PTA EXAM (scorebuilders book)

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What is the innervation level for resistive testing of cervical rotation?

What is the innervation level for dermatome testing of the posterior head?

What is the innervation level for resistive testing of shoulder elevation?

C2-C4

What is the innervation level for dermatome testing of the posterior-later neck?

What is the innervation level for dermatome testing of the AC joint?

What is the innervation level for dermatome testing of the lateral upper arm?

What is the innervation level for reflex testing of the biceps?

What is the innervation level for resistive testing of shoulder ABD?

What is the innervation level for resistive testing of elbow flexion?

C5-C6

Flexion SCI occur most often at ___-___ level of the spine while extensions SCI occur mostly at the ___-___ level

C5-C6 C4-C5

What is the innervation level for dermatome testing of the lateral forearm and thumb?

What is the innervation level for reflex testing of the brachioradialis?

What is the innervation level for resistive testing of wrist extension?

What is the innervation level for dermatome testing of the palmar distal phalanx-middle finger?

What is the innervation level for reflex testing of the triceps?

What is the innervation level for resistive testing of elbow extension?

What is the innervation level for resistive testing of wrist flexion?

Where do you put the tape measure when measuring thoracolumbar flexion and extension?

C7 and S1

What is the innervation level for dermatome testing of the little finger and ulnar border of the hand?

What is the innervation level for resistive testing of thumb extension?

What is the etiology of heart failure?

CAD Hypertension Diabetes mellitus MI Abnormal heart valves Cardiomyopathy

What is a Milwaukee orthosis?

CTLSO used to control scoliosis may be used for all kyphotic and scoliotic curves of 40 degrees or less

What is Stroke in Evolution?

CVA that usually caused by thrombus that gradually progresses; total neurologic deficits don't occur for 1-2 days

Myotome for S2

Calf and hamstring Wasting of gluteals and plantar flexors

Myotome for S1

Calf and hamstring Wasting of gluteals, peroneals and plantar flexors

What are the fine motor skills for a 2-3 month old?

Can see farther distances hands open more Visually follows through 180 degrees Grasp is reflexive Uses palmar grasp

What should you feel with a empty abnormal end feel?

Cannot reach end feel, usually do to pain ex. fracture bursitis joint inflammation

What is the largest cause of SCI?

Car accidents

Venous return must = _____ _____ when averages overtime because the cardiovascualr system is a closed loop

Cardiac Output

What are treatment options for osteogenesis imperfecta?

Caregiver education AROM Positioning Functional mobility Fracture management Use of orthotics

Where do most ischemic attack's (TIA) occur?

Carotid arteries Vertebrobasilar arteries

What is the etiology of pneumonia?

Caused by bacterial, viral, fungal or parasitic infection

What are red blood cells?

Cells that carry oxygen

What is a schwann cell?

Cells that cover nerve fibers in the peripheral nervous system and form the myelin sheath

What are white blood cells?

Cells that protect the body against infection

What part of the brain does Alzheimers originate from?

Cerebral cortex Subcortical areas of the brain

What are 10 examples of upper motor neuron diseases (UMNL)?

Cerebral palsy Hydrocephalus ALS (upper and lower) CVA Birth injuries MS Huntington's chorea TBI Pseudobulbar palsy Brain tumors

What are the parts that make up the forebrain?

Cerebrum Hippocampus Basal ganglia Amygdala Thalamus Hypothalamus Subthalamus Epithalamus

What is the most likely cause of anterior cord syndrome?

Cervical flexion

What is the most likely cause of central cord syndrome?

Cervical hyperextension that damages the spinothalamic tract, corticospinal tract and dorsal columns.

What is a halo vest orthosis?

Cervical thoracic orthosis Full restriction of all cervical motions Spinal cord injuries

What is non-fluent aphasia?

Characteristic of expressive aphasia where speech is non- functional, effortful and contains paraphasia. Writing is impaired also

What is fluent aphasia?

Characteristic of receptive aphasia where speech produces functional output regarding articulation, but lacks content and is typically dysprosodic using neologistic jargon

Abnormal Gait: What is circumduction gait?

Characterized by a circular motion to advance the leg during swing phase.

Abnormal Gait: What is ataxic gait?

Characterized by staggering and unsteadiness. There is usually a wide base of support and movements are exaggerated

What are signs and symptoms of a myocardial infarction?

Cheat discomfort Chest pressure SOB Upper body discomfort Nausea Vomiting Dizziness Sweating Palpitations

Paresthesia for C3

Cheek Side of neck

What can happen is the brainstem is impaired?

"Brain death"

What is congenital torticollis?

"Wry neck"; caused by unilateral contracture of the SCM muscle. Identified in the first 2 months of life

What is the level of assistance for ROM/ positioning for patient with high tetraplegia C1-C5? - PROM to trunk, legs and arms - pad position in bed

- Dependent - Able to verbally direct

What is the level of assistance for bathing for patient with high tetraplegia C1-C5? - bathing and drying off - upper body and lower body

- Dependent - Able to verbally direct

What is the level of assistance for bowel/ bladder problems for patient with high tetraplegia C1-C5? - intermittent catheterization - leg bag care - condom application - clean up - in bed/ wheelchair - feminine hygiene - bowel program

- Dependent - Able to verbally direct

What is the level of assistance for dressing for patient with high tetraplegia C1-C5? - dressing and undressing (in bed or wheelchair) - upper body/ lower body (in bed or wheelchair)

- Dependent - Able to verbally direct

What is the level of assistance for transfers for patient with high tetraplegia C1-C5? - bed - car - toilet - bath equipment - floor - upright wheelchair

- Dependent (C1-C4) - MaxA with level sliding board transfer (C5) - Verbally direct

What is the level of assistance for feeding for patient with high tetraplegia C1-C5? - drinking - finger feeding - utensil feeding

- Dependent (C1-C4) - MinA with adaptive equipment (C5) - Able to verbally direct

What is the level of assistance for grooming for patient with high tetraplegia C1-C5? - face - teeth - hair - makeup - shaving face

- Dependent (C1-C4) - MinA with adaptive equipment for face, teeth, makeup, shaving (C5) - MaxA/ ModA for hair (C5) - Able to verbally direct

What is the level of assistance for bed mobility for patient with high tetraplegia C1-C5? - rolling side to side - rolling supine/ prone - supine/ sitting - scooting all directions

- Dependent (C1-C4) - ModA to MaxA (C5) - Verbally direct

What is the level of assistance for wheelchair management for patient with high tetraplegia C1-C5? - wheel locks - footrest/leg rests - safety strap(s) - cushion adjustment - anti-tip levers - wheelchair maintenance

- Dependent with all - Able to verbally direct

What is the level of assistance for ROM/ positioning for patient with paraplegia? - PROM to trunk, legs and arms - pad position in bed

- Independent

What is the level of assistance for bed mobility for patient with paraplegia? - rolling side to side - rolling supine/ prone - supine/ sitting - scooting all directions

- Independent

What is the level of assistance for feeding for patient with paraplegia? - drinking - finger feeding - utensil feeding

- Independent

What is the level of assistance for grooming for patient with paraplegia? - face - teeth - hair - makeup - shaving face

- Independent

What is the level of assistance for bed mobility for patient with low tetraplegia (C7-C8)? - rolling side to side - rolling supine/ prone - supine/ sitting - scooting all directions

- Independent with all

What is the level of assistance for wheelchair management for patient with paraplegia? - wheel locks - footrest/leg rests - safety strap(s) - cushion adjustment - anti-tip levers - wheelchair maintence

- Independent with all

What is the level of assistance for transfers for patient with paraplegia? - bed - car - toilet - bath equipment - floor - upright wheelchair

- Independent with level surface and car transfer (depression) - MinA to Independent with floor transfers and uprighting wheelchair - Verbally direct

What is the level of assistance for wheelchair management for patient with low tetraplegia (C7-C8)? - wheel locks - footrest/leg rests - safety strap(s) - cushion adjustment - anti-tip levers - wheelchair maintenance

- May require assistance with cushion adjustment, anti- tip lever and wheelchair maintenance - Able to verbally direct

What is the level of assistance for bathing for patient with midlevel tetraplegia (C6)? - bathing and drying off - upper body and lower body

- MinA for upper body bathing and drying - ModA for lower body bathing and drying - Use of shower or tub chair - Able to verbally direct

What is the level of assistance for transfers for patient with midlevel tetraplegia (C6)? - bed - car - toilet - bath equipment - floor - upright wheelchair

- MinA to ModI for sliding board transfers - Dependent with wheelchair loading in car - Dependent with floor transfers and uprighting wheelchair - Verbally direct

What is the level of assistance for wheelchair mobility for patient with paraplegia? - smooth surfaces - up/ down ramps - up/down curbs - up/down steps - rough terrain

- MinA to ModI up/ down 6in curbs with manual wheelchair - ModI with descending steps with manual wheelchair - MaxA to MinA to ascend steps with manual wheelchair - Able to verbally direct

What is the level of assistance for ROM/ positioning for patient with low tetraplegia (C7-C8)? - PROM to trunk, legs and arms - pad position in bed

- MinA to ModI with all - Able to verbally direct

What is the level of assistance for bed mobility for patient with Mid-level tetraplegia (C6)? - rolling side to side - rolling supine/ prone - supine/ sitting - scooting all directions

- MinA to ModI with equipment - Verball direct

What is the level of assistance for ROM/ positioning for patient with midlevel tetraplegia (C6)? - PROM to trunk, legs and arms - pad position in bed

- ModA to ModI with all - Able to verbally direct

What is the level of assistance for dressing for patient with paraplegia? - dressing and undressing (in bed or wheelchair) - upper body/ lower body (in bed or wheelchair)

- ModI

What is the level of assistance for grooming for patient with low tetraplegia (C7-C8)? - face - teeth - hair - makeup - shaving face

- ModI

What is the level of assistance for dressing for patient with midlevel tetraplegia (C6)? - dressing and undressing (in bed or wheelchair) - upper body/ lower body (in bed or wheelchair)

- ModI for upper body in bed and wheelchair - MinA with lower body dressing in bed - ModA with lower body undressing in bed - Able to verbally direct

What is the level of assistance for dressing for patient with low tetraplegia (C7-C8)? - dressing and undressing (in bed or wheelchair) - upper body/ lower body (in bed or wheelchair)

- ModI for upper/ lower body dressing in bed - MinA with lower body dressing/ undressing in wheelchair (C7) - ModI for upper/ lower body dressing/ undressing in wheelchair (C8) - Able to verbally direct

What is the level of assistance for wheelchair mobility for patient with midlevel tetraplegia (C6)? - smooth surfaces - up/ down ramps - up/down curbs - up/down steps - rough terrain

- ModI in smooth, ramp and rough terrain with power wheelchair - Dependent to MaxA up/ down curb with power wheelchair - ModI to MinA on ramps and rough terrain with manual wheelchair - MaxA to ModA up/ down curbs with manual wheelchair - Able to verbally direct

What is the level of assistance for wheelchair mobility for patient with low tetraplegia (C7-C8)? - smooth surfaces - up/ down ramps - up/down curbs - up/down steps - rough terrain

- ModI on smooth, ramp and rough terrain with power wheelchair - Dependent to MaxA up/ down curb with power wheelchair - ModI on smooth surfaces and up/ down ramps with manual wheelchair - MinA to ModI on rough terrain - ModA to MinA up/ down curbs with manual wheelchair - Dependent to MaxA up/ down steps with manual wheelchair - Can verbally direct

What is the level of assistance for transfers for patient with low tetraplegia (C7-C8)? - bed - car - toilet - bath equipment - floor - upright wheelchair

- ModI to Independent with level surface transfer (siding board) - ModA to ModI with car trasfer - MaxA to ModA with floor transfers and uprighting wheelchair - Verbally direct

What is the level of assistance for feeding for patient with midlevel tetraplegia (C6)? - drinking - finger feeding - utensil feeding

- ModI with adaptive equipment

What is the level of assistance for grooming for patient with midlevel tetraplegia (C6)? - face - teeth - hair - makeup - shaving face

- ModI with adaptive equipment

What is the level of assistance for feeding for patient with low tetraplegia (C7-C8)? - drinking - finger feeding - utensil feeding

- ModI with adaptive equipment (C7)

What is the level of assistance for bathing for patient with paraplegia? - bathing and drying off - upper body and lower body

- ModI with all on tub bench or tub bottom cushion

What is the level of assistance for bathing for patient with low tetraplegia (C7-C8)? - bathing and drying off - upper body and lower body

- ModI with all using shower or tub chair

What is the level of assistance for weight shifts for patient with paraplegia? - pressure relief - repositioning in wheelchair

- ModI with depression weight shift

What is the level of assistance for weight shifts for patient with midlevel tetraplegia (C6)? - pressure relief - repositioning in wheelchair

- ModI with power recline/ tilt weight shift - MinA to ModI with side to side/ forward lean weight shift - Verbally direct

What is the level of assistance for weight shifts for patient with low tetraplegia (C7-C8)? - pressure relief - repositioning in wheelchair

- ModI with side to side/ forward lean, or depression weight shift

What is the level of assistance for gait for patient with high tetraplegia C1-C5? - don/ doff orthoses - sit/ stand - smooth surface - up/ down ramps - up/down curbs - up/down steps - rough terrain - safe falling

- N/A

What is the level of assistance for weight shifts for patient with high tetraplegia C1-C5? - pressure relief - repositioning in wheelchair

- Setup to ModI with power recline/ tilt weight shift - Dependent with manual recline/ tilt/ lean weight shift - Verbally direct

What is the level of assistance for wheelchair management for patient with midlevel tetraplegia (C6)? - wheel locks - footrest/leg rests - safety strap(s) - cushion adjustment - anti-tip levers - wheelchair maintenance

- Some assistance required - Able to verbally direct

What is the level of assistance for wheelchair mobility for patient with high tetraplegia C1-C5? - smooth surfaces - up/ down ramps - up/down curbs - up/down steps - rough terrain

- Supervision/ Setup to ModI on smooth, ramp, and rough terrain with power wheelchair - ModI with manual wheelchair on smooth surface in forward direction (C5) - MaxA to Dependent with manual wheelchair in all other situations (C5) - Able to verbally direct

What are the 2 main conditions of COPD

Chronic bronchitis Emphysema

What is asthma?

Chronic inflammation of the airways caused by an increased airway hypersensitivity to various stimuli

What gait pattern could be seen to compensate for insufficient hip or knee flexion or dorsiflexion?

Circumduction gait

Where is the carpal tunnel of the wrist located?

Close to the deep surface of the flexor retinaculum.

What are the 3 stages of motor learning?

Cognitive Associative Autonomous

What is the purpose of the RIGHT chambers of the heart?

Collect blood from the body and pump it to the lungs

What is the purpose of the LEFT chambers of the heart?

Collect blood from the lungs and pump it to the rest of the body

What are the 6 levels of consciousness?

Coma Stupor Obtundity Delirium Clouding of consciousness Consciousness

What is "A" considered on the ASIA Impairment Scale?

Complete- No sensory or motor function is preserved in sacral segments S4-S5

What are treatments for chronic venous insufficiency?

Compression stockings Elevation Varicose vein stripping

What is the purpose of the lower respiratory tract?

Conducts airway and the terminal respiratory units

What is a grade 2 concussion?

Confusion that last longer that 15 minutes Poor concentration, retrograde and antegrade amnesia

What is the etiology of aneurysms?

Congenital defect Weakness in the wall of the vessel often due to chronic hypertension Connective tissue disease Trauma Infection

What is the etiology of valvular heart disease?

Congenital defects, calcific degeneration, infective endocarditis, CAD, MI, rheumatic fever

What is the purpose of the Ligament Flavum?

Connects the lamina on one vertebra to another. Limits flexion and rotation.

What is akinetic mutism?

Conscious unresponsiveness

What is the parasympathetic nervous system?

Conserving and restoring energy Acetylcholine neurotransmitters Generally an inhibitory response

What is blocked practice?

Consistent practice of a single task

What are techniques used to increase ROM for mobility?

Contract- relax Hold- relax Joint distraction Rhythmical rotation Rhythmic stabilization

What is atrial systole?

Contraction of the atrias pushing blood into the ventricles

What is ventricular systole?

Contraction of the ventricles, forcing blood into the aorta and pulmonary artery

Bilateral occlusion (blockage) of the middle cerebral artery will typically produce what?

Contralateral hemiplegia and sensory impairment Dominant hemisphere impairment include global, Wernicke's or Broca's aphasia

What can happen if the medulla oblongata is impaired?

Contralateral impairment

What happens if the frontal lobe is impaired?

Contralateral weakness Perseveration, inattention Personality changes, antisocial behavior Impaired concentration, apathy Broca's aphasia (expressive deficits) Delayed or poor initiation Emotional lability

What are the fine motor skills for preschool age (3-4 yrs)?

Controls crayons better Copies circles or cross Matches color Cuts with scissors Draws recognizable human figures with head and 2 extremities Draws squares May demonstrate hand preference

what muscles are supplied by the musculocutaneous nerve?

Coracobrachialis Biceps brachii Brachialis

What are signs and symptoms of atherosclerosis?

Coronal Arteries- Angina pectoris Cerebral Arteries- Numbness or weakness of the UE or LE, difficulty speaking or slurred speech, drooping face Peripheral arteries- Intermittent claudication

The great cardiac vein, along with the small and middle cardiac veins drain into the _____ _____, emptying into the right atrium.

Coronary sinus

What do coronary venous circulation include?

Coronary sinus Cardiac veins Thebesian veins

Dermatomes for T5-T7

Costal margin

What are treatments for Huntingtons Disease?

Counseling Medication PT for endurance, strength, balance, posture and functional mobility

Where is the pia mater located?

Covers the contours of the brain Forms the choroid plexus of the ventricular system

What are some special test for elbow epicondylitis?

Cozen's test Later epicondylitis test Medial epicondylitis test

What are some special test for hip miscellaneous?

Craig's test Patrick's test (Faber test) Trendelenburg test

What are the 2 parts of the PNS?

Cranial nevers/ ganglia Spinal nerves/ ganglia/ plexuses

What are the gross motor skills for a 8-9 month old in mobility?

Crawls forwards Walks along furniture (cruising)

What is the average range of motion for extension?

What is the rang of motion for knee extension required for normal gait?

0 degrees

What is the average range of motion for digits (second to fifth) distal interphalangeal hyperextension?

0-10

What is the rang of motion for ankle dorsiflexion required for normal gait?

