PTA EXAM (scorebuilders book)
What is the innervation level for resistive testing of cervical rotation?
C1
What is the innervation level for dermatome testing of the posterior head?
C2
What is the innervation level for resistive testing of shoulder elevation?
C2-C4
What is the innervation level for dermatome testing of the posterior-later neck?
C3
What is the innervation level for dermatome testing of the AC joint?
C4
What is the innervation level for dermatome testing of the lateral upper arm?
C5
What is the innervation level for reflex testing of the biceps?
C5
What is the innervation level for resistive testing of shoulder ABD?
C5
What is the innervation level for resistive testing of elbow flexion?
C5-C6
Flexion SCI occur most often at ___-___ level of the spine while extensions SCI occur mostly at the ___-___ level
C5-C6 C4-C5
What is the innervation level for dermatome testing of the lateral forearm and thumb?
C6
What is the innervation level for reflex testing of the brachioradialis?
C6
What is the innervation level for resistive testing of wrist extension?
C6
What is the innervation level for dermatome testing of the palmar distal phalanx-middle finger?
C7
What is the innervation level for reflex testing of the triceps?
C7
What is the innervation level for resistive testing of elbow extension?
C7
What is the innervation level for resistive testing of wrist flexion?
C7
Where do you put the tape measure when measuring thoracolumbar flexion and extension?
C7 and S1
What is the innervation level for dermatome testing of the little finger and ulnar border of the hand?
C8
What is the innervation level for resistive testing of thumb extension?
C8
What is the etiology of heart failure?
CAD Hypertension Diabetes mellitus MI Abnormal heart valves Cardiomyopathy
What is a Milwaukee orthosis?
CTLSO used to control scoliosis may be used for all kyphotic and scoliotic curves of 40 degrees or less
What is Stroke in Evolution?
CVA that usually caused by thrombus that gradually progresses; total neurologic deficits don't occur for 1-2 days
Myotome for S2
Calf and hamstring Wasting of gluteals and plantar flexors
Myotome for S1
Calf and hamstring Wasting of gluteals, peroneals and plantar flexors
What are the fine motor skills for a 2-3 month old?
Can see farther distances hands open more Visually follows through 180 degrees Grasp is reflexive Uses palmar grasp
What should you feel with a empty abnormal end feel?
Cannot reach end feel, usually do to pain ex. fracture bursitis joint inflammation
What is the largest cause of SCI?
Car accidents
Venous return must = _____ _____ when averages overtime because the cardiovascualr system is a closed loop
Cardiac Output
What are treatment options for osteogenesis imperfecta?
Caregiver education AROM Positioning Functional mobility Fracture management Use of orthotics
Where do most ischemic attack's (TIA) occur?
Carotid arteries Vertebrobasilar arteries
What is the etiology of pneumonia?
Caused by bacterial, viral, fungal or parasitic infection
What are red blood cells?
Cells that carry oxygen
What is a schwann cell?
Cells that cover nerve fibers in the peripheral nervous system and form the myelin sheath
What are white blood cells?
Cells that protect the body against infection
What part of the brain does Alzheimers originate from?
Cerebral cortex Subcortical areas of the brain
What are 10 examples of upper motor neuron diseases (UMNL)?
Cerebral palsy Hydrocephalus ALS (upper and lower) CVA Birth injuries MS Huntington's chorea TBI Pseudobulbar palsy Brain tumors
What are the parts that make up the forebrain?
Cerebrum Hippocampus Basal ganglia Amygdala Thalamus Hypothalamus Subthalamus Epithalamus
What is the most likely cause of anterior cord syndrome?
Cervical flexion
What is the most likely cause of central cord syndrome?
Cervical hyperextension that damages the spinothalamic tract, corticospinal tract and dorsal columns.
What is a halo vest orthosis?
Cervical thoracic orthosis Full restriction of all cervical motions Spinal cord injuries
What is non-fluent aphasia?
Characteristic of expressive aphasia where speech is non- functional, effortful and contains paraphasia. Writing is impaired also
What is fluent aphasia?
Characteristic of receptive aphasia where speech produces functional output regarding articulation, but lacks content and is typically dysprosodic using neologistic jargon
Abnormal Gait: What is circumduction gait?
Characterized by a circular motion to advance the leg during swing phase.
Abnormal Gait: What is ataxic gait?
Characterized by staggering and unsteadiness. There is usually a wide base of support and movements are exaggerated
What are signs and symptoms of a myocardial infarction?
Cheat discomfort Chest pressure SOB Upper body discomfort Nausea Vomiting Dizziness Sweating Palpitations
Paresthesia for C3
Cheek Side of neck
What can happen is the brainstem is impaired?
"Brain death"
What is congenital torticollis?
"Wry neck"; caused by unilateral contracture of the SCM muscle. Identified in the first 2 months of life
What is the level of assistance for ROM/ positioning for patient with high tetraplegia C1-C5? - PROM to trunk, legs and arms - pad position in bed
- Dependent - Able to verbally direct
What is the level of assistance for bathing for patient with high tetraplegia C1-C5? - bathing and drying off - upper body and lower body
- Dependent - Able to verbally direct
What is the level of assistance for bowel/ bladder problems for patient with high tetraplegia C1-C5? - intermittent catheterization - leg bag care - condom application - clean up - in bed/ wheelchair - feminine hygiene - bowel program
- Dependent - Able to verbally direct
What is the level of assistance for dressing for patient with high tetraplegia C1-C5? - dressing and undressing (in bed or wheelchair) - upper body/ lower body (in bed or wheelchair)
- Dependent - Able to verbally direct
What is the level of assistance for transfers for patient with high tetraplegia C1-C5? - bed - car - toilet - bath equipment - floor - upright wheelchair
- Dependent (C1-C4) - MaxA with level sliding board transfer (C5) - Verbally direct
What is the level of assistance for feeding for patient with high tetraplegia C1-C5? - drinking - finger feeding - utensil feeding
- Dependent (C1-C4) - MinA with adaptive equipment (C5) - Able to verbally direct
What is the level of assistance for grooming for patient with high tetraplegia C1-C5? - face - teeth - hair - makeup - shaving face
- Dependent (C1-C4) - MinA with adaptive equipment for face, teeth, makeup, shaving (C5) - MaxA/ ModA for hair (C5) - Able to verbally direct
What is the level of assistance for bed mobility for patient with high tetraplegia C1-C5? - rolling side to side - rolling supine/ prone - supine/ sitting - scooting all directions
- Dependent (C1-C4) - ModA to MaxA (C5) - Verbally direct
What is the level of assistance for wheelchair management for patient with high tetraplegia C1-C5? - wheel locks - footrest/leg rests - safety strap(s) - cushion adjustment - anti-tip levers - wheelchair maintenance
- Dependent with all - Able to verbally direct
What is the level of assistance for ROM/ positioning for patient with paraplegia? - PROM to trunk, legs and arms - pad position in bed
- Independent
What is the level of assistance for bed mobility for patient with paraplegia? - rolling side to side - rolling supine/ prone - supine/ sitting - scooting all directions
- Independent
What is the level of assistance for feeding for patient with paraplegia? - drinking - finger feeding - utensil feeding
- Independent
What is the level of assistance for grooming for patient with paraplegia? - face - teeth - hair - makeup - shaving face
- Independent
What is the level of assistance for bed mobility for patient with low tetraplegia (C7-C8)? - rolling side to side - rolling supine/ prone - supine/ sitting - scooting all directions
- Independent with all
What is the level of assistance for wheelchair management for patient with paraplegia? - wheel locks - footrest/leg rests - safety strap(s) - cushion adjustment - anti-tip levers - wheelchair maintence
- Independent with all
What is the level of assistance for transfers for patient with paraplegia? - bed - car - toilet - bath equipment - floor - upright wheelchair
- Independent with level surface and car transfer (depression) - MinA to Independent with floor transfers and uprighting wheelchair - Verbally direct
What is the level of assistance for wheelchair management for patient with low tetraplegia (C7-C8)? - wheel locks - footrest/leg rests - safety strap(s) - cushion adjustment - anti-tip levers - wheelchair maintenance
- May require assistance with cushion adjustment, anti- tip lever and wheelchair maintenance - Able to verbally direct
What is the level of assistance for bathing for patient with midlevel tetraplegia (C6)? - bathing and drying off - upper body and lower body
- MinA for upper body bathing and drying - ModA for lower body bathing and drying - Use of shower or tub chair - Able to verbally direct
What is the level of assistance for transfers for patient with midlevel tetraplegia (C6)? - bed - car - toilet - bath equipment - floor - upright wheelchair
- MinA to ModI for sliding board transfers - Dependent with wheelchair loading in car - Dependent with floor transfers and uprighting wheelchair - Verbally direct
What is the level of assistance for wheelchair mobility for patient with paraplegia? - smooth surfaces - up/ down ramps - up/down curbs - up/down steps - rough terrain
- MinA to ModI up/ down 6in curbs with manual wheelchair - ModI with descending steps with manual wheelchair - MaxA to MinA to ascend steps with manual wheelchair - Able to verbally direct
What is the level of assistance for ROM/ positioning for patient with low tetraplegia (C7-C8)? - PROM to trunk, legs and arms - pad position in bed
- MinA to ModI with all - Able to verbally direct
What is the level of assistance for bed mobility for patient with Mid-level tetraplegia (C6)? - rolling side to side - rolling supine/ prone - supine/ sitting - scooting all directions
- MinA to ModI with equipment - Verball direct
What is the level of assistance for ROM/ positioning for patient with midlevel tetraplegia (C6)? - PROM to trunk, legs and arms - pad position in bed
- ModA to ModI with all - Able to verbally direct
What is the level of assistance for dressing for patient with paraplegia? - dressing and undressing (in bed or wheelchair) - upper body/ lower body (in bed or wheelchair)
- ModI
What is the level of assistance for grooming for patient with low tetraplegia (C7-C8)? - face - teeth - hair - makeup - shaving face
- ModI
What is the level of assistance for dressing for patient with midlevel tetraplegia (C6)? - dressing and undressing (in bed or wheelchair) - upper body/ lower body (in bed or wheelchair)
- ModI for upper body in bed and wheelchair - MinA with lower body dressing in bed - ModA with lower body undressing in bed - Able to verbally direct
What is the level of assistance for dressing for patient with low tetraplegia (C7-C8)? - dressing and undressing (in bed or wheelchair) - upper body/ lower body (in bed or wheelchair)
- ModI for upper/ lower body dressing in bed - MinA with lower body dressing/ undressing in wheelchair (C7) - ModI for upper/ lower body dressing/ undressing in wheelchair (C8) - Able to verbally direct
What is the level of assistance for wheelchair mobility for patient with midlevel tetraplegia (C6)? - smooth surfaces - up/ down ramps - up/down curbs - up/down steps - rough terrain
- ModI in smooth, ramp and rough terrain with power wheelchair - Dependent to MaxA up/ down curb with power wheelchair - ModI to MinA on ramps and rough terrain with manual wheelchair - MaxA to ModA up/ down curbs with manual wheelchair - Able to verbally direct
What is the level of assistance for wheelchair mobility for patient with low tetraplegia (C7-C8)? - smooth surfaces - up/ down ramps - up/down curbs - up/down steps - rough terrain
- ModI on smooth, ramp and rough terrain with power wheelchair - Dependent to MaxA up/ down curb with power wheelchair - ModI on smooth surfaces and up/ down ramps with manual wheelchair - MinA to ModI on rough terrain - ModA to MinA up/ down curbs with manual wheelchair - Dependent to MaxA up/ down steps with manual wheelchair - Can verbally direct
What is the level of assistance for transfers for patient with low tetraplegia (C7-C8)? - bed - car - toilet - bath equipment - floor - upright wheelchair
- ModI to Independent with level surface transfer (siding board) - ModA to ModI with car trasfer - MaxA to ModA with floor transfers and uprighting wheelchair - Verbally direct
What is the level of assistance for feeding for patient with midlevel tetraplegia (C6)? - drinking - finger feeding - utensil feeding
- ModI with adaptive equipment
What is the level of assistance for grooming for patient with midlevel tetraplegia (C6)? - face - teeth - hair - makeup - shaving face
- ModI with adaptive equipment
What is the level of assistance for feeding for patient with low tetraplegia (C7-C8)? - drinking - finger feeding - utensil feeding
- ModI with adaptive equipment (C7)
What is the level of assistance for bathing for patient with paraplegia? - bathing and drying off - upper body and lower body
- ModI with all on tub bench or tub bottom cushion
What is the level of assistance for bathing for patient with low tetraplegia (C7-C8)? - bathing and drying off - upper body and lower body
- ModI with all using shower or tub chair
What is the level of assistance for weight shifts for patient with paraplegia? - pressure relief - repositioning in wheelchair
- ModI with depression weight shift
What is the level of assistance for weight shifts for patient with midlevel tetraplegia (C6)? - pressure relief - repositioning in wheelchair
- ModI with power recline/ tilt weight shift - MinA to ModI with side to side/ forward lean weight shift - Verbally direct
What is the level of assistance for weight shifts for patient with low tetraplegia (C7-C8)? - pressure relief - repositioning in wheelchair
- ModI with side to side/ forward lean, or depression weight shift
What is the level of assistance for gait for patient with high tetraplegia C1-C5? - don/ doff orthoses - sit/ stand - smooth surface - up/ down ramps - up/down curbs - up/down steps - rough terrain - safe falling
- N/A
What is the level of assistance for weight shifts for patient with high tetraplegia C1-C5? - pressure relief - repositioning in wheelchair
- Setup to ModI with power recline/ tilt weight shift - Dependent with manual recline/ tilt/ lean weight shift - Verbally direct
What is the level of assistance for wheelchair management for patient with midlevel tetraplegia (C6)? - wheel locks - footrest/leg rests - safety strap(s) - cushion adjustment - anti-tip levers - wheelchair maintenance
- Some assistance required - Able to verbally direct
What is the level of assistance for wheelchair mobility for patient with high tetraplegia C1-C5? - smooth surfaces - up/ down ramps - up/down curbs - up/down steps - rough terrain
- Supervision/ Setup to ModI on smooth, ramp, and rough terrain with power wheelchair - ModI with manual wheelchair on smooth surface in forward direction (C5) - MaxA to Dependent with manual wheelchair in all other situations (C5) - Able to verbally direct
What are the 2 main conditions of COPD
Chronic bronchitis Emphysema
What is asthma?
Chronic inflammation of the airways caused by an increased airway hypersensitivity to various stimuli
What gait pattern could be seen to compensate for insufficient hip or knee flexion or dorsiflexion?
Circumduction gait
Where is the carpal tunnel of the wrist located?
Close to the deep surface of the flexor retinaculum.
What are the 3 stages of motor learning?
Cognitive Associative Autonomous
What is the purpose of the RIGHT chambers of the heart?
Collect blood from the body and pump it to the lungs
What is the purpose of the LEFT chambers of the heart?
Collect blood from the lungs and pump it to the rest of the body
What are the 6 levels of consciousness?
Coma Stupor Obtundity Delirium Clouding of consciousness Consciousness
What is "A" considered on the ASIA Impairment Scale?
Complete- No sensory or motor function is preserved in sacral segments S4-S5
What are treatments for chronic venous insufficiency?
Compression stockings Elevation Varicose vein stripping
What is the purpose of the lower respiratory tract?
Conducts airway and the terminal respiratory units
What is a grade 2 concussion?
Confusion that last longer that 15 minutes Poor concentration, retrograde and antegrade amnesia
What is the etiology of aneurysms?
Congenital defect Weakness in the wall of the vessel often due to chronic hypertension Connective tissue disease Trauma Infection
What is the etiology of valvular heart disease?
Congenital defects, calcific degeneration, infective endocarditis, CAD, MI, rheumatic fever
What is the purpose of the Ligament Flavum?
Connects the lamina on one vertebra to another. Limits flexion and rotation.
What is akinetic mutism?
Conscious unresponsiveness
What is the parasympathetic nervous system?
Conserving and restoring energy Acetylcholine neurotransmitters Generally an inhibitory response
What is blocked practice?
Consistent practice of a single task
What are techniques used to increase ROM for mobility?
Contract- relax Hold- relax Joint distraction Rhythmical rotation Rhythmic stabilization
What is atrial systole?
Contraction of the atrias pushing blood into the ventricles
What is ventricular systole?
Contraction of the ventricles, forcing blood into the aorta and pulmonary artery
Bilateral occlusion (blockage) of the middle cerebral artery will typically produce what?
Contralateral hemiplegia and sensory impairment Dominant hemisphere impairment include global, Wernicke's or Broca's aphasia
What can happen if the medulla oblongata is impaired?
Contralateral impairment
What happens if the frontal lobe is impaired?
Contralateral weakness Perseveration, inattention Personality changes, antisocial behavior Impaired concentration, apathy Broca's aphasia (expressive deficits) Delayed or poor initiation Emotional lability
What are the fine motor skills for preschool age (3-4 yrs)?
Controls crayons better Copies circles or cross Matches color Cuts with scissors Draws recognizable human figures with head and 2 extremities Draws squares May demonstrate hand preference
what muscles are supplied by the musculocutaneous nerve?
Coracobrachialis Biceps brachii Brachialis
What are signs and symptoms of atherosclerosis?
Coronal Arteries- Angina pectoris Cerebral Arteries- Numbness or weakness of the UE or LE, difficulty speaking or slurred speech, drooping face Peripheral arteries- Intermittent claudication
The great cardiac vein, along with the small and middle cardiac veins drain into the _____ _____, emptying into the right atrium.
Coronary sinus
What do coronary venous circulation include?
Coronary sinus Cardiac veins Thebesian veins
Dermatomes for T5-T7
Costal margin
What are treatments for Huntingtons Disease?
Counseling Medication PT for endurance, strength, balance, posture and functional mobility
Where is the pia mater located?
Covers the contours of the brain Forms the choroid plexus of the ventricular system
What are some special test for elbow epicondylitis?
Cozen's test Later epicondylitis test Medial epicondylitis test
What are some special test for hip miscellaneous?
Craig's test Patrick's test (Faber test) Trendelenburg test
What are the 2 parts of the PNS?
Cranial nevers/ ganglia Spinal nerves/ ganglia/ plexuses
What are the gross motor skills for a 8-9 month old in mobility?
Crawls forwards Walks along furniture (cruising)
What is the average range of motion for extension?
0
What is the rang of motion for knee extension required for normal gait?
0 degrees
What is the average range of motion for digits (second to fifth) distal interphalangeal hyperextension?
0-10
What is the rang of motion for ankle dorsiflexion required for normal gait?
0-10 degrees
What is the rang of motion for hip extension required for normal gait?
0-10 degrees
What is the average range of motion for digits (second to fifth) proximal interphalangeal flexion?
0-100
What is the average range of motion for hip flexion?
0-120
What is the average range of motion for knee flexion?
0-135
What is the average range of motion for ankle eversion?
0-15
What is the average range of motion for thumb carpometacarpal flexion?
0-15
What is the average range of motion for elbow flexion?
0-150
What is the average range of motion for shoulder abduction?
0-180
What is the average range of motion for shoulder flexion?
0-180
What is the average range of motion for ankle dorsiflexion?
0-20
What is the average range of motion for radial deviation?
0-20
What is the average range of motion for thumb carpometacarpal extension?
0-20
What is the rang of motion for ankle plantar flexion required for normal gait?
0-20 degrees
What is the average range of motion for thoracic and lumbar spine extension?
0-25
What is the average range of motion for hip adduction?
0-30
What is the average range of motion for hip extension?
0-30
What is the average range of motion for ulnar deviation?
0-30
What is the rang of motion for hip flexion required for normal gait?
0-30 degrees
What is the average range of motion for ankle inversion?
0-35
What is the average range of motion for thoracic and lumbar spine lateral flexion?
0-35
What is the average range of motion for cervical spine extension?
0-45
What is the average range of motion for cervical spine flexion?
0-45
What is the average range of motion for cervical spine lateral flexion?
0-45
What is the average range of motion for digits (second to fifth) metacarpophalangeal hyperextension?
0-45
What is the average range of motion for hip ER?
0-45
What is the average range of motion for hip IR?
0-45
What is the average range of motion for hip abduction?
0-45
What is the average range of motion for thoracic and lumbar spine rotation?
0-45
What is the average range of motion for subtalar eversion?
0-5
What is the average range of motion for subtalar inversion?
0-5
What is the average range of motion for ankle plantarflexion?
0-50
What is the average range of motion for thumb metacarpophalangeal flexion?
0-50
What is the average range of motion for cervical spine rotation?
0-60
What is the average range of motion for shoulder extension?
0-60
What is the rang of motion for knee flexion required for normal gait?
0-60 degrees
What is the average range of motion for shoulder IR?
0-70
What is the average range of motion for thumb carpometacarpal abduction?
0-70
What is the average range of motion for wrist extension?
0-70
What is the average range of motion for forearm pronation?
0-80
What is the average range of motion for forearm supination?
0-80
What is the average range of motion for thoracic and lumbar spine flexion?
0-80
What is the average range of motion for thumb interphalangeal flexion?
0-80
What is the average range of motion for wrist flexion?
0-80
What is the average range of motion for digits (second to fifth) distal interphalangeal flexion?
0-90
What is the average range of motion for digits (second to fifth) metacarpophalangeal flexion?
0-90
What is the average range of motion for shoulder ER?
0-90
How many degrees of freedom does the subtler joint have?
1
How many degrees of freedom does the talocrural joint have?
1
How fast can an athlete return after a grade 1 concussion?
1 week after being free of symptoms
What is a Thoracolumbosacra orthosis (TLSO)?
Custom molded Prevents all trunk motion Post surgical stabilizer
What are the 8 Ranchos Los Amigos Levels of Cognitive Functioning
1. No Response 2. Generalized Response 3. Localized Response 4. Confused- Agitated 5. Confused- Inappropriate 6. Confused- Appropriate 7. Automatic- Appropriate 8. Purposeful- Appropriate
What are signs and symptoms of restrictive lung dysfunction?
Dyspnea on exertion A persistent non-productive cough Increased respiratory rate Hypoxemia Decreased vital capacity Abnormal breathing sounds Reduced exercise tolerance
What is the loose packed position for the talocrual joint?
10 PF Midway between maximum inversion and eversion
Tidal volume is approximately ___% of total lung volume
10%
Hemorrhage strokes are _____-_____% of CVA's
10-15%
What is the average cadence for an adult?
110-120 steps per minute
How many cranial nerves are there?
12
How many pairs of ribs are there?
12
How many cranial nerves are there?
12 pairs
What is normal blood pressure?
120/80 mmHg
What are the levels for prehypertensive BP?
120/80 to 139/89
What are the levels for stage 1 hypertensive BP?
140/90 to 159/99
Expiratory reserve volume (ERV) is approximately _____% of total lung volume.
15%
What are the levels for stage 2 hypertensive BP?
160/100 and above`
How many degrees of freedom does the knee have?
2
How many degrees of freedom does the radoiocarpal joint have?
2
How fast can an athlete return after a grade 2 concussion?
2 week after being free of symptoms and with exertion
What is the average base of support for adults?
2-4 inches
Double leg support makes up ___% of the gait cycle
20%
Embolus CVA's are _____% of ischemic CVS'a
20%
Multiple sclerosis can occur at any age with the highest incidence between ___-___ years of age
20-35
What is the normal range for HC03?
22-26 mEq/L
How fast can an ischemic attack (TIA) resolve?
24-48 hrs
Cardiac output can increase up to _____ L/min during exercise.
25
Residual volume is approximately ___% of total lung volume
25
What age do people with Duchenne Muscular Dystrophy typically live until and what causes their death?
25 Cardiopulmonary failure
What is the loose packed position of the tibiofemoral joint?
25 flexion
What is the average step length for adults?
28 inches
What is the normal age range for the rooting reflex?
28 weeks of gestation to 3 months
What is the normal age range for moro reflex?
28 weeks of gestation to 5 months
What is the normal age range for the startle reflex?
28 weeks of gestation to 5 months
What is the normal age range for the planter grasp reflex?
28 weeks of gestation to 9 months
How many degrees of freedom does the acromioclavicular joint have?
3
How many degrees of freedom does the iliofemoral joint have?
3
How many degrees of freedom does the shoulder joint have?
3
How many degrees of freedom does the sternoclavicular joint have?
3
What is normal tissue pressure within the carpal tunnel?
3-7 mm Hg
Carpal tunnel syndrome can result in pressure greater than ___ mm Hg in the wrist which produces ischemia within the median nerve
30
What is the loose packed position for the iliofemoral (hip) joint?
30 flexion 30 ABD Slight ER
What is the normal age range for the galant reflex?
30 weeks of gestation (being in the womb) to 2 months
How many spinal nerves are there?
31 pairs: 8 cervical 12 thoracic 5 lumbar 5 sacral 1 coccygeal
What is the normal age range for the positive support reflex?
35 weeks of gestation to 2 months
What is the normal range for PaCO2?
