Term
| WIth avascular necrosis, hip ROM is decreased in what 3 motions? |
|
Definition
|
|
Term
| With Legg-Calve-Perthe's disease, what is the cause, presentation, & limitations in ROM? |
|
Definition
have inadequate blood supply to part of hip & bone can become unstable, break easily, and heal poorly. weakness of psoas major - affected LE moves in flexion, adduction, & ER - limited in extension & ABD
see positive bony crescent sign - collapse of subchondral bone at femoral neck/head |
|
|
Term
| List the hip ROM limitations with SCFE. |
|
Definition
| hip abduction, flexion, & IR |
|
|
Term
| What is considered "exessive anteversion"? |
|
Definition
|
|
Term
| What does excessive femoral anteversion lead to? |
|
Definition
| squinting patellae & in-toeing. |
|
|
Term
| List the values that define coxa vara & valga. |
|
Definition
<120 - coxa vara
>135 - coxa valga |
|
|
Term
| coxa vara usually occurs from a defect with what? |
|
Definition
| ossification of the femoral head |
|
|
Term
| The piriformis can become overworked with what motion of the foot? |
|
Definition
| overpronation. - causes tibial and femoral internal rotation. |
|
|
Term
| With piriformis syndrome you will see a _______ in internal rotation & weakness in _______. |
|
Definition
| restriction, external rotators |
|
|
Term
| List the 3 classifications of knee ligament sprains. |
|
Definition
1st - little or no instability
2nd - mild to moderate instability
3rd - severe instability |
|
|
Term
|
Definition
| abnormal superior tracking of the patella - could result in chronic patellar subluxation & positive camel-back sign - two bumps over anterior knee region instead of 1 - first is patella & 2nd is tibial tuberosity |
|
|
Term
|
Definition
| abnormal inferior patellar tracking - results in restricted knee extension with abnormal cartilaginous wearing resulting in DJD |
|
|
Term
| Lateral patellar tracking could result if there is an increase in _____ with a tendency for lateral subluxation or dislocation. |
|
Definition
|
|
Term
| Diagnostic tests utilized for patellofemoral conditions include ____ view x-ray. |
|
Definition
|
|
Term
| Normal tibiofemoral shaft angle is _____. |
|
Definition
|
|
Term
| Genu varum is an excessive _____ tibial torsion commonly referred to as "bowlegs". Results in excessive _____ patellar positioning & pigeon-toed orientation of feet. |
|
Definition
|
|
Term
| Genu valgum is an excessive ____ tibial torsion commonly referred to as "knock-knees." Results in excessive _____ patellar positioning. |
|
Definition
|
|
Term
| Which femoral condyle is most often involved in fractures? |
|
Definition
|
|
Term
| What is a common MOI for a tibial plateau fracture? |
|
Definition
| combo of valgum & compression forces to knee when the knee is in a flexed position. |
|
|
Term
| What muscles are involved with anterior tibial periostitis? |
|
Definition
| tibialis anterior and extensor hallucis longus |
|
|
Term
| What muscles are involved with medial tibial stress syndrome? |
|
Definition
| posterior tibialis & medial soleus |
|
|
Term
| What percentages of stress fractures occur in the tibia & fibula? |
|
Definition
|
|
Term
| 95% of all ankle sprains involve the ____ ligaments. |
|
Definition
|
|
Term
| WIth lateral sprains, the foot is ____ & ____ at the time of injury. |
|
Definition
|
|
Term
| List the grading system for ankle sprains. |
|
Definition
Grade I: No loss of function with minimal tearing of ATF ligament
Grade II: some loss of function with partial disruption of the ATF & calcaneofibular ligament
Grade III: Complete loss of function with complete tearing of the ATF & calcaneofibular ligaments with partial tear of the posterior talofibular ligament. |
|
|
Term
| Trimalleolar fracture involves the medial & lateral malleoli, & the _____. |
|
Definition
| posterior tubercle of the distal tibia. |
|
|
Term
| What is the difference between postural and talipes equinovarus? |
|
Definition
postural equinovarus results from improper positioning in utero
Talipes equinovarus is an abnormal development of the head of the talus |
|
|
Term
| What is the observed deformity with equinovarus and equinus? |
|
Definition
equinovarus - adduction, plantarflexion & inverted foot
equinus - plantarflexion (either of forefoot or rearfoot) |
|
|
Term
| Describe the observed deformity of hallux valgus. |
|
Definition
| medial deviation of the head of the first metatarsal from the midline of the body: metatarsal & base of proximal first phalanx moves medially, distal phalanx moves laterally. |
|
|
Term
