PTA 101 Review Questions

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Hypertension

persistent BP measurements above normal systolic or diastolic pressures

How do you deal with a NWB LE on the tilt table

place a book/block under the non-affected leg or place a pillow under affected

Mid Swing

point where limb passes underneath body; limb must be shortened via hip and knee flexion

Goal of Heel Strike

position foot to begin deceleration

List the proximal carpal bones from the lateral (thumb) side medially.

scaphoid, lunate, triquetrum, pisiform

What scapular motion is associated with shoulder hyperextension (hyperextension of the arm)?

scapular tilt

Demonstrate the palmer tripod prehension pattern. What other name is it known by? What type of grip is it and give an example of when it would be used?

three-jaw chuck; precision handling/pinch; holding a pencil

Space between underarm cushion of crutch and axilla of patient when fitting a crutch

1 - 2"

Nerve involved in claw hand

Ulnar Nerve

Nerve(s) and muscle(s) Claw Hand

Ulnar Nerve: Flexor carpi ulnaris

Wiping a counter top

Ulnar/Radial Deviation: N/A

Bony landmarks on wrist/forearm for fitting crutches

Ulnar/radial styloid processes

Windswept

Unilateral Genu Recurvatum

Heel Strike

a.k.a. Initial Contact; instant heel of reference limb touches surface

Acceleration

a.k.a. Initial Swing; from toe off the lower extremity must be accelerated to catch up with the COG

Insertion of Brachialis

Tuberosity and coronoid process off the ulna

Functional Activity: Forearm Pronation

Turn screw driver

Functional Activity: Forearm supination

Turning door knob

Force Couple

Two equal but opposing forces

Foot Flat

a.k.a. Loading Response; instant the entire plantar aspect of foot contacts walking surface

If at terminal swing the knee is still partially flexed (observed laterally) what muscle group(s) should be checked?

ankle plantar flexors

Goal of Mid-swing

clear foot

Goal of Acceleration

clear foot and vary cadence

Phlebothrombosis

clotting in the veins; want to avoid disturbing during treatments

Point at which COG is Lowest

double support

In an anterior pelvic tilt the ASIS moves

down

What scapular motion is associated with shoulder adduction?

downward rotation

What scapular motion is associated with shoulder extension?

downward rotation and retraction

Scapular Depression

dropping the shoulders

What muscles are active in shoulder horizontal abduction?

posterior deltoid, infraspinatus, teres minor

What are the muscles active in shoulder extension?

posterior deltoid, lats, teres major, pec major

Demonstrate a hook prehension pattern. What kind of grip is it and when would it be used?

power grip/grasp; used when gripping a breifcase

Demonstrate a cylndrical prehension pattern. What kind of grip is it and give an example of when it would be used.

power grip; used when gripping a bat

Goal of Pre-swing

prepare for swing

Diastolic Pressure

pressure in arteries when heart at rest

What scapular motion is associated with internal rotation of the shoulder joint?

protraction

What scapular motion is associated with shoulder horizontal adduction?

protraction

AAROM

pt is able to move jt but requires assistance

Active Assistive Range of Motion

pt is able to move jt but requires assistance

PROM

pt is unable to move jt so the jt must be moved by a second party

Passive Range of Motion

pt is unable to move jt so the jt must be moved by a second party

Imbalance

improper operation of the pelvic force couple

Main function of the patella

increase mechanical advantage of the knee joint complex

AROM

patient can move jt without assistance

Active Range of Motion

patient can move jt without assistance

What muscles are active in shoulder horizontal adduction?

pec major, anterior deltoid

What muscles are active in shoulder adduction?

pec major, teres major, lats

Systole

period of heart muscle contraction

Diastole

period of heart muscle relaxation

Mid Stance

period when body weight is directed over supported limb; begins with foot flat, ends at heel off

Describe the functional position of the hand

wrist slightly extended (30º), fingers slightly flexed, abduction and opposition of first metacarpal in line with the radius

Average Step length

15"

Normal Step Length

15"

Hip Adductor Muscles

Adductor Longus, Brevis, (Minimus) and Magnus, Gracilis, Pectineus

Pathology that causes a loss of thumb opposition, an inability to abduct the thumb.

Ape Hand

Moderate level of assisted ambulation

25 - 75%

Grip for holding a handle on a bag or briefcase

Hook

Modalities of PT

Hot pack, cold pack, moist air, e-stim, whirlpool, ultrasound, UV, paraffin bath, TENS, infared, SW diathermy, microwave diathermy, contrast baths, biofeedback, massage

Bones of the elbow

Humerus, Ulna Radius

Claw toes

Hyperextension of the MTP joint and flexion of the PIP and DIP joints. Generally involves all toes.

Hammer Toes

Hyperextension of the MTP joint, flexion of the PIP, and hyperextension of DIP. 2nd toe most commonly involved due to shoe pressure.

Ligament that assists with weak gait muscles due to spinal cord injury

Iliofemoral ligament

Strongest ligament in the body

Iliofemoral ligament

"Y" ligament

Iliofemoral ligament, supports hip anteriorly. Shaped like an upside down "Y". Attaches to the Anterior Inferior Iliac Spine and anterior femoral head.

Signs and symptoms drop foot

Inability to dorsiflex foot

Signs and symptoms Pope's blessing

Inability to flex the thumb, index and middle fingers

Assisted ambulation goal

Independence

insertion of Teres Minor

Inferior aspect of greater tubercle, capsule of shoulder joint

Origin of Posterior Deltoid

Inferior margin of the spine of the scapula

Bakers Cyst

Inflamation of the bursa of the popliteal space

Origin of Triceps Brachii: Long Head

Infraglenoid tubercle of scapula

Origin of Infraspinatus

Infraspinatus fossa of scapula

Structures that make up the Femoral Triangle

Inguinal Ligament, Sartorius, Adductor Longus

Action of Subscapularis

Internal rotation of humerus and stabilization

Lateral Ligament Injury

Inversion

Capsular Endfeel

Joint capsule stopping the jt. from moving (ex. glenohumeral capsule stopping arm)

Function of the Rotator Cuff

Keep the head of the humerus against the glenoid fossa

Main function of Anterior and Posterior Cruciate LIgaments

Keeps knee from rolling off tibia

Annular Ligament

Key ligament of the elbow, enables pronation

Largest Joint in the body

Knee

Modified hinge joint(s) of the body

Knee (Tibiofemoral), Ankle (Tibia and Talus), no true axis of motion

Kicking a ball (knee)

Knee Extension: Rectus Femoris, Vastus medialis, Vastus lateralis, Vastus intermedialis

Origin of Rhomboids

Spinous Processes of C7 - T5

Majority of gait deviations occur in which phase of the gait cycle?

Stance

Which phase has more problems & why?

Stance phase b/c longer, more stages, and more pressure exerted on limb

Functional Activity: Hip Extension

Standing up from chair

Bony landmarks of the clavicle

Sternal End, Acromial End, Body

(FF) Plantar Fascitis Deviation Causes

Stiff / Painful / No push off

Springy Endfeel

Stops but has a little bounce; ex. hinge jts and meniscus tears

Origin of Teres Minor

Superior 2/3 of dorsal surface of axillary border of scapula

Origin of Middle Deltoid

Superior surface of acromion process

Insertion of Supraspinatus

Superior surface of greater tubercle and capsule of shoulder joint

Action of Supinator

Supinates the forearm

Origin of Biceps Brachii: Long Head

Supraglenoid tubercle

Insertion of Triceps Brachii

Supraposterior surface of the olecranon process and deep fascia of the forearm

Muscles of the rotator cuff

Supraspinatus, Infraspinatus, Teres Minor, Subscapularis

Muscle(s) of the suprascapular nerve

Supraspinatus, infraspinatus

Major Proximal bony landmarks of the humerus

Surgical Neck, Anatomical Neck, Head, Shaft, Greater Tubercle, Lesser Tubercle, Deltoid Tuberosity, Bicipital Groove

Plantar Fasciitis

Swelling of the plantar fascia. Affects gait

The scapula is located lateral to which vertebrae (range)

T2 - T7

The spine of the scapula lines up with which vertebra

T3

Iliotibial band

Tendonis portion of tensor fascia latea, crosses hip and knee

Muscle(s) of the suscapular nerve

Teres Major, Subscapularis

Muscle(s) of the axillary nerve

Teres Minor, Deltoids

1947

Terminology was changed Physiotherapy to Physical Therapy

Apley Scratch Test

Test Shoulder ROM. Pt fully abducts arm, flexes elbow and reaches fingers towards superior angle of opposite shoulder to test abduction and external rotation. Pt extends arm behind body, flexes elbow and reaches for inferior angle of opposite shoulder to test adduction and internal rotation

Phalen's Test

Test for Carpal Tunnel. Backs of the hands are together for maximum degree of flexion. If test is positive there will be tingling in the thumb, index in middle fingers.