35-45 mmHg
What is the average age of developing symptoms of Huntington's Disease?
35-55yrs
What is the normal age range for the walking (stepping) reflex?
38 weeks of gestation to 2 months
The Coccyx is made up of ___ fused vertebrae
4
What is the normal blood volume?
4.5-5.0 L Women having slightly less
What is normal cardiac output?
4.5-5.0 L/ min Females may be a little less
Functional residual capacity is approximately ___% of the total lung volume
40%
The Sacrum is made up of ___ fused vertebrae
5
What is the closed pack position for the proximal radioulnar joint?
5 supination
What are the grades of manual muscle testing?
5/5 Normal- max resistance 4+/5 Good plus- mod/ max resistance 4/5 Good- mod resistance 4-/5 Good minus- min/ mod resistance 3+/5 Fair plus- min resistance 3/5 Fair- completes ROM AG but no resistance 3-/5 Fair minus- completes 1%-49% of ROM AG 2+/5 Poor plus- initiates movement AG 2/5 Poor- completes ROM in GE 2-/5 Poor minus- does not complete ROM in GE 1/5 Trace- contraction palpable but no joint movement 0/5 Zero- no palpable contraction
About ___% of DVT cases are asymptomatic.
50
Inspiratory reserve volume is approximately ___% of total lung volume
50%
What is the general age range of patients with Parkinson's?
50-79 yrs 10% are diagnosed before 40yrs old
What ages is typically seen with Guillain-Barre syndrome?
50-80yrs
What is the loose packed position for the glenohumeral joint?
55 ABD 30 horizontal ADD
What is the average stride length for adults?
56 inches
What are the normal age range for symmetrical tonic neck reflexes (STNR)?
6 to 8 months
Inspiratory capacity is approximately ___% of total lung volume
60%
What is normal stroke volume?
60-80 mL/beat
What is the average degree of toe out for an adult?
7 degrees
What is the normal range for pH?
7.35-7.45
What is the loose packed position for the ulnohumeral joint?
70 elboflexion 10 supination
What is the loose packed position for the proximal radioulnar joint?
70 elbow flexion 35 supination
VC is approximately ___% of total lung volume
75
What is the average pelvic rotation during gait for an adult?
8 degrees
Single leg support makes up ___% of the gait cycle
80%
What is the normal range for PaO2?
80-100 mmHg
What is the closed pack position for the radiohumeral joint?
90 flexion 5 supination
What is the normal range for SaO2?
95-98%
What is the capsular pattern of the tibiofemoral joint?
?Flexion Extension
What is a complete stroke?
A CVA that presents with total neurological deficits at the onset
What is post-polio syndrome?
A LMN pathology that affects the anterior horn cells of those previously affected with polio Muscle denervation
What is a DVT (deep vein thrombosis)
A blood clot that forms in a vein with the potential to dislodge as an embolism and travel until it blocks an artery
What is a comminuted fracture?
A bone breaks into many fragments
What is a stress fracture?
A break in a bone due to repeated forces to a particular portion of the bone
What is a spiral fracture?
A break in a bone shaped like an "S" due to torsion and twisting
What is a nonunion fracture?
A break in a bone that has failed to unite and heal after nine to twelve months
What is a greenstick fracture?
A break on one side of a bone that does not damage the periosteum on the opposite side. This type is often seen in children
What is a closed fracture?
A break that does not penetrate the skin
What is a neuroma?
A bundle of nerve endings that group together and produce pain due to scar tissue, pressure from the prosthesis or tension on the residual limb
What is decorticate rigidity?
A characteristic of a corticospinal lesion at the same level of the diencephalon where the trunk and the LE are positioned in extension and the UE are positioned in flexion
What is emotional liability?
A characteristic of a right hemisphere infarct where there is an inability to control emotions and outburst of laughing or crying that are inconsistent with the situation
What is decerebrate rigidity?
A characteristic of corticospinal lesion at the level of the brainstem that results in extension of the trunk and all extremities
What is epilepsy?
A chronic condition where there is temporary dysfunction of the brain what results in hypersynchronous electrical discharge of cortical neurons and seizure activity that is typically unprovoked and unpredictable
What is Amyotrophic Lateral Sclerosis (ALS)?
A chronic degenerative disease with both Upper and Lower motor neuron impairments. Results in denervation, muscle atrophy, weakness *rapid
What is osteoarthritis?
A chronic disease causing degeneration of articular cartilage, primarily in weight bearing joints More common in men then women up to age 55 More common in women then men +55 yrs old
What is chopping?
A combination of bilateral UE asymmetrical patterns performed as a closed- chair activity
What is diabetic neuropathy?
A complication and direct effect from diabetes mellitus Nerve damage
What is the proximal to distal concept of development?
A concept that uses the midline of the body as the reference point. Trunk control (midline stability) is acquired first with subsequent gain in distal control (extremities).
What is hemiplegia?
A condition of paralysis on one side of the body
What is hemiparesis?
A condition of weakness on one side of the body
What is ideomotor apraxia?
A condition where a person plans a movement or task but perform it due to motor issues. Automatic movement may occur, however, a person cannot impose additional movement on command
What is osteogenesis imperfecta?
A connective tissue disorder that affects the formation of collagen during bone development 4 levels Inheritance with type 1 and 4 is considered autosomal dominant traits Inheritance with type 2 and 3 is considered autosomal recessive traits
What is anemia?
A deficiency in red blood cells Blood carries less oxygen
What is key patterns?
A developmental sequence designed by Rood that directs patients' mobility recovery from synergy patterns through controlled motion
What is a coup lesion?
A direct lesion of the brain under the point of impact. Local brain damage is sustained
What is the pericardium?
A double walled connective tissue sac that surrounds the outside layer of the heart and great vessels
What is orthostatic hypotension?
A drop in blood pressure due to a sudden change of posture.
What is chorea?
A form of hyperkinesia that presents with brief, irregular contractions that are rapid
What is cogwheel rigidity?
A form of rigidity where resistance to movement has a phasic quality to it *parkinson's pateints
What is the 5th stage of recovery?
A further decrease in spasticity is noted with independence from limb synergy patterns
What is the mass to specific concept of development?
A general trend for a person to acquire simple movements and progress toward complex movements
What is the gross to fine concept of development?
A general trend for large muscle movement acquisition with progression to small muscle acquisition
What is down syndrome?
A genetic abnormality consisting of an extra 21st chromosome, termed trisomy 21
What is Chronic Obstructive Pulmonary Disease?
A group of lung diseases that block airflow due to narrowing of the bronchial tree The damage caused by chronic asthmatic bronchitis
What is limb synergies?
A group of muscles that produce a predictable pattern of movement in flexion or extension patterns
What is an epidural hematoma?
A hemorrhage that forms between the skull and dura mater
What is a subdural hematoma?
A hemorrhage that forms due to venous rupture between the dura and arachnoid
What is the midbrain?
A large relay station for information passing from the cerebrum, cerebellum and spinal cord Reflex center for visual, auditory and tactile responses
What is an upper motor neuron disease?
A lesion found in descending motor tracts within the cerebral motor cortex, internal capsule, brainstem or spinal cord
What is a lower motor neuron disease?
A lesion that affects nerves or their axons at or below the level of the brainstem, usually within the "final common pathway"
What is a complete lesion of a SCI?
A lesion to the spinal cord where there is no preserved motor or sensory function below the level of the lesion
What is an incomplete lesion of a SCI?
A lesion to the spinal cord with incomplete damage to the cord. There may be scattered motor function, sensory function or both below the level of the lesion
What is an aneurysm?
A localized abnormal dilation of a blood vessel, usually an artery
What is pleura?
A membrane lining of lungs and chest wall
What is light work?
A method used to develop controlled movement and skilled function by performing an activity (work) without resistance. Light work focuses on the extremities
What is heavy work?
A method used to develop stability by performing an activity (work) against gravity or resistance. Heavy work focuses on the strengthening of postural muscles
What is dysarthria?
A motor disorder of speech that is cause by an UMNL that affects muscles that are used to articulate words and sounds. Slurred speech
What is athetosis?
A movement disorder that presents with slow, twisting and writhing movements taht are large in amplitude
What is involuntary movement?
A movement that the person does not start or stop at a person's own command
What is fasciculation?
A muscular twitch that is caused by random discharge of a lower motor neuron and its muscle fibers
What is the etiology of cystic fibrosis?
A mutilation of the cystic fibrosis transmembrane conductance regulator on chromosome 7 A defective gene and its protein product cause the body to produce unusually thick, sticky mucus
What are coronary arteries?
A network of progressively smaller vessels that carry oxygenated blood to the myocardium
What is the Glasgow Coma Scale?
A neurological assessment tool used initially after injury to determine arousal and cerebral cortex function 8>x = severe brain injury 9-12 = moderate brain injury 13-15 = mild brain injury
What is Huntington's disease?
A neurological disorder of the CNS and is characterized by degeneration and atrophy of the basal ganglia and cerebral cortext of the brain. The neurotransmitters become deficient and are unable to modulate movement
What is the McGill Pain Questionnaire?
A pain assessment tool that is divided into 4 parts and has a total of 70 questions.
What is phantom limb?
A painless sensation where the patient feels that the limb is still present.
What is a grade III muscle/ tendon strain?
A palpable defect of the muscle Severe pain Poor motor control
What is rhythmic rotation (RR)? *Mobility
A passive technique used to decrease hypertonia by slowly rotating an extremity around the longitudinal axis. Relaxation of the extremity will increase ROM.
What is carpal tunnel syndrome?
A peripheral entrapment of the median nerve in the carpal tunnel causing sensory and motor issues
What is the cephalic to caudal concept of development?
A person develops head and UE control before trunk and LE control
What is spinal shock?
A physiology response that occurs between 30 and 60 minutes after trauma to the spinal cord and can last up to several weeks. Spinal shock presents with total flaccid paralysis and loss of all reflexes below the level of injury
What is strategy?
A plan used to produce a specific result or outcome that will influence the structure or system
What is an avulsion fracture?
A portion of a bone becomes fragmented at the site of tendon attachment due to a traumatic and sudden stretch of the tendon
What is the etiology of post- polio syndrome?
A previous diagnosis of polio is essential to diagnose 25-50%b of people with polio experience PPS decades after their initial recovery
How do you characterize chronic bronchitis?
A productive cough for 3months over a course of 2 consecutive years
What is the developmental sequence?
A progression of motor skill acquisition. The stages of motor control include mobility, stability, controlled mobility and skill
What is heart failure?
A progressive condition in which the heart cannot contain normal cardiac output to meet the body's demand for blood and oxygen Usually develops after other conditions have damaged the heart
What is Alzheimer's disease?
A progressive, neurodegenerative disorder that results in deterioration and irreversible damage within the cerebral cortex and subcortical areas of the brain NEURONS BREAK DOWN
What is an axon?
A projection of a nerve away from the cell body that conducts impulses
What is joint distraction? *Mobility
A proprioceptive component used to increase range of motion around a joint. Consistent manual traction is provided slowly and usually in combination with mobilization techniques. It can also be used in combination with quick stretch to initiate movement.
Abnormal Gait: What is antalgic gait?
A protective gait pattern where the involved step length is decreased in order to avoid weight bearing on the involved side
What is posterior cord syndrome?
A relatively rare syndrome that is caused by compression of the posterior spinal artery.
What is a rotator cuff tear?
A rotator cuff tear involves injury to one or more of the muscles participating in formation of that muscular structure. The supraspinatus, infraspinatus, subscapularis, and teres minor are the major muscles of the rotator cuff. Partial thickness- Extends through a portion of the tendon Full thickness- Complete tear of the tendon 1cm or less - more the 5cm
What is a contracture?
A severe tightening of a flexor muscle resulting in bending of a joint
What are motor units?
A single motor neuron and all muscle fibers innervated by it
What is non- associative learning?
A single repeated stimulus (habituation, sensitization)
What are Parapodiums?
A standing frame designed to allow a patient to sit when necessary. Ambulation is achieved by shifting weight and rocking the base across the floor. Pediatric population
What is consciousness?
A state of alertness, awareness, orientation and memory
What is obtundity?
A state of consciousness that is characterized by a state of sleep, reduced alertness to arousal and delayed responses to stimuli
What is delirium?
A state of consciousness that is characterized by disorientation, confusion, agitation, and loudness
What is clouding of consciousness?
A state of consciousness that is characterized by quiet behavior, confusion, poor attention and delayed responses
What is a stupor?
A state of general unresponsiveness with arousal occurring from repeated stimuli
What is rigidity?
A state of severe hypertonicity where a sustained muscle contraction does not allow for any movement at a specified joint
What is a coma?
A state of unconsciousness and a level of unresponsiveness to all internal and external stimuli
What is slow reversal (SR)? *Stability *Controlled mobility *Skill
A technique of slow and resisted concentric contractions of agonist and antagonist around a joint without rest between reversals. This technique is used to improve control of movement and posture
What is hold- relax active movement (HRAM)? *Mobility
A technique to improve initiation of movement to muscle groups tested at 1/5 or less. An isometric contraction performed once the extremity is passively placed into a shortened range within the pattern. Overflow and facilitation may be used to assist with the contraction. Upon relaxation, the extremity is immediately moved into a lengthened position of the pattern with a quick stretch. The patient is asked to return the extremity to the shortened position through an isotonic contraction.
What is rhythmic initiation (RI)? *Mobility
A technique used to assist in initiating movement when hypertonia exist. Movement progresses from passive ("let me move you"), to active assistive ("help me move you"), to slightly resistive ("move against the resistance"). Movement must be slow and rhythmical to reduce the hypertonia and allow for full ROM.
What is resisted progression (RP)? *Skill
A technique used to emphasize coordination of proximal components during gait. Resistance is applied to an area such as the pelvis, hips or extremity during the gait cycle in order to enhance coordination, strength or endurance.
What is normal timing (NT)? *Skill
A technique used to improve coordination of all components of a task. NT is performed in a distal to proximal sequence. Proximal components are restricted until the distal components are activated and initiate movement. repetition of the pattern produces a coordinated movement of all components.
What is rhythmic stabilization (RS)? *Mobility *Stability
A technique used to increase ROM and coordinate isometric contractions. The technique requires isometric contractions of all muscles around a joint against progressive resistance. The patient should relax and move into the newly acquired range and repeat the technique. If stability is the goal, RS should be applied as a progression from AI in order to stabilize all muscle groups simultaneously around the specific body part.
What is contract- relax (CR)? *Mobility
A technique used to increase range of motion As the extremity reaches the point of limitation, the patient performs a maximal contraction of the antagonistic muscle group. The therapist resists movement for 8-10 seconds with relaxation to follow. The technique is repeated until no further gains in range of motion are noted during the session
What is repeated contractions (RC)? *Mobility
A technique used to initiate movement and sustain a contraction through the rang of motion. RC is used to initiate a movement pattern, through a weak movement pattern or at a point of weakness within a movement pattern. The therapist provides a quick stretch followed by isometric or isotonic contractions
What is inhibition?
A technique utilized to decrease excessive tone or movement
What is facilitation?
A technique utilized to elicit voluntary muscular contraction
What is performance?
A temporary change in motor behavior seen during a particular session of practice that is a result of many variables, however, only one variable is focusing on the act of learning
What is Guillain-Barre syndrome?
A temporary inflammation and demyelination of the peripheral nerves' myelin sheaths, potentially resulting in axonal degeneration
What is paraplegia?
A term used to describe injuries that occur at the level of the thoracic, lumbar and sacral spine
What is a Taylor brace?
A thoracolumbosacral orthosis that limits trunk flexion and extension through a 3 point control design.
What is the Numerical Rating Scale?
A tool used to assess pain intensity using a 10-15cm line with the left anchor indicating "no pain" and the right anchor indicating "the worst pain you can have"
What are symptoms of an ectopic bone?
Edema Decreased ROM Increased tempurature
What are treatments options for osgood- schlatters disease?
Education Icing Flexibility exercises
What are treatments for cerebral palsy?
Education Normalizing tone Stretching Strengthening Positioning Mobility skills Splinting Assistive devices Surgery if needed
What are treatment options for Duchenne Muscular Dystrophy?
Education Respiratory function Submaximal exercises Mobility skill Orthotics Splinting Adaptive equipment Medication Surgery
What are treatment options for orthostatic hypotension?
Elastic stockings Abdominal binders Slow movements from laying to sitting Medication
Contraction of the external and internal intercostal muscles ____ (elevate/ depress) the ribs
Elevate
What is the normal value of acidemia?
Elevated acidity of blood pH < 7.35
What are the motions of the sternoclavicular joint?
Elevation Depression Protraction Retraction Medial Rotation (IR) Lateral Rotation (ER)
What is the hip strategy?
Elicited by a greater force, challenge or perturbation through the pelvis and hips
What is the stepping strategy?
Elicited through unexpected challenges or perturbation during static standing or when the perturbation produces such a movement that the center of gravity is beyond the BOS
What are some special test for hip contracture/ tightness?
Ely's test Ober's test Piriformis test Thomas test Tripod sign 90- 90 straight leg raise
What are the 4 abnormal end feels?
Empty Firm Hard Soft
What is the endocardium?
Endothelial tissue that lines the interior of the heart chambers and valves
Dermatome for C3
Entire neck Posterior cheek Temporal area Prolongation forward under mandible
The sympathetic influence is achieved by release of _____ and _____
Epinephrine Norepinephrine
What is the most common contracture associated with a transmetatarsal and Syme's amputations?
Equinus deformity
What muscles assist in thoracolumbar extension?
Erector Spinae Quadratus Lumborum Multifidus
What muscles assist with thoracic and lumbar extension?
Erector Spinae Quadratus Lumborum Multifidus
What is another name for red blood cells?
Erythrocytes
How do you challenge somatosensory input?
Examination of vibration and pressure Changing surfaces (slopes, uneven surface, standing on foam, even surface) *eyes open/ eyes closed
What are signs and symptoms of COPD?
Excessive mucus production Chronic productive cough Wheezing SOB Fatigue Reduced exercise capacity
What is glenohumeral instability?
Excessive translation of the humeral head on the glenoid during active motion
What is a closed-chain exercise?
Exercises that involve motions in which the body moves on a distal segment that is fixed or stabilized on a support surface Ex. Squats
What is an open-chain exercise?
Exercises that involves the distal segment, usually the hand or foot, moves freely in space Ex. Kicking a ball
During quiet breathing, _____ (exhalation/ inhalation)results from passive recoil of the lungs and rib cage.
Exhalation
Where is the radial collateral ligament of the elbow located?
Extends from the lateral epicondyle of the humerus to the lateral border and olecranon process of the ulna and to the annular ligament.
What is the closed pack position for the cervical spine?
Extension
What is the closed pack position for the ulnohumeral joint?
Extension
What is the closed pack position for the radoiocarpal joint?
Extension with radial deviation
What muscles assist with wrist radial deviation?
Extensor Carpi Radialis Flexor Carpi Radialis Extensor Pollicis Longus and Brevis
What muscles assist with wrist extension?
Extensor Carpi Radialis Brevis Extensor Carpi Radialis Longus Extensor Carpi Ulnaris
What muscles assist with wrist ulnar deviation?
Extensor Carpi Ulnaris Flexor Carpi Ulnaris
Myotome for L5
Extensor hallucis Peroneals Gluteus Medius Dorsiflexors Hamstrings and Calf atrophy
What is the descending tectospinal tract?
Extrapyramidal motor tract responsible for contralateral postural muscle tone associated with auditory/ visual stimuli
What is the descending reticulospinal tract?
Extrapyramidal motor tract responsible for facilitation or inhibition of voluntary and reflex activity through the influence on alpha and gamma motor neurons
What is the descending vestibulospinal tract?
Extrapyramidal motor tract responsible for ipsilateral gross postural adjustments subsequent to head movements, facilitating activity of the extensor muscles and inhibiting activity of the flexor muscles
What is the descending rubrospinal tract?
Extrapyramidal motor tract responsible for motor input of gross postural tone, fascilitating activity of flexor muscles and inhibiting the activity of the extensor muscles
What are signs and symptoms of pulmonary edema?
Extreme SOB, difficulty breathing, a feeling of suffocating or drowning, wheezing or gasping for air, anxiety, restless, a sense of apprehension, coughing, frothy/ blood tinged sputum, chest pain and rapid/ irregular pulse
What are signs and symptoms of mysthenia gravis?
Extreme fatigue Extreme skeletal muscle weakness Ocular muscles are typically affected first Ptosis Diplopia Dyspghagia Dysarthria Cranial Nerve weakness
What is knowledge of performance?
Extrinsic feedback that relates to the actual movement pattern that someone used to achieve their goal of movement
What is the equation for functional residual capacity (FRC)?
FRC = ERV + RV functional residual capacity = expiratory reserve volume + residual volume
What are ribs 8-10 called?
False ribs
What are signs and symptoms of PAD?
Fatigue, aching, numbness, or pain primarily in the buttocks, thigh, calf or foot at rest or when walking Poor healing wounds of the hands and feet Distal hair loss Trophic skin changes Hypertrophic nails
What is knowledge of results?
Feedback about the outcome
What are signs and symptoms of a PCL sprain?
Feeling as if the femur is sliding off the tibia Swelling Mild pain **Most patients are asymptomatic
What are signs and symptoms of pneumonia?
Fever Cough SOB Sweating Shaking chills Chest pain that fluctuates with breathing Headache Muscle pain Fatique
What is the sympathetic nervous system?
Fight or flight Prepares body for emergency response Norepinephrine neurotransmitters Generally a stimulating response
What are the fine motor skills for a 10-11 month old?
Fine pincer grasp developed Puts objects into containers Grasps crayon adaptively
What is the cerebellum?
Fine tuning of movement and assists with maintaining posture and balance by controlling muscle tone and positioning of the extremities in space
What are some special test for wrist/ hand miscellaneous?
Finkelstein test
What are the 3 normal end feels?
Firm Hard Soft
What are treatments for down syndrome?
Fitness Stability Respiratory function Surgery for cardiac abnormality if needed
What are characteristics of cauda equina syndrome?
Flaccidity Areflexia Impairment of bowl and bladder function
What is the capsular pattern for the iliofemoral (hip) joint?
Flexion ABD IR
What are the motions for the ulnohumeral joint?
Flexion Extension
What is the capsular pattern for the ulnohumeral joint?
Flexion Extension
What are the motions of the iliofemoral (hip) joint?
Flexion Extension ABD ADD IR ER
What motions are associated with the Atlantoaxial joints?
Flexion Extension Lateral flexion Rotation
What motions occur in the saggital plane and along what axis?
Flexion Extension Medial/ Lateral axis
What are the motions of the radiohumeral joint?
Flexion Extension Pronation Supination
What is the capsular pattern for the radiohumeral joint?
Flexion Extension Supination Pronation
What motions are associated with the Atlanto- Occipital joint?
Flexion Extension ex. Nodding yes
What are the motions of the radoiocarpal joint?
Flexion Extension Radial Deviation Ulnar Deviation
What are the motions of the tibiofemoral joint?
Flexion Extension IR ER
What is the capsular pattern for the radoiocarpal joint?
Flexion and extension equally limited
What is the response to the palmar grasp reflex?
Flexion of the fingers causing strong grip
What is homolateral synkinesis?
Flexion pattern of the involved UE facilitates flexion of the involved LE
What are the motions of the cervical spine?
Flexion/ Extension Lateral Flexion Rotation
What muscles assist with wrist flexion?
Flexor Carpi Radialis Flexor Carpi Ulnaris Palmaris Longis
What muscles are supplied by the ulnar nerve?
Flexor carpi ulnaris Flexor digitorum profundus Most small muscles of the hand
What muscles are supplied by the medial root of the median nerve?
Flexor muscles of the forearm, except flexor carpi ulnaris and 5 muscles in the hand
What muscles are supplied from the lateral root of the median nerve?
Flexor muscles of the forearm, except flexor carpi ulnaris and 5 muscles in the hand
What are ribs 11 and 12 called?
Floating ribs
What are the fine motor skills for a 16-24 month old?
Folds paper Strings beads Stacks six cubes Imitates vertical and horizontal strokes with crayon on paper Holds crayon with thumb and fingers
What is the valsalva maneuver?
Forced expiration against a closed glottis produces increased intrathoracic pressure, increased central venous pressure, and decreased venous return
What are the 3 parts of the brain?
Forebrain Midbrain Hindbrain
What motions occur in the frontal plane and along what axis?
ABD ADD Anterior/ Posterior axis
What is the closed packed position for the glenohumeral joint?
ABD Lateral Rotation (ER)
A MCL sprain often involves injury to other knee structures such as the ___ or ___.
ACL Medial Meniscus
Injury to the MCL often involves injury to other knee structures such as the ____ or ____.
ACL Medial meniscus
LCL is rarely completely torn without a concurrent injury to the ___ or ___.
ACL PCL
Where is the iliofemoral ligament. of the hip located?
ASIS to the intertrochanteric line of the femur
What is the atrioventricular valve?