0-10 degrees

What is the rang of motion for hip extension required for normal gait?

0-10 degrees

What is the average range of motion for digits (second to fifth) proximal interphalangeal flexion?

0-100

What is the average range of motion for hip flexion?

0-120

What is the average range of motion for knee flexion?

0-135

What is the average range of motion for ankle eversion?

0-15

What is the average range of motion for thumb carpometacarpal flexion?

0-15

What is the average range of motion for elbow flexion?

0-150

What is the average range of motion for shoulder abduction?

0-180

What is the average range of motion for shoulder flexion?

0-180

What is the average range of motion for ankle dorsiflexion?

0-20

What is the average range of motion for radial deviation?

0-20

What is the average range of motion for thumb carpometacarpal extension?

0-20

What is the rang of motion for ankle plantar flexion required for normal gait?

0-20 degrees

What is the average range of motion for thoracic and lumbar spine extension?

0-25

What is the average range of motion for hip adduction?

0-30

What is the average range of motion for hip extension?

0-30

What is the average range of motion for ulnar deviation?

0-30

What is the rang of motion for hip flexion required for normal gait?

0-30 degrees

What is the average range of motion for ankle inversion?

0-35

What is the average range of motion for thoracic and lumbar spine lateral flexion?

0-35

What is the average range of motion for cervical spine extension?

0-45

What is the average range of motion for cervical spine flexion?

0-45

What is the average range of motion for cervical spine lateral flexion?

0-45

What is the average range of motion for digits (second to fifth) metacarpophalangeal hyperextension?

0-45

What is the average range of motion for hip ER?

0-45

What is the average range of motion for hip IR?

0-45

What is the average range of motion for hip abduction?

0-45

What is the average range of motion for thoracic and lumbar spine rotation?

0-45

What is the average range of motion for subtalar eversion?

0-5

What is the average range of motion for subtalar inversion?

0-5

What is the average range of motion for ankle plantarflexion?

0-50

What is the average range of motion for thumb metacarpophalangeal flexion?

0-50

What is the average range of motion for cervical spine rotation?

0-60

What is the average range of motion for shoulder extension?

0-60

What is the rang of motion for knee flexion required for normal gait?

0-60 degrees

What is the average range of motion for shoulder IR?

0-70

What is the average range of motion for thumb carpometacarpal abduction?

0-70

What is the average range of motion for wrist extension?

0-70

What is the average range of motion for forearm pronation?

0-80

What is the average range of motion for forearm supination?

0-80

What is the average range of motion for thoracic and lumbar spine flexion?

0-80

What is the average range of motion for thumb interphalangeal flexion?

0-80

What is the average range of motion for wrist flexion?

0-80

What is the average range of motion for digits (second to fifth) distal interphalangeal flexion?

0-90

What is the average range of motion for digits (second to fifth) metacarpophalangeal flexion?

0-90

What is the average range of motion for shoulder ER?

0-90

How many degrees of freedom does the subtler joint have?

How many degrees of freedom does the talocrural joint have?

How fast can an athlete return after a grade 1 concussion?

1 week after being free of symptoms

What is a Thoracolumbosacra orthosis (TLSO)?

Custom molded Prevents all trunk motion Post surgical stabilizer

What are the 8 Ranchos Los Amigos Levels of Cognitive Functioning

1. No Response 2. Generalized Response 3. Localized Response 4. Confused- Agitated 5. Confused- Inappropriate 6. Confused- Appropriate 7. Automatic- Appropriate 8. Purposeful- Appropriate

What are signs and symptoms of restrictive lung dysfunction?

Dyspnea on exertion A persistent non-productive cough Increased respiratory rate Hypoxemia Decreased vital capacity Abnormal breathing sounds Reduced exercise tolerance

What is the loose packed position for the talocrual joint?

10 PF Midway between maximum inversion and eversion

Tidal volume is approximately ___% of total lung volume

10%

Hemorrhage strokes are _____-_____% of CVA's

10-15%

What is the average cadence for an adult?

110-120 steps per minute

How many cranial nerves are there?

How many pairs of ribs are there?

How many cranial nerves are there?

12 pairs

What is normal blood pressure?

120/80 mmHg

What are the levels for prehypertensive BP?

120/80 to 139/89

What are the levels for stage 1 hypertensive BP?

140/90 to 159/99

Expiratory reserve volume (ERV) is approximately _____% of total lung volume.

15%

What are the levels for stage 2 hypertensive BP?

160/100 and above`

How many degrees of freedom does the knee have?

How many degrees of freedom does the radoiocarpal joint have?

How fast can an athlete return after a grade 2 concussion?

2 week after being free of symptoms and with exertion

What is the average base of support for adults?

2-4 inches

Double leg support makes up ___% of the gait cycle

20%

Embolus CVA's are _____% of ischemic CVS'a

20%

Multiple sclerosis can occur at any age with the highest incidence between ___-___ years of age

20-35

What is the normal range for HC03?

22-26 mEq/L

How fast can an ischemic attack (TIA) resolve?

24-48 hrs

Cardiac output can increase up to _____ L/min during exercise.

Residual volume is approximately ___% of total lung volume

What age do people with Duchenne Muscular Dystrophy typically live until and what causes their death?

25 Cardiopulmonary failure

What is the loose packed position of the tibiofemoral joint?

25 flexion

What is the average step length for adults?

28 inches

What is the normal age range for the rooting reflex?

28 weeks of gestation to 3 months

What is the normal age range for moro reflex?

28 weeks of gestation to 5 months

What is the normal age range for the startle reflex?

28 weeks of gestation to 5 months

What is the normal age range for the planter grasp reflex?

28 weeks of gestation to 9 months

How many degrees of freedom does the acromioclavicular joint have?

How many degrees of freedom does the iliofemoral joint have?

How many degrees of freedom does the shoulder joint have?

How many degrees of freedom does the sternoclavicular joint have?

What is normal tissue pressure within the carpal tunnel?

3-7 mm Hg

Carpal tunnel syndrome can result in pressure greater than ___ mm Hg in the wrist which produces ischemia within the median nerve

What is the loose packed position for the iliofemoral (hip) joint?

30 flexion 30 ABD Slight ER

What is the normal age range for the galant reflex?

30 weeks of gestation (being in the womb) to 2 months

How many spinal nerves are there?

31 pairs: 8 cervical 12 thoracic 5 lumbar 5 sacral 1 coccygeal

What is the normal age range for the positive support reflex?

35 weeks of gestation to 2 months

What is the normal range for PaCO2?

35-45 mmHg

What is the average age of developing symptoms of Huntington's Disease?

35-55yrs

What is the normal age range for the walking (stepping) reflex?

38 weeks of gestation to 2 months

The Coccyx is made up of ___ fused vertebrae

What is the normal blood volume?

4.5-5.0 L Women having slightly less

What is normal cardiac output?

4.5-5.0 L/ min Females may be a little less

Functional residual capacity is approximately ___% of the total lung volume

40%

The Sacrum is made up of ___ fused vertebrae

What is the closed pack position for the proximal radioulnar joint?

5 supination

What are the grades of manual muscle testing?

5/5 Normal- max resistance 4+/5 Good plus- mod/ max resistance 4/5 Good- mod resistance 4-/5 Good minus- min/ mod resistance 3+/5 Fair plus- min resistance 3/5 Fair- completes ROM AG but no resistance 3-/5 Fair minus- completes 1%-49% of ROM AG 2+/5 Poor plus- initiates movement AG 2/5 Poor- completes ROM in GE 2-/5 Poor minus- does not complete ROM in GE 1/5 Trace- contraction palpable but no joint movement 0/5 Zero- no palpable contraction

About ___% of DVT cases are asymptomatic.

Inspiratory reserve volume is approximately ___% of total lung volume

50%

What is the general age range of patients with Parkinson's?

50-79 yrs 10% are diagnosed before 40yrs old

What ages is typically seen with Guillain-Barre syndrome?

50-80yrs

What is the loose packed position for the glenohumeral joint?

55 ABD 30 horizontal ADD

What is the average stride length for adults?

56 inches

What are the normal age range for symmetrical tonic neck reflexes (STNR)?

6 to 8 months

Inspiratory capacity is approximately ___% of total lung volume

60%

What is normal stroke volume?

60-80 mL/beat

What is the average degree of toe out for an adult?

7 degrees

What is the normal range for pH?

7.35-7.45

What is the loose packed position for the ulnohumeral joint?

70 elboflexion 10 supination

What is the loose packed position for the proximal radioulnar joint?

70 elbow flexion 35 supination

VC is approximately ___% of total lung volume

What is the average pelvic rotation during gait for an adult?

8 degrees

Single leg support makes up ___% of the gait cycle

80%

What is the normal range for PaO2?

80-100 mmHg

What is the closed pack position for the radiohumeral joint?

90 flexion 5 supination

What is the normal range for SaO2?

95-98%

What is the capsular pattern of the tibiofemoral joint?

?Flexion Extension

What is a complete stroke?

A CVA that presents with total neurological deficits at the onset

What is post-polio syndrome?

A LMN pathology that affects the anterior horn cells of those previously affected with polio Muscle denervation

What is a DVT (deep vein thrombosis)

A blood clot that forms in a vein with the potential to dislodge as an embolism and travel until it blocks an artery

What is a comminuted fracture?

A bone breaks into many fragments

What is a stress fracture?

A break in a bone due to repeated forces to a particular portion of the bone

What is a spiral fracture?

A break in a bone shaped like an "S" due to torsion and twisting

What is a nonunion fracture?

A break in a bone that has failed to unite and heal after nine to twelve months

What is a greenstick fracture?

A break on one side of a bone that does not damage the periosteum on the opposite side. This type is often seen in children

What is a closed fracture?

A break that does not penetrate the skin

What is a neuroma?

A bundle of nerve endings that group together and produce pain due to scar tissue, pressure from the prosthesis or tension on the residual limb

What is decorticate rigidity?

A characteristic of a corticospinal lesion at the same level of the diencephalon where the trunk and the LE are positioned in extension and the UE are positioned in flexion

What is emotional liability?

A characteristic of a right hemisphere infarct where there is an inability to control emotions and outburst of laughing or crying that are inconsistent with the situation

What is decerebrate rigidity?

A characteristic of corticospinal lesion at the level of the brainstem that results in extension of the trunk and all extremities

What is epilepsy?

A chronic condition where there is temporary dysfunction of the brain what results in hypersynchronous electrical discharge of cortical neurons and seizure activity that is typically unprovoked and unpredictable

What is Amyotrophic Lateral Sclerosis (ALS)?

A chronic degenerative disease with both Upper and Lower motor neuron impairments. Results in denervation, muscle atrophy, weakness *rapid

What is osteoarthritis?

A chronic disease causing degeneration of articular cartilage, primarily in weight bearing joints More common in men then women up to age 55 More common in women then men +55 yrs old

What is chopping?

A combination of bilateral UE asymmetrical patterns performed as a closed- chair activity

What is diabetic neuropathy?

A complication and direct effect from diabetes mellitus Nerve damage

What is the proximal to distal concept of development?

A concept that uses the midline of the body as the reference point. Trunk control (midline stability) is acquired first with subsequent gain in distal control (extremities).

What is hemiplegia?

A condition of paralysis on one side of the body

What is hemiparesis?

A condition of weakness on one side of the body

What is ideomotor apraxia?

A condition where a person plans a movement or task but perform it due to motor issues. Automatic movement may occur, however, a person cannot impose additional movement on command

What is osteogenesis imperfecta?

A connective tissue disorder that affects the formation of collagen during bone development 4 levels Inheritance with type 1 and 4 is considered autosomal dominant traits Inheritance with type 2 and 3 is considered autosomal recessive traits

What is anemia?

A deficiency in red blood cells Blood carries less oxygen

What is key patterns?

A developmental sequence designed by Rood that directs patients' mobility recovery from synergy patterns through controlled motion

What is a coup lesion?

A direct lesion of the brain under the point of impact. Local brain damage is sustained

What is the pericardium?

A double walled connective tissue sac that surrounds the outside layer of the heart and great vessels

What is orthostatic hypotension?

A drop in blood pressure due to a sudden change of posture.

What is chorea?

A form of hyperkinesia that presents with brief, irregular contractions that are rapid

What is cogwheel rigidity?

A form of rigidity where resistance to movement has a phasic quality to it *parkinson's pateints

What is the 5th stage of recovery?

A further decrease in spasticity is noted with independence from limb synergy patterns

What is the mass to specific concept of development?

A general trend for a person to acquire simple movements and progress toward complex movements

What is the gross to fine concept of development?

A general trend for large muscle movement acquisition with progression to small muscle acquisition

What is down syndrome?

A genetic abnormality consisting of an extra 21st chromosome, termed trisomy 21

What is Chronic Obstructive Pulmonary Disease?

A group of lung diseases that block airflow due to narrowing of the bronchial tree The damage caused by chronic asthmatic bronchitis

What is limb synergies?

A group of muscles that produce a predictable pattern of movement in flexion or extension patterns

What is an epidural hematoma?

A hemorrhage that forms between the skull and dura mater

What is a subdural hematoma?

A hemorrhage that forms due to venous rupture between the dura and arachnoid

What is the midbrain?

A large relay station for information passing from the cerebrum, cerebellum and spinal cord Reflex center for visual, auditory and tactile responses

What is an upper motor neuron disease?

A lesion found in descending motor tracts within the cerebral motor cortex, internal capsule, brainstem or spinal cord

What is a lower motor neuron disease?

A lesion that affects nerves or their axons at or below the level of the brainstem, usually within the "final common pathway"

What is a complete lesion of a SCI?

A lesion to the spinal cord where there is no preserved motor or sensory function below the level of the lesion

What is an incomplete lesion of a SCI?

A lesion to the spinal cord with incomplete damage to the cord. There may be scattered motor function, sensory function or both below the level of the lesion

What is an aneurysm?

A localized abnormal dilation of a blood vessel, usually an artery

What is pleura?

A membrane lining of lungs and chest wall

What is light work?

A method used to develop controlled movement and skilled function by performing an activity (work) without resistance. Light work focuses on the extremities

What is heavy work?

A method used to develop stability by performing an activity (work) against gravity or resistance. Heavy work focuses on the strengthening of postural muscles

What is dysarthria?

A motor disorder of speech that is cause by an UMNL that affects muscles that are used to articulate words and sounds. Slurred speech

What is athetosis?

A movement disorder that presents with slow, twisting and writhing movements taht are large in amplitude

What is involuntary movement?

A movement that the person does not start or stop at a person's own command

What is fasciculation?

A muscular twitch that is caused by random discharge of a lower motor neuron and its muscle fibers

What is the etiology of cystic fibrosis?

A mutilation of the cystic fibrosis transmembrane conductance regulator on chromosome 7 A defective gene and its protein product cause the body to produce unusually thick, sticky mucus

What are coronary arteries?

A network of progressively smaller vessels that carry oxygenated blood to the myocardium

What is the Glasgow Coma Scale?

A neurological assessment tool used initially after injury to determine arousal and cerebral cortex function 8>x = severe brain injury 9-12 = moderate brain injury 13-15 = mild brain injury

What is Huntington's disease?

A neurological disorder of the CNS and is characterized by degeneration and atrophy of the basal ganglia and cerebral cortext of the brain. The neurotransmitters become deficient and are unable to modulate movement

What is the McGill Pain Questionnaire?

A pain assessment tool that is divided into 4 parts and has a total of 70 questions.

What is phantom limb?

A painless sensation where the patient feels that the limb is still present.

What is a grade III muscle/ tendon strain?

A palpable defect of the muscle Severe pain Poor motor control

What is rhythmic rotation (RR)? *Mobility

A passive technique used to decrease hypertonia by slowly rotating an extremity around the longitudinal axis. Relaxation of the extremity will increase ROM.

What is carpal tunnel syndrome?

A peripheral entrapment of the median nerve in the carpal tunnel causing sensory and motor issues

What is the cephalic to caudal concept of development?

A person develops head and UE control before trunk and LE control

What is spinal shock?

A physiology response that occurs between 30 and 60 minutes after trauma to the spinal cord and can last up to several weeks. Spinal shock presents with total flaccid paralysis and loss of all reflexes below the level of injury

What is strategy?

A plan used to produce a specific result or outcome that will influence the structure or system

What is an avulsion fracture?

A portion of a bone becomes fragmented at the site of tendon attachment due to a traumatic and sudden stretch of the tendon

What is the etiology of post- polio syndrome?

A previous diagnosis of polio is essential to diagnose 25-50%b of people with polio experience PPS decades after their initial recovery

How do you characterize chronic bronchitis?

A productive cough for 3months over a course of 2 consecutive years

What is the developmental sequence?

A progression of motor skill acquisition. The stages of motor control include mobility, stability, controlled mobility and skill

What is heart failure?

A progressive condition in which the heart cannot contain normal cardiac output to meet the body's demand for blood and oxygen Usually develops after other conditions have damaged the heart

What is Alzheimer's disease?

A progressive, neurodegenerative disorder that results in deterioration and irreversible damage within the cerebral cortex and subcortical areas of the brain NEURONS BREAK DOWN

What is an axon?

A projection of a nerve away from the cell body that conducts impulses

What is joint distraction? *Mobility

A proprioceptive component used to increase range of motion around a joint. Consistent manual traction is provided slowly and usually in combination with mobilization techniques. It can also be used in combination with quick stretch to initiate movement.

Abnormal Gait: What is antalgic gait?

A protective gait pattern where the involved step length is decreased in order to avoid weight bearing on the involved side

What is posterior cord syndrome?

A relatively rare syndrome that is caused by compression of the posterior spinal artery.

What is a rotator cuff tear?

A rotator cuff tear involves injury to one or more of the muscles participating in formation of that muscular structure. The supraspinatus, infraspinatus, subscapularis, and teres minor are the major muscles of the rotator cuff. Partial thickness- Extends through a portion of the tendon Full thickness- Complete tear of the tendon 1cm or less - more the 5cm

What is a contracture?

A severe tightening of a flexor muscle resulting in bending of a joint

What are motor units?

A single motor neuron and all muscle fibers innervated by it

What is non- associative learning?

A single repeated stimulus (habituation, sensitization)

What are Parapodiums?

A standing frame designed to allow a patient to sit when necessary. Ambulation is achieved by shifting weight and rocking the base across the floor. Pediatric population

What is consciousness?

A state of alertness, awareness, orientation and memory

What is obtundity?

