NPTE MSK

anterior longitudinal ligament Limits what motions?

anterior longitudinal ligament Limits what motions? - Limits extension of the spine and reinforces the anterior portion of the intervertebral discs and vertebrae

anterior sacroiliac ligament: connect? which is the weakest sacroiliac ligament? - the anterior sacral iliac ligament

anterior sacroiliac ligament: connect? - Connects the anterior surface of the ilium to the anterior sacrum - It is a thickening of the joint capsule and is considered the weakest of the sacroiliac ligaments which is the weakest sacroiliac ligament? - the anterior sacral iliac ligament

What muscles do horizontal ABduction of the shoulder joint there are three of them

Posterior deltoid - Infraspinatous - Teres minor

which muscle fiber primarily uses oxidative processing is an which muscle fiber type primarily uses glycolytic processes

type one muscle fibers are oxidative - Type 2 muscle fibers are glycolytic

which type of stretching is commonly used as a warmup?

which type of stretching is commonly used as a warmup? - dynamic stretching

which method of stretching involves actively moving a body segment to the end range but not beyond and rage is only held briefly ?

which method of stretching involves actively moving a body segment to the end range but not beyond and rage is only held briefly ? - dynamic stretching

which method of stretching is best for preparing muscles for athletic activity?

which method of stretching is best for preparing muscles for athletic activity? - ballistic stretching

which type of stretching is more likely to lead to muscle soreness and injury?

which type of stretching is more likely to lead to muscle soreness and injury? - ballistic stretching due to high intensity of stretch force

Capsular pattern of interphalangeal joints

interphalangeal joints - flexion, extension

what is a muscle spindle

- In the muscle of the belly - Read muscle length and the rate of change of length - Is important in controlling of posture and involuntary movements

What three muscles primarily depress the tempo mandibular joint

- Lateral pterygoid - Superhyoid - Infra hyoid

With three muscles primarily cause protrusion of the Templar mandibular joint

- Masseter - Lateral pterygoid - Medial pterygoid

What for muscles cause side to side motion in the temporomandibular joint

- Medial pterygoid - Lateral pterygoid - Masseter - Temporalis

What muscles do rotation and lateral bending of the thoracic and lumbar spine there are eight

- Psoas major O: All lumbar vertebrae & Transverse process of T12 I: Lesser trochanter of femur A: Hip flexion N: Lumbar plexus T12-L4 - Quadratus lumborum O: iliac crest I: L1-L4, transverse process, 12th rib A: unilateral: thoracic/lumbar side bending and hip hiking N: subcostal nerve T12 - External oblique O: ribs 5-12 I: iliac crest and inguinal ligament A: bilateral: flexion of trunk unilateral: contralateral rotation of spine unilateral: ipsilateral lateral flexion N: iliohypogasatric L1 - Internal oblique O: iliac crest and inguinal ligament iliac crest and inguinal ligament iliac crest and inguinal ligament iliac crest and inguinal ligament iliac crest and inguinal ligament iliac crest and inguinal ligament I: A: N: - Multifidus O: I: A: N: - Longissimuss thoracis O: I: A: N: - Iliocostalis thoracis O: I: A: N: - Rotatores O: I: A: N:

What three muscles do flexion of the thoracic and lumbar spine

- Rectus abdominis O: I: A: N: - Internal oblique O: I: A: N: - External oblique O: ribs 5-12 I: iliac crest and inguinal ligament A: bilateral: flexion of trunk unilateral: contralateral rotation of spine unilateral: ipsilateral lateral flexion N: iliohypogasatric L1

What muscles do extension of the cervical spine there are six of them

- Splenius cervicis O: I: A: N: - Semispinalis cervicis O: I: A: N: - Iliocostalis cervicis O: I: A: N: - Longissimus cervicis O: I: A: N: - Multifidus O: I: A: N: - Trapezius O: I: A: N:

What are the three primary muscles that cause flexion cervical spine

- Sternocleidomastoid O: I: A: N: - Longus colli O: I: A: N: - Scalenus ms O: I: A: N:

What muscles do rotation and lateral side bending of the cervical spine there are seven of them

- Sternocleidomastoid O: I: A: N: - Scalenus ms O: I: A: N: - Spenius cervices O: I: A: N: - Longissimus cervicis O: I: A: N: - Iliocostalis cervicis O: I: A: N: - Levator scapulae O: I: A: N: - Multifidus O: I: A: N:

What three muscles cause retrusion of the temporomandibular joint

- Temporalis - Masseter - Digastric

what is the Swan neck deformity?

- deformity of hands DIP flexion , PIP hyper extension - one symptom of rheumatoid arthritis

what is a boutonniere deformity?

- deformity of the hands , DIP extension , PIP flexion - one symptom of rheumatoid arthritis

What three muscles do extension of the thoracic and lumbar spine

- erector spinae O: I: A: N: - Quadratus lumborum O: iliac crest I: L1-L4, transverse process, 12th rib A: unilateral: thoracic/lumbar side bending and hip hiking N: subcostal nerve T12 - Multifidus O: I: A: N:

What three muscles due toe extension

- extensor digitorum longus and brevis - Extensor hallucis longus - Extensor Hallucis brevis O: Calcaneus and extensor retinaculum I: Proximal phalanx of big toe A: Extends big toe N: Deep fibular n. L4-S1 - Lumbricals

what causes theses Gait deviations of the ankle and foot no toe off

- foot slap o weak dorsal flexors o dorsi flexor paralysis - toe down instead of heel strike o plantar flexor spasticity o plantar flexor contracture o weak dorsal flexors o dorsal flexor paralysis o leg length discrepancy o hindfoot pain - clawing of toes o toe flexor spasticity o positive support reflex - heel lift during midstance o insufficient dorsal flexion range o planter flexor spasticity - no toe off o forefoot/or toe pain o Weak plantar flexors o Weak toe flexors o insufficient planter flexion range of motion

what causes theses Gait deviations of the ankle and foot toe down instead of heel strike

- foot slap o weak dorsal flexors o dorsi flexor paralysis - toe down instead of heel strike o plantar flexor spasticity o plantar flexor contracture o weak dorsal flexors o dorsal flexor paralysis o leg length discrepancy o hindfoot pain - clawing of toes o toe flexor spasticity o positive support reflex - heel lift during midstance o insufficient dorsal flexion range o planter flexor spasticity - no toe off o forefoot/or toe pain o Weak plantar flexors o Weak toe flexors o insufficient planter flexion range of motion

What five muscles do medial rotation of the shoulder

- subscapularis O: I: A: N: - teres major O: I: A: N: - Pectoralis major - latissimus dorsi - Anterior deltoid

What three muscles do lateral rotation of the shoulder

- teres minor O: I: A: N: - infraspinatous O: I: A: N: - Posterior deltoid O: I: A: N:

2-5th finger distal interphalangeal Range of motion norms - Flexion - Hyperextension

2-5th finger distal interphalangeal Range of motion norms - Flexion 0-90 - Hyperextension 0-10

2-5th finger metacarpophalangeal Range of motion norms - Flexion Hyperextension

2-5th finger metacarpophalangeal Range of motion norms - Flexion 0-90 Hyperextension 0-45

2-5th finger proximal interphalangeal Range of motion norms - Flexion

2-5th finger proximal interphalangeal Range of motion norms - Flexion 0-100

Capsular pattern of 2nd to 5th metatarsal phalangeal joint

2nd to 5th metatarsal phalangeal joint - variable

Abducted Gait prosthetic causes: amputee causes:

Abducted Gait prosthetic causes: - prosthesis too long - high medial wall - poorly shaped lateral wall - prosthesis positioned in abd - inadequate suspension - excessive knee friction amputee causes: - abd contracture - improper training - add roll - weak hip flexors and add - pain over lateral residual limb

What three muscles due toe AB duction

Abductor hallucis - Abductor digit minimi - Dorsal interossei

Active versus passive muscle insufficiency

Active versus passive muscle insufficiency - a muscle contraction that is less than optimal due to an extremely lengthened or shortened position of the muscle - active insufficiency o two joint muscle is incapable of shortening to the extent required to produce full range of motion at all joints crossed simultaneously - passive insufficiency o when a 2 joint muscle cannot lengthen to the extent required to allow full range of motion of all joints it crosses simultaneously

What two muscles due toe adduction

Adductor hallucis - Plantar interossei

Alar ligament Origin and insertion resists which motion?

Alar ligament Origin and insertion - Attaches to dance of access to the occipital condyles resists which motion? - Resist flexion, contralateral side bending, contralateral rotation - Also helps to limit sagittal plane translation between the Atlas and occiput

Ankle (talocrural) Range of motion norms - Dorsiflexion - Plantar flexion

Ankle (talocrural) Range of motion norms - Dorsiflexion 0-20 - Plantar flexion 0-50

Annular ligament Location ? what motion does it allow ?

Annular ligament Location ? - surrounding head of radius what motion does it allow ? - allows the head of the radius to rotate and retain contact with the radial notch of the ulna

Anterior cruciate ligament ACL Common mechanism of injury Special tests that assess the integrity of the ACL?

Anterior cruciate ligament ACL Common mechanism of injury - non contact listing , varus or valgus stress to the knee with hyper extension Special tests that assess the integrity of the ACL? - Anterior door test - Lachman test - Lateral pivot shift test - Slocum Test

What for muscles do flexion of the shoulder joint

Anterior deltoid - coracobrachialis - Pec major (clavicular head) - Biceps brachii

Anterior longitudinal ligament : what motions does it limit?

Anterior longitudinal ligament : what motions does it limit? - Limits extension of the spine and reinforces the anterior portion of the intervertebral discs and vertebra

Associated spinal levels of reflex tests - C5 - C6 - C7 - L4 - S1

Associated spinal levels of reflex tests biceps reflex - C5 brachioradialis reflex - C6 triceps reflex - C7 patellar reflex - L4 Achilles reflex - S1

Associated spinal levels of reflex tests biceps reflex brachioradialis reflex triceps reflex patellar reflex Achilles reflex

Associated spinal levels of reflex tests biceps reflex - C5 brachioradialis reflex - C6 triceps reflex - C7 patellar reflex - L4 Achilles reflex - S1

Avulsion fracture closed fracture comminuted fracture compound fracture greenstick fracture nonunion fracture stress fracture spiral fracture

Avulsion fracture - Portion of bond becomes fragmented at the sight of tendon attachment due to a traumatic or sudden stretch of the tendon closed fracture - breaking a bone where the skin covers the site and remains intact comminuted fracture - a bone that breaks into fragments compound fracture - breaking bone that protrudes through the skin greenstick fracture - A break on one side of a bone that does not damage the periosteum on the opposite side. This type of fracture is often seen in children nonunion fracture - a break in a bone that has failed to Unite and heal after 9 to 12 months stress fracture - they break in a bone due to repeated forces to a particular portion of the bone spiral fracture - a break in bone shaped like an S do too torsion and twisting

Bio electrical impedance analysis BIA what is it used for ? BIA protocol

Bio electrical impedance analysis BIA what is it used for ? - assessing body composition using a small electrical current an measures the resistance or opposition to the current flow BIA protocol - abstains from eating or drinking within 4 hours prior to testing - Abstain from vigorous physical activity within 12 hours prior to testing - Urinate within 30 minutes prior testing - Avoid alcohol consumption 48 hours prior to testing - Avoid excessive water intake prior to testing

Brachial plexus, what nerve roots?

Brachial plexus - consists of nerves of C5-T1 - nerve roots Two trucks two divisions chords to peripheral nerves

Bursitis

Bursitis - a condition caused by acute or chronic inflammation of the Bursa - symptoms may include a limitation in active range of motion secondary to pain and swelling

Calcaneofibular ligament What motion does it resist?

Calcaneofibular ligament What motion does it resist? - Inversion of talus within the midrange of talocrural motion

Cervical spine Range of motion norms - Flexion - Extension - Side bending - Rotation

Cervical spine Range of motion norms - Flexion 0-45 - Extension 0-45 - Side bending 0-45 - Rotation 0-60

Cervical spine rotation goniometric technique - Patient position: - Stabilization: - End-feel: - Axis: - Stationary arm: - Moving arm: - ROM norm:

Cervical spine rotation goniometric technique - Patient position: sitting with the thoracic and lumbar spine supported - Stabilization: shoulder girdle and chest to prevent rotation of the thoracic and lumbar spines - End-feel: firm - Axis: over the center of the cranial aspect of the head - Stationary arm: parallel to an imaginary line between the two acromial processes - Moving arm: with the tip of the nose - ROM norm: 0-60

Coracoacromial ligament where does it attach? what motion does it prevent?

Coracoacromial ligament where does it attach? - between the coracoid process and the acromion - The roof over the humeral head what motion does it prevent? - superior translation of the humoral head - prevent separation of the acromioclavicular joint

Cruciform ligament Origin and insertion Function?

Cruciform ligament Vertical and horizontal portion Origin and insertion - Vertical: Connects the dense of the axes to the foramen Magnum - Horizontal: Portion connects the dens with the Atlas Function is to limit upper cervical flexion as well as translation about that Atlas on the axis

DeLorme Exercise Program

DeLorme Exercise Program First set - 10 reps x 50% of 10 rep max Second set - 10 reps x 75% of 10 reps max Third set - 10 reps x 100% of 10 reps max

Delayed-onset muscle soreness

Delayed-onset muscle soreness - DOMS - A result of microtrauma to muscle and connective tissue - most common in patients who have engaged in high intensity, eccentric strengthening exercises - symptoms are tenderness to palpation in muscle belly or at muscle tendon junction, soreness with passive stretching or active contraction of muscle, decreased range of motion, decrease tree - symptoms reach peak two days after exercise and can last for several days - soreness will diminish with each successive training session and the muscle adapts to higher levels of stress - performing only concentric and isometric exercises significantly reduces the likelihood of the DOMS

Deltoid Ligament What is it composed of? What motion does it resist?

Deltoid Ligament What is it composed of? - anterior, tibial calcaneal ligament, posterior tibiotalar ligament, tibio navicular ligament. What motion does it resist? - Eversion of talus

Difference between type one and type 2 muscle fiber size

Difference between type one and type 2 muscle fiber size - one small fibers - Type two large fibers (which muscle fiber is aerobic versus anaerobic - aerobic = type 1 (slow) - anerobic = type 2 (fast))

What two muscles do finger ABbuction

Dorsal interossei - Abductor digiti minimi 5th digit

Dysvascular

Dysvascular - refers to the disease of the blood vessels, including peripheral vascular disease, peripheral arterial disease, and complications related to diabetes

Edema effusion

Edema - increase volume of fluid in the soft tissue outside of a joint capsule effusion - an increase volume of fluid within a joint capsule

Elbow extension goniometric technique - Patient position: - Stabilization: - End-feel: - Axis: - Stationary arm: - Moving arm: - ROM norm:

Elbow extension goniometric technique - Patient position: Supine - Stabilization: humerus to prevent flexion of the shoulder - End-feel: hard Boney - Axis: lateral epicondyle of the humerus - Stationary arm: lateral midline of the humerus using the center of the acromial process for reference - Moving arm: lateral midline of the radius using the radial head and radial styloid process for reference - ROM norm: 0

Elbow flexion goniometric technique - Patient position: - Stabilization: - End-feel: - Axis: - Stationary arm: - Moving arm: - ROM norm:

Elbow flexion goniometric technique - Patient position: Supine - Stabilization: humerus to prevent flexion of the shoulder - End-feel: soft - Axis: lateral epicondyle of humerus - Stationary arm: lateral midline of the humerus using the center of the acromial process for reference - Moving arm: lateral midline of the radius using the radial head an radial styloid process for reference - ROM norm: 0-150

what is the golgi tendon organ

Encapsulated sensory receptors where muscle tendons pass immediately began their attachment to the muscle fibers - Sensitive to tension , especially when produced from an active muscle contraction - Transmit information about tension or the rate of change of tension within a muscle

resistance training parameters Exercise sequence

Exercise sequence - large muscle groups should be exercised before small muscle group - multiple joint exercises should be performed before single joint exercises - high intensity exercises should be performed before low intensity exercises - note that these recommendations can be disregarded if they conflict with rehab goals

Extensor retinaculum Location? what motion does it prevent?

Extensor retinaculum Location? - Dorsal aspect of the wrist , covers tendons of extensors what motion does it prevent? - prevents tendons from bowstring as the wrist is extended

Fatigue ability of type one versus type 2 muscle fibers

Fatigue ability of type one versus type 2 muscle fibers - type 1 low fatigue ability - Type 2 high fatigue ability (which muscle fiber is aerobic versus anaerobic - aerobic = type 1 (slow) - anerobic = type 2 (fast))

Finger 2-5 distal interphalangeal extension goniometric technique - Patient position: - Stabilization: - End-feel: - Axis: - Stationary arm: - Moving arm: - ROM norm:

Finger 2-5 distal interphalangeal extension goniometric technique - Patient position: sitting with the forearm and hand supported - Stabilization: middle and proximal failings to prevent motion at the proximal 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 - Moving arm: over the dorsal midline of the distal phalanx - ROM norm:0-10 degrees of hyperextension

Fingers 2-5 metacarpophalangeal extension goniometric technique - Patient position: - Stabilization: - End-feel: - Axis: - Stationary arm: - Moving arm: - ROM norm:

Fingers 2-5 metacarpophalangeal extension goniometric technique - Patient position: Sitting with the forearm and hand on the supporting surface - Stabilization: metacarpal to prevent wrist motion - End-feel: firm - Axis: over the dorsal aspect of the metacarpophalangeal joint - Stationary arm: over the dorsal midline of the metacarpal - Moving arm: over the dorsal midline of the proximal phalanx - ROM norm:0-45 of hyper extension

Fingers 2-5 metacarpophalangeal flexion goniometric technique - Patient position: - Stabilization: - End-feel: - Axis: - Stationary arm: - Moving arm: - ROM norm:

Fingers 2-5 metacarpophalangeal flexion goniometric technique - Patient position: sitting with the forearm and hand on supporting surface - Stabilization: metacarpal to prevent wrist motion - End-feel: firm or hard - Axis: over the dorsal aspect of the metacarpal phalangeal joint - Stationary arm: over the dorsal midline of the metacarpal - Moving arm: over the dorsal midline of the proximal phalanx - ROM norm:0-90

What five muscles due toe flexion

Flexor digitorum longus and brevis - Flexor hallucis longest an brevis - Flexor digiti minimi brevis - Quadratus plantae - Lumbricals

Flexor retinaculum Location? What motion does it prevent ?

Flexor retinaculum Location? - Palmer aspect of the wrist forming the most anterior aspect of the carpal tunnel What motion does it prevent ? - prevents tendons of the flexors from bowstringing as the wrist is flexed - Serves as an attachment site for the thenar and hypothenar muscles

Force-velocity relationship

Force-velocity relationship - is a principle that states that the speed of a muscle contraction affects the force that the muscle can produce - during a concentric contraction, as the speed of the contraction increases, the force of contraction decreases - during an eccentric contraction , as the speed of contraction increases the force of contraction also increases

Forearm Range of motion norms - supination - pronation

Forearm Range of motion norms - supination 0 -80 - pronation 0-80

Forearm pronation goniometric technique - Patient position: - Stabilization: - End-feel: - Axis: - Stationary arm: - Moving arm: - ROM norm:

Forearm pronation goniometric technique - Patient position: sitting with the elbow flexed to 90 degrees - Stabilization: distal end of the humerus to prevent medial rotation an Abd of the humerus - End-feel: firm or hard - Axis: lateral 2 the ulnar styloid process - Stationary arm: parallel to the anterior midline of the humerus - Moving arm: dorsal aspect of the forearm, just proximal to the styloid process of the radius and ulna - ROM norm: 0-80

resistance training parameters Frequency

Frequency - number of times per week

General discharge guidelines following total hip arthroplasty

General discharge guidelines following total hip arthroplasty - avoid crossing legs when sitting - Sit in firm chairs and avoid sitting in low or soft furniture. Limit forward bending when sitting or standing up - Stand with feet in neutral position, avoid turning toes inward - Use a pillow or splint between the legs when in bed - Avoid pulling blankets up in bed with forward bending - Place a night stand on the same side of the bed as the uninvolved side - Use a raised toilet seat or portable commode for toileting activities - Use a rubber, nonskid bathmat in shower - Use a long handled brush to avoid leaning forward when bathing - Remove all throw rugs and always walk with appropriate footwear - When walking, turned to the uninvolved side to avoid pivoting on the involved side - Walk for short periods and gradually increase the time period to improve endurance - When ascending stairs, step up with the uninvolved leg. Up with the good - When descending stairs, step down with the involved leg. Down with the bad

Glucocorticoid Agents (corticosteroids ) action: indication : side effects : implications for PT : examples :

Glucocorticoid Agents (corticosteroids ) action: - provide hormonal, anti inflammatory, and metabolic effects including suspension of articular and systemic disease - Reduce inflammation that can damage tissues - Vasoconstriction results from stabilizing license normal membranes and enhancing the effects of catecholamines indication : - replacement therapy for endocrine dysfunction - Anti inflammatory and immunosuppressive effects - Treatment of rheumatic, respiratory, various other disorders side effects : - muscle atrophy - GI distress - Glaucoma - Adrenal cortical suppression - Drug induced Cushing syndrome - Weakening with breakdown of supporting tissues (bone, ligament, tendon, skin ) - Mood changes - Hypertension implications for PT : - therapist must wear mask when working with patients on glucocorticoid therapy since their immune system is weakened - aware of signs of toxicity o moonface o Buffalo hump o Personality changes - patients are at risk for osteoporosis and muscle wasting - injected joints may have ligament and tendon laxity or weakening examples : - hydrocortisone or cortisol - Prednisone - Prednisolone - dexamethasone

Gross manual muscle tests screening by spinal root level - c1 - C2 -C4 - C5 - C5 -C6 - C6 - C7 - C7 - C8 - T1 - L1 -L2 - L3 - L4 - L4 - L5 - L5 - S1

Gross manual muscle tests screening by spinal root level cervical rotation - c1 shoulder elevation - C2 -C4 shoulder AB duction - C5 elbow flexion - C5 -C6 wrist extension - C6 elbow extension - C7 wrist flexion - C7 thumb extension - C8 finger adduction - T1 Hip flexion - L1 -L2 knee extension - L3 - L4 ankle dorsi flexion - L4 - L5 great toe extension - L5 ankle planter flexion - S1

Halo Vest orthosis

Halo Vest orthosis - invasive cervical thoracic orthosis that provides full restriction of all cervical motions - metal ring with four post is attached to a vest and placed on patient and secured by inserting 4 pins through the ring into the skull - Commonly used with cervical spinal cord injuries to prevent further damage - used until the spine becomes stable on its own

Hip ORIF Where is the most common place for a proximal hip fracture? What are the signs of fixation failure ?

Hip ORIF Where is the most common place for a proximal hip fracture? - femoral neck or in the intertrochanteric region - the moral neck fractures are intracapsular an may lead to disruption of blood supply two femorale head What are the signs of fixation failure ? - persistent by or groin pain - leg length discrepancy that was not present initially - positioning the limb in external rotation or trendelenburg sign that does not improve with strengthening

Hip Range of motion norms - Flexion - Extension - Abduction - Adduction - Medial rotation - Lateral rotation

Hip Range of motion norms - Flexion 0-120 - Extension 0-30 - Abduction 0-45 - Adduction 0-30 - Medial rotation 0-45 - Lateral rotation 0-45

Hip adduction goniometric technique - Patient position: - Stabilization: - End-feel: - Axis: - Stationary arm: - Moving arm: - ROM norm:

Hip adduction goniometric technique - Patient position: supine - Stabilization: pelvis to prevent lateral tilting - End-feel: firm - Axis: over the anterior superior iliac spine ASIS of the extremity being measured - Stationary arm: aligned with the imaginary horizontal line extending from 1 ASIS to the other ASIS - Moving arm: anterior midline of the femur using the midline of the Patella for reference - ROM norm:0-30

Capsular pattern of Hip joint

Hip joint - function, Abd, medial rotation (sometimes medial rotation is most limited)

Hip lateral rotation goniometric technique - Patient position: - Stabilization: - End-feel: - Axis: - Stationary arm: - Moving arm: - ROM norm:

Hip lateral rotation goniometric technique - 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 - Moving arm: anterior midline of the lower leg using the Crest of the tibia and the point midway between the two malleoli for reference - ROM norm:0-45

Iliolumbar ligament connects function? -

Iliolumbar ligament connects the posterior portion of the ilium to the transverse process of the L5 vertebra function? - Limits all motions between L5 and S1

Interspinous ligament Located? function?

Interspinous ligament Located? - Located between the spinous process function? - Limits flexion and rotation of the spine

Interspinous ligaments: Location? What motion does it resist ?

Interspinous ligaments: Location? - Between the spinous processes What motion does it resist ? - limits flexion and rotation of the spine

Ischiofemoral ligament Origin and insertion? Function?

Ischiofemoral ligament Origin and insertion? - Extends from issuel wall of the acetabulum to the neck of the femur Function? - Service to reinforce the articular capsule - Weakest of the three ligaments

Isokinetic exercise what is the difference between an isokinetic exercise and isotonic exercise and isometric exercise?

Isokinetic exercise - muscle contraction is generated with a constant maximal speed and variable load - reaction force is identical to the force applied to the equipment - very specialized equipment what is the difference between an isokinetic exercise and isotonic exercise and isometric exercise? - Isometric, the limb does not move, exercise against an immovable object - Isotonic, the muscle force remains the same throughout the contraction (concentric and eccentric contractions ) free weights - Isokinetic, constant Max speed and variable load, requires specialized equipment

Isometric exercise

Isometric exercise - no change in muscle length - often performed against immobile objects

Knee Range of motion norms - Flexion

Knee Range of motion norms - Flexion 0-135

Knee extension goniometric technique - Patient position: - Stabilization: - End-feel: - Axis: - Stationary arm: - Moving arm: - ROM norm:

Knee extension goniometric technique - Patient position: Supine - Stabilization: femur to prevent rotation, Abd, add of the hip - End-feel: firm - Axis: lateral epicondyle of the femur - Stationary arm: lateral midline of the femur using the greater trochanters for reference - Moving arm: Laura midline of the fibula using a lateral malleolus and fibular head for reference - ROM norm:?

Knee flexion goniometric technique - Patient position: - Stabilization: - End-feel: - Axis: - Stationary arm: - Moving arm: - ROM norm:

Knee flexion goniometric technique - Patient position: supine - Stabilization: femur to prevent rotation, Abd, add of the hip - End-feel: soft, firm - Axis: lateral epicondyle of the femur - Stationary arm: lateral midline of the femur using the greater trochanter for reference - Moving arm: lateral midline of the fibula using the lateral malleolus an fibular head for reference - ROM norm:0-135

Kyphosis

Kyphosis - excessive curvature of spine in a posterior direction - Common cause includes osteoporosis, Compression fracture, Poor posture secondary to paralysis

Laminectomy - What condition is indicate the need for surgery o complete Laminectomy o partial Laminectomy - Post surgical precautions

Laminectomy - What condition is indicate the need for surgery o disc protrusion o spinal stenosis - what are the types o complete Laminectomy § removal of entire lamina , and spinous process, and associated ligamentum flavum § vertebral segment less stable compared to partial Laminectomy o partial Laminectomy § removal of only one lamina § vertebral segment more stable compared to complete Laminectomy - Post surgical precautions o weight lifting limitation o active motions restriction especially extension

What are osteo kinematic motions

Large motions such as flexion extension AB duction add duction rotation

Lateral ankle reconstruction Weight bearing protocol after surgery what motion should physical therapist be very cautious with ? when are we not to use bracing after healed?

Lateral ankle reconstruction Weight bearing protocol after surgery - initially patients are usually in protective cast for short., commonly non weight bearing while in protective cast - move to walking boot in which partial weight bearing for full weight bearing is allowed what motion should physical therapist be very cautious with ? - inverting the ankle needs to be very gentle as to protect the repairing tissues when are we not to use bracing after healed? racing it may be required long term if patient plans to return to sports or higher level activities

What four muscles do extension of the shoulder joint

Latissimus dorsi - Posterior deltoid - Teres major - Triceps brachii (longhead )

Leg-calve-perthes disease What is it: - four stages Etiology: Signs and symptoms: Treatment:

Leg-calve-perthes disease What is it: - degeneration of the femoral head due to a disturbance in blood supply (avascular necrosis ) - four stages o condensation o fragmentation o re ossification o remodeling Etiology: - trauma - genetic predisposition - synovitis - vascular abnormalities - infection Signs and symptoms: - pain - decrease range of motion - antalgic gait - positive trendelenburg sign Treatment: - relieve pain - maintain femoral head in proper position - improve range of motion - stretching - splinting - crutch training - aquatherapy - traction - orthostatic devices and surgical intervention indicated depending on severity

Length-tension relationship

Length-tension relationship - is a principle that states that the ability of a muscle to produce force depends on the length of the muscle - muscle can usually produce a maximal force near its normal resting length - muscle is or shorten it will likely produce less force

Ligament position in loose packed versus close packed position of joint

Ligament position in loose packed versus close packed position of joint - loose packed is greatest laxity and ligament position - close packed is full tightness of ligament position

Ligamentum Flavum Origin and insertion? Function?

Ligamentum Flavum Origin and insertion? - Connects the lamina of 1 vertebrae to the lamina of the vertebrae above it Function? - Serves to limit flexion and rotation of the spine

Long arm split what is it, where does it go? what is it used to treat ? how to position this splint ?

Long arm split what is it, where does it go? - Rigid splint that covers the elbow joint (typically posterior side ), spanning from wrist to the distal humerus - splint is used to immobilize elbow joint to allow for healing following injury or surgery - prevents elbow flexion an extension as well as supination and pronation what is it used to treat ? - following an elbow or proximal forearm fracture - to treat a soft tissue injury such as tendonitis or a tendon repair how to position this splint ? - elbow 90 degrees of flexion - forearm neutral

Lordosis

Lordosis - excessive curvature of spine in the anterior direction - Usually related to cervical or lumbar spine - Causes include weak abdominal muscles, pregnancy , excessive weight in the abdominals area, hip flexion contraction

Lumbar plexus

Lumbar plexus - formed by the nerve roots of T-12 and L1 through 4 - innervates the anterior and medial muscles of the thigh and dermatomes of the medial leg and foot - the largest and most important branches of the plexus are the obturator and the femoral nerves

MMTs of muscles tested in Prone (16)

MMTs of muscles tested in Prone (16) - back extensors - Gluteus maximus - Lateral rotators of the shoulder , other testing positions as well - Lower trapezius - Middle trapeziu's - Posterior deltoid , other testing positions as well - Rhomboids - Teres major - Gastrocnemius - Hamstrings , other testing positions as well - Latissimus dorsi - Medial rotators of the shoulder , other testing positions as well - Neck extensors - Quadratus lumborum - soleus - Triceps , other testing positions as well

MMTs of muscles tested in Sidelying (4)

MMTs of muscles tested in Sidelying (4) - Gluteus medias - Gluteus min - Hip Adds - lateral abdominals

MMTs of muscles tested in standing (2)

MMTs of muscles tested in standing (2) - ankle planter flexors - serratus anterior , other testing positions as well

What two muscles do abduction of the shoulder joint

Middle deltoid - Supraspinatus

What two muscles do retraction of the scapula

Middle trapezius - Rhomboids

Midtarsal (transverse tarsal) Range of motion norms - Inversion - Eversion

Midtarsal (transverse tarsal) Range of motion norms - Inversion 0-35 - Eversion 0-5

Midtarsal (transverse tarsal) eversion goniometric technique - Patient position: - Stabilization: - End-feel: - Axis: - Stationary arm: - Moving arm: - ROM norm:

Midtarsal (transverse tarsal) eversion goniometric technique - Patient position: sitting with the knee flexed to 90 degrees - 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: anterior midline of the lower leg using the tibial tuberosity for reference - Moving arm: anterior midline of the second metatarsal - ROM norm:0-15

Moment arm -

Moment arm - Linear distance from the axis of rotation to the site of the external load

Muscle fatigue what is it? signs and symptoms of muscle fatigue

Muscle fatigue - characterized by decreasing ability of muscle to produce force against the load with increasing repetitions - is reversible with rest signs and symptoms of muscle fatigue - muscle pain and cramping - tremors - slow or jerky movements - inability to complete full movement pattern - substitution movement patterns

Muscle performance

Muscle performance - the ability of muscle to perform work - power + strength + endurance = muscle performance

muscles for thoraco lumbar rotation and side bending?

Muscles for thoraco lumbar flexion? - rectus abdominis , internal oblique , external oblique muscles for thoraco lumbar extension? - erector spinae, quadratics lumborum, multifidus muscles for thoraco lumbar rotation and side bending? - Psoas major , quadratics lumborum , external oblique , internal oblique, multifidus, longissimus thoracis, iliocostalis thoracis, rotatores

Myoelectrical prosthesis

Myoelectrical prosthesis - a device using Electro myography signals to control movements of the prosthesis with surface electrodes or implantable wires

Myoplasty

Myoplasty - suturing amputated muscle flaps together over the end of a bone following an amputation

Observing postures of the knees and legs good posture of the knees and legs common faulty postures of the knees and legs - knock knees - bowlegs - hyper extended knee - flex knee - medially rotated femur - laterally rotated femurs

Observing postures of the knees and legs good posture of the knees and legs - legs are straight up and down - Kneecaps face straight ahead when feet are in good position - Looking at knees from the side knees or straight neither flex nor hyper extended common faulty postures of the knees and legs - knock knees o knees touch one feed auto part - bowlegs o knees are apart when feet touch - hyper extended knee o knee curves backwards - flex knee o knee bend slightly forward, that is, it is not as straight as it should be - medially rotated femur o kneecaps face slightly toward each other o crosseyed kneecaps - laterally rotated femurs o kneecaps face slightly outwards o frog eyed kneecaps

Overload Principal

Overload Principal - In order for a muscle to adapt and become stronger, the load that is placed on it must be greater than what is normally accustomed - in resistance training, the volume (sets and reps) or intensity (resistance ) of the exercise can be altered to provide a greater challenge to muscle

Oxford Technique to exercise programs

Oxford Technique to exercise programs First set - 10 reps x 100% of 10 reps max Second set - 10 reps x 75% of 10 reps max Third set - 10 reps x 50% of 10 reps max

what muscle does finger adduction

Palmer interossei

Palmer radiocarpal ligament What does it do? Origin and insertion?

Palmer radiocarpal ligament What does it do? - Maintains the alignment of the associated joint structures and limits hyperextension of the wrist Origin and insertion? - Origin Anterior surface of the distal radius - Attaches to the capitate, triquetrum, scaphoid

What three muscles do AB duction of the shoulder joint

Pec major - Latissimus dorsi - Teres major

What three muscles do eversion

Peroneus longest - Peroneus Brevis - Peroneus tertius

Pes anserine what muscles commonly insert here? location?

Pes anserine what muscles commonly insert here? - gracilis - Semitendinosus - Sartorius muscle location? - Located medial and distal to the tibial tuberosity

Phases of rehab after an amputation pre prosthetic phase Prosthetic phase

Phases of rehab after an amputation pre prosthetic phase - immediately post amputation - six weeks - therapy is focused on protecting the limb , preventing contractures, developing single limb mobility skills, and preparing the patient for a prosthetic phase of rehab - occasionally patients are fitted with an IPOP immediate post operative prosthesis Prosthetic phase - evaluated for first prosthesis once the sutures or staples have healed and the residual limb skin integrity is intact usually 4-6 weeks - begin wearing a shrinker once the sutures are removed - first prosthetic limb is a temporary prosthesis - Permanent prosthesis is given one's residual limb volume fluctuations have stabilized

Plethysmography

Plethysmography - A method for calculating body density utilizing the amount of air displaced during testing within a specialized closed chamber - Changing pressure within the chamber is measured and converted to the percentage of body fat using a standardized equation

Plicae what are they? What is their function?

Plicae what are they? - Extensions of the synovial membranes that are sometimes found in the anterior knee most commonly medial to the Patella What is their function? - They do not serve a specific function , they can be a source of anterior knee pain

Polycentric knee

Polycentric knee - refers to a knee joint that has multiple axes of rotation that allows for a more neutral gait cycle when compared to a single axis knee

Posterior cruciate ligament PCL Common mechanism of injury Special test designed to assess the integrity of the PCL?

Posterior cruciate ligament PCL Common mechanism of injury - Superior portion optivia is stuck while the knee is flexed - Leg collide against the dashboard Special test designed to assess the integrity of the PCL? - posterior draw test - Posterior sag sign

Posterior longitudinal ligament what motion does it limit ?

Posterior longitudinal ligament what motion does it limit ? - limited flexion of the spine and reinforces the posterior aspect of the intervertebral disc

Power

Power - the rate at which work is performed - work divided by time - the greatest amount of force that can be produced within a muscle during a single contraction - assessed as one Rep Max 1RM

Pronation

Pronation o ankle rolls in o weight on inner side of the foot

Pubofemoral ligaments Origin and insertion? What motion is it prevent?

Pubofemoral ligaments Origin and insertion? - Extends from pubic portion of the rim of the acetabulum to the neck of the femur What motion is it prevent? - Prevents excessive AB duction of the femur and limits hip extension

Q angle

Q angle - degree of angulation present when measuring from the mid Patella to the anterior superior iliac spine and to the tibial tubercle - Normal Q angle measured in supine with knee straight = 13 degrees for males , 18 degrees for females - abnormal Q angle can lead to pathology an abnormal tracking

Radial gutter splint what is it, where does it go? indications for radial gutter splint ? position of body in splint ?

Radial gutter splint what is it, where does it go? - rigid splint that covers the radial side of the forearm in hand as well as the second and third digits - Splint includes a thenar hole to allow for free movement of thumb indications for radial gutter splint ? - used to immobilize the metacarpals and phalanges following a fracture of the structures position of body in splint ? - MCP joints 60 -90 degrees of flexion - IP joints in full extension - wrist in slight extension

Radio humeral joint Concave versus convex surfaces which is which ? what is the loose pack position? what is the close pack position ? what is the capsular pattern ?

Radio humeral joint Concave versus convex surfaces which is which ? - capitulum of the distal humerus = convex ball shape - distal joint surface head of radius = concave what is the loose pack position? - Full extension, supination what is the close pack position ? - 90 degrees of flexion, 5 degrees supination what is the capsular pattern ? - flexion, extension, supination, pronation

Rest Interval

Rest Interval - recovery time between sets - longer rest interval for high intensity o 3 or more mins - Short rest intervals for lower intensity o 1-2 min - Lower fitness = longer rests

Reversibility Principle

Reversibility Principle - States that the adaptation seen with resistance training are reversible at the body is not regularly challenged with the same level of resistance or greater - these reversible effects can begin one -two weeks stopping an exercise program

Rotator cuff repair How to grade up a rotator cuff tear ? General precautions

Rotator cuff repair How to grade up a rotator cuff tear ? - according to depth , full versus partial and according to wdth - small is less than 1 centimeter, medium is 1 to 3 centimeters wide, large is 3 to 5 centimeters wide , massive is greater than 5 centimeters General precautions - no active range of motion - no lifting - no weight bearing

SACH

SACH - a type of foot system for prosthetics - inexpensive , low maintenance - cannot accommodate for uneven services

SAID principle

SAID principle - specific adaptation to imposed demands - states that the body will adapt according to the specific type of training that is utilized - Trim prove function type of training should specifically mirror the desired goal

Sacral plexus

Sacral plexus - formed by the lumbosacral trunk , the ventral rami of S1 - S3 and the descending portion of S4 - supplies the muscles of the buttocks, and through the sciatic nerves innervates the muscles of the posterior thigh and lower leg

Shoulder Adduction goniometric technique - Patient position: - Stabilization: - End-feel: - Axis: - Stationary arm: - Moving arm: - ROM norm:

Shoulder Adduction goniometric technique - Patient position: Supine - Stabilization: thorax to prevent lateral flexion of the spine - End-feel: firm - Axis: anterior aspect of the acromial process - Stationary arm: parallel to the midline of the anterior aspect of the sternum - Moving arm: medial midline of the humerus - ROM norm: ?

Shoulder abduction goniometric technique - Patient position: - Stabilization: - End-feel: - Axis: - Stationary arm: - Moving arm: - ROM norm:

Shoulder abduction goniometric technique - Patient position: supine - Stabilization: thorax to prevent lateral flexion of the spine - End-feel:firm - Axis: anterior aspect of the acromial process - Stationary arm: parallel to midline of the anterior aspect of the sternum - Moving arm: medial midline of the humerus - ROM norm: 0-180

Sinus Tarsi Where is it located?

Sinus Tarsi Where is it located? - is the space between the inferior tallus, superior calcaneus, and anterior portion of the lateral malleolus - injured during a common inversion ankle sprain

Spinal Fusion - Indications for spinal Fusion - Post surgical precautions - when does outpatient occur?

Spinal Fusion - Indications for spinal Fusion o presence of axial pain with unstable spinal segments o advanced arthritis o uncontrolled peripheral pain - Post surgical precautions o weight lifting precautions o restricted active motion such as bending or twisting o logrolling encouraged - when does outpatient occur? o six weeks after the surgery maybe sooner F fixation device used

Stages of gripping

Stages of gripping 1. hand opens fully through activation of wrist and finger extensors and hand intrinsics 2. fingers move around object enclosed to grasp object through activation of finger flexors and hands intrinsics 3. the force of the grasp is modified based on the shape, weight, fragility, an surface characteristics of the object 4. the object is released by opening the hand through activation of the extensor musculature

Sternoclavicular joint what is the loose pack position What is the closed pack position what is the capsular pattern

Sternoclavicular joint what is the loose pack position - arm resting by the side What is the closed pack position - maximum shoulder elevation what is the capsular pattern - pain at extremes of range of movement

Stress versus strain

Stress versus strain stress - stress is equal to the amount of force applied to a tissue - vertical axis on graph strain - drain is equal to the amount deformation of tissues - horizontal axis on graph

Subacromial Bursa where is it located ? What does it do ?