AV valves lie between the atria and ventricles
What are the precautions to a posterolateral approach to a total hip arthroplasty?
AVOID: - hip flexion beyond 90 - hip adduction - IR
What are the precautions to a anterolateral approach to a total hip arthroplasty?
AVOID: - hip flexion beyond 90 - hip extension - hip ER - hip adduction
What are the precautions to a direct lateral approach to a total hip arthroplasty?
AVOID: - hip flexion beyond 90 - hip extension - hip ER - hip adduction
Dermatome for T8-T12
Abdomen and lumbar region
What muscles are supplied by the lateral plantar nerve?
Abductor digiti minimi Flexor digiti minimi Opponens digiti minimi Dorsal interossei Quadratus plantae Adductor hallucis Lumbrical II, III, IV Plantar interossei
What muscles are supplied by the medial plantar nerve?
Abductor hallucis Lumbrical I Flexor digitorum brevis Flexor hallucis brevis
What is the level of assistance for gait for patient with paraplegia? - don/ doff orthoses - sit/ stand - smooth surface - up/ down ramps - up/down curbs - up/down steps - rough terrain - safe falling
Abilities range from: - Exercise only with KAFO - Household gait with KAFO - Limited community gait with KAFO - Functional community ambulation with or without orthoses
What does the palmar grasp reflex interfere with?
Ability to grasp and release objects voluntarily Weight bearing on open hand for propping, crawling, protective responses
What is the purpose of localization of touch sensory testing?
Ability to identify the exact location of light touch on the body using a verbal response or gesturing
What does the tonic labyrinthine reflex (TLR) interfere with?
Ability to initiate rolling Ability to prop on elbows with extended hips when in prone Ability to flex trunk and hips to come to sitting position from supine position Often causes full body extension, which interferes with balance in sitting or standing
What is kinesthesia?
Ability to perceive the direction and extent of movement of a joint or body part
What does symmetrical tonic neck reflexes (STNR) interfere with?
Ability to prop on arms in prone position Attaining and maintaining hands and knees position Crawling reciprocally Sitting balance when looking around use of hands when looking at object in hands in sitting position
What does the planter grasp reflex interfere with?
Ability to stand with feet flat on surface Balance reactions and weight shifting in standing
What is the 8th level "Purposeful- Appropriate " of the Ranchos Los Amigos Levels of Cognitive Functioning?
Able to recall past events Carryover of new learned tasks
What is neuroma?
Abnormal growth of nerve cells; associated conditions include vasculitis, AIDS, and amyloidosis
What is ptosis?
Abnormal low-lying or drooping upper eyelid.
What is the etiology of restrictive lung dysfunction?
Abnormal lung parenchyma, abnormal pleura, and disorders affecting ventilatory pump function
What are signs and symptoms of cerebral palsy?
Abnormal muscle tone Impaired movement Abnormal reflexes Impaired mobility
What is restrictive lung dysfunction?
Abnormal reduction in lung expansion and pulmonary ventilation
What is leukocytosis?
Abnormally high WBC count which can indicated infection or leukemia
Why is a patient with a SCI at a greater risk for a DVT?
Absence or decrease in the normal pumping action by active contractions of musces in the LE
What are the 3 phases of the swing phase according to standard terminology?
Acceleration Midswing Deceleration
What is the posterolateral approach to a total hip arthroplasty?
Access to the hip occurs by splitting the glute max muscle in line with the muscle fibers. The short external rotators are then released and the hip abductors are retracted anteriorly. This approach maintains the integrity of the gluteus medius and vastus lateralis muscles. The femur is the dislocated posteriorly. Although it is the most commonly used approach, the procedure results in a high post-op dislocation rate.
What is the anterolateral approach to a total hip arthroplasty?
Access to the hip occurs through the interval between the TFL and the glute medius. Some portions of the hip ABDs are released from the greater trochanter and the hip is dislocated anteriorly.
What are treatment options for osteoarthritis?
Acetaminophen NSAIDs Corticosteroids Injections Improve range Cooling agents Education Strengthening TENS Energy conservation Weight loss
The parasympathetic influence is achieved by release of _____ from the _____ nerve
Acetylcholine Vagus
What are signs and symptoms of achilles tendonitis?
Aching or burning of the posterior heel Tenderness Pain with increased activity Swelling or thickening of the tendon area muscle weakness due to pain Morning stiffness
What are contraindications for joint mobilization?
Active disease Infection Advanced osteoporosis Articular hyper mobility Fracture Acute inflammation Muscle guarding Joint replacement
What is the reflex name for a 2+ grade and is it normal?
Active normal response Normal
What is the etiology of bronchitis?
Acute- cold viruses and exposure to smoke or other air pollutants Chronic- Smoking is primary cause but exposure to air pollutants, dust or toxic gases in the environment or workplace
What muscles assist with Hip adduction?
Adductor Magnus Adductor Longus Adductor Brevis Gracilis
What muscles are supplied by the obturator nerve?
Adductor longus Adductor brevis Adductor magnus Obturator externus Gracilis
What are some special test for thoracic outlet syndrome?
Adson maneuver Allen test Roos test
What are examples of nonopioid agents?
Advil tylenol Aleve
Vestibulocochlear Nerve (8 or VIII) Afferent (Sensory): Efferent (Motor): Test:
Afferent (Sensory): 1. Hearing: ear 2. Balance: ear Efferent (Motor): N/A Test: 1. Hear watch tick 2. Hearing tests 3. Balance and coordinatioin
Glossopharyngeal Nerve (9 or IX) Afferent (Sensory): Efferent (Motor): Test:
Afferent (Sensory): 1. Touch, pain: posterior tongue, pharynx 2. Posterior tongue Efferent (Motor): 1. Voluntary motor: select muscles of the pharynx 2. Autonomic: parotid gland Test: 1. Gag reflex 2. Ability to swallow
Optic Nerve (2 or II) Afferent (Sensory): Efferent (Motor): Test:
Afferent (Sensory): 1. Sight; eye Efferent (Motor): N/A Test: 1. Test visual fields
Olfactory Nerve (1 or I) Afferent (Sensory): Efferent (Motor): Test:
Afferent (Sensory): 1. Smell; nose Efferent (Motor): N/A Test: 1. Identifying familiar odors
Facial Nerve (7 or VII) Afferent (Sensory): Efferent (Motor): Test:
Afferent (Sensory): 1. Taste: anterior tongue Efferent (Motor): 1. Voluntary motor: Facial muscles 2. Autonomic: Lacrimal, submandibular, and sublingual glands Test: 1. Close eyes tight 2. Smile and show teeth 3. Whistle and puff cheeks 4. Identify familiar taste
Trigeminal Nerve (5 or V) Afferent (Sensory): Efferent (Motor): Test:
Afferent (Sensory): 1. Touch, pain: Skin of face, mucous membranes of nose, sinuses, mouth, anterior tongue Efferent (Motor): 1. Voluntary motor: Muscles of mastication Test: 1. Corneal reflex 2. Face sensation 3. Clench teeth; push down on chin to separate jaw
Vagas Nerve ( 10 or X) Afferent (Sensory): Efferent (Motor): Test:
Afferent (Sensory): 1. Touch, pain: pharynx, larynx, bronchi 2. Taste: tongue, epiglottis Efferent (Motor): 1. Voluntary motor: muscles of palate, pharynx and larynx 2. Autonomic: thoracic and abdominal viscera Test: 1. Gag reflex 2. Ability to swallow 3. Say "Ahhh"
Abducens Nerve (6 or VI) Afferent (Sensory): Efferent (Motor): Test:
Afferent (Sensory): N/A Efferent (Motor): 1. Voluntary motor: Lateral rectus muscle of the eyeball Test: 1. Lateral gaze
Hypoglossal Nerve (12 or XII) Afferent (Sensory): Efferent (Motor): Test:
Afferent (Sensory): N/A Efferent (Motor): 1. Voluntary motor: Muscles of tongue Test: 1. Tongue protrussion
Trochlear Nerve (4 or IV) Afferent (Sensory): Efferent (Motor): Test:
Afferent (Sensory): N/A Efferent (Motor): 1. Voluntary motor: superior oblique muscle of eyeball Test: 1. Downward and inward gaze
Accessory Nerve (11 or XI) Afferent (Sensory): Efferent (Motor): Test:
Afferent (Sensory): N/A Efferent (Motor): 1. Voluntary motor: SCM and traps Test: 1. Resisted shoulder shrug
Oculomotor Nerve (3 or III) Afferent (Sensory): Efferent (Motor): Test:
Afferent (Sensory): N/A Efferent (Motor): 1. Voluntary motor; levator of eyelid; superior, medial and inferior recti; inferior oblique muscle of eyeball. 2. Autonomic; smooth muscle of eye Test: 1. Upward, downward and medial gaze 2. Reaction to light
What are risk factors for chronic venous insufficiency?
Age FEMALE Obesity Pregnancy Prolonged sitting or standing
What are techniques used for proximal dynamic stability for stability?
Agonistic reversal Resisted progression
What are techniques used for controlled mobility?
Agonistic reversals Slow reversal Slow reversal hold
What are some special test for wrist/ hand vascular insufficiency?
Allen test Capillary refill test
Abnormal Gait: What is double step gait?
Alternate steps are of a different length or at a different rate
What are techniques used for strength?
Alternating isometrics Repeated contractions Resisted progressions Timing for emphasis
What are techniques used for stability?
Alternating isometrics Rhythmic stabilization Slow reversal Slow reversal hold
Progression of COPD includes....
Alveolar destruction Subsequent air trapping
What is venous return?
Amount of blood returning to the right atrium each minute
What is a hemorrhage stroke?
An abnormal bleeding in the brain due to a rupture in blood supply due to disruption of oxygen to an area of the brain and compression from the accumulation of blood
What is nystagmus?
An abnormal eye movement that entails non-volitional, rhythmic oscillation of the eyes. The speed of movement is typically faster in one direction and its origin is congenital or acquired.
What is saltatory conduction?
An action potential moving along an axon in a jumping fashion from node to node Decreases the use of sodium- potassium pumps and increases the speed of conduction
Where is the epidural space located?
An area between the skull and the outer dura mater that can be abnormally occupied
What is myasthenia gravis?
An autoimmune neuromuscular disease that affects transmission of nerve impulses to the muscles at the neuromuscular junction. Antibodies block or destroy the receptors that are needed for acetylcholine uptake and this prevents muscle contraction
What is cystic fibrosis?
An autosomal recessive genetic disease of the exocrine glands that primarily affects the lungs, pancreas, liver, intestines, sinuses and sex organs
What is a dendrite?
An extension from the cell body that receives signals from other neurons
What is spina bifida occulta?
An impairment and non- fusion of the spinous processes of a vertebrae, however, the spinal cord and meninges remain intact
What is anterior cord syndrome?
An incomplete lesion that results from compression and damage to the anterior part of the spinal cord or anterior spinal artery.
What is central cord syndrome?
An incomplete lesion that results from compression and damage to the central portion of the spinal cord. UE>LE Motor deficits > sensory deficits
What is Brown-Sequard syndrome?
An incomplete lesion usually caused by a stab wound, which produces hemisection of the spinal cord.
What is sacral sparing?
An incomplete lesion where some of the inner tracts remain innervated and patient still has sensation to the saddle area, movement of the toes and rectal sphincter control
What is effusion?
An increased volume of fluid within a joint capsule
What is cauda equina syndrome?
An injury that occurs below the L1 spinal level where the long nerve roots transcend.Can be complete, but they are mostly incomplete due to the large number of nerve roots in the area. Considered peripheral nerve injury Full recovery is not typical due to distance needed for axonal regeneration
What is a contrecoup lesion?
An injury that results on the opposite side of the brain. This lesion is due to the rebound effect of the brain after impact
What is associated reaction?
An involuntary and automatic movement of a body part as a result of an intentional active or resistive movement in another body part
What is mononeuropathy?
An isolated nerve lesion; associated conditions include trauma and entrapment
What are agonistic reversals (AR)? *Controlled Mobility *Skill
An isometric concentric contraction performed against resistance followed by alternating concentric and eccentric contractions with resistance. (AR) requires use in a slow and sequential manner, and may be used in increments throughout the range to attain maximum control
What is hold- relax (HR)? *Mobility
An isometric contraction used to increased ROM The contraction is facilitated for all muscle groups at the limiting point in the ROM. Relaxation occurs and the extremity moves through the newly acquired range to the next point of limitation until no further increases in ROM occur. The technique is often used for patients that present with pain
Which energy system does not require oxygen?
Anaerobic glycolysis
What do low hematocrit levels suggest?
Anemia, blood loss, and vitamin/ mineral deficiencies
What are sign and symptoms of CAD?
Angina Shortness of breath
What is an AFO?
Ankle foot orthosis
What abnormal gait pattern is secondary to pain?
Antalgic gait
The frontal plane divides the body into _________________ and _________________ portions.
Anterior Posterior
What are the special test for an ACL injury?
Anterior Drawer Lachman Lateral Pivot Shift Slocum
What are the motions of the acromioclavicular joint?
Anterior Tilting Posterior Tilting Upwards Rotation Downwards Rotation Protraction Retraction
Dermatome for C6
Anterior arm Radial side of hand to thumb and index finger
What are 5 types of incomplete SCI?
Anterior cord syndrome Brown- Sequard's syndrome Cauda equina injuries Central cord syndrom Posterior cord syndrom
What muscles assist with shoulder flexion?
Anterior deltoid Coracobrachialis Pec Major Biceps Brachii
What are some special test for knee ligamentous instability?
Anterior draw test Machman test Lateral pivot shift test Posterior drawer test Posterior sag test Valgus stress test Varus stress test
What are some special test for ankle ligamentous instability?
Anterior drawer test Talar tilt
Where is the ACL located?
Anterior intercondylar area of the tibia to the medial aspect of the lateral femoral condyle in the intercondylar notch
What are signs and symptoms of patellofemoral syndrome?
Anterior knee pain Pain with prolonged sitting Swelling Crepitus Pain when ascending and descending stairs
What are signs and symptoms of an aneurysm?
Aortic aneurysms- Asymptomatic, may include pain in abdominals or low back. Abdominal aortic aneurysms- Pulsations near the navel. Cerebral aneurysm- Sudden and severe headache, nausea and vomiting, stiff neck, seizure, loss of consciousness and double vision
What are some special test for knee meniscal pathology?
Apley's compression test MccMurray test
What are some special test for a shoulder dislocation?
Apprehension test for anterior shoulder dislocation Apprehension test for posterior shoulder dislocation
What are the fine motor skills for a 6-7 month old?
Approaches objects with one hand Arm in neutral when approaching toy Radial- palmar grasp "Rakes" with fingers to pick up small objects Voluntary release to transfer objects between hands
What is the 7th level "Automatic- Appropriate" of the Ranchos Los Amigos Levels of Cognitive Functioning?
Appropriate and oriented Goes through daily routine, looks like robot when performing tasks Minimal to no confusion Shallow recall of activities
What are some sensory stimulation techniques for facilitation?
Approximation Joint compression Icing Light touch Quick stretch Resistance Tapping Traction
What is the closed pack position for the acromioclavicular joint?
Arm ABD to 90
What is the response for asymmetrical tonic neck reflexes (ATNR)?
Arm and leg on face side are extended, arm and leg on opposite side are flexed, spine curved with convexity toward face side
What are signs and symptoms of a rotator cuff tear?
Arm positioned in IR and ADD Point tenderness at the greater tubercle and acromion Marked limitation in flexion and ADD with UT recruitment evident Increased tone on anterior shoulder structures
What is the loose pack position for the acromioclavicular joint?
Arm resting at side
What is the loose pack position for the sternoclavicular joint?
Arm resting by side
What is the response for the moro reflex?
Arms abduct with fingers open, then cross trunk into adduction; cry
What is the response to the startle reflex?
Arms abduct, elbows flexed with fingers closed, then cross trunk into adduction; cry
What are side effects of dopamine replacement agents?
Arrhythmias Gastrointestinal distress Orthostatic hypotension Dyskinesia Mood and behavioral changes Tolerance
What is the ascending spino- olivary tracts?
Ascends to the cerebellum and relays information from cutaneous and proprioceptive organs
What is the Tinetti Performance Oriented Mobility Assessment?
Asses fall risks Section 1 (Balance): sit to stand to sit with armless chair, immediate standing with eyes opened and closed, tolerating slight push while standing, turning 360 Max score of 16 Section 2 (Gait): Normal and rapid speed Max score of 12 Overall max score= 28 Score of 19= high fall risk
What is the Romberg test?
Assess balance and ataxia that initially positions the patient in unsupported standing, feet together, upper extremities folded, looking at a fixed point straight ahead with eyes opened. Next patient closes eyes and balances for 30 seconds.
What is the Timed Up and Go test?
Assess mobility and balance Sits, walks 10 ft, turns around, sits. *No support Assed on amount of postural sway, excessive movement, reaching for support, side stepping or other signs of loss of balance Rated 1 being normal and 5 being severely abnormal Independent= 10 seconds or less Limited functional independence/ low fall risk= 20 seconds High fall risk= 30 seconds or more
What is the Berg Balance Scale?
Assess patient's risk for falling 14 tasks each scored 0-4 Max score of 56 Scores less than 45 indicate an increased risk for falling
What is the Functional Reach Test and what are the norms?
Assess standing balance and fall risks 3 trials are performed and averaged together Standards 20-40yrs: 14.5-17 inches 41-69yrs: 13.5-15 inches 70-887yrs: 10.5-13.5 inches
What are dopamine replacement agents?
Assist to relieve the symptoms of Parkinson's disease
What is the pons?
Assists with regulation of respiratory rate and orientation of the head in relation to visual and auditory stimuli
What are the functions of the parietal lobe?
Associated with sensation of touch, kinesthesia , perception of vibration, and temperature Receives information from other areas of the brain regarding hearing, vision, motor, sensory and memory Provides meaning for objects Interprets language and words Spatial and visual perception
What is the etiology of mysthenia gravis?
Associated with: - an enlarged thymus gland - diabetes - RA - lupus
What are the gross motor skills for a 2-3 month old in supine?
Asymmetrical tonic neck reflex influence is strong Legs kick reciprocally Prefers head to side
What are signs and symptoms of hypertension?
Asymptomatic Severe hypertension (DBO >120mmHg)- Confusion, cortical blindness, hemiparesis, seizures, chest pain, dyspnea, renal involvement
What are treatments for PAD?
Asymptomatic people- stop smoking, medication, control diabetes and hypertension Disabling intermittent claudication people- surgery, exercise
What happens if there is a cerebellar lesion?
Ataxia Nystagmus Tremors Hypermetria Poor coordination Deficits in postural reflexes, balance and equilibrium
What are side effects of anti-epileptic agents?
Ataxia Skin issues Behavioral changes Gastrointestinal distress Headaches Blurred vision Weight gain
What is the etiology of PAD?
Atherosclerosis and thromboembolic processes that alter the structure and function of the aorta and its branches
What is a transient ischemic attack (TIA)?
Atherosclerotic thrombosis which causes temporary interruption of blood supply to an area of the brain
What is the C1 vertebrae called?
Atlas
What is the wall between the left and right atria?
Atrial septum
What are autonomic postural strategies?
Automatic motor responses that are used to maintain the center of gravity over the BOS
What are the characteristics of the autonomous stage of motor learning?
Automatic response Mainly error free regardless of environment Patterns of movement are non- cognitive and automatic Distraction does not impact the activity The person can simultaneously perform more than one task if needed Extrinsic feedback should be very limited or should not be provided Internal feedback or self assessment should be dominant
What is the C2 vertebrae called?
Axis
What is non-fluent aphasia?
Frequently in the frontal lobe of the dominant hemisphere Poor word output and dysprosodic speech (impairment in rhythm and inflection of speech) Poor articulation and increased effort for speech Content is present, but impaired syntactical words
What is fluent aphasia?
Frequently involves the temporal lobe, Wernicke's area or regions of the parietal lobe Word output and speech production are functional Prosody is acceptable but empty speech Speech lacks substance
Where is the ulnar collateral ligament of the elbow located?
From the medial epicondyle of the humerus to the proximal portion of the ulna.
Where is the interosseous membrane of the wrist located?
From the radius to the ulna
What are some special test for wrist/ hand neurological dysfunction?
Froment's sign Phalen's test Tinel's sign
What is the closed pack position for the iliofemoral (hip) joint?
Full extension IR
What is the loose packed position for the radiohumeral joint?
Full extension Supination
What is the closed packed position of the tibiofemoral joint?
Full extension Lateral rotation of the tibia
How does Aerobic Metabolism function?
Functions through oxidation of food. ex. Fatty Acids, amino acids and glucose with oxygen.
What is associative learning?
Gaining understanding of the relationship between two stimuli, casual relationships or stimulus and consequence (classical conditioning, operant conditioning
What is the purpose of the upper respiratory tract?
Gas conduits Humidify, cool or warm inspired air Filter foreign matter
Peak muscle activity during the gait cycle. Name the muscle group: Peak activity is during late stance phase. Responsible for concentric raising of the heel during toe off.
Gastroc- soleus group
What is asthenia?
Generalized weakness *cerebellar pathologies
What is the etiology of Huntingtons Disease?
Genetically transmitted as an autosomal dominate trait
What are the gross motor skills for a 8-9 month old in prone?
Gets into hands- knees position
What muscles assist with Hip Extension?
Glute Max Glute Min Semitendinosus Semimembranosus Biceps Femoris
What muscles assist with Hip lateral rotation (ER)?
Gluten Max Obturator Externus Obturator Internus Piriformis Gemelli Sartorius
plasma is important in regulating ____ and ____
BP Temperature
Dermatome for L3
Back Upper butt Anterior thigh and knee Medial lower leg
Dermatome for L2
Back, front of knee
Dermatome for L1
Back, over trochanter and groin
What are examples of anti-spasticity agents?
Baclofen Valium Dantrium
What does the moro reflex interfere with?
Balance reaction in sitting Protective responses on sitting Eye- hand coordination, visual tracking
What are implications for PT for anti-spasticity agents?
Balance the need to decrease spastic muscles with the loss of function with the reduction of hypertonicity
How do you challenge vestibular input?
Balance with movement of the head
How do you challenge visual input?
Balancing without visual input
What are implications for PT for muscle relaxant agents?
Be aware of side effects Modalities for relaxation
What are the gross motor skills for a 4-5 month old in prone?
Bearing weight on extended arms Pivots in prone to reach toys
What are the gross motor skills for a 4-5 month old in standing?
Bears all weight through legs in supported standing
What muscles assist with Hip abduction?
Gluteus Medius Gluteus Minimus Piriformis Obturator Internus Tensor Fasciae Latae
What muscles are supplied by the inferior gluteal nerve?
Gluteus maximus
What muscles are supplied by the superior gluteal nerve?
Gluteus medius Gluteus minimus TFL
How does Anaerobic Glycolysis function?
Glycogen is split into glucose, then through glycolysis, split into pyretic acid.
HDL cholesterol is the _____ (good/ bad) cholesterol
Good because it carries away LDL cholesterol and protects against atherogenesis
What are signs and symptoms of osteoarthritis?
Gradual onset of pain Increased pain after exercise Increase pain with weather changes Enlarged joints Crepitus Stiffness Limited joint ROM Heberden's nodes Bouchard's nodes
Where is the trachea located?
Begins at the larynx and ends at the carina (4th thoracic vertebra)
What is the etiology of CAD?
Begins with damage to the inner lining of a coronary artery. Then plaque accumulates. Hypertension and hypothyroidism High LDL cholesterol, Type 2 diabetes, smoking, obesity
What is the basal ganglia?
Gray matter masses located deep in white matter of the cerebrum Responsible for voluntary movement, regulation of autonomic movement, posture, muscle tone and control of motor responses
What lumbar region of the spine contains the largest amount of _____ mater.
Grey
Where does the subacromial bursa often get impinged?
Beneath the acromial arch
Dermatome for S3
Groin, posteromedial thigh to knee
What are the 6 balance tests and measures?
Berg Balance Scale Fugl- Meyer Sensorimotor Assessment of Balance Performance Battery Functional Reach Test Romberg Test Timed Get Up and Go Test Tinetti Performance Oriented Mobility Assessment
Where is the aortic semilunar valve located?
Between left ventricle and aorta
Where is the pulmonary semilunar valve located?
Between right ventricle and pulmonary arteries
Where is the prepatellar bursa located?
Between superficial surface of patella and skin
What are the left AV valve/ mitral valve/ bicuspid valve located?
Between the left atria and right ventricle
Where is the talocrural joint located?
Between the leg and the foot
Where is the superficial infrapatellar bursa located?
Between the patellar tendon and skin
Where is the deep infrapatellar bursa located?
Between the patellar tendon and the tibia
Paresthesia for L1
Groin; after holding posture, which causes pain
Where is the mid carpal joint of the wrist located?
Between the proximal and distal row of the carpals
What is the right AV valve/ tricuspid valve located?