Carrying Angle of elbow in men

5° Valgus

Percentage of gait cycle spent in Stance Phase

60%

Pulse Range for Teens & Adults

60-90 bpm

Normal Diastolic Range

60-90 mmHg

Degree of rotation of the scapula

60°

Origin of Biceps Brachii: Short Head

Apex of coracoid process

1968

Architectural Barriers Act

Base of Support

Area on which an object rests and provides support for the object

C5 Dermatome

Areas around the shoulder referring or radiating pain to the shoulder.

Anterior Cruciate Ligament

Attaches anteriorly to the intercondylar surface of tibia. Attaches posteriorly to the lateral condyle of the femur. Is lateral to the PCL.

Posterior Cruciate Ligament

Attaches posteriorly to the intercondylar surface of tibia. Attaches anteriorly to the medial condyle of the femur. Is medial to the ACL

Nerve(s) and muscle(s) Erb's Palsy

Axillary Nerve: Deltoids Musculocutaneus Nerve: Biceps Radial Nerve: Wrist Extensors Ulnar Nerve: Flexor Carpi Ulnaris Median Nerve: Pronators, Wrist Flexors

Circumduction

Combination of movements on more than one axis

Functional Activity: Shoulder Flexion

Combing Hair

Nerve involved in foot drop

Common Peroneal Nerve

Nerve(s) and muscle(s) Drop Foot

Common Peroneal Nerve: Anterior Tibialis

Pes Anserine

Common tendon shared by sartorius, gracilis and semitendinosis muscles

Adson Test - Subclavian

Compressed subclavian Artery. Stand behind patient and place one hand on back of shoulder. Take patient's radial pulse at the wrist. Adbuct, extend and externally rotate pt arm. Pt turns head and breaths deep. If test is positive, pulse woll markedly slow or be absent.

Isotonic Contraction

Constant weight throughout range of motion and a contraction with a change in length (2 types: eccentric and concentric)

Ober Test

Contraction of iliotibial Band. Pt lying on side, involved leg is upper most. Have pt abduct upper leg and flex knee to 90°. If test is positive, involved leg will remain abducted.

Isokinetic Contraction

Contraction with constant speed throughout range of motion

Thomas Test

Contracture of hip flexors. Patient is supine on table. Pt holds one leg in the knee to chest position, opposite leg remains on the table. If test is positive, opposite thigh will rise from table

Assistive Device: 3 point gait

Crutches, affected leg, unaffected leg

Lordosis

Curvature of the lumbar and cervical spine

Kyphosis

Curvature of thoracic and sacral spine

Grip for holding a bat

Cylindrical

Movement of the shoulder girdle in relation to the scapula

Elevation, depression, protraction, retraction, upward and downward rotation

The hamstrings attach to what bony landmark

ischial tuberosity of the pelvis

Antalgic Gait

joint is held immobile; shortened stance phase and step length on painful side

Talocrural/Talotibial Joint

joint where the tibia and fibula articulate with the talus

From the lateral view a patient's knee is seen to be locked in extension/hyperextension at heel strike. What muscle group(s) should be checked?

knee extensors

As a patient is walking by (lateral view) it is noticed that during mid stance the head and trunk are shifted forward at the hip joint with an exaggerated anterior pelvic rotation. What muscle group(s) should be tested? What does this position accomplish?

knee extensors; places COG anterior to knee jt, which prevents knee flexion

From the lateral aspect it is observed that the knee is hyper/fully extended during mid stance. What muscle group(s) should be checked?

knee flexors and extensors and ankle dorsiflexors (check ROM in ankle dorsiflexion)

Axis that of the ulnohumeral joint

lateral (frontal)

Carrying Angle

lateral angle formed by the axes of the upper arm and forearm when the arm is extended in the anatomical position; men 5º; women 10º-15º; valgus

Stepping over the side of a tub (knee)

Knee Flexion: Biceps Femoris, Semitendinosis, Semimebranosis

Genu Recurvatum

Knees hyperextend

Genu Valgum

Knock Kneed

Screw Home Mechanism of Knee

Last 10° - 15° of knee extension , tibia will externally rotate on the femur to reach full extension

Grip for opening a bag of chips

Lateral Pinch

Insertion of Brachioradialis

Lateral side of base of styloid process of the radius

Insertion of Anconeus

Lateral side of olecranon process and posterior surface of ulna

Lateral Ligament (LE)

Lateral, prone to injury. Runs from lateral malleolus to talus and calcaneus

Muscles that move hands over head

Latissimus Dorsi, Teres Major, Teres Minor

Muscles that adduct the humerus

Lats, Pec Major, Teres Major

Anteriorly the pelvis can be seen to have an exaggerated downward tilt on the right side during left leg mid stance. What muscle group(s) should be checked and what is the term for this gait?

Left hip abductors; Trendelenburg Gait

Eccentric Contraction

Lengthening of the muscle

Minimum level of assisted ambulation

Less than 25%

ADA Fire Extinguisher

Less than 36" high

ADA Light Switches

Less than 36" high

Insertion of Subscapularis

Lesser tubercle of humerus and capsule of the shoulder joint

Two causes of Vaulting

Locked knee, leg length discrepancy

Nerve involved in scapular winging

Long Thoracic

Nerve(s) and muscle(s) affected in Scapular Winging

Long Thoracic Nerve; Serratus Anterior

Functional Activity: Cervical Exension

Looking Up

Functional Activity: Cervical Flexion

Looking down

Signs and symptoms ape hand

Loss of thumb opposition

Signs and symptoms wrist drop

Loss of wrist extension and finger extension

Origin of Brachialis

Lower 1/2 of the anterior surface of the humerus

1975

Mainstreaming

Founding mother of PT

Mary McMillan

How to measure for wheelchair seat width

Measure across widest part of the body and add 2 inches

How to measure for wheelchair seat depth

Measure from behind the calf to back of buttocks and subtract 2 inches

How to measure for wheelchair seat height

Measure from heels to just under thigh and add 2 inches for footrest (if cushion to be used subtract 1 inch for every 2 inches of thickness)

What scapular motion is associated with shoulder external rotation?

retraction

What scapular motion is associated with shoulder horizontal abduction?

retraction

What are the muscles involved in scapular downward rotation?

rhomboids, levator scapulae, pec minor

Assistive Device: 4 point gait

right crutch, left leg, left crutch, right leg

Scapular Retraction

rolling the shoulders back, pinching the shoulder blades; retract to attract; also referred to as scapular adduction

What is the pes anserine muscle group?

sartorius, gracilis, semitendinosus (SGT); "duck foot"

Goal of Mid-stance

stabilize knee and preserve momentum

Name the three diarthrodial (synovial) joints of the shoulder?

