Eval Upper Final

The stress placed on the lumbar intervertebral disks when a person is sitting and leaning forward increases to what amount?

275 kg of pressure

What is the amount of stress placed on lumbar intervertebral discs when a person is supine?

75 kg of pressure

W, H, F vascular

Capillary refill Radial artery

A positive Phaelen's sign is suspect of what problem?

Carpal tunnel syndrome

What spinal motion is limited by the poster longitudinal ligament? (PLL)

Flexion

Which special test is used to place a rotary stress on the SI joint by forcing one hip into hyper extension?

Gaenslen's

The scapula fosse that articulates with the humerus is deepened by an additional structure called the?

Glenoid labrum

Which of the following exercises should be avoided during the initial stage of rehab program for an athlete with an acute sublux of the GH joint?

Grade 2 joint mobs

When testing for paresthesia of the C5 nerve root, where should the AT perform pinprick testing?

The lateral aspect of the upper arm over the medial deltoid

All of the following muscles are intrinsic muscles of the hand except:

The multifidi muscles

Elbow palpation anterior

Cubital fossae: Biceps Brachial Artery Median Nerve Musculotaneous nerve

Spondylosis is a condition in which?

Extension increases pain and should be avoided

Which muscles is usually affected with tennis elbow?

Extensor carpi radialis brevis

All of the following muscles are innervated by the ular nerve except?

Extensor carpi ulnaris

True or False: A Fracture that extends into enamel is considered dental emergency

False

True or false: Corman's exercises are performed with active movement of the shoulder muscles to increase shoulder motion?

False

True or false: Strengthening exercises should begin above 90 degrees to maximize scapular muscle activity?

False

True or false: The external rotators of the glenohumeral joint eccentrically contract during the cocking phase of throwing?

False

True or false: The rotator cuff muscle most commonly injured acutely is the infraspinatus?

False

Ligament that connects lamina to adjacent vertebrae?

Ligamentum Flavum

Ligament that forms posterior margin of vertebral canal?

Ligamentum Flavum

Your athlete comes to the TR after injuring his neck and left arm. You suspect involvement of the C5,6 nerve root. Which of the following actions would not be involved with an injury to a muscles with this innervation?

Little finger abduction

Which of the following signs and symptoms BEST describes the finding associated with a moderate (grade 2) AC joint sprain?

Localized swelling, palpable step-off at joint, pain with arm AROM, traction test increases pain, and deformity

Which of the carpal bones is most commonly dislocated?

Lunate

Strain vs. Counterstrain

Manual therapy technique having the patient lay in a comfortable position is the counter strain technique. Their pain should be diminished. Straining a tissue abruptly will in return, cause counterstrain on an opposing tissue

Mackenzie Extension vs. Williams flexion?

McKenzie ext. is for patients experiencing lower back pain. The treatment is a technique of self-treatment for the patient. McKenzies approach relies on directional preference. Williams flexion exercises are working more in flexion and having the patient do a series of exercises, rather than laying in one position to relieve pain.

What is the last growth plate in the body to close?

Medial clavicular epiphysis

Elbow palpation medial

Medial epicondyle Ulnar collateral ligament Wrist flexor muscles: pronator teres, flexor carpi radialis, palmares longus, flexor carpi ulnaris

What is inflammation of the common flexor origin of the forearm musculature called?

Medial epicondylitis

What nerve passes through the carpal tunnel?

Median

Lumbarization is the term used to describe which of the following conditions?

Mobility of the first sacral vertebrae

What two structures pass through the tunnel of Guyon?

Ulnar nerve and ulnar artery

Anisocoria describes a patient suffering from?

Unequal pupils

What is the usual mechanism of injury for a Colles' fracture?

A fall on an outstretched arm and hand

A "separated" shoulder is a common name for which injury?

AC sprain

Which of the following muscles abducts the little finger of the hand?

Abductor digiti minimi

What is the function of the intervertebral discs?

All of the above

The most common direction for the glenohumeral joint to dislocate is?

Anterior

You are completing a D2 upper extremity proprioceptive neuromuscular facilitation strengthening pattern with an athlete. While performing D2 flexion, the athlete is not completing the required shoulder motion. What adjustment should you make to improve this exercise?

Apply pressure on the medial wrist and encourage flexion and adduction.