Between the right atria and right ventricle
Where is the midtarsal joint located?
Between the talocalcaneonavicular joint and the calcaneocuboid joint
Where is the subtalar joint located?
Between the talus and calcaneus
Reflexes affect for C6
Biceps Brachioradialis
Myotome for C6
Biceps Supinator Wrist extensors
Reflexes affected for C5
Biceps Brachioradialis
What muscles assist with elbow flexion?
Biceps Brachii Brachialis Brachioradialis
What muscles assist with radioulnar supination?
Biceps Brachii Supinator
What muscles assist with Knee flexion?
Biceps Femoris Semitendinosus Semimebranosus Sartorius
What is diplegia/paraplegia?
Bilateral LE involvement, however UE may be affected
What are the 5 options for cortical sensory testing?
Bilateral simultaneous stimulation Stereognosis Two- point discrimination Barognosis Localization of touch
What is the normal age range of the palmar grasp reflex?
Birth to 4months
What is the normal age range for asymmetrical tonic neck reflexes (ATNR)?
Birth to 6 months
What is the normal age range for tonic labyrinthine reflex (TLR)?
Birth to 6 months
Myotomes for S4
Bladder Rectum
What is the level of assistance for bowel/ bladder problems for patient with paraplegia? - intermittent catheterization - leg bag care - condom application - clean up - in bed/ wheelchair - feminine hygiene - bowel program
Bladder/ bowel: - ModI for male and female
What is the level of assistance for bowel/ bladder problems for patient with midlevel tetraplegia (C6)? - intermittent catheterization - leg bag care - condom application - clean up - in bed/ wheelchair - feminine hygiene - bowel program
Bladder: - MinA for male in bed or wheelchair - ModA for female in bed Bowel: - ModA with use of equipment - Able to verbally direct
What is the level of assistance for bowel/ bladder problems for patient with tetraplegia (C7-C8)? - intermittent catheterization - leg bag care - condom application - clean up - in bed/ wheelchair - feminine hygiene - bowel program
Bladder: - ModI for male in bed or wheelchair - ModI for female in bed - ModA for female in wheelchair Bowel: - MinA to ModI with use of adaptive equipment - Able to verbally direct
What is the etiology of a pulmonary embolism?
Blood clots from the LE
What should you feel with a hard normal end feel?
Bone on bone ex. elbow extension
What is genu varum?
Bow legged
What muscle is supplied by the radial nerve?
Brachioradialis Triceps Supinator Wrist extensors Anconeus
What makes up the CNS?
Brain Brain stem Spinal cord
What is a secondary injury?
Brain damage that occurs as a response to the initial injury. Ex. hematoma, hypoxia, ischemia, increased intracranial pressure and post- traumatic epilepsy
What does asymmetrical tonic neck reflexes (ATNR) interfere with?
Breast feeding Visual tracking Midline use of hands Bilateral hand use Rolling Development of crawling Can lead to skeletal deformities
What is nodes of ranvier?
Brief gaps in myelination of an axon Serves to facilitate rapid conduction of a nerve impulse via jumping gap node to gap node
What is the reflex name for a 3+ grade and is it normal?
Brisk/ exaggerated response May or may not be normal
What can thrombocytopenia lead to?
Bruising Abnormal bleeding
What are the stages of recovery?
Brunnstrom separates neurological recovery into seven separate stages based on progression through abnormal tone and spasticity
What are some special test for knee swelling?
Brush test Patellar tap test
The sacral plexus supplies the muscles of the ___.
Butt
Dermatome for L5
Butt Posterior thigh Lateral aspect of leg Dorsum of foot Medial half or sole 1st, 2nd and 3rd toes
Dermatome for S2
Butt Thigh Posterior leg
Peak muscle activity during the gait cycle. Name the muscle group: Peak activity is during late swing phase. Responsible for decelerating the unsupported limb.
Hamstring group
What are the fine motor skills for early school age (5-8 yrs)?
Hand preference is evident Prints well, starting to learn cursive writing Able to button small buttons
What is body schema?
Having an understanding of the body as a whole and the relationship of its parts to the whole
What is the stimulus for the moro reflex?
Head dropping into extension suddenly for a few inches
What are the gross motor skills for a newborn to 1 month old in sitting?
Head lag in pull to sit
What are stimulus for symmetrical tonic neck reflexes (STNR)?
Head position, flexion or extension
What is the stimulus for asymmetrical tonic neck reflexes (ATNR)?
Head position, turned to one side
What are the gross motor skills for a 4-5 month old in sitting?
Head steady in supported sitting position Turns head in sitting position Sits alone for brief periods
What are the gross motor skills for a 2-3 month old in sitting?
Head upright, but bobbing Variable head lag in pull to stand position Needs full support to sit
A blockage in an artery of CAD can lead to what?
Heart attack
What is a myocardial infarction?
Heart attack When the blood flow through one or more arteries is severely reduced or cut off completely Irreversible necrosis
What are signs and symptoms of Valvular heart disease?
Heart palpitations SOB Chest pain Coughing Ankle swelling Fatigue
What are the 5 phases of the stance phase according to standard terminology?
Heel Strike Foot Flat Midstance Heel Off Toe Off
What are neutrophils?
Help protect the body from infection by ingesting bacteria and dibris
What gives red blood cells their color and enables it to bind with oxygen?
Hemoglobin
What medicine is an anticoagulant that is commonly used to reduce the risk of a DVT following surgeries?
Heparin
What is spina bifida meningocele?
Herniation of the meninges and cerebral spinal fluid into a sac that protrudes through the vertebral column. The spinal cord remains within the canal
What is another name for an ectopic bone?
Heterotopic ossification
Anaerobic: ATP - PC System _______ (High/ Low) intensity, ______ (High/ Low) duration.
High Low
What are symptoms of autonomic dysreflexia?
High BP Severe headache Blurred vision Stuffy nose Profuse sweating Goose bumps below the level of the lesion vasodilation (flushing) above the level of injury
Anaerobic: Anaerobic Glycolysis _______ (High/ Low) intensity, ______ (High/ Low) duration.
High Low
Abnormal Gait: What is tabetic gait?
High stepping ataxic gait pattern in which the feet slap the ground
Abnormal Gait: What is equine gait?
High steps; usually involves excessive activity of the gastroc
What is the most common contracture associated with a transfemoral amputation?
Hip flexion Hip ABD
What is a HKAFO?
Hip knee ankle foot orthosis Controls abduction, adduction, rotation controls hip flexion when locked. Locked hip restricts gait pattern to either swing-to or swing-through
What is the synergy pattern for the LE extensors? Hip Knee Ankle Toes
Hip: Extension, IR and Adduction Knee: Extension Ankle: PF and inversion Toes: Flexion and adduction
What are techniques used to initiate movement for mobility?
Hold- relax active movement Joint distraction Repeated contractions Rhythmic initiation Rhythmic rotation
_____ sign is a special test designed to confirm the presence of a DVT
Homan's
What are some special test for ankle miscellaneous?
Homan's sign Thompson test True leg length discrepancy test
What happens if the occipital lobe is impaired?
Homonymous hemianopsia Impaired extraocular muscle movement and visual deficits Impaired color cognition Reading and writing impairment Cortical blindness with bilateral lobe involvement
Paresthesia for C4
Horizontal band along clavicle and upper scapula
The talocrural joint offers significant stability in ___ (PF/DF) but becomes much more mobile with ___ (PF/DF)
DF PF
What are the motions of the talocrural joint?
DF PF
What is the capsular pattern for the talocrural joint?
DF PF
What is the capsular pattern for the midtarsal joint?
DF PF ADD IR
What is valvular heart disease?
Damage to or a defect in one of the four heart valves resulting in regurgitation (insufficiency) or stenosis of blood flow. BLOOD LEAK BACKWARDS.
What are some treatment options for a total hip arthroplasty?
Decrease inflammation *HIP PRECAUTIONS Minimizing muscle atrophy PROM Strengthening Endurance activities
What are treatment options for a total knee arthroplasty?
Decrease inflammation *PRECAUTIONS Minimizing muscle atrophy PROM Strengthening Endurance activities Assistive device training Knee flexion requires min of 90 degrees of ADL Knee flexion requires min of 105 degrees to rise comfortably from sitting.
What is the normal value of alkalemia?
Decreased acidity of blood pH > 7.45
What are characteristics of a Cerebellum CVA?
Decreased balance Ataxia Decreased coordination Nausea Decreased ability for postural adjustment Nystagmus
What are characteristics of the associative stage of motor learning?
Decreased errors with new skill performance Decreased need for concentration and cognition regarding the activity Skill refinement Increased coordination of movement Large amount of practice space yields refinement of the motor program surrounding the activity
What are fissures?
Deep grooves in the brain
What are some sensory stimulation techniques for inhibition?
Deep pressure Prolonged stretch Warmth Prolonged cold
What do high hematocrit levels suggest?
Dehydration or polycythemia vera
What muscle is supplied by the axillary nerve?
Deltoid Teres minor
Dermatome for C5
Deltoid area Anterior aspect of entire arm to base of thumb
What is a myotome?
Designated motor area based on spinal segment innervation
What is a dermatome?
Designated sensory areas based on spinal segment innervation
What is reflex inhibiting posture?
Designated static positions that Bobath found to inhibit abnormal tonal influences and reflexes
What is the Fugl- Meyer Sensorimotor Assessment of Balance Performance Battery test?
Designed to assess balance specifically for patients with hemiplegia 7 Items scored 0-2 Max score 14
What is the purpose of the ventricular system?
Designed to protect and nourish the brain
What does the galant reflex interfere with?
Development of sitting balance Can lead to scoliosis
What is spina bifida?
Developmental abnormality due to insufficient closure of the neural tube by the 28th day of gestation Occurs in the low thoracic, lumbar and sacral regions
What are the fine motor skills for later school age (9-12 yrs)?
Develops greater control in hand usage Learns to draw handwriting is developed
What are the fine motor skills for adolescence (+13 yrs)?
Develops greater dexterity in fingers for fine tasks (knitting, sewing)
What is the etiology of diabetic neuropathy?
Diagnosis of diabetes mellitus
Contraction of the _____ causes the chest to expand longitudinally and the lower ribs to elevate to allow for inspiration
Diaphragm
What are signs and symptoms of Alzheimer's?
Difficulty with new learning and subtle changes in memory and concentration Loss of orientation Word finding difficulties Depression Poor judgement Rigidity Bradykinesia Shuffling gait Impaired ability to perform self care
What is polyneuropathy?
Diffuse nerve disfunction that is symmetrical and typically secondary to pathology and not trauma Associated conditions include Guillain- Barre syndrome, peripheral neuropathy, use of neurotoxic drugs and HIV
What are examples of anti-epileptic agents?
Dilantin Tegretol
What is hyporeflexia?
Diminished or absent reflex response
What is the reflex name for a 1+ grade and is it normal?
Diminished/ depressed response May or may not be normal
What is an open TBI?
Direct penetration through the skull to the brain
What is a Chopart amputation?
Disarticulation at the midtarsal joint
What are signs and symptoms of impingement syndrome?
Discomfort or mild pain deep within the shoulder Pain with overhead activities Painful arc of motion (70 - 120 degrees of ABD) Positive impingement sign Tenderness over the greater tuberosity and the bicipital groove
What are causes of autonomic dysreflexia?
Distended or full bladder Kink or blockage in the catheter Bladder infections Pressure ulcers Extreme temperature changes Tight clothing Ingrown toenails
What are symptoms of orthostatic hypotension?
Dizziness Lightheadedness Nausea "Black out" laying -> sitting
What are the gross motor skills for a 8-9 month old in supine?
Does not tolerate supine position
What happens if the parietal lobe is impaired?
Dominant hemisphere (typically located in the left hemisphere): agraphia, alexia, agnosia Nondominate hemisphere (typically located in the right hemisphere): dressing apraxia, constructional apraxia, anosognosia Contralateral sensory deficits Impaired language comprehension Impaired taste
What nerves are supplied from the rami of the brachial plexus?
Dorsal scapular Long thoracic
What are some special test for a rotator cuff pathology/ impingement?
Drop arm test Hawkins- Kennedy impingement test Neer impingement test Supraspinatus test
What are side effects of anti-spasticity agents?
Drowsiness Confusion Headaches Dizziness Generalized muscle weakness Tolerance Dependence
Abnormal Gait: What is trendelenburg gait?
Due to glute med weakness. Excessive lateral trunk flexion and weight shifting over the stance limb
What are the 3 layers of the meninges?
Dura mater- Outmost layer Arachnoid mater- Middle layer Pia mater- Innermost layer
What is the purpose of a glucocorticoid agent (corticosteroids)?
Hormonal, anti-inflammatory and metabolic effects including suppression of articular and systemic diseases Reduce inflammation in chronic conditions that can damage healthy tissue through a series of reactions Vasoconstriction results from stabilizing lysosomal membranes and enhancing the effects of catecholamines
What are treatment options for Guillain-Barre syndrome?
Hospitalization Medication OT OT SLP Wheelchairs orthotics Assistive device
An excess of CSF in the brain can cause an enlargement in the ventricles causing _____.
Hydrocephalus
What are examples of glucocorticoid agents (corticosteroids)?
Hydrocortisone Prednisone Dexamethasone
What is hyperreflexia?
Hyperactive reflexes or clonus reflexes
What is the equation for inspiratory capacity?
IC = TV + IRV
What is the purpose of graphesthesia sensory testing?
Identify a number or letter drawn on the skin without visual input
What is the purpose of proprioception sensory testing?
Identify a static position of an extremity or body part
What is the purpose of stereognosis sensory testing?
Identify an object without sight
What is the purpose of kinesthesia sensory testing?
Identify direction and extent of movement of a joint or body part
What is the strongest ligament in the body?
Iliofemoral ligament
What muscles assist with Hip flexion?
Iliopsoas Sartorius Rectus Femoris Pectineus
What are treatments for autonomic dysreflexia?
Immediately check catheter REMAIN IN SITTING POSITION Check for irritating stimuli Check for bowel impaction
What is aphasia?
Impairment of processing for receptive and/ or expressive language
What is peripheral neuropathy?
Impairment or dysfunction of the peripheral nerves; associated conditions include diabetic peripheral neuropathy, trauma, alcoholism
Where are the intercostal muscles located?
In between the ribs
What is the hippocampus?
In the lower temporal lobe The process of forming and storing new memories of one's personal history and other declarative memory Learning language
What is the response for tonic labyrinthine reflex (TLR)?
In the supine position, body and extremities are held in extension; in the prone position, body and extremities are held in flexion
What is the amygdala?
In the temporal lobe of each hemisphere Functions in emotional and social processing Involved with fear and pleasure responses, arousal, processing of memory and the formation of emotional memories
What is constructional apraxia?
Inability to build, assemble or draw objects
What is akinesia?
Inability to initiate movement *parkinson's patients
What is apraxia?
Inability to perform purposeful movements even though there is no sensory or motor imairment
What is retrograde amnesia?
Inability to remember events that occurred before the incidence of trauma
What is alexia?
Inability to see words or to read
What is agraphia?
Inability to write
What is the etiology of angina pectoris?
Inadequate blood flow and oxygenation of the heart muscle due to coronary artery disease
What is the etiology of down syndrome?
Incomplete cell division
What is Brown-Sequard syndrome?
Incomplete lesion typically caused by a stab wound, which produces hemisection of the spinal cord.
What is thrombocythemia?
Increase in platelets
Patients with COPD have a(n) _____ (increased/ decreased) total lung capacity with a significant _____ (increased/ decreased) residual volume
Increased Increased
What are symptoms of spasticity?
Increased involuntary contractions increased tonic stretch reflex Exaggerated DTR
What are indications of anti-spasticity agents?
Increased tone Spasticity Spinal cord injury CVA MS
Paresthesia for C7
Index, long and ring finger
What is spastic cerebral palsy?
Indicating a lesion in the motor cortex of the cerebrum; upper motor neuron damage
What is athetoid cerebral palsy?
Indicating a lesion involving the basal ganglia
What is juvenile rheumatoid arthritis?
Inflammation in joints and connective tissues
What is pneumonia?
Inflammation of the lungs
What is plantar fasciitis?
Inflammation of the thick tissue of the bottom of the foot that connect the heel to the toes and creates an arch 40 - 60 yrs of age
What is the medulla oblongata?
Influences autonomic nervous activity and regulation of respiration and heart rate Reflex center for vomiting, coughing and sneezing
What are monocytes?
Ingest dead or damaged cells and help defend against infectious organisms
What is the etiology of Duchenne Muscular Dystrophy?
Inheritance as an X-linked recessive trait. Mother is a silent carrier Fathers offspring will manifest the disease
What is the bainbridge reflex?
Inhibits parasympathetic activity
What are the 5 phases of the stance phase according to Ranchos Los Amigos terminology?
Initial Contact Loading Response Midstance Terminal Stance Pre-swing
What are the 3 phases of the swing phase according to Ranchos Los Amigos terminology?
Initial Swing Midswing Terminal Swing
What is a primary TBI?
Initial injury to the brain sustained by impact
What is tetraplegia (quadriplegia)?
Injuries that occur at the level of the cervical spine
What is a cauda equina injury?
Injuries that occur below the L1 level of the spine LMNL
What are signs and symptoms of adhesive capsulitis?
Insidious onset of: Localized pain extending down the arm Stiffness Night pain Restricted movement in capsular pattern
Spinal nerves and blood vessels exit the spinal canal through the ___ ___.
Intervertebral Foramina
What is the purpose of the SA and AV nodes?
Intrinsic ability to depolarize and propagate electrical impulses from the cell to cell without nerve stimulation
What are the motions of the midtarsal joint?
Inversion Eversion
What are the motions of the subtalar joint?
Inversion Eversion
What is clonus?
Involuntary alternating spasmodic contraction of a muscle precipitated by a quick stretch reflex
What are signs and symptoms of Huntington's Disease?
Involuntary choreic movements Mild alteration in personality Grimacing Protrusion of the tongue Ataxia with choreoathetoid movements Mental deterioration Decrease in IQ Depression Dysphagia Incontinence Immobility Rigidity
What is athetosis?
Involuntary movements combined with unstable posture. Peripheral movements occur without central stability
What is dystonia?
Involuntary movements combined with unstable posture. axial muscle involvement occur without central stability
What is tremor?
Involuntary rhythmic/ossilating movements
What are tremors?
Involuntary, rhythmic movements of a body part
What are descending tracts?
Involved with voluntary motor function, muscle tone, reflexes and equilibrium, visceral innervation and modulation of ascending sensory signals
What happens if one side of the cerebellum is impaired?
Ipsilateral impairments
What is lateral epicondylitis?
Irritation or inflammation of the common extensor muscles at their origin on the lateral epicondyle of the humerus. Most common between the ages of 30 and 50 TENIS ELBOW
Where is the ischiofemoral ligament of the hip located?
Ischial wall of the acetabulum to the neck of the femur
What is the 6th stage of recovery?
Isolated movements are performed with coordination
What are alternating isometrics (AI)? *Stability
Isometric contractions are performed alternating from muscles on one side of the joint to the other side without rest. (AI) emphasizes endurance or strengthening
What are signs and symptoms of a meniscus tear?
Joint line pain Swelling Catching or locking sensation
What are eosinophils?
Kills parasites, destroys cancer cells and are involved in allergic response
What is a KAFO?
Knee ankle foot orthosis
What is the most common contracture associated with a transtibial amputation?
Knee flexion
Reflexes affected for L3
Knee jerk sluggish PKB positive Pain on full SLR
What is genu valgum?
Knock- kneed
What is the innervation level for resistive testing of hip flexion?
L1-L2
What is the innervation level for dermatome testing of the anterior thigh?
L2
What is the innervation level for dermatome testing of the middle third of the anterior thigh?
L3
What is the innervation level for resistive testing of knee extension?
L3-L4
What is the innervation level for dermatome testing of the patella and medial malleolus?
L4
What is the innervation level for reflex testing of the patella?
L4
What is the innervation level for functional testing of heel walking?
L4-L5
What is the innervation level for resistive testing of ankle dorsiflexion?
L4-L5
What is the innervation level for functional testing of straight leg raise?
L4-S1
What is the innervation level for dermatome testing of the fibular head and dorsum of the foot?
L5
What is the innervation level for resistive testing of great toe extension?
L5
What is the synergy pattern for the LE flexors? Hip Knee Ankle Toes
LE flexors Hip: Abduction and ER Knee: Flexion Ankle: DF and supination Toes: Extension
What are signs and symptoms of Amyotrophic Lateral Sclerosis (ALS)?
LMN- asymmetric muscle weakness, fasciculations, cramping, and atrophy within the hands. UMN- incoordination of movement, spasticity, clonus, and positive Babinski reflex. All- fatigue, oral motor impairment, motor paralysis, respiratory paralysis
What is the left side of the brain dominate in?
Language Sequence and perform movement Understand language Produce written and spoken language Analytical Controlled Logical Rational Mathematical calculations Express positive emotions such as love and happiness Process verbally coded information in an organized, logical and sequential manner
What are the characteristics of the Cognitive stage of motor learning?
Large amount of errors Inconsistent attempts Repetition of effort allows for improvement in strategies Inconsistent performance High degree of cognitive work: listening, observing and processing feedback
What is a grade 3 joint mobilization?
Large amplitude of movement performed up to the limit of the range
What is a grade 2 joint mobilization?
Large amplitude of movement performed within the range, but not reaching the limit of the range and not returning to the beginning of the range
What are characteristics of A Fibers? Size of fibers Myelinated? Unmyelinated? Speed of conduction rate Extra
Large fibers Myelinated High conduction rate Alpha, beta, gamma, delta subsets
The lower respiratory tract extends from the _____ to the ____ of the lungs
Larynx Alveoli
What is the capsular pattern for the glenohumeral joint?
Lateral Rotation (ER) ABD Medial Rotation (IR)
Dermatome for S1
Lateral and plantar aspect of foot
Dermatome for C7
Lateral arm and forearm to index, long and ring finger
Paresthesia for L5
Lateral aspect of leg Medial three toes
Where is the distal tibiofibular joint located?
Lateral aspect of the distal tibia and the distal fibula
What are signs and symptoms of congenital torticollis?
Lateral cervical flexion to same side as contracture Rotation towards the opposite side Facial asymmetries
What is scoliosis?
Lateral curvature of the spine Functional Scoliosis- Abnormalities in the body that indirectly impacts the spine (leg length discrepancy, muscle imbalance, poor posture) Neuromuscular Scoliosis- Developmental pathology resulting in alterations within the structure of the spine (CP or Marfan syndrome). Degenerative Scoliosis- Normal aging process and is facilitated by changes such as osteophyte formation, bone demineralization, and disk herniation. 10-13 yrs old 10 degrees or less = for genders 30 degrees or more = Girls> boys
Where is the LCL located?
Lateral femoral epicondyle to the head of the fibula
What is the capsular pattern for the cervical spine?
Lateral flexion and rotation equally limited, extension
What is the response for the galant reflex?
Lateral flexion of trunk to side of stimulus
Paresthesia for S2
Lateral leg, knee and heel
What nerves are supplied from the lateral cord of the brachial plexus?
Lateral pectoral Musculocutaneous Latral root if the median
What muscles assist with Head depression?
Lateral pterygoid Suprahyoid Infrahyoid
Paresthesia for S1
Lateral two toes Lateral foot Lateral leg to knee Plantar aspect of foot
What muscles assist with scapular depression?
Latissimus Dori Pec Major Pec Minor Lower Trap
What muscles assist with shoulder extension?
Latissimus Dorsi Posterior Deltoid Teres Major
What muscle is supplied by the thoracodorsal nerve?
Latissimus dorsi
What is the etiology of emphysema?
Leading cause- Smoking 1-2% have a genetic disorder that causes low levels of the protein alpha-1-antitrypsin, which protect the elastic structures in the lungs
What happens if the temporal lobe is impaired?
Learning deficits Wernicke's aphasia (receptive deficits) Antisocial, agressive behaviors Difficulty with facial recognition Difficulty with memory, memory loss Inability to categorize objects
What is procedural learning?
Learning tasks that can be performed automatically without attention or conscious thought, like a habit
What is the direct lateral approach to a total hip arthroplasty?
Leaves the posterior portion of the glute medius attached to the greater trochanter. It required longitudinal division of the TFL and vastus lateralis, along with a release of the anterior portion of the glute medius. Since the posterior soft tissue and capsule are left intact, the approach minimizes the probability of dislocation and may be ideal for noncompliant patients.
Heart failure typically begins with which ventricle, left or right?
Left
What are the 2 superior chambers of the heart?
Left and right atria
What are signs and symptoms of chronic venous insufficiency?
Leg swelling varicose veins Aching Heaviness or cramping Itching Redness Skin ulcers
What is Broca's aphasia?
Lesion: 3rd convolution from frontal lobe Non- fluent aphasia, known as "expressive aphasia" MOST COMMON Intact auditory and reading comprehension Impaired repetition and naming skills Frustration with language skill errors Paraphasia are common Motor impairment typical due to proximity of Broca's area to the motor cortex
What is Global aphasia?