A state of consciousness that is characterized by a state of sleep, reduced alertness to arousal and delayed responses to stimuli

What is delirium?

A state of consciousness that is characterized by disorientation, confusion, agitation, and loudness

What is clouding of consciousness?

A state of consciousness that is characterized by quiet behavior, confusion, poor attention and delayed responses

What is a stupor?

A state of general unresponsiveness with arousal occurring from repeated stimuli

What is rigidity?

A state of severe hypertonicity where a sustained muscle contraction does not allow for any movement at a specified joint

What is a coma?

A state of unconsciousness and a level of unresponsiveness to all internal and external stimuli

What is slow reversal (SR)? *Stability *Controlled mobility *Skill

A technique of slow and resisted concentric contractions of agonist and antagonist around a joint without rest between reversals. This technique is used to improve control of movement and posture

What is hold- relax active movement (HRAM)? *Mobility

A technique to improve initiation of movement to muscle groups tested at 1/5 or less. An isometric contraction performed once the extremity is passively placed into a shortened range within the pattern. Overflow and facilitation may be used to assist with the contraction. Upon relaxation, the extremity is immediately moved into a lengthened position of the pattern with a quick stretch. The patient is asked to return the extremity to the shortened position through an isotonic contraction.

What is rhythmic initiation (RI)? *Mobility

A technique used to assist in initiating movement when hypertonia exist. Movement progresses from passive ("let me move you"), to active assistive ("help me move you"), to slightly resistive ("move against the resistance"). Movement must be slow and rhythmical to reduce the hypertonia and allow for full ROM.

What is resisted progression (RP)? *Skill

A technique used to emphasize coordination of proximal components during gait. Resistance is applied to an area such as the pelvis, hips or extremity during the gait cycle in order to enhance coordination, strength or endurance.

What is normal timing (NT)? *Skill

A technique used to improve coordination of all components of a task. NT is performed in a distal to proximal sequence. Proximal components are restricted until the distal components are activated and initiate movement. repetition of the pattern produces a coordinated movement of all components.

What is rhythmic stabilization (RS)? *Mobility *Stability

A technique used to increase ROM and coordinate isometric contractions. The technique requires isometric contractions of all muscles around a joint against progressive resistance. The patient should relax and move into the newly acquired range and repeat the technique. If stability is the goal, RS should be applied as a progression from AI in order to stabilize all muscle groups simultaneously around the specific body part.

What is contract- relax (CR)? *Mobility

A technique used to increase range of motion As the extremity reaches the point of limitation, the patient performs a maximal contraction of the antagonistic muscle group. The therapist resists movement for 8-10 seconds with relaxation to follow. The technique is repeated until no further gains in range of motion are noted during the session

What is repeated contractions (RC)? *Mobility

A technique used to initiate movement and sustain a contraction through the rang of motion. RC is used to initiate a movement pattern, through a weak movement pattern or at a point of weakness within a movement pattern. The therapist provides a quick stretch followed by isometric or isotonic contractions

What is inhibition?

A technique utilized to decrease excessive tone or movement

What is facilitation?

A technique utilized to elicit voluntary muscular contraction

What is performance?

A temporary change in motor behavior seen during a particular session of practice that is a result of many variables, however, only one variable is focusing on the act of learning

What is Guillain-Barre syndrome?

A temporary inflammation and demyelination of the peripheral nerves' myelin sheaths, potentially resulting in axonal degeneration

What is paraplegia?

A term used to describe injuries that occur at the level of the thoracic, lumbar and sacral spine

What is a Taylor brace?

A thoracolumbosacral orthosis that limits trunk flexion and extension through a 3 point control design.

What is the Numerical Rating Scale?

A tool used to assess pain intensity using a 10-15cm line with the left anchor indicating "no pain" and the right anchor indicating "the worst pain you can have"

What are symptoms of an ectopic bone?

Edema Decreased ROM Increased tempurature

What are treatments options for osgood- schlatters disease?

Education Icing Flexibility exercises

What are treatments for cerebral palsy?

Education Normalizing tone Stretching Strengthening Positioning Mobility skills Splinting Assistive devices Surgery if needed

What are treatment options for Duchenne Muscular Dystrophy?

Education Respiratory function Submaximal exercises Mobility skill Orthotics Splinting Adaptive equipment Medication Surgery

What are treatment options for orthostatic hypotension?

Elastic stockings Abdominal binders Slow movements from laying to sitting Medication

Contraction of the external and internal intercostal muscles ____ (elevate/ depress) the ribs

Elevate

What is the normal value of acidemia?

Elevated acidity of blood pH < 7.35

What are the motions of the sternoclavicular joint?

Elevation Depression Protraction Retraction Medial Rotation (IR) Lateral Rotation (ER)

What is the hip strategy?

Elicited by a greater force, challenge or perturbation through the pelvis and hips

What is the stepping strategy?

Elicited through unexpected challenges or perturbation during static standing or when the perturbation produces such a movement that the center of gravity is beyond the BOS

What are some special test for hip contracture/ tightness?

Ely's test Ober's test Piriformis test Thomas test Tripod sign 90- 90 straight leg raise

What are the 4 abnormal end feels?

Empty Firm Hard Soft

What is the endocardium?

Endothelial tissue that lines the interior of the heart chambers and valves

Dermatome for C3

Entire neck Posterior cheek Temporal area Prolongation forward under mandible

The sympathetic influence is achieved by release of _____ and _____

Epinephrine Norepinephrine

What is the most common contracture associated with a transmetatarsal and Syme's amputations?

Equinus deformity

What muscles assist in thoracolumbar extension?

Erector Spinae Quadratus Lumborum Multifidus

What muscles assist with thoracic and lumbar extension?

Erector Spinae Quadratus Lumborum Multifidus

What is another name for red blood cells?

Erythrocytes

How do you challenge somatosensory input?

Examination of vibration and pressure Changing surfaces (slopes, uneven surface, standing on foam, even surface) *eyes open/ eyes closed

What are signs and symptoms of COPD?

Excessive mucus production Chronic productive cough Wheezing SOB Fatigue Reduced exercise capacity

What is glenohumeral instability?

Excessive translation of the humeral head on the glenoid during active motion

What is a closed-chain exercise?

Exercises that involve motions in which the body moves on a distal segment that is fixed or stabilized on a support surface Ex. Squats

What is an open-chain exercise?

Exercises that involves the distal segment, usually the hand or foot, moves freely in space Ex. Kicking a ball

During quiet breathing, _____ (exhalation/ inhalation)results from passive recoil of the lungs and rib cage.

Exhalation

Where is the radial collateral ligament of the elbow located?

Extends from the lateral epicondyle of the humerus to the lateral border and olecranon process of the ulna and to the annular ligament.

What is the closed pack position for the cervical spine?

Extension

What is the closed pack position for the ulnohumeral joint?

Extension

What is the closed pack position for the radoiocarpal joint?

Extension with radial deviation

What muscles assist with wrist radial deviation?

Extensor Carpi Radialis Flexor Carpi Radialis Extensor Pollicis Longus and Brevis

What muscles assist with wrist extension?

Extensor Carpi Radialis Brevis Extensor Carpi Radialis Longus Extensor Carpi Ulnaris

What muscles assist with wrist ulnar deviation?

Extensor Carpi Ulnaris Flexor Carpi Ulnaris

Myotome for L5

Extensor hallucis Peroneals Gluteus Medius Dorsiflexors Hamstrings and Calf atrophy

What is the descending tectospinal tract?

Extrapyramidal motor tract responsible for contralateral postural muscle tone associated with auditory/ visual stimuli

What is the descending reticulospinal tract?

Extrapyramidal motor tract responsible for facilitation or inhibition of voluntary and reflex activity through the influence on alpha and gamma motor neurons

What is the descending vestibulospinal tract?

Extrapyramidal motor tract responsible for ipsilateral gross postural adjustments subsequent to head movements, facilitating activity of the extensor muscles and inhibiting activity of the flexor muscles

What is the descending rubrospinal tract?

Extrapyramidal motor tract responsible for motor input of gross postural tone, fascilitating activity of flexor muscles and inhibiting the activity of the extensor muscles

What are signs and symptoms of pulmonary edema?

Extreme SOB, difficulty breathing, a feeling of suffocating or drowning, wheezing or gasping for air, anxiety, restless, a sense of apprehension, coughing, frothy/ blood tinged sputum, chest pain and rapid/ irregular pulse

What are signs and symptoms of mysthenia gravis?

Extreme fatigue Extreme skeletal muscle weakness Ocular muscles are typically affected first Ptosis Diplopia Dyspghagia Dysarthria Cranial Nerve weakness

What is knowledge of performance?

Extrinsic feedback that relates to the actual movement pattern that someone used to achieve their goal of movement

What is the equation for functional residual capacity (FRC)?

FRC = ERV + RV functional residual capacity = expiratory reserve volume + residual volume

What are ribs 8-10 called?

False ribs

What are signs and symptoms of PAD?

Fatigue, aching, numbness, or pain primarily in the buttocks, thigh, calf or foot at rest or when walking Poor healing wounds of the hands and feet Distal hair loss Trophic skin changes Hypertrophic nails

What is knowledge of results?

Feedback about the outcome

What are signs and symptoms of a PCL sprain?

Feeling as if the femur is sliding off the tibia Swelling Mild pain **Most patients are asymptomatic

What are signs and symptoms of pneumonia?

Fever Cough SOB Sweating Shaking chills Chest pain that fluctuates with breathing Headache Muscle pain Fatique

What is the sympathetic nervous system?

Fight or flight Prepares body for emergency response Norepinephrine neurotransmitters Generally a stimulating response

What are the fine motor skills for a 10-11 month old?

Fine pincer grasp developed Puts objects into containers Grasps crayon adaptively

What is the cerebellum?

Fine tuning of movement and assists with maintaining posture and balance by controlling muscle tone and positioning of the extremities in space

What are some special test for wrist/ hand miscellaneous?

Finkelstein test

What are the 3 normal end feels?

Firm Hard Soft

What are treatments for down syndrome?

Fitness Stability Respiratory function Surgery for cardiac abnormality if needed

What are characteristics of cauda equina syndrome?

Flaccidity Areflexia Impairment of bowl and bladder function

What is the capsular pattern for the iliofemoral (hip) joint?

Flexion ABD IR

What are the motions for the ulnohumeral joint?

Flexion Extension

What is the capsular pattern for the ulnohumeral joint?

Flexion Extension

What are the motions of the iliofemoral (hip) joint?

Flexion Extension ABD ADD IR ER

What motions are associated with the Atlantoaxial joints?

Flexion Extension Lateral flexion Rotation

What motions occur in the saggital plane and along what axis?

Flexion Extension Medial/ Lateral axis

What are the motions of the radiohumeral joint?

Flexion Extension Pronation Supination

What is the capsular pattern for the radiohumeral joint?

Flexion Extension Supination Pronation

What motions are associated with the Atlanto- Occipital joint?

Flexion Extension ex. Nodding yes

What are the motions of the radoiocarpal joint?

Flexion Extension Radial Deviation Ulnar Deviation

What are the motions of the tibiofemoral joint?

Flexion Extension IR ER

What is the capsular pattern for the radoiocarpal joint?

Flexion and extension equally limited

What is the response to the palmar grasp reflex?

Flexion of the fingers causing strong grip

What is homolateral synkinesis?

Flexion pattern of the involved UE facilitates flexion of the involved LE

What are the motions of the cervical spine?

Flexion/ Extension Lateral Flexion Rotation

What muscles assist with wrist flexion?

Flexor Carpi Radialis Flexor Carpi Ulnaris Palmaris Longis

What muscles are supplied by the ulnar nerve?

Flexor carpi ulnaris Flexor digitorum profundus Most small muscles of the hand

What muscles are supplied by the medial root of the median nerve?

Flexor muscles of the forearm, except flexor carpi ulnaris and 5 muscles in the hand

What muscles are supplied from the lateral root of the median nerve?

Flexor muscles of the forearm, except flexor carpi ulnaris and 5 muscles in the hand

What are ribs 11 and 12 called?

Floating ribs

What are the fine motor skills for a 16-24 month old?

Folds paper Strings beads Stacks six cubes Imitates vertical and horizontal strokes with crayon on paper Holds crayon with thumb and fingers

What is the valsalva maneuver?

Forced expiration against a closed glottis produces increased intrathoracic pressure, increased central venous pressure, and decreased venous return

What are the 3 parts of the brain?

Forebrain Midbrain Hindbrain

What motions occur in the frontal plane and along what axis?

ABD ADD Anterior/ Posterior axis

What is the closed packed position for the glenohumeral joint?

ABD Lateral Rotation (ER)

A MCL sprain often involves injury to other knee structures such as the ___ or ___.

ACL Medial Meniscus

Injury to the MCL often involves injury to other knee structures such as the ____ or ____.

ACL Medial meniscus

LCL is rarely completely torn without a concurrent injury to the ___ or ___.

ACL PCL

Where is the iliofemoral ligament. of the hip located?

ASIS to the intertrochanteric line of the femur

What is the atrioventricular valve?

AV valves lie between the atria and ventricles

What are the precautions to a posterolateral approach to a total hip arthroplasty?

AVOID: - hip flexion beyond 90 - hip adduction - IR

What are the precautions to a anterolateral approach to a total hip arthroplasty?

AVOID: - hip flexion beyond 90 - hip extension - hip ER - hip adduction

What are the precautions to a direct lateral approach to a total hip arthroplasty?

AVOID: - hip flexion beyond 90 - hip extension - hip ER - hip adduction

Dermatome for T8-T12

Abdomen and lumbar region

What muscles are supplied by the lateral plantar nerve?

Abductor digiti minimi Flexor digiti minimi Opponens digiti minimi Dorsal interossei Quadratus plantae Adductor hallucis Lumbrical II, III, IV Plantar interossei

What muscles are supplied by the medial plantar nerve?

Abductor hallucis Lumbrical I Flexor digitorum brevis Flexor hallucis brevis

What is the level of assistance for gait for patient with paraplegia? - don/ doff orthoses - sit/ stand - smooth surface - up/ down ramps - up/down curbs - up/down steps - rough terrain - safe falling

Abilities range from: - Exercise only with KAFO - Household gait with KAFO - Limited community gait with KAFO - Functional community ambulation with or without orthoses

What does the palmar grasp reflex interfere with?

Ability to grasp and release objects voluntarily Weight bearing on open hand for propping, crawling, protective responses

What is the purpose of localization of touch sensory testing?

Ability to identify the exact location of light touch on the body using a verbal response or gesturing

What does the tonic labyrinthine reflex (TLR) interfere with?

Ability to initiate rolling Ability to prop on elbows with extended hips when in prone Ability to flex trunk and hips to come to sitting position from supine position Often causes full body extension, which interferes with balance in sitting or standing

What is kinesthesia?

Ability to perceive the direction and extent of movement of a joint or body part

What does symmetrical tonic neck reflexes (STNR) interfere with?

Ability to prop on arms in prone position Attaining and maintaining hands and knees position Crawling reciprocally Sitting balance when looking around use of hands when looking at object in hands in sitting position

What does the planter grasp reflex interfere with?

Ability to stand with feet flat on surface Balance reactions and weight shifting in standing

What is the 8th level "Purposeful- Appropriate " of the Ranchos Los Amigos Levels of Cognitive Functioning?

Able to recall past events Carryover of new learned tasks

What is neuroma?

Abnormal growth of nerve cells; associated conditions include vasculitis, AIDS, and amyloidosis

What is ptosis?

Abnormal low-lying or drooping upper eyelid.

What is the etiology of restrictive lung dysfunction?

Abnormal lung parenchyma, abnormal pleura, and disorders affecting ventilatory pump function

What are signs and symptoms of cerebral palsy?

Abnormal muscle tone Impaired movement Abnormal reflexes Impaired mobility

What is restrictive lung dysfunction?

Abnormal reduction in lung expansion and pulmonary ventilation

What is leukocytosis?

Abnormally high WBC count which can indicated infection or leukemia

Why is a patient with a SCI at a greater risk for a DVT?

Absence or decrease in the normal pumping action by active contractions of musces in the LE

What are the 3 phases of the swing phase according to standard terminology?

Acceleration Midswing Deceleration

What is the posterolateral approach to a total hip arthroplasty?

Access to the hip occurs by splitting the glute max muscle in line with the muscle fibers. The short external rotators are then released and the hip abductors are retracted anteriorly. This approach maintains the integrity of the gluteus medius and vastus lateralis muscles. The femur is the dislocated posteriorly. Although it is the most commonly used approach, the procedure results in a high post-op dislocation rate.

What is the anterolateral approach to a total hip arthroplasty?

Access to the hip occurs through the interval between the TFL and the glute medius. Some portions of the hip ABDs are released from the greater trochanter and the hip is dislocated anteriorly.

What are treatment options for osteoarthritis?

Acetaminophen NSAIDs Corticosteroids Injections Improve range Cooling agents Education Strengthening TENS Energy conservation Weight loss

The parasympathetic influence is achieved by release of _____ from the _____ nerve

Acetylcholine Vagus

What are signs and symptoms of achilles tendonitis?

Aching or burning of the posterior heel Tenderness Pain with increased activity Swelling or thickening of the tendon area muscle weakness due to pain Morning stiffness

What are contraindications for joint mobilization?

Active disease Infection Advanced osteoporosis Articular hyper mobility Fracture Acute inflammation Muscle guarding Joint replacement

What is the reflex name for a 2+ grade and is it normal?

Active normal response Normal

What is the etiology of bronchitis?

Acute- cold viruses and exposure to smoke or other air pollutants Chronic- Smoking is primary cause but exposure to air pollutants, dust or toxic gases in the environment or workplace

What muscles assist with Hip adduction?

Adductor Magnus Adductor Longus Adductor Brevis Gracilis

What muscles are supplied by the obturator nerve?

Adductor longus Adductor brevis Adductor magnus Obturator externus Gracilis

What are some special test for thoracic outlet syndrome?

Adson maneuver Allen test Roos test

What are examples of nonopioid agents?