Your patient is diagnosed with disc herniation. Please discuss what muscles to avoid, what muscles to strengthen, what muscles to stretch, and what exercises can accomplish this task.

Avoid: muscles that put them in extension (erector spinae; illiocostalis) Strengthen: abdominal muscles quads, and hip flexors Stretch: hamstrings and quads, hip flexors Exercises: bird dogs, dead bugs, hip thrusts, plank, ball passing from hands to feet

Basketball player sustain finger injury while attempting to catch the ball. During your exam, you observe that the athlete is unable to extend the distal phalanx and the tip of his finger is positioned in approx 30 degrees of flex. You determine the athlete has a mallet finger. This injury is caused by which of the following?

Avulsion of the extensor tendon from its insertion

The acceleration phase ends when the?

Ball is released

What muscle supinates the forearm and flexes the shoulder?

Biceps Brachaii

Resisted ROM Elbow

Biceps- C6- Elbow flexion with forearm supinated Brachialis- Elbow flexion with forearm pronated Brachioradialis- Elbow flexion with forearm neutral Triceps- C7- Elbow extension Supinator, Biceps- Supination Pronator Teres- pronation

With C6 nerve root compression, reflex testing might be diminished for the?

Brachioradialis

Elbow reflexes

C5- Biceps C6- Brachioradialis C7- Triceps

A brachial plexus traction injury involves nerve roots?

C5-T1

W, H, F reflexes

C6- Brachioradialis

Elbow myotomes

C6- Elbow flexion C7- Elbow extension, finger extension, wrist flexion

Elbow dermatomes

C6- lateral aspect of elbow and lower arm, thumb and index finger C7- Middle finger C8- 4th and 5th fingers, medial aspect of lower arm T1- Medial aspect of elbow

W, H, F dermatomes

C6- thumb and index finger C7- Middle finger C8- 4th and 5th fingers

W, H, F myotomes

C6- wrist extension C7- Wrist flexion, finger extension C8- finger flexion T1- finger abduction

What is the nerve root that affects elbow extension?

C7

During an upper quarter screen, checking the strength of thumb extension correlates to what nerve root?

C8

Which of the following can not be a symptom of a posterior sternoclavicular sprain?

Cholecystitis

Dull and aching shoulder pain on left side with no significant outcomes; You should?

Continue to eval

A tennis player is in the late stages of rehab for inpingement syndrome and has returned to practice drills. The player reports feeling weakness at ball contact during the serve. Which of the following rehab exercises would be most appropriate to address this weakness?

D2 proprioceptive neuromuscular facilitation pattern emphasizing the extension portion of the pattern

Inspection of elbow?

Deformity Ecchymosis Swelling Cubitus Varus Carrying Angle Cubitus Valgus Cubital Recurvatum

Wrist, Hand and Fingers Inspection:

Deformity- fx or dislocation Deformity- Boutonniere deformity, Mallet Finger, Jersey finger Ecchymosis Ganglion Cyst Swelling Alignment of wrist and forearm Alignment of fingernails Alignment of knuckles Posture of hand Thenar and Hypothenar eminence

Subdural, epidural, and inter cranial hematomas: Signs and symptoms, vitals, care and prognosis?

Dural- bleed between skull and dura matter (delayed symptoms...hours, weeks) Subdural- bleed between brain and dura matter (typical concussion) Intercranial- within the brain Dural- disoriented, headache with increasing intensity, abnormal behavior, unilaterally dialated pupils, coma, death (if untreated) Subdural- headaches, cloudiness of consciousness, impairment, signs of cranial nerve dysfunctions intracranial- LOC, fainting, seizures, headaches, sensitivity to light.

Strengthening exercises for the scapular stabilizers following rotator cuff repair surgery?

Early in rehab program using manual resistance

All of the following are signs or symptoms of arterial inhibition of thoracic outlet syndrome except?

Edema

Purpose of heat?

Heat causes blood vessels to dilate, bringing more blood to the area, and stimulating healing of the tissue. Good for spasms.

Purpose of massage?

Helps reduce spasm and restore ROM; improves circulation by bringing blood flow to the area

Purpose of Ice?

Helps reduce swelling by reducing bleeding into the tissue. Helps with inflammation, reduces pain by numbing the area

Defect in postural humeral head resulting from chronic anterior instability?