sternoclavicular (SC), acromioclavicular (AC), glenohumeral

How to measure for wheelchair arm height

Measure from top of seat/cushion to bottom of elbow and add one inch

Origin of Supraspinatus

Medial 2/3 of supraspinous process

Insertion of Rhomboids

Medial Border of scapula from spine to inferior angle

Signs and symptoms of scapular winging

Medial border of scapula rises away from the rib cage, can be seen posteriorly

Deltoid Ligament

Medial, Big, Broad. Runs from medial malleolus to talus, navicular, and calcaneus

Nerve affected by Carpal Tunnel

Median

Nerve involved in ape's hand

Median Nerve

Nerve involved in pope's blessing

Median Nerve

Nerve(s) and muscle(s) Ape Hand

Median Nerve: Flexor Carpi Radialis, Palmeris Longus, Pronator Teres, Pronator Quadratus

Nerve(s) and muscle(s) Pope's Blessing

Median Nerve: Flexor Carpi Radialis, Palmeris Longus, Pronator Teres, Pronator Quadratus

1965

Medicare, Medicaid, Social Security Act

Muscle(s) that abduct the humerus

Middle Deltoid and surpaspinatus

Muscles involved in Shoulder Abduction

Middle Deltoid, Supraspinatus

Common cause of wrist drop

Midhumeral Fracture

Agonist

Muscle or muscle group primarily responsible for movement

Synergist

Muscle or muscle group that assists the agonist

Stabilizer

Muscle or muscle group that fixes a body segment to provide a firm foundation

Antagonist

Muscle or muscle group that opposes the action of agonist

Nerves invovled in Erb's palsy

Musculocutaneous, axillary, radial, median, ulnar; any single or combination thereof

Supervision level of assisted ambulation

No assistance, supervision only

Describe the Apley Scratch Tests and what they test for.

(A) test range of motion for internal rotation and adduction reach in front of head and touch opposite acromion; (B) test abduction and external rotation by reaching behind head and touching superior medial angle; (C) test internal rotation and abduction by reaching behind back to touch inferior angle of scapula

Muscles involved in Elbow Flexion with Neutral Forearm

(Thumb up), Brachioradialis

How to measure for wheelchair back height

(for normally active patient) subtract 4 inches from distance between seat and armpit

Where is the anatomical snuff box and what is it?

(p. 74) dorsal & distal to the radial styloid process; radial border made by abductor pollicis longus and extensor pollicis brevis tendons; ulnar border made by extensor pollicis longus tendon and the floor of the navicular

Structures of the humerus

(trochlea, capitulum, medial/lateral epicondyle, lateral supracondylar ridge, olecranon fossa)

By How Much do the Pelvis & Trunk Shift Laterally During Gait

1"

ADA Ramp Ratio

1":12"

Percentage of people who are chronically disabled by LBP

1%

Percentage Weight Bearing: Ball of foot

10 - 25%

Carrying Angle of elbow in women

10° - 15° Valgus

Percentage of Elbow flexion required for cane or crutches

15 to 20 degrees

ADA Parking Space Requirements

12 feet

ADA Parking Space Requirements

12'

Degree of flexion or abduction at GH joint only

120°

Number of bursa located around knee

13

Fast Walk

130 steps/min

Normal Range for Q angle

13° - 18°; greater in females

Normal Adult Respiration Count (/min)

14-20 resp/min

Normal BP

140 mmHg/90 mmHg (140/90)

Percentage of Elbow flexion required for cane or crutches

15 - 20 degrees

When was APTA founded

1921

Year of the first PTA graduating class

1969 (1967 program start)

When did APTA break away from AMA

1976

Saddle joint(s) of the body

1st MCP

Degree of movement at the ulnohumeral joint

By How Much Does COG Oscillate

2"

Location of Center of Gravity

2" in front of S2

Width of a Normal Base

2-4"

Percentage of gait cycle spent in Double stance/support

22%

Percentage of Weight Bearing: Mid Foot

25 - 50%

Ratio of the Scapulohumeral rhythm

2:1

Most common assistive device gait

3 point Gait

ADA Minimum Door Requirements

32 inches

ADA Handrails

32"

ADA Minimum Door Requirements

32"

ADA Ramp Width

36"

ADA Bathroom Stall Dimensions

36" x 56"

Degree of knee flexion in toe off

40%

Percentage of gait cycle spent in Swing Phase

40%

Percentage of low back pain patients who improve within one week of PT

40%

How Much Does the Pelvis Rotate in Swing Phase

40°

ADA Sidewalk Width

48"

Percentage Weight Bearing: Toe Touch

5%

What degree interval should the tilt table be progressed by

5-10° with 3-5 min rest periods

Percentage of Weight Bearing: Entire Plantar Surface

50% or greater

At what percentage of height does the Center of Gravity rest?

55 - 56%

Origin of Subscapularis

Anterior surface of subscapular fossa

Attachment site(s) of annular ligmanet

Anteriorly and posteriorly to the radial notch of the ulna

Slow Walk

70 steps/min

Pulse Range for School-Age Children

70-110 bpm

Newborn Pulse Range

70-170 bpm

Maximum level of assisted ambulation

75% assistance or greater

Number of people who will be affected by LBP in their lifetime

8 out of 10

Percentage of low back pain patients who improve within 2 weeks

80%

Pulse Range for Toddlers and Preschoolers

80-120 bpm

Infant-1 year Pulse Range

80-130 bpm

Percentage of LBP that is musculoskletal

90%

Percentage of low back pain that is musculoskletal

90%

Normal Walk

90-100 steps/min

Normal Systolic Range

90-140 mmHg

6 Major bony landmarks of the scapula

Acromium Process, Coracoid Process, Medial Border, Lateral Border, Inferior Angle, Glenoid Fossa

Axillary Temp Range

96.6-98.6°F

Oral Temp Range

97.6-99.6°F

Origin of Anterior Deltoid

Anterosuperior border of the lateral 1/3 of the clavicle

Rectal Temp Range

98.6-100.6°F

Gait

A series of rhythmical, alternating movements of trunk and limbs, which produces a forward progression of COG

Architectural Barriers

A style of construction that separates, holds apart, or prevents going ahead

Morton's neuroma

A thickening of tissues around the metatarsals causing pressure on the plantar nerves, causing the toes to tingle or go numb. Commonly caused by high heels.

Things that affect vitals

Activity, Anxiety, Eating, Exercise, Fear, Hot/cold, Illness, Medications, Noise, Sleep, Weather, Pregnancy, Menstrual cycle, Age, Emotions

Action of Teres Major

Adduction and internal rotation of the humerus, Assists in extension

Ulnar Deviation

Adduction; movement toward little finger

Muscles that originate on the Pubis

Adductor Longus, Adductor brevis, Adductor Magnus(partial)

What are the action, origin, insertion and nerves of the supraspinatus?

A: abduction of the humerus at the shoulder joint O: medial supraspinatus fossa I: superior greater tubercle of humerus N: suprascapular, C4, C5, C6

What are the action, origin, insertion and nerves of the infraspinatus?

A: lateral rotation of humerus at the shoulder, abducts inferior angle of scapula O: infraspinatus fossa I: posterior grater tubercle of humerus N: suprascapular, C4, C5, C6

What is the action, origin insertion and nerves of the teres minor?

A: lateral rotation of humerus at the shoulder; abducts inferior angle of scapula O: superior dorsal surface of axillary border of scapula I: inferior aspect of greater tubercle of humerus N: axillary, C4, C5, C6

What is the action, origin, insertion and nerves of the subscapularis?

A: medial rotation of humerus; abducts inferior angle of scapula O: anterior surface of subscapular fossa I: lesser tubercle of humerus N: upper and lower subscapular, C5, C6, C7

What are the action, origin, insertion, and nerves of the serratus anterior?

A: primary scapular protractor; upward rotation of scapula; stabilized vertebral bordar of scapula O: superior lateral surfaces of upper 8 or 9 ribs at the side of the chest I: costal surface of vertebral border along the inferior angle of scapula N: (SALT) Serratus Anterior Long Thoracic, C5, C6, C7

What are the action, origin, insertion and nerves of the rhomboid minor?

