quiz 2 Flashcards
(111 cards)
1
Q
how much motion occurs at hip (degrees)
A
35 degrees flexion at heel strike
10-15 degrees Flexion at pre swing
AB/Add 10 degrees
2
Q
greatest force of wb occurs during what activity (hip)
A
running
3
Q
order of best exercises for glut med
A
LOW: good mornings, cable walk outs
Mod: bilateral bridge, clam
High: quadruped with a lift, wall squats
Very high: lateral band walk, or SL hib abd
4
Q
what are the generals of femoral ant glide syndrome
A
limited post glide
Insufficient posterior glide during flexion
Stiff hip extensors, posterior hip capsule
Excessive flexibility of anterior capsule
5
Q
what is dominant with femoral ant glide
A
TFL
6
Q
what pathologies go with femoral ant glide
A
FAI
labrum tear
hip flexor issues (strain/pain)
7
Q
what exercise is good for femoral ant glide issue
A
PASSIVE knee flexion (supine)
8
Q
what muscles do you need to strengthen for someone with femoral ant glide
A
gluts
9
Q
list some general info about femoral lateral glide syndrome
A
Dancers
femoral head is lateral
has hypermobility
They stand adducted (bc their abductors and ER are weak)
10
Q
anatomic dx’s related to femoral lateral glide syndrome
A
Trochanteric bursitis
Snapping hip syndrome
Piriformis strain
11
Q
for femoral lateral glide, do you do mobs
A
no - they are hypermobile
12
Q
what mm to strengthen for femoral lateral glide
A
abd
ER
gluts
13
Q
what really simple task can you teach a pt with femoral lateral glide syndrome for tx
A
sleep with pillow btwn knees to abd (since they are often stuck adducted) (femoral head is lateral but leg is adducted)
14
Q
hip OA is aka
A
femoral hypomobility syndrome
15
Q
what is the cascade of pathos for hip
A
FAI = labral tear = OA
16
Q
cane goes with what leg
A
opp of impaired
17
Q
good txs for OA
A
MT and EX
water aerobics/therapy
distraction (inf and lateral)
strengthen gluts
18
Q
what 2 things cause hams strain
A
eccentric control
sprint take off
19
Q
location of acute vs chronic hams strain
A
acute - in belly (bruises)
chronic - at mm tendon junction (px deep at isc. tub)
20
Q
recovery time strain
A
6-8 wks
21
Q
chronic hams strain occur where
A
proximally
22
Q
slump stretching exercises are really good for
A
proximal (chronic) hams strain
23
Q
PFPS - list some general ideas
A
Excessive pull laterally = patella pulls laterally
IR of femur – causes patella to track laterally
Pronation of foot (at subtalar jt) creates IR of tibia which creates IR of femur
Art cart underneath the patella wears down
Contributing factors: tight ITB
24
Q
with PFPS the femur is often rotated
A
internally
25
what imbalance do you need to investigate for PFPS
quad vs gluts (which is dominant)
26
who are more apt to have quad dominance with PFPS
athletic males
27
If you notice a person medially drifting (at the knee) when they do a SL squat, how do you tx
work on abd and ER
28
what must you incorporate into tx for PFPS (strengthen what)
abd and ER
29
what can you do to "influence" the distal extremity of the knee for a person with PFPS
talocrural
do post joint mobs to increase dorsiflexion
remember, if one joint is hypomobile (ex at the ankle) the joint above or below is prob hypermobile
30
what tissue is the px generator with PFPS
cart
31
always look ___ and ___ the knee with any knee issue
above and below
32
tendonitis is aka
jumpers knee
33
itis vs osis
itis - acute, warm, inflammed
| osis -collagen issue
34
patellar tendon issue, where you watch them squat and you think quads are too weak, what is a good exercise
put them on a wedge with small side towards toes and squat
35
purpose of tendons
store and release energy = power
| plyo helps with this
36
3 insertions of ITB
Patella
Gerdy’s tubercle
Fibular head
37
the ITB decelerates ____ of tibia
IR
38
criteria of dx for knee OA
```
• Knee pain plus 3 of the following:
o Age > 50 years
o AM stiffness less than 30 min
o Tenderness with no warmth
o crepitus
o osteophytes on imaging
```
39
generals of strength vs power vs endurance
