Functional Anatomy- Cardinal Planes

___- Defined as the manner in which adjoining joint surfaces move on each other during osteokinematic joint movement. Examples: Roll Glide/Slide Spin Joint One joint surface in relation to another joint surface. Not all joints can do all things because different joints have different ___.

Arthrokinematics degrees of freedom

Growth ___ Epidemic of the 1940-50s After vaccine became available, thought PT would go away but then WWII came along WWII Thought the profession would die after the ___

Polio WWI

Growth: ___ of the 1940-50s WWII

Polio Epidemic

Continued: >___ "The health outcomes achieved per dollar spent" ->DPT's will provide safe, effective, patient/client-centered, timely, efficient, and equitable services to ensure the best value >___ PT profession will offer creative and proactive solutions to enhance health services delivery and to increase the value of PT to society

Value Innovation

Arthrokinematics Concave on Convex: -need to consider what bone is moving first (___), then is the concave surface moving on the convex or vise versa ex. of convex on concave-> ___ ex. of concave on convex-> ___ ->when you have a concave on a convex, your rolling and gliding happens in the ___ direction

osteokinematics squats leg kickouts same

Continued: -Saphenous nerve branch- find the ___ (medial part of leg), comes out of that canal and comes down the tibia; the other portion runs down and gives cutaneous supply to lower part of the leg -Quadriceps- patient ___ against some resistence and be able to feels the quads pop up; can feel ___, ___, and ___

adductor canal extend knee vastas medialis, vastas lateralis, rectus femoris (middle)

GASTROCNEMIUS: two heads; insertion ___ SOLEUS: inserts ___ ACHILLES TENDON - strong ___ bursa - lies between anterior surface of Achilles tendon and superior angle of calcaneus ___ bursa - lies between the insertion of Achilles tendon & overlying skin

plantar fascia plantar fascia Retrocalcaneal Calcaneal

· Figure four position when palpating o Superior boarder = ___ and ___ o Lateral boarder = ___ o Medial boarder = ___

pubic tubercle and ASIS ASIS pubic tubercle

Quadriceps femoris: Is there a 2 joint muscle in the anterior part of the thigh??? ___ What about for the hamstrings?? ___

rectus femoris biceps- long head

Isometric Contraction • No ___ movement • Muscle movement Concentric Contraction • Muscle length ___ • Proximal end and distal end come closer • A and B are coming closer together. • Knee flexion concentric for hamstring • Origins brings the ___ to it.

osteokinematic shortens insertion

Arthrokinematics: Knee: Left pic is a squat Right is leg extension Which one is convex on concave and concave on convex? Which direction is each sliding and gliding?

convex on concave- opposite concave on convex- same

Posterior Landmarks: •Posterior Superior Iliac Spine (PSIS) •Greater Trochanter Sacroiliac Joint (SIJ) -Starting point is still the ___ in your palpation progression, even with the posterior view. -Demo SL and standing

iliac crest

What muscle is the floor of the femoral triangle? what joint movement?? IDK

iliacus hip joint- flexes and externally rotates the thigh

Zone V: Hip and Pelvic Muscles: >Flexor Group -___ >Adductor Group -___

iliopsoas, sartorius, rectus femoris gracilis, pectineus, adductor longus/brevis/magnus

Starts at calcaneus down to first metatarsal head, apex in middle - called the ___. Across, under just distal to the metatarsal heads is the other arch - called ___. Row of cube shaped bones - first three are cuneiform, and then there is a square cubed bone on the lateral side called the cuboid.

longitudinal arch transverse arch

Zone IV · Cluneal nerves - can only feel when they are ___ with you wear a belt too tight Zone V · Hip and Pelvic Muscles - Primary Action o Flexor group: ___, ___, ___ o Abductor group: ___ o Adductor group: ___, ___, ___, ___, ___ o Extensor group: ___ and ___

pathologic iliopsoas, sartorius, rectus femoris gluteus medius gracilis, pectineus, adductor longus/brevis/magnus gluteus maximus, hamstrings

Navicular has a ___ (enlarged area on bone). Medial Talus Medial Tubercle Sustentaculum Tali (ON ___) ___: projection of calcaneous to support the talus; plantarward from medial malleolus; attachment for the spring ligament. More posterior

tubercle CALCANEUS Sustentaculum Tali

History of PT: Reconstruction Aides (___-year) Commissioned during WWI by the ___ Division of ___

1918 US Army Orthopaedic Surgery

PT: History, APTA, and Guide to PT Practice: History of PT >Reconstruction Aides (___) Commissioned during WWI by the ___ · Under the Division of ___ o Ortho surgeons feel like ___ because of this

1918 US Army Orthopaedic Surgery parents

APTA Established in ___: First President ___ Men admitted in ___

1921 Mary McMillan 1930s

APTA Established in ___ First President ___ - ___ education to the United States Men admitted in ___ ___ - first meeting Took the W out when men joined - now called ___ ___% Women, ___% Men - but shifting

1921 Mary McMillan Europe 1930s Kings Cop House in New York APTA 70, 30

· By ___, all DPT programs. Private schools drove this market. · Movement impairment and improve human performance · 1 of 28 states that have good access - we have ___ without referral, if they are not improving they have to have a referral to a physician NEW Vision Sentence: Transforming society by optimizing movement to improve the ___

