Semester 2 Ortho Exams
normal elbow ROM: 1. flexion 2. extension 3. supination 4. pronation
1. 145-160 2. 0 3. 80-85 4. 90
name two criteria that should be considered in determining the return to play after concussion
1. athletes physical state; symptoms 2. athletes mental state; confidence and how they feel about returning
which of the following describes the ratio that exists between GH elevation and upward scapular rotation?
2:1
which fingers MCP is not commonly injured
3rd
male patients over what age are more susceptible to bicep tendon ruptures
40
which bone in the hand is involved in a boxer's fracture
5th metacarpal
which cranial nerve is implicated with a positive Romberg test?
8
a "separated" shoulder is a common name for which injury?
AC sprain
which thoracic outlet tests would be positive if compression is by the pectoralis minor
Allen's Test
the circulatory integrity of the hand is examined using what special test
Allen's test
which of the following examination tools allows the athletic trainer to track symptoms of a concussion over time?
BESS test
what injury is a rupture of the central extensor tendon that causes the lateral bands to slip palmerly on each side of the PIP, changing its line of pull on this joint from an extensor to flexor
Boutonniere Deformity
cervical plexus originates from which vertebraes
C1-C4
when the athletic trainer places his or her thumb over the patient's distal bicep tendon and strikes the thumb with the reflex hammer, which nerve level is being evaluated?
C5
injury or trauma to what nerve roots may be indicated by atrophy of the deltoid muscle group?
C5-C6
in a neuro exam specifically at the elbow, what neurological levels are most appropriate
C5-C7
a sensory test over the lateral forearm would identify the dermatome of which nerve root
C6
dermatomal distribution to the index finger and the middle finger and hand area is distributed by which neurological level
C7
during an upper quarter screen, checking the strength of thumb extension correlates to what nerve root?
C8
thumb extension represents the motor nerve test for which nerve root
C8
What is the injury called that is a nonarticular fracture of the radius occurring approximately 1.5 inches proximal to the radiocarpal joint, causing the distal radius to be displaced dorsally?
Colle's fracture
what is the special test used to support or refute the presence of De Quervain's Syndrome
Finkelstein's test
a diminished pulse when completing the military brace position special test would indicate
TOS
valgus stress performed on the elbow is assessing the integrity of which ligament
UCL
you are covering a football game when two players collide. You notice that one player grabs his neck and shakes his arm. When you examine him, he complains of lateral neck discomfort and a feeling of "numbness" or "burning" down his arm. His arm is hanging limp by his side. In a few minutes, his symptoms subside. What do you expect?
a "burner" or pinched nerve syndrome
postural deviations to the cervical and thoracic spine are often functional and are not caused by what: a. activity level b. muscle imbalance c. poor postural habits d. pain
a. activity level
what position should the patient's shoulder be in to manually muscle test the middle deltoids?
abducted to 90
when a patient who suffers a head injury cannot remember events after the injury, the patient is said to be suffering from what?
anterograde amnesia
you have completed the history, inspection, and palpation portions of an on-field evaluation during a soccer game. Thus far, your findings lead you to believe the athlete has a class 1 fracture of a front tooth (no other injuries). What do you do next and why?
because the fracture is only a class 1, tooth fragment will be placed in a tooth safe container (or in whole milk in a sealed bag) until athlete is able to go to the dentist. if the player wants to return to play, they will be given a mouth guard to finish the game.
the radial tuberosity is the insertion site for what muscle
biceps brachii
what is a fracture of the medial wall or floor of the orbit called
blow out
what sports are associated with catastrophic eye injuries?
boxing, racquetball, squash
List the structures within the cubital fossa
brachial artery and its 2 subdivisions, the median nerve, and the musculocutaneous nerve
what muscle is not a typical site for reflex testing of the brachial plexus?
brachioradialis
what is chronic traumatic encephalopathy
brain degeneration likely caused by repeated head traumas
what carpal bone aligns with the third metacarpal
capitate
what is the angle formed by the long axis of the humerus and ulna known as
carrying angle
injury that poses a potential complication to the neurological structure in the cervical spine
chronic cervical joint instability
in determining TOS, special tests attempt to reproduce signs and symptoms that affect
circulation
which of the following mechanisms of injury to the neck poses the greatest risk for catastrophic spine injury?
