Formative exam 2

To strengthen the elbow extensors in a closed chain, you have the patient perform push-ups, using body weight as the source of resistance. Which of the following variations of push-ups provides the greatest amount of resistance to the elbow extensors?

Bilateral push-ups while in a fully prone position on the floor with weight on the hands and toes

Regional interdependence

"The concept that seemingly unrelated impairments in a remote anatomical region may contribute to, or be associated with, the patient's primary complaint Focus is on impairments present in proximal or distal segments Impairment-based treatment approach

What would you do in order to improve flexion at the ulnohumeral joint?

Do a distraction technique

Proposed patellofemoral joint kinematics (weight bearing)

Femur moves relative to the stationary patella -Closed chain - patella is stationary and the femur is moving. (Ex. Feel the patella while doing mini squats and the patella should stay facing forward throughout the entire motion) Femoral internal result in relative lateral displacement of patella

Metacarpalphalangeal ROM

Finger flexion: 90 Finger extension: 45

Radiocarpal ROM

Flexion: 70 Extension: 70 Radial deviation: 20 Ulnar deviation: 30

Ulnohumeral capsular pattern

Flexion>extension

Which of the following muscles helps to support the medial collateral ligament when exposed to large valgus forces?

Flexor carpi ulnaris

Which of the following muscles is the primary finger flexor of digits two through five?

Flexor digitorum profundus (FDP)

Low load long duration stretch dose

Frequency: 2x/day Intensity: <2/10 pain at elbow region symptoms Time: 5-15 minutes Type: LLLD Important to ensure pain does not exceed 2/10 because the flexors will turn on the the patient will guard the whole time and won't make any gains in muscle length Dumbell and moist heat can help facilitate the stretch as well

Radiohumeral open packed position

Full extension and full supination

Which of the following best represents the closed pack position of the wrist?

Full wrist extension

Which of the following muscles act as strong interphalangeal (proximal interphalangeal [PIP] and distal interphalangeal [DIP]) extensors and weak metacarpophalangeal (MCP) flexors?

Lumbricales

Which of the following statements is true regarding the extensor mechanism of the fingers?

Lumbricales and interossei allow active metacarpophalangeal (MCP) joint flexion, and proximal interphalangeal (PIP) and distal interphalangeal (DIP) joint extension.

Forearm supinator stretch

Place pressure on the radius Compensation adduction

Forearm pronator stretch

Place pressure on the ulna Compensation Internal rotation

Distal radioulnar convex/concave

concave on convex

Metacarpalphalangeal convex/concave

concave on convex

Tibiofemoral joint is

concave on convex in open chain and convex on concave in closed chain.

Radiocarpal convex/concave

convex on concave

Extension of the metacarpophalangeal (MCP) joint of the second digit results in a ____________________ roll and a ____________________ glide of the proximal phalanx on the metacarpal.

dorsal, dorsal

Ulnohumeral closed packed position

extension

Radiocarpal closed packed position

extension with radial deviation

Radiocarpal capsular pattern

fexion=extension

Interphalangeal capsular pattern

flexion>extension

Metacarpalphalangeal closed packed position

full extension

Interphalangeal closed packed position

full flexion

Carpometacarpal closed packed position

full opposistion

Hip hike

-Adducted on the way down -Abducted on the way up -Pelvis is moving over the femur -You are using pelvic movement to get adduction -Concentric contraction of glute med When would you choose this exercise? More functional Stance limb control Compensation: Side bending

Elbow ROM

0-150 degrees

Distal radioulnar open packed postion

10 supination

Discuss how to modify exercise based on patient's MMT grade

3/5 and up Exercises are done in a gravity resisted position 2+/5 Gravity eliminated: patient can move through full ROM and can accept resistance 2/5 Gravity eliminated: patient can move through full ROM 2-/5 Gravity eliminated: patient can move through partial ROM and no resistance 1/5 Trace: patient has a visible contraction at the muscle. 0/5 Zero: no visible contraction of the muscle

Distal radioulnar closed packed postion

5 degrees of supination

Proximal radioulnar closed packed position

5 degrees of supination

Ulnohumeral open packed position

70 degrees of flexion and 35 degrees of supination

Proximal radioulnar open packed position

70 of flexion and 35 of supination

Proximal radioulnar ROM

80 for both pronation and supination

Distal radioulnar ROM

80 pronation and supination

"W" sitting position is most associated with

ANTEVERSION at the hip

What would you do in order to improve flexion at the radiohumeral join?

An anterior glide due to the head of the radius being concave on a convex humerus

How to improve proximal radioulnar supination?

Anterior glide

Which of the following elbow flexors produces the greatest amount of compression in the elbow joint and therefore is a stabilizer of the elbow?

Brachioradialis

Carpometacarpal capsular pattern

CMC1: retroposition; CMC 2: 5 fan/fold

Interphalangeal convex/concave

Concave on convex

Radiohumeral convex/concave rule

Concave on convex

Ulnohumeral Convex/concave rule?