Lesion: Frontal, temporal and pariental lobes Non- fluent aphasia Comprehension (reading/ auditory) is severely impaired Impaired naming, writing, repetition skills May involve verbalize, usually without correct content May use nonverbal skills for communication
What is Wernicke's aphasia?
Lesion: Posterior region of superior temporal gyrus Fluent aphasia, known as 'receptive aphasia" Comprehension (reading/ auditory) impaired Good articulation, use of paraphasia Writing impaired Poor naming ability Motor impairment not typical due to the distance from Wernicke's area to the motor cortex
What is another name for white blood cells?
Leukocytes
What are treatment options for atherosclerosis?
Lifestyle changes Medications Surgery
What are treatment options for hypertension?
Lifestyle modifications Medication
What are the gross motor skills for a 6-7 month old in supine?
Lifts head
What are the gross motor skills for a 6-7 month old in sitting?
Lifts head and helps when pulled to sitting position Gets to sitting position without assistance Sits independently
What are the gross motor skills for a 2-3 month old in prone?
Lifts head to 90 degrees briefly Chest up in prone position with some weight through forearms Rolls prone to supine
What is the capsular pattern for the subtalar joint?
Limitation of various range of motion
What is the purpose of the Anterior Longitudinal Ligament?
Limits extension Reinforces the anterior portion of the intervertebral disks and vertebrae.
What is the purpose of the Posterior Longitudinal Ligament?
Limits flexion Reinforces the posterior portion of the intervertebral disks.
What is the purpose of the Interspinous Ligaments?
Limits flexion and rotation.
What is the purpose of the radial collateral ligament of the wrist?
Limits ulnar deviation and becomes taut when the wrist is in extreme extension and flexion.
What is the purpose of the dorsal radiocarpal ligament of the wrist?
Limits wrist flexion
Where is dura mater located?
Lines the periosteum of the skull and protects the brain
A cholesterol test is also called...
Lipid panel Lipid profile
What is plasma?
Liquid part of blood
Paresthesia for C8
Little finger alone or with two adjacent fingers Not ring or long fingers, alone or together (C7)
The term "congestive heart failure" comes from blood backing up into the...
Liver, abdomen, LE and lungs
What is a grade I muscle/ tendon strain?
Localized pain Minimal swelling Minimal tenderness
What is a grade II muscle/ tendon strain?
Localized pain Moderate swelling Moderate tenderness Impaired motor function
What is the subthalamus?
Located between the thalamus and hypothalamus Important for regulating movements produced by skeletal muscle
What is chemoreceptor reflexes?
Located in the carotid bodies and the aortic body respond to change in pH status and blood oxygen tension
Bilateral occlusion (blockage) of the vestibular- basilar artery will typically produce what?
Locked- in syndrome- Patient is aware but cannot move or communicate verbally due to complete paralysis of nearly all voluntary muscles in the body except for vertical eye movements and blinking. The individual is conscious and sufficiently intact cognitively to be able to communicate with eye movements. Coma Vegetative state- State of partial arousal rather that true awareness
What is the etiology of COPD?
Long term smoking or exposure to second hand smoke Air pollution and certain occupational fumes Rare- Genetic disorder that causes low levels of the protein alpha-1-antitrypsin
Myotome for C2
Longus colli SCM Rectus capitus
What is a grade 3 concussion?
Loss of consciousness, brief or prolonged
What is the results of anterior cord syndrome?
Loss of motor function, pain and temperature below the lesion due to damage of the corticospinal and spinothalamic tracts
What are the characteristics of posterior cord syndrome?
Loss of proprioception, two point discrimination and stereognosis. *Motor function is perserved
What is the stimulus for the startle reflex?
Loud, sudden noise
Aerobic: Aerobic Metabolism _______ (High/ Low) intensity, ______ (High/ Low) duration.
Low High
What is the normal value of hypoxemia?
Low level of O2 in arterial blood PaO2 < 80 mmHg
What is the normal value of hypoxia?
Low level of O2 in the tissue despite adequate perfusion of the tissue
What is thrombocytopenia?
Low platelet count
What is leukopenia?
Low white blood cell count which can increase the risk for infection
The Sacral Plexus is formed by the...
Lumbosacral trunk Ventral Rami of S1-S3 Descending portion of S4
What are the functions of the occipital lobe?
Main processing center for visual information Processes visual information regarding colors, light and shapes Judgement of distance, seeing 3D
What is the purpose of the pulsar radiocarpal ligament of the wrist ?
Maintains alignment of the associated joint structures and limits hyperextension of the wrist.
What are baroreceptor reflexes?
Maintains blood pressure
What are the 3 parts of the sternum?
Manubrium Body Xiphoid process
Abnormal Gait: What is parkinsonian gait?
Marked by increased forward flexion of the trunk and knees; gait is shuffling with quick and small steps; festinating may occur
What are the fine motor skills for a 12-15 month old?
Marks paper with crayon Builds tower using two cubes Turns over small container to obtain contents
What is synergy?
Mass movement patterns that are primitive in nature and coupled with spasticity due to brain damage
What muscles assist with Head protrusion?
Masseter Lateral Ptergoid Medial Ptergoid
What are the gross motor skills for later school age (9-12 yrs)?
Mature patterns of movement in throwing, jumping, running Competition increases, enjoys competitive games Improved balance, coordination, endurance, attention span Boys may develop preadolescent fat spurt Girls may develop prepubescent and pubescent changes in body shape
What are implications for PT for dopamine replacement agents?
Max benefits for sessions scheduled 1hr after taking the meds Monitor blood pressure
What is the closed pack position for the talocrural joint?
Maximum DF
What is the closed pack position for the sternoclavicular joint?
Maximum shoulder elevation
What are the gross motor skills for a 6-7 month old in mobility?
May crawl backwards
What is nerve conduction velocity?
Measures the speed of a nerve impulse along the axon of a nerve
How do you calculate thoracolumbar flexion and extension?
Meausre diftance between C7 and S1, log number. Have the patient bent backwards/ forwards, log number. Subtract the 2 numbers
What muscles assist with Head turning?
Medial Pterygoid Lateral Pterygoid
What motions occur in the transverse plane and along what axis?
Medial Rotion (IR) Lateral rotation (ER) Vertical axis.
Dermatome for C8
Medial arm and forearm to long, ring and little finger
Paresthesia for L4
Medial aspect of calf and ankle
Which is more common, a medical meniscus tear or a later meniscus tear?
Medial because it is less mobile due to its attachment to the joint capsule
Dematome for L4
Medial butt Lateral thigh Medial leg Dorsum of foot Big toe
Paresthesia for L3
Medial knee Anterior lower leg
What nerves are supplied from the medial cord of the brachial plexus?
Medial pectoral Ulnar Medial root of the median
Dermatome for T1
Medial side of forearm to base of littl efinger
Dermatome for T2
Medial side of upper arm to medial elbow, pectoral and midscapular areas
What nerve goes through the carpal tunnel?
Median nerve.
What are treatments for Parkinson's disease?
Medication Dopamine replacement therapy OT ST PT- Endurance, strength and functional mobility
What are treatments for a myocardial infarction?
Medication Life style change Surgery
What are treatments for restrictive lung dysfunction?
Medication Mechanical ventilation Supplemental oxygen Nutriton support Pulmonary rehab
What are treatments for multiple sclerosis?
Medication OT PT- relaxation, energy conservation, normalization of tone, balance, gait training, core stabilization and assistive device training ST Nutritional counseling Psychological counseling
What are treatments for Amyotrophic Lateral Sclerosis (ALS)?
Medication PT OT Speech Respiratory therapy Nutritional therapy
What are treatments for cystic fibrosis?
Medication PT- airway clearance, breathing techniques, assisted cough and ventilatory muscle training. Overall endurance and strengthening training
What are treatments for myasthenia gravis?
Medication PT- energy conservation, strengthening (iso's), osteoporosis treatments OT
What are treatment options for epilepsy?
Medication Surgery
What are treatments for emphysema?
Medication Surgery Lifestyle modifications Good nutrition Pulmonary rehab (airway clearance, breathing exercises, endurance and strengthening training
What are treatment options for spasticity?
Medication Surgery PT- positioning, aquatic therapy, WT bearing, functional electrical stimulation, ROM, resting splints, inhibitive casting
What are treatments for a pulmonary embolism?
Medication Surgery Prevention of clots: compression stockings, pneumatic compression, physical activity and drinking fluids
What are treatments for aneurysms?
Medications Surgery
What are treatments for valvular heart disease?
Medications Surgery
What are treatments for COPS?
Medications Surgery Lifestyle modifications Pulmonary rehab- Airway clearance, breathing exercises and endurance and strengthening training
What are characteristics of B Fibers? Size of fibers Myelinated? Unmyelinated? Speed of conduction rate Extra
Medium fibers Myelinated Reasonably fast conduction rate Pre- ganglionic fibers of the autonomic system
Is Amyotrophic Lateral Sclerosis (ALS) higher in men or women and between what ages?
Men 40-70yrs
What are examples of disease- modifying anti-rheumatic agents?
Methotrexate Ridaura Humira Enbrel
What are the 3 parts of the brain stem?
Midbrain Pons Medulla Oblongata
What muscles assist with shoulder abduction?
Middle Deltoid Supraspinatus
What is the loose packed position for the midtarsal joint?
Midway between extremes of ROM
What is the loose packed position of the subtalar joint?
Midway between extremes of ROM
What is the loose packed position of the cervical spine?
Midway between flexion and extension
What is a grade I ligament sprain?
Mild pain and swelling, little to no tear of the ligament
What are indications for nonopioid agents?
Mild to moderate pain Fever Headaches Muscle aches Inflammation Primary dysmenorrhea Reduces risk of heart attacks (aspirin only)
What are the 4 levels of motor control?
Mobility Stability Controlled Mobility Skill
What are treatment options for patellofemoral syndrome?
Modalities Stretching exercises Medial patella glides Biofeedback Patella taping Strengthening quads
What is a grade II ligament sprain?
Moderate pain and swelling, minimal instability, minimal to moderate tear of the ligament, decreased ROM
What are indications for opioid agents (narcotics)?
Moderate to severe pain Induction of conscious sedation priorto a diagnostic procedure Relief of severe and persistent cough (codeine)
What are treatments for diabetic neuropathy?
Monitoring glucose PT for pain, foot care, and overall fitness Medications
What are side effects of opioid agents (narcotics)?
Mood swings Sedation Confusion Vertigo Dulled cognitive function Orthostatic hypotension Constipation Incoordination Physical dependence Tolerance
What are examples of opioid agents (narcotics)?
Morphine Oxycodone Codeine
What is plasma made of?
Mostly water, but contains proteins and electrolytes
Ventral roots are _____ (sensory/ motor) Ventral roots contain _____ (afferent/ efferent) fibers
Motor Efferent
What is "D" considered on the ASIA Impairment Scale?
Motor Incomplete- Motor function is preserved below the neurologic level, and most key muscles below the neurologic level have a muscle grade greater than or equal to 3
What is "C" considered on the ASIA Impairment Scale?
Motor Incomplete- Motor function is preserved below the neurologic level, and most key muscles below the neurologic level have a muscle grade less than 3
What are signs and symptoms of spina bifida?
Motor loss below the level of defect Sensory deficits Hydrocephalus Osteoporosis Clubfoot Scoliosis Latex allergy Bowel and bladder disfunction Learning disabilities
What are signs and symptoms of Guillain-Barre syndrome?
Motor weakness, sensory impairment and respiratory paralysis, inability to speak and/ or swallow PROGRESSES FROM UE TO HEAD Level of disability usually peaks within 2-4 weeks of unset
What is cerebral palsy?
Movement disorders due to brain damage that are non- progressive and are acquired in utero, during birth or infancy
What are the gross motor skills for a 8-9 month old in sitting?
Moves from sitting to prone position Sits without hand support for longer periods of time Pivots in sitting position
What muscles assist with spine cervical extension?
Multifidus Trapezius Spenius Cervicis Semispinalis Cervicis Iliocostalis Cervicis Longissimus Cervicis
What is overflow?
Muscle activation of an involved extremity due to intense action of an involved muscle or group of muscles
What are side effects of glucocorticoid agents (corticosteroids)?
Muscle atrophy Gastrointestinal distress Glaucoma Adrenocortical suppression Drug induced cushings syndrome Weakening/ breakdown of supporting tissue Mood changes Hypertension
What are indications of muscle relaxant agents?
Muscle spasms
What is angina pectoris?
Myocardial ischemi
The thebesian veins arise in the _____ and drain into all the chambers of the heart, but primarily into the right atrium and right ventricle
Myocardium
What is the etiology of spina bifida?
N/A
What is the level of assistance for gait for patient with low tetraplegia (C7-C8)? - don/ doff orthoses - sit/ stand - smooth surface - up/ down ramps - up/down curbs - up/down steps - rough terrain - safe falling
N/A
What is the level of assistance for gait for patient with midlevel tetraplegia (C6)? - don/ doff orthoses - sit/ stand - smooth surface - up/ down ramps - up/down curbs - up/down steps - rough terrain - safe falling
N/A
What are treatments for DVT's?
NO ACTIVE OR PASSIVE MOVEMENT Bed rest Anticoagulant Surgery if necessary
What are treatment options for post- polio syndrome?
NO medications Life style modifications PT- Supervised exercises, functional independence, adaptive equipment, education
What are treatment options for rheumatoid arthritis?
NSAIDs Corticosteroids PROM/ AROM Heating and cooling agents Spinting Education Energy conservation Body mechanics Joint protection techniques
What are some treatments for juvenile rheumatoid arthritis?
NSAIDs, corticosteroids, anti rheumatics and immunosuppressive agents PT: Passive and active ROM, positioning, splinting, strengthening, endurance training, weight bearing activities, postural training, and functional mobility Pain management: Modalities such as paraffin, ultrasound, warm water, cryotherapy.
What does the upper respiratory tract consist of?
Nasal cavity Pharynx Larynx
What are side effects of disease- modifying anti-rheumatic agents?
Nausea Headaches Joint pain and swelling Toxicity Gastrointestinal distress Sore throat Fever Liver dysfunction Hair loss Potential for sepsis Retinal damage
What are side effects of nonopioid agents?
Nausea Vomiting Vertigo Abdominal pain Gastrointestinal distress or bleeding Ulcer formation
What nerves are supplied from the trunks of the brachial plexus?
Nerve to subclavius Suprascapular
Order the acute nerve injuries from mildest to most severe: - Axonotmesis - Neurapraxia - Neurotmesis
Neurapraxia Axonotmesis Neurotmesis
What is the loose packed position for the radiocarpal joint?
Neutral with slight ulnar deviation
What are the 5 main types of white blood cells?
Neutrophils Lymphocytes Monocytes Eosinophils Basophils
Does double leg support exist when running?
No
What are treatment options for Alzheimer's?
No cure Medication are used to inhibit acetylcholinesterase, alleviate symptoms and control behavior changes
What is a grade 1 concussion?
No loss of consciousness Symptoms will resolve within 15 minutes of event
What is the reflex name for a 0 grade and is it normal?
No response Always abnormal
Aerobic: How long can Aerobic Metabolism last?
No specific time frame
What are treatments for carpal tunnel syndrome?
No universally accepted treatment Splinting, ergonomic measures, injections, and PT Surgery
What is the 1st stage of recovery?
No volitional movement initiated
What are the most common motions for ACL injury?
Noncontact twisting motion associated with hyperextension and verges or values stress Tibia being driven anteriorly Femur being driven posteriorly Severe knee hyperextension
Myotome for C1
None
Myotome for L1
None
Myotome for S3
None
Myotome for T1
None
Myotome for T5-T7
None
Myotome for T8-T12
None
Myotomes for T2
None
Myotomes for T3-T6
None
Paresthesia for C1
None
Paresthesia for C2
None
Paresthesia for C5
None
Paresthesia for S3
None
Paresthesia for T1
None
Paresthesia for T2
None
Paresthesia for T3-T6
None
Paresthesia for T5-T7
None
Paresthesia for T8-T12
None
Reflexes affect for C2
None
Reflexes affect for C3
None
Reflexes affect for T2
None
Reflexes affected S3
None
Reflexes affected for C1
None
Reflexes affected for C4
None
Reflexes affected for C8
None
Reflexes affected for L1
None
Reflexes affected for L2
None
Reflexes affected for S4
None
Reflexes affected for T1
None
Reflexes affected for T3-T6
None
Reflexes affected for T5-T7
None
Reflexes affected for T8-T12
None
What is the right side of the brain dominate in?
Nonverbal processing Process information in a holistic manner Artistic abilities General concept comprehension Hand eye coordination Spatial relationships Kinesthetic awareness Understand music Understand nonverbal communication Mathematical reasoning Express negative emotions Body image awareness
What is the 7th stage of recovery?
Normal motor function is restored
What are techniques used for distal functional movement for stability?
Normal timing Slow reversal Slow reversal hold Timing for emphasis
What is "E" considered on the ASIA Impairment Scale?
Normal- Sensory and motor functions are normal
Paresthesia for L2
Occasional anterior thigh
What is stable angina?
Occurs at a predictable level of exertion, exercise or stress and responds to rest or nitroglycerin
What is Prinzmetal's angina?
Occurs due to coronary artery spasm most often associated with coronary artery disease
What is an isometric contraction?
Occurs when tension developes, but there is no change in the length of the muscle.
What is an eccentric contraction?
Occurs when the muscle lengthens while developing tension.
What is a concentric contraction?
Occurs when the muscle shortens while developing tension.
How fast can an athlete return after a grade 3 concussion?
Once symptom free for a minimum of 1 month
What is an ischemic stroke?
Once there is a loss of perfusion to a portion of the brain (within just seconds) there is a central area of irreversible infarction surrounded by an area or potential ischemia. *Tissue death due to lack of oxygen
What is a pulmonary embolism?
One or more arteries in the lungs become blocked
What does the rooting reflex interfere with?
Oral- motor development Developing midline control of head Optical righting, visual track ing and social interaction
Where is the pulmar radiocarpal ligament of the wrist located?
Origin: anterior surface of the distal radius Insertion: capitate, triquetrum and scaphoid
Where is the dorsal radiocarpal ligament of the wrist located?
Origin: posterior surface of the distal radius and styloid process of the radius Insertion: lunate and triquetrum
Where is the radial collateral ligament of the wrist located?
Origin: styloid process of the radius Insertion: scaphoid and trapezium
What are signs and symptoms of a MCL sprain?
Pain Swelling Antalgic gait Decreased ROM Instability
What is the capsular pattern for the sternoclavicular joint?
Pain at extremes of range of motion
What is the capsular pattern for the acromioclavicular joint?
Pain at the extremes of range of movement
What are signs and symptoms of lateral epicondylitis?
Pain immediately anterior or distal to the lateral epicondyle of the humerus Pain that worsens with repetition and resisted wrist extension
What are potential results from Brown-Sequard syndrome?
Paralysis and loss of vibratory sense and position sense on the same side as the lesion Loss of pain and temperature sense of the opposite side of the lesion
What is quadriplegia?
Paralysis of all four limbs
What is monoplegia?
Paralysis of one limb
What is hemiplegia?
Paralysis of one side of the body
What is typically the results of Brown- Sequards syndrome?
Paralysis on the same side as the lesion Loss of vibratory and position sense on the same side as the lesion Loss of pain and temperature sense onn the opposite side of the lesion
Bilateral occlusion (blockage) of the anterior cerebral artery will typically produce what?
Paraplegia Incontinence From lobe changes such as personality change and Conscious unresponsiveness
Basal ganglia disfunction has been associated with many conditions including ____ and ____.
Parkinson's disease Huntington's disease
What are indications for dopamine replacement agents?
Parkinson's disease Parkinsonism
What are basophils?
Participates in allergic responses
What is multiple sclerosis?
Patches of demyelination of the myelin sheaths that surround nerves within the brain and spinal cord Decrease in efficiency of nerve impulse transmission Plaque development
What are signs and symptoms of osteogenesis imperfecta?
Pathological fractures Osteoporosis Hypermobile joints Bowing of the long bones Weakness Scoliosis Impaired respiratory function
What is the 1st level "No Response" of the Ranchos Los Amigos Levels of Cognitive Functioning?
Patient appears in a deep sleep and is completely unresponsive to any stimuli
What is Part 3 of the McGill Pain Questionnaire?
Patient describes pattern of pain, factors that increase and relieve pain
What is the 5th level "Confused- Inappropriate" of the Ranchos Los Amigos Levels of Cognitive Functioning?
Patient is able to respond to simple commands fairly consistently. Highly distractible Converse for short period of time in social environment Verbalization is often inappropriate and confabulatory Memory severely impaired Inappropriate use of objects Unable to learn new information
What is the 4th level "Confused- Agitated" of the Ranchos Los Amigos Levels of Cognitive Functioning?
Patient is in a heightened state of activity. behavior is bizarre and non- purposeful relative to the immediate environment. Patient lacks short term and long term recall Verbalization is often inappropriate
What is Part 1 of the McGill Pain Questionnaire?