| List the mechanical and structural causes of metatarsalgia. |
|
Definition
mechanical: tight triceps surae group and/or Achilles tendon, collapse of transverse arch, short first ray, pronation of forefoot
Structural: changes in transverse arch possibly leading to vascular and/or neural compromise in tissues of forefoot |
|
|
Term
| Describe the observed deformity of metatarsus adductus. |
|
Definition
Rigid: medial subluxation of the TMT joints - hindfoot is slightly in valgus with navicular lateral to the head of the talus
Flexible: adduction of all five metatarsals at the tarsometatarsal joints |
|
|
Term
| List the cause of Charcot-Marie-Tooth disease & its progression. |
|
Definition
peroneal muscular atrophy that affects motor & sensory nerves
initially affects the muscles in the lower leg & foot, but eventually progresses to muscles of the hand and forearm |
|
|
Term
| List the differential diagnosis for esophageal cancer. |
|
Definition
| Difficulty swallowing, pain radiating to the back, dysphagia, & weight loss |
|
|
Term
| List the differential diagnosis for pancreatic cancer. |
|
Definition
| Deep gnawing pain that may radiate from chest to back. |
|
|
Term
| List the manifestations of acute pancreatitis. |
|
Definition
| mid-epigastric pain that radiates through the back. |
|
|
Term
| List the manifestations of cholecystitis. |
|
Definition
| severe abdominal pain & RUQ tenderness, nausea, vomiting, & fever. |
|
|
Term
| AAA can manifest itself as _______. |
|
Definition
|
|
Term
| Primary joint glide of the TMJ is ____. What does this glide do? |
|
Definition
| inferior - gaps joint, stretches capsule, & allows relocation of anteriorly displaced disc |
|
|
Term
| What is Rocobado's jaw opening exercise? |
|
Definition
| jaw opening while maintaining the tongue in contact with the palate & isometric mandibular exercises |
|
|
Term
| What is the "gold standard" test to diagnose a RC tear? |
|
Definition
|
|
Term
| Describe rehab for early flexor tendon repairs in terms of how long the patient is immobilized, in what position, & what motions are initially contraindicated. |
|
Definition
First 3-4 wks, distal extremity is immobilized with a protective spint that keeps IP joints in 30-50 deg. flexion with rubber bands
Resisted extension and passive flexion can be performed within contraints of splint
active extension initiated before active flexion |
|
|
Term
| Describe extensor tendon repairs in terms of how long the patient is immobilized and in what position, and what motions are originally contraindicated. |
|
Definition
Patient is placed in a splint with DIP at neutral for 6-8 weeks. Active extension is initiated first, then flexion
Proximal repairs are immobilized with the wrist and digital joints in extension for 4 weeks |
|
|
Term
| Briefly describe the differences between cemented and non-cemented THA patients. |
|
Definition
cemented hips can tolerate FWB immediately following surgery, but can crack with age, causing a loosening of the prosthesis - better for patients with fragile bones or would benefit from ability to immediately bear weight
Non-cemented technique is more stressful on bones during surgical procedure, but is better for younger/more active individuals. |
|
|
Term
| List the hip precautions after a THA & how long they must be implemented. |
|
Definition
| No hip flexion past 90 deg., IR, or ADD for 3-6 months post-op |
|
|
Term
| With a hip ORIF following fracture, how long are patients typically NWB? |
|
Definition
| 1-2 weeks and then PWB as tolerated. |
|
|
Term
| With cemented vs. non-cemented THA patients, how long are they non weight-bearing? When can each ambulate? When are they FWB? |
|
Definition
Cemented - PWB for 3 wks, then cane at 4, and FWB at 5
Non
WBAT - PWB for 3, cane at 4, FWB at 6
TDWB - 1/3 wb at 6 wks, 2/3 at 8 wks, FWB week 10, cane week 12, no AD after that. |
|
|
Term
| Describe cement vs. non cement prosthesis for TKA. |
|
Definition
Cement - WBAT after surgery
Non-cement - wb-ing 1-7 weeks 25%, 8 - 50%, 75% at week 10, & 100% w/o AD by week 12 |
|
|
Term
| List the ROM goals for weeks 1-2 & 3-4 after TKA. |
|
Definition
1-2 - 0-90 deg. - don't want to go past 90 b/c of constraints of prosthesis
3-4 - 0-120. |
|
|
Term
| Describe general procedure for ACL & PCL repair patients. |
|
Definition
ACL - CPM utilized after surgery for PROM 0-70, increased to 0-120 by week 6, reconstruction is protected with hinged brace set at 20-70 deg. flexion initially, NWB week 1 and progresses after that to WBAT to full, weaned from brace btwn weeks 2-4.