Subacromial Bursa where is it located ? - extends over the supraspinatus tendon and the distal muscle belly, beneath the acromion and deltoid muscle. What does it do ? - facilitates movement of the deltoid muscle over the fibrous capsule of the shoulder joint and supraspinatus tendon

Subacromial decompression What condition is done for ? is recovery rapid or slow?

Subacromial decompression What condition is done for ? - shoulder impingement is recovery rapid or slow? - rapid - sling is used one to two weeks

Subscapular Bursa where is it located ?

Subscapular Bursa where is it located ? - these subscapular Bursa overlies the anterior joint capsule and lies beneath the subscapularis muscle - Anterior shoulder fullness may indicate articular effusion secondary to distention of the bursa

Subtalar Range of motion norms - Inversion - Eversion

Subtalar Range of motion norms - Inversion 0-5 - Eversion 0-5

Subtalar eversion goniometric technique - Patient position: - Stabilization: - End-feel: - Axis: - Stationary arm: - Moving arm: - ROM norm:

Subtalar eversion goniometric technique - Patient position: prone with the foot extended over a supporting surface - Stabilization: tibia and fibula to prevent knee and hip motion - End-feel: firm or hard - Axis: posterior aspect of the ankle midway between the malleoli - Stationary arm: posterior midline of the lower leg - Moving arm: posterior midline of the calcaneus - ROM norm: 0-5

Subtalar inversion goniometric technique - Patient position: - Stabilization: - End-feel: - Axis: - Stationary arm: - Moving arm: - ROM norm:

Subtalar inversion goniometric technique - 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 the ankle midway between the malleoli - Stationary arm: posterior midline of the lower leg - Moving arm: posterior midline of the calcaneus - ROM norm: 0-5

Surgeries for meniscus injuries What is a partial meniscectomy ? why wood suturing the meniscus back together be chosen over a partial meniscectomy? Rehab protocol following a meniscus repair rehab protocol following a partial meniscectomy

Surgeries for meniscus injuries What is a partial meniscectomy ? - the torn piece of meniscus is removed arthroscopically - this option is usually chosen for older individuals or when the tear occurs in the inner 2/3 of the meniscus where the healing capacity is poor why wood suturing the meniscus back together be chosen over a partial meniscectomy? - partial meniscectomy is better for older individuals or when the tear occurs in the inner 2/3 of the meniscus where the healing capacity is poor - suturing that air is more likely to be chosen in younger patients outer 1/3 of the meniscus Rehab protocol following a meniscus repair - period of restricted weight bearing in addition to bracing - limits on progression of range of motion , specifically with flexion rehab protocol following a partial meniscectomy - patient is full weight bearing without the use of brace - there are no rehab restrictions and recovery time is significantly quicker

Talipes Equinovarus

Talipes Equinovarus What is it: - AKA a clubfoot - conformity characterized by the heel pointing downward and the four foot turning inward Etiology: - unknown Signs and symptoms: - a DD of four foot - various positioning of hindfoot - equinus at the ankle Treatment: - medical management begins shortly after birth and includes splinting and serial casting - goal is to restore proper positioning of foot and ankle - possible surgical intervention

Capsular pattern of Talocalcaneal (subtalar) joint

Talocalcaneal (subtalar) joint - limitation of varus range of movement

Capsular pattern of Talocrural Joint

Talocrural Joint - Planter flexion, dorsal flexion

Talocrural Joint AKA ankle - loose packed : - close pack position:

Talocrural Joint AKA ankle - loose packed position : 10 degrees of planter flexion, midway between maximum inversion and eversion - close pack position: maximum dorsi flexion

Taylor brace

Taylor brace - thoracolumbosacral ortho sis that limits trunk flexion an extension through a 3 point control design

What three muscles primarily elevate the temporomandibular joint

Temporalis masseter, medial pterygoid

Tendonitis

Tendonitis - a condition caused by an acute or chronic inflammation of a tendon - Symptoms include gradual onset, tenderness, swelling, pain

Thoracic and lumbar spine Range of motion norms - Flexion - Extension - Lateral flexion - Rotation

Thoracic and lumbar spine Range of motion norms - Flexion 0-80 - Extension 0-25 - Lateral flexion 0-35 - Rotation 0-45

Thumb carpometacarpal Range of motion norms - Flexion - Extension - Abduction - Opposition

Thumb carpometacarpal Range of motion norms - Flexion 0 -15 - Extension 0 -20 - Abduction 0-70 - Opposition thumb to base of fith digit

What three muscles do inversion

Tibialis posterior - Tibialis anterior - Flexor digitorum longus

Capsular pattern of Tibiofibular Joint

Tibiofibular Joint - pain when joint is stressed

Torque

Torque - The ability of an external load to produce rotation around an axis - magnitude of the load x moment arm = torque

Total shoulder arthroplasty - Indications for total shoulder arthroplasty o joint components have become arthritic o secondary to fractures or rotator cuff arthropathy - what is a shoulder hemiarthroplasty o replaces only glenoid or humoral surfaces - what is a reverse total shoulder arthroplasty? o Reversing the concave convex relationship

Total shoulder arthroplasty - Indications for total shoulder arthroplasty o joint components have become arthritic o secondary to fractures or rotator cuff arthropathy - what is a shoulder hemiarthroplasty o replaces only glenoid or humoral surfaces - what is a reverse total shoulder arthroplasty? o Reversing the concave convex relationship

Transfer of training principle

Transfer of training principle - there can be a carryover effect from one exercise or task to another - carryover effect are far less Beneficial from more specific training

What two muscles do extension of the elbow

Triceps brachii O: I: A: N: - anconeus

What's the difference between type one and type 2 muscle fibers

Type 1 - Aerobic , red, tonic, slowtwitch, slow oxidative - low fatigue ability, high capillary density, high myoglobin content, small fibers, extensive blood supply, large amount of mitochondria, examples marathon swimming Type 2 - Anaerobic, red /white , basic, fast twitch, fast glycolytic - high fatigue ability, low capillary density, low myoglobin content, large fibers, less blood supply, fewer mitochondria, examples high jump sprinting

Types of End-Feels (pg 79)

Types of End-Feels (pg 79) - Firm o normal stretching tissues o abnormal maybe due to increased tone, tightening of the capsule, ligament shortening - hard o normal is hard bone and bone like elbow extension o abnormal maybe due to fractures, osteoarthritis, osteophyte formation - soft o normal is tissue approximation such as flexion or knee flexion o abnormal is edema, synovitis, ligament instability - empty o cannot reach in field, usually due to pain o never normal

Ulnar collateral ligament AKA medial collateral ligament where does it attach ? what motion does it prevent ?

Ulnar collateral ligament AKA medial collateral ligament where does it attach ? - runs from the medial epicondyle of the humerus to the proximal portion of the ulna what motion does it prevent ? - prevents extensive Abd of the elbow joint

Ulnohumeral joint what is the loose pack position? what is the close pack position ? what is the capsular pattern ?

Ulnohumeral joint what is the loose pack position? - 70 degrees elbow flexion, 10 degrees supination what is the close pack position ? - extension what is the capsular pattern ? - flexion and extension

What to muscles do upward rotation of the scapula

Upper and lower trapezius - serratus anterior

What two muscles do elevation of the scapula

Upper trapezius - levator scapulae

Valsalva maneuver

Valsalva maneuver - technique that is often used to increase the intra abdominals and intrathoracic pressures during anaerobic activities that require a large effort , such as lifting a heavy box - maneuver is performed by forcefully exhale against a closed glottis, nose, throat while simultaneously contracting the abdominal muscles - increase in internal pressure helps the spine during heavy exertion and is therefore employed during powerlifting to help improve performance - the valsalva maneuver leads to negative cardiovascular effects and should be avoided in all patients but especially for patients with cardiovascular disease, intervertebral disc pathology, or who have recently undergone eye surgery - valsalva maneuver should be avoided and patients should be taught to avoid it - to avoid the valsalva maneuver patients should be taught to breathe rhythmically and to exhale during the portion of exercise that requires more exertion

Volar/dorsal forearm splint what is it, where does it go? What is it used to treat ? how to position the splint?

Volar/dorsal forearm splint what is it, where does it go? - rigid splint that extends from the proximal forearm to the metacarpal heads , allowing for full elbow an MCP joint motion - includes a thenar hole to allow for movement of the thumb What is it used to treat ? - immobilize the wrist and is commonly used for treating fractures of the carpals, fractures of the distal radius or ulna, or soft tissue conditions (sprain, tendonitis ) how to position the splint? - position of splint varies based on the condition being treated - the splint can also place the wrist and hand in a functional position to allow for improved grasping - place the rest in 20 degrees of extension, the finger flexors are shortened and have improved mechanical advantage for grasping

resistance training parameters Volume

Volume - sets and reps - total amount of work performed - reps x intensity = volume

What are the functions of an orthotic?

What are the functions of an orthotic? - preventing deformity - maintaining proper alignment - inhibiting tone - assisting weak limbs - protecting against injury - facilitating motion

What are the most likely contractions for a .... transmetatarsal and Symes imputation transtibial amputation transfemoral amputation

What are the most likely contractions for a .... transmetatarsal and Symes imputation - equinus deformity transtibial amputation - knee flexion transfemoral amputation - hip flexion and abd

What are the therapy techniques for hypersensitive limbs after amputation ?

What are the therapy techniques for hypersensitive limbs after amputation ? - weight bearing - massage - tipping - wrapping

What are the types of juvenile rheumatoid arthritis? 3

What are the types of juvenile rheumatoid arthritis? - systematic JRA o 10 to 20% of cases o acute onset o high fever o rash o enlargement of spleen and liver o inflammation of lungs and heart - polyarticular JRA o 30 to 40% of cases o hi female incident o significant rheumatoid factor o arthritis in more than four joints with symmetrical joint involvement - oligoarticular (pauciarticular) JRA o 40 to 60% of cases o affects less than five joints with asymmetrical joint involvement

What is the anatomical snuffbox ? -

What is the anatomical snuffbox ? - depression on dorsal surface of wrist - Boarded by AB doctor pollicis longus, extensor pollicis brevis, extensor pollicis longus - Use the palpate scaphoid

What is the difference between blood supply in type 1 muscle fibers and type 2 muscle fibers

What is the difference between blood supply in type 1 muscle fibers and type 2 muscle fibers - type 1 equals extensive blood supply - Type 2 equals less blood supply (which muscle fiber is aerobic versus anaerobic - aerobic = type 1 (slow) - anerobic = type 2 (fast))

What is the expected difference in grip strength between dominant and non dominant hand?

What is the expected difference in grip strength between dominant and non dominant hand? - normally a patient's dominant grip strength is 5 to 10 pounds greater than the non dominant hand

What is the most common type of shoulder dislocation and how does it occur?

What is the most common type of shoulder dislocation and how does it occur? - anterior dislocation most common and associated with Abd and lateral rotation

What motion do the acromioclavicular ligaments prevent ?

What motion do the acromioclavicular ligaments prevent ? - horizontal movements of the clavicle

What motion does the ACL prevent?

What motion does the ACL prevent? - Anterior movement of tibia on femur

What motion does the lateral collateral ligament prevent at the knee

What motion does the lateral collateral ligament prevent - Prevents excessive varus displacement of the tibia relative to femur

What occurs to the base of support as cadence increases ? s

What occurs to the base of support as cadence increases ? - Base of support is the width - the distance decreases as the cadence increases - average base of support for an adult is 2 to 4 inches

What percent of gate is in stance phase?

What percent of gate is in stance phase? - 60%

What portion of the spinal disk is compressed with flexion?

What portion of the spinal disk is compressed with flexion? flexion a vertebral segment causes the anterior portion of the disk to be compressed and posterior portion of disk to be distracted

Where should a plum line fall with proper posture Corona suture Odontoid process AKA Dens shoulder lumbar hip joint knee joint lateral malleolus calcaneocuboid joint

Where should a plum line fall with proper posture Corona suture - Plumb line slightly posterior to Corona suture external auditory meatus - Plumb line should fall through the middle of the external auditory meatus Odontoid process AKA Dens - through the access of the odontoid process shoulder - midway through the tip of the shoulder lumbar - for the bodies of the lumbar vertebrae hip joint - slightly posterior to the hip joint knee joint - slightly anterior to the access of the knee joint lateral malleolus - slightly anterior to the lateral malleolus calcaneocuboid joint - 30 calcaneocuboid joint

Which joint of the cervical spine does the yes motion? What joint of the cervical spine does the "no" motion?

Which joint of the cervical spine does the yes motion? - Atlanto occipital joint What joint of the cervical spine does the "no" motion? - Atlanto axial joint

Which muscle fiber is slow twitch and which muscle fiber is fast twitch?

Which muscle fiber is slow twitch and which muscle fiber is fast twitch? - Slowtwitch = type one - Fast twitch = type 2

Work

Work - the magnitude of the load (weight) x the distance the load is moved (ROM used ) = work

Wrist extension goniometric technique - Patient position: - Stabilization: - End-feel: - Axis: - Stationary arm: - Moving arm: - ROM norm:

Wrist extension goniometric technique - Patient position: sitting next to a supporting surface with a shoulder Abd to 90 degrees and the elbow flex to 90 degrees - Stabilization: radius and ulna to prevent supination or pronation - End-feel: firm - Axis: lateral aspect of the wrist over the triquetrum - Stationary arm: lateral midline of the owners in the olecranon an ulna styloid process for reference - Moving arm: lateral midline of the 5th metacarpal - ROM norm: 0-70

Wrist flexion goniometric technique - Patient position: - Stabilization: - End-feel: - Axis: - Stationary arm: - Moving arm: - ROM norm:

Wrist flexion goniometric technique - Patient position: Sitting next to a supporting surface with the shoulder Abd to 90 degrees and the elbow flex to 90 degrees - Stabilization: radius and ulna to prevent supination or pronation - End-feel: firm - Axis:lateral aspect of the wrist over the triquetrum - Stationary arm: lateral midline of the ulna using the olecranon an ulnar styloid process for reference - Moving arm: lateral midline of the 5th metacarpal - ROM norm:0-80

Zygapophyseal Joints Formed by?

Zygapophyseal Joints Formed by - formed by Right and left superior articular facettes of one of the vertebra in their right and left inferior articular facettes with the adjacent superior vertebra

What muscle does thumb AB duction

abductor pollicis longus and brevis

acetabular labrum Function?

acetabular labrum Function? - Enhances The depth of the acetabulum

Capsular pattern of acromioclavicular joint

acromioclavicular joint - pain at extremes of range of movement

what muscle does thumb adduction

add pollicis

What for muscles do adduction of the hip

adductor Magnus - adductor longus - Adductor brevis - Gracilis

approximately 1% of older adults with limb loss due to vascular disease will die within five years?

approximately 1% of older adults with limb loss due to vascular disease will die within five years? - 50% of older adults with limb loss due to vascular disease will die within five years , of the remaining individuals 50% will experience another amputation

Capsular pattern of atlanto-occipital joint

atlanto-occipital joint - extension, side bending equally limited

What three muscles do flexion of the elbow

biceps brachii O: I: A: N: - Brachialis - Brachioradialis

What two muscles do supination

biceps brachii O: I: A: N: - Supinator

What four muscles do flexion of the knee

biceps femoris - Semitendinosus - Semimembranosus - Sartorius

capillary density of type one versus type 2 muscle fibers

capillary density of type one versus type 2 muscle fibers - Type 1 high capillary density - Type 2 low capillary density (which muscle fiber is aerobic versus anaerobic - aerobic = type 1 (slow) - anerobic = type 2 (fast))

carpal tunnel

carpal tunnel - Located close to the deep surface of the flexor right macula - Median nerve enters through here

carpometacarpal joint - loose packed : - close pack position:

carpometacarpal joint - loose pack position : midway between Abd-ADD and flexion-extension - No closed packed position

Capsular pattern of cervical spine

cervical spine lateral flexion and rotation equally limited, extension

classes of levers - where is the axis? - example

class 1 lever Axis in the middle seesaw Very few in the body Class 2 lever effort can be smaller than load wheelbarrow class 3 lever effort has to be much larger than load most common type of lever in the body

common resulting postures of the shoulders, hips, spine due to left handedness

common resulting postures of the shoulders, hips, spine due to left handedness - slight low left shoulder - slightly high left hip - slight deviation of the spine to the right - note this is not considered incorrect posture

common resulting postures of the shoulders, hips, spine due to right handedness

common resulting postures of the shoulders, hips, spine due to right handedness - Slightly low right shoulder - slightly high right hip - slight deviation to the left for spine - Note this is not considered incorrect posture

congenital hip dysplasia What is it: Etiology: Signs and symptoms: special tests Treatment:

congenital hip dysplasia What is it: - AKA developmental dysplasia - malalignment of the femoral head within the acetabulum - develops during the last trimester in utero Etiology: - cultural predisposition - malposition in utero - genetic influences - environmental influences Signs and symptoms: - asymmetrical hip Abd with tightness an femoral shortening of the involved side special tests - Ortalani's test - barlows test - ultrasound Treatment: - variable on age, severity, previous treatments - reposition the femoral head within the acetabulum o bracing o harness o splinting o traction - surgery o PT after surgery for stretching, strengthening , education

congenital torticollis What is it: Etiology: Signs and symptoms: Treatment:

congenital torticollis What is it: - AKA "wry neck" - unilateral contracture of sternocleidomastoid muscle Etiology: - unknown Signs and symptoms: - same side as contracture side bending - rotation two opposite side of contraction - facial asymmetry Treatment: - stretching - range of motion - positioning - education - surgical management if very severe or over one year of age

contusion

contusion - a sudden blow to a part of the body that can result in mild to severe damage to superficial and deep structures - Treatment includes active range of motion, ice, compression

arthrokinematics motions of the Distal radioulnar joint

convex - concave rule convex surface moving on concave surface - roll and slide occur in opposite directions - mobilizing force should be applied in the opposite direction of the bow and movement concave surface moving on convex surface - roll and slide occur in same direction - mobilizing force should be applied in the same direction as the bones move

arthrokinematics motions of the glenohumeral joint

convex - concave rule convex surface moving on concave surface - roll and slide occur in opposite directions - mobilizing force should be applied in the opposite direction of the bow and movement concave surface moving on convex surface - roll and slide occur in same direction - mobilizing force should be applied in the same direction as the bones move

arthrokinematics motions of the proximal and distal interphalangeal joints of digits 2 -5 joint

convex - concave rule convex surface moving on concave surface - roll and slide occur in opposite directions - mobilizing force should be applied in the opposite direction of the bow and movement concave surface moving on convex surface - roll and slide occur in same direction - mobilizing force should be applied in the same direction as the bones move

arthrokinematics motions of the radiocarpal joint

convex - concave rule convex surface moving on concave surface - roll and slide occur in opposite directions - mobilizing force should be applied in the opposite direction of the bow and movement concave surface moving on convex surface - roll and slide occur in same direction - mobilizing force should be applied in the same direction as the bones move

corset what is it ? was it used to treat ?

corset what is it ? - a spine orthotic - constructed of fabric and may have metal operates within the material to provide abdominal compression and support was it used to treat ? - provide pressure and relieve pain associated with mid and low back pathology

costoclavicular ligament where does it attach? What does it do?

costoclavicular ligament where does it attach? - Between the medial portion of the clavicle in the first rib What does it do? - primary supporting ligament for the sternoclavicular joint

cubital fossa where is it located ? What structures does it contain ?

cubital fossa where is it located ? - a triangular space located at the anterior elbow that is bordered by the brachioradialis, pronator teres, brachialis, and a horizontal line passing through the humoral epicondyles What structures does it contain ? - biceps brachii tendon - Median nerve - Radial nerve - Brachial artery - Median cubital vein

dermatome testing nerve root levels - C2 - C3 - C4 - C5 - C6 - C7 - C8 - T1 - L2 - L3 - L4 - L5 - S1 - S2 - S3 - S5

dermatome testing nerve root levels posterior head - C2 posterior lateral neck - C3 acromioclavicular joint - C4 lateral arm - C5 lateral forearm and thumb - C6 Palmer distal phalanx of the middle finger - C7 little finger an ulnar border of hand - C8 medial forearm - T1 anterior thigh - L2 middle third of anterior thigh - L3 Patella and medial malleolus - L4 fibular head and dorsum of foot - L5 lateral an planter aspect of foot - S1 medial aspect of posterior thigh - S2 perianal area - S3 - S5

Capsular pattern of distal radioulnar joint

distal radioulnar joint - full range of movement, pain at extremes of rotation

dorsal radiocarpal origin and insertion ? what motion does it limit ?

dorsal radiocarpal origin and insertion ? - origin on the posterior surface of the distal radius and styloid process of the radius - insertion lunate and triquetrum what motion does it limit ? - limits wrist flexion

eccentric and concentric contractions a type of isometric or isotonic contraction?

eccentric and concentric contractions a type of isometric or isotonic contraction? - Isotonic, the muscle is exerting a continual force

elbow Range of motion norms - Flexion - Extension

elbow Range of motion norms - Flexion 0 - Extension 0 -150

endoskeletal Shank exoskeletal Shank

endoskeletal Shank - this type of Shank consists of a rigid pylon covered with a material design to simulate the contour and color of the contralateral limb exoskeletal Shank - this type of Shank consists of rigid external frame covered by a thin layer of tinted plastic to match the skin color distally

excessive knee flexion during stance prosthetic causes: amputee causes:

excessive knee flexion during stance prosthetic causes: - socket set forward in relation to foot - excessive dorsi flexion - stiff heel - prosthesis too long amputee causes: - knee flexion contracture - hip flexion contracture - pain anterior in residual limb - decrease in quadricep strength - poor balance

What three muscles do wrist extension

extensor carpi radialis longus O: I: A: N: - Extensor carpi radialis brevis - extensor carpi ulnaris

What two muscles do ulner deviation

extensor carpi ulnaris O: I: A: N: - Flexor carpi ulnaris

What three muscles do finger extension

extensor digitorum communis - Extensor indices 2nd digit - extensor digiti minimi 5th digit

What two muscles do thumb extension

extensor pollicis longus and brevis - Abductor pollicis longus

facets of Spine - loose packed : - close pack position:

facets of Spine - loose packed :midway between flexion and extension - close pack position: extension

femoral triangle Location? What can be palpated in this space ? what Goes through it ?

femoral triangle Location? - Anterior that is bordered by the inguinal ligament, sartorius, adducteur longest period What can be palpated in this space ? - Femoral artery, lymph glands what Goes through it ? - femoral nerve and vein

Capsular pattern of first metatarsophalangeal joint

first metatarsophalangeal joint - extension, flexion

What three muscles do wrist flexion

flexor carpi radialis O: I: A: N: - Flexor carpi ulnaris - Palmaris longest

What four muscles do finger flexion

flexor digitorum profundus and superficialis O: I: A: N: - flexor digiti minimi for the fifth finger O: Metatarsal 5 I: Proximal phalanx of 5th toe A: Flexes 5th toe at MTP N: Lateral plantar n. S1-2 - interossei O: I: A: N: - Lumbricals O: I: A: N:

What two muscles do thumb flexion

flexor pollicis longus and brevis - Opponents pollicis

foot orthosis

foot orthosis - semi rigid or rigid insert worn inside a shoe - correct foot alignment improves function - may also relieve pain - custom molded

forward trunk flexion prosthetic causes: amputee causes:

forward trunk flexion prosthetic causes: - socket too big - poor suspension - Knee instability amputee causes: - hip flexion contracture - weak hip extensors - pain with ischial weight bearing - inability to initiate prosthetic knee flexion

which direction is the coronal plane ?

frontal - divide into anterior posterior

genu valgum Genu verum

genu valgum - a condition where the knees touch when standing with the feet separated - Valgum will increase compression of the lateral joint line an increase stress to the medial structures - AKA knock kneed Genu verum - condition where there is bowing of the legs with the added space between the knees - Verum will increase impression of the medial joint line and increased rest to the lateral structures - AKA bowleg

Capsular pattern of glenohumeral joint

glenohumeral join - lateral rotation, Abd , medial rotation

glenohumeral joint - loose packed : - close pack position:

glenohumeral joint - loose packed : 55 degrees of AB duction 30 degrees of horizontal adduction - closed park position: Abd and lateral rotation

glenohumeral joint what is the loose pack position of the glenohumeral joint What is the closed pack position of the glenohumeral joint what is the capsular pattern of the glenohumeral joint

glenohumeral joint what is the loose pack position of the glenohumeral joint - 55 degrees of Abd, 30 degrees horizontal ADD What is the closed pack position of the glenohumeral joint - Abd and lateral rotation what is the capsular pattern of the glenohumeral joint - Lateral rotation, Abd, medial rotation

What is a 2/5 MMT

gravity eliminated moves through full range of motion

heel cup

heel cup - rigid insert that covers the planter surface of the calcaneus an extends upwards on all three sides - helps to stabilize calcaneous in neutral position as well as provides some shock absorption - used for patients with a calcaneal spur or plantar fasciitis

heel cushion

heel cushion - soft pad that is placed on the heel of the inner sole to help cushion a heel and thus decrease pain in that region - used for a patient with a calcaneal spur or planter fasciitis

heel lift

heel lift - rigid insert which adds extra height to the heel of a shoe - used to take pressure off Achilles tendon for patients with Achilles tendonitis or a recent repair of the tendon - also used to help limit the effects of leg length discrepancy

hip joint - loose packed : - close pack position:

hip joint - loose packed position : 30 degrees of flexion, 30 degrees of Abd, slight lateral rotation - close packed position : full extension, medial rotation

hip knee ankle foot orthosis HKAFO

hip knee ankle foot orthosis HKAFO - indicated for patients with hip, foot, knee, an ankle weakness - bilateral knee ankle foot orthosis with an extension to the hip joint and a pelvic band - controls rotation at the hip and Abd/Add - heavy restricts patients to a swing to our swing through gait pattern

iliofemoral joint What makes up the iliofemoral joint? Loose pack position Close pack position Capsular pattern

iliofemoral joint What makes up the iliofemoral joint? - Consist of the acetabulum (oriented laterally, inferiorly anteriorly ) distal joint surface consists of convex head of femur Loose pack position - 30 degrees flexion, 30 degrees AB duction, slight lateral rotation Close pack position - Full extension, medial rotation Capsular pattern - Question on abjection, medial rotation (sometimes medial rotation is most limited )

iliofemoral ligament What does it prevent Origin and insertion?

iliofemoral ligament What does it prevent - excessive hip extension an assist to maintain upright posture Origin and insertion? - Anterior inferior iliac spine of the pelvis - Intertrochanteric line of femur

What for muscles do flexion of the hip

iliopsoas - Sartorious - Rectus femoris - Pectineus

impingement syndrome What is it: Etiology: Signs and symptoms: Treatment:

impingement syndrome What is it: - one of the most common injuries of the shoulder - caused by repetitive microtrauma from upper extremity activity performed above the horizontal plane Etiology: - activities that place at risk o throwing o Swimming o racquet sports - humoral head an rotator cuff attachments migrating proximately an becoming impinged under the acromion and coracoacromial ligament Signs and symptoms: - Discomfort or mild deep pain - pain with overhead activities - painful arc of motion 70 -120 degrees Abd - positive impingement sign - tenderness over the greater tuberosity and the bicipital groove Treatment: - RICE - NSAIDs - activity modification - once tolerated o rotator cuff strengthening and scapular stability exercises - long term prevention o strengthening rotator cuff and scapular stabilizers o improved biometrics

interosseous membrane Location? What is its function?

interosseous membrane Location? - Connective tissue that runs obliquely from radius to older What is its function? - Stabilizer against axial force is applied to the wrist

interphalangeal joint - loose packed : - close pack position:

interphalangeal joint - loose pack position : slight flexion - close pack position :full extension

knee ankle foot orthosis KAFO

knee ankle foot orthosis KAFO - provides support and stability to the knee and ankle - fabricated using two metal uprights extending from the foot/shoe to the thigh with calf and thigh bands - custom molding - allows for a lock mechanism at the need to provide stability

Capsular pattern of knee joint

knee joint - flexion, extension

knee joint - loose packed : - close pack position:

knee joint - loose packed position : 25 degrees of flexion - close pack position: full extension, lateral rotation of tibia

lateral bending prosthetic causes: amputee causes:

lateral bending prosthetic causes: - prosthesis too short - improperly shaped lateral wall - high medial wall - prosthesis aligned in abd amputee causes: - poor balance - abd Contracture - improper training - short residual limb - weak hip abd on prosthetic side - hypersensitivity and painful residual limb

ligamentum Teres Location? Function ?

ligamentum Teres Location? - Ligament of the head of the femur Function ? - provides a physical attachment between the head of the femur an inferior rim of the acetabulum - Blood vessels and nerves travel within this ligament to the head of the femur - Ligament provides minimal stability to the hip

Capsular pattern of lumbar spine

lumbar spine - side bending and rotation equally limited, extension

lumentum nuchae function?

lumentum nuchae function? - Restricts flexion in the cervical spine

medial collateral ligament MCL of knee Common mechanism of injury? Special test designed to assess the integrity of the MCL?

medial collateral ligament MCL Common mechanism of injury? - Here valgus load any without rotation - Often with contact such as lateral blow to knee Special test designed to assess the integrity of the MCL? - Valgus stress test

medial collateral ligament sprain Etiology: - associated with activities o football Signs and symptoms: special tests: Treatment:

medial collateral ligament sprain Etiology: - Contact or non contact - fixed foot - external tibial rotation + valgus - associated with activities o football o skiing o soccer Signs and symptoms: - knee pain - swelling - antalgic gait - decrease range of motion - feeling of instability special tests: - valgus stress test Treatment: - RICE - NSAIDS - decreasing inflammation - protecting knee joint and ligament - range of motion - strengthening - surgery rarely required as MCL is well vascularised

medial or lateral whip prosthetic causes: amputee causes:

medial or lateral whip prosthetic causes: - excessive rotation of the knee - Tight socket fit - valgus in prosthetic knee - improper alignment of toe break amputee causes: - improper training - weak hip rotators - knee instability

meniscus of the knee Which side is thick versus thin? What is its function?

meniscus of the knee Which side is thick versus thin? - Bake at periphery and then at the internal attached edges - There is a lateral and medial one What is its function? - Defense the articular surface of the tibia where they articulate with the femorale condyles - Functions as a shock absorber an contributes to lubrication and nutrient of the joint

metacarpal phalangeal joint of fingers (not thumb) - loose packed : - close pack position:

metacarpal phalangeal joint of fingers (not thumb) - loose pack position: slight flexion - close packed position: full flexion

metacarpal phalangeal joint of thumb - loose packed : - close pack position:

metacarpal phalangeal joint of thumb - loose pack position : Slight flexion? - Close pack position : full opposition

Capsular pattern of metacarpophalangeal and interphalangeal joints

metacarpophalangeal and interphalangeal joints - flexion, extension

metatarsal bar/pad

metatarsal bar/pad - flat piece of padding that is placed just posterior to the metatarsal heads either on the outer soul (bar )or the inner soul (pad) of the shoes - the placement of the bar /pad helps relieve pressure from the metatarsal heads by transferring it to the metatarsal shafts thus relieving pain for patients with metatarsalgia

microprocessor

microprocessor - term used to describe type of knee prosthetic - multiple programs available to accommodate the activity level of the user - Allows for fluid management of descending stairs - Requires charging - Variable friction for improved swing and stance phase control

midtarsal joint - loose packed : - close pack position:

midtarsal joint - loose pack position : midway between extremes of range of movement - close packed position : supination

mobilization indications contraindications of mobilization

mobilization indications - restricted joint mobility, restricted accessory motion, desired neurophysiological effects contraindications of mobilization - active disease, infection, advanced osteoporosis, articular hyper mobility , fracture, acute inflammation, muscle guarding, joint replacement

myodesis

myodesis - the anchoring of muscle tissue or tendon to bone using sutures that are passed through small holes drilled in the bone - performed as a part of the amputation closure process

neuroma

neuroma - bundle of nerve endings that group together an can produce pain due to scar tissue

Bankart Lesion

o 85% of dislocations detached the glenoid labrum = Bankart Lesion

olecranon Bursa Where is it located ?

olecranon Bursa Where is it located ? - lies posterior to the olecranon process and is considered the main versa in the elbow - commonly becomes inflamed with direct trauma because of its superficial position

what muscles do opposition of the hand there are four of them

opponents pollicis - Flexor pollicis brevis - Abductor pollicis brevis - Opponents digiti minimi

osseointegration (endoprosthesis )

osseointegration (endoprosthesis ) - the process of implanting a prosthetic device directly into the residual limb of a person with limb loss - negates the need for a socket component

parapodium orthosis

parapodium orthosis - standing frame design to allow a patient to sit when necessary - prefabricated frame and ambulation is achieved by shifting weight and rocking the base across the floor - primarily used in Pediatrics

passive range of motion what is it ? indications benefits

passive range of motion what is it ? - external force without muscle activation - only within available range - it is considered stretching if the movement is beyond end range indications - patient is unable to physically move body segment such as coma or paralysis - patient is cognitively impaired and unable to move body segment - active movement is contraindicated such as post operative - active movement is painful - the therapist is preparing the joint for stretching - therapist is teaching an active movement through the patient benefits - improves mobility muscles of connective tissue and muscles - prevents joint contracture formation - improve circulation - improve synovial fluid movement for cartilage health - decreases pain - improve the patient's awareness of movement

pistoning

pistoning - the translation of the prosthetic limb from the residual limb - result of inadequate suspension in can result in distal residual limbs skin trouble

posterior longitudinal ligament function?

posterior longitudinal ligament function? - Limits flexion of the spine and reinforces the posterior aspect of the intervertebral discs

posterior sacroiliac ligament limits motion?

posterior sacroiliac ligament - strong ligament limits motion? - Limits motion of all sacral motions especially posterior rotation of the sacrum

What two muscles do pronation

pronator teres O: I: A: N: - Pronator quadratus

prosthesis versus prosthetic

prosthesis versus prosthetic - prosthesis = artificial body part used as a noun "my prosthesis is broken " - prosthetic = Describes artificial body part used as an adjective "the prosthetic limb is broken "

proximal radioulnar joint - loose packed : - close pack position:

proximal radioulnar joint - loose pack position : 70 degrees of flexion , 35 degrees of supination - closed packed position : 5 degrees of supination

Capsular pattern of proximal radioulnar joint

proximal radioulnar joint - supination, pronation

pylon

pylon - the term used to describe a pipe like structure used to connect the socket of a prosthetic to the foot / ankle component - assess with weight bearing and shock absorption

radial collateral ligament What motion does it limit Origin and insertion?

radial collateral ligament What motion does it limit - Limits owner deviation and becomes tight when the wrist is in extremes of extension and flexion Origin and insertion? - Origin from styloid process of the radius - Inserts on the scaphoid and triquetrum

radiocarpal joint AKA wrist - loose packed : - close pack position:

radiocarpal joint AKA wrist - loose packed position : neutral with slight ulnar deviation - closed packed position : extension with radial deviation

reciprocating gait orthosis RGO

reciprocating gait orthosis RGO - derivative of the HKAFO and incorporates a cable system to assist with advancement of the lower extremities during gait - when patient shifts weight onto selected lower extremity, cablesystem advances opposite lower extremity - use primarily for paraplegia

What for muscles do extension of the knee

rectus femoris - vastus latteralis - vastus intermedius - Vastus medialis

residuum

residuum - AKA residual limb

What three muscles do downward rotation of the scapula

rhomboids - levator scapulae - pect minor

rocker bar

rocker bar - similar to a metatarsal bar in it's placement (just posterior to the metatarsal heads on the outer soul ) though it consists of a convex strip instead of a flat strip - assist patients who have difficulty with the terminal stance phase of gate secondary to limited mobility within the foot , especially the great toe - helps relieve pressure from metatarsal heads for patients with pain in that area

rotation of forefoot at heel strike prosthetic causes: amputee causes:

rotation of forefoot at heel strike prosthetic causes: - excessive to out built in - Loose fitting socket - Inadequate suspension - Rigid SACH heel cushion amputee causes: - Poor muscle control - Improper training - Weak medial rotators - Short residual limb

rotationplasty

rotationplasty - an operation where a portion of the limb is removed while the remaining limb below is rotated an reattached - the procedure is often performed as a treatment for distal femoral osteosarcoma

rotator interval Where is it ?

rotator interval Where is it ? - the rotator interval is a space in the anterior superior shoulder that consists of and is bordered by the coraco humoral ligament, superior glenohumeral ligament, joint capsule, and supraspinatous and subscapularis tendons.

Capsular pattern of sacroiliac, symphysis pubis, sacrococcygeal joints

sacroiliac, symphysis pubis, sacrococcygeal joints - joints are stressed

should exercises with multiple joints be performed first or should single joint exercises be performed first?

should exercises with multiple joints be performed first or should single joint exercises be performed first? - multiple joint exercises should be performed before single joint exercises

should high intensity exercises or low intensity exercises be performed first? -

should high intensity exercises or low intensity exercises be performed first? - high intensity should be first

should large muscle groups or small muscle groups be exercised first?

should large muscle groups or small muscle groups be exercised first? - large muscle groups should be exercised first

shoulder Range of motion norms - Flexion - Extension - Abduction - Medial rotation - Lateral rotation

shoulder Range of motion norms - Flexion 0 -180 - Extension 0 -60 - Abduction 0 -180 - Medial rotation 0 -70 - Lateral rotation 0-90

stance control (safety mechanism )

stance control (safety mechanism ) - a weight activated mechanism that maintains knee extension during weight bearing even if the knee joint is not fully extended - used in prosthetics - Tiffany is flex greater than what the control mechanism is designed for, mechanism will not engage

sternoclavicular joint - loose packed : - close pack position:

sternoclavicular joint - loose packed : arm resting by side in normal physiological position - closed packed position : maximum shoulder elevation

Capsular pattern of sternoclavicular joint

sternoclavicular joint - pain at extremes of range of movement

subtalar joint - loose packed : - close pack position:

subtalar joint - loose packed position : midway between extremes of range of movement - close pack position : supination

sugar tong splint what is it, where does it go? how to position the splint ? what is it used to treat ?

sugar tong splint what is it, where does it go? - rigid splint that covers the wrist and elbow joints and allows for greater immobilization than a volar or dorsal forearm splint - splint limits supination and pronation in addition to any wrist motion - splint starts on the dorsum of the hand, extends along the dorsal forearm to wrap around the elbow, and continues along the volar forearm to end up the Palmer aspect of the hand how to position the splint ? - elbow 90 degrees of flexion - wrist and forearm in neutral what is it used to treat ? - carpal fractures - distal radius fractures - distal ulna fractures

supination

supination o ankle rolls out o more weight on outer border a foot

supraspinous ligament function?

supraspinous ligament function? - Restricts flexion in the thoracic and lumbar spine

suspension

suspension - the term used to describe how a prosthetic socket is attached to the residual limb - common types include vacuum, shuttle lock, section, waistbelt, harness

talocrural joint loose pack position? close pack position? Capsular pattern?

talocrural joint loose pack position? - 10 degrees planter flexion, midway between maximum inversion and Eeversion close pack position? - Maximum dorsi flexion Capsular pattern? - Planter flexion, dorsi flexion

tarsometatarsal joint - loose packed : - close pack position:

tarsometatarsal joint - loose packed position : midway between extremes of range of movement - close pack position : supination

Capsular pattern of temporomandibular joint

temporomandibular joint - limitation of mouth opening

temporomandibular joint - loose packed : - close pack position:

temporomandibular joint - loose packed : mouth slightly open - closed pack position : teeth clenched

What five muscles do medial rotation of the hip

tensor fascia lata - Gluteus media's - Gluteus minimas - Pectineus - Adductor longus

Capsular pattern of thoracic spine

thoracic spine - side bending and rotation equally limited, extension

thoraco lumbar fascia Origin and insertion? Function?

thoraco lumbar fascia Origin and insertion? - The thoraco lumbar fascia is connected to the spinous processes of lumbar vertebra, the posterior superior iliac spines, and the iliac crests - The fascia consists of three layers that separate the lumbar muscles into three different compartments. Function? - Provide stability to the spine, transmit force, resist lumbar flexion, provide a site for muscular attachments

thoracolombosacral orthosis TLSO

thoracolombosacral orthosis TLSO - custom molded - prevents all truck motions and is commonly utilized as a means of post surgical stabilization - rigid shell is fabricated from plastic using straps and Velcro to secure

What four muscles do dorsal flexion

tibialis anterior - Extensor hallucis longest - Extensor digitorum longus - Peroneus tertius

transverse humoral ligament where does it attach ? what does it do ?

transverse humoral ligament where does it attach ? - between the greater and lesser tubercles of the humerus spanning over the bicipital groove what does it do ? - helps to maintain the tendon of the long head of the biceps within the bicipital groove

capsular pattern of hip trapeziometacarpal joint

trapeziometacarpal joint - Abd, extension

triangular fibrocartilage complex Where is it located? what does it do?

triangular fibrocartilage complex Where is it located? - Cartledge disk that sits between the ulna, lunate, triquetrum what does it do? - Provide stability to the wrist - Connects the radius and ulna together allowing for better distribution of forces through the wrist

true or false : For upper and lower quarter screening, passive overpressure of the cervical spine is OK

true or false : For upper and lower quarter screening, passive overpressure of the cervical spine is OK - true passive overpressure of the cervical spine and upper extremities is appropriate if the patient does not exhibit signs and symptoms of pathology

true or false during a concentric contraction as the speed of the contraction increases the force also increases?

true or false during a concentric contraction as the speed of the contraction increases the force also increases? - false - during a concentric contraction, as the speed of the contraction increases, the force of the contraction decreases

tunnel of guyon where is it located? What does it do?

tunnel of guyon where is it located? - Space that is located between the hook of the hamate, pisiform, Palmer carpal ligament, flexor retinaculum What does it do? - provides message for the ulnar nerve an artery as they enter the hand - Compression of the nerve in this location may result in ulner tunnel syndrome

Capsular pattern of ulnohumeral joint

ulnohumeral joint - flexion, extension

vaulting prosthetic causes: amputee causes:

vaulting prosthetic causes: - prosthesis too long - Inadequate socket suspension - Excessive alignment stability - excessive planter flexion amputee causes: - residual limb discomfort - improper training - fear of stubbing toe - short residual limb - painful hip /residual limb

what are the differences between Grade 1 two and three Sprains?

what are the differences between Grade 1 two and three Sprains? - major differences grade 2 has impaired motor functions , grade three has substantial decrease in range of motion , grade one is primarily about pain and minimal swelling - grade one o localized pain o minimal swelling o Tenderness - grade 2 o localized pain o moderate swelling o tenderness o impaired motor functions - grade 3 o severe pain and swelling o Substantial joint instability o Total tear of the ligament o Substantial decrease in range of motion

what is a cerebellar pattern of gait?

what is a cerebellar pattern of gait? - a staggered gait pattern

what is the difference between antalgic gate in ataxic gait?

what is the difference between antalgic gate in ataxic gait? - antalgic gate is due to pain this is typically associated with the shorter swing phase of the uninvolved limb - ataxic gait is characterized by staggering and unsteadiness there is usually wide base of support and movements are exaggerated

what percent of gate is in swing phase?

what percent of gate is in swing phase? - 40%

which principle of stretching is the basis for stretching?

which principle of stretching is the basis for stretching? - creep o stretched for sustained duration will elongate return to original link after load has been removed

wrist Range of motion norms - Flexion - Extension - Radial deviation - Ulnar deviation

wrist Range of motion norms - Flexion 0 -80 - Extension 0 -70 - Radial deviation 0 -20 - Ulnar deviation 0 -30

Achilles tendon repair who is more likely to receive an Achilles tendon surgical repair ? when is the surgery done compared to the injury ? what do they do during the surgery ? initial rehab protocol after surgery ? What exercises should the therapist be cautious with ?