2015 30 days human experience

Axes: -for each movement, the axis is ___ from the plane •Vertical •Horizontal -ML = ___ -AP = ___

90 degrees medial-lateral anterior-posterior

___: ®Defined as the manner in which adjoining joint surfaces move on each other during osteokinematic joint movement. Examples: Roll Glide/Slide Spin

Arthrokinematics

Frontal Plane Motions Examples: •___ and ___ •Ulnar and radial ___ •___ and ___

Abduction and adduction deviation Eversion and inversion

Frontal Plane Motions • ___ and ___ • Ulnar and radial ___ • ___ and ___ • Axis is going to rotate about the axis (abduction and adduction). Lateral flexion of the trunk (side bending). • At the subtaylor joint - ___ and ___ • Thumb - opposable thumb (___)

Abduction and adduction deviation Eversion and inversion eversion and inversion abduction

Calcaneus Dome of the Calcaneus, Medial Tubercle Reach around ___, on both sides Medial tubercle: broad, large medial plantar surface; Attachment: ___, ___, ___ (heel spur) Gives us inversion and eversion of the rear of the foot. Posterior ___ can be palpated.

Achilles tendon abductor hallicus, flexor digitorum brevis, plantar aponeurosis 1/3

Continued: >___ PT profession will advocate for patients/clients both as individuals and as a population to manage and promote change, adopt best practice standards and ensure that systems are always built to be consumer-centered

Advocacy

ABPTRFE stands for ___

American Board of Physical Therapy Residency and Fellowship Education

ABPTS stands for ___

American Board of Physical Therapy Specialties

___: thick, flat tendons -multiple layers - strong Attaches on the calcaneus (medially and laterally) Medial has the most attaches; tubercle that hits first on the ___. Bone spur is near the ___.

Aponeurosis ground medial tubercle

Classic Normal End Feels: ®___- Elbow Extension ®___- Elbow Flexion , Knee Flexion ®___- Achilles Tendon in Dorsiflexion ->these normal end feels can be abnormal if they're ___

Bony Soft Tissue Approximation Soft Tissue Stretch found in the wrong place

Continued: ___: Feels like normal bone-on-bone with restriction prior to normal end of ROM Ex: Osteophyte formation in C-spine ___: Extreme pain, cannot complete ROM ___: Rebound effect with thick stretch feel Common in meniscal tears

Bony Empty Springy Block

Abnormal End Feels: •___ -Feels like normal bone-on-bone with restriction prior to normal end of ROM -Ex: Osteophyte formation in C-spine •___ -Extreme pain, cannot complete ROM; PAIN is the reason, so no endfeel, but the pain has to prevent them from completing ROM •___ -Rebound effect with thick stretch feel; feels like pop back out at you -Common in ___

Bony Empty Springy Block meniscal tears

Classic Normal End Feels: ___ Elbow Extension ___ Elbow Flexion, Knee Flexion ___ Achilles Tendon in Dorsiflexion

Bony Soft Tissue Approximation Soft Tissue Stretch

Prime Mover/Synergist/Antagonist Prime mover ___ = elbow flexion Synergist ___ and ___ Antagonist ___ = elbow extension

Biceps Brachialis Brachioradialis Triceps

Prime Mover/Synergist/Antagonist: ®Prime mover ___ = elbow flexion ®Synergist ___ and ___ ®Antagonist ___ = elbow extension

Biceps Brachialis and Brachioradialis Triceps

___ - bone that touches the ground first when taking a step. Reach on either side of Achilles tendon, feel the sides of the dome of the calcaneus. Medial Landmarks: First Metatarsophanlangeal Joint, First Cuneiform First Metatarsal Metatarsophalangeal Joint, First Metatarsocuneiform At the first MTP joint, toe comes up - where your shoe and foot ___ when you walk. This is where ___ are.

Calcaneus bends bunions

-___—hyperextension of the MP joints and flexion of the PIP and DIP joints -___—hyperextension of the MP joints and DIP and flexion of the PIPjoints, usually caused by shoe pressure -___—flexion of the DIP joint, MP and PIP are neutral 2.-Neuromas of the Foot and Other Pathologies

Claw Toe Hammer Toe Mallet Toe

Zone IV: ___ -Sensory nerves; belt injuries with hip huggers

Cluneal nerves

Quality PT profession will commit to establishing and adopting best practice standards across the domains of practice, education and research. ___ profession will value collaboration with other health care providers, consumers, community organizations and other disciplines. Rehab and acute care environments. Collaboration in outpatient is not as good as it should be. Suicidal thoughts - co-manage with ___

Collaboration PT psychologist

___ Contraction: •Muscle length shortens •Proximal end and distal end come closer -insertion of the muscle is on the moving segment ex. biceps- moves the radius (bc inserts on radial tuberosity)

Concentric

___-centricity PT profession will hold patient/client values and goals central to all efforts DPT's will embrace cultural competence as a necessary skill to ensure best practice ___ PT Profession will recognize health inequities and disparities and work to ameliorate them through innovative models of service delivery

Consumer Access/Equity

___- Independent movements allowed at a joint Up to ___ degrees available per joint Example: Shoulder has 3 degrees of freedom as it has motion in all 3 planes Movement occurs in a plane and about an axis.