compression
the immediate, transient, posttraumatic impairment of cerebral function describes which injury
concussion
when the head is moving and strikes an immoveable or slowly moving object, the result is what type of injury?
contrcoup
what is the function of the triangular fibrocartilage complex (TFCC)
decreases loading stress, provides stability during pronation and supination, and stabilizes the distal radioulnar joint
what may be indicated when a patient reports a loss of portions of the visual field, typically described as resembling a shade or curtain being pulled over the eye?
detached retina
what is not a predisposing condition associated with distal biceps tendon ruptures
diabetes
what are the two primary mechanisms of injury for an acromioclavicular joint sprain?
direct blow to the acromion and falling on an outstretched hand
during active range of motion in elbow, limitation can be caused by
direct contact from upper arm with the forearm
which of the following is indicative of a "battle sign" from a head injury?
discoloration behind the ears
preferred elbow and forearm position when testing general elbow flexion for overall strength
elbow flexed to 90 with forearm at midpronation or supination
contraction of the biceps muscle helps to perform what motions
elbow flexion and forearm supination
in order to determine the presence of ulnar nerve compression in the cubital tunnel, what special test would be most useful
elbow flexion test
which of the following tests for rotator cuff pathology?
empty can test
describe the difference between an epidural and subdural hematoma
epidural hematoma Is a hematoma trapped between the dura mater and the skull subdural hematoma is a hematoma trapped between the brain and the dura mater
T/F: a decerebrate posture is identified when there is flexion of the elbows and wrists, clenched fists, and extension of the lower extremity
false
T/F: the otoscope is an instrument used as part of a routine eye examination to examine the inner structures of the eye
false
the athlete may have difficulty performing what actions if the medial and lateral pectoral nerves are injured?
flexion, adduction, and internal rotation of the upper arm
what is a benign collection of thick fluid within a tendinous sheath or joint capsule found on the wrist and hand called
ganglion cyst (Bible cyst)
which motions does eccentric contraction of the latissimus dorsi resist?
glenohumeral external rotation, flexion, abduction
what motions does concentric contraction of the latissimus dorsi produce
glenohumeral internal rotation, extension, and adduction
if there is inflammation of the elbow at the sight of the medial epicondyle of the elbow, what injury would you expect
golfer's elbow
what is the common name for medial epicondylitis
golfer's elbow
what test is used to determine whether cerebrospinal fluid (CSF) is present in fluids leaking from a head-injury patient's nose or ears?
halo's test
the device used to measure grip strength is
hand dynamometer
during passive ROM in elbow and forearm, what physiological end feel would be produced during forearm pronation
hard end point
list two tests used to identify an impingement syndrome in the shoulder
hawkins kennedy and shear's test
a cranial nerve check examines the integrity of the nerves that provide sensory and motor function to which area?
head
To properly check cranial nerve 8, the examiner should check what?
hearing and balance
observations of mild brain injury may include all of the following signs and symptoms except
hunger
in order to prevent lateral epicondylitis, what actions should be avoided via technique motion
hyperextension of the wrist when performing a backhand shot in tennis
injury characterized by blood in the anterior chamber of the eye
hyphema
when checking pupillary reaction, what is considered a positive test?
if the pupils do not react to light or if they do not constrict or dilate along with the other eye
emergency action is required for all of the following progressive signs and symptoms of head trauma EXCEPT
increased, irregular respirations
what muscle aids in glenohumeral external rotation
infraspinatus
what are the rotator cuff muscles
infraspinatus, supraspinatus, subscapular, and teres minor
which of the following tests for rotator cuff pathology?
kennedy hawkins test
a baseball player comes to see the athletic trainer and is complaining of diffuse pain, clicking, and a sensation of "slipping" of his right shoulder when throwing. What pathology might the athletic trainer suspect with this type of presentation?
labral pathology
what is the treatment for a patient who has an object that is impaled in the eye?
leave the object in place, stabilize it, and cover both eyes for transportation
severe winging of the scapula can occur from injury to what nerve?