A: retracts and elevates the scapula; assists in rotating the scapula downward O: lower part of ligamentum nuchae; spinous processes of C7 and T1 I: medial border of scapula by root of spine N: dorsal scapular, C4, C5

Daily Life Tasks

ADL and any activity necessary or desirable for each individual

RC 44-00

APTA Vision Statement for PT 2020

Origin of the Sartorius Muscle

ASIS

Measure true leg length discrepancy

ASIS to medial malleoli

Muscles involved in posterior pelvic tilt

Abdominals, Gluteals, Hamstrings

Action of Supraspinatus

Abduction (first 15°) and stabilization

Movement that occurs on the Anterior/Posterior (saggital) axis

Abduction and Adduction

Movement that occurs on the lateral plane

Abduction and Adduction

Action of Middle Deltoid

Abduction of the humerus

Radial Deviation

Abduction; movement toward thumb

Structures of Anatomical Snuff Box

Abductor pollicus longus, extensor pollicus brevis, extensor pollicus longus and scaphoid (navicular) bone

Osgood-Schlatter

Abnormal deposit of calcium on the tibia, beneath the patellar tendon, most common in teen years

Stages of Swing Phase (in order)

Acceleration, Mid Swing, Deceleration

Gliding joints of the body

Acromioclavicular, patelofemoral, tibiofibular joint

Signs and symptoms of Erb's palsy

Affected arm hangs with the shoulder in extension and medial rotation, elbow is extended, forearm pronated and wrist flexed

Assistive Device: Swing-To Gait

Affected leg and unaffected leg swing even with crutches/walker

Assistive Device: Swing-Through Gait

Affected leg and unaffected leg swing through crutches

2010

Affordable Care Act

1990

Americans with Disabilities Act

Walking on heels

Ankle Dorsiflexion: Anterior tibialis, Extensor Hallicus longus

Active Muscles of Mid-Swing

Ankle Dorsiflexors (Anterior Tibialis, Extensor Hallicus Longus)

Walking on tip toes

Ankle Plantarflexion: Gastrocnemius, Soleus, Plantaris

Active Muscles of Terminal Stance

Ankle Plantarflexors (Soleus, Gastrocnemius, Plantaris)--Concentric

Active Muscles of Mid-Stance

Ankle Plantarflexors (Soleus, Gastrocnemius, Plantaris)--Isometric

Muscles active in Mid-swing

Ankle dorsiflexors

While observing a patient from the side during terminal swing it is notice that the arms are at an uneven distance from the body midline and the elbows are flexed. What muscle group(s) should be tested and what might be accomplished through this positioning?

Ankle plantar flexors and hip and knee extensors; exaggerated forceful arm swing used to assist push off and step may be shortened

Muscles active in Push Off/Terminal Stance

Ankle plantarflexors (concentric)

If a person has a blister on their heel, what gait might they be using?

Antalgic Gait

Muscles involved in Shoulder Flexion

Anterior Deltoid

Muscles that internally rotate the humerus

Anterior Deltoid, Subscapularis, Pec Major, Lats, Teres Major

What muscle is weak in steppage gait?

Anterior Tibialis

Ankle Dorsiflexors

Anterior Tibialis, Extensor Hallicus Longus

Muscle(s) of the Musculocutaneus nerve

Biceps, Brachialis

Muscles that flex the elbow

Biceps, Brachialis, Brachioradials

Tinel Test

Test for Carpal Tunnel. Tap hook of hammate. If test is positive there will be tingling in the thumb, index in middle fingers.

Joint with 3° of freedom

Ball and socket

Activities of Daily LIving

Bed, Ambulation, self care, Hand activities

Swing Phase

Begins at toe off and ends at heel strike; typically comprises 40% of cycle

Muscles involved in Elbow Flexion with Supinated Forearm

Biceps Brachii

Knee Flexors

Biceps Femoris, Semitendonosis, Semimembranosus

Muscles that supinate the forearm

Biceps and Supinator

Bone-on-bone Endfeel

Bone stops the motion; especially in a hing jt

Genu Varum

Bow Legged

Muscles involved in Elbow Flexion with Pronated Forearm

Brachialis

Functional Activity: Finger Flexion

Buttoning up

Major Dermatome nerve of upper arm and shoulder girdle

C5

Causes of Weak Dorsiflexor Gait Deviations

CVA / Peripheral Nerve Damage

Possible causes of weak dorsiflexors

CVA, peripheral nerve damage

Major weight bearing bone of the body

Calcaneus

Quad Lag

Cannot fully "actively" extend the knee due to weak quads

Heel spurs

Caused by Plantar Fascia pulling on the calcaneus and remodeling the bone

Restriction Endfeel

Caused by clothing

Looking Up

Cervical Exension

Looking down

Cervical Flexion

Pathology that causes a loss of the intrinsic muscle due to ulnar nerve damage. Phalanges are hyperextended and the middle and distal phalanges are in extreme flexion.

Claw Hand

Purpose of good body mechanics

Decrease energy expenditure, increase efficiency

Action of Anterior Deltoid

Delete

Insertion of Anterior Deltoid

Deltoid Tuberosity

Insertion of Middle Deltoid

Deltoid Tuberosity

Insertion of Posterior Deltoid

Deltoid tuberosity

Action of Subclavius

Depresses clavicle, pulls it inferiorly and anteriorly

Action of Pectoralis Minor

Depression and downward rotation of scapula

Step Length

Distance between successive contact points of opposite limbs

Anatomical Snuff box location

Dorsal and distal to the radial styloid

Pathology where nerve damage causes foot drop.

Drop Foot

Hinge Joint(s) of the body

Elbow (Ulnarhumeral), Interphalangeal joints, Ankle (talocrural/talotibial)

Pushing up from chair

Elbow Extension: Triceps, Anconeous

Bringing a cup to the mouth for a drink

Elbow Flexion (Neutral): Brachioradialis

Pulling top drawer of file cabinet open

Elbow Flexion (Pronated): Brachialis

Washing face

Elbow Flexion (supinated): Biceps brachii

Rise from sit to stand (arms)

Elbow extension: Triceps and aneconous

Action of the Levator Scapulae

Elevation and downward rotation of the scapula, assists with retraction

Action of Rhomboids

Elevation and retraction of the scapula, assists in downward rotation

Pathology that present's in babies where affected arm hangs with the shoulder in extension and medial rotation with the elbow extended, forearm pronated, and wrist flexed.

Erb's Palsy

Deltoid Ligament Injury

Eversion

Action of Anconeus

Extension and pronation of the forearm

Action of Posterior Deltoid

Extension, external rotation and abduction of the humerus

Action of Triceps Brachii

Extension. Long head aids in adduction and extension of the shoudler

Wrist Extensor Muscles

Extensor Carpi Radialis Longus & Brevis, Extensor Carpi Ulnaris, Extensor Digitorum

Muscles that perform wrist extension

Extensor carpi radialis longus and brevis, extensor carpi ulnaris, extensor digitorum

Action of Teres Minor

External Rotation of humerus and stabilization

Action of Infraspinatus

External rotation of humerus and stabilization

Muscles that perform the action of a clenched fist

FLexor digitorum superficialis and profundus, flexor pollicus previs, dorsal interossei, palmer brevis

(MS) Calluses Deviation Causes

Fallen Arch

Plantar Fascia

Fascia of the inferior surface of the foot. Runs from calcaneus to th 5 MP joints

Guarding Endfeel

Fast muscle guarding in response to acute injury or slow muscle guarding when less severe; patient stops from moving because fear/pain

Functional Activity: Shoulder Internal Rotation

Fastening/unfastening bra

Structures that lie within the Femoral Triangle

Femoral vein, femoral artery, femoral nerve

Largest bone of the body

Femur

Glenoid Labrum

Fiberous tissue that surrounds rim of glenoid fossa

Buttoning, zipping, holding a pencil

Finger Flexion: Flexor Pollicus Brevis, Flexor DIgitorum Superficialis, Flexor Digitorum Profundus, Palmar Brevis, Dorsal Interossei,

Clench Fist

Finger Flexion: Palmar Brevis, Dorsal Interossei, Flexor Pollicus Brevis, Flexor DIgitorum Superficialis, Flexor Digitorum Profundus

Grip for picking up a bead

Finger tip

Precision Grips

Fingertips, Palmas Tripod (3 jaw chuck), Lateral Pinch

Hallux Valgus

First metatarsal head is abducted laterally, causing lateral deviation of phalanx.