Achilles tendon repair who is more likely to receive an Achilles tendon surgical repair ? - active patients when is the surgery done compared to the injury ? - within days of the injury as soon as possible what do they do during the surgery ? - the torn portion of the tendon is sutured back together - if the surgery was delayed after the injury, surgery may need to be performed as an open procedure instead of arthroscopically. Augmentation with use of a graft may be needed for the repair instead of suturing together the original tendon initial rehab protocol after surgery ? - casted with ankle in slight planter flexion - non weight bearing for first several weeks What exercises should the therapist be cautious with ? - be cautious with active planter flexion an anything that stretches the Achilles tendon

Acromial clavicular joint - loose packed : - close pack position:

Acromial clavicular joint - loose packed : arm resting by side in normal physiological position - closed pack position: arm Abd to 90 degrees

Adhesive capsulitis What is it: Etiology: Signs and symptoms: Treatment:

Adhesive capsulitis What is it: - Loss of active and passive range of motion due to soft tissue contracture - cost 5 at least in fibrosis and scarring between the capsule, rotator cuff, subacromial Bursa, and deltoid Etiology: - may be related to injury or may begin insidiously - peak occurrence between 40 and 60 years of age - females more common than males - increase occurrence with diabet - results in one -2 years o some people have residual loss of motion Signs and symptoms: - insidious onset of localized pain often extending down the arm - stiffness - night pain - decreased range of motion in capsular pattern Treatment: - increasing range of motion with.. o mobilization o range of motion o palliative modalities - avoid overstretching - surgical options include suprascapular nerve block an closed manipulation

Ankle (talocrural) Dorsiflexion goniometric technique - Patient position: - Stabilization: - End-feel: - Axis: - Stationary arm: - Moving arm: - ROM norm:

Ankle (talocrural) Dorsiflexion goniometric technique - Patient position: sitting with the knee flexed to 90 degrees - 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 - Moving arm: parallel to the lateral aspect of the 5th metatarsal - ROM norm:0-20

Ankle (talocrural) plantar flexion goniometric technique - Patient position: - Stabilization: - End-feel: - Axis: - Stationary arm: - Moving arm: - ROM norm:

Ankle (talocrural) plantar flexion goniometric technique - Patient position: Sitting with the knee flexed to 90 degrees - 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 - Moving arm: parallel to the lateral aspect of the 5th metatarsal - ROM norm: 0-50

Cervical spine extension goniometric technique - Patient position: - Stabilization: - End-feel: - Axis: - Stationary arm: - Moving arm: - ROM norm:

Cervical spine extension goniometric technique - Patient position: sitting with the thoracic and lumbar spine supported - Stabilization: shoulder girdle and chest to prevent extension of the thoracic and lumbar spine - End-feel: firm - Axis: over the external auditory meatus - Stationary arm: perpendicular or parallel to the ground - Moving arm: along the base of the nose - ROM norm: 0-45

Cervical spine flexion goniometric technique - Patient position: - Stabilization: - End-feel: - Axis: - Stationary arm: - Moving arm: - ROM norm:

Cervical spine flexion goniometric technique - Patient position: sitting with the thoracic and lumbar spine supported - Stabilization: shoulder girdle and chest, the patient hands should be placed on their knees - End-feel: firm - Axis: over the external auditory meatus - Stationary arm: perpendicular or parallel to the ground - Moving arm: along the base of the nose or if using a tongue depressor align parallel to the tongue depressor - ROM norm: 0-45

Cervical spine side bending goniometric technique - Patient position: - Stabilization: - End-feel: - Axis: - Stationary arm: - Moving arm: - ROM norm:

Cervical spine side bending goniometric technique - Patient position: Sitting - Stabilization: shoulder girdle and chest to prevent lateral flexion of the thoracic and lumbar spine - End-feel: firm - Axis: over the spinous process of the C7 vertebra - Stationary arm: what the spinous process of the thoracic vertebra so the arm is perpendicular to the ground - Moving arm: along the dorsal midline of the head using the occipital protuberance for reference - ROM norm:0-45

Cubital tunnel what is it formed by ? What runs through it ?

Cubital tunnel what is it formed by ? - formed by the ulnar collateral ligament and the flexor carpi ulnaris, the medial head of the triceps, and the medial epicondyle What runs through it ? - ulnar nerve when is the cubital tunnel the smallest? - elbow held in full flexion

During the terminal stance phase of gate what are the plantar flexors doing? what is occurring at the knee? what stabilizes the pelvis? what slows the rate of hip extension?

During the terminal stance phase of gate what are the plantar flexors doing? - contracting concentrically to to aid the foot in its propulsion of the body forward what is occurring at the knee? - knee muscle activity remains limited what stabilizes the pelvis? - hip Abductors what slows the rate of hip extension? - Iliopsoas, eccentric contraction

Finger 2-5 distal interphalangeal flexion goniometric technique - Patient position: - Stabilization: - End-feel: - Axis: - Stationary arm: - Moving arm: - ROM norm:

Finger 2-5 distal interphalangeal flexion goniometric technique - Patient position: sitting with the forearm in hand supported - Stabilization: midline and proximal failings to prevent motion at the proximal interphalangeal joint - End-feel: firm - Axis: over the dorsal aspect of the distal interphalangeal joint - Stationary arm: over the dorsal midline of the mid phalanx - Moving arm: over the dorsal midline of the distal phalanx - ROM norm:0-90

Finger 2-5 proximal interphalangeal extension goniometric technique - Patient position: - Stabilization: - End-feel: - Axis: - Stationary arm: - Moving arm: - ROM norm:

Finger 2-5 proximal interphalangeal extension goniometric technique - Patient position: sitting with the forearm and hand supported - Stabilization: proximal phalanx to prevent motion at the metacarpal phalangeal joint - End-feel: firm - Axis: over the dorsal aspect of the proximal interphalangeal joint - Stationary arm: over the dorsal midline of the proximal phalanx - Moving arm: over the dorsal midline of the middle phalanx - ROM norm:?

Glenoid labrum What does it do ?

Glenoid labrum What does it do ? - serves to deepen the glenoid fossa an increase the size of the articular surface - consists of dense fibrous connective tissue that is often damaged with the recurrent shoulder instability

Milwaukee orthosis

Milwaukee orthosis - designed to promote realignment of the spine due to scoliosis - custom made an extends from pelvis to the upper chest - corrective padding is applied to the areas of severity of the curve

Posterior cruciate ligament reconstruction what are the indications for the need PCL reconstruction ? what exercises should be avoided ?

Posterior cruciate ligament reconstruction what are the indications for the need PCL reconstruction ? - surgery is indicated if pain and or instability do not improve with therapy what exercises should be avoided ? - therapist should choose exercises that will limit posterior shear forces within the knee - should also avoid repetitive knee flexion

Radial deviation goniometric technique - Patient position: - Stabilization: - End-feel: - Axis: - Stationary arm: - Moving arm: - ROM norm:

Radial deviation goniometric technique - Patient position: sitting next to a supporting surface with the shoulder Abd to 90 degrees in the elbow flex to 90 degrees - Stabilization: radius and ulna to prevent supination or pronation - End-feel: firm or hard - Axis: over the midline of the dorsal aspect of the wrist over the capitate - Stationary arm: dorsal midline of the forearm using the lateral epicondyle of the humerus for reference - Moving arm: dorsal midline of a third metacarpal - ROM norm:0-20

Radiocarpal Joint What is the distal joint surface formed by? How many degrees of freedom ? what is the loose pack position ? what is the close pack position what is the capsular pattern

Radiocarpal Joint What is the distal joint surface formed by? - Scaphoid, lunate, triquetrum How many degrees of freedom ? - 2 what is the loose pack position ? - neutral with slight ulnar devation what is the close pack position - extension with radial deviation what is the capsular pattern - Flexion and extension equally limited

Radiohumeral joint - loose packed : - close pack position:

Radiohumeral joint - loose packed : full extension, full supination - closed packed position: elbow flexed 90 degrees, forearm supinated 5 degrees

Shoulder extension goniometric technique - Patient position: - Stabilization: - End-feel: - Axis: - Stationary arm: - Moving arm: - ROM norm:

Shoulder extension goniometric technique - Patient position: prone - Stabilization: thorax to prevent flexion of spine - End-feel: firm - Axis: acromial process - Stationary arm: midaxillary line of thorax - Moving arm: Lateral midline of the humerus - ROM norm: 0-60

Shoulder flexion goniometric technique - Patient position: - Stabilization: - End-feel: - Axis: - Stationary arm: - Moving arm: - ROM norm:

Shoulder flexion goniometric technique - Patient position: supine - Stabilization: thorax to prevent spine extension - End-feel: firm - Axis: acromial process - Stationary arm: midaxillary line of thorax - Moving arm: lateral midline of humerus - ROM norm: 0-180

Thoracolumbar flexion and extension goniometric technique - Patient position: - Stabilization: - End-feel: - Axis: - Stationary arm: - Moving arm: - ROM norm:

Thoracolumbar flexion and extension goniometric technique - Patient position: standing with tape mesurer - tape measure between the spinous processes of T1 an S2 - ROM norm: flexion 0-80 degrees, exstension 0-25

Patellofemoral syndrome

What is it: - general term describing pain or discomfort in the anterior knee - often termed "chondromalacia patella" which refers to softening of the articular cartilage of the Patella Etiology: - repetitive overuse from increased force at patellofemoral joint - decrease quadriceps strength - decrease lower extremity flexibility - patellar instability - increased tibial torsion or femoral anteversion - females > mails - risks o growth spurt o runners who have increased mileage o overweight Signs and symptoms: - anterior knee pain - pain with prolonged sitting - swelling - crepitus - pain when asending or descending stairs Treatment: - decrease inflammation and pain - lower extremity flexibility - medial patellar glides - biofeedback - Patella taping - strengthening with emphasis on quads and VMO

What is the primary etiology requiring amputation ?

What is the primary etiology requiring amputation ? - peripheral vascular disease

Which injuries are more common ACL or PCL?

Which injuries are more common ACL or PCL? - ACL injuries are more common as PCL injuries rarely occur in isolation

What is a 5/5 MMT

full range of motion against gravity with maximal resistance

acromioclavicular joint What kind of a joint is this ? how many degrees of freedom ? what is the loose pack position what is the closed pack position what is the capsular pattern

acromioclavicular joint What kind of a joint is this ? - plain synovial joint how many degrees of freedom ? - 3 , maintains relationship between the scapula and clavicle during glenohumeral range of motion what is the loose pack position - arm resting by side what is the closed pack position - arm Abd to 90 degrees what is the capsular pattern - pain at extremes of range of movement

active assisted range of motion definition indications benefits

active assisted range of motion definition - AAROM produced by the patient through active muscular contraction with some assistance from an external force indications - the patient is unable to fully contract a muscle such as paresis or pain - full activation of muscle is contraindicated such as post operative precautions - performed prior to initiating active movement benefits - improve the mobility of connective tissue and muscles - prevents joint contraction formation - improve circulation - improve synovial fluid movement for cartilage health - decrease pain - improves neuromuscular activity - improves kinesthesia and proprioception

active range of motion definition indications benefits

active range of motion definition - AROM produced through patients active muscular contraction without external assistance indications - patient is able to contract on muscle, but demonstrates weakness - perform prior to initiating resistance training to teach the desired movement benefits - improves the mobility of connective tissues and muscles - prevents joint contracture formation - improve circulation - improve synovial fluid movement for cartilage health - decrease pain - improves neuromuscular activity - improves kinesthesia and proprioception - improve strength in very weak muscles such as three out of five strength

ankle foot orthosis AFO What are the common conditions this is prescribed for ?

ankle foot orthosis AFO What are the common conditions this is prescribed for ? - peripheral neuropathy - nerve lesions - hemiplegia metal ankle foot orthosis - two metal uprights connected proximately to calf band and ixtle to mechanical ankle joint and shoe - ankle may have the ability to lock or have limited anterior posterior capability plastic ankle foot orthosis - molded cast - the benefit of plastic is cosmetic, lighter, does not allow for adima - casted in sub Taylor neutral - footplate can be added to assist with tone reduction solid ankle foot orthosis - controls dorsiflexion and planter flexion - controls inversion and E version with a trimline anterior to the malleoli - can be a fabricated to keep the ankle at 90 degrees or may include articulating ankle joint ankle foot orthosis with articulating ankle joint - the articulation allows for tivia to advance over the foot during the mid to late stance phase of gate posterior leaf spring - plastic afo with a trimline posterior to the malleoli - assist with dorsiflexion and prevent footdrop - requires adequate medial and lateral control by patient floor reaction afo - and ankle foot orthosis that can influence knee control - assist with knee extension during stance through positioning of the calf or positioning of the ankle

anterior cruciate ligament sprain What is it: Etiology: Signs and symptoms: Special tests: Treatment:

anterior cruciate ligament sprain What is it: - Prevents anterior displacement of tibia - grade one = microscopic tears - grade 3 = completely torn Etiology: - non contact twisting with hyper extension and varus or valgus - commonly injured with medial capsule, medial collateral ligament, meniscus Signs and symptoms: - loud pop, feeling of the knee "giving away "or "buckling" - swelling Special tests: - anterior drawer test - lachman test - lateral pivot shift test Treatment: - RICE - NSAIDs - analgesics - lower extremity strengthening emphasizing the quads and hamstrings - surgery for complete ACL tear - a derotation brace may be beneficial however not following surgery

What two muscles do horizontal add duction of the shoulder joint

anterior deltoid - pec major

anterior ligament where does it attach ?

anterior ligament where does it attach ? - stretches from radial collateral ligament and attaches above the upper edge of the coronoid fossa, extending to just below the coronoid process

dermatome testing nerve root levels posterior head posterior lateral neck acromioclavicular joint lateral arm lateral forearm and thumb Palmer distal phalanx of the middle finger little finger an ulnar border of hand medial forearm anterior thigh middle third of anterior thigh Patella and medial malleolus fibular head and dorsum of foot lateral an planter aspect of foot medial aspect of posterior thigh perianal area

dermatome testing nerve root levels posterior head - C2 posterior lateral neck - C3 acromioclavicular joint - C4 lateral arm - C5 lateral forearm and thumb - C6 Palmer distal phalanx of the middle finger - C7 little finger an ulnar border of hand - C8 medial forearm - T1 anterior thigh - L2 middle third of anterior thigh - L3 Patella and medial malleolus - L4 fibular head and dorsum of foot - L5 lateral an planter aspect of foot - S1 medial aspect of posterior thigh - S2 perianal area - S3 - S5

disease modifying antiheumatic agents action: indication : side effects : implications for PT : examples :

disease modifying antiheumatic agents action: - AKA DMARD - call to the progression or slow the progression of rheumatic disease - used early during disease process prior to widespread damage - They modify the pathology and inhibit the immune response indication : - rheumatic disease during early treatment side effects : - nausea - Headaches - Joint pain and swelling - Toxicity - Gastro intestinal distress - Sore throat - Fever - Liver dysfunction - Hair loss - Potential for sepsis - Renal damage implications for PT : - Recognize that many of the agents have a high incidence of toxicity examples : - methotrexate - arava - Chloroquine - hydrochloroquine

distal interphalangeal splint what is it, where does it go ? what conditions is this used to treat ?

distal interphalangeal splint what is it, where does it go ? - AKA DIP splint - rigid splint that is placed on either the volar or dorsal aspect of the finger and spans from the tip of the finger to the proximal portion of the middle phalanx - is used to immobilize the DIP joint to allow injured structures to heal or to rest a painful or inflamed joint what conditions is this used to treat ? - mallet finger (DIP joint should be placed in neutral or slight hyper extension to allow for healing of the damaged extensor tendon ) - distal phalanx fracture - DIP joint arthritis

distal radioulnar joint - loose packed : - close pack position:

distal radioulnar joint - loose pack position: 10 degrees of supination - closed packed position: 5 degrees of supination

during the initial contact of gait What muscle causes the knee to extend? what do the hamstrings do ? what muscles contract to stabilize the trunk and pelvis over the leg?

during the initial contact of gait What muscle causes the knee to extend? - quadriceps - hamstrings help stabilize the knee and prevent hyperextension what do the hamstrings do ? - hamstrings help stabilize the knee and prevent hyperextension what muscles contract to stabilize the trunk and pelvis over the leg? - hip extensors and Abd

during the initial swing of gate What are ankle dorsi flexors doing? where are the hamstrings doing ? what are the hip flexors doing?

during the initial swing of gate What are ankle dorsi flexors doing? - contracting concentrically to clear the foot from the ground where are the hamstrings doing ? - hamstrings assist with foot clearance by flexing knee what are the hip flexors doing? - contracting concentrically producing hip flexion to advanced the limb forward

What three muscles do radial deviation

extensor carpi radialis longus and brevis O: I: A: N: - Flexor carpi radialis - Extensor pollicis longus and brevis

glenohumeral instability What is it: Etiology: Signs and symptoms: - Subluxation - Dislocation Treatment: - initial treatment - middle treatment - later treatment

glenohumeral instability What is it: - excessive translation of the humoral head on the glenoid during active rotation - subluxation = joint laxity o more than 50% of humeral head to passively translate over glenoid rim without dislocation - dislocation o complete separation o 85% of dislocations detached the glenoid labrum = Bankart Lesion Etiology: - combination of stress to o Anterior capsule o glenohumeral ligament o rotator cuff - humerus moves anteriorly out of glenoid fossa - anterior dislocation most common and associated with Abd and lateral rotation Signs and symptoms: - Subluxation o feeling the shoulder "popping "out and back into place o pain o paresthesia o sensation of the arm feeling "dead " o positive apprehension test o capsular tenderness o swelling - Dislocation o severe pain o paresthesia o limited range of motion o weakness o visible shoulder fullness o arms supported by contralateral limb Treatment: - initial treatment 3-6 weeks o immobilization with sling o RICE o NSA IDs - middle treatment o immobilization o range of motion o isometric strengthening - later treatment o progressive resistance exercises emphasizing internal and external rotators and large scapular muscles What is the most common type of shoulder dislocation and how does it occur? - anterior dislocation most common and associated with Abd and lateral rotation

What 6 muscles do lateral rotation of the hip

gluteus maximus - Obturator externus - Obturator internus - Piriformis - gemelli - sartorius

What for muscles do extension of the hip

gluteus maximus and gluteus medias - Semitendinosus - Semimembranosus - Biceps femoris

joint surface of loose packed versus closed pack positions

joint surface of loose packed versus closed pack positions - loose packed is no volitional separation of joint surface - close packed is compressed joint surface

juvenile rheumatoid arthritis What is it: Etiology: Signs and symptoms: - systematic JRA - polyarticular JRA - oligoarticular (pauciarticular) JRA Treatment:

juvenile rheumatoid arthritis What is it: - JRA - most common chronic rheumatic disease in children - inflammation of joints and connective tissue - classifications include o systemic o polyarticular o oligoarticular Etiology: - unknown Signs and symptoms: - systematic JRA o 10 to 20% of cases o acute onset o high fever o rash o enlargement of spleen and liver o inflammation of lungs and heart - polyarticular JRA o 30 to 40% of cases o hi female incident o significant rheumatoid factor o arthritis in more than four joints with symmetrical joint involvement - oligoarticular (pauciarticular) JRA o 40 to 60% of cases o affects less than five joints with asymmetrical joint involvement Treatment: - Pharmacological o NSA IDs o cortical steroids o ANTIRHEUMATICS o immunosuppressive agents - passive an active range of motion - positioning - splinting - strengthening - endurance training - weight bearing activities - postrel training - functional mobility - pain management o paraffine o ultrasound o warm water o cryotherapy - surgical interventions indicated when contractures or irreversible joint destruction

lateral collateral ligament LCL of knee Common mechanism of injury? Special test designed to assess the integrity of the LCL?

lateral collateral ligament LCL Common mechanism of injury? - Varus load at the knee without rotation - Contact activities such as medial blow to the knee The LCL is rarely completely torn without a concurrent injury to the ACL or PCL Special test designed to assess the integrity of the LCL? - Varus stress test

lateral epicondylitis What is it: Etiology: Signs and symptoms: Treatment:

lateral epicondylitis What is it: - Irritation or inflammation of common extensor muscles at the origin on the lateral epicondyle of humerus Etiology: - activities at risk o racquet sports o throwing - caused by eccentric loading of the wrist extensor muscles o usually carpay radialis brevis - increased risk with poor mechanics or faulty equipment - most common between 30 and 50 years of age Signs and symptoms: - pain immediately anterior or distal to lateral epicondyle of humerus - pain increases with repetition an resisted wrist extension Treatment: - RICE - NSAIDS - Activity modification - increase strength - increase flexibility - increase endurance of wrist extensors - strap placed 2-3 inches distal to elbow joint can reduce muscular tension placed on epicondyle

What four muscles do depression of the scapula

latissimus dorsi - pectoralis major - pectoralis minor - lower trapezius

metatarsal phalangeal joint - loose packed : - close pack position:

metatarsal phalangeal joint - loose pack position : neutral - close pack position : full extension

Capsular pattern of midtarsal joints

midtarsal joints - Dorsal flexion, plantar flexion, ADD, medial rotation

What two muscles do protraction of the scapula

serratus anterior - Pectoralis minor

- Murphy's sign o Testing procedure: o Positive result is o Positive test means:

miscellaneous special tests of the wrist and hand - Finkelstein test o Testing procedure: patient in sitting or standing and makes fits with them tucked inside fingers. Therapist ulnerly deviates the wrist o Positive result is Pain over the Abd pollicis longest an extensor pollicis brevis tendons at the wrist o Positive test means: synovitis in the thumb AKA de Quervian's disease - grind test o Testing procedure: patient in sitting or standing. Therapist applies compression in rotation through metacarpal o Positive result is pain o Positive test means: degenerative joint disease in the carpal metacarpal joint - Murphy's sign o Testing procedure: patient in sitting or standing and makes fist o Positive result is patient's third metacarpal remaining level with the 2nd and 4th metacarpals o Positive test means: dislocated lunate

- grind test o Testing procedure: o Positive result is o Positive test means:

miscellaneous special tests of the wrist and hand - Finkelstein test o Testing procedure: patient in sitting or standing and makes fits with them tucked inside fingers. Therapist ulnerly deviates the wrist o Positive result is Pain over the Abd pollicis longest an extensor pollicis brevis tendons at the wrist o Positive test means: synovitis in the thumb AKA de Quervian's disease - grind test o Testing procedure: patient in sitting or standing. Therapist applies compression in rotation through metacarpal o Positive result is pain o Positive test means: degenerative joint disease in the carpal metacarpal joint - Murphy's sign o Testing procedure: patient in sitting or standing and makes fist o Positive result is patient's third metacarpal remaining level with the 2nd and 4th metacarpals o Positive test means: dislocated lunate

sacrospinous ligament Function ?

sacrospinous ligament Function ? - connects the issues bind to the lateral sacrum and coccyx - also has fibers that blend with the sacrotuberous ligament - limits anterior rotation of the sacrum on the pelvis

osteo kinematic motions of the cervical spine loose pack position of the cervical spine close pack position of the cervical spine

osteo kinematic motions of the cervical spine - flexion, extension, side bending, rotation loose pack position of the cervical spine - midway between flexion and extension close pack position of the cervical spine - extension - side bending and rotation equally limited, extension

osteo kinematic motions of the thoraco lumbar spine loose pack position of the thoraco lumbar spine Close pack position of the thoraco lumbar spine capsular pattern of the thoraco lumbar spine

osteo kinematic motions of the thoraco lumbar spine - flexion, extension, side bending, rotation loose pack position of the thoraco lumbar spine - Midway between flexion and extension Close pack position of the thoraco lumbar spine - extension capsular pattern of the thoraco lumbar spine - side bending and rotation equally limited, extension

sacrotuberous ligament attachments and insertions? Function?

sacrotuberous ligament attachments and insertions? - Several attachment sites including the posterior iliac spine, lateral sacrum, coccyx, issuel tuberosity. Function? - Resist sacral anterior rotation and prevents superior translation of the sacrum

opioid agents (narcotics ) action: - provide analgesic for acute severe pain management - Stimulates opioid receptors within the central nervous system to prevent pain impulses from reaching their destination - Some are used to assist with dependency and withdrawal indication : - moderate to severe pain in various origins - Induction of conscious sedation prior to a diagnostic procedure - Management of opioid dependence - Relief of severe and persistent cough (codeine ) side effects : - mood swings - Sedation - Confusion - Vertigo - Dulled cognitive function - Ortho static hypo tension - Constipation - In coordination - Physical dependence - Tolerance implications for PT : - monitor for potential side effects especially signs of respiratory depression - Schedule treatment 2 hours after administration - Keep in mind a patient might not accurately report if something is painful in clinic examples : - morphine - demerol - OxyContin (oxycodone) - Sublimaze (fentanyl ) - Peveral (codeine )

opioid agents (narcotics ) action: - provide analgesic for acute severe pain management - Stimulates opioid receptors within the central nervous system to prevent pain impulses from reaching their destination - Some are used to assist with dependency and withdrawal indication : - moderate to severe pain in various origins - Induction of conscious sedation prior to a diagnostic procedure - Management of opioid dependence - Relief of severe and persistent cough (codeine ) side effects : - mood swings - Sedation - Confusion - Vertigo - Dulled cognitive function - Ortho static hypo tension - Constipation - In coordination - Physical dependence - Tolerance implications for PT : - monitor for potential side effects especially signs of respiratory depression - Schedule treatment 2 hours after administration - Keep in mind a patient might not accurately report if something is painful in clinic examples : - morphine - demerol - OxyContin (oxycodone) - Sublimaze (fentanyl ) - Peveral (codeine )

stress -relaxation

principles of stretching elasticity - ability of soft tissue to return to its previous length after a stretch is no longer applied Viscoelasticity - time dependent property of soft tissue that results in resistance to stretch when initially applied, but allows for a soft tissue elongation as the stretch is held for longer durations. - tissue will return to previous length after stretch is no longer applied plasticity - property of soft tissue that allows for tissue elongation even after stretches no longer apply stress -strain curve - a graphic representation that depicts the relationship between the amount of force = stress applied to connective tissue and the amount of deformation = strain it experiences Creep - due to the viscoelastic properties, soft tissue that is stretched for a sustained duration will along gate and not return to its original length after the load has been removed. The principle of Creek is the basis for stretching stress -relaxation - the longer a stretch force is maintained, the more the tension within the tissue decreases, therefore less force is required to maintain the same tissue length

stress -strain curve

principles of stretching elasticity - ability of soft tissue to return to its previous length after a stretch is no longer applied Viscoelasticity - time dependent property of soft tissue that results in resistance to stretch when initially applied, but allows for a soft tissue elongation as the stretch is held for longer durations. - tissue will return to previous length after stretch is no longer applied plasticity - property of soft tissue that allows for tissue elongation even after stretches no longer apply stress -strain curve - a graphic representation that depicts the relationship between the amount of force = stress applied to connective tissue and the amount of deformation = strain it experiences Creep - due to the viscoelastic properties, soft tissue that is stretched for a sustained duration will along gate and not return to its original length after the load has been removed. The principle of Creek is the basis for stretching stress -relaxation - the longer a stretch force is maintained, the more the tension within the tissue decreases, therefore less force is required to maintain the same tissue length

proximal radioulnar joint Which surface is concave and which is convex ? what is the loose pack position ? what is the closed pack position ? what is the capsular pattern ?

proximal radioulnar joint Which surface is concave and which is convex ? - radial notch of ulna = concave - radial head = convex what is the loose pack position ? - 70 degrees of elbow flexion, 35 degrees of supination what is the closed pack position ? - 5 degrees of supination what is the capsular pattern ? - supination, pronation

radio collateral ligament AKA lateral collateral ligament what does it attach to ? what motion does it prevent ?

radio collateral ligament AKA lateral collateral ligament what does it attach to ? - extends from the lateral epicondyle of the humerus to the lateral border and olecranon process of the ulna and to the annular ligament - Fan shaped what motion does it prevent ? - prevents ADD of the elbow - provides reinforcement for the radiohumeral articulation

- foraminal compression test o Testing procedure: o Positive result is o Positive test means:

special tests of the cervical spine - cervical flexion rotation test o Testing procedure: With patient in supine, therapist fully flexes patient cervical spine. Therapist rotates cervical spine in each direction while maintaining flexion. Patient should have 45 degrees of rotation in each direction o Positive result is less than 45 degrees of rotation in each direction o Positive test means: dysfunction likely occurring at the atlanto axial joint o this test can also be used as a provocation test for cervicogenic headache - distraction test cervical spine o Testing procedure: this test is used for patients who are currently experiencing ridiculous symptoms. With patient sitting, therapist places one hand under patients chin and the other hand under the occiput. Therapist applies upward distraction force. o Positive result is Pain is decreased with distraction force o Positive test means: cervical nerve root compression - foraminal compression test o Testing procedure: patient is positioned in sitting with the head laterally flexed. The therapist places both hands on top of subjects head and applies downward force. o Positive result is Pain radiating into the arms toward the flexed side o Positive test means: nerve root compression - vertebral artery test o Testing procedure: patient in supine . Therapist places the patient's head into extension, lateral flexion rotation to the ipsilateral side. o Positive result is Dizziness, nystagmus, slurred speech, loss of consciousness o Positive test means: compression of the vertebral artery

- ulnar collateral ligament instability test o Testing procedure: o Positive result is o Positive test means:

special tests of the wrist and hand for ligamentous instability - ulnar collateral ligament instability test o Testing procedure: patient in sitting . Therapist holds thumb in extension and applies a valgus force to the metacarpophalangeal joint of the thumb o Positive result is excessive valgus movement o Positive test means: care of the owner collateral and accessory collateral ligaments aka game keepers or skiers thumb

true or false during an eccentric contraction as the speed of the contraction increases the force of the contraction decreases?

true or false during an eccentric contraction as the speed of the contraction increases the force of the contraction decreases? - false - during an ecentric contraction, as the speed of contraction increases the force of the contraction also increases

true or false passive overpressure of the lumbosacral spine is part of lower quarter screening?

true or false passive overpressure of the lumbosacral spine is part of lower quarter screening? - true passive overpressure of the lumbosacral spine and lower extremities is appropriate if the patient does not exhibit signs and symptoms of pathology

total hip arthroplasty What is it: o anterior lateral o direct lateral o posterior lateral · o superior o cemented o cementless or hybrid fixation - lifespan of a total hip arthroplasty - possible complications Etiology: Signs and symptoms: Treatment: hip precautions for anterior lateral approach of total hip arthroplasty hip precautions for direct lateral approach of total hip arthroplasty hip precautions for posterior lateral approach of total hip arthroplasty

total hip arthroplasty What is it: - Approach types o anterior lateral § Hip is accessed between TfL and glute media's § hip abd's are released from greater trochanter § dislocated anteriorly § hip precautions · avoid flexion beyond 90 degrees, extension, lateral rotation, a DD o direct lateral § division of TfL and vastus lateralus § release of anterior gluteus medias § minimizes possibility of dislocation § hip precautions · avoid flexion beyond 90, extension, lateral rotation, ADD o posterior lateral § Splitting gluteus maximus § external rotators released , hip Abd retracted § dislocated posteriorly § most common approach § highest dislocation rate after surgery § hip precautions · avoid flexion beyond 90 degrees, ADD, medial rotation o superior § Variable on surgeon because so new - fixation types o cemented § weight bearing as tolerated faster o cementless or hybrid fixation § rely on bone growth Ann may require partial weight bearing or non weight bearing initially - lifespan of a total hip arthroplasty o 15 to 20 years - possible complications o DVT o infection o pulmonary embolus o heterotopic ossification o femoral fractures o dislocation o nuro vascular injury Etiology: - osteoarthritis - rheumatoid arthritis - osteomyelitis - avascular necrosis Signs and symptoms: - prior to surgery o severe pain with weight bearing o loss of mobility o instability or limited range of motion o failure of conservative treatments Treatment: - Decreasing inflammation - emphasize hip precautions - minimizing muscle atrophy - regaining full passive range of motion - ankle pumps - quad and glute sets - active hip flexion within available range of motion - assistive device training - progressive ambulation hip precautions for anterior lateral approach of total hip arthroplasty - flexion beyond 90 - extension - lateral rotation - ADD hip precautions for direct lateral approach of total hip arthroplasty - avoid flexion beyond 90 - extension - lateral rotation - ADD hip precautions for posterior lateral approach of total hip arthroplasty - avoid flexion beyond 90 degrees - ADD - medial rotation

what are the layers of muscle tissue?

what are the layers of muscle tissue? - Endomysium o innermost that covers individual muscle fibers - perimysium o connective tissue layer that groups bundles of muscle fibers called faciculus - epimysium o outermost connective tissue layer that surrounds entire muscle

Achilles Tendonitis What is it: Etiology: Signs and symptoms: Treatment: Prevention:

Achilles Tendonitis What is it: - Overuse disorder resulting in microscopic tears collagen - the tendon is most often impacted in the avascular zone located 2-6 centimeters above the insertion of the tendon Etiology: - repetitive overload caused by changes in training intensity or faulty technique - increase risk o limited flexibility and strength in gastrocnemius and soleus o pronated or cavus foot - Activities frequently associated o running o basketball o gymnastics o dancing - history of Achilles tendonitis increases risk of Achilles tendon rupture Signs and symptoms: - aching or burning in posterior heel - Achilles tendon tenderness - pain with activity - swelling and thickening of tendon area - muscle weakness due to pain - morning stiffness Treatment: - RICE - NSAIDS - Analgesiscs - Heel lift + cross training to limit tensile loading through tendon Prevention: - Heel cord stretching - Footwear - Ecc strengthening of gastroc and soleus - Avoid sudden changes in intensity of training program

Adaptations that occur with endurance training

Adaptations that occur with strength training - muscle fiber hypertrophy - fiber type remodeling from 2B to 2A - increase neuromuscular activity through number of motor units and firing rate - decreased or no change in capillary bed density - decreased mitochondrial density - increase stores of ATP, CP and other energy sources - increase tensile strength of tendons and ligaments - increase bone mineral density - increase lean body mass - decrease body fat percent Adaptations that occur with endurance training - increased capillary bed density - increased mitochondrial density - increased stores of ATP, CP, and other energy sources - increased tensile strength of tendons and ligaments - increased bone mineral density - decreased body fat percentage

Anterior cruciate ligament reconstruction Is an ACL reconstruction done with cadaver tissue or the patient's tissue? What exercise is not appropriate after ACL reconstruction ? at what time is the graph most vulnerable ? what time is the graph fully matured ? what is the criteria that must be met in order to return to sport ?

Anterior cruciate ligament reconstruction Is an ACL reconstruction done with cadaver tissue or the patient's tissue? - Usually done with autograph AKA their own tissue - bone patellar tendon bone graft is considered the gold standard What exercise is not appropriate after ACL reconstruction ? - open chain exercises between 0-45 degrees of flexion should be avoided since they place extra stress on the graph site at what time is the graph most vulnerable ? - the graft is most vulnerable at 6 to 8 weeks after surgery - as the tendon transforms into ligament tissue, it actually becomes weaker before it gets stronger - Failure of the graph site generally happens around that time secondary to poor compliance with protocol what time is the graph fully matured ? - 12 to 16 months postoperatively - however most protocols allow return to sport closer to six months what is the criteria that must be met in order to return to sport ? - no pain or swelling - Full range of motion - No instability - Quadriceps strength is 85 to 90% of the opposite leg - Hamstring strength is 90 to 100% of the opposite leg - Functional testing is 85 to 90% of the opposite leg such as single leg hop

Craig -Scott knee ankle foot orthosis

Craig -Scott knee ankle foot orthosis - design specifically for persons with paraplegia - design allows a person to stand with a posterior lean of the trunk

Fatigue ability of type one versus type 2 muscle fibers capillary density of type one versus type 2 muscle fibers Difference between type one and type 2 muscle fiber size what is the difference in my own globin content between type one and type 2 muscle fibers What is the difference between blood supply in type 1 muscle fibers and type 2 muscle fibers What is the difference in mitochondria between type one and type 2 muscle fibers which muscle fiber is aerobic versus anaerobic Which muscle fiber is slow twitch and which muscle fiber is fast twitch?

Fatigue ability of type one versus type 2 muscle fibers - type 1 low fatigue ability - Type 2 high fatigue ability capillary density of type one versus type 2 muscle fibers - Type 1 high capillary density - Type 2 low capillary density Difference between type one and type 2 muscle fiber size - one small fibers - Type two large fibers what is the difference in my own globin content between type one and type 2 muscle fibers - Type 1 high myoglobin content - Type 2 low mile globin content What is the difference between blood supply in type 1 muscle fibers and type 2 muscle fibers - type 1 equals extensive blood supply - Type 2 equals less blood supply What is the difference in mitochondria between type one and type 2 muscle fibers - Type 1 Large amount of mitochondria - Type 2 fewer mitochondria which muscle fiber is aerobic versus anaerobic - aerobic = type 1 (slow) - anerobic = type 2 (fast) Which muscle fiber is slow twitch and which muscle fiber is fast twitch? - Slowtwitch = type one - Fast twitch = type 2

Forearm supination goniometric technique - Patient position: - Stabilization: - End-feel: - Axis: - Stationary arm: - Moving arm: - ROM norm:

Forearm supination goniometric technique - Patient position: sitting with the elbow flexed to 90 degrees - Stabilization: distal end of the humerus to prevent lateral rotation and add of the humerus - End-feel: firm - Axis: medial to the ulnar styloid process - Stationary arm: Parallel to the anterior midline of the humerus - Moving arm: ventral aspect of the forearm, just proximal to the styloid process of the radius and ulna - ROM norm:0-80

Heel wedge

Heel wedge - applied to medial heel to prevent excessive hindfoot eversion or to the lateral heel to prevent excessive hindfoot inversion - used to treat symptoms associated with Pes planus or Pes cavus

Gross manual muscle tests screening by spinal root level cervical rotation shoulder elevation shoulder AB duction elbow flexion wrist extension elbow extension wrist flexion thumb extension finger adduction Hip flexion knee extension ankle dorsi flexion great toe extension ankle planter flexion

Gross manual muscle tests screening by spinal root level cervical rotation - c1 shoulder elevation - C2 -C4 shoulder AB duction - C5 elbow flexion - C5 -C6 wrist extension - C6 elbow extension - C7 wrist flexion - C7 thumb extension - C8 finger adduction - T1 Hip flexion - L1 -L2 knee extension - L3 - L4 ankle dorsi flexion - L4 - L5 great toe extension - L5 ankle planter flexion - S1

Hip abduction goniometric technique - Patient position: - Stabilization: - End-feel: - Axis: - Stationary arm: - Moving arm: - ROM norm:

Hip abduction goniometric technique - Patient position: supine - Stabilization: pelvis to prevent lateral tilting and rotation, trunk to prevent lateral flexion - End-feel: firm - Axis: over the anterior iliac spine ASIS of the extremity being measured - Stationary arm: aligned with imaginary horizontal line extending from 1 ASIS to the other ASIS - Moving arm: anterior midline of the femur using the midline of the Patella for reference - ROM norm:0-45

Hip extension goniometric technique - Patient position: - Stabilization: - End-feel: - Axis: - Stationary arm: - Moving arm: - ROM norm:

Hip extension goniometric technique - 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 - Moving arm: lateral midline of the femur using the lateral epicondyle for reference - ROM norm: 0-30

Hip flexion goniometric technique - Patient position: - Stabilization: - End-feel: - Axis: - Stationary arm: - Moving arm: - ROM norm:

Hip flexion goniometric technique - 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 trochanters of the femur for reference - Stationary arm: lateral midline of the pelvis - Moving arm: lateral midline of the femur using the lateral epicondyle for reference - ROM norm:0-120

K levels what is a K level ? level 0 - description - knee unit - foot ankle assembly level 1 - description - knee unit - foot ankle assembly level 2 - description - knee unit - foot ankle assembly Level 3 - description - knee unit - foot ankle assembly level 4 - description - knee unit - foot ankle assembly

K levels what is a K level ? - a functional scale to classify patients for Medicare - the level of sign plays a primary role in what componentry will be used in a patients prosthesis - determined by patients current level of function, their potential function , and particular needs - can be determined objectively with the use of outcome measures such as amputee mobility predictor or through a history in exam of patient - K level determined by medical doctor, prostitutes, and physical therapists level 0 - description o prosthetic will not improve quality of life or mobility - knee unit o not eligible - foot ankle assembly o not eligible level 1 - description o transfers o ambulation on level surfaces o fixed cadence o limited or unlimited household ambulator - knee unit o single access o constant friction mechanism - foot ankle assembly o SACH o single axis level 2 - description o transverse low level barriers such as curbs, stairs, uneven surfaces o limited community ambulator - knee unit o Poly centric o constant friction mechanism - foot ankle assembly o flexible-Keel foot o multi-axial foot/ankle Level 3 - description o Variable cadence ambulator o unlimited community ambulator o traverses most environmental barriers o prosthetic used beyond simple locomotion - knee unit o hydraulic /pneumatic o microprocessor o variable friction mechanism - foot ankle assembly o energy storing o dynamic response foot o multi - axial foot /ankle level 4 - description o exceeds basic ambulation skills o exhibits high impact, stress, or energy levels o typical of child, athlete, or active adult - knee unit o any system - foot ankle assembly o any system

MMTs of muscles tested in sitting (8)

MMTs of muscles tested in sitting (8) - coracobrachialis - Hip flexors , other testing positions as well - Medial rotators of hip - Upper trapezius - Deltoid , other positions as well - Lateral rotators of hip - Quadriceps - serratus anterior , other testing positions as well

MMTs of muscles tested in supine (28)

MMTs of muscles tested in supine (28) - Abdominals - Biceps - Finger flexors - Iliopsoas - Lateral rotators of shoulder, other testing positions as well - Neck flexors - Pectoralis minor - Pronators - serratus anterior - TfL - Thumb muscles - Tibialis posterior - Toe Flexors - wrist extensors - Anterior deltoid , other testing positions as well - Brachioradialis - Finger extensors - Infraspinatous - Medial rotators of shoulder, other testing positions as well - Pectoralis major - Peroneals - sartorius - Supinator's - Teres minor - Tibialis anterior - Toe extensors - Triceps, other testing positions as well - Wrist flexors

Midtarsal (transverse tarsal) inversion goniometric technique - Patient position: - Stabilization: - End-feel: - Axis: - Stationary arm: - Moving arm: - ROM norm:

Midtarsal (transverse tarsal) inversion goniometric technique - Patient position: sitting with the knee flexed to 90 degrees - 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: anterior midline of the lower leg using the tibial tuberosity for reference - Moving arm: anterior midline of the second metatarsal - ROM norm:0-35

Muscles for thoraco lumbar flexion? muscles for thoraco lumbar extension? muscles for thoraco lumbar rotation and side bending?