Degrees of Freedom 3

___ = medial. If you move or stretch the ligament and it has more motion than it should, then your patient will be in a lot of pain. Behind the tibia is the ___ - PF. PF also comes from your ___. How do you find this muscle? You need to come up on your toes and look on the medial side of your leg. As you come down, most of us will be able to palpate it. ___ - all the way to the distal toes. It is a helper for PF.

Deltoid ligament tibialis posterior gastroc FDL

Dorsal Structures/Pulses: EDL, EHL, Dorsal pedal artery Dorsum of Foot (TEDE) 1. Tibialis Anterior 2. Extensor Hallicus Longus 3. Dorsal Pedal Artery 4. Extensor Digitorum Longus Artery next to the ___ - ask patient to lift their big toe to see the longus tendon and then ___ to it is the artery.

EHL lateral

___ Contraction: •Muscle lengthens •Proximal and distal ends separate from each other. ex. biceps curls but go slow on the way down- NOT just letting it fall

Eccentric

___: •Subjective assessment of the quality of the feel when slight pressure is applied at the end of the joint's passive range of motion. -a way for you to know what is keeping your joint from going further along your ROM

End Feels

Sesamoids Sesamoid Bones located in the FHB 2 sesamoid bones located in the: ___ @ 1st MTP 1st MTP is weight bearing Flexor of the big toe = ___ FHB have two bones - sitting in the tendon to give more leverage to the toe. More leverage to have ___. Patella also sits in the ___ muscle.

FHBrevis flexor hallicus push off quad

Sagittal Plane Motions • ___ and ___ • Dorsiflexion and Plantar Flexion • Forward and Backward Bending

Flexion and Extension

Sagittal Plane Motions Examples: •___ and ___ •Dorsiflexion and Plantar ___ •Forward and Backward Bending

Flexion and Extension Flexion

Continued: -___—foot medially rotated in under resting conditions (common in children) -___—formed by the excrescence of bone that grows over the medial aspect of the first metatarsal head and causes the surrounding tissue to swell and the resultant increased pressure and friction against the shoe can cause the development of a bursa, which frequently becomes inflamed and appears red

Forefoot adductus Bunions

Calcaneus: ZONE VII ___ - muscle with two heads and the great muscle for heal raises, Cross the ___ ___ - PF (does not cross the knee) ___ - strongest tendon, has two bursas (fluid filled sac that is over a bony area in order to reduce friction) ___ bursa - posterior to tendon and bone ___ bursa - between tendon and bone

Gastrocnemius knee Soleus Achilles tendon Calcaneal Retrocalcaneal

Inspection Gait Swelling Muscle symmetry Posture in stance o ___- bow legged o ___ - gum between knees to make them stick together ___ - hyperextension

Genu Varum Genu Valgum Genu Recurvatum

Lateral Palpation: -Lateral tibial plateau- already found -Lateral tubercle (aka ___)- ___ attaches, should be more prominent feature -Lateral Femoral Condyle- already identified

Gerdy's Tubercle IT band

Zone II: ___ and ___

Gluteus medius Trochanteric bursa

-___—common at the 1st metacarpal joint -___—deposits ofurate crystals in joints -___—flat feet, loss of the medial longitudinal arch -___—results if the dorsiflexors (extensor hallucis, tibialis anterior, andextensor digitorum longus) are paralyzed—deep peroneal nerve damage

Gout Tophi Pes planus Drop-foot

•L4-5 segment level with ___ •S2 level ___ and ___ to PSISs

Iliac crests medial and slightly inf.

Borders: ___(sup); ___ (lat); ___ (med) Lateral to medial: ___, ___, ___, ___

Inguinal ligament Sartorius Adductor longus Femoral nerve Femoral artery Femoral vein Lymph nodes

Transverse Motions: •___ (medial) rotation •___ (lateral) rotation •___ Rotation- such as trunk or C-spine

Internal External Axial

Transverse Motions • ___ rotation • ___ rotation • ___ Rotation

Internal (medial) External (lateral) Axial

___ Contraction: •Same speed through contraction- very safe •Not functional- don't see a lot in clinic •Safe

Isokinetic

Types of Muscle Contractions ___ - same length Concentric Eccentric Isokinetic Isotonic

Isometric

___ Contraction: •No osteokinematic movement •Muscle movement -muscle contracts but no shortening or lengthening of the muscle so no muscle movement occurs, however the muscle may get thicker because of contraction of sarcomeres ex. guy contracting abs in picture

Isometric

___ Contraction: •Same resistance throughout full ROM. •Controversial what a true isotonic is -Free weights with bicep curl, lever is different in different level, it is harder to hold weight at 90 degree than 180 so not sure if its truly isotonic -one thing considered a true isotonic is theraband or machines or cable column, free weights are controversal