Pes Planus

Flat foot, fallen arch. Does not directly affect gait, but can cause other issues that will.

Movement that occurs on the lateral (frontal) axis

Flexion and Extension

Movement that occurs on the saggital plane

Flexion and Extention

Action of Biceps Brachii

Flexion and supination

Action of Brachialis

Flexion of the forearm

Action of Brachioradialis

Flexion of the forearm.

Hands over head

Flexion: Latissimus Dorsi, Teres Major, Teres Minor

Muscle(s) of the median nerve

Flexor Carpi Radialis, Palmeris Longus, Pronator Teres, Pronator Quadratus

Wrist Flexor Muscles

Flexor Carpi Radialis/Ulnaris, Palmaris Longus, Abductor Pollicus Longus

Muscles that perform wrist flexion

Flexor Carpi radialis and ulnaris, palmaris longus and abductor pollicus longus

Muscle(s) of the ulnar nerve

Flexor carpi ulnaris

Using a Screw Driver

Forearm Pronation:

Turning door knob

Forearm Supination

FWB

Full Weight Bearing

Causes of (Swing) Vaulting Deviation

Fused joint / Leg length discrepancy

Condition of being knock kneed

Genu Valgus

Condition of being bow legged

Genu Varum

Frozen Shoulder

Glenohumeral Joint does not move, patient may be able to abduct to 60° with only scapulo thoracic motion

Joints of the shoulder girdle

Glenohumeral, Acromioclavicular, Sternal clavicular

Hip Abductor Muscles

Gluteus Medius/Minimus

Anteriorly it is observed that at heel strike a patient's trunk is laterally displaced (to the right/left) and the leg is in lateral rotation. What muscle group(s) should be checked?

Hip medial rotators, knee extensors and foot everters

Define body mechanics

Good posture in motion

Bony landmark on LE for fitting a cane

Greater Trochanter

Contact Gaurd

Hand hold or walking belt

Bony Landmarks of the Radius

Head, Radial Tuberosity, Styloid Process

1996

Health Insurance Portability and Accountability Act

HIPAA

Health Insurance Portability and Accountability Act

Stages of Stance Phase (in order)

Heel Strike, Foot Flat, Mid Stance, Push Off

(HS) Antalgic Gait Deviation Causes

Heel spur / Burn / Blister

Possible causes of antalgic gait

Heel spur, burn, blister

Complications that can cause Plantar Fascitis

Heel spurs / repetitive trauma

Functional Activity: Ankle dorsiflexion

Heel strike phase of gait

HNP

Herniated Nucleus Pulposis

Active Muscles of Loading Response

Hip Abductors (Gluteus Medius/Minimus), Knee Extensors (Vastus Medialis/Lateralis/Intermedialis, Rectus Femoris), Ankle Plantarflexors (Soleus, Gastrocnemius, Plantaris)

Kicking the legs when swimming

Hip Extension: Gluteus Maximus

Active Muscles of Initial Contact

Hip Extensors (Gluteus Maximus), Knee Flexors (Biceps Femoris, Semitendonosis, Semimembranosus), Ankle Dorsiflexors (Anterior Tibialis, Extensor Hallicus Longus)

Active Muscles of Terminal Swing

Hip Extensors (Gluteus Maximus), Knee Flexors (Biceps Femoris, Semitendonosis, Semimembranosus), Knee Extensors (Vastus Medialis/Lateralis/Intermedialis, Rectus Femoris), Ankle Dorsiflexors (Anterior Tibialis, Extensor Hallicus Longus)

Muscles active in Heel Strike/Initial Contact

Hip Extensors, Knee Flexors, Ankle Dorsiflexors

Active Muscles of Pre-Swing

Hip Flexors (Illiacus, Psoas Major/Minor)

Active Muscles of Initial Swing

Hip Flexors (Illiacus, Psoas Major/Minor), Ankle Dorsiflexors (Anterior Tibialis, Extensor Hallicus Longus)

Muscles active in Foot Flat/Loading Response

Hip abductors, knee extensors, ankle plantarflexors

During mid swing (viewing head-on) a patient's trunk is displaced to the left and the pelvis is lifted up on the right side (hip hiking). What muscle group(s) should be checked?

Hip and knee flexors and ankle dorsiflexors

Rise from sit to stand (pelvis)

Hip extension: Biceps Femoris, Semitendinosis, Semimembranosis

Muscles active in Deceleration/Terminal Swing

Hip extensors, knee flexors, knee extensors, ankle dorsiflexors

As a patient is walking by (lateral view) it is noticed that during mid stance the head and trunk are shifted backward at the hip joint with posterior pelvic rotation. What muscle group(s) should be tested? What does this position accomplish?

Hip extensors; places COG posterior to hip joint to prevent the forward shift of the trunk

Muscles active in Pre-swing

Hip flexors

Muscles active in Acceleration/Initial Swing

Hip flexors, ankle dorsiflexors

Empty Endfeel

No movement because can't move

(FF) Foot Flat Deviation Characteristics

No push off

NWB

Non Weight Bearing

Orthostatic Hypotension

Normal BP when lying down but drops upon standing (dizziness, lightheadedness)

Bony landmarks of the Ulna

Olecranon Process, Trochlear Notch, Coranoid Process, Radial Notch, Ulnar Tuberosity, Styloid Process

(MS) Corns Deviation Characteristics

Painful / Limping/ Avoids toe off

Muscles Needed to Clench Fist

Palmar Brevis, Dorsal Interossei, Flexor Pollicus Brevis, Flexor Digitorum Superficialis/Profundus

Grip for buttoning a shirt or holding a pen

Palmas tripod / 3 jaw chuck

PWB

Partial Weight Bearing

Faber or Patrick Test

Pathology in sacroiliac joint. Pt lying supine, foot of involved side is placed on opposite knee so that the involved leg is flexed, abducted, externally rotated. If test is positive, patient will have increased pain

Double Stance

Period of gait when both extremities are in contact with surface in reference limb; occurs early in stance (heel off of one foot with toe off of other); usually 22% of a cycle

Ankle Evertors

Peroneus Longus/Brevis/Tertiius

Causes of Anterior toeing in

Pes cavus, Genu Valgus, metatarsus varus or spasticity of internal rotators of the hip (cerebral palsy)

Causes of Anterior toeing out

Pes planus, Genu Varum, or flacid paralysis of internal rotators of the hip

Signs and symptoms claw hand

Phalanges hyperextend and the PIP and DIP joints are in extreme flextion

Swallowing Test

Test for anterior cervical spine pathologies by reproducing pain. Pt simply swallows. If test is positive, pt will be able to report exact distribution of pain

Physical Therapy Referral Sources

Physician, Podiatrist, Dentist, Doctor of Osteopathic Medicine

Complications derived from pes planus

Plantar Fasciitis, heel spurs, bunions, hallus valgus

Pes Cavus

Plantarflexion in forefoot causing a high arch (High Arch)

Pathology that causes an inability to flex the thumb, index and middle fingers.

Pope's Blessing

Muscle(s) that externally rotate the humerus

Posterior Deltoid, Infraspinatus, Teres Minor

Insertion of Infraspinatus

Posterior aspect of greater tubercle and capsule of shoulder

Origin of Triceps Brachii: Lateral and Medial heads

Posterior lateral surface of the humerus

Origin of Anconeus

Posterior surface of lateral epicondyle of humerus

From a lateral perspective a patient is observed shifting the head and trunk forward at heel strike, placing the COG anterior to the knee joint. What does this accomplish and what muscle group(s) should be checked?