Muscles for thoraco lumbar flexion? - rectus abdominis , internal oblique , - External oblique O: ribs 5-12 I: iliac crest and inguinal ligament A: bilateral: flexion of trunk unilateral: contralateral rotation of spine unilateral: ipsilateral lateral flexion N: iliohypogasatric L1 muscles for thoraco lumbar extension? - erector spinae, quadratics lumborum, multifidus muscles for thoraco lumbar rotation and side bending? - Psoas major , quadratics lumborum , external oblique , internal oblique, multifidus, longissimus thoracis, iliocostalis thoracis, rotatores

Muscles for thoraco lumbar flexion?

Muscles for thoraco lumbar flexion? - rectus abdominis , internal oblique , external oblique muscles for thoraco lumbar extension? - erector spinae, quadratics lumborum, multifidus muscles for thoraco lumbar rotation and side bending? - Psoas major , quadratics lumborum , external oblique , internal oblique, multifidus, longissimus thoracis, iliocostalis thoracis, rotatores

muscles for thoraco lumbar extension?

Muscles for thoraco lumbar flexion? - rectus abdominis , internal oblique , external oblique muscles for thoraco lumbar extension? - erector spinae, quadratics lumborum, multifidus muscles for thoraco lumbar rotation and side bending? - Psoas major , quadratics lumborum , external oblique , internal oblique, multifidus, longissimus thoracis, iliocostalis thoracis, rotatores

Shoulder lateral rotation goniometric technique - Patient position: - Stabilization: - End-feel: - Axis: - Stationary arm: - Moving arm: - ROM norm:

Shoulder lateral rotation goniometric technique - Patient position: Supine with the shoulder Abd to 90 degrees an elbow flexion to 90 degrees - Stabilization: distal end of the humerus to maintain the shoulder in 90 degrees Abd - End-feel: firm - Axis: olecranon process - Stationary arm: parallel or perpendicular to the floor - Moving arm: or not using the electron process an owner styloid process for reference - ROM norm:0-90

Shoulder medial rotation goniometric technique - Patient position: - Stabilization: - End-feel: - Axis: - Stationary arm: - Moving arm: - ROM norm:

Shoulder medial rotation goniometric technique - Patient position: supine with the shoulder Abd to 90 degrees in elbow flex to 90 degrees - Stabilization: distal end of the humerus to maintain the shoulder in a 90 degree Abd - End-feel: firm - Axis: olecranon process - Stationary arm: parallel or perpendicular to the floor - Moving arm: ulna Using the electron process and ulnar styloid process for reference - ROM norm:0-70

- Talar tilt test o Testing procedure: o Positive result is o Positive test means:

Special tests for ligament instability at the ankle - anterior drawer test o Testing procedure: Patient is positioned in supine. Therapist stabilizes the distal tibia and fibula with one hand, while the other hand holds the foot in 20 degrees of planter flexion and draws the tallis forward in the ankle mortis. o Positive result is Excessive anterior translation of the tallis away from the ankle mortis o Positive test means: anterior talofibular ligament sprain - Lateral rotation stress test (Kleiger test ) o Testing procedure: patient is seated at edge of table with their knee and 90 degrees of flexion. Therapist stabilizes patients lower leg and holds patients put in neutral. Therapist applies lateral rotation to foot. o Positive result is Pain over the anterior or posterior tibial fibular ligaments And the interosseous membrane, the test is positive for high ankle sprain o Positive test means: high ankle sprain . aka syndesmosis injury o the test is positive for a deltoid ligament tear if the patient has pain medially and the therapist can feel the tallis shift away from the medial malleolus - Talar tilt test o Testing procedure: patient is positioned in sideline with knee flexed 90 degrees . Therapist stabilizes distal tibia with one hand while grasping the tallis with other hand. Maintain neutral foot. therapist tilt Alice into Abd and add. o Positive result is excessive add o Positive test means: calcaneofibular ligament sprain

Subtalar joint Location? - How many degrees of freedom? - convex surfaces? concave? - Osteo kinematic motions? - Loose pack position? - close pack position - capsular pattern -

Subtalar joint Location? - between talus and calcaneus How many degrees of freedom? - 1 convex surfaces? - Talus anterior and middle articulations concave? - Calcanious Osteo kinematic motions? - Inversion, eversion Loose pack position? - Midway between extremes of range of movement close pack position - Supination capsular pattern - limitation of varus

Thumb interphalangeal Range of motion norms - Flexion

Thumb interphalangeal Range of motion norms - Flexion 0-80

Thumb metacarpophalangeal Range of motion norms - Flexion

Thumb metacarpophalangeal Range of motion norms - Flexion 0-50

Types of post operative amputation dressings rigid (plaster of Paris ) Advantages : disadvantages : non weight bearing rigid removable limb protectors Advantages : disadvantages : semirigid (Unna paste , air splint ) Advantages : disadvantages : soft (ace wrap ,shrinker ) Advantages : disadvantages :

Types of post operative amputation dressings rigid (plaster of Paris ) Advantages : - early ambulation with pylon - promote circulation and healing - stimulates proprioception - provides protection - provide soft tissue support - limits edema disadvantages : - immediate wound inspection not possible - does not allow for daily dressing changes - requires professional application non weight bearing rigid removable limb protectors Advantages : - removable - accommodates edema fluctuation - easily applied - Prevents contractions - provides protection disadvantages : - not for ambulation semirigid (Unna paste , air splint ) Advantages : - reduces postoperative swelling - Provides soft tissue support - Promotes earlier ambulation - Provides protection - Easily changeable disadvantages : - does not protect as well as rigid dressing - Requires more changing than rigid dressing - May loosen an allow for development of swelling soft (ace wrap ,shrinker ) Advantages : - reduces postoperative swelling - provide some protection - relatively inexpensive - easily removed for wound inspection - allows for active joint range of motion disadvantages : - tissue healing is are interrupted by frequent dressing changes - joint range of motion may delay the healing of the incision - less control of the residual limb pain - cannot control the amount of tension in the bandage - risk of a tourniquet effect - shrinker cannot be applied until sutures or staples are removed

Ulnar deviation goniometric technique - Patient position: - Stabilization: - End-feel: - Axis: - Stationary arm: - Moving arm: - ROM norm:

Ulnar deviation goniometric technique - Patient position: sitting next to a supporting surface with the shoulder Abd to 90 degrees and the elbow flexed to 90 degrees - Stabilization: radius and ulna to prevent supination or pronation - End-feel: firm - Axis: Over the midline of the dorsal aspect of the wrist over the capitate - Stationary arm: dorsal midline of the forearm using the lateral epicondyle of the humerus for reference - Moving arm: dorsal midline of the third metacarpal - ROM norm: 0-30

Ulnohumeral joint AKA elbow - loose packed : - close pack position:

Ulnohumeral joint AKA elbow - loose packed :70degrees of flexion, 10 degrees of supination - closed packed position: extension

What is a parkinsonian pattern of gait?

What is a parkinsonian pattern of gait? - increase forward flexion of the trunk and knees, gait is shuffling with quick and small steps

What is a steppage gait pattern?

What is a steppage gait pattern? - a gait pattern in which the feet and toes are lifted through hip and knee flexion to excessive Heights - foot will slap at initial content secondary to decreased control

What is hydrostatic weighing?

What is hydrostatic weighing? - calculate the density of body AKA percent body fat , by immersing a person in water and measuring the amount of water displaced

circumducted gait prosthetic causes: amputee causes:

circumducted gait prosthetic causes: - prosthesis too long - excessive knee friction - socket too small - excessive planter flexion amputee causes: - abd contracture - improper training - weak hip flexors - lacks confidence to flex the knee - painful anterior distal residual limb - inability to initiate prosthetic knee flexion

congenital limb deficiencies What is it: Etiology: Signs and symptoms: Treatment:

congenital limb deficiencies What is it: - Malformation that occurs in utero - classified as longitudinal or transverse - longitudinal limb deficiency o reduction or absence of long axis of the bone - transverse limb deficiency o limb that has developed to a particular level beyond which no skeletal element exists Etiology: - idiopathic or genetic is the majority - other possible reasons are poor blood supply, constricting amniotic bands, infection, maternal drug exposure Signs and symptoms: - structural or acquired abnormality of limb - Phantom limb pain Treatment: - symmetrical movements - strengthening - range of motion - weight bearing activities - prosthetic training when appropriate

convex - concave rule convex surface moving on concave surface concave surface moving on convex surface

convex - concave rule convex surface moving on concave surface - roll and slide occur in opposite directions - mobilizing force should be applied in the opposite direction of the bow and movement concave surface moving on convex surface - roll and slide occur in same direction - mobilizing force should be applied in the same direction as the bones move

during loading response of gate are the ankle dorsi flexors acting eccentrically or concentrically? what muscle controls knee flexion? what muscle controls pronation of the foot? what muscles control dorsiflexion as the tibia moves over the foot?

during loading response of gate are the ankle dorsi flexors acting eccentrically or concentrically? - essentially to lower the foot toward the ground what muscle controls knee flexion? - quadriceps contract eccentrically to control knee flexion as the limb accepts the weight of the body what muscle controls pronation of the foot? - tibialis posterior eccentrically control pronation of foot what muscles control dorsiflexion as the tibia moves over the foot? - planter flexors eccentrically control dorsal flexion as the tibia moves over the foot and moves over the foot in the later portion of this phase

functional test for L4 through L5 functional test for S1 functional test for L4 through S1

functional test for L4 through L5 - Heel walking functional test for S1 - Toe walking functional test for L4 through S1 - straight leg race

glenohumeral ligaments different types (3) superior glenohumeral what does it limit? Middle glenohumeral ligament what does it limit? inferior glenohumeral ligament what are the parts ? what motion does it limit?

glenohumeral ligaments different types - superior - Middle - Inferior glenohumeral ligament superior glenohumeral what does it limit? - add of shoulder and lateral rotation of shoulder in zero-45 degrees of Abd Middle glenohumeral ligament what does it limit? - Limits lateral rotation with the shoulder in 45 dash 90 degrees of AB duction inferior glenohumeral ligament what are the parts ? - anterior an posterior band and between those two is an axillary pouch what motion does it limit? - limits lateral rotation and medial rotation above 90 degrees of Abd - the axillary pouch limits inferior translation when the shoulder is above 90 degrees of Abd

grade one mobilizations grade two mobilizations grade three mobilizations grade 4 mobilization grade 5 mobilizations

grade one mobilizations - small amplitude movements performed at beginning of range grade two mobilizations - large amplitude movement performed within the range, but not reaching the limit of the range and not returning to the beginning of range grade three mobilizations - large amplitude movement performed up to the limit of range grade 4 mobilization - small amplitude movement performed at limit of range grade 5 mobilizations - small amplitude, high velocity thrust technique performed to snap adhesions at the limit of range

hip precautions for anterior lateral approach of total hip arthroplasty

hip precautions for anterior lateral approach of total hip arthroplasty - flexion beyond 90 - extension - lateral rotation - ADD hip precautions for direct lateral approach of total hip arthroplasty - avoid flexion beyond 90 - extension - lateral rotation - ADD hip precautions for posterior lateral approach of total hip arthroplasty - avoid flexion beyond 90 degrees - ADD - medial rotation

hip precautions for direct lateral approach of total hip arthroplasty

hip precautions for anterior lateral approach of total hip arthroplasty - flexion beyond 90 - extension - lateral rotation - ADD hip precautions for direct lateral approach of total hip arthroplasty - avoid flexion beyond 90 - extension - lateral rotation - ADD hip precautions for posterior lateral approach of total hip arthroplasty - avoid flexion beyond 90 degrees - ADD - medial rotation

hip precautions for posterior lateral approach of total hip arthroplasty

hip precautions for anterior lateral approach of total hip arthroplasty - flexion beyond 90 - extension - lateral rotation - ADD hip precautions for direct lateral approach of total hip arthroplasty - avoid flexion beyond 90 - extension - lateral rotation - ADD hip precautions for posterior lateral approach of total hip arthroplasty - avoid flexion beyond 90 degrees - ADD - medial rotation

how often does Medicare give new prosthetics?

how often does Medicare give new prosthetics? - every five years they can get a new one

resistance training parameters intensity

intensity - Resistance - the amount of efforts includes weight, speed - amount of weight is expressed as a percentage of the patients one repetition maximum 1RM - to increase strength = less reps, higher intensity/weight - to increase endurance = less load, higher reps - to increase power = low reps very high intensity load (intensity is very high because of addition of speed)

interosseous sacroiliac ligament Origin and insertion? function?

interosseous sacroiliac ligament Origin and insertion? - Connects sacrum and is located deep to the posterior sacroiliac ligament - very strong ! function? - Functions to resist anterior and inferior movement of the sacrum

interphalangeal joint - loose packed : - close pack position:

interphalangeal joint - loose packed position : slight flexion - closed packed position : full extension

isotonic exercise

isotonic exercise - muscle exerts constant tension - have muscle moves with constant load such as pully - performed against resistance, often employing equipment such as handheld weights - two types of isotonic contractions o eccentric and concentric

meniscus tear What is it: Etiology: Signs and symptoms: special tests : Treatment:

meniscus tear What is it: - More commonly injured ban lateral meniscus because it is less mobile due to its attachment to the joint capsule - incidents of medial meniscal tears increase overtime with ACL deficiency - definitively diagnosed by arthroscopic or magnetic resonance imaging Etiology: - fixed foot rotation while weight bearing on flex knee - compression and rotation forces on meniscus Signs and symptoms: - joint line pain - swelling - catching or locking sensation special tests : - apelys compression test - bounce home test - McMurray test Treatment: - RICE - NSAIDS - strengthening - surgery warranted for active individuals

Dynamic stretching

methods of stretching static stretching - Placing muscle at its maximal length and holding the position against an external force for a prolonged period of time - low intensity long duration - safest form of stretching - results in the greatest gains and tissue extensibility - last activation of the muscle spindles as compared to ballistic stretching and thus less resistance to stretch - no consensus on optimal duration although generally perceived 30 seconds ballistic stretching - characterized by quick, jerky movements that result in rapid change in muscle length. - muscle is placed near its end of range of movement and then the patient bounces back and forth to place repetitive stretch on the muscle - high intensity short duration - ballistic stretching occurs quickly, therefore it activates the muscle spindles and results in greater resistance to stretch - it is not as effective for approving tissue extensibility because of this resistance it may be more effective when preparing the muscles for athletic activity - more likely to lead to muscle soreness an injury due to high intensity of stretch force proprioceptive neuromuscular facilitation PNF stretching - PNF Incorporates active muscle contractions into stretching muscle contraction is thought to lead to muscle relaxation through the principles of autogenetic and reciprocal inhibition and results in greater gains in muscle flexibility - what are you doing muscle relaxation technique occurs on muscle fibers , they are more effective at treating range of motion limitations due to the muscle spasm as opposed to connective tissue - another theory for PNF is that improved flexibility is due to increased tolerance change is secondary - not an effective technique for patients with paralysis or spasticity due to requirement for active muscle control - examples include o contract relax o agonist contraction o contract relax with agonist contraction Dynamic stretching - involves the patient actively moving a body segment to the end of range but not beyond the limits while the antagonist muscle relaxes and stretches - unlike static stretching, in range movement is held only briefly and is performed repeatedly - most commonly used as a warmup prepare the body for athletic activities - is more effective at preparing the body for explosive movements when compared to static stretching - dynamic stretching emphasizes a movement based approach, while ballistic stretching emphasizes bouncing movements

midtarsal joint AKA? formed by? How many axes? - osteo kinematic motions? loose pack position? Close pack position? capsular pattern?

midtarsal joint AKA? - Transverse tarsal joint formed by? - Talocalcaneonavicular joint and the calcanieal cuboid joint How many axes? - 2 - one longitudinal, one oblique - Try planner motion on both osteo kinematic motions? - Inversion, eversion loose pack position? - Midway between extremes of range of motion Close pack position? - Supination capsular pattern? - Dorsi flexion, planter flexion, adduction, medial rotation

observing posture of the foot good posture of the foot common faulty postures at the foot - Pronation - supination - toeing-out - toeing-in

observing posture of the foot good posture of the foot - in standing the longitudinal arch has the shape of 1/2 Dome - Barefoot or in shoes without heels, the feet to out slightly - In shoes with heels, the feet are parallel - And walking with or without shoes, the feet are parallel and the weight is transferred from the heel along the outer border to the ball of the foot - And sprinting, the feet are parallel or toe in slightly. The weight is on the balls of the feet and toes because the heels do not come in contact with ground common faulty postures at the foot - low longitudinal arch or flat foot - Low metatarsal arch, usually indicated by callus under the ball of the foot - Pronation o ankle rolls in o weight on inner side of the foot - supination o ankle rolls out o more weight on outer border a foot - toeing-out o slue footed - toeing-in o Pigeon toed

observing posture of the hips, pelvis, and spine from the posterior view Good postures of the hip, pelvis, spine from posterior view common faulty postures of the hips, pelvis and spine - lateral pelvic tilt - rotated hips

observing posture of the hips, pelvis, and spine from the posterior view Good postures of the hip, pelvis, spine from posterior view - body weight is distributed evenly on both feet and the hips are level - One side should not be more prominent than the other as seen from the front or back, nor is one hit more forward or backward than the other when seen in the sagittal view - Spine does not curve - A slight deviation of the spine to the left in right handed individuals and to the right and left handed individuals is not uncommon . Also a tendency towards a slightly low right shoulder and slightly high right hip is frequently found in right handed people and vice versa for left handed people common faulty postures of the hips, pelvis and spine - lateral pelvic tilt o one hip is higher than the other o sometimes it's not really higher but appears because a sideways sway of the body has made it more prominent - rotated hips o the hips are rotated so that one is farther forward than the other (clockwise or counterclockwise rotation )

observing posture of the toes What is good posture of the toes? hammertoe hallux valgus

observing posture of the toes What is good posture of the toes? - to should be straight, neither point it down or up - they should extend forward in line with the foot and should not be squeezed together or overlap Common faulty postures of the toes hammertoe - toes bend up at the first joint and down at the middle joint so the weight rests on the tips of the toes - often associated with wearing shoes that are too short hallux valgus - big toe slants inward towards the midline of the foot - AKA bunion - default is often associated with wearing shoes that are too narrow and pointed at the toes

precision grip what is a precision grip ? What are the types of precision grips? - digital prehension grip - lateral prehension grip - tip prehension grip

precision grip what is a precision grip ? - is used when accurate and precise movements of hand are needed. This type of grip involves the metacarpophalangeal an interphalangeal joints on the radial side of the hand. What are the types of precision grips? - digital prehension grip o three finger pinch o Pulp to pulp contact between the thumb, index finger, middle finger such as holding a pencil - lateral prehension grip o key o Contact between the thumb and lateral side of the index finger. This type of grip may be used when using a key - tip prehension grip o tip pitch o thumb opposition so that the tip of the thumb Contacts the tip of another finger. This type of grip may be used when holding a needle

Capsular pattern of radiocarpal joints (wrist)

radiocarpal joints (wrist) - flexion an extension equally limited

Capsular pattern of radiohumeral joint

radiohumeral joint - flexion, extension, supination, pronation

range of motion contraindications

range of motion contraindications - should not be performed when motion is detrimental to healing of tissues - however controlled motion within a pain free range has been shown to be beneficial in the early stages of healing - increase pain or inflammation are signs that range of motion activities may be too aggressive

- Allen test o Testing procedure: o Positive result is o Positive test means:

special tests of the wrist and hand for vascular insufficiency - Allen test o Testing procedure: patient is sitting or standing open and close hand several times in succession and then maintain hand in closed position. Therapist compresses radial and ulnar arteries . Patient asked to relax hand and therapist releases the pressure on one of the arteries while serving the color of the hand and fingers o Positive result is delayed or absent flashing of the radial or ulnar half of the hand o Positive test means: occlusion in the radial or ulnar arteries

thumb spica splint what is it, where does it go? what is it used to treat ? what position should the digits be ?

thumb spica splint what is it, where does it go? - Rigid splint that covers the radial side of the forearm and hand as well as the thumb - Covers the entire thumb or may stop at the proxamol failings of the thumb and thus allow for IP joint motion what is it used to treat ? - used to immobilize the wrist an MCP joints of the thumb for treating gamekeepers then , scaphoid fractures, first metacarpal fractures, de quervians syndrome, other thumb injuries what position should the digits be ? - wrist in 20 degrees of extension - MCP joints in slight flexion

What 7 muscles do planter flexion

tibialis posterior - Gastrocnemius - Soleus - Peroneus longus - Peroneus brevis - Plantaris - Flexor hallucis

tibiofemoral Joint convex surface? concave surface? loose pack position? closed packed position Capsular pattern

tibiofemoral Joint convex surface? - Medial and lateral condyles of the distal femur concave surface? - Medial and lateral condyles of the proximal tibia loose pack position? - 25 degrees of flexion closed packed position - Full extension, lateral rotation of tibia Capsular pattern - Flexion, extension

total knee arthroplasty What is it: o Unicompartmental o Bicompartmental o Tricompartmental o unconstrained o semi constrained o fully constrained - fixation types - lifespan for a total knee arthroplasty - potential complications Etiology: Signs and symptoms: Treatment: Goals for flexion

total knee arthroplasty What is it: - Types of total knee arthroplasty o Unicompartmental § Only the medial or lateral joint surface was replaced o Bicompartmental § entire surface of the femur and tibia were replaced o Tricompartmental § replacement of femur and tibia along with Patella - Degree of constraints o unconstrained § no inherent stability § relies on soft tissue integrity for stability § primarily used with unicompartmental o semi constrained § some degree of stability without compromising mobility § most common classification of TKA o fully constrained § most ability by restricting one or more planes of motion § results in greater implant stress with a higher likelihood of implant problems - fixation types o cemented o uncemented - lifespan for a total knee arthroplasty o 15 to 20 years - potential complications o DVT o infection o pulmonary embolism o peroneal nerve palsy o restricted range of motion o Periprosthetic fractures o chronic joint effusion Etiology: - osteoarthritis - osteomyelitis Signs and symptoms: - prior to surgery o severe pain with weight bearing o Loss of mobility o Gross instability or limitation in range of motion o Marked deformity of the knee o Failure of conservative management Treatment: - Decreasing inflammation - Emphasizing adherence to need precautions - Minimize muscle atrophy - Regain full passive range of motion - Ankle pumps - Quad and glute sets - Active range of motion within available range - Continuous passive motion machine - Assistive device training - Progressive ambulation Goals for flexion - minimum of 90 degrees of knee flexion required for ADLs - minimum of 105 degrees of knee flexion to rise comfortably from sitting

ulnar gutter splinter What is it, where does it go? indications for ulner gutter splinter what position should it be in ?

ulnar gutter splinter What is it, where does it go? - rigid splint that covers the owner side of the forearm in hand as well as the 4th and 5th digits - used to immobilize the metacarpals and phalanges an is commonly used following a fracture to these structures indications for ulner gutter splinter - fractured two metacarpals and or phalanges what position should it be in ? - metacarpal phalangeal joints MCP are placed in 60 -90 degrees of flexion - with the Inter phalangeal IP joints in full extension - and the wrist in slight extension

types of amputations Forequarter (scapulothoracic) amputation Shoulder Disarticulation amputation Transhumeral amputation Elbow disarticulation amputation Transradial amputation Wrist disarticulation amputation Partial hand amputation Digital amputation Hemicorporectomy amputation Hemipelvectomy amputation Hip disarticulation amputation Transfemoral amputation Knee Disarticulation amputation Transtibial amputation Syme's amputation Transverse tarsal (Chopart's) amputation Tarsometatarsal (Lisfranc) Amputation

types of amputations Forequarter (scapulothoracic) amputation - Surgical removal of the upper extremity including the shoulder girdle Shoulder Disarticulation amputation - surgical removal of the upper extremity through the shoulder Transhumeral amputation - surgical removal of the upper extremity proximal to the joint of the elbow Elbow disarticulation amputation - surgical removal of the lower arm and hand through the elbow joint Transradial amputation - surgical removal of the upper extremity distal to the elbow joint Wrist disarticulation amputation - surgical removal of the hand through the wrist joint Partial hand amputation - surgical removal of a portion of the hand and or digits at either the trans carpal, trans metacarpal or trans phalangeal level Digital amputation - surgical removal of a digit at either the metacarpal phalangeal, proximal interphalangeal or distal interphalangeal level Hemicorporectomy amputation - surgical removal of the pelvis and lower extremities Hemipelvectomy amputation - surgical removal of 1/2 of the pelvis and the lower extremity Hip disarticulation amputation - surgical removal of the lower extremity from the pelvis Transfemoral amputation - surgical removal of the lower extremity above the knee joint Knee Disarticulation amputation - surgical removal of the lower extremity through the knee joint Transtibial amputation - surgical removal of the lower extremity below the knee joint Syme's amputation - surgical removal of the foot at the ankle joint with removal of the malleoli Transverse tarsal (Chopart's) amputation - amputation through the talonavicular and calcaneocuboid joints - preserves the plantar flexors, but sacrifices the dorsal flexors often resulting in equinus contracture Tarsometatarsal (Lisfranc) Amputation - surgical removal of the metatarsals - preserves the dorsi flexors and plantar flexors

what are the range of motion requirements of ... for normal gait ? - hip flexion - hip extension - knee flexion - knee extension - ankle dorsi flexion - ankle plantar flexion

what are the range of motion requirements of ... for normal gait ? - hip flexion o 0-30 degrees - hip extension o 0-10 degrees - knee flexion o 0-60 degrees - knee extension o zero degrees - ankle dorsi flexion o 0-10 degrees - ankle plantar flexion o 0-20 degrees

what are the range of motion requirements of ankle DF for normal gait ?

what are the range of motion requirements of ... for normal gait ? - hip flexion o 0-30 degrees - hip extension o 0-10 degrees - knee flexion o 0-60 degrees - knee extension o zero degrees - ankle dorsi flexion o 0-10 degrees - ankle plantar flexion o 0-20 degrees

what are the range of motion requirements of ankle PF for normal gait ?

what are the range of motion requirements of ... for normal gait ? - hip flexion o 0-30 degrees - hip extension o 0-10 degrees - knee flexion o 0-60 degrees - knee extension o zero degrees - ankle dorsi flexion o 0-10 degrees - ankle plantar flexion o 0-20 degrees

what motion does the medial collateral ligament prevent at the knee?

what motion does the medial collateral ligament prevent - Prevents excessive valgus displacement of the tibia relative to femur

what is the average stride length of an adult? how is it measured?

what is the average stride length of an adult? - 56 inches how is it measured? - between right heel strike

what causes theses Gait deviations of the ankle and foot clawing of toes

- foot slap o weak dorsal flexors o dorsi flexor paralysis - toe down instead of heel strike o plantar flexor spasticity o plantar flexor contracture o weak dorsal flexors o dorsal flexor paralysis o leg length discrepancy o hindfoot pain - clawing of toes o toe flexor spasticity o positive support reflex - heel lift during midstance o insufficient dorsal flexion range o planter flexor spasticity - no toe off o forefoot/or toe pain o Weak plantar flexors o Weak toe flexors o insufficient planter flexion range of motion

what causes theses Gait deviations of the ankle and foot foot slap

- foot slap o weak dorsal flexors o dorsi flexor paralysis - toe down instead of heel strike o plantar flexor spasticity o plantar flexor contracture o weak dorsal flexors o dorsal flexor paralysis o leg length discrepancy o hindfoot pain - clawing of toes o toe flexor spasticity o positive support reflex - heel lift during midstance o insufficient dorsal flexion range o planter flexor spasticity - no toe off o forefoot/or toe pain o Weak plantar flexors o Weak toe flexors o insufficient planter flexion range of motion

what causes theses Gait deviations of the ankle and foot heel lift during midstance

- foot slap o weak dorsal flexors o dorsi flexor paralysis - toe down instead of heel strike o plantar flexor spasticity o plantar flexor contracture o weak dorsal flexors o dorsal flexor paralysis o leg length discrepancy o hindfoot pain - clawing of toes o toe flexor spasticity o positive support reflex - heel lift during midstance o insufficient dorsal flexion range o planter flexor spasticity - no toe off o forefoot/or toe pain o Weak plantar flexors o Weak toe flexors o insufficient planter flexion range of motion

Adaptations that occur with strength training

Adaptations that occur with strength training - muscle fiber hypertrophy - fiber type remodeling from 2B to 2A - increase neuromuscular activity through number of motor units and firing rate - decreased or no change in capillary bed density - decreased mitochondrial density - increase stores of ATP, CP and other energy sources - increase tensile strength of tendons and ligaments - increase bone mineral density - increase lean body mass - decrease body fat percent Adaptations that occur with endurance training - increased capillary bed density - increased mitochondrial density - increased stores of ATP, CP, and other energy sources - increased tensile strength of tendons and ligaments - increased bone mineral density - decreased body fat percentage

Finger 2-5 proximal interphalangeal flexion goniometric technique - Patient position: - Stabilization: - End-feel: - Axis: - Stationary arm: - Moving arm: - ROM norm:

Finger 2-5 proximal interphalangeal flexion goniometric technique - Patient position: sitting with the forearm and hand supported - Stabilization: proximal phalanx to prevent motion at the metacarpophalangeal joint - End-feel: soft, firm, hard - Axis: over the dorsal aspect of the proximal interphalangeal joint - Stationary arm: over the dorsal midline of the proximal phalanx - Moving arm: over the dorsal midline of the middle phalanx - ROM norm:0-100

Fingers 2-5 metacarpophalangeal abduction goniometric technique - Patient position: - Stabilization: - End-feel: - Axis: - Stationary arm: - Moving arm: - ROM norm:

Fingers 2-5 metacarpophalangeal abduction goniometric technique - Patient position: sitting with the forearm and hand on the supporting surface - Stabilization: metacarpal to prevent wrist motion - End-feel: firm - Axis: over the dorsal aspect of the metacarpalphalangeal joint - Stationary arm: Over the dorsal midline of the metacarpal - Moving arm: dorsal midline of the proximal phalanx - ROM norm:?

Fingers 2-5 metacarpophalangeal adduction goniometric technique - Patient position: - Stabilization: - End-feel: - Axis: - Stationary arm: - Moving arm: - ROM norm:

Fingers 2-5 metacarpophalangeal adduction goniometric technique - Patient position: sitting with the forearm in hand supported - Stabilization: metacarpal to prevent wrist motion - End-feel: firm - Axis: over the dorsal aspect of the metacarpal phalangeal joint - Stationary arm: over the dorsal midline of the metacarpal - Moving arm: dorsal midline of the proximal phalanx - ROM norm:?

What five muscles do AB duction of the hip

Gluteus medias - Gluteus minimas - Piriformis - Obturator internus - Tensor fascia lata

Hip medial rotation goniometric technique - Patient position: - Stabilization: - End-feel: - Axis: - Stationary arm: - Moving arm: - ROM norm:

Hip medial rotation goniometric technique - 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 - Moving arm: anterior midline of the lower leg using the Crest of the tibia and a point midway between the two malleoli for reference - ROM norm:0-45

Posterior ligament of elbow where is its location/ what is it attached to ?

Posterior ligament where is its location/ what is it attached to ? - posterior ligament resembles the anterior ligament - It blends each side of the collateral ligaments - It is attached to the upper portion of the olecranon fossa Attached just below the olecranon process

Power Grip What is a power grip? - cylindrical grasp - fist grasp - spherical grasp - hook grasp

Power Grip What is a power grip? - is used when a strong or forceful grip is needed an involved stabilization of the object against the palm of the hand. Fingers are in flexion in the wrist is an ulner deviation in slight extension what are the types of power grip? - cylindrical grasp o entire hand wraps around object with thumb on one side and the four fingers on the opposite side . This type of grasp is used for cylindrically shaped objects such as a soda can - fist grasp o similar to a cylindrical grasp but involves grasping around a narrower object so the thumb and fingers overlap. This type of grasp is used for smaller cylindrically shaped objects such as a hammer - spherical grasp o characterized by the entire hand wrapping around a spherical object. It differs from a cylindrical grasping that fingers are separated from one another and there is a great amount of thumb opposition. This type of grasp is used for spherical objects such as a baseball - hook grasp o characterized by the use of 2nd and 3rd interphalangeal joints although it can involve all four fingers, to create a hook to hold an object. A hook grasp is controlled by the forearm flexors and extensors. This type of grasp is used for objects with a handle such as a pail

Shoulder stabilization surgeries Capsular shift procedure what is it ? what condition is a capsular shift used to fix ? why is labral repair often accompanying shoulder stabilization surgeries ? what is a bankart repair? What are the post surgical precautions for a SLAP repair ? what are the precautions if the anterior capsule was repaired what are the precautions if the posterior capsule was repaired

Shoulder stabilization surgeries Capsular shift procedure what is it ? - tightening of the joint capsule by cutting the capsule and overlapping the ends to reduce capsular redundancy what condition is a capsular shift used to fix ? - chronic shoulder instability why is labral repair often accompanying shoulder stabilization surgeries ? - labral tears often accompany dislocation injuries what is a bankart repair? - a type of labral repair of the anterior labrum what is a SLAP repair - repair of superior labrum What are the post surgical precautions for a SLAP repair ? - patient should avoid contracting or stretching the biceps since the biceps is attached at the superior labrum what are the precautions if the anterior capsule was repaired - utilizing normal sling - avoid external rotation, extension, horizontal abd, resisted internal rotation if these subscapularis muscle was detached what are the precautions if the posterior capsule was repaired - immobilized in handshake position with the shoulder in neutral rotation - patient should avoid internal rotation, flection, horizontal ADD

- Lateral rotation stress test (Kleiger test ) o Testing procedure: o Positive result is o Positive test means:

Special tests for ligament instability at the ankle - anterior drawer test o Testing procedure: Patient is positioned in supine. Therapist stabilizes the distal tibia and fibula with one hand, while the other hand holds the foot in 20 degrees of planter flexion and draws the tallis forward in the ankle mortis. o Positive result is Excessive anterior translation of the tallis away from the ankle mortis o Positive test means: anterior talofibular ligament sprain - Lateral rotation stress test (Kleiger test ) o Testing procedure: patient is seated at edge of table with their knee and 90 degrees of flexion. Therapist stabilizes patients lower leg and holds patients put in neutral. Therapist applies lateral rotation to foot. o Positive result is Pain over the anterior or posterior tibial fibular ligaments And the interosseous membrane, the test is positive for high ankle sprain o Positive test means: high ankle sprain . aka syndesmosis injury o the test is positive for a deltoid ligament tear if the patient has pain medially and the therapist can feel the tallis shift away from the medial malleolus - Talar tilt test o Testing procedure: patient is positioned in sideline with knee flexed 90 degrees . Therapist stabilizes distal tibia with one hand while grasping the tallis with other hand. Maintain neutral foot. therapist tilt Alice into Abd and add. o Positive result is excessive add o Positive test means: calcaneofibular ligament sprain

- anterior drawer test at ankle o Testing procedure: o Positive result is o Positive test means:

Special tests for ligament instability at the ankle - anterior drawer test o Testing procedure: Patient is positioned in supine. Therapist stabilizes the distal tibia and fibula with one hand, while the other hand holds the foot in 20 degrees of planter flexion and draws the tallis forward in the ankle mortis. o Positive result is Excessive anterior translation of the tallis away from the ankle mortis o Positive test means: anterior talofibular ligament sprain - Lateral rotation stress test (Kleiger test ) o Testing procedure: patient is seated at edge of table with their knee and 90 degrees of flexion. Therapist stabilizes patients lower leg and holds patients put in neutral. Therapist applies lateral rotation to foot. o Positive result is Pain over the anterior or posterior tibial fibular ligaments And the interosseous membrane, the test is positive for high ankle sprain o Positive test means: high ankle sprain . aka syndesmosis injury o the test is positive for a deltoid ligament tear if the patient has pain medially and the therapist can feel the tallis shift away from the medial malleolus - Talar tilt test o Testing procedure: patient is positioned in sideline with knee flexed 90 degrees . Therapist stabilizes distal tibia with one hand while grasping the tallis with other hand. Maintain neutral foot. therapist tilt Alice into Abd and add. o Positive result is excessive add o Positive test means: calcaneofibular ligament sprain

- Apley's compression test o Testing procedure: o Positive result is o Positive test means:

Special tests for meniscal pathology of the knee - Apley's compression test o Testing procedure: patient in prone with knees flexed 90 degrees. Therapist stabilizes patients femur places other hand on patients heal. Therapist immediately and laterally rotates tibia while applying a compressive force through tibia. o Positive result is Pain or clicking o Positive test means: meniscal Lesion - bounce home test o Testing procedure: patient positioned in supine. Therapist grasp the patients heel and maximally flexes knee. Patients knee is extended passively. o Positive result is Incomplete extension or a rubbery end feel o Positive test means: meniscal lesion - McMurray test o Testing procedure: patient positions in supine. Therapist palpates knee joint line with kneee fully flex, therapist medially rotates the tibia and extends the knee. Therapist repeats same procedure while laterally rotating the tibia. o Positive result is Click or pronounced crepitation felt over the joint line o Positive test means: posterior meniscal lesion - Thessaly test o Testing procedure: patient stands on one leg with approximately 5 degrees of knee flexion. Patient rotates femur and tibia laterally immediately three times. Test is repeated with a 20 degree knee bend. o Positive result is Joint line discomfort or catching or locking in the knee in either position o Positive test means:meniscal lesion

- McMurray test o Testing procedure: o Positive result is o Positive test means:

Special tests for meniscal pathology of the knee - Apley's compression test o Testing procedure: patient in prone with knees flexed 90 degrees. Therapist stabilizes patients femur places other hand on patients heal. Therapist immediately and laterally rotates tibia while applying a compressive force through tibia. o Positive result is Pain or clicking o Positive test means: meniscal Lesion - bounce home test o Testing procedure: patient positioned in supine. Therapist grasp the patients heel and maximally flexes knee. Patients knee is extended passively. o Positive result is Incomplete extension or a rubbery end feel o Positive test means: meniscal lesion - McMurray test o Testing procedure: patient positions in supine. Therapist palpates knee joint line with kneee fully flex, therapist medially rotates the tibia and extends the knee. Therapist repeats same procedure while laterally rotating the tibia. o Positive result is Click or pronounced crepitation felt over the joint line o Positive test means: posterior meniscal lesion - Thessaly test o Testing procedure: patient stands on one leg with approximately 5 degrees of knee flexion. Patient rotates femur and tibia laterally immediately three times. Test is repeated with a 20 degree knee bend. o Positive result is Joint line discomfort or catching or locking in the knee in either position o Positive test means:meniscal lesion

- Thessaly test o Testing procedure: o Positive result is o Positive test means:

Special tests for meniscal pathology of the knee - Apley's compression test o Testing procedure: patient in prone with knees flexed 90 degrees. Therapist stabilizes patients femur places other hand on patients heal. Therapist immediately and laterally rotates tibia while applying a compressive force through tibia. o Positive result is Pain or clicking o Positive test means: meniscal Lesion - bounce home test o Testing procedure: patient positioned in supine. Therapist grasp the patients heel and maximally flexes knee. Patients knee is extended passively. o Positive result is Incomplete extension or a rubbery end feel o Positive test means: meniscal lesion - McMurray test o Testing procedure: patient positions in supine. Therapist palpates knee joint line with kneee fully flex, therapist medially rotates the tibia and extends the knee. Therapist repeats same procedure while laterally rotating the tibia. o Positive result is Click or pronounced crepitation felt over the joint line o Positive test means: posterior meniscal lesion - Thessaly test o Testing procedure: patient stands on one leg with approximately 5 degrees of knee flexion. Patient rotates femur and tibia laterally immediately three times. Test is repeated with a 20 degree knee bend. o Positive result is Joint line discomfort or catching or locking in the knee in either position o Positive test means:meniscal lesion

- bounce home test o Testing procedure: o Positive result is o Positive test means:

Special tests for meniscal pathology of the knee - Apley's compression test o Testing procedure: patient in prone with knees flexed 90 degrees. Therapist stabilizes patients femur places other hand on patients heal. Therapist immediately and laterally rotates tibia while applying a compressive force through tibia. o Positive result is Pain or clicking o Positive test means: meniscal Lesion - bounce home test o Testing procedure: patient positioned in supine. Therapist grasp the patients heel and maximally flexes knee. Patients knee is extended passively. o Positive result is Incomplete extension or a rubbery end feel o Positive test means: meniscal lesion - McMurray test o Testing procedure: patient positions in supine. Therapist palpates knee joint line with kneee fully flex, therapist medially rotates the tibia and extends the knee. Therapist repeats same procedure while laterally rotating the tibia. o Positive result is Click or pronounced crepitation felt over the joint line o Positive test means: posterior meniscal lesion - Thessaly test o Testing procedure: patient stands on one leg with approximately 5 degrees of knee flexion. Patient rotates femur and tibia laterally immediately three times. Test is repeated with a 20 degree knee bend. o Positive result is Joint line discomfort or catching or locking in the knee in either position o Positive test means:meniscal lesion

Surgeries to fix articular cartilage defects What is a micro fracture procedure ? what is osteochondral autograft transplantation what is autologous chondrocyte implantation ? what are the general post surgical precautions ?