Isotonic

-___—usually located between the 3rd and 4th metatarsal -Localized vs. Generalized swelling: >___—around a malleoli after ankle sprain >___—around whole foot—cardiovascular/lymphatic problem

Morton's neuroma Localized Generalized

Abnormal End Feels ___: Protective - sudden and hard Instability/pain ___: Restriction early in ROM "thick stretch" Ex: Frozen shoulder

Muscle spasm Capsular

Abnormal End Feels: •___ -Protective - sudden and hard, but not like bony; like a mix between bony end feel and soft tissue -Instability/pain •___ -Restriction early in ROM "thick stretch"; more solid than soft tissue but not as sudden as a bony -Ex: ___ *both of these feel similar

Muscle spasm Capsular Frozen shoulder

Femoral Triangle: Contents From lateral to medial: ___, ___, ___, ___

NAVL STRUCTURES IN THE TRIANGLE: LATERAL = nerve, MIDDLE = artery, MEDIAL = vein, L = lymph

___- Defined as one bone moving on another 3 examples: flexion / extension abduction / adduction internal rotation / external rotation

Osteokinematics

___: ®Defined as one bone moving on another, always talking about the bone that actually is moving on another bone ®3 examples: flexion / extension abduction / adduction internal rotation / external rotation ->these are all osteokinematic terms

Osteokinematics

Medial Landmarks: Navicular, Talar head: Navicular Tubercle, Head of the Talus, Medial Malleolus Navicular - articulates with 5 other bones: talar head, 3 cuneiforms, cuboid Head of talus: becomes more prominent with ___ ___: projection of calcaneous to support the talus; plantarward from medial malleolus; attachment for the spring ligament.

PES PLANUS Sustentaculum Tali

Posterior Landmarks Posterior Superior Iliac Spine (PSIS) Greater Trochanter Sacroiliac Joint (SIJ) - find ___ and ___, not a structure a space (___) Starting point is still ___ in your palpation progression, even with posterior view. ___ level with Iliac crests - level with the space between L4 and L5* S2 level ___ and slightly ___ to PSISs

PSIS and S2 ridge iliac crest L4-5 segment medial and slightly inf.

HIP PATHOLOGIES: -___-when hip is flexed, adducted, and bearing weight, the tensor fascia lata can ride anteriorly over the greater trochanter—repetition of this snappingcan cause trochanteric bursitis -___ can cause irritation of the psoas muscle -Pain while palpating hamstring muscles can be due to ___

Pain and Bursitis of the Hip Osteoarthritis ischial bursitis

Peroneal Landmarks: peroneal tubercle, peroneus brevis Zone V, Peroneus longus, Peroneus brevis ___ - below & behind lateral malleolus ___ - GOES BEHIND & below to insert on the 1st MTP ___ - goes above to styloid process insertion

Peroneal Tubercle Peroneus longus Peroneus Brevis

FOOT DISORDERS AND DEFORMITIES: -___—abnormally high arch -___—a deformity characterized by lateral deviation of the great toe -___—first metatarsal shaft is medially angulated

Pes Cavus Hallux valgus Metatarsusprimus varus

Roles of Muscles ___ - does most of the movement. Muscle groups that cause the motion ___ - help prime mover. Muscle that works with one or muscles to enhance a particular motion ___ - does opposite of prime and synergist Muscle that performs opposite motion of prime mover

Prime Mover Synergist Antagonist

Roles of Muscles: ®___- Muscle groups that cause the motion ®___- Muscle that works with one or muscles to enhance a particular motion, secondary muscle that helps in function ®___- Muscle that performs opposite motion of prime mover

Prime Mover Synergist Antagonist

Guiding Principles: >___ PT profession will commit to establishing and adopting best practice standards across the domains of practice, education and research >___ PT profession will value collaboration with other health care providers, consumers, community organizations and other disciplines

Quality Collaboration

Zone III: Sciatic Nerve >sciatic notch- is between the ___ and ___ >sciatic nerve- lies in the notch

Sciatic notch between trochanter and ischial tuberosity

___: depression just anterior to lateral malleolus; deep is EDB It is the ___

Sinus tarsi talo/calcaneal sulcus

Progression of PT Education: ___ included a definition of "outpatient PT services". Practice of PT established in state laws across the country. Advanced management of ___ conditions Practice evolution along with ___ populations (joint replacements, etc)

Social Security Act of 1967 neuromuscular orthopaedic

Arthrokinematics: Concave on Convex · ___ - like a top. One joint can spin on top of another joint. · It can ___ like ice - ballerina. Roll - its rolling on the other joints surface. · ___ has a flex. ___ is a cave. It is a relative term. · Squat - ___ is flexing on the ___ (osteo), also need to say which bone moved. o Artho - I have rolled and glided. When a convex moves on a concave, the movements will be in ___. Rolls ___ and glide ___ to stay centered. Vex on cave - opposite directions.

Spin glide/slide Convex Concave femur, tibia opposite directions posteriorly, anteriorly

Soft Tissue Palpation · Zone 1 Anterior Aspect Quadriceps Infrapatellar tendon > ___ bursa (anterior to tendon) · Deep is more posterior > ___ bursa (anterior) Pes anserine bursa

Superficial infrapatellar Prepatellar

Talus also has a tubercle = medial tubercle of the talus and lateral. Bone that is under the talus, but it is not part of the talus. It is a shelf on the calcaneus that the talus sits on called the ___ - keeps ankle from rolling in.