PCL - same but brace is set at neutral (0 deg.) |
|
|
Term
| When is a lateral retinacular release of the knee performed? |
|
Definition
| as a result of patellofemoral pain syndrome - purpose is to restore normal tracking of the patella during contraction of quads |
|
|
Term
| Describe rehab for a partial meniscectomy vs. menicsus repair. |
|
Definition
partial meniscectomy - PWBAT when full knee ext. is obtained - AROM post-op day 1, strengthening by day 3, & later jogging on heel or ball of foot to decrease loading of knee joint
Repairs - NWB 3-6 weeks, rehab begins 7-10 days after |
|
|
Term
| WIth multilevel vertebral fusions, typically ___ weeks of trunk immobility with bracing is required. |
|
Definition
|
|
Term
| With a particular technique during spinal surgery, bracing is seldom used post-op. What is this technique? |
|
Definition
| combined anterior/posterior surgical approach |
|
|
Term
| Describe early rehab after Harrington rod placement. |
|
Definition
| focus is on coughing ability and bed mobility - ambulation is permitted 4-7 days post-op |
|
|
Term
| What is the Feldenkrais technique? |
|
Definition
| facilitates development of normal movement patters - use skillful, supportive, gentle hands to create a sense of safety, maintain supportive contact, while introducing new movement possibilities in small, easily available increments. |
|
|
Term
| Breifly list some pros/cons for Hamstring vs. Patellar tendon ACL grafts. |
|
Definition
Hamstring: Pros: typically fewer symptoms post-op, greater return to pre-injury level, allows earlier rehab
Cons: expensive, more difficult technique, rehab is slower
Patellar tendon: less expensive, better at maintaining graft tension post-op, faster healing time
Cons: increased potential for ant. knee pain & later patellofemoral osteoarthrosis, increased potential for knee extension deficit, & potential delay in rehab secondary to more atrophy of quads. |
|
|
Term
| List adverse side-effects of COX-1 & COX-2 inhibitors. |
|
Definition
NSAIDS
COX-1 - general - GI irritation, fluid retention, renal or liver problems, and prolonged bleeding
COX-2 - selective - decreased GI side-effects, but can cause heart-related conditions (Celebrex, Bextra) |
|
|
Term
| List examples & adverse side effects of muscle relaxants. |
|
Definition
Cyclobenzaprine HCl (Flexeril), Methocarbamol (Robaxim), & carisoprodol (Soma)
drowsiness, lethargy, ataxia, & decreased alertness |
|
|
Term
| List the adverse side effect of too much acetaminophen. |
|
Definition
| liver disease or acute liver shutdown |
|
|
Term
|
Definition
| evaluation of amount of pressure the patient's heels place on the therapist's hands when the patient is asked to raise one LE in the supine position. |
|
|
Term
| What is the functional unit of the nervous system? |
|
Definition
| neuron - have nerve cell body, dendrites, & axon. |
|
|
Term
|
Definition
| non-neuronal cells that provide services to neurons (protect, nourish, support) |
|
|
Term
| white matter is composed of ____ & ____. |
|
Definition
|
|
Term
| List the different names of bundles of myelinated axons that travel together in the CNS. |
|
Definition
| tract, peduncle, column, capsule, lemniscus, fasciculus |
|
|
Term
| What is gray matter composed of? |
|
Definition
|
|
Term
| groups of neuron cell bodies in the CNS are called _______ & in the PNS they are called ______. |
|
Definition
|
|
Term
| gray matter on the surface of the brain is called ____. |
|
Definition
| cortical matter or cortex |
|
|
Term
| The axons in white matter _____. What does the gray matter do? |
|
Definition
convey information along parts of the nervous system
gray - information is integrated here. |
|
|
Term
| The spinal cord runs from the foramen magnum to the level of the ____ lumbar vertebra & ends in the ______. |
|
Definition
|
|
Term
| How many cranial nerves exit from the medulla? the pons? the midbrain? |
|
Definition
medulla - 4
pons - 4
midbrain - 2 |
|
|
Term
| The anterior portion of the midbrain features what? What about the posterior midbrain? |
|
Definition
anterior - two cerebral peduncles
posterior - tectum of midbrain has four small rounded bodies - two superior & two inferior colliculi |
|
|
Term
| Where are the colliculi and what are they important in functioning? |
|
Definition
| auditory & visual stimuli - tectum of midbrain |
|
|
Term
| List the purely sensory cranial nerves. |
|
Definition
| olfactory (I), optic(II), verstibulocochlear (VIII) |
|
|
Term
| List the motor only cranial nerves. |