Prevents knee flexion; check knee extensors

d

Process of treatment and education that help disabled individuals to attain maximum function, a sense of well-being, and a personally satisfying level of independence

Muscles that pronate the forearm

Pronator Teres and Pronator Quadratus

Primary movement(s) of the Serratus Anterior

Protraction and Upward rotation of scapula

Origin of Brachioradialis

Proximal 2/3 of lateral supraconylar ridge of the humerus and lateral intermuscular septum

Insertion of the Sartorius muscle

Proximal Medial aspect of tibia

Insertion of Pes Anserine

Proximal medial aspect of tibia

Hip Flexor Muscles

Psoas Major/Minor, Illiacus

Functional Activity: Wrist Flexion

Pulling up on car handle

Functional Activity: Finger extension

Pushing door open with hand

Functional Activity: Elbow Extension

Pushing up from chair

Functional Activity: Wrist Extension

Pushing up from support surface

While observing a patient anteriorly it is seen that the head and trunk tip to the right as the pelvis tips upward on the left side during mid stance. The right arm is held away from the body. What muscle group(s) should be checked and what is the term for this gait?

Right hip abductors; Gluteus Medius Gait

Functional Activity: Knee Extension

Rise from sit to stand

Movement that occurs on the Transverse (horizontal) plane

Rotation

Movement that occurs on the Vertical axis

Rotation

Muscles involved in anterior pelvic tilt

Quadriceps and hip flexors

Nerve involved in wrist drop

Radial Nerve

Nerve(s) and muscle(s) affected in Wrist Drop

Radial Nerve: Extensor Carpi Ulnaris, Extensor Carpi Radialis Longus and Brevis

Insertion of Biceps Brachii

Radial tuberosity and bicipital aponeurosis

Uniaxial Pivot joint of the arm

Radioulnar joint

Pivot joint(s) of the body

Radioulnar joints

Functional Activity: Shoulder Extension

Reach back for arm of chair

Functional Activity: Shoulder External Rotation

Reaching back for coat sleeve

1918

Reconstruction Aide Program Implemented

Which temperature locations are most and least reliable?

Rectal (most), Axillary (least)

At Heel Strike, A Weak Quadriceps Deviation Can Cause

Recurrent dislocations

1973

Rehabilitation Act

Q Angle

Relates to the alignment of the patella on the knee. Angle between quadriceps muscle and patellar tendon

Pelvic Force Couple

Relationship between Pelvis, Sacrum, and vertebral column and the forces acting upon them

Primary movement(s) of the Rhomboids

Retraction and Downward rotation of scapula

Philosophy of PT

Return the patient to optimal level of function as determined through evaluation and treatment

Muscle(s) of the dorsal scapular nerve

Rhomboids

Assistive Device: 2 point gait

Right Crutch and left leg, Left crutch and right leg

Movements to avoid when lifting

Rotation, Flexion, and side bending

What is happening in gait when double stance/support = 0

Running

Plane of the ulnohumeral joint

Saggital

Muscles of the Pes Anserine Group

Sartorius, Gracilis, Semitendinosis

Proximal Carpal Row - Lateral to Medial

Scaphoid(Navicular), Lunate, Triquetrium, Pisiform

Shoulder Shrugs

Scapular Elevation: Upper Trapezius

Pathology that weakens or paralyzes the serratus anterior muscle causing the medial border of the scapula to rise away from the rib cage.

Scapular Winging

Action of Trapezius and Serratus Anterior

Scapular rotation for shoulder abduction beyond 90°

Muscles that originate on the Ischeal Tuberosity

Semimembranosis, Semitendinosis, Biceps Femoris

Muscle(s) of the long thoracic nerve

Serratus Anterior

Scapular Winging is caused by a weakness in which muscle?

Serratus Anterior

Concentric Contraction

Shortening of the muscle

Ball and Socket Joint(s) of the body

Shoudler (Glenohumeral), hip joint (Acetabelum of pelvis and Femur)

Action of the Middle Deltoid

Shoulder Abduction (up to 90°); lifting arm to put on deoderant

Waving

Shoulder Abduction: Middle Deltoid, Supraspinatus

Washing opposite side of body

Shoulder Adduction: Anterior Deltoid, Pectoralis Major

Reach back for arm of chair

Shoulder Extension: Posterior Deltoid

Reaching back for coat sleeve

Shoulder External Rotation:

Combing Hair

Shoulder Flexion: Anterior Deltoid

Action of Anterior Deltoid

Shoulder Flexion; reaching into a cupboard

Fastening/unfastening bra

Shoulder Internal Rotation

Functional Activity: Hip Abduction

Side stepping over bath tub

Pattern of Motion COG Follows

Sinusoidal

Functional Activity: Hip Flexion

Sit down to put on socks

Functional Activity: Hip Adduction

Sitting with legs crossed

Functional Activity: Ankle Plantar Flexion

Sliding foot into an enclosed shoe

Soft Tissue Approximation Endfeel

Soft tissue interferes (ex. biceps interfering with arm flexion)

Ankle Plantarflexors

Soleus, Gastrocnemius, Plantaris

Grip for holding a ball

Spherical

Power Grips

Spherical, Cylindrical, Hook

Compression Test

Test for cervical spine pathologies by reproducing pain. Hands rest on the top of pt head and press down. If test is positive, pt will be able to report exact distribution of pain

Valsalva Test

Test for cervical spine pathologies by reproducing pain. Pt holds breath and bears down as if moving bowels. If test is positive, pt will be able to report exact distribution of pain

Distraction Test

Test for cervical spine pathologies. Hold pt chin in one hand and occiput in the opposite hand and lift up. If test is positive, pt will have relief in from pain

Adson Test - Cervical Rib

Test for extra rib jutting off of C7. Stand behind patient with hand on back of shoulder. Holding the wrist with the opposite hand, adbuct, extend and externally rotate pt arm. Pt turns head and breaths deep. If test is positive, pt will report pain.

Scapular Protraction Test

Test for scapular winging. Patient flexes arm to 90°, and flexes elbow completely. Stabilize patient at spine and hold elbow. Have pt push bent arm until maximum resistance is apparent. Test is positive if vertebral border of scapula presses out away from spine.

Apprehension test

Test for shoulder dislocation. Externally rotate patients arm to a position where it could possibly dislocate. If test is positive patient will have a look of apprehension and resist further motion

Anterior Draw Sign - Knee

Test for tear in Anterior Cruciate Ligament. Pt lying supine, knees flexed, feet flat on table. Stabilize patients feet, cup hands around pt knee. Fingers rest on area of insertion of medial and lateral hamstrings, thumbs are on medial and lateral joint lines. Draw tibia forward. Test is positive if tibia slides forward.

Posterior Draw Sign - Knee

Test for tear in Posterior Cruciate Ligament. Pt lying supine, knees flexed, feet flat on table. Stabilize patients feet, cup hands around pt knee. Fingers rest on area of insertion of medial and lateral hamstrings, thumbs are on medial and lateral joint lines. Push tibia away. Test is positive if tibia slides backwards.

Anterior Draw Sign - Ankle

Test for tear in anterior talofibular ligament. One hand on pt calcaneus, one hand on lower tibia. Draw the calcaneus forward, while pushing tibia posteriorly. Test is positive if there is forward movement of talus on tibia.

Drop Arm Test

Test for torn rotator cuff. Patient fully abducts arm. Have patient slowly lower arm. If test is positive, arm will drop suddenly once it reaches 90° abduction.

Trendelenberg test

Testing strength of gluteus medius. Standing behind patient, ask patient to stand on one leg. If test is positive, pelvis of unsupported side drops.