Advil tylenol Aleve

Vestibulocochlear Nerve (8 or VIII) Afferent (Sensory): Efferent (Motor): Test:

Afferent (Sensory): 1. Hearing: ear 2. Balance: ear Efferent (Motor): N/A Test: 1. Hear watch tick 2. Hearing tests 3. Balance and coordinatioin

Glossopharyngeal Nerve (9 or IX) Afferent (Sensory): Efferent (Motor): Test:

Afferent (Sensory): 1. Touch, pain: posterior tongue, pharynx 2. Posterior tongue Efferent (Motor): 1. Voluntary motor: select muscles of the pharynx 2. Autonomic: parotid gland Test: 1. Gag reflex 2. Ability to swallow

Optic Nerve (2 or II) Afferent (Sensory): Efferent (Motor): Test:

Afferent (Sensory): 1. Sight; eye Efferent (Motor): N/A Test: 1. Test visual fields

Olfactory Nerve (1 or I) Afferent (Sensory): Efferent (Motor): Test:

Afferent (Sensory): 1. Smell; nose Efferent (Motor): N/A Test: 1. Identifying familiar odors

Facial Nerve (7 or VII) Afferent (Sensory): Efferent (Motor): Test:

Afferent (Sensory): 1. Taste: anterior tongue Efferent (Motor): 1. Voluntary motor: Facial muscles 2. Autonomic: Lacrimal, submandibular, and sublingual glands Test: 1. Close eyes tight 2. Smile and show teeth 3. Whistle and puff cheeks 4. Identify familiar taste

Trigeminal Nerve (5 or V) Afferent (Sensory): Efferent (Motor): Test:

Afferent (Sensory): 1. Touch, pain: Skin of face, mucous membranes of nose, sinuses, mouth, anterior tongue Efferent (Motor): 1. Voluntary motor: Muscles of mastication Test: 1. Corneal reflex 2. Face sensation 3. Clench teeth; push down on chin to separate jaw

Vagas Nerve ( 10 or X) Afferent (Sensory): Efferent (Motor): Test:

Afferent (Sensory): 1. Touch, pain: pharynx, larynx, bronchi 2. Taste: tongue, epiglottis Efferent (Motor): 1. Voluntary motor: muscles of palate, pharynx and larynx 2. Autonomic: thoracic and abdominal viscera Test: 1. Gag reflex 2. Ability to swallow 3. Say "Ahhh"

Abducens Nerve (6 or VI) Afferent (Sensory): Efferent (Motor): Test:

Afferent (Sensory): N/A Efferent (Motor): 1. Voluntary motor: Lateral rectus muscle of the eyeball Test: 1. Lateral gaze

Hypoglossal Nerve (12 or XII) Afferent (Sensory): Efferent (Motor): Test:

Afferent (Sensory): N/A Efferent (Motor): 1. Voluntary motor: Muscles of tongue Test: 1. Tongue protrussion

Trochlear Nerve (4 or IV) Afferent (Sensory): Efferent (Motor): Test:

Afferent (Sensory): N/A Efferent (Motor): 1. Voluntary motor: superior oblique muscle of eyeball Test: 1. Downward and inward gaze

Accessory Nerve (11 or XI) Afferent (Sensory): Efferent (Motor): Test:

Afferent (Sensory): N/A Efferent (Motor): 1. Voluntary motor: SCM and traps Test: 1. Resisted shoulder shrug

Oculomotor Nerve (3 or III) Afferent (Sensory): Efferent (Motor): Test:

Afferent (Sensory): N/A Efferent (Motor): 1. Voluntary motor; levator of eyelid; superior, medial and inferior recti; inferior oblique muscle of eyeball. 2. Autonomic; smooth muscle of eye Test: 1. Upward, downward and medial gaze 2. Reaction to light

What are risk factors for chronic venous insufficiency?

Age FEMALE Obesity Pregnancy Prolonged sitting or standing

What are techniques used for proximal dynamic stability for stability?

Agonistic reversal Resisted progression

What are techniques used for controlled mobility?

Agonistic reversals Slow reversal Slow reversal hold

What are some special test for wrist/ hand vascular insufficiency?

Allen test Capillary refill test

Abnormal Gait: What is double step gait?

Alternate steps are of a different length or at a different rate

What are techniques used for strength?

Alternating isometrics Repeated contractions Resisted progressions Timing for emphasis

What are techniques used for stability?

Alternating isometrics Rhythmic stabilization Slow reversal Slow reversal hold

Progression of COPD includes....

Alveolar destruction Subsequent air trapping

What is venous return?

Amount of blood returning to the right atrium each minute

What is a hemorrhage stroke?

An abnormal bleeding in the brain due to a rupture in blood supply due to disruption of oxygen to an area of the brain and compression from the accumulation of blood

What is nystagmus?

An abnormal eye movement that entails non-volitional, rhythmic oscillation of the eyes. The speed of movement is typically faster in one direction and its origin is congenital or acquired.

What is saltatory conduction?

An action potential moving along an axon in a jumping fashion from node to node Decreases the use of sodium- potassium pumps and increases the speed of conduction

Where is the epidural space located?

An area between the skull and the outer dura mater that can be abnormally occupied

What is myasthenia gravis?

An autoimmune neuromuscular disease that affects transmission of nerve impulses to the muscles at the neuromuscular junction. Antibodies block or destroy the receptors that are needed for acetylcholine uptake and this prevents muscle contraction

What is cystic fibrosis?

An autosomal recessive genetic disease of the exocrine glands that primarily affects the lungs, pancreas, liver, intestines, sinuses and sex organs

What is a dendrite?

An extension from the cell body that receives signals from other neurons

What is spina bifida occulta?

An impairment and non- fusion of the spinous processes of a vertebrae, however, the spinal cord and meninges remain intact

What is anterior cord syndrome?

An incomplete lesion that results from compression and damage to the anterior part of the spinal cord or anterior spinal artery.

What is central cord syndrome?

An incomplete lesion that results from compression and damage to the central portion of the spinal cord. UE>LE Motor deficits > sensory deficits

What is Brown-Sequard syndrome?

An incomplete lesion usually caused by a stab wound, which produces hemisection of the spinal cord.

What is sacral sparing?

An incomplete lesion where some of the inner tracts remain innervated and patient still has sensation to the saddle area, movement of the toes and rectal sphincter control

What is effusion?

An increased volume of fluid within a joint capsule

What is cauda equina syndrome?

An injury that occurs below the L1 spinal level where the long nerve roots transcend.Can be complete, but they are mostly incomplete due to the large number of nerve roots in the area. Considered peripheral nerve injury Full recovery is not typical due to distance needed for axonal regeneration

What is a contrecoup lesion?

An injury that results on the opposite side of the brain. This lesion is due to the rebound effect of the brain after impact

What is associated reaction?

An involuntary and automatic movement of a body part as a result of an intentional active or resistive movement in another body part

What is mononeuropathy?

An isolated nerve lesion; associated conditions include trauma and entrapment

What are agonistic reversals (AR)? *Controlled Mobility *Skill

An isometric concentric contraction performed against resistance followed by alternating concentric and eccentric contractions with resistance. (AR) requires use in a slow and sequential manner, and may be used in increments throughout the range to attain maximum control

What is hold- relax (HR)? *Mobility

An isometric contraction used to increased ROM The contraction is facilitated for all muscle groups at the limiting point in the ROM. Relaxation occurs and the extremity moves through the newly acquired range to the next point of limitation until no further increases in ROM occur. The technique is often used for patients that present with pain

Which energy system does not require oxygen?

Anaerobic glycolysis

What do low hematocrit levels suggest?

Anemia, blood loss, and vitamin/ mineral deficiencies

What are sign and symptoms of CAD?

Angina Shortness of breath

What is an AFO?

Ankle foot orthosis

What abnormal gait pattern is secondary to pain?

Antalgic gait

The frontal plane divides the body into _________________ and _________________ portions.

Anterior Posterior

What are the special test for an ACL injury?

Anterior Drawer Lachman Lateral Pivot Shift Slocum

What are the motions of the acromioclavicular joint?

Anterior Tilting Posterior Tilting Upwards Rotation Downwards Rotation Protraction Retraction

Dermatome for C6

Anterior arm Radial side of hand to thumb and index finger

What are 5 types of incomplete SCI?

Anterior cord syndrome Brown- Sequard's syndrome Cauda equina injuries Central cord syndrom Posterior cord syndrom

What muscles assist with shoulder flexion?

Anterior deltoid Coracobrachialis Pec Major Biceps Brachii

What are some special test for knee ligamentous instability?

Anterior draw test Machman test Lateral pivot shift test Posterior drawer test Posterior sag test Valgus stress test Varus stress test

What are some special test for ankle ligamentous instability?

Anterior drawer test Talar tilt

Where is the ACL located?

Anterior intercondylar area of the tibia to the medial aspect of the lateral femoral condyle in the intercondylar notch

What are signs and symptoms of patellofemoral syndrome?

Anterior knee pain Pain with prolonged sitting Swelling Crepitus Pain when ascending and descending stairs

What are signs and symptoms of an aneurysm?

Aortic aneurysms- Asymptomatic, may include pain in abdominals or low back. Abdominal aortic aneurysms- Pulsations near the navel. Cerebral aneurysm- Sudden and severe headache, nausea and vomiting, stiff neck, seizure, loss of consciousness and double vision

What are some special test for knee meniscal pathology?

Apley's compression test MccMurray test

What are some special test for a shoulder dislocation?

Apprehension test for anterior shoulder dislocation Apprehension test for posterior shoulder dislocation

What are the fine motor skills for a 6-7 month old?

Approaches objects with one hand Arm in neutral when approaching toy Radial- palmar grasp "Rakes" with fingers to pick up small objects Voluntary release to transfer objects between hands

What is the 7th level "Automatic- Appropriate" of the Ranchos Los Amigos Levels of Cognitive Functioning?

Appropriate and oriented Goes through daily routine, looks like robot when performing tasks Minimal to no confusion Shallow recall of activities

What are some sensory stimulation techniques for facilitation?

Approximation Joint compression Icing Light touch Quick stretch Resistance Tapping Traction

What is the closed pack position for the acromioclavicular joint?

Arm ABD to 90

What is the response for asymmetrical tonic neck reflexes (ATNR)?

Arm and leg on face side are extended, arm and leg on opposite side are flexed, spine curved with convexity toward face side

What are signs and symptoms of a rotator cuff tear?

Arm positioned in IR and ADD Point tenderness at the greater tubercle and acromion Marked limitation in flexion and ADD with UT recruitment evident Increased tone on anterior shoulder structures

What is the loose pack position for the acromioclavicular joint?

Arm resting at side

What is the loose pack position for the sternoclavicular joint?

Arm resting by side

What is the response for the moro reflex?

Arms abduct with fingers open, then cross trunk into adduction; cry

What is the response to the startle reflex?

Arms abduct, elbows flexed with fingers closed, then cross trunk into adduction; cry

What are side effects of dopamine replacement agents?

Arrhythmias Gastrointestinal distress Orthostatic hypotension Dyskinesia Mood and behavioral changes Tolerance

What is the ascending spino- olivary tracts?

Ascends to the cerebellum and relays information from cutaneous and proprioceptive organs

What is the Tinetti Performance Oriented Mobility Assessment?

Asses fall risks Section 1 (Balance): sit to stand to sit with armless chair, immediate standing with eyes opened and closed, tolerating slight push while standing, turning 360 Max score of 16 Section 2 (Gait): Normal and rapid speed Max score of 12 Overall max score= 28 Score of 19= high fall risk

What is the Romberg test?

Assess balance and ataxia that initially positions the patient in unsupported standing, feet together, upper extremities folded, looking at a fixed point straight ahead with eyes opened. Next patient closes eyes and balances for 30 seconds.

What is the Timed Up and Go test?

Assess mobility and balance Sits, walks 10 ft, turns around, sits. *No support Assed on amount of postural sway, excessive movement, reaching for support, side stepping or other signs of loss of balance Rated 1 being normal and 5 being severely abnormal Independent= 10 seconds or less Limited functional independence/ low fall risk= 20 seconds High fall risk= 30 seconds or more

What is the Berg Balance Scale?

Assess patient's risk for falling 14 tasks each scored 0-4 Max score of 56 Scores less than 45 indicate an increased risk for falling

What is the Functional Reach Test and what are the norms?

Assess standing balance and fall risks 3 trials are performed and averaged together Standards 20-40yrs: 14.5-17 inches 41-69yrs: 13.5-15 inches 70-887yrs: 10.5-13.5 inches

What are dopamine replacement agents?

Assist to relieve the symptoms of Parkinson's disease

What is the pons?

Assists with regulation of respiratory rate and orientation of the head in relation to visual and auditory stimuli

What are the functions of the parietal lobe?

Associated with sensation of touch, kinesthesia , perception of vibration, and temperature Receives information from other areas of the brain regarding hearing, vision, motor, sensory and memory Provides meaning for objects Interprets language and words Spatial and visual perception

What is the etiology of mysthenia gravis?

Associated with: - an enlarged thymus gland - diabetes - RA - lupus

What are the gross motor skills for a 2-3 month old in supine?

Asymmetrical tonic neck reflex influence is strong Legs kick reciprocally Prefers head to side

What are signs and symptoms of hypertension?

Asymptomatic Severe hypertension (DBO >120mmHg)- Confusion, cortical blindness, hemiparesis, seizures, chest pain, dyspnea, renal involvement

What are treatments for PAD?

Asymptomatic people- stop smoking, medication, control diabetes and hypertension Disabling intermittent claudication people- surgery, exercise

What happens if there is a cerebellar lesion?

Ataxia Nystagmus Tremors Hypermetria Poor coordination Deficits in postural reflexes, balance and equilibrium

What are side effects of anti-epileptic agents?

Ataxia Skin issues Behavioral changes Gastrointestinal distress Headaches Blurred vision Weight gain

What is the etiology of PAD?

Atherosclerosis and thromboembolic processes that alter the structure and function of the aorta and its branches

What is a transient ischemic attack (TIA)?

Atherosclerotic thrombosis which causes temporary interruption of blood supply to an area of the brain

What is the C1 vertebrae called?

Atlas

What is the wall between the left and right atria?

Atrial septum

What are autonomic postural strategies?

Automatic motor responses that are used to maintain the center of gravity over the BOS

What are the characteristics of the autonomous stage of motor learning?

Automatic response Mainly error free regardless of environment Patterns of movement are non- cognitive and automatic Distraction does not impact the activity The person can simultaneously perform more than one task if needed Extrinsic feedback should be very limited or should not be provided Internal feedback or self assessment should be dominant

What is the C2 vertebrae called?

Axis

What is non-fluent aphasia?

Frequently in the frontal lobe of the dominant hemisphere Poor word output and dysprosodic speech (impairment in rhythm and inflection of speech) Poor articulation and increased effort for speech Content is present, but impaired syntactical words

What is fluent aphasia?

Frequently involves the temporal lobe, Wernicke's area or regions of the parietal lobe Word output and speech production are functional Prosody is acceptable but empty speech Speech lacks substance

Where is the ulnar collateral ligament of the elbow located?

From the medial epicondyle of the humerus to the proximal portion of the ulna.

Where is the interosseous membrane of the wrist located?

From the radius to the ulna

What are some special test for wrist/ hand neurological dysfunction?

Froment's sign Phalen's test Tinel's sign

What is the closed pack position for the iliofemoral (hip) joint?

Full extension IR

What is the loose packed position for the radiohumeral joint?

Full extension Supination

What is the closed packed position of the tibiofemoral joint?

Full extension Lateral rotation of the tibia

How does Aerobic Metabolism function?

Functions through oxidation of food. ex. Fatty Acids, amino acids and glucose with oxygen.

What is associative learning?

Gaining understanding of the relationship between two stimuli, casual relationships or stimulus and consequence (classical conditioning, operant conditioning

What is the purpose of the upper respiratory tract?

Gas conduits Humidify, cool or warm inspired air Filter foreign matter

Peak muscle activity during the gait cycle. Name the muscle group: Peak activity is during late stance phase. Responsible for concentric raising of the heel during toe off.

Gastroc- soleus group

What is asthenia?

Generalized weakness *cerebellar pathologies

What is the etiology of Huntingtons Disease?

Genetically transmitted as an autosomal dominate trait

What are the gross motor skills for a 8-9 month old in prone?

Gets into hands- knees position

What muscles assist with Hip Extension?

Glute Max Glute Min Semitendinosus Semimembranosus Biceps Femoris

What muscles assist with Hip lateral rotation (ER)?

Gluten Max Obturator Externus Obturator Internus Piriformis Gemelli Sartorius

plasma is important in regulating ____ and ____

BP Temperature

Dermatome for L3

Back Upper butt Anterior thigh and knee Medial lower leg

Dermatome for L2

Back, front of knee

Dermatome for L1

Back, over trochanter and groin

What are examples of anti-spasticity agents?

Baclofen Valium Dantrium

What does the moro reflex interfere with?

Balance reaction in sitting Protective responses on sitting Eye- hand coordination, visual tracking

What are implications for PT for anti-spasticity agents?

Balance the need to decrease spastic muscles with the loss of function with the reduction of hypertonicity

How do you challenge vestibular input?

Balance with movement of the head

How do you challenge visual input?

Balancing without visual input

What are implications for PT for muscle relaxant agents?

Be aware of side effects Modalities for relaxation

What are the gross motor skills for a 4-5 month old in prone?

Bearing weight on extended arms Pivots in prone to reach toys

What are the gross motor skills for a 4-5 month old in standing?

Bears all weight through legs in supported standing

What muscles assist with Hip abduction?

Gluteus Medius Gluteus Minimus Piriformis Obturator Internus Tensor Fasciae Latae

What muscles are supplied by the inferior gluteal nerve?

Gluteus maximus

What muscles are supplied by the superior gluteal nerve?

Gluteus medius Gluteus minimus TFL

How does Anaerobic Glycolysis function?

Glycogen is split into glucose, then through glycolysis, split into pyretic acid.

HDL cholesterol is the _____ (good/ bad) cholesterol

Good because it carries away LDL cholesterol and protects against atherogenesis

What are signs and symptoms of osteoarthritis?

Gradual onset of pain Increased pain after exercise Increase pain with weather changes Enlarged joints Crepitus Stiffness Limited joint ROM Heberden's nodes Bouchard's nodes

Where is the trachea located?

Begins at the larynx and ends at the carina (4th thoracic vertebra)

What is the etiology of CAD?

Begins with damage to the inner lining of a coronary artery. Then plaque accumulates. Hypertension and hypothyroidism High LDL cholesterol, Type 2 diabetes, smoking, obesity

What is the basal ganglia?

Gray matter masses located deep in white matter of the cerebrum Responsible for voluntary movement, regulation of autonomic movement, posture, muscle tone and control of motor responses

What lumbar region of the spine contains the largest amount of _____ mater.