long thoracic
a ball that inadvertently strikes the tip of an extended finger can cause what injury
mallet finger
a tongue blade test is commonly used to rule out what type of fracture
mandibular
a direct blow to the ulnar nerve will distribute pain signs and symptoms along the
medial forearm into the 4th and 5th fingers
a reverse Phalen's test is used to assess which nerve
median
which nerve supplies the primary innervation for wrist flexion and radial deviation
median
which nerve travels through the carpal tunnel in the wrist
median
neurocognitive tests used to determine cognitive function after a concussion are used in relation to
memory
most common fracture site of the clavicle
middle
which special test would be best for detecting chronic tears in the UCL
moving valgus (gold standard), valgus, and milking maneuver
what are you looking for when assessing eye movement
normal - in sync, bilateral eye movement ; abnormal - nystagmus, eye shaking, one or both eyes lacking movement
in conducting a clinical history for a cervical spine injury, the examiner would be most concerned with what signs and symptoms
numbness
which special test is performed by running a blunt object or fingernail across the crest of the anteromedial tibia of a patient who has suffered an acute head or spinal injury?
oppenheim test
cranial nerves responsible for eye movement
optic, occulomotor, abducens, and trochlear
patients with rotator cuff injury frequently describe which of the following complaints?
pain with sleeping, pain with arm elevation, and pain in the anterior shoulder
name a muscle of the wrist flexor group that is not present in everyone
palmaris longus
what is an infection around the periphery of the fingernail that results in redness and swelling
paronychia
for which muscle does the coracoid process serve as the point of insertion?
pectoralis minor
what is the difference between post-concussion syndrome and second impact syndrome?
post concussion syndrome: occurs when concussion symptoms last beyond the expected recovery period after the initial injury second impact syndrome: happens when the brain swells rapidly shortly after a person suffers a second concussion before symptoms from an earlier concussion have subsided
which directional force on the sterno-clavicular joint is potentially a medical emergency?
posterior
which two tests can be used to evaluate posterior GH instability?
posterior drawer and internal rotation apprehension
what is not a correct position in performing the test for lateral epicondylalgia
pt positioned with elbow flexed and forearm supinated
which ROM is not initially needed during the early stages of an examination and may actually contribute to further pain and possible injury
resistive
what is the term for the inability to recall events before the onset of a head injury?
retrograde amnesia
special tests for brachial plexus injuries are positive when....
right and left side differ in symptom reproduction
what is the pain during the follow-through phase of the pitching motion commonly associated with?
rotator cuff pathology
what is the most commonly fractured carpal bone in the hand
scaphoid
which carpal bone is palpable as the floor of the anatomical snuff box
scaphoid
to test the function of the rhomboid major muscle, the athletic trainer should ask the patient to perform what movement?
scapular retraction
which assessment can quickly assess or determine a patient's analytical skills?
serial 7's test
which of the following tests is used to assess inferior instability of the acromioclavicular joint?
shear's test
in what special test does a patient actively abduct an arm so that the hand rests on top of the head and must maintain this position for 30 seconds to determine whether a nerve root compression exists?
shoulder abduction
what is the typical mechanism of injury for an anterior shoulder dislocation?
shoulder abduction with external rotation
what is the name of a radial fracture that displaces palmarly
smith's fracture
which of the following tests can be used to identify biceps brachii tendinitis
speed's test
which of the following tests for biceps tendon / glenohumeral labral pathology?
speed's test
which of the following bones is not part of the shoulder girdle? a. sternum b. clavical c. scapula d. humerus e. all of the above
sternum
which neurovascular structures exit through the thoracic outlet
subclavian vein, subclavian artery, and brachial plexus
which of the following tests for glenohumeral instability?
sulcus sign
which of the following tests is used to assess inferior instability of the glenohumeral joint?
sulcus sign
anterior apprehension test is used to reproduce symptoms associated with the athlete in what position
supine with arm at 90 of abduction and external rotation
the anterior apprehension test is used to reproduce symptoms associated with the athlete in what position?
supine with arm at 90 of abduction and external rotation
which of the following conditions often contributes to shoulder impingement?
suprascapular nerve entrapment
tears most commonly occur in which rotator cuff muscle?
supraspinatus
the Empty Can test assesses the integrity of what muscle?
supraspinatus
list three structures that are typically involved in an impingement syndrome.