Sustentaculum tali

-"___"—Inflammation of the bursa overlying the lateral side of the head of the 5th metatarsal bone -___—will protrude from medial tubercle and its bursa -___—inflammation of the plantar aponeurosis

Tailor's bunion Heel spur Plantar's Fascitis

KNEE PATHOLOGIES: Because knee has minimal protection, injury rates are high -___—common in snow skiers -___—occurs at the tibial tubercle during late childhoodand early adolescence- -The infra-patellar fat pad lies beneath infrapatellar tendon and is the source of much ___ pain- -___—often injured in a lateral blow due to superficial location

Tibial plateau fractures Osgood Slaughter's disease anterior knee Peroneal nerve

Plantar Surface: Metatarsal heads Metatarsal Heads ___ is not just straight across - it follows the anatomy, pointed towards the toe just before the metatarsal heads. Proximal to the metatarsal heads. Fatty pad = overtime will ___ Biggest fat pad at the ___ Inside tendons are a number of muscles and tendon splits on the planter surface of the foot.

Transverse arch disperse heel

AXIAL (Transverse) PLANE: Divided into ___ (superior) and ___ (inferior) Each axis relates to a plane. Where is the axis and what movement occurs in the transverse plane? Axis is ___ degrees from the plane. Rotational movement Hinge point is at the 90-degree angle. TP - top and bottom. Axis has to be 90 degrees from the plane. The axis rotates about that axis (rotating spine, skull on spine - neck rotation, pronation and supination) Never ___ - always named based on anatomical position.

cephalad caudad 90 changes

•Greater Trochanter -___ of hip can help you find it •Pubic Tubercles

internal rotation/external rotation

New Vision Sentence: Transforming society by ___

optimizing movement to improve the human experience

Lateral Landmarks: Tibia, Fibula, Talar dome Dome of the Talus, Inferior Tibiofibular Joint Tib/Fib Syndesmosis: proximal to talus Dome of talus: ___ and ___ to palpate laterally Tibia and fibula are not just sitting there. They have a very strong attachment by the ___. It is not a join, but the attachments between the fibula and tibia is called the ___ PF - look just ___ to the tibia and feel smooth part of the dome of the talus.

invert & plantarflex interosseous membrane syndesmosis distal

Anterior Palpation: -Patella- partner in ___, identify as round and somewhat ___ at the end of the bone -Trochlear Groove- find the ___, move superiorly and run fingers ___ to ___, find the peaks and valley of this -Joint Line- find medial femoral condyle by moving medial to the patella; move lateral and find the lateral condyle, look for the medial condyle of the tibla and find medial and lateral crest, inbetween the ___ and ___ is the joint line

sitting pointed patella lateral to medial femoral and tibial condyles

Isokinetic Contraction • Same ___ through contraction • Not functional • Safe • Force and speed are the same. • Speed acting on a lever is a force. Move at same force throughout a speed. • ___ because they cannot overload because you are controlling the force and speed. • ___, because it does not happen in the real world. • Example, cruise control

speed Safe Not functional

Picture: ex. Knee Flexion- Osteokinematics Figure A- the ____ is flexing on the ___ (like doing the quad kick out machine) Figure B- the ___ is flexing on the ___ (like someone doing squats)

tibia femur femur tibia

Lateral Ligaments: ___, ___, ___ Distal end of the fibula is attached to calcaneus. This side has the most amount of ___.

Posterior talofibular, Anterior talofibular, calcanofibular sprains

Vision 2020 · First vision state that APTA created in the ___ · By ___, physical therapy will be provided by physical therapists who are doctors of physical therapy, recognized by consumers and other health care professionals as practitioners of choice to whom consumers have direct access for the diagnosis of, interventions for, and prevention of impairments, functional limitations, and disabilities related to movement, function, and health.

2005 2020

PT Education Today · ___ - graduated first DPT class, started in ___ (Shreveport) · Added time into the curriculum, added PT diagnosis, added women's health, therapeutic exercise, radiology, medicine - adds to diagnostic capacity · Increased public expectations - ___% increase in small practice PT · DPT continuing to rise = ___ entry level PT programs in the country · Graduating ___ DPT per year, which is not keeping up with the demand in the work force

2009, 2005 30 246 10,000

Vision Statement: By ___, physical therapy will be provided by physical therapists who are doctors of physical therapy, recognized by consumers and other health care professionals as practitioners of choice to whom consumers have ___ for the diagnosis of, interventions for, and prevention of ___, functional ___, and disabilities related to movement, function, and health.

2020 direct access impairments limitations

Foot & Ankle Bony Landmarks: Dorsal Medial REVIEW: bones of the foot- ___ bones per foot therefore = 52 bones of the 206 in the body = about ___% Navicular - articulates with 5 other bones: ___, ___, ___ Head of talus: becomes more prominent with PES PLANUS ___: projection of calcaneous to support the talus; plantarward from medial malleolus; attachment for the spring ligament.