Surgeries to fix articular cartilage defects What is a micro fracture procedure ? - uses a awl two penetrates subchondral bone, which causes ingrowth of fibrocartilage what is osteochondral autograft transplantation - procedure where cartledge is harvested from several non weight bearing services to form a plug that can fill the chondral defect what is autologous chondrocyte implantation ? - procedure where healthy cartilage is harvested an cultured so it will grow, then later implanted into the cartledge defect what are the general post surgical precautions ? - weight bearing limitations specific to the surgeon - wear a brace that is locked into extension

Thoracolumbar rotation goniometric technique - Patient position: - Stabilization: - End-feel: - Axis: - Stationary arm: - Moving arm: - ROM norm:

Thoracolumbar rotation goniometric technique - Patient position: sitting on a chair without a back with the feet position on the floor for pelvic stabilization - Stabilization: pelvis to prevent rotation - End-feel: firm - Axis: over the center of the cranial aspect of the head - Stationary arm: parallel to an imaginary line between the two prominent tubercles on the iliac crests - Moving arm: along an imaginary line between the two acromial processes - ROM norm: Zero to 45 degrees

Thoracolumbar side bending goniometric technique - Patient position: - Stabilization: - End-feel: - Axis: - Stationary arm: - Moving arm: - ROM norm:

Thoracolumbar side bending goniometric technique - Patient position: Standing with the feet shoulder with apart - Stabilization: pelvis to prevent lateral tilting - End-feel: firm - Axis: over the posterior aspect of the spinous process of S2 - Stationary arm: perpendicular to the ground - Moving arm: along the posterior aspect of the spinous process of T1 - ROM norm: zero to 35 degrees

what are the 3 types of energy systems?

Three types of energy systems 1.ATP -PC or phosphagen system 2. anaerobic glycolysis or lactic acid system 3. aerobic or oxygen system anaerobic metabolism 1. ATP-PC system -high intensity, short duration -100 meter Sprint -15 seconds -ATP and PC are stored directly in muscle 2. anaerobic glycolysis -400 -800 meter Sprint -glycogen split into glucose, glucose split into pyruvic acid releasing ATP -30 to 40 seconds 3. Aerobic metabolism -low intensity long duration -marathon -makes most ATP but it's slowest

Thumb carpometacarpal abduction goniometric technique - Patient position: - Stabilization: - End-feel: - Axis: - Stationary arm: - Moving arm: - ROM norm:

Thumb carpometacarpal abduction goniometric technique - Patient position: sitting with the 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 radial styloid process - Stationary arm: lateral midline of the second metacarpal using the center of the second metacarpal phalangeal joint for reference - Moving arm: lateral midline of the first metacarpal using the center of the first metacarpophalangeal joint for reference - ROM norm:0-70

Thumb carpometacarpal adduction goniometric technique - Patient position: - Stabilization: - End-feel: - Axis: - Stationary arm: - Moving arm: - ROM norm:

Thumb carpometacarpal adduction goniometric technique - Patient position: sitting with the forearm and hand supported - Stabilization: carpals and 2nd metacarpal to prevent wrist motion - End-feel: firm - Axis: over the lateral aspect of the radial styloid process - Stationary arm: lateral midline of the second metacarpal using the center of the second metacarpal phalangeal joint for reference - Moving arm: lateral midline of the first metacarpal using the center of the first metacarpal phalangeal joint for reference - ROM norm:?

Thumb carpometacarpal extension goniometric technique - Patient position: - Stabilization: - End-feel: - Axis: - Stationary arm: - Moving arm: - ROM norm:

Thumb carpometacarpal extension goniometric technique - Patient position: sitting with the forearm and hand on supporting surface - Stabilization: carpels, radius, ulna to prevent wrist motion - End-feel: firm - Axis: over the Palmer aspect of the first carpal metacarpal joint - Stationary arm: ventral midline of the radius using the ventral surface of the radial head and radial styloid process for reference - Moving arm: ventral midline of the first metacarpal - ROM norm:0-20

Thumb carpometacarpal flexion goniometric technique - Patient position: - Stabilization: - End-feel: - Axis: - Stationary arm: - Moving arm: - ROM norm:

Thumb carpometacarpal flexion goniometric technique - Patient position: sitting with the forearm an hand on supporting surface - Stabilization: carpels, radius, an ulna to prevent wrist motion - End-feel: firm - Axis: over the Palmer aspect of the first carpal metacarpal joint - Stationary arm: ventral midline of the radius using the ventral surface of the radial head an radial styloid process for reference - Moving arm: ventral midline of the first metacarpal - ROM norm: 0-15

Osteoarthritis

What is it: - Chronic disease - degeneration of articular cartilage primarily in weight bearing joints - subsequent deformity and thickening of subchondral bone resulting in impaired function - may affect any joints - most common joints include hands and weight bearing joints Etiology: - unknown - typically Biggins during middle age - effects almost everyone by the age of 70 - more common in men up to 55, more common in women later in life - risk factors o overweight o fractures, joint injuries o occupational or athletic overuse Signs and symptoms: - gradual onset of pain - increased pain after exercise - increased pain with weather changing - large joints - crepitus - stiffness - limited range of motion - Heberden's nodes - Bouchard's nodes - Blood tests not helpful - radiograph helpful in diagnosing Treatment: - reduce pain - promote function - sometimes injections of hyaluronic acid - improve range of motion - heating and cooling agents - education - strengthen - transcutaneous electrical nerve stimulation - energy conservation - weight loss - body mechanics - bracing - surgical intervention

rheumatoid arthritis

What is it: - Systemic autoimmune disorder - chronic inflammatory reaction in the synovial tissues of joint that result in erosion of cartledge and support structures within the capsule - common in small joints of hand foot wrist and ankle - periods of exacerbation and remission - diagnose based on clinical presentation of involved joints, the presence of blood rheumatoid factor, radiograph changes Etiology: - unknown - more common in women - age of onset between 40 and 60 years Signs and symptoms: - on set may be gradual or immediate - Symmetrical involvement - pain and tenderness of joints - morning stiffness - warm joint - decrease in appetite - fatigue - Swan neck deformity (DIP flexion PIP hyper extension ) - boutonniere deformity (DIP extension , PIP flexion) - fever Treatment: - reduce inflammation - Passive and active range of motion - Heating and cooling - Splinting - Education - Energy conservation - Body mechanics - Joint protection techniques

osteogenesis imperfecta

What is it: - aka glass bones Etiology: - genetic - type 1 and 4 autosomal dominate - type 2 and 3 autosomal recessive Signs and symptoms: - Pathological fractures - osteoporosis - hypermobile joints - bowing of long bones - weakness - scoliosis - impaired respiratory function Treatment: - begins at birth with education and proper handling - active range of motion - positioning - functional mobility - fracture management - orthotics - equipment management

Osgood Schlatter disease

What is it: - aka traction apophysisitis Etiology: - repetitive tension to patellar tendon over the tibial tuberosity in young athletes - may result in small avulsion and swelling Signs and symptoms: - point tenderness over Patella tendon insertion on tibial tubercle - antalgic gait - pain with increased activity Treatment: - education - Ice - flexibility - eliminating activities that place strain on Patella tendon such as squatting, jumping, running

planter fasciitis

What is it: - inflammation of planter fascia at the proximal insertion on medial tubercle of calcaneus Etiology: - excessive loading of foot or chronic irritation from excessive amount of pronation - most common between 40 and 60 years of age Signs and symptoms: - tenderness at insertion of plantar fascia - heel spur - pain worse in AM - pain worse after activity - difficulty with prolonge standing - increase pain when walking in bare feet Treatment: - RICE - NSAIDs - Heel cup - massage - taping - joint mobilization prevention : - calf stretching - appropriate footwear - avoiding sudden change in intensity of training - orthotics to minimize over pronation

scoliosis

What is it: - lateral curvature of spine - functional scoliosis = YouTube leg length discrepancy, muscle imbalance, poor posture generally things that are not the spine itself - degenerative scoliosis = permanent changes in the spine Etiology: - Idiopathic - commonly diagnosed between 10 and 13 years of age - girls and boys have equal chances developing mild curvature, 10 degrees or less - girls have significantly greater risk of acquiring a curvature greater than 30 degrees Signs and symptoms: - shoulder level asymmetry with or without the presence of rib hump - Pain is not typically associated, Pain is due to abnormal forces on other tissues Treatment: - Muscle strengthening - flexibility - shoe lift - bracing - spinal ortho sis if curve is between 25 and 40 degrees - surgical intervention with curves greater than 40 degrees

rotator cuff tear

What is it: - partial thickness tears = extend through only a portion of the tendon - full thickness tears = complete tear of tendon - size of American range from small = 1 centimeter or less or large = more than 5 centimeters Etiology: - may be due to acute trauma or chronic degenerative pathology - over 50 increase risk for chronic degenerative pathology - intrinsic factors o impaired blood supply to the tendon - extrinsic factors o trauma o repetitive microtrauma o postural abnormalities Signs and symptoms: - arm positioned in internal rotation and add - point tenderness at greater tubercle and acromion - Limitation in shoulder flexion and Abd - upper trapeziaus compensation - increased tone in anterior shoulder structures Treatment: - RICE , NSAIDs - primary focus of therapy is to prevent adhesive capsulitis and strengthen upper extremity musculature - surgery o immobilized in sling , time depends on surgeon , large tear four to six weeks o begins with passive range of motion and gradually moves to active assisted motion o active motion an isometric exercises once approved by surgeon - return to functional activities requiring dynamic overhead motion in nine to 12 months

posterior cruciate ligament sprain

What is it: - prevents posterior displacement of tibia Etiology: - landing on tibia with flex knee or hitting dashboard in MVA - isolated PCL tears are not common and often involve ACL, MCL, LCL, meniscus Signs and symptoms: - patient reports feeling "femur is sliding off tibia " - swelling - mild pain - Often asymptomatic special test : - posterior drawer test - posterior sag sign Treatment: - RICE - NSAIDs - strengthening - surgery if needed o after surgery isolated hamstring exercises are avoided for six weeks

What is the difference in mitochondria between type one and type 2 muscle fibers

What is the difference in mitochondria between type one and type 2 muscle fibers - Type 1 Large amount of mitochondria - Type 2 fewer mitochondria (which muscle fiber is aerobic versus anaerobic - aerobic = type 1 (slow) - anerobic = type 2 (fast))

What is the gate control theory?

What is the gate control theory? - explains the regulation of pain , specifically how other stimuli can help to decrease the sensation of pain - A -Delta fibers and C fibers synapse with a secondary neuron which send the pain signal to the brain. However they also synapse with an inhibitory interneurons at the same junction. - A -Alpha and a -beta fibers provide input in these inhibitory interneurons - therefore nerve transmission through a -Alpha and a -beta fibers can stimulate these interneurons to inhibit pain signals in the brain (closing the gate ) - the use of electrical stimulation and massage as interventions work on this theory by stimulating a -Alpha and a -beta fibers - pain regulation is also controlled by the endogenous opioid known as opiopeptin AKA endorphins - endorphins , which are located throughout the nervous system, resulting in inhibition of pain signals. - Endorphins have a direct effect on nerve signals by controlling the amount of calcium and potassium that move into and out of the cell during depolarization - Indirect effects on nerve signals by inhibiting the release of GABA , except since that normally inhibits the activity of structures that help to control pain such as a -beta fibers

What stimulus activates free nerve endings?

What stimulus activates free nerve endings? - thermal, mechanical or chemical - A-Delta fibers and C fibers

anterior talofibular ligament What motion does it resist?

anterior talofibular ligament What motion does it resist? - Tight during planter flexion and resists inversion of talus and calcaneous - resist anterior translation of talus on tibia

arthrokinematics motions of the Temporomandibular joint

convex - concave rule convex surface moving on concave surface - roll and slide occur in opposite directions - mobilizing force should be applied in the opposite direction of the bow and movement concave surface moving on convex surface - roll and slide occur in same direction - mobilizing force should be applied in the same direction as the bones move

arthrokinematics motions of the hip joint

convex - concave rule convex surface moving on concave surface - roll and slide occur in opposite directions - mobilizing force should be applied in the opposite direction of the bow and movement concave surface moving on convex surface - roll and slide occur in same direction - mobilizing force should be applied in the same direction as the bones move

arthrokinematics motions of the inter phalangeal joints of toes joint

convex - concave rule convex surface moving on concave surface - roll and slide occur in opposite directions - mobilizing force should be applied in the opposite direction of the bow and movement concave surface moving on convex surface - roll and slide occur in same direction - mobilizing force should be applied in the same direction as the bones move

congruency of joint an loose packed position versus close packed position

congruency of joint an loose packed position versus close packed position - minimal congruency of joint with loose pack - full concurrency of joint in closed pack

arthrokinematics motions of the Distal tibiofibular joint

convex - concave rule convex surface moving on concave surface - roll and slide occur in opposite directions - mobilizing force should be applied in the opposite direction of the bow and movement concave surface moving on convex surface - roll and slide occur in same direction - mobilizing force should be applied in the same direction as the bones move

arthrokinematics motions of the Intermetatarsal joint

convex - concave rule convex surface moving on concave surface - roll and slide occur in opposite directions - mobilizing force should be applied in the opposite direction of the bow and movement concave surface moving on convex surface - roll and slide occur in same direction - mobilizing force should be applied in the same direction as the bones move

arthrokinematics motions of the Metatarsal phalangeal joint

convex - concave rule convex surface moving on concave surface - roll and slide occur in opposite directions - mobilizing force should be applied in the opposite direction of the bow and movement concave surface moving on convex surface - roll and slide occur in same direction - mobilizing force should be applied in the same direction as the bones move

arthrokinematics motions of the Patellofemoral joint

convex - concave rule convex surface moving on concave surface - roll and slide occur in opposite directions - mobilizing force should be applied in the opposite direction of the bow and movement concave surface moving on convex surface - roll and slide occur in same direction - mobilizing force should be applied in the same direction as the bones move

arthrokinematics motions of the Proximal radioulnar joint

convex - concave rule convex surface moving on concave surface - roll and slide occur in opposite directions - mobilizing force should be applied in the opposite direction of the bow and movement concave surface moving on convex surface - roll and slide occur in same direction - mobilizing force should be applied in the same direction as the bones move

arthrokinematics motions of the Proximal tibiofibular joint

convex - concave rule convex surface moving on concave surface - roll and slide occur in opposite directions - mobilizing force should be applied in the opposite direction of the bow and movement concave surface moving on convex surface - roll and slide occur in same direction - mobilizing force should be applied in the same direction as the bones move

arthrokinematics motions of the Subtalar joint

convex - concave rule convex surface moving on concave surface - roll and slide occur in opposite directions - mobilizing force should be applied in the opposite direction of the bow and movement concave surface moving on convex surface - roll and slide occur in same direction - mobilizing force should be applied in the same direction as the bones move

arthrokinematics motions of the Talocrural joint

convex - concave rule convex surface moving on concave surface - roll and slide occur in opposite directions - mobilizing force should be applied in the opposite direction of the bow and movement concave surface moving on convex surface - roll and slide occur in same direction - mobilizing force should be applied in the same direction as the bones move

arthrokinematics motions of the metacarpal phalangeal joints of digits 2 -5 joint

convex - concave rule convex surface moving on concave surface - roll and slide occur in opposite directions - mobilizing force should be applied in the opposite direction of the bow and movement concave surface moving on convex surface - roll and slide occur in same direction - mobilizing force should be applied in the same direction as the bones move

arthrokinematics motions of the radiohumeral joint

convex - concave rule convex surface moving on concave surface - roll and slide occur in opposite directions - mobilizing force should be applied in the opposite direction of the bow and movement concave surface moving on convex surface - roll and slide occur in same direction - mobilizing force should be applied in the same direction as the bones move

arthrokinematics motions of the sternoclavicular joint

convex - concave rule convex surface moving on concave surface - roll and slide occur in opposite directions - mobilizing force should be applied in the opposite direction of the bow and movement concave surface moving on convex surface - roll and slide occur in same direction - mobilizing force should be applied in the same direction as the bones move

arthrokinematics motions of the tibiofemoral joint

convex - concave rule convex surface moving on concave surface - roll and slide occur in opposite directions - mobilizing force should be applied in the opposite direction of the bow and movement concave surface moving on convex surface - roll and slide occur in same direction - mobilizing force should be applied in the same direction as the bones move

arthrokinematics motions of the ulnohumeral joint

convex - concave rule convex surface moving on concave surface - roll and slide occur in opposite directions - mobilizing force should be applied in the opposite direction of the bow and movement concave surface moving on convex surface - roll and slide occur in same direction - mobilizing force should be applied in the same direction as the bones move

during midstance phase of gate are the planter flexors functioning eccentrically or concentrically? what are the muscles of the knee doing? what muscles stabilize the pelvis and prevent contralateral hip drop? what muscle controls hip extension?

during midstance phase of gate are the planter flexors functioning eccentrically or concentrically? - enter flexors continue to act eccentrically 2 control Dorsi flexion as the body moves over the stand slim what are the muscles of the knee doing? - activity in any musculature is minimal during this phase although the quadriceps contracts concentrically to continue producing closed chain the extension what muscles stabilize the pelvis and prevent contralateral hip drop? - hip ABD what muscle controls hip extension? - iliopsoas also begins to contract eccentrically to control his extension

during the mid swing phase of gate what are the ankle dorsi flexors doing? what's occurring at the knee and hip?

during the mid swing phase of gate what are the ankle dorsi flexors doing? - track concentrically to maintain dorsiflexion what's occurring at the knee and hip? - knee and hip muscle activity are minimal during this phase sends forward momentum allows the advancement of the limb

during the pre swing phase of gate what are the planter flexors doing? what are the hamstrings doing ? what is the iliopsoas doing?

during the pre swing phase of gate what are the planter flexors doing? - planter flexors activity as they put toes off from the ground what are the hamstrings doing ? - hamstrings began to produce knee flexion to prepare for the swing phase although the momentum of the body also aids in this motion what is the iliopsoas doing? - contracting concentrically to produce hip flexion along with other hip flexors rectus femoris, sartorius, add longus

during the terminal swing phase of gate what are the ankle dorsi flexors doing? what are the angle inverters doing? what are the quadriceps doing? what are the hamstrings doing? what are the hip extensors doing?

during the terminal swing phase of gate what are the ankle dorsi flexors doing? - contract concentrically to maintain dorsiflexion what are the angle inverters doing? - contract concentrically to prepare the foot for initial contact what are the quadriceps doing? - contract concentrically to place the need an extension for initial contact what are the hamstrings doing? - contract eccentrically to control the rate of knee extension what are the hip extensors doing? - contract eccentrically to slow the rate of hip flexion and prepare the limb for initial contact

Types of joint receptors (5) -location -what they sense - primary distribution

free nerve endings -Location:Joint capsule, ligaments, Synovium, fat pads -Sensitivity: one type is sensitive to non noxious mechanical stress , other type -of sensitive to noxious mechanical or biomechanical stimuli -Primary Distribution: all joints golgi ligament endings -Location: ligaments, adjacent to ligaments Bony attachment -Sensitivity: tension, stretch on ligaments -Primary Distribution: majority of joints Golgi-Mazzoni corpuscles -Location: capsule -Sensitivity: compression of joint capsule -Primary Distribution: knee joint, joint capsule Pacinian corpuscles -Location: fibrous layer of joint capsule -Sensitivity: high frequency vibration, acceleration, high velocity changes in --joint position -Primary Distribution: all joints Ruffini endings -Location: fibrous layers joint capsule -Sensitivity: stretching of joint capsule, amplitude and velocity of joint position -Primary Distribution: greater density in proximal joints, particularly in capsular regions

ballistic stretching

methods of stretching static stretching - Placing muscle at its maximal length and holding the position against an external force for a prolonged period of time - low intensity long duration - safest form of stretching - results in the greatest gains and tissue extensibility - last activation of the muscle spindles as compared to ballistic stretching and thus less resistance to stretch - no consensus on optimal duration although generally perceived 30 seconds ballistic stretching - characterized by quick, jerky movements that result in rapid change in muscle length. - muscle is placed near its end of range of movement and then the patient bounces back and forth to place repetitive stretch on the muscle - high intensity short duration - ballistic stretching occurs quickly, therefore it activates the muscle spindles and results in greater resistance to stretch - it is not as effective for approving tissue extensibility because of this resistance it may be more effective when preparing the muscles for athletic activity - more likely to lead to muscle soreness an injury due to high intensity of stretch force proprioceptive neuromuscular facilitation PNF stretching - PNF Incorporates active muscle contractions into stretching muscle contraction is thought to lead to muscle relaxation through the principles of autogenetic and reciprocal inhibition and results in greater gains in muscle flexibility - what are you doing muscle relaxation technique occurs on muscle fibers , they are more effective at treating range of motion limitations due to the muscle spasm as opposed to connective tissue - another theory for PNF is that improved flexibility is due to increased tolerance change is secondary - not an effective technique for patients with paralysis or spasticity due to requirement for active muscle control - examples include o contract relax o agonist contraction o contract relax with agonist contraction Dynamic stretching - involves the patient actively moving a body segment to the end of range but not beyond the limits while the antagonist muscle relaxes and stretches - unlike static stretching, in range movement is held only briefly and is performed repeatedly - most commonly used as a warmup prepare the body for athletic activities - is more effective at preparing the body for explosive movements when compared to static stretching - dynamic stretching emphasizes a movement based approach, while ballistic stretching emphasizes bouncing movements

methods of stretching static stretching ballistic stretching proprioceptive neuromuscular facilitation PNF stretching Dynamic stretching

methods of stretching static stretching - Placing muscle at its maximal length and holding the position against an external force for a prolonged period of time - low intensity long duration - safest form of stretching - results in the greatest gains and tissue extensibility - last activation of the muscle spindles as compared to ballistic stretching and thus less resistance to stretch - no consensus on optimal duration although generally perceived 30 seconds ballistic stretching - characterized by quick, jerky movements that result in rapid change in muscle length. - muscle is placed near its end of range of movement and then the patient bounces back and forth to place repetitive stretch on the muscle - high intensity short duration - ballistic stretching occurs quickly, therefore it activates the muscle spindles and results in greater resistance to stretch - it is not as effective for approving tissue extensibility because of this resistance it may be more effective when preparing the muscles for athletic activity - more likely to lead to muscle soreness an injury due to high intensity of stretch force proprioceptive neuromuscular facilitation PNF stretching - PNF Incorporates active muscle contractions into stretching muscle contraction is thought to lead to muscle relaxation through the principles of autogenetic and reciprocal inhibition and results in greater gains in muscle flexibility - what are you doing muscle relaxation technique occurs on muscle fibers , they are more effective at treating range of motion limitations due to the muscle spasm as opposed to connective tissue - another theory for PNF is that improved flexibility is due to increased tolerance change is secondary - not an effective technique for patients with paralysis or spasticity due to requirement for active muscle control - examples include o contract relax o agonist contraction o contract relax with agonist contraction Dynamic stretching - involves the patient actively moving a body segment to the end of range but not beyond the limits while the antagonist muscle relaxes and stretches - unlike static stretching, in range movement is held only briefly and is performed repeatedly - most commonly used as a warmup prepare the body for athletic activities - is more effective at preparing the body for explosive movements when compared to static stretching - dynamic stretching emphasizes a movement based approach, while ballistic stretching emphasizes bouncing movements

proprioceptive neuromuscular facilitation PNF stretching

methods of stretching static stretching - Placing muscle at its maximal length and holding the position against an external force for a prolonged period of time - low intensity long duration - safest form of stretching - results in the greatest gains and tissue extensibility - last activation of the muscle spindles as compared to ballistic stretching and thus less resistance to stretch - no consensus on optimal duration although generally perceived 30 seconds ballistic stretching - characterized by quick, jerky movements that result in rapid change in muscle length. - muscle is placed near its end of range of movement and then the patient bounces back and forth to place repetitive stretch on the muscle - high intensity short duration - ballistic stretching occurs quickly, therefore it activates the muscle spindles and results in greater resistance to stretch - it is not as effective for approving tissue extensibility because of this resistance it may be more effective when preparing the muscles for athletic activity - more likely to lead to muscle soreness an injury due to high intensity of stretch force proprioceptive neuromuscular facilitation PNF stretching - PNF Incorporates active muscle contractions into stretching muscle contraction is thought to lead to muscle relaxation through the principles of autogenetic and reciprocal inhibition and results in greater gains in muscle flexibility - what are you doing muscle relaxation technique occurs on muscle fibers , they are more effective at treating range of motion limitations due to the muscle spasm as opposed to connective tissue - another theory for PNF is that improved flexibility is due to increased tolerance change is secondary - not an effective technique for patients with paralysis or spasticity due to requirement for active muscle control - examples include o contract relax o agonist contraction o contract relax with agonist contraction Dynamic stretching - involves the patient actively moving a body segment to the end of range but not beyond the limits while the antagonist muscle relaxes and stretches - unlike static stretching, in range movement is held only briefly and is performed repeatedly - most commonly used as a warmup prepare the body for athletic activities - is more effective at preparing the body for explosive movements when compared to static stretching - dynamic stretching emphasizes a movement based approach, while ballistic stretching emphasizes bouncing movements

static stretching

methods of stretching static stretching - Placing muscle at its maximal length and holding the position against an external force for a prolonged period of time - low intensity long duration - safest form of stretching - results in the greatest gains and tissue extensibility - last activation of the muscle spindles as compared to ballistic stretching and thus less resistance to stretch - no consensus on optimal duration although generally perceived 30 seconds ballistic stretching - characterized by quick, jerky movements that result in rapid change in muscle length. - muscle is placed near its end of range of movement and then the patient bounces back and forth to place repetitive stretch on the muscle - high intensity short duration - ballistic stretching occurs quickly, therefore it activates the muscle spindles and results in greater resistance to stretch - it is not as effective for approving tissue extensibility because of this resistance it may be more effective when preparing the muscles for athletic activity - more likely to lead to muscle soreness an injury due to high intensity of stretch force proprioceptive neuromuscular facilitation PNF stretching - PNF Incorporates active muscle contractions into stretching muscle contraction is thought to lead to muscle relaxation through the principles of autogenetic and reciprocal inhibition and results in greater gains in muscle flexibility - what are you doing muscle relaxation technique occurs on muscle fibers , they are more effective at treating range of motion limitations due to the muscle spasm as opposed to connective tissue - another theory for PNF is that improved flexibility is due to increased tolerance change is secondary - not an effective technique for patients with paralysis or spasticity due to requirement for active muscle control - examples include o contract relax o agonist contraction o contract relax with agonist contraction Dynamic stretching - involves the patient actively moving a body segment to the end of range but not beyond the limits while the antagonist muscle relaxes and stretches - unlike static stretching, in range movement is held only briefly and is performed repeatedly - most commonly used as a warmup prepare the body for athletic activities - is more effective at preparing the body for explosive movements when compared to static stretching - dynamic stretching emphasizes a movement based approach, while ballistic stretching emphasizes bouncing movements

- jerk test o Testing procedure: o Positive result is o Positive test means:

miscellaneous special tests for tests of the shoulder - acromioclavicular crossover test o Testing procedure: therapist moves patient shoulder into 90 degrees of flexion then horizontally add the shoulder o Positive result is pain over the acromial clavicular joint o Positive test means: acromioclavicular joint injury - active compression test (O'Brien's test ) o Testing procedure: patient standing with shoulder flexed to 90 degrees horizontally add 10 to 15 degrees in medially rotated so the thumb points down. patient resists downward force from therapist on arm . Shoulder then laterally rotated on the same downward force is applied o Positive result is pain when the shoulder is medially rotated , decreased pain with the shoulder laterally rotated. pain has to be located over the acromioclavicular joint o Positive test means: superior labral tear - glenoid labrum tear test o Testing procedure: patient in supine . Therapist places hand on posterior aspect of humeral head while the other hand stabilizes the humerus proximal to elbow. Therapist passively Abd an laterally rotates the arm over the patient's head and then proceeds to apply anterior direct force to the humerus o Positive result is clunk or grinding sound o Positive test means: glenoid labrum tear - jerk test o Testing procedure: patient sitting which filter elevated to 90 degrees and medial rotation with elbow bent. Therapist applies actual compression while horizontally add the shoulder o Positive result is sudden clonk or jerk as the humoral head sublux is posteriorly o Positive test means: posterior instability of the shoulder

- Craig's test o Testing procedure: o Positive result is o Positive test means:

miscellaneous special tests at the hip - anterior labral tear test o Testing procedure: therapist places head in full flexion, lateral rotation, Abd to begin the test. Therapist moves hip into extension, medial rotation, add o Positive result is pain and or a click o Positive test means: iliopsoas tendonitis or anterior superior impingement - Craig's test o Testing procedure: patient in prone with knees flexed to 90 degrees. Therapist palpates posterior aspect of greater trochanter and medially and laterally rotates the hip until the greater trochanter is parallel with the table. o Positive result is Normal anteversion for adults is 8 two 15 degrees. the degree of femoral anteversion corresponds to the angle formed by the lower leg with the perpendicular axis of the table o Positive test means: - Patrick's test (FABER test) o Testing procedure: patient in supine with test leg flexed, Abd, laterally rotated at the hip on to the opposite leg. Therapist slowly lowers test leg through Abd tord table o Positive result is failure of this leg to Abd below the level of the opposite leg o Positive test means: iliopsoas, sacroiliac or hip joint abnormalities - Quadrant Scouring test o Testing procedure: patient positioned in supine. Therapist passively flexes and add the hip with knee in Max flexion. Therapist applies compressive force through shaft of femur while continuing to passively move patients hip. o Positive result is Grinding, catching or crepitus in the hip o Positive test means: arthritis, avascular necrosis or in osteochondral effect - trendelenburg test o Testing procedure: you know o Positive result is drop a pelvis on the unsupported side o Positive test means: indicative of weakness of the gluteus medias muscle on the supporting side

- Patrick's test (FABER test) o Testing procedure: o Positive result is o Positive test means:

miscellaneous special tests at the hip - anterior labral tear test o Testing procedure: therapist places head in full flexion, lateral rotation, Abd to begin the test. Therapist moves hip into extension, medial rotation, add o Positive result is pain and or a click o Positive test means: iliopsoas tendonitis or anterior superior impingement - Craig's test o Testing procedure: patient in prone with knees flexed to 90 degrees. Therapist palpates posterior aspect of greater trochanter and medially and laterally rotates the hip until the greater trochanter is parallel with the table. o Positive result is Normal anteversion for adults is 8 two 15 degrees. the degree of femoral anteversion corresponds to the angle formed by the lower leg with the perpendicular axis of the table o Positive test means: - Patrick's test (FABER test) o Testing procedure: patient in supine with test leg flexed, Abd, laterally rotated at the hip on to the opposite leg. Therapist slowly lowers test leg through Abd tord table o Positive result is failure of this leg to Abd below the level of the opposite leg o Positive test means: iliopsoas, sacroiliac or hip joint abnormalities - Quadrant Scouring test o Testing procedure: patient positioned in supine. Therapist passively flexes and add the hip with knee in Max flexion. Therapist applies compressive force through shaft of femur while continuing to passively move patients hip. o Positive result is Grinding, catching or crepitus in the hip o Positive test means: arthritis, avascular necrosis or in osteochondral effect - trendelenburg test o Testing procedure: you know o Positive result is drop a pelvis on the unsupported side o Positive test means: indicative of weakness of the gluteus medias muscle on the supporting side

- Quadrant Scouring test o Testing procedure: o Positive result is o Positive test means:

miscellaneous special tests at the hip - anterior labral tear test o Testing procedure: therapist places head in full flexion, lateral rotation, Abd to begin the test. Therapist moves hip into extension, medial rotation, add o Positive result is pain and or a click o Positive test means: iliopsoas tendonitis or anterior superior impingement - Craig's test o Testing procedure: patient in prone with knees flexed to 90 degrees. Therapist palpates posterior aspect of greater trochanter and medially and laterally rotates the hip until the greater trochanter is parallel with the table. o Positive result is Normal anteversion for adults is 8 two 15 degrees. the degree of femoral anteversion corresponds to the angle formed by the lower leg with the perpendicular axis of the table o Positive test means: - Patrick's test (FABER test) o Testing procedure: patient in supine with test leg flexed, Abd, laterally rotated at the hip on to the opposite leg. Therapist slowly lowers test leg through Abd tord table o Positive result is failure of this leg to Abd below the level of the opposite leg o Positive test means: iliopsoas, sacroiliac or hip joint abnormalities - Quadrant Scouring test o Testing procedure: patient positioned in supine. Therapist passively flexes and add the hip with knee in Max flexion. Therapist applies compressive force through shaft of femur while continuing to passively move patients hip. o Positive result is Grinding, catching or crepitus in the hip o Positive test means: arthritis, avascular necrosis or in osteochondral effect - trendelenburg test o Testing procedure: you know o Positive result is drop a pelvis on the unsupported side o Positive test means: indicative of weakness of the gluteus medias muscle on the supporting side

- anterior labral tear test o Testing procedure: o Positive result is o Positive test means:

miscellaneous special tests at the hip - anterior labral tear test o Testing procedure: therapist places head in full flexion, lateral rotation, Abd to begin the test. Therapist moves hip into extension, medial rotation, add o Positive result is pain and or a click o Positive test means: iliopsoas tendonitis or anterior superior impingement - Craig's test o Testing procedure: patient in prone with knees flexed to 90 degrees. Therapist palpates posterior aspect of greater trochanter and medially and laterally rotates the hip until the greater trochanter is parallel with the table. o Positive result is Normal anteversion for adults is 8 two 15 degrees. the degree of femoral anteversion corresponds to the angle formed by the lower leg with the perpendicular axis of the table o Positive test means: - Patrick's test (FABER test) o Testing procedure: patient in supine with test leg flexed, Abd, laterally rotated at the hip on to the opposite leg. Therapist slowly lowers test leg through Abd tord table o Positive result is failure of this leg to Abd below the level of the opposite leg o Positive test means: iliopsoas, sacroiliac or hip joint abnormalities - Quadrant Scouring test o Testing procedure: patient positioned in supine. Therapist passively flexes and add the hip with knee in Max flexion. Therapist applies compressive force through shaft of femur while continuing to passively move patients hip. o Positive result is Grinding, catching or crepitus in the hip o Positive test means: arthritis, avascular necrosis or in osteochondral effect - trendelenburg test o Testing procedure: you know o Positive result is drop a pelvis on the unsupported side o Positive test means: indicative of weakness of the gluteus medias muscle on the supporting side

- trendelenburg test o Testing procedure: o Positive result is o Positive test means:

miscellaneous special tests at the hip - anterior labral tear test o Testing procedure: therapist places head in full flexion, lateral rotation, Abd to begin the test. Therapist moves hip into extension, medial rotation, add o Positive result is pain and or a click o Positive test means: iliopsoas tendonitis or anterior superior impingement - Craig's test o Testing procedure: patient in prone with knees flexed to 90 degrees. Therapist palpates posterior aspect of greater trochanter and medially and laterally rotates the hip until the greater trochanter is parallel with the table. o Positive result is Normal anteversion for adults is 8 two 15 degrees. the degree of femoral anteversion corresponds to the angle formed by the lower leg with the perpendicular axis of the table o Positive test means: - Patrick's test (FABER test) o Testing procedure: patient in supine with test leg flexed, Abd, laterally rotated at the hip on to the opposite leg. Therapist slowly lowers test leg through Abd tord table o Positive result is failure of this leg to Abd below the level of the opposite leg o Positive test means: iliopsoas, sacroiliac or hip joint abnormalities - Quadrant Scouring test o Testing procedure: patient positioned in supine. Therapist passively flexes and add the hip with knee in Max flexion. Therapist applies compressive force through shaft of femur while continuing to passively move patients hip. o Positive result is Grinding, catching or crepitus in the hip o Positive test means: arthritis, avascular necrosis or in osteochondral effect - trendelenburg test o Testing procedure: you know o Positive result is drop a pelvis on the unsupported side o Positive test means: indicative of weakness of the gluteus medias muscle on the supporting side

- Clarke's sign o Testing procedure: o Positive result is o Positive test means:

miscellaneous special tests at the knee - Clarke's sign o Testing procedure: patient positioned in supine with knees extended. Therapist applies slight pressure distally to the web space of their hand over the superior pole of the Patella. Therapist asked patient to contract quad while maintaining pressure on Patella. o Positive result is Failure to complete the contraction without pain o Positive test means: patellofemoral dysfunction - Hughston's plica test o Testing procedure: patient positioned in supine. Therapist flexes knee and medially rotates the tibia with one hand while the other hand attempts to move the Patella medially and palpate the medial femorale condyle. o Positive result is Popping sound over the medial plica while the knee is passively flexed and extended o Positive test means: abnormal or irritated plica - Noble compression test o Testing procedure: patient is positioned in supine with the in slight flexion and knee in 90 degrees of flexion. Therapist places thumb of one hand over the lateral epicondyle of the femur and the other hand around the patient's ankle. The therapist maintains pressure over the lateral epicondyle while the patient is asked to slowly extend the knee. o Positive result is Pain over the lateral femoral epicondyle at approximately 30 degrees of knee flexion o Positive test means: iliotibial band friction syndrome - Patellar apprehension test o Testing procedure: patient is in supine with knees extended. Therapist places both hands on medial border of Patella and applies lateral force. o Positive result is Look of apprehension or an attempt to contract the quad in an effort to avoid subluxation o Positive test means: Patella subluxation or dislocation

- Hughston's plica test o Testing procedure: o Positive result is o Positive test means:

miscellaneous special tests at the knee - Clarke's sign o Testing procedure: patient positioned in supine with knees extended. Therapist applies slight pressure distally to the web space of their hand over the superior pole of the Patella. Therapist asked patient to contract quad while maintaining pressure on Patella. o Positive result is Failure to complete the contraction without pain o Positive test means: patellofemoral dysfunction - Hughston's plica test o Testing procedure: patient positioned in supine. Therapist flexes knee and medially rotates the tibia with one hand while the other hand attempts to move the Patella medially and palpate the medial femorale condyle. o Positive result is Popping sound over the medial plica while the knee is passively flexed and extended o Positive test means: abnormal or irritated plica - Noble compression test o Testing procedure: patient is positioned in supine with the in slight flexion and knee in 90 degrees of flexion. Therapist places thumb of one hand over the lateral epicondyle of the femur and the other hand around the patient's ankle. The therapist maintains pressure over the lateral epicondyle while the patient is asked to slowly extend the knee. o Positive result is Pain over the lateral femoral epicondyle at approximately 30 degrees of knee flexion o Positive test means: iliotibial band friction syndrome - Patellar apprehension test o Testing procedure: patient is in supine with knees extended. Therapist places both hands on medial border of Patella and applies lateral force. o Positive result is Look of apprehension or an attempt to contract the quad in an effort to avoid subluxation o Positive test means: Patella subluxation or dislocation

- Noble compression test o Testing procedure: o Positive result is o Positive test means:

miscellaneous special tests at the knee - Clarke's sign o Testing procedure: patient positioned in supine with knees extended. Therapist applies slight pressure distally to the web space of their hand over the superior pole of the Patella. Therapist asked patient to contract quad while maintaining pressure on Patella. o Positive result is Failure to complete the contraction without pain o Positive test means: patellofemoral dysfunction - Hughston's plica test o Testing procedure: patient positioned in supine. Therapist flexes knee and medially rotates the tibia with one hand while the other hand attempts to move the Patella medially and palpate the medial femorale condyle. o Positive result is Popping sound over the medial plica while the knee is passively flexed and extended o Positive test means: abnormal or irritated plica - Noble compression test o Testing procedure: patient is positioned in supine with the in slight flexion and knee in 90 degrees of flexion. Therapist places thumb of one hand over the lateral epicondyle of the femur and the other hand around the patient's ankle. The therapist maintains pressure over the lateral epicondyle while the patient is asked to slowly extend the knee. o Positive result is Pain over the lateral femoral epicondyle at approximately 30 degrees of knee flexion o Positive test means: iliotibial band friction syndrome - Patellar apprehension test o Testing procedure: patient is in supine with knees extended. Therapist places both hands on medial border of Patella and applies lateral force. o Positive result is Look of apprehension or an attempt to contract the quad in an effort to avoid subluxation o Positive test means: Patella subluxation or dislocation