HillSachs Lesion

An athlete has a wrist injury that is limiting his ability to supinate his forearm. In what plane of motion does supination and pronation of the forearm take place (in anatomical position)?

Horizontal

In order to prevent medial epicondylitis, all of the following actions should be avoided via technique modification except:

Hyperextension of the wrist when performing a backhand shot in tennis

Collection of blood within anterior chamber of eye?

Hyphemia

Concussion test best for follow up and not for sideline testing?

Impact

When rehabbing an athlete following a ligamentous wrist injury, once the ligament has healed enough where active motion can be initiated, it is important to educate the athlete to exercise only

In a pain free range

Where is the scaphoid bone of the wrist palpated?

Just distal to the styloid process of the radius

Elbow palpation lateral

Lateral epicondyle Radial head (annular ligament) Radial collateral ligament Brachioradialis Wrist extensor muscles

Pain down the leg is a sign of?

Muscle spasm, myofacsial restriction, disc lesion

What is the purpose of stim?

Muscle spasms, pain, swelling, muscle atrophy, strength. It works by contracting the muscles and helps increase ROM and circulation in the body. It blocks the nerves that delivers pain sensation (gait control theory). It also causes the body to release endorphins to help with pain relief.

Epistaxis results in direct blow to?

Nasal bone

Signs or symptoms that ALWAYS accompany bony cervical trauma?

None of the above

The first cervical vertebrae

None of the above

The patient is supine. Examiner passively extends and laterally flexes C spine. Head rotation toward lateral flexed side. _________ positive sign because __________.

Nystagmus. Vertebral artery occluded

What muscles would you stretch and what muscles would you avoid with a spondyalgia?

Pain arising from vertebrae: Avoid extension- erector spinae Work in flexion- work abdominals Stretch hamstrings and quads

Symptoms of L5 never root involvement might include?

Pain down the leg

For which muscles does the coracoid process serve as the point of insertion?

Pectoralis Minor

You are completing D1 shoulder flexion pattern during an athlete's postoperative shoulder rehab. While completing rhythmic initiation, you appreciate some weakness at a point in the range. How would you modify this exercise to address this weakness?

Perform a slow several hold technique with an isometric contraction against the weak point in the range.

W, H, F palpation soft

RCL ligament MCP and IP collateral ligaments Wrist flexors: flexor carpi radialis, palmares longus, flexor carpi ulnaris UCL (between fingers) Wrist extensors: ext. carpi radialis, ext. carpi ulnaris Finger flexor tendons: flexor digitorum profundus (tip), flexor digitorum superficialis (middle) Finger extensor tendons: extensor digitorum Thumb extensors: Abductor pollicis longus tendon (medial), extensor pollicis brevis tendon (middle), extensor pollicis longus tendon (lateral)

Which of the following is the appropriate treatment of a Bennett's fracture?

RICE and analgesics followed by immobilization of the CMC joint; it is structurally unstable and the athlete should be immediately referred to an orthopedic surgeon.

A wrestler comes into the ATR after sustaining a major elbow injury. There is intense pain, and the area is grossly swollen. The athlete is unable to straighten his elbow, and the forearm appears shortened. The AT suspects an acute dislocation. Which 2 areas would the AT check for possible vascular impairment?

Radial pulse and color of the nail beds after compression

W, H, F palpation Bony

Radial styloid process Metacarpal bones MCP and IP joints Carpal bones: Navicular (snuff box), Lunate, Triquetrium, Pisiform, Hamate, Capitate, Trapezoid, Trapezium

What is the purpose of the Makenzie back treatment program?

Reduce disc pressure

Williams flexion is used to?

Reduce hyperextension. Reduce lumbar lordosis

Normal cervical flexion motion is demonstrated when the patient can?

Rest the chin on the chest

A patient complains of right muscular abdominal point tenderness 4 inches lateral to the umbilicus. This pain increases with RROM lumbar flexion, RROM spinal rotation to the right, PROM spinal rotation to the left, and RROM lateral flexion. Your diagnosis is the involvement of which of the following musculature?

Right internal obliques

Which type of disc injury/herniation involves the nucleus pulposus being extruded through a weakened region in the annulus fibrosis and involves a separation of part of the nucleus pulposus?