26 25 talar head, 3 cuneiforms, cuboid Sustentaculum Tali

___ PT profession will advocate for patients/clients both as individuals and as a population to manage and promote change, adopt best practice standards and ensure that systems are always built to be consumer-centered

Advocacy

Continued: >___ PT profession will hold patient/client values and goals central to all efforts ->DPT's will embrace cultural competence as a necessary skill to ensure best practice >___ PT Profession will recognize health inequities and disparities and work to ameliorate them through innovative models of service delivery

Consumer-centricity Access/Equity

___: • Subjective assessment of the quality of the feel when slight pressure is applied at the end of the joint's passive range of motion. • Only a ___ can assess an end feel. You cannot know what the end feels is unless it's a passive movement. • What you feel at the ends of available ___

End Feels PT ROM

Inspection: -___- are they walking with a limb/walking like they have pain -___- esp. around knee joint line -Muscle ___- possible quad atrophy -Posture in stance -> ___- knees bow outward -> ___- knees bow inward -> ___- knee hyperextension

Gait Swelling Symmetry Genu Varum Genu Valgum Genu Recurvatum

Continued: ___ - force. Bone movement - ___. Ulna flexes in relation to ___. Humurus externally rotated on ___. Movement of bones in relation to each other.

Kinetics osteokinematics humurus scapula

· The machine is controlling the force and the speed. · Number into computer - 0 to 90 degrees. Not linear velocity, typing in ___ velocity.

angular

CORONAL (Frontal) PLANE: • Divided into ___ (ventral) and ___ (dorsal) • "Front and back sections" • Think of a "corona" surrounding a ___. • Parallel to ___ suture of skull • ___ - crown, dividing them front and back (anterior, posterior)

anterior posterior saint's head coronal Coronal

BS to MS - moving up in ability to ___ for services (Medicare for outpatient services), which is where private practice PT evolved NPI #, licensure = bill/collect for services; can be signed over to someone else APTA gained us the right to ___ and ___. In Texas, no direct access. Scope of practice different in different states. ___ board - regulate practice of PT in Louisiana, every state has their own

bill bill and collect LPTA

Axial (transverse) Plane: •Divides the body into ___ (superior) and ___ (inferior) -plane and axis of movement is different -axis of movement is ___ to the plane; that is axis of rotation for planes -the axis of rotation is ___ for the transverse plane -> ex. cervical rotation, internal and external rotation

cephalad caudad perpendicular (90 degrees) vertical- twisting

Progression of PT Education Began as ___ at military institutions such as Walter Reed Army Hospital during WWI Certificate - early ___ Progressed to BS degree programs in the ___ as practice expectations moved from technical to professional. In the mid 50s, certificate to BS

certification program 20s 1950s

Progression of PT Education: Began as ___ at military institutions such as Walter Reed Army Hospital during ___ Progressed to BS degree programs in the ___ as practice expectations moved from technical to professional.

certification program WWI 1950s

-Lateral Femoral Epicondyle- run hand up along condyle and where it ___ is epicondyle -Lateral Collateral Ligament- have partner sit in a ___, feel it between femur and tibia at joint line -Iliotibial Band- have partner dig heel into the ground and it should stretch of pop out

dips in figure four position

Lateral Landmarks: Styloid process, Peroneal tubercle Calcaneus, Peroneus Tubercle, Lateral Malleolus is more? Peroneal tubercle of the calcaneus: ___ to the lateral malleolus; Peroneii pass behind peroneal tubercle separates peroneus longus from brevis; Styloid process: insertion of ___ and ___ Compare malleoli; lateral extended further distally giving more stability

distal peroneus brevis; peroneus longus

Value "The health outcomes achieved per ___" DPT's will provide safe, effective, patient/client-centered, timely, efficient, and equitable services to ensure the best value Internal Medicine - first non-physician group to be part of choosing wisely Innovation PT profession will offer creative and proactive solutions to enhance health services delivery and to increase the value of PT to society

dollar spent

Lateral Aspect of knee Lateral tibial plateau Lateral Tibial Tubercle - ___ from plateau ___ - inserts the IT band Lateral Femoral Condyle Lateral Femoral Epicondyle Troclear Groove and Patella Lateral groove is ___ than the medial.

down Gerdy's Tubercle higher

-Medial Tibial Plateau- we already found -Medial Collateral Ligament- runs from the ___ to the ___, externally rotate the tibia and should be able to feel the edges of the ligament -Semimembranosus tendon- have patient ___ against some resistance, should feel tendons pop out, this one is more ___ and ___ (semitendenosus is more shaped like a tendon)

femoral condyle to the tibial condyle flex knee medial and flat

Arthrokinematics: Convex on Concave · Squat - ___ is flexing on the ___ (osteo), also need to say which bone moved. Artho - I have rolled and glided. When a convex move on a concave, the movements will be in opposite directions. Rolls posteriorly and glide anteriorly to stay centered. Vex on cave - opposite directions. · Kick while sitting - osteo: ___ has extended on my ___. Concave moved on convex. Concave on convex stays the same. Rolling and gliding the ___. · Concave on convex - same way.