Patient marks on a drawing of the body to indicate area and type of pain (internal or external)
Goni techniques Hip Extension: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:
Patient position: prone Stabilization: pelvis to prevent anterior tilting End feel: firm Axis: over the lateral aspect of the hip joint using the greater trochanter of the femur for reference Stationary arm: lateral midline of the pelvis Moveable arm: lateral midline of the femur using a lateral epicondyle for a reference
Goni techniques Shoulder Extension: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:
Patient position: prone Stabilization: thorax to prevent flexion of the spine End feel: firm Axis: acromial process Stationary arm: midaxillary of the thorax Moveable arm: lateral midline of the humerus using the lateral epicondyle of the humerus for reference
Goni techniques Subtalar Inversion: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:
Patient position: prone with the foot extended over a supporting surface Stabilization: tibia and fibula to prevent knee and hip motion End feel: firm Axis: posterior aspect of ankle ankle midway between the malleoli Stationary arm: posterior midline of the lower leg Moveable arm: posterior midline of the calcaneus
Goni techniques Subtalar Eversion: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:
Patient position: prone with the foot extended over a supporting surface Stabilization: tibia and fibula to prevent knee and hip motion End feel: firm hard Axis: posterior aspect of ankle ankle midway between the malleoli Stationary arm: posterior midline of the lower leg Moveable arm: posterior midline of the calcaneus
Goni techniques Hip Lateral Rotation: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:
Patient position: sitting Stabilization: distal end of the femur End feel: firm Axis: anterior aspect of the patella Stationary arm: perpendicular to the floor or parallel to the supporting surface Moveable arm: anterior midline of the lower leg using the crest of the tibia and a point midway between the two malleoli for reference
Goni techniques Hip Medial Rotation: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:
Patient position: sitting Stabilization: distal end of the femur End feel: firm Axis: anterior aspect of the patella Stationary arm: perpendicular to the floor or parallel to the supporting surface Moveable arm: anterior midline of the lower leg using the crest of the tibia and a point midway between the two malleoli for reference
Goni techniques Wrist Extension: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:
Patient position: sitting next to a supporting surface with the shoulder abducted to 90° and the elbow flex to 90° Stabilization: radius and ulna to prevent supination and pronation End feel: firm Axis: the lateral aspect of the wrist over the triquetrum Stationary arm: lateral midline of the ulna using the olecranon and ulnar styloid process for reference Moveable arm: lateral midline of the 5th metacarpal
Goni techniques Wrist Radial Deviation: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:
Patient position: sitting next to a supporting surface with the shoulder abducted to 90° and the elbow flex to 90° Stabilization: radius and ulna to prevent supination and pronation End feel: firm or hard Axis: over the middle of the dorsal aspect of the wrist over the capitate Stationary arm: dorsal midline of the forearm using the lateral epicondyle of the humorous for reference Movable arm: dorsal midline of the 3rd metacarpal
Goni techniques Wrist Ulnar Deviation: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:
Patient position: sitting next to a supporting surface with the shoulder abducted to 90° and the elbow flex to 90° Stabilization: radius and ulna to prevent supination and pronation End feel: firm or hard Axis: over the middle of the dorsal aspect of the wrist over the capitate Stationary arm: dorsal midline of the forearm using the lateral epicondyle of the humorous for reference Movable arm: dorsal midline of the 3rd metacarpal
Goni techniques Wrist Flexion: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:
Patient position: sitting next to a supporting surface with the shoulder abducted to 90° and the elbow flex to 90° Stabilization: radius and ulna to prevent supination and pronation End feel: firm Axis: the lateral aspect of the wrist over the triquetrum Stationary arm: lateral midline of the ulna using the olecranon and ulnar styloid process for reference Moveable arm: lateral midline of the 5th metacarpal
Goni technique Thoracolumbar Rotation: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:
Patient position: sitting on a chair without back with the feet position on the floor for pelvis stabilization Stabilization: pelvis to prevent rotation End feel: firm Axis: over the center of the cranial aspect of the head Stationary arm: parallel to imaginary line between the two prominent tubercles of the iliac crest Moveable arm: along the imaginary line between the two acromial processes
Goni techniques Forearm supination: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:
Patient position: sitting with elbow flexed to 90 Stabilization: distal end of the humerus to prevent ER and adduction of the humerus End feel: firm Axis: medial to the ulnar styloid process Stationary arm: parallel to the anterior midline of the humerus Moveable arm: ventral aspect of the forearm, just proximal to the styloid process of the radius and ulna
Goni techniques Forearm pronation: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:
Patient position: sitting with elbow flexed to 90 Stabilization: distal end of the humerus to prevent IR and abduction of the humerus End feel: firm or hard Axis: lateral to the ulnar styloid process Stationary arm: parallel to the anterior midline of the humerus Moveable arm: dorsal aspect of the forearm, just proximal to the styloid process of the radius and ulna
Goni techniques Thumb Carpometacarpal Abduction: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:
Patient position: sitting with forearm and hand on a supporting surface Stabilization: carpals and 2nd metacarpal to prevent wrist motion End feel: firm Axis: over the lateral aspect of the radios styloid process Stationary arm: lateral midline of the second metacarpal using the center of the second metacarpophalangeal joint for reference Moveable arm: lateral midline of the first metacarpal using the center of the first metacarpophalangeal joint for reference
Goni techniques Thumb Carpometacarpal Adduction: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:
Patient position: sitting with forearm and hand on a supporting surface Stabilization: carpals and 2nd metacarpal to prevent wrist motion End feel: firm Axis: over the lateral aspect of the radios styloid process Stationary arm: lateral midline of the second metacarpal using the center of the second metacarpophalangeal joint for reference Moveable arm: lateral midline of the first metacarpal using the center of the first metacarpophalangeal joint for reference
Goni techniques Thumb Carpometacarpal Extension: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:
Patient position: sitting with forearm and hand on a supporting surface Stabilization: carpals, radius and ulna to prevent wrist motion End feel: firm Axis: over the palmar aspect of the first carpometacarpal joint Stationary arm: ventral midline of the radius using the ventral surface of the radial head and radial styloid process for reference Moveable arm: ventral midline of the first metacarpal
Goni techniques Thumb Carpometacarpal Flexion: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:
Patient position: sitting with forearm and hand on a supporting surface Stabilization: carpals, radius and ulna to prevent wrist motion End feel: firm Axis: over the palmar aspect of the first carpometacarpal joint Stationary arm: ventral midline of the radius using the ventral surface of the radial head and radial styloid process for reference Moveable arm: ventral midline of the first metacarpal
Goni techniques Fingers Metacarpophalangeal Abduction: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:
Patient position: sitting with forearm and hand on a supporting surface Stabilization: metacarpal to prevent wrist motion End feel: firm Axis: over the dorsal aspect of the metacarpophalangeal joint Stationary arm: over in the dorsal midline of the metacarpal Moveable arm: dorsal midline of the proximal phalanx
Goni techniques Fingers Metacarpophalangeal Adduction: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:
Patient position: sitting with forearm and hand on a supporting surface Stabilization: metacarpal to prevent wrist motion End feel: firm Axis: over the dorsal aspect of the metacarpophalangeal joint Stationary arm: over in the dorsal midline of the metacarpal Moveable arm: over in the dorsal midline of the proximal phalanx
Goni techniques Fingers Metacarpophalangeal Extension: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:
Patient position: sitting with forearm and hand on a supporting surface Stabilization: metacarpal to prevent wrist motion End feel: firm Axis: over the dorsal aspect of the metacarpophalangeal joint Stationary arm: over in the dorsal midline of the metacarpal Moveable arm: over in the dorsal midline of the proximal phalanx
Goni techniques Fingers Metacarpophalangeal Flexion: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:
Patient position: sitting with forearm and hand on a supporting surface Stabilization: metacarpal to prevent wrist motion End feel: firm or hard Axis: over the dorsal aspect of the metacarpophalangeal joint Stationary arm: over in the dorsal midline of the metacarpal Moveable arm: over in the dorsal midline of the proximal phalanx
Goni techniques Distal Interphalangeal Extension: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:
Patient position: sitting with forearm and hand on a supporting surface Stabilization: middle and proximal phalanx to prevent motion of the interphalangeal joint End feel: firm Axis: over the dorsal aspect of the distal interphalangeal joint Stationary arm: over the dorsal midline of the middle phalanx Moveable arm: over the dorsal midline of the distal phalanx
Goni techniques Distal Interphalangeal Flexion: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:
Patient position: sitting with forearm and hand on a supporting surface Stabilization: middle and proximal phalanx to prevent motion of the interphalangeal joint End feel: firm Axis: over the dorsal aspect of the distal interphalangeal joint Stationary arm: over the dorsal midline of the middle phalanx Moveable arm: over the dorsal midline of the distal phalanx
Goni techniques Proximal Interphalangeal Extension: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:
Patient position: sitting with forearm and hand on a supporting surface Stabilization: proximal phalanx to prevent motion of the metacarpophalangeal joint End feel: firm Axis: over the dorsal aspect of the proximal interphalangeal joint Stationary arm: over the dorsal midline of the proximal phalanx Moveable arm: over the dorsal midline of the middle phalanx
Goni techniques Proximal Interphalangeal Flexion: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:
Patient position: sitting with forearm and hand on a supporting surface Stabilization: proximal phalanx to prevent motion of the metacarpophalangeal joint End feel: soft, firm or hard Axis: over the dorsal aspect of the proximal interphalangeal joint Stationary arm: over the dorsal midline of the proximal phalanx Moveable arm: over the dorsal midline of the middle phalanx
Goni techniques Ankle Inversion: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:
Patient position: sitting with the knee flexed to 90 Stabilization: tibia and fibula to prevent knee and hip motion End feel: firm Axis: anterior aspect of the ankle midway between the malleoli Stationary arm: midline of the lower leg using the tibial tuberosity for reference Moving arm: anterior midline of the second metatarsal
Goni techniques Ankle Dorsiflexion: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:
Patient position: sitting with the knee flexed to 90 Stabilization: tibia and fibula to prevent knee and hip motion End feel: firm Axis: lateral aspect of the lateral malleolus Stationary arm: lateral midline of the fibula using the head of the fibula for reference Moveable arm: parallel to the lateral aspect of the fifth metatarsal
Goni techniques Ankle Eversion: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:
Patient position: sitting with the knee flexed to 90 Stabilization: tibia and fibula to prevent knee and hip motion End feel: firm or hard Axis: anterior aspect of the ankle midway between the malleoli Stationary arm: midline of the lower leg using the tibial tuberosity for reference Moving arm: anterior midline of the second metatarsal
Goni techniques Ankle Plantarflexion: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:
Patient position: sitting with the knee flexed to 90 Stabilization: tibia and fibula to prevent knee and hip motion End feel: firm or hard Axis: lateral aspect of the lateral malleolus Stationary arm: lateral midline of the fibula using the head of the fibula for reference Moveable arm: parallel to the lateral aspect of the fifth metatarsal
Goni techniques Cervical Rotation: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:
Patient position: sitting with the thoracic and lumbar spine supported Stabilization: shoulder girdle and chest; the patient's hand should be placed on their knees End feel: firm Axis: over the center of the cranial aspect of the head Stationary arm: parallel to the imaginary line between the two acromial processes Moveable arm: with the tip of her nose or if using a tongue depressor align the goniometer parallel to the tongue depressor
Goni techniques Cervical Lateral Flexion: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:
Patient position: sitting with the thoracic and lumbar spine supported Stabilization: shoulder girdle and chest; the patient's hand should be placed on their knees End feel: firm Axis: over the spinous process of C7 Stationary arm: with the spinous processes of the thoracic vertebrae so that the arm is perpendicular to the ground Moveable arm: along the dorsal midline of the head using the occipital protuberance for reference
Goni techniques Cervical Extension: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:
Patient position: sitting with the thoracic and lumbar spine supported Stabilization: shoulder girdle and chest; the patient's hand should be placed on their knees End feel: firm Axis: the external auditory meatus Stationary arm: perpendicular parallel to the ground Moveable arm: along the base of the nares or if using a tongue depressor, align goniometer parallel with the tongue depressor
Goni techniques Cervical Flexion: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:
Patient position: sitting with the thoracic and lumbar spine supported Stabilization: shoulder girdle and chest; the patient's hand should be placed on their knees End feel: firm Axis: the external auditory meatus Stationary arm: perpendicular parallel to the ground Moveable arm: along the base of the nares or if using a tongue depressor, align goniometer parallel with the tongue depressor
Goni techniques Knee Extension: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:
Patient position: supine Stabilization: femur to prevent rotation, abduction and abduction of the hip End feel: firm Axis: lateral epicondyle of the femur Stationary arm: later midline of the femurs using the greater trochanter for reference Moveable arm: lateral midline of the fibula using the lateral malleolus and fibular head for reference
Goni techniques Knee Flexion: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:
Patient position: supine Stabilization: femur to prevent rotation, abduction and abduction of the hip End feel: soft or firm Axis: lateral epicondyle of the femur Stationary arm: later midline of the femurs using the greater trochanter for reference Moveable arm: lateral midline of the fibula using the lateral malleolus and fibular head for reference
Goni techniques Elbow extension: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:
Patient position: supine Stabilization: humerus to prevent flexion of the shoulder End feel: hard Axis: later epicondyle of the humerus Stationary arm: lateral midline of the humerus using the center of the acromial process for reference Moveable arm: lateral midline of the radius using the radial head and radial styloid process for reference
Goni techniques Elbow flexion: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:
Patient position: supine Stabilization: humerus to prevent flexion of the shoulder End feel: soft Axis: later epicondyle of the humerus Stationary arm: lateral midline of the humerus using the center of the acromial process for reference Moveable arm: lateral midline of the radius using the radial head and radial styloid process for reference
Goni techniques Hip Adduction: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:
Patient position: supine Stabilization: pelvis to prevent lateral tilting End feel: firm Axis: over the ASIS of the extremity being measured Stationary arm: align with imaginary horizontal Line extending from one ASIS to the other ASIS Moveable arm: anterior midline of the femur using the midline of the patella for reference
Goni techniques Hip Abduction: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:
Patient position: supine Stabilization: pelvis to prevent lateral tilting and rotation; trunk to prevent lateral flexion End feel: firm Axis: over the ASIS of the extremity being measured Stationary arm: align with imaginary horizontal Line extending from one ASIS to the other ASIS Moveable arm: anterior midline of the femur using the midline of the patella for reference
Goni techniques Shoulder Flexion: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:
Patient position: supine Stabilization: thorax to prevent extension of the spine End feel: firm Axis: acromial process Stationary arm: midaxillary line of the thorax Moveable arm: lateral midline of the humerus using the lateral epicondyle of the humerus for reference
Goni techniques Shoulder Abduction: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:
Patient position: supine Stabilization:thorax to prevent lateral bending End feel: firm Axis: anterior aspect of acromial process Stationary arm: parallel to the midline of the anterior aspect of the sternum Moveable arm: medial midline of the humerus
Goni techniques Shoulder Adduction: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:
Patient position: supine Stabilization:thorax to prevent lateral bending End feel: firm Axis: anterior aspect of acromial process Stationary arm: parallel to the midline of the anterior aspect of the sternum Moveable arm: medial midline of the humerus
Goni techniques Hip Flexion: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:
Patient position: supine Stabilization: pelvis to prevent posterior tilting End feel: soft or firm Axis: over the lateral aspect of the hip joint using the greater trochanter of the femur for reference Stationary arm: lateral midline of the pelvis Moveable arm: lateral midline of the femur using a lateral epicondyle for a reference
Goni techniques Shoulder ER: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:
Patient position: supine with shoulder abducted to 90 and elbow flexed to 90 Stabilization: distal end of the humerus to maintain the shoulder in 90 degrees of abduction End feel: firm Axis: olecranon process Stationary arm: parallel or perpendicular to the floor Moveable arm: ulna using the olecranon process and ulnar styloid process for reference
Goni techniques Shoulder IR: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:
Patient position: supine with shoulder abducted to 90 and elbow flexed to 90 Stabilization: distal end of the humerus to maintain the shoulder in 90 degrees of abduction End feel: firm Axis: olecranon process Stationary arm: parallel or perpendicular to the floor Moveable arm: ulna using the olecranon process and ulnar styloid process for reference
Goni technique Thoracolumbar Lateral Flexion: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:
Patient position: with the feet shoulders width apart Stabilization: pelvis to prevent lateral tilting End feel: firm Axis: over the posterior aspect of spinous process of C1 Stationary arm: perpendicular to the ground Moveable arm: posterior aspect of C7
What is Part 4 of the McGill Pain Questionnaire?
Patient rates intensity of pain on a scale of 0-5
What is the 2nd level "Generalized Response" of the Ranchos Los Amigos Levels of Cognitive Functioning?
Patient reacts inconsistently and non-purposefully to stimuli in a nonspecific manner. Responses are limited and often the same regardless of stimulus presented. Responses bay be physiological changes, gross body movements, and/ or vocalization
What is the 3rd level "Localized Response" of the Ranchos Los Amigos Levels of Cognitive Functioning?
Patient reacts specifically, but inconsistently to stimuli. responses are directly related to the type of stimulus presented. May follow simple commands such as closing eyes or squeezing the hand in an inconsistent, delayed manor
Abnormal Gait: What is hemiplegic gait?
Patient who abducts the paralyzed limb, swings it around, and brings it forward so the foot comes to the ground in front of them
What is Part 2 of the McGill Pain Questionnaire?
Patients choose one word that best describes the pain from each of the 20 categories
What is tenodesis?
Patients with tetraplegia that do not possess motor control for grasp can utilize the tight finger flexors in combination with wrist extension to produce a form of grasp
What muscles assist with shoulder adduction?
Pec Major Latissimus Dorsi Teres Major
What muscles are supplied from the medial pectoral nerve?
Pectoralis Major Pectoralis Minor
What muscles are supplied by the lateral pectoral nerve?
Pectoralis major- clavicular head
What is LE D2 Extension? Pelvis Hip Knee Ankle/ toes
Pelvis: Depression Hip: Extension, ADD, ER Knee: Flexion or extension Ankle/ toes: PF, Inversion
What is LE D2 Flexion? Pelvis Hip Knee Ankle/ toe
Pelvis: Elevation Hip:Flexion, ABD, IR Knee: Flexion or extension Ankle/ toes: DF, Eversion
What is LE D1 Flexion? Pelvis Hip Knee Ankle/ toes
Pelvis: Protraction Hip: Flexion, ADD, ER Knee: Flexion or extension Ankle/ toes: Dorsiflexion, Inversion
What is LE D1 Extension? Pelvis Hip Knee Ankle/ toes
Pelvis: Retraction Hip: Extension, ABD, IR Knee: Flexion or extension Ankle/ toes: PF, Eversion
What is the purpose of pain sensory testing?
Perceive pain through sharp vs dull sensation using a wartenburg pinwheel
What is the purpose of barognosis sensory testing?
Perceive the weight of different objects in the hand
What is the purpose of light touch sensory testing?
Perceive touch through light pressure or use of a cotton ball
What is the purpose of vibration sensory testing?
Perceive vibration or pain through a tuning fork
What is the purpose of temperature sensory testing?
Perceive warm and cold test tubes
Dermatome for S4
Perimueum Genitals Lower Sacrum
What muscles assist with Ankle eversion?
Peroneus Longus Peroneus Brevis Peroneus Tertius
What muscles are supplied by the superficial peroneal nerve?
Peroneus longus peroneus brevis
What are signs and symptoms of bronchitis?
Persistent cough with production of thick sputum Increased use of accessory muscles to breathe Wheezing Dyspnea Cyanosis Increased pulmonary artery pressure *Chronic- cough is worse in the morning and during damp weather
How does the ATP-PC system function?
Phosphocreatine decomposes and releases a large amount of energy that is used to construct APT.
What are the gross motor skills for a newborn to 1 month old in Prone?
Physiological flexion Lifts head briefly Head to side
What are the gross motor skills for a newborn to 1 month old in supine?
Physiological flexion Rolls partly to side
The epithalamus is primarily represented by the ___ gland.
Pineal gland
What muscles are supplied by the sacral plexus?
Piriformis Superior gemelli Inferior gemelli Obturator internus Quadratus femoris
What are signs and symptoms on osgood- schlatters disease
Point tenderness over the patella tendon at the insertion on the tibial tubercle Antalgic gait pain with increasing activity
What are 11 examples of lower motor neuron diseases (LMNL)?
Poliomyelitis ALS (both upper and lower) Guillain- Barre syndrome Tumors involving the spinal cord Trauma Progressive muscular atrophy Infection Bell's palsy Carpal tunnel syndrome Muscular dystrophy Spinal muscular atrophy
What are the gross motor skills for a 2-3 month old in standing?
Poor weight bearing Hips in flexion, behind shoulders
What is the stimulus for tonic labyrinthine reflex (TLR)?
Position of labyrinth in inner ear - reflected in head position
What are treatments for spina bifida?
Positioning Handling ROM Therapeutic exercise Skin care Strengthening Mobility and balance Adaptive equipment Splinting Orthotics Wheelchair
What are the special tests for a PCL injury?
Posterior Drawer Test Posterior Sag Sign
Where is the PCL located?
Posterior intercondylar area of the tibia to the lateral aspect of the medial femoral condyle in the intercondylar notch
What is constant practice?
Practice of a given task under a uniform condition
What is variable practice?
Practice of a given task under differing conditions
What is whole training?
Practice of an entire task
What is part training?
Practice of an individual component or select components of a task
What are signs and symptoms of angina pectoris?
Pressure Heaviness Fullness Squeezing Burning or aching behind the sternum Difficulty breathing Nausea Vomiting Sweating
What are the stimulus to the palmar grasp reflex?
Pressure in the palm on the ulnar side of hand
What is the stimulus for the planter grasp reflex?
Pressure to base of toes
What is the purpose of the iliofemoral ligament of the hip?
Prevents excessive hip extension and assist with upright posture
What are the functions of the temporal lobe?
Primary auditory processing and olfaction Wernicke's area (typically located in the left hemisphere): ability to understand and produce meaningful speech, verbal and general memory, assists with understanding language The rear of the temporal lobe enables humans to interpret other peoples emotions and reactions
What are signs and symptoms for a total hip arthroplasty?
Prior to surgery- Severe pain with weight bearing, loss of mobility, gross instability or limitation in ROM
What are signs and symptoms for a total knee arthroplasty?
Prior to surgery: Severe pain with weight bearing Decreased ROM Gross instability Marked deformity of the knee
What is Duchenne Muscular Dystrophy?
Progressive disorder caused by the absence of the gene required to produce the muscle proteins dystrophin and nebulin. Without these, cell membranes weaken, myofibrils are destroyed and muscular contractility is lost.
What are signs and symptoms of Cor Pulmonale?
Progressive shortness of breath, fatigue, palpitations, atypical chest pain, swelling of the LE, dizziness and syncope
What are muscle relaxant agents?
Promote relaxation in muscles that typically present with spasm that is a continuous, tonic contraction
What is the purpose of anti-spasticity agents?
Promotes relaxation in a spastic muscle
What are the motions for the proximal radioulnar joint?
Pronation Supination
What muscles assist with radioulnar pronation?
Pronator Teres Pronator Quadratus
What are the 3 options for deep sensory testing?
Proprioception Kinesthesia Vibration
What are meninges?
Protection layers of the brain Blood vessels CFS is inside the meninges
What is myelin?
Proteins and lipids that form to create a sheath around particular nerves Increases conductivity of the nerve impulse
What is the purpose of a nonopioid agent?
Provide analgesia and pain relief, produce anti-inflammatory effects, and initiate anti-pyretic (reduces fever) properties.
What is the purpose of an opioid agaent (narcotics)?
Provide analgesia for acute severe pain, stimulates opioid receptors within the CNS to prevent pain impulses from reaching their destination
What is a corset orthosis?
Provides pressure and relieves pain associated with mid and low back pathologies.
Myotome for L2
Psoas Hip adductors
Myotome for L3
Psoas Quads Thigh atrophy
What muscles assist in thoracolumbar rotation and side bending?
Psoas Major Quadratus Lumborum Internal Obliques External Obliques Multifidus Longissiumus Thoracic Iliocostalis Thoracis Rotatores
What muscles assist with thoracic and lumbar rotation and lateral bending?
Psoas Major Quadratus Lumborum Internal Obliques External Obliques multifidus Longissimus Thoracis Rotatores
What muscles are supplied by the lumbar plexus?
Psoas major Psoas minor Quadratus lumborum
Where is the pubofemoral ligament located?
Pubic portion of the rim of the acetabulum to the neck of the femur
What is Cor Pulmonale?
Pulmonary heart disease Hypertrophy of the right ventricle caused by altered structure or function of the lungs
What is the etiology of Cor Pulmonale?
Pulmonary hypertension
What is the descending corticospinal tract (lateral)?
Pyramidal motor tract responsible for contralateral voluntary fine movement
What is the descending corticospinal tract (anterior)?
Pyramidal motor tract responsible for ipsilateral voluntary, discrete and skilled movements
Peak muscle activity during the gait cycle. Name the muscle group: Two periods of peak activity. In periods of single support during early stance phase and just before toe off to initiate swing phase.
Quadriceps group
What are some treatments for impingement syndrome?
RICE NSAIDS Activity modification Rotator cuff strengthening Shoulder stability exercises
What are treatment options for plantar fasciitis?
RICE NSAIDs Analgesics Heel cup Massage Taping Joint mobilization Stretching Orthotics Soft- soled footware
What are some treatments for a MCL sprain?
RICE NSAIDs Analgesics Increasing ROM Strengthening
What are treatment options for a meniscus tear?
RICE NSAIDs Analgesics Modalities Strengthening
What are treatment options for a PCL sprain?
RICE NSAIDs Analgesics Strengthening
What are some treatments for lateral epicondylitis?
RICE NSAIDs Activity modification PT: Strength Flexibility Endurance
With are treatment options for a rotator cuff tear?
RICE NSAIDs Analgesics Adhesive capsulitis prevention Strengthening
What are treatment options for achilles tendonitis?
RICE (Rest, ice, compression, elevation) NSAIDS Stretching Eccentric exercises of the soleus and gastroc
What are treatment options for adhesive capsulitis?
ROM exercises Palliative modalities
What is Souque's phenomenon?
Raising the involved UE above 100 degrees with elbow extension will produce extension and abduction of the fingers
What are the gross motor skills for adolescence (+13 yrs)?
Rapid growth in size and strength, boys more than girls Puberty Balance and coordination skills, hand eye coordination, endurance may plateau during growth spurt
What is the hypothalamus?
Receives and integrates information from the AND and assists with regulating hormones Controls functions such as hunger, thirst, sexual behavior, and sleeping Regulates body temperature, the adrenal glands, the pituitary glands and many other vital activities
What is the response to the walking (stepping) reflex?
Reciprocal flexion/ extension of legs
What is a RGO?
Reciprocating Gait Orthosis When the patient shifts weight onto a selected lower extremity, the cable system advances to the opposite lower extremity. Paraplegic patients
What muscles assist in thoracolumbar flexion?
Rectus Abdominis Internal Obliques External Obliques
What muscles assist with thoracic and lumbar flexion
Rectus Abdominus Internal Obliques External Obliques
What muscles assist with Knee extension?
Rectus Femoris Vastus Lateralis Vastus Intermedius Vastus Medialis
What muscles activate during forceful breathing, which depresses the lower ribs and compresses the abdominal contents?
Rectus abdominis External oblique Internal oblique Transverse abdominis
What are symptoms of pressure ulcers?
Reddened area that persists or an open area of the skin
What is the purpose of anti-epileptic agents?
Reduce or eliminate seizure activity within the brain
What are the gross motor skills for a newborn to 1 month old in standing?
Reflex standing and walking
Lower motor neuron disease Reflexes: hyperactive or diminished/ absent Atrophy: mild or present Fasciculations: absent or present Tone: hypertonic or flaccid
Reflexes: diminished/ absent Atrophy: present Fasciculations: present Tone: flaccid
Upper motor neuron disease Reflexes: hyperactive or diminished/ absent Atrophy: mild or present Fasciculations: absent or present Tone: hypertonic or flaccid
Reflexes: hyperactive Atrophy: mild from disuse Fasciculations: absent Tone: hypertonic
What are the fine motor skills for a newborn to 1 month old?
Regards objects in direct line of sight Follows moving object to midline Hands fisted Arms movements jerky Movements may be purposeful or random
What is the purpose of the ischiofemoral ligament of the hip?
Reinforces the articular capsule
What is atrial diastole?
Relaxation of the atria
What is the purpose of ascending tracts?
Relay sensory feedback to the cerebrum and cerebellum
What is the brain stem?
Relay station Made up of the midbrain, pons and medulla oblongata Survival regulations
What is the thalamus?
