MSK 1A

Question 1

regional interdependence

Answer 1

unrelated impairments in a remote region may be associated with pt’s primary c/o or possibly mediated by central mechanisms

Question 2

when is regional interdependence considered?

Answer 2

when pt’s presentation is unclear or response to tx is less than favorable

Question 3

what is the biomedical model?

Answer 3

a diagnosis is required to prescribe treatment

Question 4

what is limitation of biomedical model?

Answer 4

less suited for non op MSK disorders b/c no clear structural cause identified

Question 5

what is the impairment model?

Answer 5

focused on physical impairments (pain,ROM)

neurophysiologic
biopsychosocial
somatovisceral

Question 6

thoracic HVLAT txt purpose?

Answer 6

↓’s cervical spine pain
↑’s lower trap strength
Improved outcomes in pts w/ RC tendinopathy and adhesive capsulitis

Question 7

By identifying contributing factors, PTs can tailor tx to address specific impairments, either ____ or ___

Answer 7

local or remote

Question 8

goal of scanning exam

Answer 8

determine that no serious pathology is present and exam can continue

narrow search local vs remote response

exam neuro status

identify primary contributing source

improve rehab outcomes

Question 9

what are regions to scan?

Answer 9

No MOI or hx related to S&S

proximal cause for distal symptoms

non MSK sounding

Question 10

UQ scanning exam

Answer 10

observation

pt hx

cervical AROM (OP*)

UE ROM

Myotomes C5-T1

Dermatomes C4-T1

Neuroprovocation testing (ULTT 1)

pathologic reflexes

palpation

Question 11

ROS vs system reviews

Answer 11

ROS: collects info about each system to determine what warrants physical examining

Systems review: hands-on component of exam

Question 12

fever of what is concerning

Answer 12

99.5 or more for >2 weeks

Question 13

yellow vs blue flags

Answer 13

yellow: psycho factors (anxiety, depression, kinesiophobia,dizzy, faint, weak)

blue: socioeconimic factors (SES and social determinants of health)

Question 14

medical screening questions are what kind?

Answer 14

YES/NO

Question 15

In 1 LBP research study, __% pf pts w/ LBP had 1 red flag, but <1% actually had a serious disease/pathology

Answer 15

80

Question 16

what muscle action does C6 innervate

Answer 16

elbow flx:MCN
wrist extension: radial

Question 17

what muscle action does C7 innervate?

Answer 17

elbow ex: radial
wrist flx: median

Question 18

cervical compression pain reproduced suggests

Answer 18

Disc herniation
Vertebral end plate fx
Vertebral body fx
Acute arthritis/joint inflammation
Nerve root irritation (if radicular symptoms produced)

Question 19

Pain reproduced w/ distraction suggests:

Answer 19

Spinal ligament tear
Tear/inflammation of annulus fibrosis
Muscle spasm
Large disc herniation
Dural irritability (if non-radicular arm pain produced)

Question 20

Radicular arm pain:
Non-radicular arm pain:

Answer 20

symptoms often ‘shoot’ below the elbow

symptoms typically stay above the elbow

Question 21

ULTT steps

Answer 21

C-spine neutral → shoulder depression → GH abduction → wrist/finger extension, forearm supination → GH ER → elbow extension → C-spine contralateral side bending

Question 22

ULTT + findings

Answer 22

Differences b/t limbs in elbow ROM

Reproduction of concordant neurologic symptoms in UE w/ movement of DISTANT component

Different symptoms b/t 2 extremities

Question 23

ULTT 1 is bias for what nerves

Answer 23

median and anterior interosseous

Question 24

NINDS Grading Scale (5-point): reflexes

0

Answer 24

absent

Question 25

NINDS Grading Scale (5-point): reflexes 1

Answer 25

slight (hyporeflexia)

Question 26

NINDS Grading Scale (5-point): reflexes 2

Answer 26

normal

Question 27

NINDS Grading Scale (5-point): reflexes 3

Answer 27

brisk - normal

Question 28

NINDS Grading Scale (5-point): reflexes 4

Answer 28

enhanced hyperreflexia including clonus if present

Question 29

what reflex tests if + indicate UMN lesion?

Answer 29

Hoffman and Babinski

Question 30

what reflex test if + indicates demyelination on spinal cord (UMN lesions)

Answer 30

Lhermitte

Question 32

normal pulse grade

Answer 32

3

Question 33

when to palpate thyroid glands/cervical?

Answer 33

Only palpate when indicated based on symptoms and visible asymmetries

Question 34

decision making process is a multi faceted ____ process that combines _____ and ____

Answer 34

flexible implicit knowledge accumulated clinical experience