Lateral Collateral Ligament Test

Tests lateral knee stability. Pt lying supine one knee slightly flexed. Apply varus (medial) stress to open knee joint on lateral side

Medial Collateral Ligament Test

Tests medial knee stability. Pt lying supine one knee slightly flexed. Apply valgus (lateral) stress to open knee joint on medial side

Mechanical advantage

The closer the weight is to the lever, the easier it is to lift

Muscles involved in Elbow Extension

Triceps, Anconeus

Muscles that extend the elbow

Triceps, Aneconeus

Muscle(s) of the radial nerve

Triceps, Aneconous, Brachioradialis, Supinator, Extensor Carpi Ulnaris, Extensor Carpi Radialis Longus and Brevis

Bony landmarks of the distal humerus

Trochlea, Capitulum, Medial Epicondyle, Lateral Epicondyle, Lateral Supercondylar Ridge, Olecranon Fossa

How does leg extension affect weight bearing

The straighter the leg the greater the weight it is holding

Insertion of the quadriceps tendon

Tibial Tuberosity

Ankle Invertors

Tibialis Posterior

T.W.B.

Toe Touch Weigh Bearing

TWB

Toe Touch Weigh Bearing

Self-Care

Toilet, Dressing, Eating

Contralateral pelvic droop is associated with what gait deviation?

Trandelenberg Gait or Gluteus Medial gait

Distal Carpal Row - Lateral to Medial

Trapezium, Trapezoid, Capitate, Hamate

What muscles are the primary movers of the scapula?

Trapezius, levator scapulae, rhomboids, serratus anterior, pec minor

Muscles that shrug shoulder

Upper Trapezius

Knee Extensors

Vastus Medialis/Lateralis/Intermedialis, Rectus Femoris

Steps in managed care referral

Visit PCP, PCP sends referral, PT evaluates and submits to PCP, PCP approves

Functional Activity: Elbow FLexion

Washing face

Functional Activity: Shoulder Adduction

Washing opposite side of body

Functional Activity: Shoulder Abduction

Waving

WBAT

Weight Bearing as Tolerated

6 Questions for work simplification

Who, what, where, when, why and how

Pathology that causes a loss of wrist extension and a weakened ability to release objects (finger extension)

Wrist Drop

Holding hand out to signal someone to stop

Wrist Extension: Extensors Carpi Ulnar, Extensors Carpi Radialis Longus and Brevis, Extensor digitorum

Pushing a door with an open hand

Wrist Extension: Extensors Carpi Ulnar, Extensors Carpi Radialis Longus and Brevis, Extensor digitorum

Pushing up from a support surface (wrist)

Wrist Extension: Extensors Carpi Ulnar, Extensors Carpi Radialis Longus and Brevis, Extensor digitorum

Pulling up on a card door handle

Wrist Flexion: Flexors Carpi Ulnar and Carpi Radialis, Palmeris Longus, Abductor Pollicus Longus

Functional position of the hand

Wrist slightly extended (30°), fingers slightly flexed, abduction and opposition of 1st metacarpal

Condyloid joint(s) of the body

Wrist, metacarpophalangeal

Tenderness in the anatomical snuffbox might indicate...

a fracture

What is the iliotibial band/tract?

a very long tendinous portion of tensor facia latae muscle; attaches to anterior portion of iliac creat and runs down lateral side of thigh, inserting on the tibia; may cause I.T. bursitis

Quadriceps Deficit Gait

a.k.a. back knee gait; knee locked into hyperextension throughout stance by compensatory action of g-max on thigh and soleus on leg; hand on thigh may aid hyperextension; hip ER assists tibial collateral ligament to resist flexion; vertical rise in COG

Lurch Gait

a.k.a. gluteus maximus gait; hyperextension of hip to move COG posterior to the hip because G. max weak; lurches forward with initial contact; may place hand behind weak hip

Anterior Tibial Compartment Gait

a.k.a. slap foot gait, steppage gait; inadequate control of dorsiflexion; paralyzed foot drops during swing causing an increase in hip and knee flexion and/or circumduction

Push Off

a.k.a. terminal stance; begins with heel off, ends with toe off of same foot

If from the lateral view a patient's pelvis has an exaggerated anterior rotation during terminal swing what muscle group(s) should be checked?

abdominals and hip extensors (check ROM in hip extension)

How can you test for a frozen shoulder?

abduct the patient's arm and feel for scapular motion; the scapula shouldn't move until about 20º of abduction (after which they move together in a 2/1 ratio); if moves before patient has restricted glenohumeral movement (frozen shoulder)

Scapular Upward Rotation

abducting arms above head

What movements take place in the frontal plane?

abduction/adduction

Opposition

ability to adduct thumb and little finger towards eachother

Goal of Push Off

accelerate mass

Goal of Foot Flat

accept weight, stabilize pelvis, and decelerate mass

Respiration

act of breathing air into and out of lungs (inhalation/exhalation)

Scapular Downward Rotation

adducting arms from above head, returning to anatomical position

If from an anterior aspect during mid swing the forefoot is dropped and eversion is not visible what muscle groups should be tested?

ankle dorsiflexors and foot evertors

From the lateral aspect a patient's knee can be seen to have exaggerated flexion during mid stance. What muscle group(s) should be checked?

ankle plantar flexors

Frozen Shoulder Syndrome

adhesive capsulitis; no glenohumeral motion, only scapulothoracic; glenohumeral joint doesn't move in normal ratio and is fixed in adduction; patient will have around 60º of motion from scapular rotation but is missing the other 120º of glenohumeral motion

Blood Pressure

amount of force exerted against the walls of an artery by the blood

Systolic Pressure

amount of force it takes to pump blood out of heart into arterial circulation

Body Temperature

amount of heat in the body that is a balance between the amount of heat produced and the amount lost by the body

Scapular winging can be caused by...

an injury to the long thoracic nerve (which innervates the serratus anterior)

orthostatic position

anatomical position

As a patient is walking toward him/her, a therapist observes that the plantar surface of the forefoot is not in view at heel strike. What muscle group(s) should be checked?

ankle dorsiflexors

Laterally it is observed that a patient's foot is slapping the floor at heel strike. What muscle group(s) should be checked?

ankle dorsiflexors

As a patient is walking away from you it can be seen that the arms are an an unequal distance from the body with both elbows flexed at terminal swing. What muscle group(s) would you check?

ankle plantar flexors and hip and knee extensors

If during terminal swing the plantar surface of the foot is not visible posteriorly and the forefoot is not in contact with the floor as heel is lifted what muscle groups should be tested?

ankle plantar flexors and hip and knee extensors

If it can be seen that during terminal swing a patient's leg is in exaggerated lateral rotation at the hip when observed from behind what muscle group(s) might need to be checked?

ankle plantar flexors and hip and knee extensors; knee may be forcefully extended to assist in push-off

Muscles active in Mid-stance

ankle plantarflexors (isometric)

What are the muscles active in shoulder flexion?

anterior deltoid, pec major

Lordosis increases when the pelvis tilts

anteriorly

Disability

any physical, mental or fictional impairment that limits a major activity; may be partial or complete; pc term is impairment

ADA Outlets

at least 24" high

Posterior Cruciate Ligament

attaches to posterior tibia in intercondylar area and runs to medial side of ACL; attaches to medial condyle of anterior femur; stabilizes knee in sagittal plane; hyperflexion can cause problems

Pulse

beat of heart felt at an artery as a wave of blood passes through the artery

Stance Phase

begins at heel strike and ends at toe off (reference limb); typically comprises 60% of cycle

Joint with 2° of freedom

biaxial

Common cause of drop foot

cast pressure at fibular head (where the nerve is superficial)

Hypotension

condition in which systolic BP is below 90 mmHg and diastolic is below 60 mmHg

(MS) Calluses Deviation Characteristics

d

Habilitation

d

Running

d

What is the action, origin, insertion and nerve of rhomboid major?