strength and power are typically higher load lower rep
| endurance is opp (low load high rep)
40
there is an impingement zone with the ITB at 20-30 degrees of flexion as the ITB rubs the lateral femoral condyle, what test mimics this
noble compression
41
ant vs post portion of ITB
```
ant = TFL
post = glut max
```
42
what (that is under the IT band) can often get irritated and inflamed and need injections
fat pad
43
4 biomechanical factors that can cause ITB syndrome
Prominent LFC (lateral condyle)
Weak hip abductors
ITB tightness
Genu varum
44
what 2 surgeries are common for serious ITB issues
shaving the lateral femoral condyle
| clipping the band itself
45
what strengthening is essential for knee OA
quad
46
would you use open or closed ex for knee oa
both
| open isolates quad better though
47
what part of knee is often most affected with OA (lateral or medial)
medial
48
general ideas for OA activities (knee)
closed chain or water good
some open chain for experienced
no jumpy/plyo activities
49
order of muscle firing with glut med test
glut med first
TFL
QL later (after full abd of 45)
50
for testing of glut max, how to differentiate what might be weak/strong
2. If the patient is unable to tolerate maximal resistance anywhere = glut max is weak.
3. If the patient tests weak in the standard position, but tests strong when the hip is allowed to move forward 10º-15º, the gluteus maximus is long.
4. If the hip rolls into medial rotation and/or flexion upon resistance, the TFL is dominant.
5. if pelvis hikes QL is dominate
51
proper firing pattern of hip ext should be
(1) gluteus maximus
(2) hamstrings,
(3) contralateral paraspinals,
(4) ipsilateral paraspinals.
max, ham, contra, ipsi
52
prone quadriceps length test
prone foot to buttock
if pelvic motion is detected there is an imbalance
if you can lock down pelvis and take foot all way to buttock then abs are weak
if you lock down pelvis and cannot take foot to buttock quads are tight
53
TA and multifidus are ___ stabalizers
local
54
RA, the obliques, thoracis's and QL are ___ stabalizers
global
| TORQ
55
T or F, even if the forces generated by global muscles were adequate, the spine was unstable if local muscles were not sufficient.
T
56
these stabalizers stabalize the spinal SEGMENT
local
57
these stabalizers have to do with the entire vertebrae and trunk movement
global
58
The main function of the global muscles is to balance ______to the trunk so that the local muscles can handle the residual forces transferred to the spine (primarily lumbar).
external loads
59
if iliacus is tight, it can do what to pelvis
Iliacus
Although this muscle is a hip flexor, by reverse pull it can create anterior pelvic tilt if tight.
It is often tight, as with an ilial inflare.
60
psoas major can cause ___ tilt
anterior
61
TFL can cause ___ tilt
ant (in full knee ext)
62
primary goal of dry needling
• The Primary goal of Dry Needling is to desensitize supersensitive structures and restore motion and function.
63
goal of dry needling is to ilicit a
local twitch response
64
active vs latent trigger point (dry needling)
active -feels like "my pain"
| latent-not familiar to the pt
65
ART is for ___ tissue
soft
66
ART tension is applied in what direction
Tension is usually applied longitudinal to the mm and with venous flow.
67
principles of ART
soft tissue is taken in position from short to long
68
ART formula
Insult to tissue = Number of reps x Force of rep/ Amplitude x Relaxation time between reps
NF/ARt
meaning, large reps large force without relaxation = injury
69
professions that can do ART
```
ATCs
OTs
PT
MD
Massage
```
70
trigger pts produce ___ px
referred
71
Anchor the tape to the coracoid process and pull posteriorly, caudally, and medially (pull away from pec minor)
This is what scapular tape job
post tilt
72
similiar to post tilt tape but start at clavicle, and extended posteriorly, caudally, and medially (perpendicular to the course of the upper trapezius) to the area just distal to the spine of the scapula.