Relaying or processing station for the majority of information that goes to the cerebral cortex Coordinates sensory perception and movement with other parts of the brain and spinal cord Receives information from the cerebellum, basal ganglia and all sensory pathways except for olfactory tract
What is practice?
Repeated performance of an activity in order to learn or perfect a skill
What is Osgood-Schlatter disease?
Repetitive traction on the tibial tuberosity apophysis Also know as traction apophysis
What are indications for glucocorticoid agents (corticosteroids)?
Replacement therapy for endocrine dysfunction Anti-inflammatory and immunosuppressive effects Treatment if rheumatic, respiratory and various other disorders
What is intrinsic (inherent) feedback?
Represents all feedback that comes to the person through sensory systems as a result of the movement including visual, vestibular, proprioceptive and somatosensory inputs
What is extrinsic (augmented) feedback?
Represents the information that can be provided while a task or movement is n progress or subsequent to the movement Ex. verbal feedback or manual contacts
What is declarative learning?
Requires attention, awareness, and reflection in order to attain knowledge that can be consciously recalled (mental practice)
What is the etiology of asthma?
Respiratory infections Allergens to pollen, mold, animal dander, feathers, dust, food, cockroaches, exposure to cold air, cigarette smoke
What are blood platelets?
Responsible for clotting blood
What are treatments for bronchitis?
Rest Fluids Warm moist air Medication Life style changes Airway clearance Breathing exercises Endurance training
What are signs and symptoms of Parkinson's?
Resting tremors Balance issues Difficulty rolling over and getting out of bed Impairment with fine manipulative movements seen in writing, bathing and dressing Poor posture Shuffling gait Bradykinesia
What are the 3 groups of tremors?
Resting: Observable at rest and may or may not disappear with movement; may increase with mental stress Postural: Observable during a voluntary contraction to maintain posture Intention (kinetic): Absent at rest but observable with activity and typically increase as the target approaches
What are indications for joint mobilization?
Restricted joint mobility Restricted accessory motion Desired neurophysiological effects
What is the purpose of the Ligament Nuchae?
Restricts flexion in the cervical spine.
What is the purpose of the Supraspinous Ligament?
Restricts flexion in the thoracic and lumbar spine
What is deep vein thrombosis (DVT)?
Results from the formation of a blood clot that becomes dislodged and is termed an embolus.
What are indications for disease- modifying anti-rheumatic agents?
Rheumatic disease
What muscles does the dorsal scapular nerve supply?
Rhomboids Levator Scapulae
What muscles assist with scapular downwards rotation?
Rhomboids Levator Scap Pec Min
What are the gross motor skills for a 2 yr old?
Rides tricycle Walks on tip toes Runs on toes Walks downstairs alternating feet Catches large ball Hops on one foot
What are gyrus>
Ridges of the brain
The sagittal plane divides the body into _________________ and _________________ portions.
Right Left
What are the 2 inferior chambers of the heart?
Right and left ventricles
What is the cerebrum?
Right vs left Joined by white matter called the corpus, which relays information from one side of the brain to another Outer surface of the cerebrum is termed grey matter Inner surface of the cerebrum is termed white matter
How many bronchopulmonary segments are on the right lung? Left lung?
Right- 10 Left- 8
How many lobes are there in the right lung? Left lung?
Right- 3 Left- 2
What are the gross motor skills for a 6-7 month old in prone?
Rolls from supine to prone position Holds weight on one hand to reach for toy
What are the gross motor skills for a 4-5 month old in supine?
Rolls from supine to side position Plays with feet to mouth
What is the etiology of myocardial infarctions?
Ruptured atherosclerotic plaque or blood clot blocks the flow of blood through the coronary artery Uncommon- spasm of the coronary artery
What is the innervation level for dermatome testing of the lateral and plantar aspect of the foot?
S1
What is the innervation level for functional testing of toe walking?
S1
What is the innervation level for reflex testing of the achillies?
S1
What is the innervation level for resistive testing of ankle plantar flexion?
S1
What is the innervation level for dermatome testing of the medial aspect of the posterior thigh?
S2
What is the innervation level for dermatome testing of the perianal area?
S3-S5
What is the pacemaker of the heart?
SA node
What is autonomic dysreflexia?
SCI= occurs with lesions at or above T6 A Noxious stimulus below the level of the lesion triggers the ANS causing sudden elevation of BP
What muscles make up the rotator cuff?
SITS: Subscapularis Infraspinatus Teres minor Supraspinatus
Reflexes affected for S1
SLR limited Achillies reflex weak or absent
Reflexes affected for S2
SLR limited Achillies reflex weak or absent
Reflexes affected for L4
SLR limited Neck flexion pain Weak or absent knee jerk Side flexion limited
Reflexes affect for L5
SLR limited one side Neck flexion painful Ankle decrease Crossed- leg raising pain
What are signs and symptoms of a pulmonary embolism?
SOB Chest pain what is worse with deep breathing, coughing, eating or bending Coughing up bloody or blood streaked sputum Wheezing LE swelling Excessive sweating Rapid or irregular pulse Lightheadedness or fainting
What are signs and symptoms of heart failure?
SOB Fatigue and weakness Swelling of the legs, feet and abdomen Rapid or irregular HR Persistent cough or wheezing Weight gain from fluid retension
What are signs and symptoms of emphysema?
SOB Wheezing Chronic cough Orthopnea BARREL CHEST Increased use of accessory muscles Increased respiration rate Fatigue Reduced exercises capacity
What is a cerebrovascular accident?
STROKE The sudden death of some brain cells due to lack of oxygen when the blood flow to the brain is impaired by blockage or rupture of an artery to the brain
Paresthesia for S4
Saddle area Genitals Anus Impotence Massive posterior herniation
What are signs and symptoms if cystic fibrosis?
Salty tasting skin Persistent and progressive cough Frequent lung infections Wheezing SOB Poor growth/ weight gain in spite of good appetite Frequent greasy and bulky stools
What is the sharpened Romberg test?
Same as Romberg but in tandem stance
What is the synergy pattern for the UE extensors? Scapula Shoulder Elbow Forearm Wrist Fingers Thumb
Scapula: Depression and protraction Shoulder: Adduction and IR Elbow: Extension Forearm: Pronation Wrist: Extension Fingers: Flexion with adduction Thumb: Flexion and adduction
What is UE D2 Extension Scapula Shoulder Elbow Radioulnar Wrist Thumb
Scapula: Depression, ABD, Downwards rotation Shoulder: Extension, ADD, IR Elbow: Flexion or extension Radioulnar: Pronation Wrist: Flexion, Ulnar deviation Thumb: Opposition Tuck the sword away
What is UE D1 Extension Scapula Shoulder Elbow Radioulnar Wrist Thumb
Scapula: Depression, ADD, Downwards rotation Shoulder: Extension, ABD, IR Elbow: Flexion or extension Radioulnar: Pronation Wrist: Extension, Ulnar deviation Thumb: ABD car seatbelt
What is UE D1 Flexion Scapula Shoulder Elbow Radioulnar Wrist Thumb
Scapula: Elevation, ABD, Upwards rotation Shoulder: Flexion, ADD, ER Elbow: Flexion or extension Radioulnar: Supination Wrist: Flexion, Radial deviation Thumb: Adduction Grabbing something off top left shelf with right hand
What is UE D2 Flexion Scapula Shoulder Elbow Radioulnar Wrist Thumb
Scapula: Elevation, ADD, Upwards rotation Shoulder: Flexion, ABD, ER Elbow: Flexion or extension Radioulnar: Supination Wrist: Extension, Radial deviation Thumb: Extension take out sword
What is the synergy pattern for the UE flexors? Scapula Shoulder Elbow Forearm Wrist Fingers Thumb
Scapula: elevation and retraction Shoulder: Abduction and ER Elbow: Flexion Forearm: Supination Wrist: Flexion Fingers: Flexion with adduction Thumb: Flexion and adduction
What are treatment options for pressure ulcers?
Seat cushions Movement Nutrition Hydration Skin care Surgery if necessary
What is the epithalamus?
Secretes melatonin, and is involved in circadian rhythms, the internal clock, selected regulation of motor pathways and emotions
What are side effects of muscle relaxant agents?
Sedation Drowsiness Dizziness Nausea Vomiting Headache Tolerance Dependence
What is diplopia?
Seeing two images of an object, also known as double vision
What are indications of anti-epileptic agents?
Seizure activity
What are signs and symptoms of epilepsy?
Seizure symptoms, loss of awareness, loss of consciousness, disturbance of movement, sensation, mood or mental function
What muscles are supplied by the sciatic nerve?
Semitendinosus Semimembranosus Biceps femoris
Dorsal roots are _____ (sensory/ motor) Dorsal roots contain _____ (afferent/ efferent) fibers
Sensory Afferent
What is "B" considered on the ASIA Impairment Scale?
Sensory Incomplete- Sensory but not motor function is preserved below the neurologic level and extends through sacral segments S4-S5
What are signs and symptoms of carpal tunnel syndrome?
Sensory changes and paresthesia along the median nerve Radiates to upper arm, shoulder and neck Night pain, weakness, muscle atrophy, decreased grip strength, clumsiness and decreased wrist mobility
What is the ascending spinothalamic tract (anterior)?
Sensory tract for light touch and pressure
What is the ascending spinothalamic tracts (lateral)?
Sensory tract for pain and temperature sensation
What is the ascending fasciculus gracilis (posterior or dorsal column) tracts?
Sensory tract for the trunk and lower extremity proprioception, two- point discrimination, vibration and graphesthesia
What is the ascending fasciculus cuneatus (posterior or dorsal column) tracts?
Sensory tract for trunk, neck and upper extremity proprioception, vibration, two point discrimination and graphesthesia
What is the ascending spinotectal tract?
Sensory tract providing afferent information for spinovisual reflexes and assists with movement of eyes and head towards stimulus
What is the ascending spinocerebellar tract (dorsal)?
Sensory tract that ascends to the cerebellum for ipsilateral subconscious proprioception, tension in muscles, joint sense, and posture of the trunk and lower extremities
What is the ascending spinocerebellar tract (ventral)?
Sensory tract that ascends to the cerebellum, some fibers crossing with subsequent recrossing at the level of the pons for ipsilateral subconscious proprioception, tension in muscles, joint sense and posture of the trunk, upper extremities and lower extremities
What muscles does the long thoracic nerve supply?
Serratus Anterior
What muscles assist with scapular protraction?
Serratus Anterior Pec Minor
What is spina bifida myelomeningocele?
Severe form of spina bifida herniation of the meninges, cerebral spinal fluid and the spinal cord extend through the spinal column and a cyst forms
What is a grade III ligament sprain?
Severe pain and swelling, substantial joint instability, total tear of the ligament, substantial decrease in ROM
What are sulci?
Shallow grooves
What are symptoms of anemia?
Shortness of breath, fatigue, weakness, pale
Dermatome for C4
Shoulder area Clavicular area Upper scapular area
What are signs and symptoms of scoliosis?
Shoulder level asymmetrical Rib hump
What is the 6th level "Confused- Appropriate" of the Ranchos Los Amigos Levels of Cognitive Functioning?
Shows goal directed behavior Follows simple direction Appropriate responses
What are examples of dopamine replacement agents?
Sinemet Levodopa
What is the best position for a patient with autonomic dysreflexia?
Sitting
What does the startle reflex interfere with?
Sitting balance Protective responses in sitting Eye- hand coordination, visual tracking Social interaction, attention
What are the gross motor skills for early school age (5-8 yrs)?
Skips on alternate feet Gallops Can play hopscotch, balance on 1 foot, controlled hopping, squatting on one leg Jumps with rhythm, controlled (jump rope) Bounces large ball Kicks ball with greater control Limbs growing faster than trunk allowing greater speed, leverage
What is patellofemoral syndrome?
Slight malalignment of the patella that causes knee pain pain under patella and/or around it Chondromalacia patella- softening of the articular cartilage of the patella Females > men
Where is the location of the MCL?
Slightly above medial femoral epicondyle to the medial aspect of the of the tibial shaft
Where should the plumb line run through for proper posture?
Slightly posterior to the coronal suture Through the external auditory meatus Through the axis of the odontoid process Midway though the tip of the shoulder Through the bodies of the lumbar vertebrae Slightly posterior to the hip Slightly anterior to the axis of the knee joint Slightly anterior to the lateral malleolus Through the calcaneocuboid joint
What are signs and symptoms of post- polio syndrome?
Slow and progressive weakness Fatigue Atrophy Pain Swallowing issues
What is bradykinesia?
Slow movement
What are disease- modifying anti-rheumatic agents?
Slows or halts the progression of rheumatic diseases. They are used in early disease process to slow the progression prior to widespread damage of the affected joints. They act to induce remission by modifying the pathology and inhibiting the immune response responsible for rheumatic disease.
What is dysarthria?
Slurred and impaired speech due to a motor deficit of the tongue or other muscles essential for speech
What is a grade 1 joint mobilization?
Small amplitude of movement performed at the beginning of the range
What is a grade 4 joint mobilization?
Small amplitude of movement performed at the limit of the range
What are characteristics of C Fibers? Size of fibers Myelinated? Unmyelinated? Speed of conduction rate Extra
Small fibers Poorly myelinated or unmyelinated Slowed conduction rate Post- ganglionic fibers of the sympathetic system Exteroceptors for pain, temperature and touch
What should you feel with a soft normal end feel?
Soft tissue approximation ex. elbow flexion knee flexion
What muscles are supplied by the tibial nerve?
Soleus Popliteus Plantaris Tibalis posterior Gastrocnemius Flexor hallucis longus Flexor digitorum longus
What are the 3 components of balance?
Somatosensory information Visual information Vestibular information
What is the 4th stage of recovery?
Spasticity begins to decrease. Movement patterns are not dictated coley by limb synergies
What are key points of control?
Specific handling of designated areas of the body will influence and facilitate posture, alignment and control
What are some special test for a biceps tendon pathology?
Speeds test Yergason's test
Brachioradialis Tendon DTR Testing Spinal level: Procedure: Normal response:
Spinal level: C5-C6 Procedure: 1. Rest the hand on the lab in sitting with the forearm supported and in neutral 2. Strike the radius 1-2 inches superior to the wrist Normal response: 1. Contraction of the brachioradialis muscle 2. Elbow flexion and/ or forearm supination
Biceps Tendon DTR testing Spinal level: Procedure: Normal response:
Spinal level: C5-C6 Procedure: 1. Support the elbow in partial flexion in sitting or supine 2. Place the thumb firmly over the biceps tendon at the elbow 3. Strike the hammer through the thumb Normal response: 1. Contraction of the biceps muscle 2. Flexion of the elbow
Triceps Tendon DTR Testing Spinal level: Procedure: Normal response:
Spinal level: C6-C7 Procedure: 1. Support the UE through the humerus and allow the lower portion to hang with elbow flexion 2. Strike the tendon directly above the elbow Normal response: 1. Contraction of the triceps muscle 2. Elbow extension
Patellar Tendon DTR Testing Spinal level: Procedure: Normal response: Spinal level: Procedure: Normal response:
Spinal level: L3-L4 Procedure: 1. Supported knee flexion with the patient sitting or supine 2. Strike the tendon directly inferior to the patella Normal response: 1. Contraction of the quads 2. Knee extensoin
Achillis Tendon DTR Testing Spinal level: Procedure: Normal response:
Spinal level: S1-S2 Procedure: 1. In sitting, flex the foot at the ankle putting the achillies on stretch 2. Strike the achillies tendon above the foot Normal response: 1. Plantar flexion
What is a posterior cruciate ligament sprain?
Sprain of a PCL Not common Accompanied by ACL, MCL, LCL and/or menisci injuries
What is a Medical Collateral Ligament Sprain?
Sprain to the MCL of the knee
What are the gross motor skills for a 16-24 month old?
Squats in play Walks backwards Walks up and down stairs with one hand held using both feet on step propels ride on toys Kicks ball Throws ball Picks up toy from floor without falling
What are 3 activities that you should avoid doing with osgood- schlatters disease?
Squatting Running Jumping
What is the purpose of the interosseous membrane of the wrist?
Stabilizes against axial forces applied to the wrist
Abnormal Gait: What is cerebellar gait?
Staggering gait pattern seen in children with a cerebellar disease.
Which phase takes up 60% of the gait cycle?
Stance Phase
What does the positive support reflex interfere with?
Standing and walking Balance reactions and weight shifting in standing Can lead to contractures of the ankles into PF
What does the walking (stepping) reflex interfere with?
Standing and walking Balance reactions and weight shifting in standing Development of smooth, coordinated reciprocal movements of LE
What are the gross motor skills for a 8-9 month old in standing?
Stands at furniture Pulls to stand at furniture Lowers to sitting position from supported stand
What are the gross motor skills for a 10-11 month old in standing?
Stands without support briefly Pulls to stand using half kneel intermediate position Picks up object from floor from standing with support
What are the signs and symptoms of Duchenne Muscular Dystrophy?
Start between 2-5yrs old Progressive weakness Disinterest in running Falling Toe walking Excessive lordosis Pseudohypertrophy
What is a thrombus?
Stationary blood clot Symptoms appear in minutes or over several days
What is peripheral arterial disease?
Stenotic, occlusive and aneurysmal diseases of the aorta and peripheral arteries
According to standard terminology, what is heel strike?
Step 1/8: The instant the heel touches the ground to begin stance phase
According to Ranchos Los Amigos, what is initial contact?
Step 1/8: When the foot touches the ground
According to Ranchos Los Amigos, what is loading response?
Step 2/8: The amount of time between initial contact and the beginning of the swing phase for the other leg
According to standard terminology, what is foot flat?
Step 2/8: The point in which the entire foot makes contact with the ground and should occur directly after heel strike
According to standard terminology, what is midstance?
Step 3/8: The point during the stance phase when the entire body weight is directly over the stance limb
According to Ranchos Los Amigos, what is midstance?
Step 3/8: The point in stance phase when the other foot is off the ground until the body is directly over the stance limb
According to standard terminology, what is heel off?
Step 4/8: The point in which the heel of the stance limb leaves the ground
According to Ranchos Los Amigos, what is terminal stance?
Step 4/8: When the heel of the stance limb rises and ends when the other foot touches the ground
According to standard terminology, what is toe off?
Step 5/8: The point in which only the toe of the stance limb remains on the ground
According to Ranchos Los Amigos, what is pre-swing?
Step 5/8: When the other foot touches the ground and ends when the stance foot reaches toe off
According to Ranchos Los Amigos, what is initial swing?
Step 6/8: When the stance foot lifts from the floor and ends with maximal knee flexion during swing
According to standard terminology, what is acceleration?
Step 6/8: When toe off is complete and the reference limb swings until positioned directly under the body
According to Ranchos Los Amigos, what is midswing?
Step 7/8: Begins with maximal knee flexion during swing and ends when the tibia is perpendicular with the ground
According to standard terminology, what is midswing?
Step 7/8: The point when the swing limb is directly under the body
According to standard terminology, what is deceleration?
Step 8/8: When the swing limb begins to extend and ends just prior to heel strike
According to Ranchos Los Amigos, what is terminal swing?
Step 8/8: When the tibia is perpendicular to the floor and ends when the foot touches the ground.
What muscles assist with spine cervical flexion?
Sternocleidomastoid Longus Colli Scalenes muscles
What muscles assist with spine cervical rotation and lateral bending?
Sternocleidomastoid Scalenus muscles Splenius Cervicis Iliocostalis Cervicis Levator Scapulae Multifidus
What is the thorax made up of?
Sternum Spine Ribs Connective cartilage
Abnormal Gait: What is spastic gait?
Stiff movement, toes seeming to catch and drag, legs held together, and hip and knee joints slightly flexed. Commonly seen in spastic paraplegia
What is the response to the positive support reflex?
Stiffening legs and trunk into extension
What are treatment options for scoliosis?
Strengthening Stretching Shoe lifts Bracing Spinal orthosis if curve is 25-40 degrees Surgery if curve is x >40 degrees
What should you feel with a firm normal end feel?
Stretch ex. ankle DF finger extension
Where is the anterior ligament of the elbow located?
Stretches from the radiocarpal joint and attaches above the upper coronoid fossa.
What are treatment options of congenital torticollis?
Stretching AROM Positioning Caregiver education
What can polycythemia lead to?
Stroke Heart Attack
What can thrombocythemia lead to?
Stroke Heart Attack
What muscles does the nerve to the subclavius supply?
Subclavius
What are signs and symptoms of glenohumeral instability?
Subluxation: Feeling the shoulder "popping" in and out Pain Paresthesias Sensations of the arm feeling "dead" Positive apprehension test Capsular tenderness Swelling Dislocation: Sever pain Paresthesia Limited ROM Weakness Visible shoulder fullness Arm supported by contralateral limb
What muscle is supplied by the upper subscapular nerve?
Subscapularis
What muscles assist with shoulder medial rotation (IR)?
Subscapularis Teres Major Pec Major Latissimus Dorsi Anterior Deltoid
What muscle is supplied by the lower subscapular nerve?
Subscapularis Teres Major
What are tics?
Sudden, brief, repetitive coordinated movements that will occur usually at irregular intervals
The Zygapophyseal joints are formed by the right and left ____ ____ ____ of one vertebra and the right and left inferior articular facets of an adjacent superior vertebra.
Superior Articular Facet
What are the most common motions for a PCL injury?
Superior portion of the tibia is struck while the knee is flexed Tibia being struck posteriorly Tibia being driving anteriorly Severe hyper flexion *** CAR ACCIDENTS- when knee hits dashboard
The patella slides ___ in knee extension and ___ in knee flexion.
Superiorly Inferiorly
What is the closed pack position for the midtarsal joint?
Supination
What is the closed pack position of the subtalar joint?
Supination
What is the capsular pattern for the proximal radioulnar joint?
Supination Pronation
What are treatments for Cor Pulmonale?
Supplemental oxygen Diuretics Anticoagulation
What are treatments for pulmonary edema?
Supplemental oxygen Medication
What are treatments for angina pectoris?
Supplemental oxygen Nitroglycerin Rest Beta blockers Calcium cannel blockers Angioplasty surgry Coronary artery bypass surgery
What is the stimulus for the walking (stepping) reflex?
Supported upright position with soles of feet on firm surface
Myotome for C5
Supraspinatus Infraspinatus Deltoids Biceps
What muscles does the suprascapular nerve supply?
Supraspinatus Infraspinatus
What is a myelotomy?
Surgical procedure that severs certain tracts within the spinal cord in order to decrease spasticity and improve function
What is a partial hand amputation?
Surgical removal of a portion of the hand and/or digits at either the transcarpal, transmetacarpal or transphalangeal level
What is a neurectomy?
Surgical removal of a segment of a nerve in order to decrease spasticity and improve function
What is a hemipelvectomy?
Surgical removal of one half of the pelvis and the LE
What is a transtibial amputation?
Surgical removal of the LE below the knee joint
What is a Syme's amputation?
Surgical removal of the foot at the ankle joint with removal of the malleoli
What is a wrist disarticulation?
Surgical removal of the hand through the wrist joint
What is a elbow disarticulation amputation?
Surgical removal of the lower arm and hand through the elbow joint 100% of humerus
What is a transfemoral amputation?
Surgical removal of the lower extremity above the knee joint
What is a hip disarticulation?
Surgical removal of the lower extremity from the pelvis
What is a transmetatarsal amputation?
Surgical removal of the midsection of the metatarsals
What is a transradial amputation?
Surgical removal of the upper extremity distal to the elbow joint
What is a transhumeral amputation?
Surgical removal of the upper extremity proximal to the elbow joint
What is a shoulder disarticulation?
Surgical removal of the upper extremity through the shoulder
What is a knee disarticulation?
Surgical removal through the knee joint
What is a rhizotomy?
Surgical resection of sensory component of a spinal nerve in order to decrease spasticity and improve function
Where is the arachnoid mater located?
Surrounds the brain in a loose manner Impermeable
Where is the location of the annular ligament of the elbow?
Surrounds the head of the humerus.
What is dystonia?
Sustained muscle contractions that frequently causes twisting, abnormal postures and repetitive movements
What are pressure ulcers caused by?
Sustained pressure, friction and/ or shearing to a surface
What are symptoms of a DVT?
Swelling of LE Pain Sensitivity over the area of the clot Warmth in the area
What are signs and symptoms of rheumatoid arthritis?
Symmetrical involvement Pain Tenderness Morning stiffness Warm joints Decreased appetite Malaise Increased fatigue Swan neck deformity Boutonniere deformity Low grade fever
What makes up the ANS?
Sympathetic nervous system Parasympathetic nervous system
Excess fluid within the spinal cord is termed _____.
Syringomyelia
What are the 3 classifications of juvenile rheumatoid arthritis?
Systemic Polyarticular Oligoarticular
What are lymphocytes?
T Lymphocytes AND Natural killer- Both help protect against viral infection and can detect and destroy some cancer cells B Lymphocytes- Develop into cells that produce antibodies
What is the innervation level for dermatome testing of the medial forearm?