Grey

Where does the subacromial bursa often get impinged?

Beneath the acromial arch

Dermatome for S3

Groin, posteromedial thigh to knee

What are the 6 balance tests and measures?

Berg Balance Scale Fugl- Meyer Sensorimotor Assessment of Balance Performance Battery Functional Reach Test Romberg Test Timed Get Up and Go Test Tinetti Performance Oriented Mobility Assessment

Where is the aortic semilunar valve located?

Between left ventricle and aorta

Where is the pulmonary semilunar valve located?

Between right ventricle and pulmonary arteries

Where is the prepatellar bursa located?

Between superficial surface of patella and skin

What are the left AV valve/ mitral valve/ bicuspid valve located?

Between the left atria and right ventricle

Where is the talocrural joint located?

Between the leg and the foot

Where is the superficial infrapatellar bursa located?

Between the patellar tendon and skin

Where is the deep infrapatellar bursa located?

Between the patellar tendon and the tibia

Paresthesia for L1

Groin; after holding posture, which causes pain

Where is the mid carpal joint of the wrist located?

Between the proximal and distal row of the carpals

What is the right AV valve/ tricuspid valve located?

Between the right atria and right ventricle

Where is the midtarsal joint located?

Between the talocalcaneonavicular joint and the calcaneocuboid joint

Where is the subtalar joint located?

Between the talus and calcaneus

Reflexes affect for C6

Biceps Brachioradialis

Myotome for C6

Biceps Supinator Wrist extensors

Reflexes affected for C5

Biceps Brachioradialis

What muscles assist with elbow flexion?

Biceps Brachii Brachialis Brachioradialis

What muscles assist with radioulnar supination?

Biceps Brachii Supinator

What muscles assist with Knee flexion?

Biceps Femoris Semitendinosus Semimebranosus Sartorius

What is diplegia/paraplegia?

Bilateral LE involvement, however UE may be affected

What are the 5 options for cortical sensory testing?

Bilateral simultaneous stimulation Stereognosis Two- point discrimination Barognosis Localization of touch

What is the normal age range of the palmar grasp reflex?

Birth to 4months

What is the normal age range for asymmetrical tonic neck reflexes (ATNR)?

Birth to 6 months

What is the normal age range for tonic labyrinthine reflex (TLR)?

Birth to 6 months

Myotomes for S4

Bladder Rectum

What is the level of assistance for bowel/ bladder problems for patient with paraplegia? - intermittent catheterization - leg bag care - condom application - clean up - in bed/ wheelchair - feminine hygiene - bowel program

Bladder/ bowel: - ModI for male and female

What is the level of assistance for bowel/ bladder problems for patient with midlevel tetraplegia (C6)? - intermittent catheterization - leg bag care - condom application - clean up - in bed/ wheelchair - feminine hygiene - bowel program

Bladder: - MinA for male in bed or wheelchair - ModA for female in bed Bowel: - ModA with use of equipment - Able to verbally direct

What is the level of assistance for bowel/ bladder problems for patient with tetraplegia (C7-C8)? - intermittent catheterization - leg bag care - condom application - clean up - in bed/ wheelchair - feminine hygiene - bowel program

Bladder: - ModI for male in bed or wheelchair - ModI for female in bed - ModA for female in wheelchair Bowel: - MinA to ModI with use of adaptive equipment - Able to verbally direct

What is the etiology of a pulmonary embolism?

Blood clots from the LE

What should you feel with a hard normal end feel?

Bone on bone ex. elbow extension

What is genu varum?

Bow legged

What muscle is supplied by the radial nerve?

Brachioradialis Triceps Supinator Wrist extensors Anconeus

What makes up the CNS?

Brain Brain stem Spinal cord

What is a secondary injury?

Brain damage that occurs as a response to the initial injury. Ex. hematoma, hypoxia, ischemia, increased intracranial pressure and post- traumatic epilepsy

What does asymmetrical tonic neck reflexes (ATNR) interfere with?

Breast feeding Visual tracking Midline use of hands Bilateral hand use Rolling Development of crawling Can lead to skeletal deformities

What is nodes of ranvier?

Brief gaps in myelination of an axon Serves to facilitate rapid conduction of a nerve impulse via jumping gap node to gap node

What is the reflex name for a 3+ grade and is it normal?

Brisk/ exaggerated response May or may not be normal

What can thrombocytopenia lead to?

Bruising Abnormal bleeding

What are the stages of recovery?

Brunnstrom separates neurological recovery into seven separate stages based on progression through abnormal tone and spasticity

What are some special test for knee swelling?

Brush test Patellar tap test

The sacral plexus supplies the muscles of the ___.

Butt

Dermatome for L5

Butt Posterior thigh Lateral aspect of leg Dorsum of foot Medial half or sole 1st, 2nd and 3rd toes

Dermatome for S2

Butt Thigh Posterior leg

Peak muscle activity during the gait cycle. Name the muscle group: Peak activity is during late swing phase. Responsible for decelerating the unsupported limb.

Hamstring group

What are the fine motor skills for early school age (5-8 yrs)?

Hand preference is evident Prints well, starting to learn cursive writing Able to button small buttons

What is body schema?

Having an understanding of the body as a whole and the relationship of its parts to the whole

What is the stimulus for the moro reflex?

Head dropping into extension suddenly for a few inches

What are the gross motor skills for a newborn to 1 month old in sitting?

Head lag in pull to sit

What are stimulus for symmetrical tonic neck reflexes (STNR)?

Head position, flexion or extension

What is the stimulus for asymmetrical tonic neck reflexes (ATNR)?

Head position, turned to one side

What are the gross motor skills for a 4-5 month old in sitting?

Head steady in supported sitting position Turns head in sitting position Sits alone for brief periods

What are the gross motor skills for a 2-3 month old in sitting?

Head upright, but bobbing Variable head lag in pull to stand position Needs full support to sit

A blockage in an artery of CAD can lead to what?

Heart attack

What is a myocardial infarction?

Heart attack When the blood flow through one or more arteries is severely reduced or cut off completely Irreversible necrosis

What are signs and symptoms of Valvular heart disease?

Heart palpitations SOB Chest pain Coughing Ankle swelling Fatigue

What are the 5 phases of the stance phase according to standard terminology?

Heel Strike Foot Flat Midstance Heel Off Toe Off

What are neutrophils?

Help protect the body from infection by ingesting bacteria and dibris

What gives red blood cells their color and enables it to bind with oxygen?

Hemoglobin

What medicine is an anticoagulant that is commonly used to reduce the risk of a DVT following surgeries?

Heparin

What is spina bifida meningocele?

Herniation of the meninges and cerebral spinal fluid into a sac that protrudes through the vertebral column. The spinal cord remains within the canal

What is another name for an ectopic bone?

Heterotopic ossification

Anaerobic: ATP - PC System _______ (High/ Low) intensity, ______ (High/ Low) duration.

High Low

What are symptoms of autonomic dysreflexia?

High BP Severe headache Blurred vision Stuffy nose Profuse sweating Goose bumps below the level of the lesion vasodilation (flushing) above the level of injury

Anaerobic: Anaerobic Glycolysis _______ (High/ Low) intensity, ______ (High/ Low) duration.

High Low

Abnormal Gait: What is tabetic gait?

High stepping ataxic gait pattern in which the feet slap the ground

Abnormal Gait: What is equine gait?

High steps; usually involves excessive activity of the gastroc

What is the most common contracture associated with a transfemoral amputation?

Hip flexion Hip ABD

What is a HKAFO?

Hip knee ankle foot orthosis Controls abduction, adduction, rotation controls hip flexion when locked. Locked hip restricts gait pattern to either swing-to or swing-through

What is the synergy pattern for the LE extensors? Hip Knee Ankle Toes

Hip: Extension, IR and Adduction Knee: Extension Ankle: PF and inversion Toes: Flexion and adduction

What are techniques used to initiate movement for mobility?

Hold- relax active movement Joint distraction Repeated contractions Rhythmic initiation Rhythmic rotation

_____ sign is a special test designed to confirm the presence of a DVT

Homan's

What are some special test for ankle miscellaneous?

Homan's sign Thompson test True leg length discrepancy test

What happens if the occipital lobe is impaired?

Homonymous hemianopsia Impaired extraocular muscle movement and visual deficits Impaired color cognition Reading and writing impairment Cortical blindness with bilateral lobe involvement

Paresthesia for C4

Horizontal band along clavicle and upper scapula

The talocrural joint offers significant stability in ___ (PF/DF) but becomes much more mobile with ___ (PF/DF)

DF PF

What are the motions of the talocrural joint?

DF PF

What is the capsular pattern for the talocrural joint?

DF PF

What is the capsular pattern for the midtarsal joint?

DF PF ADD IR

What is valvular heart disease?

Damage to or a defect in one of the four heart valves resulting in regurgitation (insufficiency) or stenosis of blood flow. BLOOD LEAK BACKWARDS.

What are some treatment options for a total hip arthroplasty?

Decrease inflammation *HIP PRECAUTIONS Minimizing muscle atrophy PROM Strengthening Endurance activities

What are treatment options for a total knee arthroplasty?

Decrease inflammation *PRECAUTIONS Minimizing muscle atrophy PROM Strengthening Endurance activities Assistive device training Knee flexion requires min of 90 degrees of ADL Knee flexion requires min of 105 degrees to rise comfortably from sitting.

What is the normal value of alkalemia?

Decreased acidity of blood pH > 7.45

What are characteristics of a Cerebellum CVA?

Decreased balance Ataxia Decreased coordination Nausea Decreased ability for postural adjustment Nystagmus

What are characteristics of the associative stage of motor learning?

Decreased errors with new skill performance Decreased need for concentration and cognition regarding the activity Skill refinement Increased coordination of movement Large amount of practice space yields refinement of the motor program surrounding the activity

What are fissures?

Deep grooves in the brain

What are some sensory stimulation techniques for inhibition?

Deep pressure Prolonged stretch Warmth Prolonged cold

What do high hematocrit levels suggest?

Dehydration or polycythemia vera

What muscle is supplied by the axillary nerve?

Deltoid Teres minor

Dermatome for C5

Deltoid area Anterior aspect of entire arm to base of thumb

What is a myotome?

Designated motor area based on spinal segment innervation

What is a dermatome?

Designated sensory areas based on spinal segment innervation

What is reflex inhibiting posture?

Designated static positions that Bobath found to inhibit abnormal tonal influences and reflexes

What is the Fugl- Meyer Sensorimotor Assessment of Balance Performance Battery test?

Designed to assess balance specifically for patients with hemiplegia 7 Items scored 0-2 Max score 14

What is the purpose of the ventricular system?

Designed to protect and nourish the brain

What does the galant reflex interfere with?

Development of sitting balance Can lead to scoliosis

What is spina bifida?

Developmental abnormality due to insufficient closure of the neural tube by the 28th day of gestation Occurs in the low thoracic, lumbar and sacral regions

What are the fine motor skills for later school age (9-12 yrs)?

Develops greater control in hand usage Learns to draw handwriting is developed

What are the fine motor skills for adolescence (+13 yrs)?

Develops greater dexterity in fingers for fine tasks (knitting, sewing)

What is the etiology of diabetic neuropathy?

Diagnosis of diabetes mellitus

Contraction of the _____ causes the chest to expand longitudinally and the lower ribs to elevate to allow for inspiration

Diaphragm

What are signs and symptoms of Alzheimer's?

Difficulty with new learning and subtle changes in memory and concentration Loss of orientation Word finding difficulties Depression Poor judgement Rigidity Bradykinesia Shuffling gait Impaired ability to perform self care

What is polyneuropathy?

Diffuse nerve disfunction that is symmetrical and typically secondary to pathology and not trauma Associated conditions include Guillain- Barre syndrome, peripheral neuropathy, use of neurotoxic drugs and HIV

What are examples of anti-epileptic agents?

Dilantin Tegretol

What is hyporeflexia?

Diminished or absent reflex response

What is the reflex name for a 1+ grade and is it normal?

Diminished/ depressed response May or may not be normal

What is an open TBI?

Direct penetration through the skull to the brain

What is a Chopart amputation?

Disarticulation at the midtarsal joint

What are signs and symptoms of impingement syndrome?

Discomfort or mild pain deep within the shoulder Pain with overhead activities Painful arc of motion (70 - 120 degrees of ABD) Positive impingement sign Tenderness over the greater tuberosity and the bicipital groove

What are causes of autonomic dysreflexia?

Distended or full bladder Kink or blockage in the catheter Bladder infections Pressure ulcers Extreme temperature changes Tight clothing Ingrown toenails

What are symptoms of orthostatic hypotension?

Dizziness Lightheadedness Nausea "Black out" laying -> sitting

What are the gross motor skills for a 8-9 month old in supine?

Does not tolerate supine position

What happens if the parietal lobe is impaired?

Dominant hemisphere (typically located in the left hemisphere): agraphia, alexia, agnosia Nondominate hemisphere (typically located in the right hemisphere): dressing apraxia, constructional apraxia, anosognosia Contralateral sensory deficits Impaired language comprehension Impaired taste

What nerves are supplied from the rami of the brachial plexus?

Dorsal scapular Long thoracic

What are some special test for a rotator cuff pathology/ impingement?

Drop arm test Hawkins- Kennedy impingement test Neer impingement test Supraspinatus test

What are side effects of anti-spasticity agents?

Drowsiness Confusion Headaches Dizziness Generalized muscle weakness Tolerance Dependence

Abnormal Gait: What is trendelenburg gait?

Due to glute med weakness. Excessive lateral trunk flexion and weight shifting over the stance limb

What are the 3 layers of the meninges?

Dura mater- Outmost layer Arachnoid mater- Middle layer Pia mater- Innermost layer

What is the purpose of a glucocorticoid agent (corticosteroids)?

Hormonal, anti-inflammatory and metabolic effects including suppression of articular and systemic diseases Reduce inflammation in chronic conditions that can damage healthy tissue through a series of reactions Vasoconstriction results from stabilizing lysosomal membranes and enhancing the effects of catecholamines

What are treatment options for Guillain-Barre syndrome?

Hospitalization Medication OT OT SLP Wheelchairs orthotics Assistive device

An excess of CSF in the brain can cause an enlargement in the ventricles causing _____.

Hydrocephalus

What are examples of glucocorticoid agents (corticosteroids)?

Hydrocortisone Prednisone Dexamethasone

What is hyperreflexia?

Hyperactive reflexes or clonus reflexes

What is the equation for inspiratory capacity?

IC = TV + IRV

What is the purpose of graphesthesia sensory testing?

Identify a number or letter drawn on the skin without visual input

What is the purpose of proprioception sensory testing?

Identify a static position of an extremity or body part

What is the purpose of stereognosis sensory testing?

Identify an object without sight

What is the purpose of kinesthesia sensory testing?

Identify direction and extent of movement of a joint or body part

What is the strongest ligament in the body?

Iliofemoral ligament

What muscles assist with Hip flexion?

Iliopsoas Sartorius Rectus Femoris Pectineus

What are treatments for autonomic dysreflexia?

Immediately check catheter REMAIN IN SITTING POSITION Check for irritating stimuli Check for bowel impaction

What is aphasia?

Impairment of processing for receptive and/ or expressive language

What is peripheral neuropathy?

Impairment or dysfunction of the peripheral nerves; associated conditions include diabetic peripheral neuropathy, trauma, alcoholism

Where are the intercostal muscles located?

In between the ribs

What is the hippocampus?

In the lower temporal lobe The process of forming and storing new memories of one's personal history and other declarative memory Learning language

What is the response for tonic labyrinthine reflex (TLR)?

In the supine position, body and extremities are held in extension; in the prone position, body and extremities are held in flexion

What is the amygdala?

In the temporal lobe of each hemisphere Functions in emotional and social processing Involved with fear and pleasure responses, arousal, processing of memory and the formation of emotional memories

What is constructional apraxia?

Inability to build, assemble or draw objects

What is akinesia?

Inability to initiate movement *parkinson's patients

What is apraxia?

Inability to perform purposeful movements even though there is no sensory or motor imairment

What is retrograde amnesia?

Inability to remember events that occurred before the incidence of trauma

What is alexia?

Inability to see words or to read

What is agraphia?

Inability to write

What is the etiology of angina pectoris?

Inadequate blood flow and oxygenation of the heart muscle due to coronary artery disease

What is the etiology of down syndrome?

Incomplete cell division

What is Brown-Sequard syndrome?

Incomplete lesion typically caused by a stab wound, which produces hemisection of the spinal cord.

What is thrombocythemia?

Increase in platelets

Patients with COPD have a(n) _____ (increased/ decreased) total lung capacity with a significant _____ (increased/ decreased) residual volume

Increased Increased

What are symptoms of spasticity?

Increased involuntary contractions increased tonic stretch reflex Exaggerated DTR

What are indications of anti-spasticity agents?

Increased tone Spasticity Spinal cord injury CVA MS

Paresthesia for C7

Index, long and ring finger

What is spastic cerebral palsy?

Indicating a lesion in the motor cortex of the cerebrum; upper motor neuron damage

What is athetoid cerebral palsy?

Indicating a lesion involving the basal ganglia

What is juvenile rheumatoid arthritis?

Inflammation in joints and connective tissues

What is pneumonia?

Inflammation of the lungs

What is plantar fasciitis?

Inflammation of the thick tissue of the bottom of the foot that connect the heel to the toes and creates an arch 40 - 60 yrs of age

What is the medulla oblongata?

Influences autonomic nervous activity and regulation of respiration and heart rate Reflex center for vomiting, coughing and sneezing

What are monocytes?

Ingest dead or damaged cells and help defend against infectious organisms

What is the etiology of Duchenne Muscular Dystrophy?

Inheritance as an X-linked recessive trait. Mother is a silent carrier Fathers offspring will manifest the disease

What is the bainbridge reflex?

Inhibits parasympathetic activity

What are the 5 phases of the stance phase according to Ranchos Los Amigos terminology?

Initial Contact Loading Response Midstance Terminal Stance Pre-swing

What are the 3 phases of the swing phase according to Ranchos Los Amigos terminology?

Initial Swing Midswing Terminal Swing

What is a primary TBI?

Initial injury to the brain sustained by impact

What is tetraplegia (quadriplegia)?

Injuries that occur at the level of the cervical spine

What is a cauda equina injury?

Injuries that occur below the L1 level of the spine LMNL

What are signs and symptoms of adhesive capsulitis?