- Patellar apprehension test o Testing procedure: o Positive result is o Positive test means:

miscellaneous special tests at the knee - Clarke's sign o Testing procedure: patient positioned in supine with knees extended. Therapist applies slight pressure distally to the web space of their hand over the superior pole of the Patella. Therapist asked patient to contract quad while maintaining pressure on Patella. o Positive result is Failure to complete the contraction without pain o Positive test means: patellofemoral dysfunction - Hughston's plica test o Testing procedure: patient positioned in supine. Therapist flexes knee and medially rotates the tibia with one hand while the other hand attempts to move the Patella medially and palpate the medial femorale condyle. o Positive result is Popping sound over the medial plica while the knee is passively flexed and extended o Positive test means: abnormal or irritated plica - Noble compression test o Testing procedure: patient is positioned in supine with the in slight flexion and knee in 90 degrees of flexion. Therapist places thumb of one hand over the lateral epicondyle of the femur and the other hand around the patient's ankle. The therapist maintains pressure over the lateral epicondyle while the patient is asked to slowly extend the knee. o Positive result is Pain over the lateral femoral epicondyle at approximately 30 degrees of knee flexion o Positive test means: iliotibial band friction syndrome - Patellar apprehension test o Testing procedure: patient is in supine with knees extended. Therapist places both hands on medial border of Patella and applies lateral force. o Positive result is Look of apprehension or an attempt to contract the quad in an effort to avoid subluxation o Positive test means: Patella subluxation or dislocation

- acromioclavicular crossover test o Testing procedure: o Positive result is o Positive test means:

miscellaneous special tests for tests of the shoulder - acromioclavicular crossover test o Testing procedure: therapist moves patient shoulder into 90 degrees of flexion then horizontally add the shoulder o Positive result is pain over the acromial clavicular joint o Positive test means: acromioclavicular joint injury - active compression test (O'Brien's test ) o Testing procedure: patient standing with shoulder flexed to 90 degrees horizontally add 10 to 15 degrees in medially rotated so the thumb points down. patient resists downward force from therapist on arm . Shoulder then laterally rotated on the same downward force is applied o Positive result is pain when the shoulder is medially rotated , decreased pain with the shoulder laterally rotated. pain has to be located over the acromioclavicular joint o Positive test means: superior labral tear - glenoid labrum tear test o Testing procedure: patient in supine . Therapist places hand on posterior aspect of humeral head while the other hand stabilizes the humerus proximal to elbow. Therapist passively Abd an laterally rotates the arm over the patient's head and then proceeds to apply anterior direct force to the humerus o Positive result is clunk or grinding sound o Positive test means: glenoid labrum tear - jerk test o Testing procedure: patient sitting which filter elevated to 90 degrees and medial rotation with elbow bent. Therapist applies actual compression while horizontally add the shoulder o Positive result is sudden clonk or jerk as the humoral head sublux is posteriorly o Positive test means: posterior instability of the shoulder

- active compression test (O'Brien's test ) o Testing procedure: o Positive result is o Positive test means:

miscellaneous special tests for tests of the shoulder - acromioclavicular crossover test o Testing procedure: therapist moves patient shoulder into 90 degrees of flexion then horizontally add the shoulder o Positive result is pain over the acromial clavicular joint o Positive test means: acromioclavicular joint injury - active compression test (O'Brien's test ) o Testing procedure: patient standing with shoulder flexed to 90 degrees horizontally add 10 to 15 degrees in medially rotated so the thumb points down. patient resists downward force from therapist on arm . Shoulder then laterally rotated on the same downward force is applied o Positive result is pain when the shoulder is medially rotated , decreased pain with the shoulder laterally rotated. pain has to be located over the acromioclavicular joint o Positive test means: superior labral tear - glenoid labrum tear test o Testing procedure: patient in supine . Therapist places hand on posterior aspect of humeral head while the other hand stabilizes the humerus proximal to elbow. Therapist passively Abd an laterally rotates the arm over the patient's head and then proceeds to apply anterior direct force to the humerus o Positive result is clunk or grinding sound o Positive test means: glenoid labrum tear - jerk test o Testing procedure: patient sitting which filter elevated to 90 degrees and medial rotation with elbow bent. Therapist applies actual compression while horizontally add the shoulder o Positive result is sudden clonk or jerk as the humoral head sublux is posteriorly o Positive test means: posterior instability of the shoulder

- glenoid labrum tear test o Testing procedure: o Positive result is o Positive test means:

miscellaneous special tests for tests of the shoulder - acromioclavicular crossover test o Testing procedure: therapist moves patient shoulder into 90 degrees of flexion then horizontally add the shoulder o Positive result is pain over the acromial clavicular joint o Positive test means: acromioclavicular joint injury - active compression test (O'Brien's test ) o Testing procedure: patient standing with shoulder flexed to 90 degrees horizontally add 10 to 15 degrees in medially rotated so the thumb points down. patient resists downward force from therapist on arm . Shoulder then laterally rotated on the same downward force is applied o Positive result is pain when the shoulder is medially rotated , decreased pain with the shoulder laterally rotated. pain has to be located over the acromioclavicular joint o Positive test means: superior labral tear - glenoid labrum tear test o Testing procedure: patient in supine . Therapist places hand on posterior aspect of humeral head while the other hand stabilizes the humerus proximal to elbow. Therapist passively Abd an laterally rotates the arm over the patient's head and then proceeds to apply anterior direct force to the humerus o Positive result is clunk or grinding sound o Positive test means: glenoid labrum tear - jerk test o Testing procedure: patient sitting which filter elevated to 90 degrees and medial rotation with elbow bent. Therapist applies actual compression while horizontally add the shoulder o Positive result is sudden clonk or jerk as the humoral head sublux is posteriorly o Positive test means: posterior instability of the shoulder

what is a mild curvature in scoliosis? what is a significant curvature in scoliosis what curvature of scoliosis is a spinal orthosis appropriate? what curvature of scoliosis is surgical intervention indicated?

what is a mild curvature in scoliosis? - 10 degrees or less what is a significant curvature in scoliosis - greater than 30 degrees what curvature of scoliosis is a spinal orthosis appropriate? - between 25 and 40 degrees what curvature of scoliosis is surgical intervention indicated? - greater than 40 degrees

what is a myofibril?

what is a myofibril? - subunits of muscle fibers made up of Sacromere

- Thompson's test o Testing procedure: o Positive result is o Positive test means:

miscellaneous special tests of the ankle - Thompson's test o Testing procedure: patient position over the edge of table. Therapist asked the patient to relax and proceeds to squeeze the muscle belly of the gastrocnemius and soleus muscles. o Positive result is Absence of plantarflexion o Positive test means: ruptured Achilles tendon - tibial torsion test o Testing procedure: patient is positioned in sitting with knees over the edge of the table. Therapist places them an index finger of one hand over the medial and lateral malleolus. therapist measures the acute angle formed by the axis of the knee an ankle. o Positive result is Normal lateral portion of the tibia is 12 -18 degrees in an adult o Positive test means: - true leg length discrepancy test o Testing procedure: patient is positioned in supine with the hips and knees extended, the legs 15 -20 centimeters apart, Andy pelvis in balance with the legs. Using a tape measure, the therapist measures from the distal point of the anterior superior iliac spines to the distal point of the medial malleoli. o Positive result is bilateral variation of greater than 1 centimeter o Positive test means: true leg length discrepancy

- tibial torsion test o Testing procedure: o Positive result is o Positive test means:

miscellaneous special tests of the ankle - Thompson's test o Testing procedure: patient position over the edge of table. Therapist asked the patient to relax and proceeds to squeeze the muscle belly of the gastrocnemius and soleus muscles. o Positive result is Absence of plantarflexion o Positive test means: ruptured Achilles tendon - tibial torsion test o Testing procedure: patient is positioned in sitting with knees over the edge of the table. Therapist places them an index finger of one hand over the medial and lateral malleolus. therapist measures the acute angle formed by the axis of the knee an ankle. o Positive result is Normal lateral portion of the tibia is 12 -18 degrees in an adult o Positive test means: - true leg length discrepancy test o Testing procedure: patient is positioned in supine with the hips and knees extended, the legs 15 -20 centimeters apart, Andy pelvis in balance with the legs. Using a tape measure, the therapist measures from the distal point of the anterior superior iliac spines to the distal point of the medial malleoli. o Positive result is bilateral variation of greater than 1 centimeter o Positive test means: true leg length discrepancy

- true leg length discrepancy test o Testing procedure: o Positive result is o Positive test means:

miscellaneous special tests of the ankle - Thompson's test o Testing procedure: patient position over the edge of table. Therapist asked the patient to relax and proceeds to squeeze the muscle belly of the gastrocnemius and soleus muscles. o Positive result is Absence of plantarflexion o Positive test means: ruptured Achilles tendon - tibial torsion test o Testing procedure: patient is positioned in sitting with knees over the edge of the table. Therapist places them an index finger of one hand over the medial and lateral malleolus. therapist measures the acute angle formed by the axis of the knee an ankle. o Positive result is Normal lateral portion of the tibia is 12 -18 degrees in an adult o Positive test means: - true leg length discrepancy test o Testing procedure: patient is positioned in supine with the hips and knees extended, the legs 15 -20 centimeters apart, Andy pelvis in balance with the legs. Using a tape measure, the therapist measures from the distal point of the anterior superior iliac spines to the distal point of the medial malleoli. o Positive result is bilateral variation of greater than 1 centimeter o Positive test means: true leg length discrepancy

- Finkelstein test o Testing procedure: o Positive result is o Positive test means:

miscellaneous special tests of the wrist and hand - Finkelstein test o Testing procedure: patient in sitting or standing and makes fits with them tucked inside fingers. Therapist ulnerly deviates the wrist o Positive result is Pain over the Abd pollicis longest an extensor pollicis brevis tendons at the wrist o Positive test means: synovitis in the thumb AKA de Quervian's disease - grind test o Testing procedure: patient in sitting or standing. Therapist applies compression in rotation through metacarpal o Positive result is pain o Positive test means: degenerative joint disease in the carpal metacarpal joint - Murphy's sign o Testing procedure: patient in sitting or standing and makes fist o Positive result is patient's third metacarpal remaining level with the 2nd and 4th metacarpals o Positive test means: dislocated lunate

non opioid agents action: indication : side effects : implications for PT : examples :

non opioid agents action: - provide analgesia and pain relief, producing anti-inflammatory effects, initiating anti-pyretic ( reduces fever ) properties - Promotes reduction of prostaglandin formation that decreases inflammatory process decreases uterine contractions, lowers fever, minimizes impulse formation of pain fibers indication : - mild to moderate pain of various origins - Fever - Headache - Muscle ache - Inflammation - Dysmenorrhoea - Reduction of risk of myocardial infarction (aspirin only ) side effects : - nausea - Vomiting - Vertigo - Abdominal pain - GI distress or bleeding - Ulcer formation - Reye's syndrome in children (aspirin only ) implications for PT : - increase risk for mast pain that would allow for movement beyond limitations or false understanding of their level mobility - Complaints of stomach pain should be taken seriously with a subsequent referral to physician examples : - Tylenol (acetaminophen ) - non steroidal anti inflammatories NSAIDs - aspirin (acetylsalicylic acid) - Aleve (Naproxon) - Advil (ibuprofen) - Celebrex (celecoxib)

what is a spastic gait pattern?

what is a spastic gait pattern? - Stiff movement, toes catching/drag, legs held together, any slightly flexed , commonly seen in spastic paraplegia

what is a sprain? how do you grade Sprains? - grade one - grade 2 - grade 3

what is a sprain? - an acute injury involving a ligament how do you grade Sprains? - grade one o localized pain o minimal swelling o Tenderness - grade 2 o localized pain o moderate swelling o tenderness o impaired motor functions - grade 3 o severe pain and swelling o Substantial joint instability o Total tear of the ligament o Substantial decrease in range of motion

Creep

principles of stretching elasticity - ability of soft tissue to return to its previous length after a stretch is no longer applied Viscoelasticity - time dependent property of soft tissue that results in resistance to stretch when initially applied, but allows for a soft tissue elongation as the stretch is held for longer durations. - tissue will return to previous length after stretch is no longer applied plasticity - property of soft tissue that allows for tissue elongation even after stretches no longer apply stress -strain curve - a graphic representation that depicts the relationship between the amount of force = stress applied to connective tissue and the amount of deformation = strain it experiences Creep - due to the viscoelastic properties, soft tissue that is stretched for a sustained duration will along gate and not return to its original length after the load has been removed. The principle of Creek is the basis for stretching stress -relaxation - the longer a stretch force is maintained, the more the tension within the tissue decreases, therefore less force is required to maintain the same tissue length

Viscoelasticity

principles of stretching elasticity - ability of soft tissue to return to its previous length after a stretch is no longer applied Viscoelasticity - time dependent property of soft tissue that results in resistance to stretch when initially applied, but allows for a soft tissue elongation as the stretch is held for longer durations. - tissue will return to previous length after stretch is no longer applied plasticity - property of soft tissue that allows for tissue elongation even after stretches no longer apply stress -strain curve - a graphic representation that depicts the relationship between the amount of force = stress applied to connective tissue and the amount of deformation = strain it experiences Creep - due to the viscoelastic properties, soft tissue that is stretched for a sustained duration will along gate and not return to its original length after the load has been removed. The principle of Creek is the basis for stretching stress -relaxation - the longer a stretch force is maintained, the more the tension within the tissue decreases, therefore less force is required to maintain the same tissue length

elasticity

principles of stretching elasticity - ability of soft tissue to return to its previous length after a stretch is no longer applied Viscoelasticity - time dependent property of soft tissue that results in resistance to stretch when initially applied, but allows for a soft tissue elongation as the stretch is held for longer durations. - tissue will return to previous length after stretch is no longer applied plasticity - property of soft tissue that allows for tissue elongation even after stretches no longer apply stress -strain curve - a graphic representation that depicts the relationship between the amount of force = stress applied to connective tissue and the amount of deformation = strain it experiences Creep - due to the viscoelastic properties, soft tissue that is stretched for a sustained duration will along gate and not return to its original length after the load has been removed. The principle of Creek is the basis for stretching stress -relaxation - the longer a stretch force is maintained, the more the tension within the tissue decreases, therefore less force is required to maintain the same tissue length

plasticity

principles of stretching elasticity - ability of soft tissue to return to its previous length after a stretch is no longer applied Viscoelasticity - time dependent property of soft tissue that results in resistance to stretch when initially applied, but allows for a soft tissue elongation as the stretch is held for longer durations. - tissue will return to previous length after stretch is no longer applied plasticity - property of soft tissue that allows for tissue elongation even after stretches no longer apply stress -strain curve - a graphic representation that depicts the relationship between the amount of force = stress applied to connective tissue and the amount of deformation = strain it experiences Creep - due to the viscoelastic properties, soft tissue that is stretched for a sustained duration will along gate and not return to its original length after the load has been removed. The principle of Creek is the basis for stretching stress -relaxation - the longer a stretch force is maintained, the more the tension within the tissue decreases, therefore less force is required to maintain the same tissue length

principles of stretching elasticity Viscoelasticity plasticity stress -strain curve Creep stress -relaxation

principles of stretching elasticity - ability of soft tissue to return to its previous length after a stretch is no longer applied Viscoelasticity - time dependent property of soft tissue that results in resistance to stretch when initially applied, but allows for a soft tissue elongation as the stretch is held for longer durations. - tissue will return to previous length after stretch is no longer applied plasticity - property of soft tissue that allows for tissue elongation even after stretches no longer apply stress -strain curve - a graphic representation that depicts the relationship between the amount of force = stress applied to connective tissue and the amount of deformation = strain it experiences Creep - due to the viscoelastic properties, soft tissue that is stretched for a sustained duration will along gate and not return to its original length after the load has been removed. The principle of Creek is the basis for stretching stress -relaxation - the longer a stretch force is maintained, the more the tension within the tissue decreases, therefore less force is required to maintain the same tissue length

skin fold measurements what are they used for? how many spots is it measured in ? procedure?

skin fold measurements what are they used for? - to measure percentage of body fat how many spots is it measured in ? - 9 Abdominals, triceps, biceps, chest /pectoral, medial calf, midaxillary, subscapular, super iliac, thigh procedure? - All measurements should be taken on the right side of the body - Take multiple measures at each site to ensure accuracy and retest of the differences greater than one to two millimeters - Skin fold caliper should be positioned 1 centimeter away from the examiner's finger when pinching the side, positioned perpendicular to the skin fold, an centered between the base and the top of the fold - wait one to two seconds before reading the calipers - Maintain pinch of the site during reading of the caliper

what is a tabetic gait pattern?

what is a tabetic gait pattern? - a high stepping ataxic gait pattern in which the feet slap the ground

what is a vaulting gait pattern ?

what is a vaulting gait pattern ? - a gait pattern where the swing Leg advances by compensating through the combination of elevation of the pelvis and planter flexion of the stance leg

what is an equine pattern of gait?

what is an equine pattern of gait? - high steps usually involves excessive activity of the gastrocnemius

- carpal compression test (median nerve compression test ) o Testing procedure: o Positive result is o Positive test means:

special test for neurological dysfunction of the wrist in hand - carpal compression test (median nerve compression test ) o Testing procedure: therapist phone patients risk in both hands and applies pressure over the median nerve in the carpal tunnel for 30 seconds . May also be performed with 60 degrees of wrist flexion before applying pressure i o Positive result is pain or paresthesia in median nerve distribution o Positive test means: carpal tunnel syndrome - froment's sign o Testing procedure: patient in sitting or standing , holds a piece of paper between thumb and index finger. Therapist tries to pull paper away o Positive result is patient flexing the distal failings of the thumb due to add after pollicis muscle paralysis or/and patient hyperextends the metacarpal phalangeal joint of the thumb o Positive test means: ulnar nerve compromise or paralysis - phalen's test o Testing procedure: patient in sitting or standing. Therapist flexes wrist maximally and ask patient to hold position for 60 seconds. o Positive result is Tingling in the thumb, index finger, middle finger, lateral half of the ring finger o Positive test means: median nerve compression resulting in carpal tunnel syndrome - tinel's sign o Testing procedure: patient in sitting or standing. Therapist taps over the voler aspect of wrist. o Positive result is Tingling in the thumb, index finger, middle finger, lateral half of the ring finger distal to the contact side at the wrist. o Positive test means: Carpal tunnel syndrome due to median nerve compression

- froment's sign o Testing procedure: o Positive result is o Positive test means:

special test for neurological dysfunction of the wrist in hand - carpal compression test (median nerve compression test ) o Testing procedure: therapist phone patients risk in both hands and applies pressure over the median nerve in the carpal tunnel for 30 seconds . May also be performed with 60 degrees of wrist flexion before applying pressure i o Positive result is pain or paresthesia in median nerve distribution o Positive test means: carpal tunnel syndrome - froment's sign o Testing procedure: patient in sitting or standing , holds a piece of paper between thumb and index finger. Therapist tries to pull paper away o Positive result is patient flexing the distal failings of the thumb due to add after pollicis muscle paralysis or/and patient hyperextends the metacarpal phalangeal joint of the thumb o Positive test means: ulnar nerve compromise or paralysis - phalen's test o Testing procedure: patient in sitting or standing. Therapist flexes wrist maximally and ask patient to hold position for 60 seconds. o Positive result is Tingling in the thumb, index finger, middle finger, lateral half of the ring finger o Positive test means: median nerve compression resulting in carpal tunnel syndrome - tinel's sign o Testing procedure: patient in sitting or standing. Therapist taps over the voler aspect of wrist. o Positive result is Tingling in the thumb, index finger, middle finger, lateral half of the ring finger distal to the contact side at the wrist. o Positive test means: Carpal tunnel syndrome due to median nerve compression

- phalen's test o Testing procedure: o Positive result is o Positive test means:

special test for neurological dysfunction of the wrist in hand - carpal compression test (median nerve compression test ) o Testing procedure: therapist phone patients risk in both hands and applies pressure over the median nerve in the carpal tunnel for 30 seconds . May also be performed with 60 degrees of wrist flexion before applying pressure i o Positive result is pain or paresthesia in median nerve distribution o Positive test means: carpal tunnel syndrome - froment's sign o Testing procedure: patient in sitting or standing , holds a piece of paper between thumb and index finger. Therapist tries to pull paper away o Positive result is patient flexing the distal failings of the thumb due to add after pollicis muscle paralysis or/and patient hyperextends the metacarpal phalangeal joint of the thumb o Positive test means: ulnar nerve compromise or paralysis - phalen's test o Testing procedure: patient in sitting or standing. Therapist flexes wrist maximally and ask patient to hold position for 60 seconds. o Positive result is Tingling in the thumb, index finger, middle finger, lateral half of the ring finger o Positive test means: median nerve compression resulting in carpal tunnel syndrome - tinel's sign o Testing procedure: patient in sitting or standing. Therapist taps over the voler aspect of wrist. o Positive result is Tingling in the thumb, index finger, middle finger, lateral half of the ring finger distal to the contact side at the wrist. o Positive test means: Carpal tunnel syndrome due to median nerve compression

- tinel's sign o Testing procedure: o Positive result is o Positive test means:

special test for neurological dysfunction of the wrist in hand - carpal compression test (median nerve compression test ) o Testing procedure: therapist phone patients risk in both hands and applies pressure over the median nerve in the carpal tunnel for 30 seconds . May also be performed with 60 degrees of wrist flexion before applying pressure i o Positive result is pain or paresthesia in median nerve distribution o Positive test means: carpal tunnel syndrome - froment's sign o Testing procedure: patient in sitting or standing , holds a piece of paper between thumb and index finger. Therapist tries to pull paper away o Positive result is patient flexing the distal failings of the thumb due to add after pollicis muscle paralysis or/and patient hyperextends the metacarpal phalangeal joint of the thumb o Positive test means: ulnar nerve compromise or paralysis - phalen's test o Testing procedure: patient in sitting or standing. Therapist flexes wrist maximally and ask patient to hold position for 60 seconds. o Positive result is Tingling in the thumb, index finger, middle finger, lateral half of the ring finger o Positive test means: median nerve compression resulting in carpal tunnel syndrome - tinel's sign o Testing procedure: patient in sitting or standing. Therapist taps over the voler aspect of wrist. o Positive result is Tingling in the thumb, index finger, middle finger, lateral half of the ring finger distal to the contact side at the wrist. o Positive test means: Carpal tunnel syndrome due to median nerve compression

- Apprehension test for anterior shoulder dislocation o Testing procedure: o Positive result is o Positive test means:

special test for shoulder Dislocation - Apprehension test for anterior shoulder dislocation o Testing procedure: Patient in supine with arm in 90 degrees of Abd and 90 degrees of elbow flexion. therapist laterally rotates patient shoulder o Positive result is indicated by a look of apprehension or facial grimace o Positive test means: possible instability anteriorly - apprehension test for posterior shoulder dislocation o Testing procedure: patient in supine with arm in 90 degrees on flexion and medial rotation. Therapist applies posterior force through long access of humerus o Positive result is look of apprehension or facial grimace o Positive test means: instability posterior - sulcus sign o Testing procedure: in standing therapist positions the patients arm in 20 to 50 degrees of Abd. Therapist pulls arm inferiorly o Positive result is depression seen between the acromion and humeral head o Positive test means :inferior instability

- apprehension test for posterior shoulder dislocation o Testing procedure: o Positive result is o Positive test means:

special test for shoulder Dislocation - Apprehension test for anterior shoulder dislocation o Testing procedure: Patient in supine with arm in 90 degrees of Abd and 90 degrees of elbow flexion. therapist laterally rotates patient shoulder o Positive result is indicated by a look of apprehension or facial grimace o Positive test means: possible instability anteriorly - apprehension test for posterior shoulder dislocation o Testing procedure: patient in supine with arm in 90 degrees on flexion and medial rotation. Therapist applies posterior force through long access of humerus o Positive result is look of apprehension or facial grimace o Positive test means: instability posterior - sulcus sign o Testing procedure: in standing therapist positions the patients arm in 20 to 50 degrees of Abd. Therapist pulls arm inferiorly o Positive result is depression seen between the acromion and humeral head o Positive test means :inferior instability

- sulcus sign o Testing procedure: o Positive result is o Positive test means:

special test for shoulder Dislocation - Apprehension test for anterior shoulder dislocation o Testing procedure: Patient in supine with arm in 90 degrees of Abd and 90 degrees of elbow flexion. therapist laterally rotates patient shoulder o Positive result is indicated by a look of apprehension or facial grimace o Positive test means: possible instability anteriorly - apprehension test for posterior shoulder dislocation o Testing procedure: patient in supine with arm in 90 degrees on flexion and medial rotation. Therapist applies posterior force through long access of humerus o Positive result is look of apprehension or facial grimace o Positive test means: instability posterior - sulcus sign o Testing procedure: in standing therapist positions the patients arm in 20 to 50 degrees of Abd. Therapist pulls arm inferiorly o Positive result is depression seen between the acromion and humeral head o Positive test means :inferior instability

- brush test o Testing procedure: o Positive result is o Positive test means:

special test for swelling at the knee - brush test o Testing procedure: patient in supine. Therapist places one hand below the joint line on the medial surface of the Patella and strokes proximally with the palm and fingers as far as the Super patellar pouch. Other hand and strokes down the lateral surface of the Patella. o Positive result is Wave of fluid just below the medial distal border of the Patella o Positive test means: knee swelling - patellar tap test o Testing procedure: patient position in supine with knee flexed or extended to appoint discomfort. Therapist applies slight tap over Patella o Positive result is tell appears to be floating and can tap on the bone below o Positive test means: joint effusion

- patellar tap test o Testing procedure: o Positive result is o Positive test means:

special test for swelling at the knee - brush test o Testing procedure: patient in supine. Therapist places one hand below the joint line on the medial surface of the Patella and strokes proximally with the palm and fingers as far as the Super patellar pouch. Other hand and strokes down the lateral surface of the Patella. o Positive result is Wave of fluid just below the medial distal border of the Patella o Positive test means: knee swelling - patellar tap test o Testing procedure: patient position in supine with knee flexed or extended to appoint discomfort. Therapist applies slight tap over Patella o Positive result is tell appears to be floating and can tap on the bone below o Positive test means: joint effusion

- Barlow's test o Testing procedure: o Positive result is o Positive test means:

special tests for Pediatrics at the hip - Barlow's test o Testing procedure: patient positioned in supine with hips flexed to 90 degrees and knees flexed. Therapist test each hip individually by stabilizing the femur and pelvis with one hand while the other hand moves the test leg into ad while applying forward pressure posterior to the greater trochanter o Positive result is click or clunk o Positive test means: hip dislocation being reduced - Ortolani's test o Testing procedure: patient in supine with hip flex to 90 degrees and knees flexed. Therapist Abd the patient's hip And gently applies pressure to greater trochanter until resistance is felt at approximately 30 degrees o Positive result is click or clunk o Positive test means: hip dislocation being reduced

- Ortolani's test o Testing procedure: o Positive result is o Positive test means:

special tests for Pediatrics at the hip - Barlow's test o Testing procedure: patient positioned in supine with hips flexed to 90 degrees and knees flexed. Therapist test each hip individually by stabilizing the femur and pelvis with one hand while the other hand moves the test leg into ad while applying forward pressure posterior to the greater trochanter o Positive result is click or clunk o Positive test means: hip dislocation being reduced - Ortolani's test o Testing procedure: patient in supine with hip flex to 90 degrees and knees flexed. Therapist Abd the patient's hip And gently applies pressure to greater trochanter until resistance is felt at approximately 30 degrees o Positive result is click or clunk o Positive test means: hip dislocation being reduced

- Hawkins-kennedy impingement test o Testing procedure: o Positive result is o Positive test means:

special tests for Rotator cuff pathology / impingement - drop arm test o Testing procedure: patient in sitting or standing with arm in 90 degrees of Abd. Patient is asked to slowly lower the arm to their side o Positive result is failing to slightly lower arm or by the presence of severe pain o Positive test means: tear in the rotator cuff - Hawkins-kennedy impingement test o Testing procedure: patient is in sitting or standing. Patients shoulder to 90 degrees and then medially rotates the arm o Positive result is pain o Positive test means: Shoulder impingement involving this supraspinatus tendon - Infraspinatus test o Testing procedure: Patient stands with elbow flex to 90 degrees and the shoulder and 45 degrees of medial rotation. Patient resists as therapist applies medial directed force to the forearm o Positive result is pain or weakness o Positive test means: presence of and infraspinatous strain or tear - lateral rotation lag sign o Testing procedure: patience album band, therapist possibly move shoulder into 20 degrees of scaption and near end range lateral rotation and ask patient to hold position o Positive result is cannot hold position o Positive test means: infraspinatous and or superspinatous pathology o test can also be performed with patients shoulder in varying levels of elevation - liftoff sign (medial rotation lag sign ) o Testing procedure: patient stands in place is back of hand on low back . Patient asked to move hand away from back o Positive result is unable to move hand away from back or hold position o Positive test means: subscapularis lesion - Neer impingement test o Testing procedure: patient in sitting or standing. Therapist holds patient scapula another hand stabilizing elbow . Therapist elevates the patients arm through flexion. o Positive result is Facial grimace or pain o Positive test means: shoulder impingement involving the supraspinatus tendon - Supine impingement test o Testing procedure: patient supine wall therapist passively moves the shoulder into full flexion and then laterally rotates in aDD the shoulder so that the arm is near the patient's head. Next therapist medially rotate shoulder o Positive result is increase in pain with medial rotation o Positive test means: rotator cuff pathology or impingement - supraspinatus test o Testing procedure: patient position with arm in 90 degrees of Abd an followed by 30 degrees of horizontal adD with the thumb pointing down. therapist resist the patient's attempt to Abd the arm o Positive result is weakness or pain o Positive test means: care of the Supraspinatus tendon, impingement or subscapular nerve involvement

what is cadence? what is the average cadence?

what is cadence? - the number of steps an individual will walk over a period of time what is the average cadence? - 110 to 120 steps per minute

what is the McGill pain questionnaire?

what is the McGill pain questionnaire? - a pain assessment tool that is divided into 4 parts with a total of 70 questions part one : - patient marks on a drawing locate pain Part 2 : - patient chooses one word that best describes the pain Part 3 : - describes pattern of pain, factors that increase relief pain part 4 : - rates intensity of pain on zero to five

- Infraspinatus test o Testing procedure: o Positive result is o Positive test means:

special tests for Rotator cuff pathology / impingement - drop arm test o Testing procedure: patient in sitting or standing with arm in 90 degrees of Abd. Patient is asked to slowly lower the arm to their side o Positive result is failing to slightly lower arm or by the presence of severe pain o Positive test means: tear in the rotator cuff - Hawkins-kennedy impingement test o Testing procedure: patient is in sitting or standing. Patients shoulder to 90 degrees and then medially rotates the arm o Positive result is pain o Positive test means: Shoulder impingement involving this supraspinatus tendon - Infraspinatus test o Testing procedure: Patient stands with elbow flex to 90 degrees and the shoulder and 45 degrees of medial rotation. Patient resists as therapist applies medial directed force to the forearm o Positive result is pain or weakness o Positive test means: presence of and infraspinatous strain or tear - lateral rotation lag sign o Testing procedure: patience album band, therapist possibly move shoulder into 20 degrees of scaption and near end range lateral rotation and ask patient to hold position o Positive result is cannot hold position o Positive test means: infraspinatous and or superspinatous pathology o test can also be performed with patients shoulder in varying levels of elevation - liftoff sign (medial rotation lag sign ) o Testing procedure: patient stands in place is back of hand on low back . Patient asked to move hand away from back o Positive result is unable to move hand away from back or hold position o Positive test means: subscapularis lesion - Neer impingement test o Testing procedure: patient in sitting or standing. Therapist holds patient scapula another hand stabilizing elbow . Therapist elevates the patients arm through flexion. o Positive result is Facial grimace or pain o Positive test means: shoulder impingement involving the supraspinatus tendon - Supine impingement test o Testing procedure: patient supine wall therapist passively moves the shoulder into full flexion and then laterally rotates in aDD the shoulder so that the arm is near the patient's head. Next therapist medially rotate shoulder o Positive result is increase in pain with medial rotation o Positive test means: rotator cuff pathology or impingement - supraspinatus test o Testing procedure: patient position with arm in 90 degrees of Abd an followed by 30 degrees of horizontal adD with the thumb pointing down. therapist resist the patient's attempt to Abd the arm o Positive result is weakness or pain o Positive test means: care of the Supraspinatus tendon, impingement or subscapular nerve involvement

- Neer impingement test o Testing procedure: o Positive result is o Positive test means:

special tests for Rotator cuff pathology / impingement - drop arm test o Testing procedure: patient in sitting or standing with arm in 90 degrees of Abd. Patient is asked to slowly lower the arm to their side o Positive result is failing to slightly lower arm or by the presence of severe pain o Positive test means: tear in the rotator cuff - Hawkins-kennedy impingement test o Testing procedure: patient is in sitting or standing. Patients shoulder to 90 degrees and then medially rotates the arm o Positive result is pain o Positive test means: Shoulder impingement involving this supraspinatus tendon - Infraspinatus test o Testing procedure: Patient stands with elbow flex to 90 degrees and the shoulder and 45 degrees of medial rotation. Patient resists as therapist applies medial directed force to the forearm o Positive result is pain or weakness o Positive test means: presence of and infraspinatous strain or tear - lateral rotation lag sign o Testing procedure: patience album band, therapist possibly move shoulder into 20 degrees of scaption and near end range lateral rotation and ask patient to hold position o Positive result is cannot hold position o Positive test means: infraspinatous and or superspinatous pathology o test can also be performed with patients shoulder in varying levels of elevation - liftoff sign (medial rotation lag sign ) o Testing procedure: patient stands in place is back of hand on low back . Patient asked to move hand away from back o Positive result is unable to move hand away from back or hold position o Positive test means: subscapularis lesion - Neer impingement test o Testing procedure: patient in sitting or standing. Therapist holds patient scapula another hand stabilizing elbow . Therapist elevates the patients arm through flexion. o Positive result is Facial grimace or pain o Positive test means: shoulder impingement involving the supraspinatus tendon - Supine impingement test o Testing procedure: patient supine wall therapist passively moves the shoulder into full flexion and then laterally rotates in aDD the shoulder so that the arm is near the patient's head. Next therapist medially rotate shoulder o Positive result is increase in pain with medial rotation o Positive test means: rotator cuff pathology or impingement - supraspinatus test o Testing procedure: patient position with arm in 90 degrees of Abd an followed by 30 degrees of horizontal adD with the thumb pointing down. therapist resist the patient's attempt to Abd the arm o Positive result is weakness or pain o Positive test means: care of the Supraspinatus tendon, impingement or subscapular nerve involvement

- Supine impingement test o Testing procedure: o Positive result is o Positive test means:

special tests for Rotator cuff pathology / impingement - drop arm test o Testing procedure: patient in sitting or standing with arm in 90 degrees of Abd. Patient is asked to slowly lower the arm to their side o Positive result is failing to slightly lower arm or by the presence of severe pain o Positive test means: tear in the rotator cuff - Hawkins-kennedy impingement test o Testing procedure: patient is in sitting or standing. Patients shoulder to 90 degrees and then medially rotates the arm o Positive result is pain o Positive test means: Shoulder impingement involving this supraspinatus tendon - Infraspinatus test o Testing procedure: Patient stands with elbow flex to 90 degrees and the shoulder and 45 degrees of medial rotation. Patient resists as therapist applies medial directed force to the forearm o Positive result is pain or weakness o Positive test means: presence of and infraspinatous strain or tear - lateral rotation lag sign o Testing procedure: patience album band, therapist possibly move shoulder into 20 degrees of scaption and near end range lateral rotation and ask patient to hold position o Positive result is cannot hold position o Positive test means: infraspinatous and or superspinatous pathology o test can also be performed with patients shoulder in varying levels of elevation - liftoff sign (medial rotation lag sign ) o Testing procedure: patient stands in place is back of hand on low back . Patient asked to move hand away from back o Positive result is unable to move hand away from back or hold position o Positive test means: subscapularis lesion - Neer impingement test o Testing procedure: patient in sitting or standing. Therapist holds patient scapula another hand stabilizing elbow . Therapist elevates the patients arm through flexion. o Positive result is Facial grimace or pain o Positive test means: shoulder impingement involving the supraspinatus tendon - Supine impingement test o Testing procedure: patient supine wall therapist passively moves the shoulder into full flexion and then laterally rotates in aDD the shoulder so that the arm is near the patient's head. Next therapist medially rotate shoulder o Positive result is increase in pain with medial rotation o Positive test means: rotator cuff pathology or impingement - supraspinatus test o Testing procedure: patient position with arm in 90 degrees of Abd an followed by 30 degrees of horizontal adD with the thumb pointing down. therapist resist the patient's attempt to Abd the arm o Positive result is weakness or pain o Positive test means: care of the Supraspinatus tendon, impingement or subscapular nerve involvement

- drop arm test o Testing procedure: o Positive result is o Positive test means:

special tests for Rotator cuff pathology / impingement - drop arm test o Testing procedure: patient in sitting or standing with arm in 90 degrees of Abd. Patient is asked to slowly lower the arm to their side o Positive result is failing to slightly lower arm or by the presence of severe pain o Positive test means: tear in the rotator cuff - Hawkins-kennedy impingement test o Testing procedure: patient is in sitting or standing. Patients shoulder to 90 degrees and then medially rotates the arm o Positive result is pain o Positive test means: Shoulder impingement involving this supraspinatus tendon - Infraspinatus test o Testing procedure: Patient stands with elbow flex to 90 degrees and the shoulder and 45 degrees of medial rotation. Patient resists as therapist applies medial directed force to the forearm o Positive result is pain or weakness o Positive test means: presence of and infraspinatous strain or tear - lateral rotation lag sign o Testing procedure: patience album band, therapist possibly move shoulder into 20 degrees of scaption and near end range lateral rotation and ask patient to hold position o Positive result is cannot hold position o Positive test means: infraspinatous and or superspinatous pathology o test can also be performed with patients shoulder in varying levels of elevation - liftoff sign (medial rotation lag sign ) o Testing procedure: patient stands in place is back of hand on low back . Patient asked to move hand away from back o Positive result is unable to move hand away from back or hold position o Positive test means: subscapularis lesion - Neer impingement test o Testing procedure: patient in sitting or standing. Therapist holds patient scapula another hand stabilizing elbow . Therapist elevates the patients arm through flexion. o Positive result is Facial grimace or pain o Positive test means: shoulder impingement involving the supraspinatus tendon - Supine impingement test o Testing procedure: patient supine wall therapist passively moves the shoulder into full flexion and then laterally rotates in aDD the shoulder so that the arm is near the patient's head. Next therapist medially rotate shoulder o Positive result is increase in pain with medial rotation o Positive test means: rotator cuff pathology or impingement - supraspinatus test o Testing procedure: patient position with arm in 90 degrees of Abd an followed by 30 degrees of horizontal adD with the thumb pointing down. therapist resist the patient's attempt to Abd the arm o Positive result is weakness or pain o Positive test means: care of the Supraspinatus tendon, impingement or subscapular nerve involvement

- lateral rotation lag sign o Testing procedure: o Positive result is o Positive test means:

special tests for Rotator cuff pathology / impingement - drop arm test o Testing procedure: patient in sitting or standing with arm in 90 degrees of Abd. Patient is asked to slowly lower the arm to their side o Positive result is failing to slightly lower arm or by the presence of severe pain o Positive test means: tear in the rotator cuff - Hawkins-kennedy impingement test o Testing procedure: patient is in sitting or standing. Patients shoulder to 90 degrees and then medially rotates the arm o Positive result is pain o Positive test means: Shoulder impingement involving this supraspinatus tendon - Infraspinatus test o Testing procedure: Patient stands with elbow flex to 90 degrees and the shoulder and 45 degrees of medial rotation. Patient resists as therapist applies medial directed force to the forearm o Positive result is pain or weakness o Positive test means: presence of and infraspinatous strain or tear - lateral rotation lag sign o Testing procedure: patience album band, therapist possibly move shoulder into 20 degrees of scaption and near end range lateral rotation and ask patient to hold position o Positive result is cannot hold position o Positive test means: infraspinatous and or superspinatous pathology o test can also be performed with patients shoulder in varying levels of elevation - liftoff sign (medial rotation lag sign ) o Testing procedure: patient stands in place is back of hand on low back . Patient asked to move hand away from back o Positive result is unable to move hand away from back or hold position o Positive test means: subscapularis lesion - Neer impingement test o Testing procedure: patient in sitting or standing. Therapist holds patient scapula another hand stabilizing elbow . Therapist elevates the patients arm through flexion. o Positive result is Facial grimace or pain o Positive test means: shoulder impingement involving the supraspinatus tendon - Supine impingement test o Testing procedure: patient supine wall therapist passively moves the shoulder into full flexion and then laterally rotates in aDD the shoulder so that the arm is near the patient's head. Next therapist medially rotate shoulder o Positive result is increase in pain with medial rotation o Positive test means: rotator cuff pathology or impingement - supraspinatus test o Testing procedure: patient position with arm in 90 degrees of Abd an followed by 30 degrees of horizontal adD with the thumb pointing down. therapist resist the patient's attempt to Abd the arm o Positive result is weakness or pain o Positive test means: care of the Supraspinatus tendon, impingement or subscapular nerve involvement