femur tibia tibia, femur same way

-Biceps femoris tendon- have partner flex against resistance and will be able to feel tendon pop out -Fibular Head- run fingers from posterior thigh down inferiorly, should be able to grab it with your fingers -Common Peroneal Nerve- wraps around the ___, run finger in posterior portion of knee, feels ___ and ___; partner should feel ___ when you find it

fibular head rubbery and round uncomfortable

Posterior Tibial Artery: Pulses Posterior Tibial Artery: main blood supply to the ___ Leg should not be elevated. Take fingers and wrap them around behind the structures, then squeeze so you are pushing the artery into the ___.

foot bone

Coronal (___) Plane- like a crown: •Divided into anterior (___) and posterior (___) •"Front and back sections" •Think of a "corona" surrounding a saint's head. •Parallel to ___ of skull -movement is ___ to this plane

frontal ventral dorsal coronal suture perpendicular

Continued: >Abductor Group -___ >Extensor Group -___

gluteus medius gluteus maximus, hamstrings

Floor of the triangle · What joint movement? Zone II (abductors) · Gluteus medius · Trochanteric bursa Zone III - Sciatic Nerve · Sciatic notch · Sciatic nerve o Sciatic notch between ___ and ___

greater trochanter and ischial tuberosity

Cardinals, Plains, Cardinals Plane... · Cardinal means ___ in Latin. The most important part of mechanical device is the ___. · ___ is about which the motion occurs. · ___ is the point that all the motion occurs. · Hinge between where the Pope is and Rome · Only ____ cardinal planes

hinge hinge Axis Hinge three

Continued: -Patella Tendon- go ___ to patella, follow it down to tibial tuberacle -Tibial Tuberacle- go inferior to patella, follow it down; end point of tendon and bony part at ___ -Infrapateller fat pad- lies under the ___; grab it and move fingers a little bit underneath

inferior superior part of tibia patella tendon

•Sciatic Nerve palpation -Halfway between ___ and ___ -Be careful

ischial tuberosity and greater trochanter

Ischial Tuberosity - flex the hips, find it then palpate it Sciatic Nerve palpation Halfway between ___ and ___ Piriformis and scitaic nerve get confused on palpation - near each other, but palpating in a different direction. Piriformis - origins on the ___, inserts on the ___. Anterior sacrum to the greater trochanter Palpate ___

ischial tuberosity and greater trochanter pelvis, femur perpendicular

Biodex -> can do both ___ and ___ movement and training

isotonic isokinetic

Lateral Dorsal Landmarks: Lateral malleolus, Fifth metatarsal, Fifth MTP Sinus tarsi contains: anterior to ___; normally concave; filled with edema with ankle sprain; talofibular ligament runs through; lies deep under talus dome; ___ lies in this sinus.

lateral malleolus extensor digitorum brevis (EDB)

Eccentric Contraction • Muscle ___ • Proximal and distal ends ___ from each other. • Muscle is lengthening under the force of the ___. • Not the passive drop - steady ___.

lengthens separate contraction lowering

-Pes Anserine- on ___ side of tibia, run finger inferior to tibial condyle and tibial plateau, just inferior to plateau if where all of these muscles attach ->Sartorius ->Gracilis ->Semiteninosus

medial

Bony Palpation · Medial aspect of knee ___- medial and lateral to the tendon On meniscus in this space Tibial Tubercle - ___ inserts onto this (one big bone) ___ - above joint line (sharp edge) Move superior and posterior to find the medial epicondyle of the femur Adductor Tubercle - from epicondyle more ___ and ___

medial Tibial Plateau patella tendon Medial Femoral Condyle superiorly, posterior

Medial Palpation: -Medial Condyle- already identified earlier -Adductor Tubercle- find ___, then find ___ to it, it is tender so if partner doesn't like the way it feels you're probably in the right spot -Medial Meniscus-palpate the medial joint line, ___ the tibia and should be able to feel it ___ more

medial femoral condyle, epicondyle superior, internally rotate, pop out

·Zone 2 Medial Aspect o Medial Meniscus o Medial Collateral Ligament - connects to ___ > Deep portion inserts directly into the edge of the ___ and ___ > Superficial portion inserts more distally onto the flare of the tibia o Sartorius o Gracilis o Semitendinosus

meniscus tibial plateau and meniscus

Guiding Principles: Identity PT profession will define and promote the ___ as the foundation for optimizing movement to improve the health of society >The PT will be responsible for evaluating and managing an individual's movement system across the lifespan to promote optimal development; diagnose impairments, activity limitations and participation restrictions; and provide interventions targeted at preventing activity limitations and participation restrictions

movement system

Guiding Principles: Identity PT profession will define and promote the movement system as the foundation for optimizing movement to improve the health of society. The PT will be responsible for evaluating and managing an individual's ___ across the lifespan to promote optimal development; diagnose impairments, activity limitations and participation restrictions; and provide interventions targeted at preventing activity limitations and participation restrictions

movement system

Zone 1= Femoral Triangle: LATERAL = ___, MIDDLE = ___, MEDIAL = ___ BORDERS: ___ = superior, ___ = medial, ___ = lateral FLOOR: ___

nerve artery vein inguinal ligament adductor longus sartorius iliopsoas

Zone I = Femoral Triangle *KNOW FOR WRITTEN* · LATERAL = ___, MIDDLE = ___, MEDIAL = ___ · BORDERS: ___ = superior, ___ = medial, ___ = lateral · FLOOR: iliopsoas · Femoral Triangle: Contents - STRUCTURES IN THE TRIANGLE: ___ o Artery will have a ___.