Insidious onset of: Localized pain extending down the arm Stiffness Night pain Restricted movement in capsular pattern

Spinal nerves and blood vessels exit the spinal canal through the ___ ___.

Intervertebral Foramina

What is the purpose of the SA and AV nodes?

Intrinsic ability to depolarize and propagate electrical impulses from the cell to cell without nerve stimulation

What are the motions of the midtarsal joint?

Inversion Eversion

What are the motions of the subtalar joint?

Inversion Eversion

What is clonus?

Involuntary alternating spasmodic contraction of a muscle precipitated by a quick stretch reflex

What are signs and symptoms of Huntington's Disease?

Involuntary choreic movements Mild alteration in personality Grimacing Protrusion of the tongue Ataxia with choreoathetoid movements Mental deterioration Decrease in IQ Depression Dysphagia Incontinence Immobility Rigidity

What is athetosis?

Involuntary movements combined with unstable posture. Peripheral movements occur without central stability

What is dystonia?

Involuntary movements combined with unstable posture. axial muscle involvement occur without central stability

What is tremor?

Involuntary rhythmic/ossilating movements

What are tremors?

Involuntary, rhythmic movements of a body part

What are descending tracts?

Involved with voluntary motor function, muscle tone, reflexes and equilibrium, visceral innervation and modulation of ascending sensory signals

What happens if one side of the cerebellum is impaired?

Ipsilateral impairments

What is lateral epicondylitis?

Irritation or inflammation of the common extensor muscles at their origin on the lateral epicondyle of the humerus. Most common between the ages of 30 and 50 TENIS ELBOW

Where is the ischiofemoral ligament of the hip located?

Ischial wall of the acetabulum to the neck of the femur

What is the 6th stage of recovery?

Isolated movements are performed with coordination

What are alternating isometrics (AI)? *Stability

Isometric contractions are performed alternating from muscles on one side of the joint to the other side without rest. (AI) emphasizes endurance or strengthening

What are signs and symptoms of a meniscus tear?

Joint line pain Swelling Catching or locking sensation

What are eosinophils?

Kills parasites, destroys cancer cells and are involved in allergic response

What is a KAFO?

Knee ankle foot orthosis

What is the most common contracture associated with a transtibial amputation?

Knee flexion

Reflexes affected for L3

Knee jerk sluggish PKB positive Pain on full SLR

What is genu valgum?

Knock- kneed

What is the innervation level for resistive testing of hip flexion?

L1-L2

What is the innervation level for dermatome testing of the anterior thigh?

What is the innervation level for dermatome testing of the middle third of the anterior thigh?

What is the innervation level for resistive testing of knee extension?

L3-L4

What is the innervation level for dermatome testing of the patella and medial malleolus?

What is the innervation level for reflex testing of the patella?

What is the innervation level for functional testing of heel walking?

L4-L5

What is the innervation level for resistive testing of ankle dorsiflexion?

L4-L5

What is the innervation level for functional testing of straight leg raise?

L4-S1

What is the innervation level for dermatome testing of the fibular head and dorsum of the foot?

What is the innervation level for resistive testing of great toe extension?

What is the synergy pattern for the LE flexors? Hip Knee Ankle Toes

LE flexors Hip: Abduction and ER Knee: Flexion Ankle: DF and supination Toes: Extension

What are signs and symptoms of Amyotrophic Lateral Sclerosis (ALS)?

LMN- asymmetric muscle weakness, fasciculations, cramping, and atrophy within the hands. UMN- incoordination of movement, spasticity, clonus, and positive Babinski reflex. All- fatigue, oral motor impairment, motor paralysis, respiratory paralysis

What is the left side of the brain dominate in?

Language Sequence and perform movement Understand language Produce written and spoken language Analytical Controlled Logical Rational Mathematical calculations Express positive emotions such as love and happiness Process verbally coded information in an organized, logical and sequential manner

What are the characteristics of the Cognitive stage of motor learning?

Large amount of errors Inconsistent attempts Repetition of effort allows for improvement in strategies Inconsistent performance High degree of cognitive work: listening, observing and processing feedback

What is a grade 3 joint mobilization?

Large amplitude of movement performed up to the limit of the range

What is a grade 2 joint mobilization?

Large amplitude of movement performed within the range, but not reaching the limit of the range and not returning to the beginning of the range

What are characteristics of A Fibers? Size of fibers Myelinated? Unmyelinated? Speed of conduction rate Extra

Large fibers Myelinated High conduction rate Alpha, beta, gamma, delta subsets

The lower respiratory tract extends from the _____ to the ____ of the lungs

Larynx Alveoli

What is the capsular pattern for the glenohumeral joint?

Lateral Rotation (ER) ABD Medial Rotation (IR)

Dermatome for S1

Lateral and plantar aspect of foot

Dermatome for C7

Lateral arm and forearm to index, long and ring finger

Paresthesia for L5

Lateral aspect of leg Medial three toes

Where is the distal tibiofibular joint located?

Lateral aspect of the distal tibia and the distal fibula

What are signs and symptoms of congenital torticollis?

Lateral cervical flexion to same side as contracture Rotation towards the opposite side Facial asymmetries

What is scoliosis?

Lateral curvature of the spine Functional Scoliosis- Abnormalities in the body that indirectly impacts the spine (leg length discrepancy, muscle imbalance, poor posture) Neuromuscular Scoliosis- Developmental pathology resulting in alterations within the structure of the spine (CP or Marfan syndrome). Degenerative Scoliosis- Normal aging process and is facilitated by changes such as osteophyte formation, bone demineralization, and disk herniation. 10-13 yrs old 10 degrees or less = for genders 30 degrees or more = Girls> boys

Where is the LCL located?

Lateral femoral epicondyle to the head of the fibula

What is the capsular pattern for the cervical spine?

Lateral flexion and rotation equally limited, extension

What is the response for the galant reflex?

Lateral flexion of trunk to side of stimulus

Paresthesia for S2

Lateral leg, knee and heel

What nerves are supplied from the lateral cord of the brachial plexus?

Lateral pectoral Musculocutaneous Latral root if the median

What muscles assist with Head depression?

Lateral pterygoid Suprahyoid Infrahyoid

Paresthesia for S1

Lateral two toes Lateral foot Lateral leg to knee Plantar aspect of foot

What muscles assist with scapular depression?

Latissimus Dori Pec Major Pec Minor Lower Trap

What muscles assist with shoulder extension?

Latissimus Dorsi Posterior Deltoid Teres Major

What muscle is supplied by the thoracodorsal nerve?

Latissimus dorsi

What is the etiology of emphysema?

Leading cause- Smoking 1-2% have a genetic disorder that causes low levels of the protein alpha-1-antitrypsin, which protect the elastic structures in the lungs

What happens if the temporal lobe is impaired?

Learning deficits Wernicke's aphasia (receptive deficits) Antisocial, agressive behaviors Difficulty with facial recognition Difficulty with memory, memory loss Inability to categorize objects

What is procedural learning?

Learning tasks that can be performed automatically without attention or conscious thought, like a habit

What is the direct lateral approach to a total hip arthroplasty?

Leaves the posterior portion of the glute medius attached to the greater trochanter. It required longitudinal division of the TFL and vastus lateralis, along with a release of the anterior portion of the glute medius. Since the posterior soft tissue and capsule are left intact, the approach minimizes the probability of dislocation and may be ideal for noncompliant patients.

Heart failure typically begins with which ventricle, left or right?

Left

What are the 2 superior chambers of the heart?

Left and right atria

What are signs and symptoms of chronic venous insufficiency?

Leg swelling varicose veins Aching Heaviness or cramping Itching Redness Skin ulcers

What is Broca's aphasia?

Lesion: 3rd convolution from frontal lobe Non- fluent aphasia, known as "expressive aphasia" MOST COMMON Intact auditory and reading comprehension Impaired repetition and naming skills Frustration with language skill errors Paraphasia are common Motor impairment typical due to proximity of Broca's area to the motor cortex

What is Global aphasia?

Lesion: Frontal, temporal and pariental lobes Non- fluent aphasia Comprehension (reading/ auditory) is severely impaired Impaired naming, writing, repetition skills May involve verbalize, usually without correct content May use nonverbal skills for communication

What is Wernicke's aphasia?

Lesion: Posterior region of superior temporal gyrus Fluent aphasia, known as 'receptive aphasia" Comprehension (reading/ auditory) impaired Good articulation, use of paraphasia Writing impaired Poor naming ability Motor impairment not typical due to the distance from Wernicke's area to the motor cortex

What is another name for white blood cells?

Leukocytes

What are treatment options for atherosclerosis?

Lifestyle changes Medications Surgery

What are treatment options for hypertension?

Lifestyle modifications Medication

What are the gross motor skills for a 6-7 month old in supine?

Lifts head

What are the gross motor skills for a 6-7 month old in sitting?

Lifts head and helps when pulled to sitting position Gets to sitting position without assistance Sits independently

What are the gross motor skills for a 2-3 month old in prone?

Lifts head to 90 degrees briefly Chest up in prone position with some weight through forearms Rolls prone to supine

What is the capsular pattern for the subtalar joint?

Limitation of various range of motion

What is the purpose of the Anterior Longitudinal Ligament?

Limits extension Reinforces the anterior portion of the intervertebral disks and vertebrae.

What is the purpose of the Posterior Longitudinal Ligament?

Limits flexion Reinforces the posterior portion of the intervertebral disks.

What is the purpose of the Interspinous Ligaments?

Limits flexion and rotation.

What is the purpose of the radial collateral ligament of the wrist?

Limits ulnar deviation and becomes taut when the wrist is in extreme extension and flexion.

What is the purpose of the dorsal radiocarpal ligament of the wrist?

Limits wrist flexion

Where is dura mater located?

Lines the periosteum of the skull and protects the brain

A cholesterol test is also called...

Lipid panel Lipid profile

What is plasma?

Liquid part of blood

Paresthesia for C8

Little finger alone or with two adjacent fingers Not ring or long fingers, alone or together (C7)

The term "congestive heart failure" comes from blood backing up into the...

Liver, abdomen, LE and lungs

What is a grade I muscle/ tendon strain?

Localized pain Minimal swelling Minimal tenderness

What is a grade II muscle/ tendon strain?

Localized pain Moderate swelling Moderate tenderness Impaired motor function

What is the subthalamus?

Located between the thalamus and hypothalamus Important for regulating movements produced by skeletal muscle

What is chemoreceptor reflexes?

Located in the carotid bodies and the aortic body respond to change in pH status and blood oxygen tension

Bilateral occlusion (blockage) of the vestibular- basilar artery will typically produce what?

Locked- in syndrome- Patient is aware but cannot move or communicate verbally due to complete paralysis of nearly all voluntary muscles in the body except for vertical eye movements and blinking. The individual is conscious and sufficiently intact cognitively to be able to communicate with eye movements. Coma Vegetative state- State of partial arousal rather that true awareness

What is the etiology of COPD?

Long term smoking or exposure to second hand smoke Air pollution and certain occupational fumes Rare- Genetic disorder that causes low levels of the protein alpha-1-antitrypsin

Myotome for C2

Longus colli SCM Rectus capitus

What is a grade 3 concussion?

Loss of consciousness, brief or prolonged

What is the results of anterior cord syndrome?

Loss of motor function, pain and temperature below the lesion due to damage of the corticospinal and spinothalamic tracts

What are the characteristics of posterior cord syndrome?

Loss of proprioception, two point discrimination and stereognosis. *Motor function is perserved

What is the stimulus for the startle reflex?

Loud, sudden noise

Aerobic: Aerobic Metabolism _______ (High/ Low) intensity, ______ (High/ Low) duration.

Low High

What is the normal value of hypoxemia?

Low level of O2 in arterial blood PaO2 < 80 mmHg

What is the normal value of hypoxia?

Low level of O2 in the tissue despite adequate perfusion of the tissue

What is thrombocytopenia?

Low platelet count

What is leukopenia?

Low white blood cell count which can increase the risk for infection

The Sacral Plexus is formed by the...

Lumbosacral trunk Ventral Rami of S1-S3 Descending portion of S4

What are the functions of the occipital lobe?

Main processing center for visual information Processes visual information regarding colors, light and shapes Judgement of distance, seeing 3D

What is the purpose of the pulsar radiocarpal ligament of the wrist ?

Maintains alignment of the associated joint structures and limits hyperextension of the wrist.

What are baroreceptor reflexes?

Maintains blood pressure

What are the 3 parts of the sternum?

Manubrium Body Xiphoid process

Abnormal Gait: What is parkinsonian gait?

Marked by increased forward flexion of the trunk and knees; gait is shuffling with quick and small steps; festinating may occur

What are the fine motor skills for a 12-15 month old?

Marks paper with crayon Builds tower using two cubes Turns over small container to obtain contents

What is synergy?

Mass movement patterns that are primitive in nature and coupled with spasticity due to brain damage

What muscles assist with Head protrusion?

Masseter Lateral Ptergoid Medial Ptergoid

What are the gross motor skills for later school age (9-12 yrs)?

Mature patterns of movement in throwing, jumping, running Competition increases, enjoys competitive games Improved balance, coordination, endurance, attention span Boys may develop preadolescent fat spurt Girls may develop prepubescent and pubescent changes in body shape

What are implications for PT for dopamine replacement agents?

Max benefits for sessions scheduled 1hr after taking the meds Monitor blood pressure

What is the closed pack position for the talocrural joint?

Maximum DF

What is the closed pack position for the sternoclavicular joint?

Maximum shoulder elevation

What are the gross motor skills for a 6-7 month old in mobility?

May crawl backwards

What is nerve conduction velocity?

Measures the speed of a nerve impulse along the axon of a nerve

How do you calculate thoracolumbar flexion and extension?

Meausre diftance between C7 and S1, log number. Have the patient bent backwards/ forwards, log number. Subtract the 2 numbers

What muscles assist with Head turning?

Medial Pterygoid Lateral Pterygoid

What motions occur in the transverse plane and along what axis?

Medial Rotion (IR) Lateral rotation (ER) Vertical axis.

Dermatome for C8

Medial arm and forearm to long, ring and little finger

Paresthesia for L4

Medial aspect of calf and ankle

Which is more common, a medical meniscus tear or a later meniscus tear?

Medial because it is less mobile due to its attachment to the joint capsule

Dematome for L4

Medial butt Lateral thigh Medial leg Dorsum of foot Big toe

Paresthesia for L3

Medial knee Anterior lower leg

What nerves are supplied from the medial cord of the brachial plexus?

Medial pectoral Ulnar Medial root of the median

Dermatome for T1

Medial side of forearm to base of littl efinger

Dermatome for T2

Medial side of upper arm to medial elbow, pectoral and midscapular areas

What nerve goes through the carpal tunnel?

Median nerve.

What are treatments for Parkinson's disease?

Medication Dopamine replacement therapy OT ST PT- Endurance, strength and functional mobility

What are treatments for a myocardial infarction?

Medication Life style change Surgery

What are treatments for restrictive lung dysfunction?

Medication Mechanical ventilation Supplemental oxygen Nutriton support Pulmonary rehab

What are treatments for multiple sclerosis?

Medication OT PT- relaxation, energy conservation, normalization of tone, balance, gait training, core stabilization and assistive device training ST Nutritional counseling Psychological counseling

What are treatments for Amyotrophic Lateral Sclerosis (ALS)?

Medication PT OT Speech Respiratory therapy Nutritional therapy

What are treatments for cystic fibrosis?

Medication PT- airway clearance, breathing techniques, assisted cough and ventilatory muscle training. Overall endurance and strengthening training

What are treatments for myasthenia gravis?

Medication PT- energy conservation, strengthening (iso's), osteoporosis treatments OT

What are treatment options for epilepsy?

Medication Surgery

What are treatments for emphysema?

Medication Surgery Lifestyle modifications Good nutrition Pulmonary rehab (airway clearance, breathing exercises, endurance and strengthening training

What are treatment options for spasticity?

Medication Surgery PT- positioning, aquatic therapy, WT bearing, functional electrical stimulation, ROM, resting splints, inhibitive casting

What are treatments for a pulmonary embolism?

Medication Surgery Prevention of clots: compression stockings, pneumatic compression, physical activity and drinking fluids

What are treatments for aneurysms?

Medications Surgery

What are treatments for valvular heart disease?

Medications Surgery

What are treatments for COPS?

Medications Surgery Lifestyle modifications Pulmonary rehab- Airway clearance, breathing exercises and endurance and strengthening training

What are characteristics of B Fibers? Size of fibers Myelinated? Unmyelinated? Speed of conduction rate Extra

Medium fibers Myelinated Reasonably fast conduction rate Pre- ganglionic fibers of the autonomic system

Is Amyotrophic Lateral Sclerosis (ALS) higher in men or women and between what ages?

Men 40-70yrs

What are examples of disease- modifying anti-rheumatic agents?

Methotrexate Ridaura Humira Enbrel

What are the 3 parts of the brain stem?

Midbrain Pons Medulla Oblongata

What muscles assist with shoulder abduction?

Middle Deltoid Supraspinatus

What is the loose packed position for the midtarsal joint?

Midway between extremes of ROM

What is the loose packed position of the subtalar joint?

Midway between extremes of ROM

What is the loose packed position of the cervical spine?

Midway between flexion and extension

What is a grade I ligament sprain?

Mild pain and swelling, little to no tear of the ligament

What are indications for nonopioid agents?

Mild to moderate pain Fever Headaches Muscle aches Inflammation Primary dysmenorrhea Reduces risk of heart attacks (aspirin only)

What are the 4 levels of motor control?

Mobility Stability Controlled Mobility Skill

What are treatment options for patellofemoral syndrome?

Modalities Stretching exercises Medial patella glides Biofeedback Patella taping Strengthening quads

What is a grade II ligament sprain?

Moderate pain and swelling, minimal instability, minimal to moderate tear of the ligament, decreased ROM

What are indications for opioid agents (narcotics)?

Moderate to severe pain Induction of conscious sedation priorto a diagnostic procedure Relief of severe and persistent cough (codeine)

What are treatments for diabetic neuropathy?

Monitoring glucose PT for pain, foot care, and overall fitness Medications

What are side effects of opioid agents (narcotics)?

Mood swings Sedation Confusion Vertigo Dulled cognitive function Orthostatic hypotension Constipation Incoordination Physical dependence Tolerance

What are examples of opioid agents (narcotics)?

