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PTFE MSK Flashcards

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1
Q

goniometry steps

A
  1. determine joints
  2. organize by body position
  3. educate pt
  4. stabilize proximal segment
  5. move joint through ROM and determine end feel
  6. make clinical estimate
  7. align goniometer, record starting position
  8. record end position
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2
Q

empty end feels are d/t

A

pain

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3
Q

boggy end feels are d/t

A

hemoarthrosis - blood in joint

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4
Q

passive insufficiency

A
  • inability of 2 joint muscle to passively extend across full ROM of both joints
  • stretch - hamstrings w/ hip flexed and knee extended
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5
Q

active insufficiency

A
  • inability of 2 joint muscle to actively contract across full ROM of both joints
  • can’t flex wrist AND flex fingers
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6
Q

open-packed positions - arm

A
  • GH: abd 55-70, abd 30, neutral rotation
  • humeroulnar: 70 flexion, 10 supination
  • humeroradial: full ext and supination
  • prox radioulnar: 70 flexion, 35 supination
  • distal radioulnar: 10 degrees supination
  • radiocarpal: neutral
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7
Q

vertebral open pack

A

midway between flexion and extension

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8
Q

LE open-pack positions

A
  • hip: 30 flexion, 30 abd, sligh ER
  • knee: 25 flexion
  • ankle: 10 PF
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9
Q

hip closed pack

A
  • ligamentous: full ext, abd, IR
  • bony: 90 flex, slight abd, ER
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10
Q

phases of healing

A
  • hemostasis: day 1-3
  • inflammation: day 3-20 - new BV growth
  • proliferation/granulation: week 1-6 - scar tissue formation
  • remodeling/maturation: week 6-2 years
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11
Q

6/6/6 rule

A
  • first 6 weeks: max protection - limit ROM, activation, & stretching
  • second 6 weeks: mod protection - control loading
  • 6 month: return to sport, ACL, RTC for hi-load and hi-velocity
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12
Q

pancoast tumor

A
  • tumor in apical segment
  • like TOS but w/ lung symptoms
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13
Q

osteosarcoma

A
  • cancer in end of bone, metaphysis, M > F
  • painful bump, sunburst X-ray
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14
Q

ewing’s sarcoma

A
  • in shaft, diaphysis
  • painful lumps, sunburst patterns on x-ray
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15
Q

convex on concave rules

A
  • opposite direction
  • shoulder, ankle, hip
  • improve IR - post mob, ER - ant mob, flexion - post/inf, abd - inf
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16
Q

concave on convex

A
  • same direction
  • fingers
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17
Q

shoulder upward rotators

A
  • SA: serratus anterior
  • LT: lower trap
  • UT: upper trap
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18
Q

shoulder downward rotators

A
  • Love: levator
  • Rha: rhomboids
  • Min: pec minor
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19
Q

scapular dyskinesia

A
  • needs coordination
  • pt ABD alone, then w/ PT
  • (+) is pt feel better
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20
Q

TOS testing

A
  • Adson: head toward PT
  • ROOS: 3 minutes
  • Allen: head away from PT
  • Halstead: reverse adson
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21
Q

shoulder impingement and testing

A
  • primary: bony
  • secondary: RTC
  • Hawkin’s kennedy: arm 90, PT moves into IR
  • Neer: arm near ear
  • painful arc: abd 60-120
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22
Q

RTC tear tests

A
  • drop arm: supraspinatus
  • lag: ER - supra or infra, IR - subscap
  • empty can: supraspinatus
  • hornblower/Patte: teres minor
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23
Q

SLAP tests

A
  • o’briens: “oh that’s better”
  • speeds: speedily bring arm forward
  • biceps load/kim: pt supine, activates bicep
  • yergasons: turn palm over - strong supination, “why am i doing this”
  • clunk test: pt supine
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24
Q