Sequestrian

Weakness of which muscle causes scapular winging?

Seratus Anterior

With an on the field anterior GH dislocation, the athlete's arm will most likely be in?

Slight abduction and external rotation

Which of the following PNF techniques is not a strengthening technique?

Slow reversal hold relax

A positive yergason's test indicates what pathology?

Subluxing long head of the biceps brachii

Empty can test used to eval presence of pathology to which muscle?

Supraspinatus

3 structures that can be pathologically involved in an impingement syndrome are?

Supraspinatus tendon, biceps tendon, subacromial bursae

Which vertebrae normally align with the medial border of the scapular spine?

T4

All of the following structures should be evaluated before and after a dislocated elbow is reduced except?

The axillary nerve

Allen's test is used to test what?

The integrity for the radial and ulnar arteries of the hand

The flexor pollicus longus is responsible for which of the following actions?

Thumb flexion

The sciatic nerve diverges to immediately form which of the following nerves?

Tibial, common Peroneal

Reduction of the lordotic curve can occur from which of the following?

Tight hamstrings

What special test identifies ulnar nerve compression or transmission interference at the elbow?

Tinel's sign

Purpose of ultrasound?

Tissue injuries; generates new cell growth and stimulates healing of the tissue

True or False: Fractures of the transverse and spinous processes present little danger to the athlete and will usually permit considerable activity within the range of pain tolerance.

True

True or False: In a brachial plexus injury, pain is usually transient and resolves itself in 5-10 minutes.

True

True or false: Tests for rotator cuff integrity are always performed actively, not passively.

True

Where is the olecranon process located?

Ulna

Elbow palpation posterior:

Ulna Olecranon Process Olecranon fossae Ulnar nerve Olecranon bursae Triceps

"Handlebar palsy", which occurs in cyclists, presents with motor weakness of what nerve(s)?

Ulnar

What is the best method of determining the recovery status of the hand and forearm after a flexor injury?

Use of a hand dynamometer

Elbow special tests

Valgus stress tests (at 0 and 25 degrees)- UCL- Laxity and pain Varus stress test (at 0 and 25 degrees)- RCL- pain and laxity Tennis Elbow test- lateral epicondylitis- pain Tinel sign- Ulnar nerve irritation- Pinch grip test- Median nerve involvement- Elbow flexion test- Cubital fosse syndrome-

The amount of accessory movement of the spine?

Varies by segment and age

W, H, F special tests

Varus test for MCP and IP joints- collateral ligaments- pain and laxity Valgus test for MCP and IP joints- collateral ligaments- pain and laxity Valgus for wrist- UCL- pain and laxity Varus for wrist- RCL- pain and laxity Valgus test thumb- UCL- pain and laxity Phalen's test- carpal túnel syndrome- Finkelstein's test- tenosynovitis- Glide test- RCL, UCL, triangular fibrocartilage- Tinel sign- carpal tunnel syndrome (median nerve)- Long bone compression test- fracture Tap (percussion) test- fracture- Long finger flexor test: PIP flexion- flexor digitorum superficialis; DIP flexion- flexor digitorum profundus Digital allen test- occlusion of radial and ulnar arteries

Which of the following is a simple movement to check the integrity of the radial nerve?

Wrist extension

W, H, F RROM

Wrist: Flexion- C7- flexor carpi radialis and ulnaris; extension- C6- extensor carpi radialis and ulnaris; radial deviation- abductor pollicis longus and thumb extensors; ulnar deviation- extensor and flexor carpi ulnaris Thumb CMC: flexion- flexor pollicis longus and brevis; extension- extensor pollicis longus and brevis; adduction- adductor pollicus longus and brevis; abduction- abductor pollicus longus and brevis; opposition- flexors and adductors MCP: flexion- flexor digitorum; extension- extensor digitorum; adduction- palmar interossei; abduction- T1- palmar interossei Finger: flexion- C8- flexor digitorum; extension- C7- extensor digitorum

W, H, F ROM

Wrist: flexion, extension, radial deviation, ulnar deviation Thumb CMC: Flexion, extension, adduction, abduction, opposition MCP: flexion, extension, adduction, abduction Finger: flexion, extension

Which of the following muscles are the primary muscles involved when performing a resisted wrist curl (palms up)?

flexor carpi radialis, flexor carpi ulnaris