Morphine Oxycodone Codeine

What is plasma made of?

Mostly water, but contains proteins and electrolytes

Ventral roots are _____ (sensory/ motor) Ventral roots contain _____ (afferent/ efferent) fibers

Motor Efferent

What is "D" considered on the ASIA Impairment Scale?

Motor Incomplete- Motor function is preserved below the neurologic level, and most key muscles below the neurologic level have a muscle grade greater than or equal to 3

What is "C" considered on the ASIA Impairment Scale?

Motor Incomplete- Motor function is preserved below the neurologic level, and most key muscles below the neurologic level have a muscle grade less than 3

What are signs and symptoms of spina bifida?

Motor loss below the level of defect Sensory deficits Hydrocephalus Osteoporosis Clubfoot Scoliosis Latex allergy Bowel and bladder disfunction Learning disabilities

What are signs and symptoms of Guillain-Barre syndrome?

Motor weakness, sensory impairment and respiratory paralysis, inability to speak and/ or swallow PROGRESSES FROM UE TO HEAD Level of disability usually peaks within 2-4 weeks of unset

What is cerebral palsy?

Movement disorders due to brain damage that are non- progressive and are acquired in utero, during birth or infancy

What are the gross motor skills for a 8-9 month old in sitting?

Moves from sitting to prone position Sits without hand support for longer periods of time Pivots in sitting position

What muscles assist with spine cervical extension?

Multifidus Trapezius Spenius Cervicis Semispinalis Cervicis Iliocostalis Cervicis Longissimus Cervicis

What is overflow?

Muscle activation of an involved extremity due to intense action of an involved muscle or group of muscles

What are side effects of glucocorticoid agents (corticosteroids)?

Muscle atrophy Gastrointestinal distress Glaucoma Adrenocortical suppression Drug induced cushings syndrome Weakening/ breakdown of supporting tissue Mood changes Hypertension

What are indications of muscle relaxant agents?

Muscle spasms

What is angina pectoris?

Myocardial ischemi

The thebesian veins arise in the _____ and drain into all the chambers of the heart, but primarily into the right atrium and right ventricle

Myocardium

What is the etiology of spina bifida?

N/A

What is the level of assistance for gait for patient with low tetraplegia (C7-C8)? - don/ doff orthoses - sit/ stand - smooth surface - up/ down ramps - up/down curbs - up/down steps - rough terrain - safe falling

N/A

What is the level of assistance for gait for patient with midlevel tetraplegia (C6)? - don/ doff orthoses - sit/ stand - smooth surface - up/ down ramps - up/down curbs - up/down steps - rough terrain - safe falling

N/A

What are treatments for DVT's?

NO ACTIVE OR PASSIVE MOVEMENT Bed rest Anticoagulant Surgery if necessary

What are treatment options for post- polio syndrome?

NO medications Life style modifications PT- Supervised exercises, functional independence, adaptive equipment, education

What are treatment options for rheumatoid arthritis?

NSAIDs Corticosteroids PROM/ AROM Heating and cooling agents Spinting Education Energy conservation Body mechanics Joint protection techniques

What are some treatments for juvenile rheumatoid arthritis?

NSAIDs, corticosteroids, anti rheumatics and immunosuppressive agents PT: Passive and active ROM, positioning, splinting, strengthening, endurance training, weight bearing activities, postural training, and functional mobility Pain management: Modalities such as paraffin, ultrasound, warm water, cryotherapy.

What does the upper respiratory tract consist of?

Nasal cavity Pharynx Larynx

What are side effects of disease- modifying anti-rheumatic agents?

Nausea Headaches Joint pain and swelling Toxicity Gastrointestinal distress Sore throat Fever Liver dysfunction Hair loss Potential for sepsis Retinal damage

What are side effects of nonopioid agents?

Nausea Vomiting Vertigo Abdominal pain Gastrointestinal distress or bleeding Ulcer formation

What nerves are supplied from the trunks of the brachial plexus?

Nerve to subclavius Suprascapular

Order the acute nerve injuries from mildest to most severe: - Axonotmesis - Neurapraxia - Neurotmesis

Neurapraxia Axonotmesis Neurotmesis

What is the loose packed position for the radiocarpal joint?

Neutral with slight ulnar deviation

What are the 5 main types of white blood cells?

Neutrophils Lymphocytes Monocytes Eosinophils Basophils

Does double leg support exist when running?

What are treatment options for Alzheimer's?

No cure Medication are used to inhibit acetylcholinesterase, alleviate symptoms and control behavior changes

What is a grade 1 concussion?

No loss of consciousness Symptoms will resolve within 15 minutes of event

What is the reflex name for a 0 grade and is it normal?

No response Always abnormal

Aerobic: How long can Aerobic Metabolism last?

No specific time frame

What are treatments for carpal tunnel syndrome?

No universally accepted treatment Splinting, ergonomic measures, injections, and PT Surgery

What is the 1st stage of recovery?

No volitional movement initiated

What are the most common motions for ACL injury?

Noncontact twisting motion associated with hyperextension and verges or values stress Tibia being driven anteriorly Femur being driven posteriorly Severe knee hyperextension

Myotome for C1

None

Myotome for L1

None

Myotome for S3

None

Myotome for T1

None

Myotome for T5-T7

None

Myotome for T8-T12

None

Myotomes for T2

None

Myotomes for T3-T6

None

Paresthesia for C1

None

Paresthesia for C2

None

Paresthesia for C5

None

Paresthesia for S3

None

Paresthesia for T1

None

Paresthesia for T2

None

Paresthesia for T3-T6

None

Paresthesia for T5-T7

None

Paresthesia for T8-T12

None

Reflexes affect for C2

None

Reflexes affect for C3

None

Reflexes affect for T2

None

Reflexes affected S3

None

Reflexes affected for C1

None

Reflexes affected for C4

None

Reflexes affected for C8

None

Reflexes affected for L1

None

Reflexes affected for L2

None

Reflexes affected for S4

None

Reflexes affected for T1

None

Reflexes affected for T3-T6

None

Reflexes affected for T5-T7

None

Reflexes affected for T8-T12

None

What is the right side of the brain dominate in?

Nonverbal processing Process information in a holistic manner Artistic abilities General concept comprehension Hand eye coordination Spatial relationships Kinesthetic awareness Understand music Understand nonverbal communication Mathematical reasoning Express negative emotions Body image awareness

What is the 7th stage of recovery?

Normal motor function is restored

What are techniques used for distal functional movement for stability?

Normal timing Slow reversal Slow reversal hold Timing for emphasis

What is "E" considered on the ASIA Impairment Scale?

Normal- Sensory and motor functions are normal

Paresthesia for L2

Occasional anterior thigh

What is stable angina?

Occurs at a predictable level of exertion, exercise or stress and responds to rest or nitroglycerin

What is Prinzmetal's angina?

Occurs due to coronary artery spasm most often associated with coronary artery disease

What is an isometric contraction?

Occurs when tension developes, but there is no change in the length of the muscle.

What is an eccentric contraction?

Occurs when the muscle lengthens while developing tension.

What is a concentric contraction?

Occurs when the muscle shortens while developing tension.

How fast can an athlete return after a grade 3 concussion?

Once symptom free for a minimum of 1 month

What is an ischemic stroke?

Once there is a loss of perfusion to a portion of the brain (within just seconds) there is a central area of irreversible infarction surrounded by an area or potential ischemia. *Tissue death due to lack of oxygen

What is a pulmonary embolism?

One or more arteries in the lungs become blocked

What does the rooting reflex interfere with?

Oral- motor development Developing midline control of head Optical righting, visual track ing and social interaction

Where is the pulmar radiocarpal ligament of the wrist located?

Origin: anterior surface of the distal radius Insertion: capitate, triquetrum and scaphoid

Where is the dorsal radiocarpal ligament of the wrist located?

Origin: posterior surface of the distal radius and styloid process of the radius Insertion: lunate and triquetrum

Where is the radial collateral ligament of the wrist located?

Origin: styloid process of the radius Insertion: scaphoid and trapezium

What are signs and symptoms of a MCL sprain?

Pain Swelling Antalgic gait Decreased ROM Instability

What is the capsular pattern for the sternoclavicular joint?

Pain at extremes of range of motion

What is the capsular pattern for the acromioclavicular joint?

Pain at the extremes of range of movement

What are signs and symptoms of lateral epicondylitis?

Pain immediately anterior or distal to the lateral epicondyle of the humerus Pain that worsens with repetition and resisted wrist extension

What are potential results from Brown-Sequard syndrome?

Paralysis and loss of vibratory sense and position sense on the same side as the lesion Loss of pain and temperature sense of the opposite side of the lesion

What is quadriplegia?

Paralysis of all four limbs

What is monoplegia?

Paralysis of one limb

What is hemiplegia?

Paralysis of one side of the body

What is typically the results of Brown- Sequards syndrome?

Paralysis on the same side as the lesion Loss of vibratory and position sense on the same side as the lesion Loss of pain and temperature sense onn the opposite side of the lesion

Bilateral occlusion (blockage) of the anterior cerebral artery will typically produce what?

Paraplegia Incontinence From lobe changes such as personality change and Conscious unresponsiveness

Basal ganglia disfunction has been associated with many conditions including ____ and ____.

Parkinson's disease Huntington's disease

What are indications for dopamine replacement agents?

Parkinson's disease Parkinsonism

What are basophils?

Participates in allergic responses

What is multiple sclerosis?

Patches of demyelination of the myelin sheaths that surround nerves within the brain and spinal cord Decrease in efficiency of nerve impulse transmission Plaque development

What are signs and symptoms of osteogenesis imperfecta?

Pathological fractures Osteoporosis Hypermobile joints Bowing of the long bones Weakness Scoliosis Impaired respiratory function

What is the 1st level "No Response" of the Ranchos Los Amigos Levels of Cognitive Functioning?

Patient appears in a deep sleep and is completely unresponsive to any stimuli

What is Part 3 of the McGill Pain Questionnaire?

Patient describes pattern of pain, factors that increase and relieve pain

What is the 5th level "Confused- Inappropriate" of the Ranchos Los Amigos Levels of Cognitive Functioning?

Patient is able to respond to simple commands fairly consistently. Highly distractible Converse for short period of time in social environment Verbalization is often inappropriate and confabulatory Memory severely impaired Inappropriate use of objects Unable to learn new information

What is the 4th level "Confused- Agitated" of the Ranchos Los Amigos Levels of Cognitive Functioning?

Patient is in a heightened state of activity. behavior is bizarre and non- purposeful relative to the immediate environment. Patient lacks short term and long term recall Verbalization is often inappropriate

What is Part 1 of the McGill Pain Questionnaire?

Patient marks on a drawing of the body to indicate area and type of pain (internal or external)

Goni techniques Hip Extension: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:

Patient position: prone Stabilization: pelvis to prevent anterior tilting End feel: firm Axis: over the lateral aspect of the hip joint using the greater trochanter of the femur for reference Stationary arm: lateral midline of the pelvis Moveable arm: lateral midline of the femur using a lateral epicondyle for a reference

Goni techniques Shoulder Extension: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:

Patient position: prone Stabilization: thorax to prevent flexion of the spine End feel: firm Axis: acromial process Stationary arm: midaxillary of the thorax Moveable arm: lateral midline of the humerus using the lateral epicondyle of the humerus for reference

Goni techniques Subtalar Inversion: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:

Patient position: prone with the foot extended over a supporting surface Stabilization: tibia and fibula to prevent knee and hip motion End feel: firm Axis: posterior aspect of ankle ankle midway between the malleoli Stationary arm: posterior midline of the lower leg Moveable arm: posterior midline of the calcaneus

Goni techniques Subtalar Eversion: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:

Patient position: prone with the foot extended over a supporting surface Stabilization: tibia and fibula to prevent knee and hip motion End feel: firm hard Axis: posterior aspect of ankle ankle midway between the malleoli Stationary arm: posterior midline of the lower leg Moveable arm: posterior midline of the calcaneus

Goni techniques Hip Lateral Rotation: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:

Patient position: sitting Stabilization: distal end of the femur End feel: firm Axis: anterior aspect of the patella Stationary arm: perpendicular to the floor or parallel to the supporting surface Moveable arm: anterior midline of the lower leg using the crest of the tibia and a point midway between the two malleoli for reference

Goni techniques Hip Medial Rotation: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:

Goni techniques Wrist Extension: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:

Patient position: sitting next to a supporting surface with the shoulder abducted to 90° and the elbow flex to 90° Stabilization: radius and ulna to prevent supination and pronation End feel: firm Axis: the lateral aspect of the wrist over the triquetrum Stationary arm: lateral midline of the ulna using the olecranon and ulnar styloid process for reference Moveable arm: lateral midline of the 5th metacarpal

Goni techniques Wrist Radial Deviation: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:

Patient position: sitting next to a supporting surface with the shoulder abducted to 90° and the elbow flex to 90° Stabilization: radius and ulna to prevent supination and pronation End feel: firm or hard Axis: over the middle of the dorsal aspect of the wrist over the capitate Stationary arm: dorsal midline of the forearm using the lateral epicondyle of the humorous for reference Movable arm: dorsal midline of the 3rd metacarpal

Goni techniques Wrist Ulnar Deviation: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:

Patient position: sitting next to a supporting surface with the shoulder abducted to 90° and the elbow flex to 90° Stabilization: radius and ulna to prevent supination and pronation End feel: firm or hard Axis: over the middle of the dorsal aspect of the wrist over the capitate Stationary arm: dorsal midline of the forearm using the lateral epicondyle of the humorous for reference Movable arm: dorsal midline of the 3rd metacarpal

Goni techniques Wrist Flexion: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:

Goni technique Thoracolumbar Rotation: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:

Patient position: sitting on a chair without back with the feet position on the floor for pelvis stabilization Stabilization: pelvis to prevent rotation End feel: firm Axis: over the center of the cranial aspect of the head Stationary arm: parallel to imaginary line between the two prominent tubercles of the iliac crest Moveable arm: along the imaginary line between the two acromial processes

Goni techniques Forearm supination: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:

Patient position: sitting with elbow flexed to 90 Stabilization: distal end of the humerus to prevent ER and adduction of the humerus End feel: firm Axis: medial to the ulnar styloid process Stationary arm: parallel to the anterior midline of the humerus Moveable arm: ventral aspect of the forearm, just proximal to the styloid process of the radius and ulna

Goni techniques Forearm pronation: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:

Patient position: sitting with elbow flexed to 90 Stabilization: distal end of the humerus to prevent IR and abduction of the humerus End feel: firm or hard Axis: lateral to the ulnar styloid process Stationary arm: parallel to the anterior midline of the humerus Moveable arm: dorsal aspect of the forearm, just proximal to the styloid process of the radius and ulna

Goni techniques Thumb Carpometacarpal Abduction: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:

Patient position: sitting with forearm and hand on a supporting surface Stabilization: carpals and 2nd metacarpal to prevent wrist motion End feel: firm Axis: over the lateral aspect of the radios styloid process Stationary arm: lateral midline of the second metacarpal using the center of the second metacarpophalangeal joint for reference Moveable arm: lateral midline of the first metacarpal using the center of the first metacarpophalangeal joint for reference

Goni techniques Thumb Carpometacarpal Adduction: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:

Goni techniques Thumb Carpometacarpal Extension: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:

Patient position: sitting with forearm and hand on a supporting surface Stabilization: carpals, radius and ulna to prevent wrist motion End feel: firm Axis: over the palmar aspect of the first carpometacarpal joint Stationary arm: ventral midline of the radius using the ventral surface of the radial head and radial styloid process for reference Moveable arm: ventral midline of the first metacarpal

Goni techniques Thumb Carpometacarpal Flexion: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:

Goni techniques Fingers Metacarpophalangeal Abduction: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:

Patient position: sitting with forearm and hand on a supporting surface Stabilization: metacarpal to prevent wrist motion End feel: firm Axis: over the dorsal aspect of the metacarpophalangeal joint Stationary arm: over in the dorsal midline of the metacarpal Moveable arm: dorsal midline of the proximal phalanx

Goni techniques Fingers Metacarpophalangeal Adduction: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:

Goni techniques Fingers Metacarpophalangeal Extension: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:

Goni techniques Fingers Metacarpophalangeal Flexion: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:

Patient position: sitting with forearm and hand on a supporting surface Stabilization: metacarpal to prevent wrist motion End feel: firm or hard Axis: over the dorsal aspect of the metacarpophalangeal joint Stationary arm: over in the dorsal midline of the metacarpal Moveable arm: over in the dorsal midline of the proximal phalanx

Goni techniques Distal Interphalangeal Extension: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:

Patient position: sitting with forearm and hand on a supporting surface Stabilization: middle and proximal phalanx to prevent motion of the interphalangeal joint End feel: firm Axis: over the dorsal aspect of the distal interphalangeal joint Stationary arm: over the dorsal midline of the middle phalanx Moveable arm: over the dorsal midline of the distal phalanx

Goni techniques Distal Interphalangeal Flexion: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:

Goni techniques Proximal Interphalangeal Extension: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:

Patient position: sitting with forearm and hand on a supporting surface Stabilization: proximal phalanx to prevent motion of the metacarpophalangeal joint End feel: firm Axis: over the dorsal aspect of the proximal interphalangeal joint Stationary arm: over the dorsal midline of the proximal phalanx Moveable arm: over the dorsal midline of the middle phalanx

Goni techniques Proximal Interphalangeal Flexion: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:

Patient position: sitting with forearm and hand on a supporting surface Stabilization: proximal phalanx to prevent motion of the metacarpophalangeal joint End feel: soft, firm or hard Axis: over the dorsal aspect of the proximal interphalangeal joint Stationary arm: over the dorsal midline of the proximal phalanx Moveable arm: over the dorsal midline of the middle phalanx

Goni techniques Ankle Inversion: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:

Patient position: sitting with the knee flexed to 90 Stabilization: tibia and fibula to prevent knee and hip motion End feel: firm Axis: anterior aspect of the ankle midway between the malleoli Stationary arm: midline of the lower leg using the tibial tuberosity for reference Moving arm: anterior midline of the second metatarsal

Goni techniques Ankle Dorsiflexion: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:

Patient position: sitting with the knee flexed to 90 Stabilization: tibia and fibula to prevent knee and hip motion End feel: firm Axis: lateral aspect of the lateral malleolus Stationary arm: lateral midline of the fibula using the head of the fibula for reference Moveable arm: parallel to the lateral aspect of the fifth metatarsal