- Ely's test o Testing procedure: o Positive result is o Positive test means:

special tests for contracture and tightness in the hip - Ely's test o Testing procedure: Patient in prone . Therapist flexes patients knee o Positive result is Spontaneous hip flexion occurring simultaneously with knee flexion o Positive test means: rectus femoris contracture - obers test o Testing procedure: patient in sidelying lower Leg flexed at the hip and the knee. Therapist moves leg into hip extension and Abd and then attempts to slowly lower the test Leg o Positive result is inability of the text leg 2 touch the table and add o Positive test means: IT band or tensor fascae latae contracture - piriformis test o Testing procedure: Patient in sidelying. Test leg Position tord ceiling and hip flex 290 degrees knee flex 290 . Therapist stabilizes pelvis and applice ADD force on the knee o Positive result is pain or tightness o Positive test means: piriformis tightness or compression on the sciatic nerve caused by the piriformis - Thomas test o Testing procedure:patient in supine , legs fully extended. Patient brings one knee to chest in order to flatten lumbar spine. Therapist observes position of contralateral hip while patient holds the flexed hip. o Positive result is Straight play rising from the table o Positive test means: hip flexion contraction - Tripod sign o Testing procedure: Patient positioned in sitting with knees flexed to 90 degrees over the edge of the table. Therapist passively extends one knee. o Positive result is Tightness in hamstrings or extension of trunk in order to limit the effects of tight hamstrings o Positive test means: see above - 90-90 Straight leg raise test o Testing procedure: patient positioned in supine, hips in 90 degrees of flexion with knees relaxed. Patient Alternatively extend each knee as much as possible while maintaining hip in 90 degrees of flexion. o Positive result is Knee remaining in 20 degrees or more flexion o Positive test means: hamstring tightness

- liftoff sign (medial rotation lag sign ) o Testing procedure: o Positive result is o Positive test means:

special tests for Rotator cuff pathology / impingement - drop arm test o Testing procedure: patient in sitting or standing with arm in 90 degrees of Abd. Patient is asked to slowly lower the arm to their side o Positive result is failing to slightly lower arm or by the presence of severe pain o Positive test means: tear in the rotator cuff - Hawkins-kennedy impingement test o Testing procedure: patient is in sitting or standing. Patients shoulder to 90 degrees and then medially rotates the arm o Positive result is pain o Positive test means: Shoulder impingement involving this supraspinatus tendon - Infraspinatus test o Testing procedure: Patient stands with elbow flex to 90 degrees and the shoulder and 45 degrees of medial rotation. Patient resists as therapist applies medial directed force to the forearm o Positive result is pain or weakness o Positive test means: presence of and infraspinatous strain or tear - lateral rotation lag sign o Testing procedure: patience album band, therapist possibly move shoulder into 20 degrees of scaption and near end range lateral rotation and ask patient to hold position o Positive result is cannot hold position o Positive test means: infraspinatous and or superspinatous pathology o test can also be performed with patients shoulder in varying levels of elevation - liftoff sign (medial rotation lag sign ) o Testing procedure: patient stands in place is back of hand on low back . Patient asked to move hand away from back o Positive result is unable to move hand away from back or hold position o Positive test means: subscapularis lesion - Neer impingement test o Testing procedure: patient in sitting or standing. Therapist holds patient scapula another hand stabilizing elbow . Therapist elevates the patients arm through flexion. o Positive result is Facial grimace or pain o Positive test means: shoulder impingement involving the supraspinatus tendon - Supine impingement test o Testing procedure: patient supine wall therapist passively moves the shoulder into full flexion and then laterally rotates in aDD the shoulder so that the arm is near the patient's head. Next therapist medially rotate shoulder o Positive result is increase in pain with medial rotation o Positive test means: rotator cuff pathology or impingement - supraspinatus test o Testing procedure: patient position with arm in 90 degrees of Abd an followed by 30 degrees of horizontal adD with the thumb pointing down. therapist resist the patient's attempt to Abd the arm o Positive result is weakness or pain o Positive test means: care of the Supraspinatus tendon, impingement or subscapular nerve involvement

- supraspinatus test o Testing procedure: o Positive result is o Positive test means:

special tests for Rotator cuff pathology / impingement - drop arm test o Testing procedure: patient in sitting or standing with arm in 90 degrees of Abd. Patient is asked to slowly lower the arm to their side o Positive result is failing to slightly lower arm or by the presence of severe pain o Positive test means: tear in the rotator cuff - Hawkins-kennedy impingement test o Testing procedure: patient is in sitting or standing. Patients shoulder to 90 degrees and then medially rotates the arm o Positive result is pain o Positive test means: Shoulder impingement involving this supraspinatus tendon - Infraspinatus test o Testing procedure: Patient stands with elbow flex to 90 degrees and the shoulder and 45 degrees of medial rotation. Patient resists as therapist applies medial directed force to the forearm o Positive result is pain or weakness o Positive test means: presence of and infraspinatous strain or tear - lateral rotation lag sign o Testing procedure: patience album band, therapist possibly move shoulder into 20 degrees of scaption and near end range lateral rotation and ask patient to hold position o Positive result is cannot hold position o Positive test means: infraspinatous and or superspinatous pathology o test can also be performed with patients shoulder in varying levels of elevation - liftoff sign (medial rotation lag sign ) o Testing procedure: patient stands in place is back of hand on low back . Patient asked to move hand away from back o Positive result is unable to move hand away from back or hold position o Positive test means: subscapularis lesion - Neer impingement test o Testing procedure: patient in sitting or standing. Therapist holds patient scapula another hand stabilizing elbow . Therapist elevates the patients arm through flexion. o Positive result is Facial grimace or pain o Positive test means: shoulder impingement involving the supraspinatus tendon - Supine impingement test o Testing procedure: patient supine wall therapist passively moves the shoulder into full flexion and then laterally rotates in aDD the shoulder so that the arm is near the patient's head. Next therapist medially rotate shoulder o Positive result is increase in pain with medial rotation o Positive test means: rotator cuff pathology or impingement - supraspinatus test o Testing procedure: patient position with arm in 90 degrees of Abd an followed by 30 degrees of horizontal adD with the thumb pointing down. therapist resist the patient's attempt to Abd the arm o Positive result is weakness or pain o Positive test means: care of the Supraspinatus tendon, impingement or subscapular nerve involvement

- Ludington's test o Testing procedure: o Positive result is o Positive test means:

special tests for biceps tendon pathology - Ludington's test o Testing procedure: Patient is in sitting and is asked to class both hands behind the head with the fingers in are locked. Patient contracts in relax the bicep muscle. o Positive result is Absence of movement in the biceps tendon o Positive test means: rupture of the long head of the biceps - Speed's test o Testing procedure: Patient isn't sitting or standing extended in the forearm supinated. Therapist palpates over bicipital groove in the other hand on the surface of the forearm. Therapist resist active shoulder flexion o Positive result is pain or tenderness in the bicipital groove o Positive test means: bicipital tendonitis - Yergason's test o Testing procedure: Patient is in sitting with 90 degrees of elbow flexion and the form pronated. Humerus is stabilized against the patients thorax. Therapist places one hand on the patient's forearm on the other hand over the bicipital groove patient is directed to actively supination laterally rotate against resistance o Positive result is pain or tenderness in the bicipital groove o Positive test means: bicycle tendonitis

- Speed's test o Testing procedure: o Positive result is o Positive test means:

special tests for biceps tendon pathology - Ludington's test o Testing procedure: Patient is in sitting and is asked to class both hands behind the head with the fingers in are locked. Patient contracts in relax the bicep muscle. o Positive result is Absence of movement in the biceps tendon o Positive test means: rupture of the long head of the biceps - Speed's test o Testing procedure: Patient isn't sitting or standing extended in the forearm supinated. Therapist palpates over bicipital groove in the other hand on the surface of the forearm. Therapist resist active shoulder flexion o Positive result is pain or tenderness in the bicipital groove o Positive test means: bicipital tendonitis - Yergason's test o Testing procedure: Patient is in sitting with 90 degrees of elbow flexion and the form pronated. Humerus is stabilized against the patients thorax. Therapist places one hand on the patient's forearm on the other hand over the bicipital groove patient is directed to actively supination laterally rotate against resistance o Positive result is pain or tenderness in the bicipital groove o Positive test means: bicycle tendonitis

- Yergason's test o Testing procedure: o Positive result is o Positive test means:

special tests for biceps tendon pathology - Ludington's test o Testing procedure: Patient is in sitting and is asked to class both hands behind the head with the fingers in are locked. Patient contracts in relax the bicep muscle. o Positive result is Absence of movement in the biceps tendon o Positive test means: rupture of the long head of the biceps - Speed's test o Testing procedure: Patient isn't sitting or standing extended in the forearm supinated. Therapist palpates over bicipital groove in the other hand on the surface of the forearm. Therapist resist active shoulder flexion o Positive result is pain or tenderness in the bicipital groove o Positive test means: bicipital tendonitis - Yergason's test o Testing procedure: Patient is in sitting with 90 degrees of elbow flexion and the form pronated. Humerus is stabilized against the patients thorax. Therapist places one hand on the patient's forearm on the other hand over the bicipital groove patient is directed to actively supination laterally rotate against resistance o Positive result is pain or tenderness in the bicipital groove o Positive test means: bicycle tendonitis

- 90-90 Straight leg raise test o Testing procedure: o Positive result is o Positive test means:

special tests for contracture and tightness in the hip - Ely's test o Testing procedure: Patient in prone . Therapist flexes patients knee o Positive result is Spontaneous hip flexion occurring simultaneously with knee flexion o Positive test means: rectus femoris contracture - obers test o Testing procedure: patient in sidelying lower Leg flexed at the hip and the knee. Therapist moves leg into hip extension and Abd and then attempts to slowly lower the test Leg o Positive result is inability of the text leg 2 touch the table and add o Positive test means: IT band or tensor fascae latae contracture - piriformis test o Testing procedure: Patient in sidelying. Test leg Position tord ceiling and hip flex 290 degrees knee flex 290 . Therapist stabilizes pelvis and applice ADD force on the knee o Positive result is pain or tightness o Positive test means: piriformis tightness or compression on the sciatic nerve caused by the piriformis - Thomas test o Testing procedure:patient in supine , legs fully extended. Patient brings one knee to chest in order to flatten lumbar spine. Therapist observes position of contralateral hip while patient holds the flexed hip. o Positive result is Straight play rising from the table o Positive test means: hip flexion contraction - Tripod sign o Testing procedure: Patient positioned in sitting with knees flexed to 90 degrees over the edge of the table. Therapist passively extends one knee. o Positive result is Tightness in hamstrings or extension of trunk in order to limit the effects of tight hamstrings o Positive test means: see above - 90-90 Straight leg raise test o Testing procedure: patient positioned in supine, hips in 90 degrees of flexion with knees relaxed. Patient Alternatively extend each knee as much as possible while maintaining hip in 90 degrees of flexion. o Positive result is Knee remaining in 20 degrees or more flexion o Positive test means: hamstring tightness

what is the average degree of toe-out for an adult?

what is the average degree of toe-out for an adult? - 7 degrees

- Thomas test o Testing procedure: o Positive result is o Positive test means:

special tests for contracture and tightness in the hip - Ely's test o Testing procedure: Patient in prone . Therapist flexes patients knee o Positive result is Spontaneous hip flexion occurring simultaneously with knee flexion o Positive test means: rectus femoris contracture - obers test o Testing procedure: patient in sidelying lower Leg flexed at the hip and the knee. Therapist moves leg into hip extension and Abd and then attempts to slowly lower the test Leg o Positive result is inability of the text leg 2 touch the table and add o Positive test means: IT band or tensor fascae latae contracture - piriformis test o Testing procedure: Patient in sidelying. Test leg Position tord ceiling and hip flex 290 degrees knee flex 290 . Therapist stabilizes pelvis and applice ADD force on the knee o Positive result is pain or tightness o Positive test means: piriformis tightness or compression on the sciatic nerve caused by the piriformis - Thomas test o Testing procedure:patient in supine , legs fully extended. Patient brings one knee to chest in order to flatten lumbar spine. Therapist observes position of contralateral hip while patient holds the flexed hip. o Positive result is Straight play rising from the table o Positive test means: hip flexion contraction - Tripod sign o Testing procedure: Patient positioned in sitting with knees flexed to 90 degrees over the edge of the table. Therapist passively extends one knee. o Positive result is Tightness in hamstrings or extension of trunk in order to limit the effects of tight hamstrings o Positive test means: see above - 90-90 Straight leg raise test o Testing procedure: patient positioned in supine, hips in 90 degrees of flexion with knees relaxed. Patient Alternatively extend each knee as much as possible while maintaining hip in 90 degrees of flexion. o Positive result is Knee remaining in 20 degrees or more flexion o Positive test means: hamstring tightness

- Tripod sign o Testing procedure: o Positive result is o Positive test means:

special tests for contracture and tightness in the hip - Ely's test o Testing procedure: Patient in prone . Therapist flexes patients knee o Positive result is Spontaneous hip flexion occurring simultaneously with knee flexion o Positive test means: rectus femoris contracture - obers test o Testing procedure: patient in sidelying lower Leg flexed at the hip and the knee. Therapist moves leg into hip extension and Abd and then attempts to slowly lower the test Leg o Positive result is inability of the text leg 2 touch the table and add o Positive test means: IT band or tensor fascae latae contracture - piriformis test o Testing procedure: Patient in sidelying. Test leg Position tord ceiling and hip flex 290 degrees knee flex 290 . Therapist stabilizes pelvis and applice ADD force on the knee o Positive result is pain or tightness o Positive test means: piriformis tightness or compression on the sciatic nerve caused by the piriformis - Thomas test o Testing procedure:patient in supine , legs fully extended. Patient brings one knee to chest in order to flatten lumbar spine. Therapist observes position of contralateral hip while patient holds the flexed hip. o Positive result is Straight play rising from the table o Positive test means: hip flexion contraction - Tripod sign o Testing procedure: Patient positioned in sitting with knees flexed to 90 degrees over the edge of the table. Therapist passively extends one knee. o Positive result is Tightness in hamstrings or extension of trunk in order to limit the effects of tight hamstrings o Positive test means: see above - 90-90 Straight leg raise test o Testing procedure: patient positioned in supine, hips in 90 degrees of flexion with knees relaxed. Patient Alternatively extend each knee as much as possible while maintaining hip in 90 degrees of flexion. o Positive result is Knee remaining in 20 degrees or more flexion o Positive test means: hamstring tightness

- obers test o Testing procedure: o Positive result is o Positive test means:

special tests for contracture and tightness in the hip - Ely's test o Testing procedure: Patient in prone . Therapist flexes patients knee o Positive result is Spontaneous hip flexion occurring simultaneously with knee flexion o Positive test means: rectus femoris contracture - obers test o Testing procedure: patient in sidelying lower Leg flexed at the hip and the knee. Therapist moves leg into hip extension and Abd and then attempts to slowly lower the test Leg o Positive result is inability of the text leg 2 touch the table and add o Positive test means: IT band or tensor fascae latae contracture - piriformis test o Testing procedure: Patient in sidelying. Test leg Position tord ceiling and hip flex 290 degrees knee flex 290 . Therapist stabilizes pelvis and applice ADD force on the knee o Positive result is pain or tightness o Positive test means: piriformis tightness or compression on the sciatic nerve caused by the piriformis - Thomas test o Testing procedure:patient in supine , legs fully extended. Patient brings one knee to chest in order to flatten lumbar spine. Therapist observes position of contralateral hip while patient holds the flexed hip. o Positive result is Straight play rising from the table o Positive test means: hip flexion contraction - Tripod sign o Testing procedure: Patient positioned in sitting with knees flexed to 90 degrees over the edge of the table. Therapist passively extends one knee. o Positive result is Tightness in hamstrings or extension of trunk in order to limit the effects of tight hamstrings o Positive test means: see above - 90-90 Straight leg raise test o Testing procedure: patient positioned in supine, hips in 90 degrees of flexion with knees relaxed. Patient Alternatively extend each knee as much as possible while maintaining hip in 90 degrees of flexion. o Positive result is Knee remaining in 20 degrees or more flexion o Positive test means: hamstring tightness

- piriformis test o Testing procedure: o Positive result is o Positive test means:

special tests for contracture and tightness in the hip - Ely's test o Testing procedure: Patient in prone . Therapist flexes patients knee o Positive result is Spontaneous hip flexion occurring simultaneously with knee flexion o Positive test means: rectus femoris contracture - obers test o Testing procedure: patient in sidelying lower Leg flexed at the hip and the knee. Therapist moves leg into hip extension and Abd and then attempts to slowly lower the test Leg o Positive result is inability of the text leg 2 touch the table and add o Positive test means: IT band or tensor fascae latae contracture - piriformis test o Testing procedure: Patient in sidelying. Test leg Position tord ceiling and hip flex 290 degrees knee flex 290 . Therapist stabilizes pelvis and applice ADD force on the knee o Positive result is pain or tightness o Positive test means: piriformis tightness or compression on the sciatic nerve caused by the piriformis - Thomas test o Testing procedure:patient in supine , legs fully extended. Patient brings one knee to chest in order to flatten lumbar spine. Therapist observes position of contralateral hip while patient holds the flexed hip. o Positive result is Straight play rising from the table o Positive test means: hip flexion contraction - Tripod sign o Testing procedure: Patient positioned in sitting with knees flexed to 90 degrees over the edge of the table. Therapist passively extends one knee. o Positive result is Tightness in hamstrings or extension of trunk in order to limit the effects of tight hamstrings o Positive test means: see above - 90-90 Straight leg raise test o Testing procedure: patient positioned in supine, hips in 90 degrees of flexion with knees relaxed. Patient Alternatively extend each knee as much as possible while maintaining hip in 90 degrees of flexion. o Positive result is Knee remaining in 20 degrees or more flexion o Positive test means: hamstring tightness

- Bunnel-Littler test o Testing procedure: o Positive result is o Positive test means:

special tests for contracture or tightness in the wrist and hand - Bunnel-Littler test o Testing procedure: Patient in sitting extension therapist attempts to move the proximal interphalangeal joint into flexion. o is Proximal interphalangeal joint does not flex with the metacarpal phalangeal joint extended = type intrinsic muscles or capsular tightness o if proximal interphalangeal joint fully flexes with the metacarpal phalangeal joint in slight flexion = intrinsic muscle tightness without capsular tightness - tight retinacular ligament test o Testing procedure: Proximal interphalangeal joint is held in a neutral position while the therapist attempts to flex the distal interphalangeal joint. o Positive result is Therapist is unable to flex the distal interphalangeal joint = retinacular ligaments or capsule may be tight o therapist able to flex the distal Inter phalangeal joint with the proximal interphalangeal joint in flexion = retinacular ligaments may be tight and the capsule may be normal

- tight retinacular ligament test o Testing procedure: o Positive result is o Positive test means:

special tests for contracture or tightness in the wrist and hand - Bunnel-Littler test o Testing procedure: Patient in sitting extension therapist attempts to move the proximal interphalangeal joint into flexion. o is Proximal interphalangeal joint does not flex with the metacarpal phalangeal joint extended = type intrinsic muscles or capsular tightness o if proximal interphalangeal joint fully flexes with the metacarpal phalangeal joint in slight flexion = intrinsic muscle tightness without capsular tightness - tight retinacular ligament test o Testing procedure: Proximal interphalangeal joint is held in a neutral position while the therapist attempts to flex the distal interphalangeal joint. o Positive result is Therapist is unable to flex the distal interphalangeal joint = retinacular ligaments or capsule may be tight o therapist able to flex the distal Inter phalangeal joint with the proximal interphalangeal joint in flexion = retinacular ligaments may be tight and the capsule may be normal

what are the range of motion requirements of hip extension for normal gait ?

what are the range of motion requirements of ... for normal gait ? - hip flexion o 0-30 degrees - hip extension o 0-10 degrees - knee flexion o 0-60 degrees - knee extension o zero degrees - ankle dorsi flexion o 0-10 degrees - ankle plantar flexion o 0-20 degrees

what are the range of motion requirements of hip flexion for normal gait ?

what are the range of motion requirements of ... for normal gait ? - hip flexion o 0-30 degrees - hip extension o 0-10 degrees - knee flexion o 0-60 degrees - knee extension o zero degrees - ankle dorsi flexion o 0-10 degrees - ankle plantar flexion o 0-20 degrees

- Mills test o Testing procedure: o Positive result is o Positive test means:

special tests for epicondylitis - cozens test o Testing procedure: Patient in sitting with elbow and slight flexion. Therapist palpates lateral epicondyle patient makes fist pronates the forearm, radially deviates, and extends the wrist against resistance o Positive result is pain in the lateral epicondyle region or muscle weakness o Positive test means: lateral epicondylitis - lateral epicondylitis test o Testing procedure: patient in sitting. Patient asked to extend 3rd digit against resistance o Positive result is pain in lateral epicondyle region or muscle weakness o Positive test means: lateral epicondylitis - medial epicondylitis test o Testing procedure: patient in sitting. Therapist palpates medial epicondyle and supinates the patient's forearm, extending the risk, extending the elbow o Positive result is pain in medial epicondyle o Positive test means: medial epicondylitis - Mills test o Testing procedure: patient in sitting. Therapist palpates lateral epicondyle, pronates the patient's forearm, flexes the wrist, extends elbow o Positive result is pain in the lateral epicondyle o Positive test means: lateral epicondylitis

- cozens test o Testing procedure: o Positive result is o Positive test means:

special tests for epicondylitis - cozens test o Testing procedure: Patient in sitting with elbow and slight flexion. Therapist palpates lateral epicondyle patient makes fist pronates the forearm, radially deviates, and extends the wrist against resistance o Positive result is pain in the lateral epicondyle region or muscle weakness o Positive test means: lateral epicondylitis - lateral epicondylitis test o Testing procedure: patient in sitting. Patient asked to extend 3rd digit against resistance o Positive result is pain in lateral epicondyle region or muscle weakness o Positive test means: lateral epicondylitis - medial epicondylitis test o Testing procedure: patient in sitting. Therapist palpates medial epicondyle and supinates the patient's forearm, extending the risk, extending the elbow o Positive result is pain in medial epicondyle o Positive test means: medial epicondylitis - Mills test o Testing procedure: patient in sitting. Therapist palpates lateral epicondyle, pronates the patient's forearm, flexes the wrist, extends elbow o Positive result is pain in the lateral epicondyle o Positive test means: lateral epicondylitis

- lateral epicondylitis test o Testing procedure: o Positive result is o Positive test means:

special tests for epicondylitis - cozens test o Testing procedure: Patient in sitting with elbow and slight flexion. Therapist palpates lateral epicondyle patient makes fist pronates the forearm, radially deviates, and extends the wrist against resistance o Positive result is pain in the lateral epicondyle region or muscle weakness o Positive test means: lateral epicondylitis - lateral epicondylitis test o Testing procedure: patient in sitting. Patient asked to extend 3rd digit against resistance o Positive result is pain in lateral epicondyle region or muscle weakness o Positive test means: lateral epicondylitis - medial epicondylitis test o Testing procedure: patient in sitting. Therapist palpates medial epicondyle and supinates the patient's forearm, extending the risk, extending the elbow o Positive result is pain in medial epicondyle o Positive test means: medial epicondylitis - Mills test o Testing procedure: patient in sitting. Therapist palpates lateral epicondyle, pronates the patient's forearm, flexes the wrist, extends elbow o Positive result is pain in the lateral epicondyle o Positive test means: lateral epicondylitis

- medial epicondylitis test o Testing procedure: o Positive result is o Positive test means:

special tests for epicondylitis - cozens test o Testing procedure: Patient in sitting with elbow and slight flexion. Therapist palpates lateral epicondyle patient makes fist pronates the forearm, radially deviates, and extends the wrist against resistance o Positive result is pain in the lateral epicondyle region or muscle weakness o Positive test means: lateral epicondylitis - lateral epicondylitis test o Testing procedure: patient in sitting. Patient asked to extend 3rd digit against resistance o Positive result is pain in lateral epicondyle region or muscle weakness o Positive test means: lateral epicondylitis - medial epicondylitis test o Testing procedure: patient in sitting. Therapist palpates medial epicondyle and supinates the patient's forearm, extending the risk, extending the elbow o Positive result is pain in medial epicondyle o Positive test means: medial epicondylitis - Mills test o Testing procedure: patient in sitting. Therapist palpates lateral epicondyle, pronates the patient's forearm, flexes the wrist, extends elbow o Positive result is pain in the lateral epicondyle o Positive test means: lateral epicondylitis

- Slocum test o Testing procedure: o Positive result is o Positive test means:

special tests for ligament and stability at the knee - anterior drawer test o Testing procedure: Patient in supine with knees flexed to 90 degrees and hip flex to 45 degrees. Therapist stabilizes lower leg by sitting on the forefoot. Therapist holds proximal tibia with two hands an administers anterior direct force to the tibia on the femur. o Positive result is Excessive anterior translation of the tibia on the femur with a diminished or absent endpoint o Positive test means: ACL injury - lachman's test o Testing procedure: patient in supine with knee flex two 20-30 degree. Therapist stabilizes distal femur with one hand and places other hand on proximal tibia. Therapist applies anterior directed force two tibia o Positive result is excessive anterior translation of the tibia on the femur with diminished or absent endpoint o Positive test means: ACL injury - lateral pivot shift test o Testing procedure: patient in supine with hip flexed an Abd to 30 degrees with slight medial rotation. therapist medially rotates the tibia and applies valgus force to knee while knee is slowly flexed. o Positive result is shift or clunk occurring between 20 and 40 degrees of flexion o Positive test means: reduction of tibia on femur .anterior lateral Rotary instability - posterior drawer test o Testing procedure: patient in supine with knees flexed to 90 degrees and the hip flex 45 degrees. Therapist stabilizes lower leg by sitting on 4 foot. Therapist administers posterior direct force to tibia and femur. o Positive result is Excessive posterior translation of the tibia on the femur with diminished or absent endpoint o Positive test means: PCL injury - posterior sag sign o Testing procedure: patient in supine with knee flex to 90 degrees and hip flex to 45 degrees. o Positive result is tibia sagging o Positive test means: PCL injury - Slocum test o Testing procedure: patient in supine with knee flex to 90 degrees and hip flexed 45 degrees. Therapist rotates patients foot 30 degrees medially to test anterior lateral instability. Therapist stabilizes lower leg by sitting on 4 foot. Therapist administers anterior direct force to tibia and femur. o Positive result is Movement of tibia occurring primarily on the lateral side o Positive test means: anterior lateral instability o this test can also be performed to assess anterior medial instability by rotating the patient's foot 15 degrees laterally - Valgus stress test o Testing procedure: patient is positioned in supine with knee flexed 20 to 30 degrees. therapist applies valgus force to knee. o Positive result is excessive valgus movement o Positive test means: medial collateral ligament sprain o a positive test with the knee in full extension may be indicative of damage to the MCL, posterior cruciate ligament, posterior oblique ligament, posterior medial capsule - Varus stress test o Testing procedure: Patient positions in supine with knee flexed 20 to 30 degrees . Therapist has one hand on ankle another hand on knee. Therapist applies various force to me with distal hand. o Positive result is Excessive varus movement o Positive test means: lateral collateral ligament sprain. o A positive test with the knee in full extension may be indicative of damage to the lateral collateral ligament, PCL, arcuate complex, posterior lateral capsule

- Valgus stress test of knee o Testing procedure: o Positive result is o Positive test means:

special tests for ligament and stability at the knee - anterior drawer test o Testing procedure: Patient in supine with knees flexed to 90 degrees and hip flex to 45 degrees. Therapist stabilizes lower leg by sitting on the forefoot. Therapist holds proximal tibia with two hands an administers anterior direct force to the tibia on the femur. o Positive result is Excessive anterior translation of the tibia on the femur with a diminished or absent endpoint o Positive test means: ACL injury - lachman's test o Testing procedure: patient in supine with knee flex two 20-30 degree. Therapist stabilizes distal femur with one hand and places other hand on proximal tibia. Therapist applies anterior directed force two tibia o Positive result is excessive anterior translation of the tibia on the femur with diminished or absent endpoint o Positive test means: ACL injury - lateral pivot shift test o Testing procedure: patient in supine with hip flexed an Abd to 30 degrees with slight medial rotation. therapist medially rotates the tibia and applies valgus force to knee while knee is slowly flexed. o Positive result is shift or clunk occurring between 20 and 40 degrees of flexion o Positive test means: reduction of tibia on femur .anterior lateral Rotary instability - posterior drawer test o Testing procedure: patient in supine with knees flexed to 90 degrees and the hip flex 45 degrees. Therapist stabilizes lower leg by sitting on 4 foot. Therapist administers posterior direct force to tibia and femur. o Positive result is Excessive posterior translation of the tibia on the femur with diminished or absent endpoint o Positive test means: PCL injury - posterior sag sign o Testing procedure: patient in supine with knee flex to 90 degrees and hip flex to 45 degrees. o Positive result is tibia sagging o Positive test means: PCL injury - Slocum test o Testing procedure: patient in supine with knee flex to 90 degrees and hip flexed 45 degrees. Therapist rotates patients foot 30 degrees medially to test anterior lateral instability. Therapist stabilizes lower leg by sitting on 4 foot. Therapist administers anterior direct force to tibia and femur. o Positive result is Movement of tibia occurring primarily on the lateral side o Positive test means: anterior lateral instability o this test can also be performed to assess anterior medial instability by rotating the patient's foot 15 degrees laterally - Valgus stress test o Testing procedure: patient is positioned in supine with knee flexed 20 to 30 degrees. therapist applies valgus force to knee. o Positive result is excessive valgus movement o Positive test means: medial collateral ligament sprain o a positive test with the knee in full extension may be indicative of damage to the MCL, posterior cruciate ligament, posterior oblique ligament, posterior medial capsule - Varus stress test o Testing procedure: Patient positions in supine with knee flexed 20 to 30 degrees . Therapist has one hand on ankle another hand on knee. Therapist applies various force to me with distal hand. o Positive result is Excessive varus movement o Positive test means: lateral collateral ligament sprain. o A positive test with the knee in full extension may be indicative of damage to the lateral collateral ligament, PCL, arcuate complex, posterior lateral capsule

- Varus stress test of knee o Testing procedure: o Positive result is o Positive test means:

special tests for ligament and stability at the knee - anterior drawer test o Testing procedure: Patient in supine with knees flexed to 90 degrees and hip flex to 45 degrees. Therapist stabilizes lower leg by sitting on the forefoot. Therapist holds proximal tibia with two hands an administers anterior direct force to the tibia on the femur. o Positive result is Excessive anterior translation of the tibia on the femur with a diminished or absent endpoint o Positive test means: ACL injury - lachman's test o Testing procedure: patient in supine with knee flex two 20-30 degree. Therapist stabilizes distal femur with one hand and places other hand on proximal tibia. Therapist applies anterior directed force two tibia o Positive result is excessive anterior translation of the tibia on the femur with diminished or absent endpoint o Positive test means: ACL injury - lateral pivot shift test o Testing procedure: patient in supine with hip flexed an Abd to 30 degrees with slight medial rotation. therapist medially rotates the tibia and applies valgus force to knee while knee is slowly flexed. o Positive result is shift or clunk occurring between 20 and 40 degrees of flexion o Positive test means: reduction of tibia on femur .anterior lateral Rotary instability - posterior drawer test o Testing procedure: patient in supine with knees flexed to 90 degrees and the hip flex 45 degrees. Therapist stabilizes lower leg by sitting on 4 foot. Therapist administers posterior direct force to tibia and femur. o Positive result is Excessive posterior translation of the tibia on the femur with diminished or absent endpoint o Positive test means: PCL injury - posterior sag sign o Testing procedure: patient in supine with knee flex to 90 degrees and hip flex to 45 degrees. o Positive result is tibia sagging o Positive test means: PCL injury - Slocum test o Testing procedure: patient in supine with knee flex to 90 degrees and hip flexed 45 degrees. Therapist rotates patients foot 30 degrees medially to test anterior lateral instability. Therapist stabilizes lower leg by sitting on 4 foot. Therapist administers anterior direct force to tibia and femur. o Positive result is Movement of tibia occurring primarily on the lateral side o Positive test means: anterior lateral instability o this test can also be performed to assess anterior medial instability by rotating the patient's foot 15 degrees laterally - Valgus stress test o Testing procedure: patient is positioned in supine with knee flexed 20 to 30 degrees. therapist applies valgus force to knee. o Positive result is excessive valgus movement o Positive test means: medial collateral ligament sprain o a positive test with the knee in full extension may be indicative of damage to the MCL, posterior cruciate ligament, posterior oblique ligament, posterior medial capsule - Varus stress test o Testing procedure: Patient positions in supine with knee flexed 20 to 30 degrees . Therapist has one hand on ankle another hand on knee. Therapist applies various force to me with distal hand. o Positive result is Excessive varus movement o Positive test means: lateral collateral ligament sprain. o A positive test with the knee in full extension may be indicative of damage to the lateral collateral ligament, PCL, arcuate complex, posterior lateral capsule

- anterior drawer test o Testing procedure: o Positive result is o Positive test means:

special tests for ligament and stability at the knee - anterior drawer test o Testing procedure: Patient in supine with knees flexed to 90 degrees and hip flex to 45 degrees. Therapist stabilizes lower leg by sitting on the forefoot. Therapist holds proximal tibia with two hands an administers anterior direct force to the tibia on the femur. o Positive result is Excessive anterior translation of the tibia on the femur with a diminished or absent endpoint o Positive test means: ACL injury - lachman's test o Testing procedure: patient in supine with knee flex two 20-30 degree. Therapist stabilizes distal femur with one hand and places other hand on proximal tibia. Therapist applies anterior directed force two tibia o Positive result is excessive anterior translation of the tibia on the femur with diminished or absent endpoint o Positive test means: ACL injury - lateral pivot shift test o Testing procedure: patient in supine with hip flexed an Abd to 30 degrees with slight medial rotation. therapist medially rotates the tibia and applies valgus force to knee while knee is slowly flexed. o Positive result is shift or clunk occurring between 20 and 40 degrees of flexion o Positive test means: reduction of tibia on femur .anterior lateral Rotary instability - posterior drawer test o Testing procedure: patient in supine with knees flexed to 90 degrees and the hip flex 45 degrees. Therapist stabilizes lower leg by sitting on 4 foot. Therapist administers posterior direct force to tibia and femur. o Positive result is Excessive posterior translation of the tibia on the femur with diminished or absent endpoint o Positive test means: PCL injury - posterior sag sign o Testing procedure: patient in supine with knee flex to 90 degrees and hip flex to 45 degrees. o Positive result is tibia sagging o Positive test means: PCL injury - Slocum test o Testing procedure: patient in supine with knee flex to 90 degrees and hip flexed 45 degrees. Therapist rotates patients foot 30 degrees medially to test anterior lateral instability. Therapist stabilizes lower leg by sitting on 4 foot. Therapist administers anterior direct force to tibia and femur. o Positive result is Movement of tibia occurring primarily on the lateral side o Positive test means: anterior lateral instability o this test can also be performed to assess anterior medial instability by rotating the patient's foot 15 degrees laterally - Valgus stress test o Testing procedure: patient is positioned in supine with knee flexed 20 to 30 degrees. therapist applies valgus force to knee. o Positive result is excessive valgus movement o Positive test means: medial collateral ligament sprain o a positive test with the knee in full extension may be indicative of damage to the MCL, posterior cruciate ligament, posterior oblique ligament, posterior medial capsule - Varus stress test o Testing procedure: Patient positions in supine with knee flexed 20 to 30 degrees . Therapist has one hand on ankle another hand on knee. Therapist applies various force to me with distal hand. o Positive result is Excessive varus movement o Positive test means: lateral collateral ligament sprain. o A positive test with the knee in full extension may be indicative of damage to the lateral collateral ligament, PCL, arcuate complex, posterior lateral capsule

- lachman's test o Testing procedure: o Positive result is o Positive test means:

special tests for ligament and stability at the knee - anterior drawer test o Testing procedure: Patient in supine with knees flexed to 90 degrees and hip flex to 45 degrees. Therapist stabilizes lower leg by sitting on the forefoot. Therapist holds proximal tibia with two hands an administers anterior direct force to the tibia on the femur. o Positive result is Excessive anterior translation of the tibia on the femur with a diminished or absent endpoint o Positive test means: ACL injury - lachman's test o Testing procedure: patient in supine with knee flex two 20-30 degree. Therapist stabilizes distal femur with one hand and places other hand on proximal tibia. Therapist applies anterior directed force two tibia o Positive result is excessive anterior translation of the tibia on the femur with diminished or absent endpoint o Positive test means: ACL injury - lateral pivot shift test o Testing procedure: patient in supine with hip flexed an Abd to 30 degrees with slight medial rotation. therapist medially rotates the tibia and applies valgus force to knee while knee is slowly flexed. o Positive result is shift or clunk occurring between 20 and 40 degrees of flexion o Positive test means: reduction of tibia on femur .anterior lateral Rotary instability - posterior drawer test o Testing procedure: patient in supine with knees flexed to 90 degrees and the hip flex 45 degrees. Therapist stabilizes lower leg by sitting on 4 foot. Therapist administers posterior direct force to tibia and femur. o Positive result is Excessive posterior translation of the tibia on the femur with diminished or absent endpoint o Positive test means: PCL injury - posterior sag sign o Testing procedure: patient in supine with knee flex to 90 degrees and hip flex to 45 degrees. o Positive result is tibia sagging o Positive test means: PCL injury - Slocum test o Testing procedure: patient in supine with knee flex to 90 degrees and hip flexed 45 degrees. Therapist rotates patients foot 30 degrees medially to test anterior lateral instability. Therapist stabilizes lower leg by sitting on 4 foot. Therapist administers anterior direct force to tibia and femur. o Positive result is Movement of tibia occurring primarily on the lateral side o Positive test means: anterior lateral instability o this test can also be performed to assess anterior medial instability by rotating the patient's foot 15 degrees laterally - Valgus stress test o Testing procedure: patient is positioned in supine with knee flexed 20 to 30 degrees. therapist applies valgus force to knee. o Positive result is excessive valgus movement o Positive test means: medial collateral ligament sprain o a positive test with the knee in full extension may be indicative of damage to the MCL, posterior cruciate ligament, posterior oblique ligament, posterior medial capsule - Varus stress test o Testing procedure: Patient positions in supine with knee flexed 20 to 30 degrees . Therapist has one hand on ankle another hand on knee. Therapist applies various force to me with distal hand. o Positive result is Excessive varus movement o Positive test means: lateral collateral ligament sprain. o A positive test with the knee in full extension may be indicative of damage to the lateral collateral ligament, PCL, arcuate complex, posterior lateral capsule

- lateral pivot shift test o Testing procedure: o Positive result is o Positive test means:

special tests for ligament and stability at the knee - anterior drawer test o Testing procedure: Patient in supine with knees flexed to 90 degrees and hip flex to 45 degrees. Therapist stabilizes lower leg by sitting on the forefoot. Therapist holds proximal tibia with two hands an administers anterior direct force to the tibia on the femur. o Positive result is Excessive anterior translation of the tibia on the femur with a diminished or absent endpoint o Positive test means: ACL injury - lachman's test o Testing procedure: patient in supine with knee flex two 20-30 degree. Therapist stabilizes distal femur with one hand and places other hand on proximal tibia. Therapist applies anterior directed force two tibia o Positive result is excessive anterior translation of the tibia on the femur with diminished or absent endpoint o Positive test means: ACL injury - lateral pivot shift test o Testing procedure: patient in supine with hip flexed an Abd to 30 degrees with slight medial rotation. therapist medially rotates the tibia and applies valgus force to knee while knee is slowly flexed. o Positive result is shift or clunk occurring between 20 and 40 degrees of flexion o Positive test means: reduction of tibia on femur .anterior lateral Rotary instability - posterior drawer test o Testing procedure: patient in supine with knees flexed to 90 degrees and the hip flex 45 degrees. Therapist stabilizes lower leg by sitting on 4 foot. Therapist administers posterior direct force to tibia and femur. o Positive result is Excessive posterior translation of the tibia on the femur with diminished or absent endpoint o Positive test means: PCL injury - posterior sag sign o Testing procedure: patient in supine with knee flex to 90 degrees and hip flex to 45 degrees. o Positive result is tibia sagging o Positive test means: PCL injury - Slocum test o Testing procedure: patient in supine with knee flex to 90 degrees and hip flexed 45 degrees. Therapist rotates patients foot 30 degrees medially to test anterior lateral instability. Therapist stabilizes lower leg by sitting on 4 foot. Therapist administers anterior direct force to tibia and femur. o Positive result is Movement of tibia occurring primarily on the lateral side o Positive test means: anterior lateral instability o this test can also be performed to assess anterior medial instability by rotating the patient's foot 15 degrees laterally - Valgus stress test o Testing procedure: patient is positioned in supine with knee flexed 20 to 30 degrees. therapist applies valgus force to knee. o Positive result is excessive valgus movement o Positive test means: medial collateral ligament sprain o a positive test with the knee in full extension may be indicative of damage to the MCL, posterior cruciate ligament, posterior oblique ligament, posterior medial capsule - Varus stress test o Testing procedure: Patient positions in supine with knee flexed 20 to 30 degrees . Therapist has one hand on ankle another hand on knee. Therapist applies various force to me with distal hand. o Positive result is Excessive varus movement o Positive test means: lateral collateral ligament sprain. o A positive test with the knee in full extension may be indicative of damage to the lateral collateral ligament, PCL, arcuate complex, posterior lateral capsule