d

What is the glenohumeral to scapular (glenohumeral:scapular) ratio with regard to degrees of flexion or abduction?

d

Goal of Deceleration

decelerate leg, shank, position foot/prepare for contact

What is the action of the subclavius?

depress clavicle and pull anteriorly/inferiorly

Bones of the ankle

distal tibia and fibula sit atop the talus, which articulates with the superior surface of the calcaneus

Stride Length

distance between successive contact of the same limb (HS-HS=1 gait cycle); usually 2Xs step length

What action will make scapular winging apparent?

doing a push-up against the wall

How do you stress the SI joint for the Faber's test?

extend ROM by placing one hand on flexed knee and other on ASIS of opposite side; press down and if increased pain may be pathology of SI joint

Movements of the ulnohumeral joint

extension and flexion

(FF) Foot Flat Deviation Causes

fallen arch

Possible causes of a flat foot

fallen arch

Apparent Leg Length Discrepancy

first must establish that there is no true leg length discrepancy; no true bony inequality, but stems from pelvic obliquity or adduction/flexion hip deformity; with patient lying neutral in supine measure from umbilicus to the medial malleoli; unequal differences indicate a discrepancy

What movements take place in the saggital plane?

flexion/extention

What areas does the sciatic nerve supply

formed by the ventral rami of L4-S3;motor innervation to posterior compartment of the thigh, the "hamstring portion" of adductor magnus and all muscles of the leg & foot; sensory innervation to the skin of the lateral aspect of the leg, and almost all of the foot

Possible causes for hip hiking

fused joint, cast, prosthesis too long

Possible causes for vaulting

fused joint, leg length discrepancy

Causes for circumduction

fused joint, prosthetic knee too tight

Which carpal bone's prominent feature is a hook?

hamate

Possible causes of plantar fascitits

heel spurs, repetitive trauma

A patient is observed walking from an anterior aspect. During mid stance the right leg has an exaggerated outward rotation at the hip. What muscle group(s) should be tested?

hip adductors and medial rotators, knee extensors and ankle evertors

If it observed anteriorly that the leg is in abduction or circumducted while in mid swing what muscle group(s) should be tested?

hip and knee flexors (check ROM for hip adduction/flexion and knee flexion)

During mid swing a patient's leg is laterally rotated at the hip. This can be observed anteriorly. What muscles should be tested?

hip medial rotators and foot evertor

What is the action of the coracobrachialis?

horizontal flexion and adductionof the humerus at the shoulder

What bones make up the shoulder joint?

humerus, clavicle, scapula

Scapular Protraction

hunching shoulders; also referred to as scapular abduction

Shuffle

increased double stance time; found in diabetics (b/c loss of sensation) and elderly (b/c fear of falling)

Subtalar/Talocalcaneal Joint

inferior surface of the talus articulates with the superior-anterior surface of the calcaneus

What muscles are active in shoulder lateral rotation?

infraspinatus, teres minor, posterior deltoid

Stethoscope

instrument used to listen to sounds made by heart, lungs, and other organs

Sphygmomanometer

instrument used to measure BP

What movements take place in the transverse plane?

internal/external rotation

Anteriorly it is observed that at heel strike a patient's trunk is laterally displaced (to the right/left) and the leg is in lateral rotation. Upon testing it is found that foot evertors are weak. What would this gait accomplish?

lateral rotation prevents the ankle from rolling

What muscles are active in shoulder hyperextension?

lats, posterior deltoid

What muscles are active in shoulder medial rotation?

lats, teres major, subscapularis, pec major, anterior deltoid

Anteriorly it is observed that at heel strike a patient's trunk is laterally displaced (to the right/left) and the leg is in lateral rotation. Upon testing it is found that the knee extensors are weak. What would this gait accomplish?

leg is in lateral rotation to prevent hip flexion

Physical Mobility, impaired

limitation in independent, purposeful physical movement of the body or one or more extremities

Sciatic nerve location/palpation

located halfway between the ischial tuberosity and greater trochanter

What are the muscles involved in scapular depression?

lower traps, pec minor

Point When COG is at its Highest

mid stance

What muscles are active in shoulder abduction?

middle deltoid, supraspinatus

What are the muscles involved in scapular retraction?

middle trap, rhomboids

Pulse Rate

number of heartbeats or pulses felt in one minute

Cadence

number of steps per unit of time

Characteristics of weak dorsiflexors

occurs at heel strike, foot slap, steppage gait during mid-swing to compensate

Characteristics of weak quadriceps

occurs at heel strike, may need to manually extend knee

Characteristics of Antalgic Gait

occurs at heel strike, painful, tries to avoid weight bearing

Characteristics of foot flat (gait deviation)

occurs during foot flat, no push off

Characteristics of Plantar Fascitis

occurs during foot flat, stiff, painful, no push off

Characteristics of G. Medius Gait

occurs during mid-stance, head and trunk tip to stance side and pelvis tips upward during swing of opposite leg

Characteristics gait affected by corns

occurs during mid-stance, painful, limping, avoids toe off

Characteristics of Trendelenburg Gait

occurs during mid-stance, pelvis tips downward on swing side

Characteristics of hip hiking

occurs during swing, raise hip to allow foot to clear floor

Possible causes of weak quadriceps

recurrent dislocations

What are the muscles involved in scapular protraction?

serratus anterior, pec minor

Scapular Elevation

shoulder shrugging

Functional Activity: Knee Flexion

sitting

What are the muscles of the rotator cuff?

supraspinatus, infraspinatus, teres minor, subscapularis

Apical-Radial Pulse

taking apical & radial pulse at same time (stethoscope over heart=true HR)

Explain the Tinel sign test? What does it test for?

tap wrist over median nerve to see if reproduce symptoms of CTS; positive Tinel's sign produces a tingling/electrical shock sensation (usually without pain) in the distribution of the median nerve and indicates possible CTS

Vital Signs

temperature, pulse, respirations, and BP

Handicap

term frequently used as a synonym for disability or fictional limitation; now viewed as pejorative and "limitation in participation" is preferred

Pulse Deficit

the difference between apical and radial pulse rates

What is the Y-Ligament? Where are its attachments?

the illiofemoral ligament; looks like an inverted Y, reinforces the joint capsule anteriorly; attaches proximally to anterior inferior iliac spine

What is the femoral triangle?

the triangular formation made by the sartorius, adductor longus and inguinal ligament

True Leg Length Discrepancy

to determine measure with patient's legs in comparable positions from the anterior superior iliac spine to the medial malleolus (fixed bony landmarks); to determine which bone is shorter have patient flex knees and examine the knee: if one knee is higher than the other then the discrepancy lies in the tibia; if one knee is projected forward further, the discrepancy lies in the fibula

Demonstrate Phalen's test. What does it test for?

to reproduce symptoms of carpal tunnel syndrome; held for 1 minute

List the distal carpal bones from lateral (thumb) side medially?

trapezium, trapezoid, capitate, hamate

Uniaxial hingejoint of the arm

ulnohumeral

Joint with 1° of freedom

uniaxial

In a posterior pelvic tilt the ASIS moves

up

What are the muscles involved in scapular upward rotation?

upper and lower traps, serratus anterior

What are the muscles involved in scapular elevation?

upper traps, levator scapulae

What scapular motion is associated with shoulder abduction?

upward rotation

What scapular motion is associated with shoulder flexion?

upward rotation and protraction

Trendelenburg Gait

weak gluteus medius causes contralateral pelvis drop; bilateral causes penguin walk; stance leg is weak

Gluteus Medius Gait

weak gluteus medius causes pelvic drop on swing (non-affected) side with compensation by leaning trunk toward stance/affected side

Possible causes for trendelenburg gait

weak hip abduction on stance side

Possible causes of gluteus medius gait

weak hip abduction on stance side

Functional Activity: Ulnar/radial deviation

wiping down a counter top

Which sex generally has a larger carrying angle?

women (between 10º and 15º); men only fall around 5º


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