

What happens to the foot in the mid stance phase?

Converts from mobile adaptor to rigid lever

112

T or F

During mid stance the subtalar joint begins to pronate?

False

Pronate

113

T or F

During mid stance the ankle joint moves into 10 degrees of DF

True

114

T or F

During the propulsive phase the MTP joints move into extension

True