|
Definition
| oculomotor (III), trochlear (IV), abducens (VI), acessory (XI), & hypoglossal (XII) |
|
|
Term
| List the mixed cranial nerves. |
|
Definition
| Trigeminal (V), Facial (VII), Glossopharyngeal (IX), Vagus (X) |
|
|
Term
| List the function of the first 4 cranial nerves. |
|
Definition
Olfactory - sense of smell
Optic - sight
Oculomotor - eye movements - moves eyes up, down, medially, raises upper eyelid, & constricts pupil
Trochlear - moves eye medially & down |
|
|
Term
| List the function of cranial nerves V-VIII. |
|
Definition
Trigeminal nerve - facial sensation, chewing, & sensation from TMJ
Abducens - abducts eye
Facial - facial expression, closes eyes, tears, salivation, & taste
Vestibulocochlear - sensation of head position relative to gravity & head movement & hearing |
|
|
Term
| List the function of cranial nerves IX-XII. |
|
Definition
Glossopharyngeal (IX) - swallowing, salivation, & taste
Vagus (X) - regulates viscera, swallowing, speech, & taste
Accessory (IX) - elevates shoulders, turns head
Hypoglossal (XII) - tongue movements |
|
|
Term
| The superior, middle, & inferior ______ join the midbrain, pons, & medulla to the cerebellum. |
|
Definition
|
|
Term
| List the four structures that make up the diencephalon. |
|
Definition
| thalamus, hypothalamus, epithalamus, & subthalamus |
|
|
Term
| List the purpose of the thalamic nuclei. |
|
Definition
relay info the the cerebral cortex, process emotional & some memory information, integrate sensation, regulate consciousness, arousal, & attention
hypothalamus maintains body temp., metabolic rate, & chemical composition of tissues & fluids within optimal range - also regulates eating, reproduction, defensive behaviors, expression of emotions, growth, & function of reproductive organs
epithalamus consists of primarily pineal gland - influences secretion of other endocrine glands, including the pituitary & adrenal glands
subthalamus - part of a neural circuit controlling movement |
|
|
Term
| What are the six lobes of the brain? |
|
Definition
| frontal, parietal, temporal, occipital, limbic, insula |
|
|
Term
| The entire surface of the cerebral hemispheres is composed of gray matter. Deep to the cortex is white matter. What are collections of white matter fibers in this region that are of particular interest? |
|
Definition
| commissures (corpus callosum) - bundles of axons that convey info between right & left cerebral hemispheres & internal capsule- axons projecting from cerebral cortex to subcortical structures & vice-versa - has ant. & post. limbs with a genu (bend) between them |
|
|
Term
| Within the white matter inside the gray matter of the cerebral hemispheres, there is additional gray matter, the most prominent being the basal ganglia. What are the basal ganglia nuclei? |
|
Definition
putamen, globus pallidus, caudate, subthalamic, & substantia nigra
putamen + globus pallidus = lenticular nucleus
putamen + caudate = corpus striatum |
|
|
Term
| where is the substantia nigra located? |
|
Definition
|
|
Term
| The lateral ventricles are connected to the third ventricle by the _______. |
|
Definition
| interventricular foramina |
|
|
Term
| The third & fourth ventricles of the brain are connected by the ____. |
|
Definition
|
|
Term
| Describe the falx cerebri & the tentorium cerebelli. What layers of the meninges do they arise from? |
|
Definition
| both dura mater projections - falx cerebri separates the two cerebral hemispheres; tentorium cerebelli separates the posterior cerebral hemispheres from the cerebellum. |
|
|
Term
| List the blood supply to the spinal cord. |
|
Definition
the posterior spinal arteries supply posterior third of cord, anterior supplies anterior 2/3 (both branches of vertebral artery)
also supplied by medullary arteries |
|
|
Term
| List the three main branches of the vertebral artery & what they supply. |
|
Definition
anterior spinal arteries - spinal cord
posterior spinal arteries - spinal cord
posterior inferior cerebellar artery - inf. cerebellum
all three branches supply medulla |
|
|
Term
| List the branches of the basilar artery & what they supply. |
|
Definition
anterior inferior cerebellar artery - most of cerebellum
superior cerebellar artery
- both supply pons |
|
|
Term
| At the junction of the midbrain & pons, the basilar artery divides to become the _______, which supply what? |
|
Definition
| posterior cerebral arteries - primary blood supply to midbrain, occipital lobe, medial & inferior temporal lobes |
|
|
Term