bankart lesion

A
  • inferior labrum
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25
apprehension test
- posterior or anterior
26
adhesive capsulitis
- lose ER -> ABD -> IR - AROM and PROM - F > M - after immobilization, hypothyroidism - protection - freezing, pendulum - controlled - subacute, progress ROM, function, self-mob - return to function - stretch and strengthen as tolerated
27
midshaft humerus fracture results in damage to
radial nerve
28
distal humerus fracture (supracondylar) results in damage to
- lateral side: radial nerve - medial side: median nerve
29
lateral epicondylitis
- tennis elbow - wrist extensors - cozen's test: resisted extension and radial deviation - treatment: night immobilization, counter force brace, cross-friction, eccentric
30
medial epicondylitis
- golfer's elbow - wrist flexors - test w/ passive supination, elbow extension, wrist extension - treatment: night immob, counterforce brace, cross-friction, eccentric
31
de quervain's tenosynovitis
- abductor pollicis longus and extensor pollicis brevis - overuse w/ gripping and lifting - finklestein's: passive thumb flexion w/ ulnar deviation - eichoff's: thumb in clenched fist, active/passive ulnar dev
32
bunnell-littler test
- test tightness of MCP intrinsics - MCP tight capsule vs tight intrinsics - PT move finger to MCP ext to stretch lumbrical and flex PIP to further to further stretch - then MCP flexion for slack - if tight in both -> capsular - if different -> muscle tightness | normally, lumbricals flex MCP and extend PIP
33
elbow moves
- concave on convex - distraction improves flexion and extension - distal/hook improves flexion
34
radioulnar joint
- PPP - at Proximal joint, to improve Pronation, do a Posterior/dorsal glide - at distal, to improve pronation, do an anterior glide (opposite of proximal)
35
radiocarpal joint
- convex on concave - improve ext - volar/ant glide - improve flex - dorsal/post glide
36
fingers and toes move
- concave on convex - improve extension - volar/ant glide - improve flexion - dorsal/post glide
37
thumb movement
- out/in is flexion/extension - concave on convex - forward is abd/add - convex on concave | bc thumb is a saddle joint
38
nutation
- anterior sacral tilt w/ posterior pelvic tilt - apex at bottom of sacrum posterior and superior
39
counter nutation
- post sacral tilt w/ anterior pelvic tilt - apex anterior and inferior
40
achilles tendonitis
- burning/aching in heel - TTP - pain w/ **activity** - swelling - thickening - morning stiffness - weakness d/t pain
41
plantar fasciitis
- TTP at insertion - heel spur - pain worse in AM or after **prolonged inactivity** - difficulty w/ prolonged **standing** - pain w/ **walking barefoot**
42
patellofemoral syndrome chondomalacia patella
- ant knee pain - **pain w/ prolonged sitting** - swelling - crepitus - pain w/ stairs
43
osgood schlatter
- tenderness over patellar tendon and tibial tuberosity - antalgic gait - pain w/ **increased activity**
44
leg-calve perthes vs slipped capital femoral epiphysis
- **LCP** - 4-8 YO - short child - femoral head deformity - conservative treatment - achy dull pain - like OA - **SCFE** - 10-15 YO - overweight - displacement of femoral neck - operative treatment - groin pain
45
dupuytrens
- abnormal thickening of tissues in palm of hand
46
swan neck
- caused by damage to extensor mechanism of digit
47
mallet finger
stretching or tearing of extensors mechanism
48
boutonnieres deformity
- extensor tendon injury
49
LE amputation levels
- chopart - below calcaenus - syme's - through ankle
50
K levels
- K1: prosthesis for transfers - K2: walk short distances - K3: variable cadence - K4: high level activities
51
pressure w/ prosthetics
- bony areas are sensitive - fleshier areas are more tolerant
52
transfemoral sockets
- ischial containment - subiscial containment - suction
53
transfemoral suspension
- suction - lanyard
54
transtibial sockets
- patella tendon bearing (PTB) - supracondylar patella tendon (PTS) - supcondylar suprapatellar socket (SC-SP)
55
transtibial suspension
- sleeve - pin - suction
56
types of prosthetic knees
- locked knee: no movement - mechanical: can lock or unlock, swings through w/ gait - piston: can control speed of swing, can lower slower (for downhill) - micro-processor: piston w/ computer
57
58
prosthetic feet
- solid ankle cushion heel (SACH): starter - stationary attachment flexible endoskeleton (SAFE) - single axis: PF and DF - multi axis: all axes of movement
59
lateral bending with prosthetic
- prosthetic causes: too short, bad fit, high medial wall, prosthesis aligned in ABD
60
excess knee flexion in stance with prosthetic
- prosthetic socket forward in relation to foot - foot in excess DF - stiff heel - prosthetic too long - pt causes: flexion contractures, decr quad strength
61
circumduction with prosthetic
- prosthetic too long, too much knee friction, socket too small, excess PF of foot
62
vaulting with prosthetic
- prosthetic too long - bad socket suspension - excessive alignment stability - foot in excess PF
63
forefoot rotation at heel strike with prosthetic
- excessive toe out/in build - loose socket - inadequate suspension - rigid SACH
64
lateral/medial whip with prosthetic