inhibit upper trap
73
put arm in scaption
anchor the tape slightly medial to the spine of scapula. Passively elevate the shoulder into full “flexion” (scaption) to fully upwardly rotate the scapula. Pull the tape medially and caudally toward the lower thoracic spine. Remember the lower trapezius attaches at T12
taping for UR
74
if you ever tape scap for elevation it must be done
B
75
Apply the tape to the lateral edge of the acromion process and passively elevate the scapula, making sure the acromial end rotates upward. Pull the tape medially toward the cervical spine in the suprascapular space, following the direction of the upper trapezius. Apply a piece without forceful elevation to the opposite side. Tape to – but not over – the spinous processes.
scap elevation
76
Begin at the spinous process of the upper segment and pull the tape in the opposite direction you want the vertebral body to rotate. Anchor the next strip at the lower segment and pull it in the opposite direction of the first strip.
(This might be a technique you use after performing manual joint mobilization. The tape is useful in maintaining the corrected position.)
tape for rotated segment
77
what pathologies go with lat femoral glide syndrome
bursitis
snappy hip
piriformis syndrome
78
with femoral lateral glide syndrome, is it more capsular or ligg issue
capsular
79
different outcomes for thomas test
bent knee is iliopsoas tight,
straight knee is RF
if they IR = tight TFL
if they ext rotate then tight sartourious
80
what is difference in 30 vs 5 degrees when do MCL/LCL valgus/varus test
5 degrees and pos it tells you other structures are involved = more serious
if pos only at 30 it's just the MCL or LCL
81
Mcmurrays tests for
meniscus
IR -tests ext fibers
ER -tests internal fibers
82
Thessaly's tests for what
meniscus (twist)
83
aply's is for
meniscus
| prone as you grind
84
hx of clicking, locking, joint line px is prob
meniscus
85
explain Clarke's test
clark is uncomfortable
| they do quad set as you push on sup aspect of patella
86
explain noble compression
find lat fem condyle and push as they ext knee
87
kleigers is for the ___ lig
deltoid
| push laterally
88
talar tilt tests
CF and ATF
89
ant drawer (ankle) tests
ATF
90
what should you do before doing taping of knee
do a medial mob of the patella first. You should be able to expose the lateral femoral condyle: if you can’t, it suggests that the lateral retinacular structures are too tight. so Mobilize the retinaculum first before considering taping.
91
when forward bending, men typically do what and women do what
men bend at lumbar and women bend with hips
92
good exercise for QL
side plank
93
most support to the spine is the ___ sx
the ligamentous structures (PASSIVE) provide the most support to the spine at the end ranges of motion where they check excessive mobility
94
ligg are ___ sx
passive
95
the active sx is the
myo/fascia
96
what is the control sx
feedback (proprioception)
97
taping of the scap into UR looks
backwards from what you would think
98
diff btwn scap taping for taping into post tilt vs taping to inhibit upper traps
post tilt - it goes ant to post and stops at the spine of scap
inhibit upper traps goes past the spine of scap and distal some.
99
bakers cyst is where
popliteal fossa
100
doing stairs and feeling like their knee will buckle or give out is a sign of
meniscus
101
this hip pathology is Commonly felt in the anterior superior region of the hip; c/o of anterior hip pain;
FAI
102
```
Medial wrist pain distal to the ulna
Think what (pronation and supination hurt)
```
TFCC
| disc btwn carpals and ulna
103
structures in the carpal tunnel
4 FDP tendons, 4 FDS tendons, Median N, FPL tendon.
104
if short, the psoas major causes
inc lumbar lordosis, ant translation/ant issues of the hip
105
often times if the hip medially rotates what is tight
TFL
106
if QL is tight what might occur
hip hike
107
what posture accompanies tight hip flexors
ant pelvic tilt
108
what posture accompanies tight hams
post pelvic tilt
| and will have stretched hip flexors
109
what posture accompanies genu recurvatum
post pelvic tilt
110
explain RF, VL, VM functions other than knee extension
The rectus femoris also flexes the hip. The vastus lateralis pulls the patella more laterally; the vastus medialis pulls the patella more medially
111
why would weak abductors contribute to ITBS
if other abductors are weak ITB will try to take over but it's not meant to be the primary abductor