| What forms the circle of Willis? |
|
Definition
| anterior & posterior cerebral arteries, internal carotid artery, & ant. & post. communicating branches. |
|
|
Term
| List what the anterior cerebral artery supplies. |
|
Definition
| medial surface of the frontal & parietal lobes. |
|
|
Term
| List what the MCA supplies. |
|
Definition
| internal capsule, globus pallidus, putamen, caudate - most of lateral hemisphere |
|
|
Term
| The anterior choroidal artery is a branch of the ______, and supplies... |
|
Definition
internal carotid
supplies choroid plexus of lat. ventricle, parts of visual pathway (optic tract & radiations), putamen, thalamus, internal capsule, & hippocampus |
|
|
Term
| What results from damage to the oculomotor nerve? |
|
Definition
| ptosis, dilation of pupil, loss of accomodation to light reflex |
|
|
Term
| What results from damage to the trochlear nerve? |
|
Definition
| failure to rotate the eye up & out (innervates superior oblique) & diplopia |
|
|
Term
| What results from damage to the abducens nerve? |
|
Definition
| medial strabismus, diplopia, & abductor paralysis in ipsilateral eye |
|
|
Term
| What vertebral level is the spine of the scapula? |
|
Definition
|
|
Term
| What vertebral level is the xiphoid process of the sternum? |
|
Definition
|
|
Term
| What landmarks are at T10? |
|
Definition
|
|
Term
| What vertebral level is the iliac crest located? |
|
Definition
|
|
Term
| What vertebral level is the PSIS? |
|
Definition
|
|
Term
| What is the capsular pattern of the hip? |
|
Definition
|
|
Term
| What is the capsular pattern for the toes? |
|
Definition
|
|
Term
| List areas on the body that correspond to dermatomes C2-T1 & L2-S2. |
|
Definition
C2 - occiput
C3 - sides of neck
C4 - tops of shoulders
C5 - front of biceps
C6 - thumb
C7 - digits 2 & 3
C8 - digits 4 & 5
T1 - upper chest
L2 - upper thigh - swoops down medially
L3 - just above knee on medial side swoops down to medial knee
L4 - anterior surface of knee over patella swoops down and in over medial tibia
L5 - web space and most of dorsum of foot
S1 - lateral calf (posteriorly)
S2 - medial calf (posteriorly) |
|
|
Term
| Anticholinergic drugs (benztropine, oxybutynin, & Artane) for muscle spasm or PD can have side effects such as ____, ____, ___, & _____. What are signs of toxicity. |
|
Definition
dry skin, no sweating, palpitations, mental status changes
toxicity causes patient to be dry, hot , & mad |
|
|
Term
| List the cord levels for the following reflexes: biceps, brachioradialis, triceps, patellar tendon, Achilles tendon. |
|
Definition
biceps (C5)
brachioradialis (C6)
triceps (C7)
patellar tendon (L3-4)
Achilles tendon (S1-2) |
|
|
Term
|
Definition
1: in neutral, spinal segments side-bend & rotate to opposite sides
2: in flexion or extension, side-bending occur to the same side
3: taking up a segment with one motion limits the other two motions |
|
|
Term
| What indicates denervation during a nerve conduction velocity test? What about reinnervation? No denervation (neuropraxia)? |
|
Definition
denervation - spontaneous fibrillation potentials & positive sharp waves on EMG 2-3 wks after injury
reinnervation - polyphasic motor units of low amplitude & short duration
Neuropraxia - no spontaneous activity |
|
|
Term
| Piriformis can be overworked with excessive foot ____, which causes abnormal femoral _____ rotation. Signs & symptoms of piriformis syndrome include restriction in hip ____, pain with palpation of piriforms, referral of pain to ____, & weakness in ____ with positive piriformis test |
|
Definition
pronation, internal
internal rotation, posterior thigh
external rotation |
|
|
Term
| Describe the piriformis test. |
|
Definition
| Patient supine with foot of test leg passively placed lateral to opposite limb's knee - testing hip is adducted - observe position of testing knee relative to the opposite knee - positive if the testing knee is unable to pass over the resting knee and/or reproduction of pain in the buttock or along sciatic nerve distribution. |
|
|
Term
| With a L scoliosis, what happens to the L shoulder, L scapula, & L hip? |
|
Definition
| L shoulder elevated, L scapula is prominent & protruding, L hip normal - would be R hip protruding |
|
|
Term
| List the muscles and cord levels for the UE & LE muscles with the ASIA scale. |
|
Definition
UE
C5 - elbow flexors
C6 - wrist extensors
C7 - elbow extensors
C8 - finger flexors
T1 - finger ABD
LE
L2 - hip flexors
L3 - knee extensors
L4 - DF
L5 - great toe ext.
S1 - plantar flexion |
|
|