- if it's above knee, it's a prosthetic issue: excess knee rotation, valgus in knee, improper alignment of toe - if it's below knee, it's a patient issue: weak, improper training, knee instability
65
ely's test
- for hip flexion contracture - pt prone
66
ober's test
- test for IT band tightness - pt sidelying w/ hip extended - modified - knee extended for rec fem slack
67
thomas test
- hip flexor tightness - pt supine, single KTC
68
FABER also called
patrick's test
69
craig's test
- femoral anteversion test - pt prone - normal is 8-15 degrees - retrOversion: < 8, toe-Out - inversion: > 15, toe- In
70
barlow's test
- "bad guy" - dislocating - developmental dysplasia of hip w/ shallow, underdeveloped acetabulum - hip begins reduced, PT dislocated
71
ortolani's sign
- "gOOd guy" - (+) is clunk as hip relocates onto acetabulum - hold knees and abduct hip while lifting on greater trochanter
72
slipped capital femoral epiphysis
- "teenagers love skippy PB" - usually at puberty - groin, medial thigh pain, dull, aching, decreased ROM (esp IR)
73
legg-calve-perthes disease
- "limping child problem" - in young children who are small for their age - avascular necrosis of femoral head - goals: matinain femur in acetabulum, WBAT
74
iliopsoas bursitis
- pain/snapping in medial groin, thigh
75
with open chain movement at knee, follow _ rule
- concave
76
knee ROM requirements
77
popliteus
- function: IR and flexion - unlocks knee - OKC - internal rotation of tibia, for initiation of flexus - CKC - external rotation of femur
77
apex of patella
- at bottom
78
slocum's test
- for ACL - pt supine, knee flexed to 90 - medial 30 IR, 15 ER - excessive tibial movement in relation to sound knee
79
ottowa & pittsburgh knee rules
- for after trauma - inability to walk 2 WB steps on affected leg at time of injury and in ED - inability to flex knee to 90 - tenderness over fibular head - isolated patellar tenderness - age > 55 (<12 or >50)
80
for talocrural joint, follow _ rule
convex
81
talipes equinovarus | clubfoot
- congenital - PF, supination, adduction, inversion, cavus, varus - flexible: can be treated with bracing and stretching - rigid: requires surgical intervention
82
metatarsus adductus (hooked forefoot)
- most common foot deviation in children - adducted and supinated - hindfoot spared - 90% causes resolve spontaneously
83
subtalar joint mobilization | posterior compartment
- convex calcaneus, concave talus - LIME - medial glide - increase eversion - lateral glide - increase inversion
84
intertarsal and tarsometatarsal joints
- proximal segment (fixed segment) - convex - distal segment (mobile segment) - concave
85
kleiger test
- ankle ER of talus in mortise - for syndesmosis/high ankle sprain
86
ottowa ankle rules
- fibular tenderness - tibial tenderness - navicular tenderness - 5th metatarsal tenderness - inability to WB immediately after and in ED
87
cervical ROM
- 80-90 flexion - 70 extension - 45 sidebending - 90 rotation
88
vertebral artery test
- turn L to test R - dizziness - diplopia - dysarthria - dysphagia - drop attacks - numbness - nystagmus - nausea - ataxia
89
lhermitte's sign
- MS, cervical myelopathy, trauma - pt seated w/ full neck flexion in long sitting - electric shock-like sensation radiating down spine
90
alar ligament test
- seated, examiner side bends head - alar ligament should move immediately - laxity if C2 does not move w/ rotation or SB
91
sharp purser
- for transverse ligament test - not down syndrome, ehlers danlos, pregnancy, marfan, RA
92
spondylosis
- agre related changes to vertebral discs - DDD - arthritic changes
93
spondylolysis
- bony defect/fx in pars interarticularis (scotty dog fx)
94
spondylolisthesis
- anterior slippage of vertebral segment d/t pars defect - usually in L5-S1
95
ankylosing spondylitis
- chronic rheumatoid disorders, autoimmune - bamboo spine - M > F, 15-30 YO
96
degenerative disc disease
- loss of intervertebral disk height and substance - prefer flexion - L4-L5, L5-S1
97
herniated nucleus pulposus
- prefer extension - SC s/s: weak ankle DF, impaired ankle reflexes, positive crossed SLR test
98
radiculopathy
- nerve root impingement - cervical, thoracic, or lumbar
99
supine to long sit test for rotated innominate
- ALS: anteriorly rotated innominate - longer in supine, shorter in sitting - PSL: posteriorly rotated innominate - shorter in supine, longer in sitting
100
SLR nerve biases
- basic: sciatic and tibial nerves - TED: tibial nerve - eversion, DF - SID: sural - inversion, DF - PIP: peroneal - inversion, PF
101
upglide is like _ and _ facets; downglide is like _ and _ facets
- upglide - like flexion, opens facets - downglide - like etension, closes facets
102
sidebending and rotation coupled motion in spine
- C1/C2 - opposite - cervical and thoracic - same - lumbar - opposite
103
pool water temperature should be
76-95 degrees F
104
precautions for pool therapy
- fear of water - ataxia - seizures - cardiac dysfunction - small wounds (covered)
105
contraindications for pool therapy
- cardiac failure/unstable angina - vital capacity < 1 L (restrictive diseases) - severe peripheral disease - bleeding/hemorrhages - severe kidney disease - open wounds - uncontrolled b/b - infectious disease - uncontrolled seizures
106
WB changes in pool therapy
- C7: 10% WB - xiphoid process: 33% WB - ASIS: 50% WB
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