T1
What is the innervation level for resistive testing of finger ADD?
T1
The Lumbar Plexus is formed by the nerve root of ___ and ___-___
T12 L1-L4
What muscles assist with Hip medial rotation (IR)?
TFL Gluten Med Gluten Min Pectineus Adductor Longus
What are the 3 joints of the forefoot?
Tarsometatarsal joints Metatarsophalangeal joints Interphalangeal joints
Dermatome for C2
Temple Forehead Occiput
What muscles assist with Head retrusion?
Temporalis Masseter Digastric
What muscles assist with Head elevation?
Temporalis Masseter Medial Pterygoid
What are the 3 options for superficial sensory testing?
Tempurature Light touch Pain
What are signs and symptoms of plantar fasciitis?
Tenderness at the insertion of the plantar fascia Heel spurs Pain worse in the morning and after period of prolonged inactivity Difficulty with prolonged standing Pain when walking on bare feet
What muscles assist with shoulder lateral rotation (ER)?
Teres Minor Infraspinus Posterior Deltoid
How do you classify level of SCI through motor index scoring?
Testing each key muscle using the 0-5 scoring, with total points of 25 per extremity for the total possible score of 100
Bilateral occlusion (blockage) of the posterior cerebral artery will typically produce what?
Thalamic pain syndrome and cortical blindness Thalamic pain syndrome- Abnormal sensations of pain, temperature, touch and proprioception Cortical blindness- The loss of vision due to damage to the visual portion of the occipital lobe. Although the affected eye is physically normal, there is full or partial visual loss
What is the Cognitive stage of motor learning?
The 1st stage of learning where there is a high concentration of conscious processing of information. The person will acquire information regarding the goal of the activity and begin to problem solve as to how to attain the goal
What is the associative stage of motor learning?
The 2nd stage of learning where a person is able to more independently distinguish correct vs incorrect performance
What is the autonomous stage of motor learning?
The 3rd stage of learning where a person improves the efficiency of the activity without a great need for cognitive control The person can also perform the task with interference from a variable environment
What part of the brain controls rapid alternating movements?
The Cerebellum
What is plasticity?
The ability of modify or change at the synapse level either temporarily or permanently in order to perform a particular function
What is skill?
The ability to consistently perform functional tasks and manipulate the environment with normal postural reflex mechanisms and balance reactions. Ex. ADLs, community locomotions
What is mobility?
The ability to initiate movement through a functional range of motion
What is stability?
The ability to maintain a position or posture through cocontraction and tonic holding around a joint. Ex. Unsupported sitting with midline control
What is compensation?
The ability to utilize alternate motor and sensory strategies due to an impairment that limits the normal completion of a task
What is placing?
The act of moving an extremity into a position that the patient must hold against gravity
What is the ascending spinoreticular tract?
The afferent pathway for the reticular formation that influences level of consciousness
What is emphysema?
The alveolar walls are gradually destroyed and the alveoli are turned into large, irregular pockets with gaping holes in the walls The elastic fibers that hold open the bronchioles are destroyed, so that they collapse during exhalation, NOT LETTING AIR EXCAPE FROM THE LUNGS DEAD SPACE INCREASES
What does cholesterol test measure?
The amount of cholesterol and triglycerides on the blood
What is distributed practice?
The amount of rest time between trials is equal to or is greater than the amount of practice time for each trial
What is cadence?
The amount of steps over a period of time
What is degree of toe out?
The angle formed by each foots line of progression and a line intersecting the center of the heel and second toe.
What is the body's largest artery?
The aorta
What is the 2nd stage of recovery?
The appearance of basic limb synergies. The beginning of spasticity
Where is the subarachnoid space located?
The area between the arachnoid and pia mater that contains CSF and the circulatory system for the cerebral cortex
Where is the subdural space located?
The area between the dura and arachnoid meninges
What are Pulmonary Arteries?
The arteries that cary deoxygenated blood from the right ventricle to the left and right lungs
Where does the right and left coronary arteries arise from?
The ascending aorta
What is neurogenic reflexive bladder?
The bladder empties reflexively for a patient with an injury above the level T12. The sacral reflex arc remains intact
What is neurogenic nonreflexive bladder?
The bladder is flaccid as a result of a cauda equina or conus medullaris lesion. The sacral reflex arc is damaged
What is the aorta?
The body's largest artery and the central conduit of blood from the heart to the body
What is the apex of the heart?
The bottom of the heart
What is habituation?
The decrease in response that will occur as a result of consistent exposure to non- painful stimuli
What separates the thoracic cavity from the abdominal cavity?
The diaphragm
What is step length?
The distance between the right heel strike and the left heel strike
What is stride length?
The distance measured between right heel strike and the following right heel strike
Abnormal Gait: What is steppage gait?
The feet and toes are lifted through hip and knee flexion to excessive heights; usually secondary to dorsiflexor weakness. the foot will slap at initial contact with the ground secondary to the decreased control
What is the ankle strategy?
The first strategy to be elicited by a small rand and slow velocity perturbation when the feet are on the ground
What is afterload?
The forces that impede the flow of blood out of the heart, primarily the pressure in the peripheral vasculature, the compliance of the aorta, and the mass and viscosity of blood
What are mass movement patterns?
The hip, knee and ankle move into flexion/ extension simultaneously
What is impingement syndrome?
The humeral head and the associated rotator cuff attachments migrating proximally and becoming impinged on the under surface of the acromion and the coracoacromial ligament
What is aphasia?
The inability to communicate or comprehend due to damage to specific areas of the brain
What is dysmetria?
The inability to control the range of movement and the force of muscular activity
What is anterograde amnesia?
The inability to create new memory Last thing to recover after comatose state
What is ideational apraxia?
The inability to formulate an initial motor plan and sequence tasks where the proprioceptive input necessary for movement is impaired
What is agnosia?
The inability to interpret information
What is unilateral neglect?
The inability to interpret stimuli and events on the contralateral side of a hemispheric lesion. Left side neglect is most common with a lesion to the right inferior parietal or superior temporal lobes
What is dysdiadochokinesia?
The inability to perform rapidly alternating movements
What is dysphagia?
The inability to properly swallow
What is astereognosis?
The inability to recognize objects by sense of touch
What is agraphesthesia?
The inability to recognize symbols, letters or numbers traced on the skin
What is bronchitis?
The inflammation of the bronchi Hypertrophy of the mucus secreting glands, increased mucus secretions and insufficient oxygenation due to mucus blockage
What is Raimiste's phenomenon?
The involved lower extremity will abduct or adduct with applied resistance to the uninvolved LE in the same direction
Abnormal Gait: What is scissor gait?
The legs cross the midline upon advancement
What is homonymous hemianopsia?
The loss of the right or left half of the visual field on both eyes
What is a neurologic level?
The lowest segment (most caudal) of the spinal cord with intact strength and sensation. Muscle groups at this level must receive a grade of fair.
What is peak expiratory flow (PEF)?
The maximal flow of air during the beginning of a forced expiratory rate
What is forced expiratory volume (FEV)?
The maximal volume of air exhaled in a specific period of time
What is expiratory reserve volume (ERV)?
The maximal volume of air that can be exhaled after a normal tidal exhalation
What is inspiratory reserve volume (IRV)?
The maximal volume of air that can be inspired after normal tidal volume inspiration.
What is inspiratory capacity?
The maximum amount of air that can be inhaled after a normal tidal exhalation
How do you classify level of SCI through motor level?
The motor level is determined by the most caudal key muscles that have strength of 3 or greater with the superior segment tested as normal or 5
What is an isotonic contraction?
The muscle shortens or lengthens while resisting a constant load
What is CAD?
The narrowing or blockage of the coronary arteries due to atheromatous plaques resulting in diminished blood flow
What is phantom pain?
The patients perception of some sort of painful stimuli as it relates to the residual limb
What is massed practice?
The practice time in a trial is greater than the amount of rest between trials
What is learning?
The process of acquiring knowledge about the world that leads to a relatively permanent change in a person's capability to perform a skilled action
What is a total hip arthroplasty?
The removal of the proximal and distal joint surfaces of the hip with subsequent replacement by an acetabular component and a femoral implant. Cement fixation- immediate WBAT Cementless fixation- PWB/ NWB Last 15-20 years
What is a total knee arthroplasty?
The removal of the proximal and distal joint surfaces of the knee and replacing them with an implant. Unicompartmental- Only the medial or lateral joint surface was replaced. Bicompartmental- The entire surface of the femur and tibia were replaced. Tricompartmental- Replacement of the femur, tibia and patella. Last 15-20 yrs
What is vertigo?
The sensation of movement and rotation of oneself or the surrounding environment
How do you classify level of SCI through sensory level?
The sensory level is determined by the most caudal dermatome with a normal score if 2/2 for pinprick and light touch
What is the epicardium?
The serous layer of the pericardium Contains the epicardial coronary arteries and veins, autonomic nerves and lymphatics
What is atherosclerosis?
The slow hardening of the arteries by accumulation of fatty deposits which form blood clots
What is an ectopic bone?
The spontaneous formation of bone in the soft tissue
What is balance?
The state of physical equilibrium Maintenance and control of the center of gravity Achieving and maintaining and upright posture
What is perseveration?
The state of repeatedly performing that same segment of a task or repeatedly saying the same word/ phrase without purpose.
What is motor learning?
The study of the acquisition and/or modification of movement Learning vs performance
What is motor control?
The study of the nature of movement; or the ability to regulate or direct essential movement
Abnormal Gait: What is vaulting gait?
The swing leg advances by compensating through the combination of elevation of the pelvis and plantar flexion of the stance leg
What is the 3rd stage of recovery?
The synergies are performed voluntarily; spasticity increases
What is preload?
The tension in the ventricular wall at the end of diastole. It reflects the venous filling pressure that fills the left ventricle during diastole
Where are the most common sites for aneurysms?
The thoracic and abdominal aorta and vessels within the heart
What is the superior vena cava?
The vein that returns venous blood from the head, neck and arms to the right atrium
What is the inferior vena cava?
The vein that returns venous blood from the lower body and viscera to the right atrium
What is chronic venous insufficiency?
The veins and valves in the LE are damaged and cannot keep blood flowing toward the heart.Veins remain filled with blood
What are the pulmonary veins?
The veins that carry blood back to the heart from the lungs to the left atrium
What is vital capacity?
The volume change that occurs between maximal inspiration and maximal expiration
What is forced vital capacity (FVC)?
The volume of air expired during a forced maximal expiration after a forced maximal inspiration
What is minute volume ventilation?
The volume of air expired in one minute
What is total lung capacity (TLC)?
The volume of air in the lungs after maximal inspiration The sum of all lung values TCL=RV+VC TCL=FRC+IC
What is anatomical dead space volume (VD)?
The volume of air that occupies the non-respiratory conducting airways
What is stroke volume?
The volume of blood pumped from the left ventricle per beat
What is Risidual Volume?
The volume of gas remaining in the lungs at the end of a maximal expiration
What are implications for PT for anti-epileptic agents?
Therapist must know protocol for seizures and side eddects
The Lumbar Plexus innervates the anterior and medial muscles of the ___
Thigh
What is the open system model?
This is characterized by a single transfer of information without any feedback loop
What is another name for blood platelets?
Thrombocytes
What are the gross motor skills for preschool age (3-4 yrs)?
Throws ball 10ft Walks on a line 10ft Hops 2-10 times on one foot Jumps distances of up to 2ft Jumps over obstacles up to 12inches Throw and catches small ball Runs fast and avoids obsticles
Paresthesia for C6
Thumb Index finger
What muscles assist with Ankle DF?
Tibialis Anterior Extensor Hallucis Longus Extensor Digitorum Longus Peroneus Tertius
What muscles assist with Ankle PF?
Tibialis Posterior Gastroc Soleus Peroneus Longus Peroneus Brevis Plantaris Flexor Hallucis
What muscles assist with Ankle inversion?
Tibialis Posterior Tibialis Anterior Flexor Digitorum Longus
Peak muscle activity during the gait cycle. Name the muscle group: Peak activity is just after heel strike. Responsible for eccentric lowering of the foot into plantar flexion.
Tibialis anterior
What muscles are supplied by the deep peroneal nerve?
Tibialis anterior Extensor digitorum longus Extensor hallucis longus Peroneus tertius Extensor digitorum brevis
Myotome for L4
Tibialis anterior Extensor hallucis
What are some special test for elbow neurological dysfunction?
Tinel's sign
What is the average range of motion for thumb carpometacarpal opposition?
Tip of the thumb to the base of fifth digit
What is the etiology of an ectopic bone?
Tissue hypoxia Abnormal calcium metabolism
What is the purpose of the heart valves?
To control unidirectional flow
What is the purpose of collecting arterial blood gas?
To evaluate acid- base status (pH), ventilation (PaCO2), and oxygenation of arterial blood (PaO2)
What is the purpose of a hematocrit (HCT) test?
To measure the percentage of red blood cells in total blood volume
Whats the purpose of a complete blood count?
To measure the red blood cell count, total white blood cell count, platelets, hemoglobin and hematocit
What is the response for the planter grasp reflex?
Toe flexion
What is polycythemia?
Too many red blood cells Blood too thick
The transverse plane divides the body into _________________ and _________________ portions.
Top Bottom
What is the base of the heart?
Top of the heart
What is tidal volume?
Total volume inspired and expired with each breath during quiet breathing
What is the stimulus for the rooting reflex?
Touch on cheek
What is the stimulus for the galant reflex?
Touching the skin along spine from shoulder to hip
What is the closed system model?
Transfer of information that incorporates multiple feedback loops and larger distribution control
Myotome for C4
Trapezius Levator scapulae
Myotome for C3
Trapezius Splenius capitus
What muscles assist with scapular retraction?
Traps Rhomboids
What muscles assist with scapular upwards rotation?
Traps Serratus Anterior
What are treatments for heart failure?
Treating underlying cause Medication Lifestyle change Surgery/ medical devices
Reflexes affected for C7
Triceps
Myotome for C7
Triceps Wrist flexors
What muscles assist with elbow extension?
Triceps Brachii Anconeus
True or false: People who have cystic fibrosis inherit two faulty CF genes, one from each parent.
True
What are ribs 1-7 called?
True ribs
What is the response to the rooting reflex?
Turning head to same side with mouth open
What are the fine motor skills for a 2 yr old?
Turns knob opens and closes jar Able to button large buttons Uses child sized scissors with help Does 12-15 piece puzzles Folds paper or clothes
What are some special test for wrist/ hand ligamentous instability?
Ulnar collateral ligament instability test
Myotome for C8
Ulnar deviators Thumb extensors Thumb adductors
What is anosognosia?
Unawareness or denial of illness
What is ataxia?
Uncoordinated or unsteady gait
What is lead pipe rigidity?
Uniform and constant resistance to range of motion
What is the etiology of Alzheimers?
Unknown
What is the etiology of Parkinson's disease?
Unknown Contributing factors: - Genetic defect - Toxicity from carbon monoxide - Encephalitis - Huntington's disease - Alzheimers
What is the etiology of atherosclerosis?
Unknown Damage or injury to the inner wall of the artery from hypertension, high cholesterol, smoking or diabetes
What is the etiology of multiple sclerosis?
Unknown Genetics, viral infections and environment all have a role in the development of MS
What is the etiology of hypertension?
Unknown Secondary hypertension- renal cause
What is the etiology of Guillain-Barre syndrome?
Unknown Theory- an autoimmune response to previous respiratory infection, influenza, immunization or surgery
What is the etiology of Amyotrophic Lateral Sclerosis (ALS)?
Unknown Theory- inheritance, virus, metabolic disturbance and toxicity of lead and aluminum
What is the etiology of carpal tunnel syndrome?
Unknown Theory: repetitive use, rheumatoid arthritis, pregnancy, diabetes, cumulative trauma disorder, tumor, hypothyroidism, and wrist sprain or fracture
What are characteristics of a Brainstem CVA?
Unstable vital signs Decreased consciousness Decreased ability to swallow Weakness on both sides of the body Paralysis on both sides of the body
Anaerobic: How long can the ATP - PC System last?
Up to 15 seconds
Anaerobic: How long can Anaerobic Glycolysis last?
Up to 30-40 seconds
Where is the posterior ligament of the elbow located?
Upper portion of the olecranon fossa to just below the olecranon process.
What nerves are supplied from the posterior cord of the brachial plexus?
Upper subscapular Thoracodorsal Lower subscapular Axillary Radial
Dermatome for T3-T6
Upper thorax
What muscles assist with scapular elevation?
Upper trap Levator Scap
What is a Craig-Scott KAFO?
Used for those with paraplegia shoe attachments with reinforced foot plates. Design allows a person to stand with a posterior lean of the trunk.
What is the suspensory strategy ?
Used to lower the center of gravity during standing or ambulation in order to better control the center of gravity ex. knee flexion, crouching, squatting
What is timing for emphasis (TE)? *Skill
Used to strengthen the weak component of a motor pattern. Isotonic and isometric contractions produce overflow to weak muscles
What is the purpose of two point discrimination sensory testing?
Using a 2 point caliper on the skin, identify one or two points without visual input
What is slow reversal hold (SRH)? *Stability *Controlled mobility *Skill
Using slow reversal with the addition of an isometric contraction that is performed at the end of each movement in order to gain stability
What is unstable angina?
Usually is more intense, last longer, is precipitated by less exertion, occurs spontaneously at rest, is progressive, or any combination of these
What is the equation for vital capacity?
VC=TV+IRV+ERV
What is the equation for minute volume ventilation?
VE = TV x Respiratory rate minute volume ventilation = tidal volume x respiratory rate
What is a vestibulo-ocular reflex (VOR)?
VOR allows for head/ eye movement coordination Supports gaze stabilization through eye movement that counters movements of the head Maintains a stable image on the retina during movement
What is a vestibulospinal reflex (VSR)?
VSR attempt to stabilize the body and control movement Assists with stability while the head is moving as well as coordination of the trunk during upright postures
What are the most common motions for a MCL injury?
Valgus load at the knee without rotation Lateral blows to the knees *Contact activities
What are special tests for a MCL injury?
Valgus stress test
What are examples of muscle relaxant agents?
Valium Flexeril
What is a special test for a LCL injury?
Varus stress
What are some special test for elbow ligamentous instability?
Varus stress test Valgus stress test
What are the most common motions for a LCL injury?
Varus stress without rotation Medial blow to the knee **Contact sports
What is random practice?
Varying practice amongst different tasks
What muscles are supplied by the femoral nerve?
Vastus lateralis Rectus femoris Vastus medialis Vastus intermedius Iliacus Sartorius Pectineus
What is ventricular diastole?
Ventricular relaxation
What is the wall between the left and right ventricle?
Ventricular septum
Dermatome for C1
Vertex of skull
What is the reflex name for a 4+ grade and is it normal?
Very brisk/ hyperactive Always abnormal
What is poliomyelitis?
Viral infection resulting in neuropathy that includes local and asymmetrical motor impairments
What are signs and symptoms of multiple sclerosis?
Visual problems Paresthesia and sensory changes Clumsiness Weakness Ataxia Balance dysfunction Fatigue **Period of exacerbations and remissions
What is functional residual capacity (FRC)?
Volume of air remaining in lungs at end of normal exhalation
What are functions of the frontal lobe of the brain?
Voluntary movement (primary motor cortex/ precentral gyrus), intellect, orientation Brocas area (typically located on the left hemisphere): speech, concentration Personality, temper, judgement, reasoning, behavior, self-awareness, executive functions
What are the gross motor skills for a 10-11 month old in mobility?
Walks with both hands held Walks with one hand held Creeps on hands and feet (bear walk)
What are the gross motor skills for a 12-15 month old?
Walks without support Fast walking Walks sideways Bends over to look between legs Creeps or hitches upstairs Throws ball in sitting
What is the etiology of chronic venous insufficiency?
Weak or damaged valves inside the veins
What are signs and symptoms of diabetic neuropathy?
Weakness and sensory disturbances occur distally in a symmetrical pattern Tingling, numbness, pain, especially in the feet
What are characteristics of a Right Hemisphere CVA?
Weakness, paralysis of the left side Decreased attention span Left hemianopsia Decreased awareness and judgement Memory deficits Left inattention Decreased abstract reasoning Emotional lability Impulsive behaviors Decreased spacial orientation
What are characteristics of a Left Hemisphere CVA?
Weakness, paralysis of the right side Increased frustration Decreased processing Possible aphasia Possible dysphagia Possible motor apraxia Decreased discrimination between left and right Right Hemianopsia
What are treatment options for CAD?
Weight loss Stop Smoking Diet Medication Surgery
What is the stimulus for the positive support reflex?
Weight places on balls of feet when upright
What is a synergy pattern?
What the higher centers of the brain lose control and the uncontrolled or partially controlled stereotyped patterns of the middle and lower centers emerge
What are signs and symptoms of asthma?
Wheezing Chest tightness Slight shortness of breath
What is active insufficiency?
When a 2 joint muscle contracts across both joints simultaneously
What is passive insufficiency?
When a 2 joint muscle lengthens across both joints simultaneously
What is pulmonary edema?
When fluid collects in the alveoli within the lungs, making it difficult to breathe
What is the response of symmetrical tonic neck reflexes (STNR)?
When head is in flexion, arms are in flexion and legs are in extension. When head is in extension, arms are in extension and legs are in flexion
What is the etiology of pulmonary edema
When the left ventricle is unable to pump blood adequately (left side heart failure). As a result, pressure increases inside the left atrium and then in the pulmonary veins and capillaries, causing fluid to be pushed through the capillary walls into the alveoli
Abnormal Gait: What is festinating gait?
Where a patient walks on toes as though pushed. Ot starts slowly, increases, and may continue until the patient grasps an object in order to stop
What is a closed TBI?
Without penetration to the skull
Is Alzheimer's more common in men or women?
Women
Is acute pulmonary edema a medical emergency?
Yes
What is an embolus?
a blood clot (can be a solid, liquid or gas) that has broken loose and is floating freely in the blood stream of the cerebral arteries
What is rheumatoid arthritis?
a chronic progressive autoimmune disease causing inflammation in the synovial tissue of a joint that results in erosion of cartilage Common in small joints 1-2% of american population is affected Woman x3 more than men Onset: 40-60yrs
What is Achilles tendonitis?
a repetitive overuse disorder resulting in microscopic tears of collagen fibers on the surface or in the substance of the Achilles tendon
What is cardiac output?
amount of blood pumped by the left OR right ventricle in one minute
What is Parkinson's disease?
degenerative disorder of the CNS resulting in loss of dopamine neurotransmitters Responsible for voluntary movement
What are the fine motor skills for a 8-9 month old?
develops active supination Radial- digital grasp develops Uses inferior pincer grasp Extends wrist actively Points with index finger Pokes with index finger Release of objects is more refined Takes objects out of containers
What should you feel with a soft abnormal end feel?
ex. edema synovitis ligament instability/ tear
What should you feel with a hard abnormal end feel?
ex. fracture osteoarthritis osteophyte formation
What should you feel with a firm abnormal end feel?
ex. increased tone tightening of a capsule ligament shortening
What are signs and symptoms of down syndrome?
flattened face, small head, short neck, protruding tongue, upward standing eyelids (palpebral fissures), unusually shaped or small ears, poor muscle tone; broad, short hands with a single crease in the palm; relatively short fingers and small hands and feet, Brushfield's spots
The spinal cord runs from the _____ to the _____.
foramen magnum Conus medullaris (L1/L2)
What is adhesive capsulitis?
frozen shoulder- soft tissue contracture More common in women Occurs mostly between 40-60 yrs of age Occurs a lot in diabetics due to decreased blood flow lasts usually 1-2 yrs
What is hypertension?
high blood pressure 140/90 < x >95th percentile for children
What is the etiology of epilepsy?
idiopathic or r/t another condition (causing abnormal brain wiring)
What is the etiology of cerebral palsy?
lack of oxygen, maternal infection, drug or alcohol abuse, placental abnormalities, prolonged labor
What is an isokinetic contraction?
tension developed by the muscle, while shortening or lengthening at a constant speed, is maximal over the full range of motion
What is controlled mobility?
the ability to move within a weight bearing position or rotate around a long axis. Ex. Activities in prone on elbows or weight shifting in quadruped
What is post- traumatic amnesia?
the time between the injury and when the patient is able to recall recent events. Patient does not recall the injury or events up until this point in recovery.
What is a compound fracture?
type of fracture where the bone breaks through the skin
What are signs and symptoms of juvenile rheumatoid arthritis?
~ Systemic 10-20% of the cases, and present with acute onset, high fever, rash, enlargement of the spleen and liver, inflammation of the lungs and heart ~ Polyarticular 30-40% of the cases, and present with high female incidence, significant rheumatoid factor, and arthritis in more than four joints with symmetrical joint involvement ~ Oligoarticular 50-60%, affects less than 5 joints with asymmetric joint involvement