nerve, artery, vein inguinal ligament, adductor longus, sartorius LATERAL = nerve, MIDDLE = artery, MEDIAL = vein, L = lymph pulse

ABPTRFE Programs: •Cardiovascular & Pulmonary •Clinical Electrophysiology •Geriatrics •Neurology •Orthopaedics •Pediatrics •Sports •Women's Health •Wound Care Management >Which ones do we offer??

neurology, orthopaedics, would care management

Combined Planes: Functional ___ movements Examples Scaption: in line with scapula Foot supination and pronation PNF techniques Foot - triplaneal movement - inversion, flexion, and in/external rotation

oblique

Combined Planes: •Functional ___ movements •Examples -Scaption -Foot supination and pronation -PNF techniques

oblique

ABPTS specialties include: Cardiopulmonary Electrophysiology Geriatrics Neurology Oncology Orthopaedics Pediatrics Sports Women's Health which is the only specialty that doesn't have a residency?

oncology

Arthrokinematics: Convex on Concave -convex on concave, like a squat, you roll and glide in the ___ direction

opposite

Accreditation of programs under control, early 60s accreditation by us (self-determined profession) Social Security Act of 1967 included a definition of "___ services". Practice of PT established in state laws across the country. Advanced management of neuromuscular conditions Practice evolution along with orthopaedic populations (joint replacements, etc)

outpatient PT

Process is the attachment for the peroneal muscles, which are long muscles that go up and down the outside of your foot and up your fibula. Brevis comes behind the lateral and up above tubercle called ___. Brevis attaches to the styloid process. Longus behind tubercle and comes up under the foot and attaches at the ___.

peroneal tubercle first metatarsal

SAGITTAL PLANE • Divided into ___ and ___ sections • Parallel to ___ suture of the skull • Dividing right and left if it's the ___ plane (midline). • ALL ___ and ___

right and left sagittal mid-sagittal flexion and extension

Sagittal Plane: •Divided into ___ and ___ sections •Parallel to ___ of the skull -if right down the middle of the body, is ___ -axis is ___ to it

right and left sagittal suture midsaggital perpendicular

Dorsal View Extensor Digitorum Brevis: muscle belly is in the ___ ___ - from the fibula into the sinus tarsi. 5th metatarsal head - called ___. Often from rubbing from your shoe.

sinus tarsi ATL tailors bunion

Fifth metatarsal has the ___. Attachment of the peroneus brevis. Behind cuboid is the ___ - medial and lateral tubercle. Indentation on the lateral side called the ___ - extensor digitorium brevis inside. Lateral malleolus is the ___ (bone).

styloid process calcaneus sinus tarsi fibula

Degrees of Freedom- means ___ •Independent movements allowed at a joint •Up to ___ degrees available per joint (some say 6 because of the opposites movements that go with it, ex. flexion and extension •Example: Shoulder has 3 degrees of freedom as it has motion in all 3 planes

the number of planes that a joint is able to travel through 3

Continued: How much does the joint move? Shoulder - ___ degrees of movement, some people will say it has three degrees of freedom, some say 6 because of all 6 movements. IP joint on thumb - ___/___ in the sagittal plane. A single joint not the shoulder with degrees of freedom.

three (all three planes) flex/extension

Isotonic Contraction: Literally, same ___. Same ___ throughout full ROM. Controversial ___: Forces acting on different level arms. Cables, theraband if they are long enough. 10 pound weight example.

tone resistance Free weights

Navicular - small ___ on it (head) Talus bone - head of the talus, base of the talus (it is rounded - called the ___) Bone sits on the ___ bone, sitting over the rounded dome and extends down - tibia On the medial side it has another projection, which is the weight baring direction when we bare weight. Projection called the ___

tubercle dome talor medial malleolus

Posterior Palpation: -Popliteal Fossa- between ___, find crease of knee, fossa is ___ to crease -Tibial Nerve, Popliteal Artery, Popliteal Vein- ___ in the popliteal fossa, should be able to find a pulse, and know you're on tibial nerve when partner is ___ -Gastrocnemius- have person ___, should be able to outline the muscle (calf)

two hamstring tendons superior central uncomfortable get up on toes

Anterior Landmarks Females has a ___ iliac, men are more "___" shaped. Women flare more. Points are ___ on males - boner, sharper, and pointer. Female is more ___ and ___. Soft tissue difference - females are more ___ in the pelvis area than men. Iliac Crest Iliac Tubercle Anterior Superior Iliac Spine (ASIS) All of these should be assessed in a ___ posture. · Greater Trochanter - buritis at the hip right here, leg length, and muscles insert here IR/ER of hip Pubic Tubercles

wider H sharper rounded and curved insulated standing