Concave on convex

Proximal radioulnar concave/convex rule

Convex on concave

Radiohumeral closed packed position

Elbow flexed 90 degrees and forearm supinated 5 degrees

What is a sign of quad weakness during a SLR?

Extensor Lag- Leg starts completely straight but once the pt begins to perform the SLR they are unable to keep the leg straight and it bends or it begins to bend after a few reps due to fatigue

Which of the following muscles is the only muscle capable of extending the metacarpophalangeal (MCP) joint of the digits?

Extensor digitorum

Your patient has an "extensor lag" of the MCP joint. The exercise of choice to remediate this problem is:

Have the patient move actively from the full fist position of the hand to the hook fist (claw hand) position.

Each of the following is true about the use of early controlled motion after tendon repair in the hand and forearm EXCEPT:

It is used more often after extensor tendon repair than after flexor tendon repair.

Superior glide of the patella is associated with

KNEE EXTENSION

Inferior glide of the patella is associated with

KNEE FLEXION

Metacarpalphalangeal capsular pattern

MP 2-5: flexion>extension

Which of the following structures is the primary stabilizer of elbow to valgus stress between 20° and 120° flexion?

Medial collateral ligament

Thinking about injuries at the elbow, the most common ligament to be injured is the

Medial collateral ligament due to the valgus forces placed on it

Main nerves of the elbow, wrist, and hand

Median Ulnar Radial

Carpometacarpal open packed position

Midway between abduction-adduction and flexion-extension

RAdiohumeral capsular pattern

No true pattern, possibly equal pronation and supination

Interphalangeal ROM

PIP Ext: 0 PIP fex: 100 DIP Ext: 0 DIP Flex: 90

Which of the following would you consider to be a limiter of motion when a patient cannot achieve full elbow extension?

Passive tension of the flexor muscles

Proposed patellofemoral joint kinematics (non weight bearing)

Patella moves relative to stationary femur -Open chain LAQ - the patella moves with segment

2 general principles for designing a therapeutic exercise program to address proximal impairments related to knee injury

Pelvis and trunk stability -Improve lumbopelvic proprioception -Iumbopelvic neuromuscular control Dynamic hip joint control -Improve muscle performance of gluteus maximus and gluteus medius

How to improve proximal radioulnar pronation?

Posterior glide

During the subacute stage of soft tissue healing after injury and repair of the flexor tendons of the hand or forearm, each of the following is an important intervention except:

Progressive resistance exercise.

Which of the following muscles works to dynamically support the distal radioulnar joint?

Pronator quadratus

Signs of short biceps

Protracted scapula Arms internally rotated Arms flexed at the side

How do you know the pt is performing the SLR correctly?

The calf will make contact with the table before the heel as they bring the leg back down..

Discuss Regional Interdependence and Clinical Decision Making

The patient's local area of primary complaint should be examined initially and treated as indicated in accordance with current best evidence Screen the regions above and below the area of primary dysfunction

Each of the following is true about flexor tendon-gliding exercises EXCEPT:

To perform these exercises, the therapist passively moves the patient's fingers into five different positions in a particular sequence.

What are some compensations for Bridging?

Use of Paraspinals and/or hamstrings

Using a handheld weight as the source of resistance, which of the following positions to strengthen the elbow extensors begins with the long head of the triceps brachii fully lengthened?

With the patient standing or sitting in a chair, begin with the elbow fully flexed and the arm elevated overhead and stabilized to maintain the shoulder in as much flexion as possible.

Ex. of Regional interdependence

Your patient has low back pain. Your patient demonstrates hypomobility of both hips and bilateral weakness of the gluteus maximus. In addition to treating impairments in the lumbar spine region, your interventions will be directed at improving hip mobility and gluteus maximus strength. Analysis 1. Patient has to much lumbar flexion and limited hip flexion. This could be a contributing factor to their back pain. 2. Glute max eccentrically lowers the body bending forward and concentrically pulls you back up.

The range and direction of motion at the first carpometacarpal (CMC) joint produces opposition of the thumb. Opposition is sequentially ____________________.

abduction, flexion, and adduction of the first metacarpal

How to improve proximal Distal radioulnar pornation?

anterior glide

The ____________________ radioulnar joint has a disc that is also known as ____________________.

inferior, triangular fibrocartilage complex (TFC)

Radiocarpal open packed position

neutral with slight ulnar deviation

Proximal radioulnar capsular pattern

no true pattern, possibly equal pronation and supination

How to improve proximal Distal radioulnar supination?

posterior glide

During elbow extension from 90° flexion at the humeroradial joint, the radial head rolls in a(n) ____________________ direction and glides in a(n) ____________________ direction on the capitulum at the humeroradial joint.

posterior/caudal, posterior/inferior

Interphalangeal open packed position

slight flexion

Metacarpalphalangeal open packed position

slight flexion

To achieve terminal knee extension

you are most likely going to want to stretch the gastrocnemius muscle NOT THE HAMSTRING.