- posterior drawer test of knee o Testing procedure: o Positive result is o Positive test means:

special tests for ligament and stability at the knee - anterior drawer test o Testing procedure: Patient in supine with knees flexed to 90 degrees and hip flex to 45 degrees. Therapist stabilizes lower leg by sitting on the forefoot. Therapist holds proximal tibia with two hands an administers anterior direct force to the tibia on the femur. o Positive result is Excessive anterior translation of the tibia on the femur with a diminished or absent endpoint o Positive test means: ACL injury - lachman's test o Testing procedure: patient in supine with knee flex two 20-30 degree. Therapist stabilizes distal femur with one hand and places other hand on proximal tibia. Therapist applies anterior directed force two tibia o Positive result is excessive anterior translation of the tibia on the femur with diminished or absent endpoint o Positive test means: ACL injury - lateral pivot shift test o Testing procedure: patient in supine with hip flexed an Abd to 30 degrees with slight medial rotation. therapist medially rotates the tibia and applies valgus force to knee while knee is slowly flexed. o Positive result is shift or clunk occurring between 20 and 40 degrees of flexion o Positive test means: reduction of tibia on femur .anterior lateral Rotary instability - posterior drawer test o Testing procedure: patient in supine with knees flexed to 90 degrees and the hip flex 45 degrees. Therapist stabilizes lower leg by sitting on 4 foot. Therapist administers posterior direct force to tibia and femur. o Positive result is Excessive posterior translation of the tibia on the femur with diminished or absent endpoint o Positive test means: PCL injury - posterior sag sign o Testing procedure: patient in supine with knee flex to 90 degrees and hip flex to 45 degrees. o Positive result is tibia sagging o Positive test means: PCL injury - Slocum test o Testing procedure: patient in supine with knee flex to 90 degrees and hip flexed 45 degrees. Therapist rotates patients foot 30 degrees medially to test anterior lateral instability. Therapist stabilizes lower leg by sitting on 4 foot. Therapist administers anterior direct force to tibia and femur. o Positive result is Movement of tibia occurring primarily on the lateral side o Positive test means: anterior lateral instability o this test can also be performed to assess anterior medial instability by rotating the patient's foot 15 degrees laterally - Valgus stress test o Testing procedure: patient is positioned in supine with knee flexed 20 to 30 degrees. therapist applies valgus force to knee. o Positive result is excessive valgus movement o Positive test means: medial collateral ligament sprain o a positive test with the knee in full extension may be indicative of damage to the MCL, posterior cruciate ligament, posterior oblique ligament, posterior medial capsule - Varus stress test o Testing procedure: Patient positions in supine with knee flexed 20 to 30 degrees . Therapist has one hand on ankle another hand on knee. Therapist applies various force to me with distal hand. o Positive result is Excessive varus movement o Positive test means: lateral collateral ligament sprain. o A positive test with the knee in full extension may be indicative of damage to the lateral collateral ligament, PCL, arcuate complex, posterior lateral capsule

what are the range of motion requirements of knee extension for normal gait ?

what are the range of motion requirements of ... for normal gait ? - hip flexion o 0-30 degrees - hip extension o 0-10 degrees - knee flexion o 0-60 degrees - knee extension o zero degrees - ankle dorsi flexion o 0-10 degrees - ankle plantar flexion o 0-20 degrees

what are the range of motion requirements of knee flexion for normal gait ?

what are the range of motion requirements of ... for normal gait ? - hip flexion o 0-30 degrees - hip extension o 0-10 degrees - knee flexion o 0-60 degrees - knee extension o zero degrees - ankle dorsi flexion o 0-10 degrees - ankle plantar flexion o 0-20 degrees

what causes these gate deviations of the knee? - exaggerated knee flexion at contact

what causes these gate deviations of the knee? - exaggerated knee flexion at contact o weak quadriceps o quadriceps paralysis o hamstring spasticity o insufficient extension range of motion - hyper extension in stance o compensation for weak quadriceps o plantar flexor contraction

- posterior sag sign o Testing procedure: o Positive result is o Positive test means:

special tests for ligament and stability at the knee - anterior drawer test o Testing procedure: Patient in supine with knees flexed to 90 degrees and hip flex to 45 degrees. Therapist stabilizes lower leg by sitting on the forefoot. Therapist holds proximal tibia with two hands an administers anterior direct force to the tibia on the femur. o Positive result is Excessive anterior translation of the tibia on the femur with a diminished or absent endpoint o Positive test means: ACL injury - lachman's test o Testing procedure: patient in supine with knee flex two 20-30 degree. Therapist stabilizes distal femur with one hand and places other hand on proximal tibia. Therapist applies anterior directed force two tibia o Positive result is excessive anterior translation of the tibia on the femur with diminished or absent endpoint o Positive test means: ACL injury - lateral pivot shift test o Testing procedure: patient in supine with hip flexed an Abd to 30 degrees with slight medial rotation. therapist medially rotates the tibia and applies valgus force to knee while knee is slowly flexed. o Positive result is shift or clunk occurring between 20 and 40 degrees of flexion o Positive test means: reduction of tibia on femur .anterior lateral Rotary instability - posterior drawer test o Testing procedure: patient in supine with knees flexed to 90 degrees and the hip flex 45 degrees. Therapist stabilizes lower leg by sitting on 4 foot. Therapist administers posterior direct force to tibia and femur. o Positive result is Excessive posterior translation of the tibia on the femur with diminished or absent endpoint o Positive test means: PCL injury - posterior sag sign o Testing procedure: patient in supine with knee flex to 90 degrees and hip flex to 45 degrees. o Positive result is tibia sagging o Positive test means: PCL injury - Slocum test o Testing procedure: patient in supine with knee flex to 90 degrees and hip flexed 45 degrees. Therapist rotates patients foot 30 degrees medially to test anterior lateral instability. Therapist stabilizes lower leg by sitting on 4 foot. Therapist administers anterior direct force to tibia and femur. o Positive result is Movement of tibia occurring primarily on the lateral side o Positive test means: anterior lateral instability o this test can also be performed to assess anterior medial instability by rotating the patient's foot 15 degrees laterally - Valgus stress test o Testing procedure: patient is positioned in supine with knee flexed 20 to 30 degrees. therapist applies valgus force to knee. o Positive result is excessive valgus movement o Positive test means: medial collateral ligament sprain o a positive test with the knee in full extension may be indicative of damage to the MCL, posterior cruciate ligament, posterior oblique ligament, posterior medial capsule - Varus stress test o Testing procedure: Patient positions in supine with knee flexed 20 to 30 degrees . Therapist has one hand on ankle another hand on knee. Therapist applies various force to me with distal hand. o Positive result is Excessive varus movement o Positive test means: lateral collateral ligament sprain. o A positive test with the knee in full extension may be indicative of damage to the lateral collateral ligament, PCL, arcuate complex, posterior lateral capsule

- valgus stress test o Testing procedure: o Positive result is o Positive test means:

special tests for ligamentous instability tests of the elbow - valgus stress test o Testing procedure: Patient in sitting with elbow in 20 to 30 degrees of flexion. Therapist applies valgus force to test the medial collateral ligament while palpating the medial joint line o Positive result is apprehension or pain increased laxity compared to other side o Positive test means: medial collateral ligament sprain - varus stress test o Testing procedure: patient in sitting with elbow in 20 to 30 degrees of flexion. Therapist applies various forms to test the lateral collateral ligament while palpating the lateral joint line o Positive result is increased laxity compared to other side apprehension or pain o Positive test means: lateral collateral ligament spring

- varus stress test o Testing procedure: o Positive result is o Positive test means:

special tests for ligamentous instability tests of the elbow - valgus stress test o Testing procedure: Patient in sitting with elbow in 20 to 30 degrees of flexion. Therapist applies valgus force to test the medial collateral ligament while palpating the medial joint line o Positive result is apprehension or pain increased laxity compared to other side o Positive test means: medial collateral ligament sprain - varus stress test o Testing procedure: patient in sitting with elbow in 20 to 30 degrees of flexion. Therapist applies various forms to test the lateral collateral ligament while palpating the lateral joint line o Positive result is increased laxity compared to other side apprehension or pain o Positive test means: lateral collateral ligament spring

- Tinel's sign o Testing procedure: o Positive result is o Positive test means:

special tests for neurological dysfunction of the elbow - elbow flexion test o Testing procedure: patient fully flexes both elbows while extending wrist hold position for three to five minutes o Positive result is tingling or paresthesia is noted in the ulnar nerve distribution of the forearm in hand o Positive test means: cubital tunnel syndrome - pinch grip test o Testing procedure: patient pinch index finger and thumb together o Positive result is cannot pinch tip to tip instead presses the pads of the fingers together o Positive test means: anterior interosseous nerve pathology - Tinel's sign o Testing procedure: patient in sitting with elbow slightly flexed. Therapist taps with the index finger between the electron process and the medial epicondyle o Positive result is feeling sensation in the owner of distribution of the forearm hand and fingers o Positive test means: ulnar nerve compression or compromise

- elbow flexion test o Testing procedure: o Positive result is o Positive test means:

special tests for neurological dysfunction of the elbow - elbow flexion test o Testing procedure: patient fully flexes both elbows while extending wrist hold position for three to five minutes o Positive result is tingling or paresthesia is noted in the ulnar nerve distribution of the forearm in hand o Positive test means: cubital tunnel syndrome - pinch grip test o Testing procedure: patient pinch index finger and thumb together o Positive result is cannot pinch tip to tip instead presses the pads of the fingers together o Positive test means: anterior interosseous nerve pathology - Tinel's sign o Testing procedure: patient in sitting with elbow slightly flexed. Therapist taps with the index finger between the electron process and the medial epicondyle o Positive result is feeling sensation in the owner of distribution of the forearm hand and fingers o Positive test means: ulnar nerve compression or compromise

- pinch grip test o Testing procedure: o Positive result is o Positive test means:

special tests for neurological dysfunction of the elbow - elbow flexion test o Testing procedure: patient fully flexes both elbows while extending wrist hold position for three to five minutes o Positive result is tingling or paresthesia is noted in the ulnar nerve distribution of the forearm in hand o Positive test means: cubital tunnel syndrome - pinch grip test o Testing procedure: patient pinch index finger and thumb together o Positive result is cannot pinch tip to tip instead presses the pads of the fingers together o Positive test means: anterior interosseous nerve pathology - Tinel's sign o Testing procedure: patient in sitting with elbow slightly flexed. Therapist taps with the index finger between the electron process and the medial epicondyle o Positive result is feeling sensation in the owner of distribution of the forearm hand and fingers o Positive test means: ulnar nerve compression or compromise

- gapping test o Testing procedure: o Positive result is o Positive test means:

special tests for the lumbar and sacroiliac region - gapping test o Testing procedure: patient lies supine while the therapist crosses their arms and applies pressure in a downward and lateral direction two each anterior superior iliac spine. o Positive result is Pain in the sacroiliac joints, gluteus or posterior leg o Positive test means: sprain of anterior sacroiliac ligaments - sacroiliac joint stress test o Testing procedure: patient in supine. Therapist crossed his arms placing the palms of the hands on the patients anterior superior iliac spines. Therapist applies downward and lateral force to pelvis. o Positive result is Unilateral pain in the sacroiliac joint or gluteal area o Positive test means: sacroiliac joint dysfunction - sitting flexion test o Testing procedure: patient is positioned in sitting with knees flexed 90 degrees and feet on floor. Patience hips Abd to allow patient to bend forward. Therapist places thumbs an inferior margin of the posterior superior iliac spines Anne monitors movement of the Bony structures as the patient bends forward and reaches towards the floor. o Positive result is One posterior superior iliac spine moving farther in a cranial direction compared to the other o Positive test means: articular restriction - slump test o Testing procedure: patient sits at edge of table and is asked to slump. Then bring their chin tord chest. Therapist uses one hand to maintain the position of full spinal flexion while using the other hand to place the patient's ankle in full dorsi flexion. Patient asked to actively extend me or passively. If the patient cannot fully extend the knee because of pain, the therapist asked the patient to extend their neck, and then try to extend the knee again. o Positive result is Symptoms decrease with neck extension compared to neck flexion or the patient can extend knee farther o Positive test means:neural tension - standing flexion test o Testing procedure: patient is positioned in standing with the feet 12 inches apart. The therapist places their thumbs on the inferior margin of the posterior superior iliac spines and monitors the movement of the Bony structures as the patient bends forward with the knees extended. o Positive result is One posterior superior iliac spine moving farther in a cranial direction than the other o Positive test means: articular restriction - straight leg raise test o Testing procedure: patient in supine, therapist flexes patients hip while maintaining knee extension and slight medial rotation of the hip. Therapist continues to flex the hip until the patient complains of pain or tightness in the low back or posterior leg. Therapist then lowers leg until the patient feels no pain or tightness. At this point the therapist dorsi flexes the ankle or has the patient flexed their neck. o Positive result is If symptoms return with dorsiflexion or neck flexion o Positive test means: neural tension or a lesion within the spinal cord such as a disc herniation

- sacroiliac joint stress test o Testing procedure: o Positive result is o Positive test means:

special tests for the lumbar and sacroiliac region - gapping test o Testing procedure: patient lies supine while the therapist crosses their arms and applies pressure in a downward and lateral direction two each anterior superior iliac spine. o Positive result is Pain in the sacroiliac joints, gluteus or posterior leg o Positive test means: sprain of anterior sacroiliac ligaments - sacroiliac joint stress test o Testing procedure: patient in supine. Therapist crossed his arms placing the palms of the hands on the patients anterior superior iliac spines. Therapist applies downward and lateral force to pelvis. o Positive result is Unilateral pain in the sacroiliac joint or gluteal area o Positive test means: sacroiliac joint dysfunction - sitting flexion test o Testing procedure: patient is positioned in sitting with knees flexed 90 degrees and feet on floor. Patience hips Abd to allow patient to bend forward. Therapist places thumbs an inferior margin of the posterior superior iliac spines Anne monitors movement of the Bony structures as the patient bends forward and reaches towards the floor. o Positive result is One posterior superior iliac spine moving farther in a cranial direction compared to the other o Positive test means: articular restriction - slump test o Testing procedure: patient sits at edge of table and is asked to slump. Then bring their chin tord chest. Therapist uses one hand to maintain the position of full spinal flexion while using the other hand to place the patient's ankle in full dorsi flexion. Patient asked to actively extend me or passively. If the patient cannot fully extend the knee because of pain, the therapist asked the patient to extend their neck, and then try to extend the knee again. o Positive result is Symptoms decrease with neck extension compared to neck flexion or the patient can extend knee farther o Positive test means:neural tension - standing flexion test o Testing procedure: patient is positioned in standing with the feet 12 inches apart. The therapist places their thumbs on the inferior margin of the posterior superior iliac spines and monitors the movement of the Bony structures as the patient bends forward with the knees extended. o Positive result is One posterior superior iliac spine moving farther in a cranial direction than the other o Positive test means: articular restriction - straight leg raise test o Testing procedure: patient in supine, therapist flexes patients hip while maintaining knee extension and slight medial rotation of the hip. Therapist continues to flex the hip until the patient complains of pain or tightness in the low back or posterior leg. Therapist then lowers leg until the patient feels no pain or tightness. At this point the therapist dorsi flexes the ankle or has the patient flexed their neck. o Positive result is If symptoms return with dorsiflexion or neck flexion o Positive test means: neural tension or a lesion within the spinal cord such as a disc herniation

- sitting flexion test o Testing procedure: o Positive result is o Positive test means:

special tests for the lumbar and sacroiliac region - gapping test o Testing procedure: patient lies supine while the therapist crosses their arms and applies pressure in a downward and lateral direction two each anterior superior iliac spine. o Positive result is Pain in the sacroiliac joints, gluteus or posterior leg o Positive test means: sprain of anterior sacroiliac ligaments - sacroiliac joint stress test o Testing procedure: patient in supine. Therapist crossed his arms placing the palms of the hands on the patients anterior superior iliac spines. Therapist applies downward and lateral force to pelvis. o Positive result is Unilateral pain in the sacroiliac joint or gluteal area o Positive test means: sacroiliac joint dysfunction - sitting flexion test o Testing procedure: patient is positioned in sitting with knees flexed 90 degrees and feet on floor. Patience hips Abd to allow patient to bend forward. Therapist places thumbs an inferior margin of the posterior superior iliac spines Anne monitors movement of the Bony structures as the patient bends forward and reaches towards the floor. o Positive result is One posterior superior iliac spine moving farther in a cranial direction compared to the other o Positive test means: articular restriction - slump test o Testing procedure: patient sits at edge of table and is asked to slump. Then bring their chin tord chest. Therapist uses one hand to maintain the position of full spinal flexion while using the other hand to place the patient's ankle in full dorsi flexion. Patient asked to actively extend me or passively. If the patient cannot fully extend the knee because of pain, the therapist asked the patient to extend their neck, and then try to extend the knee again. o Positive result is Symptoms decrease with neck extension compared to neck flexion or the patient can extend knee farther o Positive test means:neural tension - standing flexion test o Testing procedure: patient is positioned in standing with the feet 12 inches apart. The therapist places their thumbs on the inferior margin of the posterior superior iliac spines and monitors the movement of the Bony structures as the patient bends forward with the knees extended. o Positive result is One posterior superior iliac spine moving farther in a cranial direction than the other o Positive test means: articular restriction - straight leg raise test o Testing procedure: patient in supine, therapist flexes patients hip while maintaining knee extension and slight medial rotation of the hip. Therapist continues to flex the hip until the patient complains of pain or tightness in the low back or posterior leg. Therapist then lowers leg until the patient feels no pain or tightness. At this point the therapist dorsi flexes the ankle or has the patient flexed their neck. o Positive result is If symptoms return with dorsiflexion or neck flexion o Positive test means: neural tension or a lesion within the spinal cord such as a disc herniation

- slump test o Testing procedure: o Positive result is o Positive test means:

special tests for the lumbar and sacroiliac region - gapping test o Testing procedure: patient lies supine while the therapist crosses their arms and applies pressure in a downward and lateral direction two each anterior superior iliac spine. o Positive result is Pain in the sacroiliac joints, gluteus or posterior leg o Positive test means: sprain of anterior sacroiliac ligaments - sacroiliac joint stress test o Testing procedure: patient in supine. Therapist crossed his arms placing the palms of the hands on the patients anterior superior iliac spines. Therapist applies downward and lateral force to pelvis. o Positive result is Unilateral pain in the sacroiliac joint or gluteal area o Positive test means: sacroiliac joint dysfunction - sitting flexion test o Testing procedure: patient is positioned in sitting with knees flexed 90 degrees and feet on floor. Patience hips Abd to allow patient to bend forward. Therapist places thumbs an inferior margin of the posterior superior iliac spines Anne monitors movement of the Bony structures as the patient bends forward and reaches towards the floor. o Positive result is One posterior superior iliac spine moving farther in a cranial direction compared to the other o Positive test means: articular restriction - slump test o Testing procedure: patient sits at edge of table and is asked to slump. Then bring their chin tord chest. Therapist uses one hand to maintain the position of full spinal flexion while using the other hand to place the patient's ankle in full dorsi flexion. Patient asked to actively extend me or passively. If the patient cannot fully extend the knee because of pain, the therapist asked the patient to extend their neck, and then try to extend the knee again. o Positive result is Symptoms decrease with neck extension compared to neck flexion or the patient can extend knee farther o Positive test means:neural tension - standing flexion test o Testing procedure: patient is positioned in standing with the feet 12 inches apart. The therapist places their thumbs on the inferior margin of the posterior superior iliac spines and monitors the movement of the Bony structures as the patient bends forward with the knees extended. o Positive result is One posterior superior iliac spine moving farther in a cranial direction than the other o Positive test means: articular restriction - straight leg raise test o Testing procedure: patient in supine, therapist flexes patients hip while maintaining knee extension and slight medial rotation of the hip. Therapist continues to flex the hip until the patient complains of pain or tightness in the low back or posterior leg. Therapist then lowers leg until the patient feels no pain or tightness. At this point the therapist dorsi flexes the ankle or has the patient flexed their neck. o Positive result is If symptoms return with dorsiflexion or neck flexion o Positive test means: neural tension or a lesion within the spinal cord such as a disc herniation

- standing flexion test o Testing procedure: o Positive result is o Positive test means:

special tests for the lumbar and sacroiliac region - gapping test o Testing procedure: patient lies supine while the therapist crosses their arms and applies pressure in a downward and lateral direction two each anterior superior iliac spine. o Positive result is Pain in the sacroiliac joints, gluteus or posterior leg o Positive test means: sprain of anterior sacroiliac ligaments - sacroiliac joint stress test o Testing procedure: patient in supine. Therapist crossed his arms placing the palms of the hands on the patients anterior superior iliac spines. Therapist applies downward and lateral force to pelvis. o Positive result is Unilateral pain in the sacroiliac joint or gluteal area o Positive test means: sacroiliac joint dysfunction - sitting flexion test o Testing procedure: patient is positioned in sitting with knees flexed 90 degrees and feet on floor. Patience hips Abd to allow patient to bend forward. Therapist places thumbs an inferior margin of the posterior superior iliac spines Anne monitors movement of the Bony structures as the patient bends forward and reaches towards the floor. o Positive result is One posterior superior iliac spine moving farther in a cranial direction compared to the other o Positive test means: articular restriction - slump test o Testing procedure: patient sits at edge of table and is asked to slump. Then bring their chin tord chest. Therapist uses one hand to maintain the position of full spinal flexion while using the other hand to place the patient's ankle in full dorsi flexion. Patient asked to actively extend me or passively. If the patient cannot fully extend the knee because of pain, the therapist asked the patient to extend their neck, and then try to extend the knee again. o Positive result is Symptoms decrease with neck extension compared to neck flexion or the patient can extend knee farther o Positive test means:neural tension - standing flexion test o Testing procedure: patient is positioned in standing with the feet 12 inches apart. The therapist places their thumbs on the inferior margin of the posterior superior iliac spines and monitors the movement of the Bony structures as the patient bends forward with the knees extended. o Positive result is One posterior superior iliac spine moving farther in a cranial direction than the other o Positive test means: articular restriction - straight leg raise test o Testing procedure: patient in supine, therapist flexes patients hip while maintaining knee extension and slight medial rotation of the hip. Therapist continues to flex the hip until the patient complains of pain or tightness in the low back or posterior leg. Therapist then lowers leg until the patient feels no pain or tightness. At this point the therapist dorsi flexes the ankle or has the patient flexed their neck. o Positive result is If symptoms return with dorsiflexion or neck flexion o Positive test means: neural tension or a lesion within the spinal cord such as a disc herniation

- straight leg raise test o Testing procedure: o Positive result is o Positive test means:

special tests for the lumbar and sacroiliac region - gapping test o Testing procedure: patient lies supine while the therapist crosses their arms and applies pressure in a downward and lateral direction two each anterior superior iliac spine. o Positive result is Pain in the sacroiliac joints, gluteus or posterior leg o Positive test means: sprain of anterior sacroiliac ligaments - sacroiliac joint stress test o Testing procedure: patient in supine. Therapist crossed his arms placing the palms of the hands on the patients anterior superior iliac spines. Therapist applies downward and lateral force to pelvis. o Positive result is Unilateral pain in the sacroiliac joint or gluteal area o Positive test means: sacroiliac joint dysfunction - sitting flexion test o Testing procedure: patient is positioned in sitting with knees flexed 90 degrees and feet on floor. Patience hips Abd to allow patient to bend forward. Therapist places thumbs an inferior margin of the posterior superior iliac spines Anne monitors movement of the Bony structures as the patient bends forward and reaches towards the floor. o Positive result is One posterior superior iliac spine moving farther in a cranial direction compared to the other o Positive test means: articular restriction - slump test o Testing procedure: patient sits at edge of table and is asked to slump. Then bring their chin tord chest. Therapist uses one hand to maintain the position of full spinal flexion while using the other hand to place the patient's ankle in full dorsi flexion. Patient asked to actively extend me or passively. If the patient cannot fully extend the knee because of pain, the therapist asked the patient to extend their neck, and then try to extend the knee again. o Positive result is Symptoms decrease with neck extension compared to neck flexion or the patient can extend knee farther o Positive test means:neural tension - standing flexion test o Testing procedure: patient is positioned in standing with the feet 12 inches apart. The therapist places their thumbs on the inferior margin of the posterior superior iliac spines and monitors the movement of the Bony structures as the patient bends forward with the knees extended. o Positive result is One posterior superior iliac spine moving farther in a cranial direction than the other o Positive test means: articular restriction - straight leg raise test o Testing procedure: patient in supine, therapist flexes patients hip while maintaining knee extension and slight medial rotation of the hip. Therapist continues to flex the hip until the patient complains of pain or tightness in the low back or posterior leg. Therapist then lowers leg until the patient feels no pain or tightness. At this point the therapist dorsi flexes the ankle or has the patient flexed their neck. o Positive result is If symptoms return with dorsiflexion or neck flexion o Positive test means: neural tension or a lesion within the spinal cord such as a disc herniation

what causes these gate deviations of the knee? - hyper extension in stance

what causes these gate deviations of the knee? - exaggerated knee flexion at contact o weak quadriceps o quadriceps paralysis o hamstring spasticity o insufficient extension range of motion - hyper extension in stance o compensation for weak quadriceps o plantar flexor contraction

- Adson maneuver o Testing procedure: o Positive result is o Positive test means:

special tests for thoracic outlet syndrome - Adson maneuver o Testing procedure: Patient positioned in sitting or standing. Therapist monitors the radial pulse and ask patient to rotate their head to face the testing shoulder . Patient is then asked to extend their head while the therapist laterally rotates and extends the patient shoulder o Positive result is absent or diminished radial pulse o Positive test means: thoracic outlet syndrome - Allan test o Testing procedure: patient positioned in sitting or standing with the testing arm in 90 degrees of Abd, lateral rotation, elbow flexion. o Positive result is Absent or diminished pulse when the head is rotated away from the test shoulder o Positive test means: thoracic outlet syndrome - costoclavicular syndrome test o Testing procedure: patient in sitting. Therapist feels radial pulse While patient assumes military posture. o Positive result is absent or diminished radial pulse o Positive test means: indicative of thoracic outlet syndrome caused by compression of the subclavian artery between the first rib and the clavicle - roos test o Testing procedure: patient in sitting or standing with arm positioned in 90 degrees of Abd, lateral rotation and elbow flexion. They open and closed their hands 4 three minutes. o Positive result is Inability to maintain the test position, weakness of arms, sensory loss or ischemic pain o Positive test means: thoracic outlet syndrome - wright test (hyperabduction test) o Testing procedure:sitting or supine therapist moves the patients arm overhead in the frontal plane while monitoring radial pulse o Positive result is absent or diminished radial pulse Positive test means: compression in the costoclavicular space

- Allan test o Testing procedure: o Positive result is o Positive test means:

special tests for thoracic outlet syndrome - Adson maneuver o Testing procedure: Patient positioned in sitting or standing. Therapist monitors the radial pulse and ask patient to rotate their head to face the testing shoulder . Patient is then asked to extend their head while the therapist laterally rotates and extends the patient shoulder o Positive result is absent or diminished radial pulse o Positive test means: thoracic outlet syndrome - Allan test o Testing procedure: patient positioned in sitting or standing with the testing arm in 90 degrees of Abd, lateral rotation, elbow flexion. o Positive result is Absent or diminished pulse when the head is rotated away from the test shoulder o Positive test means: thoracic outlet syndrome - costoclavicular syndrome test o Testing procedure: patient in sitting. Therapist feels radial pulse While patient assumes military posture. o Positive result is absent or diminished radial pulse o Positive test means: indicative of thoracic outlet syndrome caused by compression of the subclavian artery between the first rib and the clavicle - roos test o Testing procedure: patient in sitting or standing with arm positioned in 90 degrees of Abd, lateral rotation and elbow flexion. They open and closed their hands 4 three minutes. o Positive result is Inability to maintain the test position, weakness of arms, sensory loss or ischemic pain o Positive test means: thoracic outlet syndrome - wright test (hyperabduction test) o Testing procedure:sitting or supine therapist moves the patients arm overhead in the frontal plane while monitoring radial pulse o Positive result is absent or diminished radial pulse Positive test means: compression in the costoclavicular space

- costoclavicular syndrome test o Testing procedure: o Positive result is o Positive test means:

special tests for thoracic outlet syndrome - Adson maneuver o Testing procedure: Patient positioned in sitting or standing. Therapist monitors the radial pulse and ask patient to rotate their head to face the testing shoulder . Patient is then asked to extend their head while the therapist laterally rotates and extends the patient shoulder o Positive result is absent or diminished radial pulse o Positive test means: thoracic outlet syndrome - Allan test o Testing procedure: patient positioned in sitting or standing with the testing arm in 90 degrees of Abd, lateral rotation, elbow flexion. o Positive result is Absent or diminished pulse when the head is rotated away from the test shoulder o Positive test means: thoracic outlet syndrome - costoclavicular syndrome test o Testing procedure: patient in sitting. Therapist feels radial pulse While patient assumes military posture. o Positive result is absent or diminished radial pulse o Positive test means: indicative of thoracic outlet syndrome caused by compression of the subclavian artery between the first rib and the clavicle - roos test o Testing procedure: patient in sitting or standing with arm positioned in 90 degrees of Abd, lateral rotation and elbow flexion. They open and closed their hands 4 three minutes. o Positive result is Inability to maintain the test position, weakness of arms, sensory loss or ischemic pain o Positive test means: thoracic outlet syndrome - wright test (hyperabduction test) o Testing procedure:sitting or supine therapist moves the patients arm overhead in the frontal plane while monitoring radial pulse o Positive result is absent or diminished radial pulse Positive test means: compression in the costoclavicular space

- roos test o Testing procedure: o Positive result is o Positive test means:

special tests for thoracic outlet syndrome - Adson maneuver o Testing procedure: Patient positioned in sitting or standing. Therapist monitors the radial pulse and ask patient to rotate their head to face the testing shoulder . Patient is then asked to extend their head while the therapist laterally rotates and extends the patient shoulder o Positive result is absent or diminished radial pulse o Positive test means: thoracic outlet syndrome - Allan test o Testing procedure: patient positioned in sitting or standing with the testing arm in 90 degrees of Abd, lateral rotation, elbow flexion. o Positive result is Absent or diminished pulse when the head is rotated away from the test shoulder o Positive test means: thoracic outlet syndrome - costoclavicular syndrome test o Testing procedure: patient in sitting. Therapist feels radial pulse While patient assumes military posture. o Positive result is absent or diminished radial pulse o Positive test means: indicative of thoracic outlet syndrome caused by compression of the subclavian artery between the first rib and the clavicle - roos test o Testing procedure: patient in sitting or standing with arm positioned in 90 degrees of Abd, lateral rotation and elbow flexion. They open and closed their hands 4 three minutes. o Positive result is Inability to maintain the test position, weakness of arms, sensory loss or ischemic pain o Positive test means: thoracic outlet syndrome - wright test (hyperabduction test) o Testing procedure:sitting or supine therapist moves the patients arm overhead in the frontal plane while monitoring radial pulse o Positive result is absent or diminished radial pulse Positive test means: compression in the costoclavicular space

what is the average pelvic rotation during gait for an adult?

what is the average pelvic rotation during gait for an adult? - 8 degrees - 4 degrees forward with the swing leg and four degrees backward with the stance leg

what is the average step length for an adult? how is it measured?

what is the average step length for an adult? - 28 inches how is it measured? - between right heel strike and left heel strike

- wright test (hyperabduction test) o Testing procedure: o Positive result is o Positive test means:

special tests for thoracic outlet syndrome - Adson maneuver o Testing procedure: Patient positioned in sitting or standing. Therapist monitors the radial pulse and ask patient to rotate their head to face the testing shoulder . Patient is then asked to extend their head while the therapist laterally rotates and extends the patient shoulder o Positive result is absent or diminished radial pulse o Positive test means: thoracic outlet syndrome - Allan test o Testing procedure: patient positioned in sitting or standing with the testing arm in 90 degrees of Abd, lateral rotation, elbow flexion. o Positive result is Absent or diminished pulse when the head is rotated away from the test shoulder o Positive test means: thoracic outlet syndrome - costoclavicular syndrome test o Testing procedure: patient in sitting. Therapist feels radial pulse While patient assumes military posture. o Positive result is absent or diminished radial pulse o Positive test means: indicative of thoracic outlet syndrome caused by compression of the subclavian artery between the first rib and the clavicle - roos test o Testing procedure: patient in sitting or standing with arm positioned in 90 degrees of Abd, lateral rotation and elbow flexion. They open and closed their hands 4 three minutes. o Positive result is Inability to maintain the test position, weakness of arms, sensory loss or ischemic pain o Positive test means: thoracic outlet syndrome - wright test (hyperabduction test) o Testing procedure:sitting or supine therapist moves the patients arm overhead in the frontal plane while monitoring radial pulse o Positive result is absent or diminished radial pulse Positive test means: compression in the costoclavicular space

- cervical flexion rotation test o Testing procedure: o Positive result is o Positive test means:

special tests of the cervical spine - cervical flexion rotation test o Testing procedure: With patient in supine, therapist fully flexes patient cervical spine. Therapist rotates cervical spine in each direction while maintaining flexion. Patient should have 45 degrees of rotation in each direction o Positive result is less than 45 degrees of rotation in each direction o Positive test means: dysfunction likely occurring at the atlanto axial joint o this test can also be used as a provocation test for cervicogenic headache - distraction test cervical spine o Testing procedure: this test is used for patients who are currently experiencing ridiculous symptoms. With patient sitting, therapist places one hand under patients chin and the other hand under the occiput. Therapist applies upward distraction force. o Positive result is Pain is decreased with distraction force o Positive test means: cervical nerve root compression - foraminal compression test o Testing procedure: patient is positioned in sitting with the head laterally flexed. The therapist places both hands on top of subjects head and applies downward force. o Positive result is Pain radiating into the arms toward the flexed side o Positive test means: nerve root compression - vertebral artery test o Testing procedure: patient in supine . Therapist places the patient's head into extension, lateral flexion rotation to the ipsilateral side. o Positive result is Dizziness, nystagmus, slurred speech, loss of consciousness o Positive test means: compression of the vertebral artery

- distraction test cervical spine o Testing procedure: o Positive result is o Positive test means:

special tests of the cervical spine - cervical flexion rotation test o Testing procedure: With patient in supine, therapist fully flexes patient cervical spine. Therapist rotates cervical spine in each direction while maintaining flexion. Patient should have 45 degrees of rotation in each direction o Positive result is less than 45 degrees of rotation in each direction o Positive test means: dysfunction likely occurring at the atlanto axial joint o this test can also be used as a provocation test for cervicogenic headache - distraction test cervical spine o Testing procedure: this test is used for patients who are currently experiencing ridiculous symptoms. With patient sitting, therapist places one hand under patients chin and the other hand under the occiput. Therapist applies upward distraction force. o Positive result is Pain is decreased with distraction force o Positive test means: cervical nerve root compression - foraminal compression test o Testing procedure: patient is positioned in sitting with the head laterally flexed. The therapist places both hands on top of subjects head and applies downward force. o Positive result is Pain radiating into the arms toward the flexed side o Positive test means: nerve root compression - vertebral artery test o Testing procedure: patient in supine . Therapist places the patient's head into extension, lateral flexion rotation to the ipsilateral side. o Positive result is Dizziness, nystagmus, slurred speech, loss of consciousness o Positive test means: compression of the vertebral artery

- vertebral artery test o Testing procedure: o Positive result is o Positive test means:

special tests of the cervical spine - cervical flexion rotation test o Testing procedure: With patient in supine, therapist fully flexes patient cervical spine. Therapist rotates cervical spine in each direction while maintaining flexion. Patient should have 45 degrees of rotation in each direction o Positive result is less than 45 degrees of rotation in each direction o Positive test means: dysfunction likely occurring at the atlanto axial joint o this test can also be used as a provocation test for cervicogenic headache - distraction test cervical spine o Testing procedure: this test is used for patients who are currently experiencing ridiculous symptoms. With patient sitting, therapist places one hand under patients chin and the other hand under the occiput. Therapist applies upward distraction force. o Positive result is Pain is decreased with distraction force o Positive test means: cervical nerve root compression - foraminal compression test o Testing procedure: patient is positioned in sitting with the head laterally flexed. The therapist places both hands on top of subjects head and applies downward force. o Positive result is Pain radiating into the arms toward the flexed side o Positive test means: nerve root compression - vertebral artery test o Testing procedure: patient in supine . Therapist places the patient's head into extension, lateral flexion rotation to the ipsilateral side. o Positive result is Dizziness, nystagmus, slurred speech, loss of consciousness o Positive test means: compression of the vertebral artery

stress on the joints an loose packed versus closed packed position

stress on the joints an loose packed versus closed packed position - minimal stress on the joint in loose pack - maximal stress on joint and close packed

stretching definition indication contraindication

stretching definition - passive motion at end of range indication - decrease joint range of motion - decreased muscle flexibility contraindication - acute inflammation during soft tissue healing such as following a tendon repair - range of motion limited by bone on bone contact - recent fracture - hyper mobility - hypo mobility that allows for improved function - acute pain associated with stretching

what is the difference between a-Delta fibers and C fibers?

what is the difference between a-Delta fibers and C fibers? A-Delta: a Delta fibers transmit rapidly from peripheral cutaneous structures - more likely to transmit pain signals that are sharp and localized C Fibers: C fibers transmit information from deeper tissues (joints, viscera) and do so more slowly - transmit pain signals that are dull, aching, diffuse both types of nerve fibers send their impulses to the dorsal horn of the spinal cord, where impulses are then carried to the thalamus via spinothalamic tracks , then projected to sensory cortex for conscious pain

what is the difference between dynamic stretching and ballistic stretching?

what is the difference between dynamic stretching and ballistic stretching? - dynamic stretching is Actively moving into end range o movement based approach - ballistic stretching is bouncing at in range

what is the difference between edema and effusion ?

what is the difference between edema and effusion ? - edema is swelling outside of a joint capsule where effusion is swelling inside of a joint capsule

what is the difference between step length and stride length?

what is the difference between step length and stride length? - step length is the distance between right an left heel strike whereas stride length is the distance between right heel strike to right heel strike

what is the difference in hemoglobin content between type one and type 2 muscle fibers

what is the difference in my own globin content between type one and type 2 muscle fibers - Type 1 high myoglobin content - Type 2 low mile globin content (which muscle fiber is aerobic versus anaerobic - aerobic = type 1 (slow) - anerobic = type 2 (fast))

what is the minimum amount of knee flexion required for activities of daily living ?

what is the minimum amount of knee flexion required for activities of daily living ? - 90 degrees flexion

what is the minimum amount of knee flexion required to rise comfortably from sitting?

what is the minimum amount of knee flexion required to rise comfortably from sitting? - 105 degrees flexion

what is the normal Q angle in men and women ? how is Q angle measured ?

what is the normal Q angle in men and women ? - men = 13 degrees - women = 18 degrees how is Q angle measured ? - mid Patella to the anterior superior iliac spine and to the tibial tubercle

what is the smallest unit of muscle?

what is the smallest unit of muscle? - Sacromere

what is the visual analog scale

what is the visual analog scale - tool used to assess pain intensity using a 10 to 15 centimeter line with the left anchor indicating no pain and the right anchor indicating the worst pain you have - Patient marks on the line where they feel their pain is - the scale is highly sensitive if small increments such as millimeters are used to measure the patients point of pain on the scale - the visual analog scale is a valid tool if measurements are taken accurately - not face tool ...

What muscles do cervical rotation and side bending?

what muscles do cervical flexion? 3 - Sternocleidomastoid, longus colli, scalenes what muscles do cervical extension ? - Splenius cervicis, semispinalis cervicis, iliocostalis cervices, longissimus cervicis, multifidus, trapezius What muscles do cervical rotation and side bending? - Sternocleidomastoid, scalenes, splenius cervicis, longissimus cervices, iliocostalis cervicis, levator scapulae, multifidus

what muscles do cervical extension ?

what muscles do cervical flexion? 3 - Sternocleidomastoid, longus colli, scalenes what muscles do cervical extension ? - Splenius cervicis, semispinalis cervicis, iliocostalis cervices, longissimus cervicis, multifidus, trapezius What muscles do cervical rotation and side bending? - Sternocleidomastoid, scalenes, splenius cervicis, longissimus cervices, iliocostalis cervicis, levator scapulae, multifidus

what muscles do cervical flexion? 3

what muscles do cervical flexion? 3 - Sternocleidomastoid, longus colli, scalenes what muscles do cervical extension ? - Splenius cervicis, semispinalis cervicis, iliocostalis cervices, longissimus cervicis, multifidus, trapezius What muscles do cervical rotation and side bending? - Sternocleidomastoid, scalenes, splenius cervicis, longissimus cervices, iliocostalis cervicis, levator scapulae, multifidus

what muscles do cervical flexion? 3 - Sternocleidomastoid, longus colli, scalenes what muscles do cervical extension ? - Splenius cervicis, semispinalis cervicis, iliocostalis cervices, longissimus cervicis, multifidus, trapezius What muscles do cervical rotation and side bending? - Sternocleidomastoid, scalenes, splenius cervicis, longissimus cervices, iliocostalis cervicis, levator scapulae, multifidus

what muscles do cervical flexion? 3 - Sternocleidomastoid, longus colli, scalenes what muscles do cervical extension ? - Splenius cervicis, semispinalis cervicis, iliocostalis cervices, longissimus cervicis, multifidus, trapezius What muscles do cervical rotation and side bending? - Sternocleidomastoid, scalenes, splenius cervicis, longissimus cervices, iliocostalis cervicis, levator scapulae, multifidus

when should a person exhale with exercise?

when should a person exhale with exercise? - a person should exhale during the part that requires the most exertion - this is to avoid the valsalva maneuver as the valsalva maneuver increases abdominal pressure and may lead to undesirable effects on the cardiovascular system

which method of stretching involves active muscle contraction?

which method of stretching involves active muscle contraction? - proprioceptive neuromuscular facilitation stretching PNF

which method of stretching is best for improving tissue extensibility?

which method of stretching is best for improving tissue extensibility? - static stretching

which method of stretching is high intensity and short duration?

which method of stretching is high intensity and short duration? - Ballistic stretching

which method of stretching is low intensity and long duration?

which method of stretching is low intensity and long duration? - static stretching