supraspinatus, subacromial bursa, and long head of biceps tendon
the radioulnar joints are classified as what type of joint
syndesmotic
when testing for paresthesia of the C5 nerve root, where should the athletic trainer perform pinprick testing?
the lateral aspect of the upper arm over the middle deltoid
the shoulder region is a location for referred pain from which anatomic area
the visceral organs and the cervical spine
acute tearing or stretching of the UCL in the elbow joint can occur from what mechanism of injury
throwing motion
the flexor pollicis longus is responsible for what movement
thumb flexion
what does a positive Drop Arm sign indicate?
torn rotator cuff muscle
a congenital or acquired spasm of the sternocleidomastoid muscle that causes rotation of the chin opposite the side of the tilt is common referred to as what
torticolis
which ligament forms the roof of the carpal tunnel
transverse carpal
what plane does shoulder external rotation occur in
transverse plane
what wrist pathology is commonly associated with clicking on the ulnar side of the wrist
triangular fibrocartilage tear (TFCC)
T/F: athletes with a history of multiple concussions can show signs and symptoms of a concussion in the absence of a recent concussion
true
T/F: proper concussion management, including rest until all symptoms resolve, would be followed by a graduated return to play protocol before full return to activity
true
T/F: the classic sign of the inability to look up is consistent with an orbital blow-out fracture
true
describe the 3 types of le fort fractures
type 1: fracture through the maxilla type 2: fracture though the maxilla, up into the nasal bone type 3: fracture through both the maxilla and the nasal bone, up into the zygomatic region
what is the nerve that innervates the flexi carpi ulnaris muscle and the medial portion of the flexor digitorum profundus in the forearm
ulnar
which would indicate a life-threatening condition: a. hot, moist lips and face b. bleeding c. unusual body posturing d. vomiting
unusual body posturing
dizziness or nystagmus caused by passive neck extension, lateral flexion, and eventual rotation are signs and symptoms implicating the
vertebral artery
what special test indicates a scapholunate ligament injury
watson test
briefly describe how the rotator cuff works to stabilize the glenohumeral joint?
works to stabilize the GH joint by surrounding the joint in muscles to assure to humerus stays in place while allowing for movement
what is not included when extending the elbow during the pivot shift test
wrist flexion or extension
which of the following tests for biceps tendon / glenohumeral labral pathology?
yorgaon's test
T/F: To assess for concussion, one shoulder monitor changes in pulse, blood pressure, and respiration
true
T/F: a postitive cervical distraction relief test occurs when nerve pain is reduced or subsides
true
T/F: athletes who lose consciousness, no matter how short in time, should be seen by a physician
true
T/F: scapular dyskinesis is considered a source of internal impingement
true
an articular hematoma, or cauliflower ear, results from friction or repetitive trauma to the external ear
true
all of the following are tests used to identify thoracic outlet syndrome except: a. allen's b. adson's c. andrew's d. military brace
andrew's
in what direction is the shoulder most commonly dislocated?
anterior
which of the following tests the patient's active range of motion?
apley's scratch
an epiphyseal plate injury that is secondary to a fracture of the lateral epicondyle can result in what abnormality
cubital valgus
when checking pupillary reaction, what is considered a positive test
if the pupil does not react to light, or dilate and constrict the same time as the other when compared bilaterally
the difference between a nerve root injury in the cervical spine and a brachial plexus stretch in the shoulder is that the brachial plexus injury will be characterized by
I got this wrong so idk.. but i know its not loss of shoulder function.. its either a single nerve root or multiple nerve roots :)
during passive ROM in elbow, what type of end feel would you normally expect with extension
firm
what is the superior section of the sternum anatomically known as
manubrium
MMT wrist extension will examine motor function of which peripheral nerve
radial
trauma or pathology to which nerve results in a drop-wrist deformity
radial
describe the difference between shoulder impairments and limitations, provide specific examples of each.
shoulder impairments: inflammation of the acromioclavicular capsule causing impingement shoulder limitations: weak/tight rotator cuff muscles causing lack of mobility or weak muscles causing instability
what is the only member of the rotator cuff group that internally rotates the humerus?
subscapularis
which of the following muscles does NOT adduct the shoulder?
subscapularis
the deep branch of what nerve innervates the hypothenar eminence
ulnar