Goni techniques Ankle Eversion: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:

Patient position: sitting with the knee flexed to 90 Stabilization: tibia and fibula to prevent knee and hip motion End feel: firm or hard Axis: anterior aspect of the ankle midway between the malleoli Stationary arm: midline of the lower leg using the tibial tuberosity for reference Moving arm: anterior midline of the second metatarsal

Goni techniques Ankle Plantarflexion: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:

Patient position: sitting with the knee flexed to 90 Stabilization: tibia and fibula to prevent knee and hip motion End feel: firm or hard Axis: lateral aspect of the lateral malleolus Stationary arm: lateral midline of the fibula using the head of the fibula for reference Moveable arm: parallel to the lateral aspect of the fifth metatarsal

Goni techniques Cervical Rotation: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:

Patient position: sitting with the thoracic and lumbar spine supported Stabilization: shoulder girdle and chest; the patient's hand should be placed on their knees End feel: firm Axis: over the center of the cranial aspect of the head Stationary arm: parallel to the imaginary line between the two acromial processes Moveable arm: with the tip of her nose or if using a tongue depressor align the goniometer parallel to the tongue depressor

Goni techniques Cervical Lateral Flexion: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:

Patient position: sitting with the thoracic and lumbar spine supported Stabilization: shoulder girdle and chest; the patient's hand should be placed on their knees End feel: firm Axis: over the spinous process of C7 Stationary arm: with the spinous processes of the thoracic vertebrae so that the arm is perpendicular to the ground Moveable arm: along the dorsal midline of the head using the occipital protuberance for reference

Goni techniques Cervical Extension: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:

Patient position: sitting with the thoracic and lumbar spine supported Stabilization: shoulder girdle and chest; the patient's hand should be placed on their knees End feel: firm Axis: the external auditory meatus Stationary arm: perpendicular parallel to the ground Moveable arm: along the base of the nares or if using a tongue depressor, align goniometer parallel with the tongue depressor

Goni techniques Cervical Flexion: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:

Patient position: sitting with the thoracic and lumbar spine supported Stabilization: shoulder girdle and chest; the patient's hand should be placed on their knees End feel: firm Axis: the external auditory meatus Stationary arm: perpendicular parallel to the ground Moveable arm: along the base of the nares or if using a tongue depressor, align goniometer parallel with the tongue depressor

Goni techniques Knee Extension: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:

Patient position: supine Stabilization: femur to prevent rotation, abduction and abduction of the hip End feel: firm Axis: lateral epicondyle of the femur Stationary arm: later midline of the femurs using the greater trochanter for reference Moveable arm: lateral midline of the fibula using the lateral malleolus and fibular head for reference

Goni techniques Knee Flexion: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:

Patient position: supine Stabilization: femur to prevent rotation, abduction and abduction of the hip End feel: soft or firm Axis: lateral epicondyle of the femur Stationary arm: later midline of the femurs using the greater trochanter for reference Moveable arm: lateral midline of the fibula using the lateral malleolus and fibular head for reference

Goni techniques Elbow extension: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:

Patient position: supine Stabilization: humerus to prevent flexion of the shoulder End feel: hard Axis: later epicondyle of the humerus Stationary arm: lateral midline of the humerus using the center of the acromial process for reference Moveable arm: lateral midline of the radius using the radial head and radial styloid process for reference

Goni techniques Elbow flexion: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:

Patient position: supine Stabilization: humerus to prevent flexion of the shoulder End feel: soft Axis: later epicondyle of the humerus Stationary arm: lateral midline of the humerus using the center of the acromial process for reference Moveable arm: lateral midline of the radius using the radial head and radial styloid process for reference

Goni techniques Hip Adduction: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:

Patient position: supine Stabilization: pelvis to prevent lateral tilting End feel: firm Axis: over the ASIS of the extremity being measured Stationary arm: align with imaginary horizontal Line extending from one ASIS to the other ASIS Moveable arm: anterior midline of the femur using the midline of the patella for reference

Goni techniques Hip Abduction: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:

Patient position: supine Stabilization: pelvis to prevent lateral tilting and rotation; trunk to prevent lateral flexion End feel: firm Axis: over the ASIS of the extremity being measured Stationary arm: align with imaginary horizontal Line extending from one ASIS to the other ASIS Moveable arm: anterior midline of the femur using the midline of the patella for reference

Goni techniques Shoulder Flexion: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:

Patient position: supine Stabilization: thorax to prevent extension of the spine End feel: firm Axis: acromial process Stationary arm: midaxillary line of the thorax Moveable arm: lateral midline of the humerus using the lateral epicondyle of the humerus for reference

Goni techniques Shoulder Abduction: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:

Patient position: supine Stabilization:thorax to prevent lateral bending End feel: firm Axis: anterior aspect of acromial process Stationary arm: parallel to the midline of the anterior aspect of the sternum Moveable arm: medial midline of the humerus

Goni techniques Shoulder Adduction: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:

Goni techniques Hip Flexion: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:

Patient position: supine Stabilization: pelvis to prevent posterior tilting End feel: soft or firm Axis: over the lateral aspect of the hip joint using the greater trochanter of the femur for reference Stationary arm: lateral midline of the pelvis Moveable arm: lateral midline of the femur using a lateral epicondyle for a reference

Goni techniques Shoulder ER: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:

Patient position: supine with shoulder abducted to 90 and elbow flexed to 90 Stabilization: distal end of the humerus to maintain the shoulder in 90 degrees of abduction End feel: firm Axis: olecranon process Stationary arm: parallel or perpendicular to the floor Moveable arm: ulna using the olecranon process and ulnar styloid process for reference

Goni techniques Shoulder IR: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:

Goni technique Thoracolumbar Lateral Flexion: Patient position: Stabilization: End feel: Axis: Stationary arm: Moveable arm:

Patient position: with the feet shoulders width apart Stabilization: pelvis to prevent lateral tilting End feel: firm Axis: over the posterior aspect of spinous process of C1 Stationary arm: perpendicular to the ground Moveable arm: posterior aspect of C7

What is Part 4 of the McGill Pain Questionnaire?

Patient rates intensity of pain on a scale of 0-5

What is the 2nd level "Generalized Response" of the Ranchos Los Amigos Levels of Cognitive Functioning?

Patient reacts inconsistently and non-purposefully to stimuli in a nonspecific manner. Responses are limited and often the same regardless of stimulus presented. Responses bay be physiological changes, gross body movements, and/ or vocalization

What is the 3rd level "Localized Response" of the Ranchos Los Amigos Levels of Cognitive Functioning?

Patient reacts specifically, but inconsistently to stimuli. responses are directly related to the type of stimulus presented. May follow simple commands such as closing eyes or squeezing the hand in an inconsistent, delayed manor

Abnormal Gait: What is hemiplegic gait?

Patient who abducts the paralyzed limb, swings it around, and brings it forward so the foot comes to the ground in front of them

What is Part 2 of the McGill Pain Questionnaire?

Patients choose one word that best describes the pain from each of the 20 categories

What is tenodesis?

Patients with tetraplegia that do not possess motor control for grasp can utilize the tight finger flexors in combination with wrist extension to produce a form of grasp

What muscles assist with shoulder adduction?

Pec Major Latissimus Dorsi Teres Major

What muscles are supplied from the medial pectoral nerve?

Pectoralis Major Pectoralis Minor

What muscles are supplied by the lateral pectoral nerve?

Pectoralis major- clavicular head

What is LE D2 Extension? Pelvis Hip Knee Ankle/ toes

Pelvis: Depression Hip: Extension, ADD, ER Knee: Flexion or extension Ankle/ toes: PF, Inversion

What is LE D2 Flexion? Pelvis Hip Knee Ankle/ toe

Pelvis: Elevation Hip:Flexion, ABD, IR Knee: Flexion or extension Ankle/ toes: DF, Eversion

What is LE D1 Flexion? Pelvis Hip Knee Ankle/ toes

Pelvis: Protraction Hip: Flexion, ADD, ER Knee: Flexion or extension Ankle/ toes: Dorsiflexion, Inversion

What is LE D1 Extension? Pelvis Hip Knee Ankle/ toes

Pelvis: Retraction Hip: Extension, ABD, IR Knee: Flexion or extension Ankle/ toes: PF, Eversion

What is the purpose of pain sensory testing?

Perceive pain through sharp vs dull sensation using a wartenburg pinwheel

What is the purpose of barognosis sensory testing?

Perceive the weight of different objects in the hand

What is the purpose of light touch sensory testing?

Perceive touch through light pressure or use of a cotton ball

What is the purpose of vibration sensory testing?

Perceive vibration or pain through a tuning fork

What is the purpose of temperature sensory testing?

Perceive warm and cold test tubes

Dermatome for S4

Perimueum Genitals Lower Sacrum

What muscles assist with Ankle eversion?

Peroneus Longus Peroneus Brevis Peroneus Tertius

What muscles are supplied by the superficial peroneal nerve?

Peroneus longus peroneus brevis

What are signs and symptoms of bronchitis?

Persistent cough with production of thick sputum Increased use of accessory muscles to breathe Wheezing Dyspnea Cyanosis Increased pulmonary artery pressure *Chronic- cough is worse in the morning and during damp weather

How does the ATP-PC system function?

Phosphocreatine decomposes and releases a large amount of energy that is used to construct APT.

What are the gross motor skills for a newborn to 1 month old in Prone?

Physiological flexion Lifts head briefly Head to side

What are the gross motor skills for a newborn to 1 month old in supine?

Physiological flexion Rolls partly to side

The epithalamus is primarily represented by the ___ gland.

Pineal gland

What muscles are supplied by the sacral plexus?

Piriformis Superior gemelli Inferior gemelli Obturator internus Quadratus femoris

What are signs and symptoms on osgood- schlatters disease

Point tenderness over the patella tendon at the insertion on the tibial tubercle Antalgic gait pain with increasing activity

What are 11 examples of lower motor neuron diseases (LMNL)?

Poliomyelitis ALS (both upper and lower) Guillain- Barre syndrome Tumors involving the spinal cord Trauma Progressive muscular atrophy Infection Bell's palsy Carpal tunnel syndrome Muscular dystrophy Spinal muscular atrophy

What are the gross motor skills for a 2-3 month old in standing?

Poor weight bearing Hips in flexion, behind shoulders

What is the stimulus for tonic labyrinthine reflex (TLR)?

Position of labyrinth in inner ear - reflected in head position

What are treatments for spina bifida?

Positioning Handling ROM Therapeutic exercise Skin care Strengthening Mobility and balance Adaptive equipment Splinting Orthotics Wheelchair

What are the special tests for a PCL injury?

Posterior Drawer Test Posterior Sag Sign

Where is the PCL located?

Posterior intercondylar area of the tibia to the lateral aspect of the medial femoral condyle in the intercondylar notch

What is constant practice?

Practice of a given task under a uniform condition

What is variable practice?

Practice of a given task under differing conditions

What is whole training?

Practice of an entire task

What is part training?

Practice of an individual component or select components of a task

What are signs and symptoms of angina pectoris?

Pressure Heaviness Fullness Squeezing Burning or aching behind the sternum Difficulty breathing Nausea Vomiting Sweating

What are the stimulus to the palmar grasp reflex?

Pressure in the palm on the ulnar side of hand

What is the stimulus for the planter grasp reflex?

Pressure to base of toes

What is the purpose of the iliofemoral ligament of the hip?

Prevents excessive hip extension and assist with upright posture

What are the functions of the temporal lobe?

Primary auditory processing and olfaction Wernicke's area (typically located in the left hemisphere): ability to understand and produce meaningful speech, verbal and general memory, assists with understanding language The rear of the temporal lobe enables humans to interpret other peoples emotions and reactions

What are signs and symptoms for a total hip arthroplasty?

Prior to surgery- Severe pain with weight bearing, loss of mobility, gross instability or limitation in ROM

What are signs and symptoms for a total knee arthroplasty?

Prior to surgery: Severe pain with weight bearing Decreased ROM Gross instability Marked deformity of the knee

What is Duchenne Muscular Dystrophy?

Progressive disorder caused by the absence of the gene required to produce the muscle proteins dystrophin and nebulin. Without these, cell membranes weaken, myofibrils are destroyed and muscular contractility is lost.

What are signs and symptoms of Cor Pulmonale?

Progressive shortness of breath, fatigue, palpitations, atypical chest pain, swelling of the LE, dizziness and syncope

What are muscle relaxant agents?

Promote relaxation in muscles that typically present with spasm that is a continuous, tonic contraction

What is the purpose of anti-spasticity agents?

Promotes relaxation in a spastic muscle

What are the motions for the proximal radioulnar joint?

Pronation Supination

What muscles assist with radioulnar pronation?

Pronator Teres Pronator Quadratus

What are the 3 options for deep sensory testing?

Proprioception Kinesthesia Vibration

What are meninges?

Protection layers of the brain Blood vessels CFS is inside the meninges

What is myelin?

Proteins and lipids that form to create a sheath around particular nerves Increases conductivity of the nerve impulse

What is the purpose of a nonopioid agent?

Provide analgesia and pain relief, produce anti-inflammatory effects, and initiate anti-pyretic (reduces fever) properties.

What is the purpose of an opioid agaent (narcotics)?

Provide analgesia for acute severe pain, stimulates opioid receptors within the CNS to prevent pain impulses from reaching their destination

What is a corset orthosis?

Provides pressure and relieves pain associated with mid and low back pathologies.

Myotome for L2

Psoas Hip adductors

Myotome for L3

Psoas Quads Thigh atrophy

What muscles assist in thoracolumbar rotation and side bending?

Psoas Major Quadratus Lumborum Internal Obliques External Obliques Multifidus Longissiumus Thoracic Iliocostalis Thoracis Rotatores

What muscles assist with thoracic and lumbar rotation and lateral bending?

Psoas Major Quadratus Lumborum Internal Obliques External Obliques multifidus Longissimus Thoracis Rotatores

What muscles are supplied by the lumbar plexus?

Psoas major Psoas minor Quadratus lumborum

Where is the pubofemoral ligament located?

Pubic portion of the rim of the acetabulum to the neck of the femur

What is Cor Pulmonale?

Pulmonary heart disease Hypertrophy of the right ventricle caused by altered structure or function of the lungs

What is the etiology of Cor Pulmonale?

Pulmonary hypertension

What is the descending corticospinal tract (lateral)?

Pyramidal motor tract responsible for contralateral voluntary fine movement

What is the descending corticospinal tract (anterior)?

Pyramidal motor tract responsible for ipsilateral voluntary, discrete and skilled movements

Peak muscle activity during the gait cycle. Name the muscle group: Two periods of peak activity. In periods of single support during early stance phase and just before toe off to initiate swing phase.

Quadriceps group

What are some treatments for impingement syndrome?

RICE NSAIDS Activity modification Rotator cuff strengthening Shoulder stability exercises

What are treatment options for plantar fasciitis?

RICE NSAIDs Analgesics Heel cup Massage Taping Joint mobilization Stretching Orthotics Soft- soled footware

What are some treatments for a MCL sprain?

RICE NSAIDs Analgesics Increasing ROM Strengthening

What are treatment options for a meniscus tear?

RICE NSAIDs Analgesics Modalities Strengthening

What are treatment options for a PCL sprain?

RICE NSAIDs Analgesics Strengthening

What are some treatments for lateral epicondylitis?

RICE NSAIDs Activity modification PT: Strength Flexibility Endurance

With are treatment options for a rotator cuff tear?

RICE NSAIDs Analgesics Adhesive capsulitis prevention Strengthening

What are treatment options for achilles tendonitis?

RICE (Rest, ice, compression, elevation) NSAIDS Stretching Eccentric exercises of the soleus and gastroc

What are treatment options for adhesive capsulitis?

ROM exercises Palliative modalities

What is Souque's phenomenon?

Raising the involved UE above 100 degrees with elbow extension will produce extension and abduction of the fingers

What are the gross motor skills for adolescence (+13 yrs)?

Rapid growth in size and strength, boys more than girls Puberty Balance and coordination skills, hand eye coordination, endurance may plateau during growth spurt

What is the hypothalamus?

Receives and integrates information from the AND and assists with regulating hormones Controls functions such as hunger, thirst, sexual behavior, and sleeping Regulates body temperature, the adrenal glands, the pituitary glands and many other vital activities

What is the response to the walking (stepping) reflex?

Reciprocal flexion/ extension of legs

What is a RGO?

Reciprocating Gait Orthosis When the patient shifts weight onto a selected lower extremity, the cable system advances to the opposite lower extremity. Paraplegic patients

What muscles assist in thoracolumbar flexion?

Rectus Abdominis Internal Obliques External Obliques

What muscles assist with thoracic and lumbar flexion

Rectus Abdominus Internal Obliques External Obliques

What muscles assist with Knee extension?

Rectus Femoris Vastus Lateralis Vastus Intermedius Vastus Medialis

What muscles activate during forceful breathing, which depresses the lower ribs and compresses the abdominal contents?

Rectus abdominis External oblique Internal oblique Transverse abdominis

What are symptoms of pressure ulcers?

Reddened area that persists or an open area of the skin

What is the purpose of anti-epileptic agents?

Reduce or eliminate seizure activity within the brain

What are the gross motor skills for a newborn to 1 month old in standing?

Reflex standing and walking

Lower motor neuron disease Reflexes: hyperactive or diminished/ absent Atrophy: mild or present Fasciculations: absent or present Tone: hypertonic or flaccid

Reflexes: diminished/ absent Atrophy: present Fasciculations: present Tone: flaccid

Upper motor neuron disease Reflexes: hyperactive or diminished/ absent Atrophy: mild or present Fasciculations: absent or present Tone: hypertonic or flaccid

Reflexes: hyperactive Atrophy: mild from disuse Fasciculations: absent Tone: hypertonic

What are the fine motor skills for a newborn to 1 month old?

Regards objects in direct line of sight Follows moving object to midline Hands fisted Arms movements jerky Movements may be purposeful or random

What is the purpose of the ischiofemoral ligament of the hip?

Reinforces the articular capsule

What is atrial diastole?

Relaxation of the atria

What is the purpose of ascending tracts?

Relay sensory feedback to the cerebrum and cerebellum

What is the brain stem?

Relay station Made up of the midbrain, pons and medulla oblongata Survival regulations

What is the thalamus?

Relaying or processing station for the majority of information that goes to the cerebral cortex Coordinates sensory perception and movement with other parts of the brain and spinal cord Receives information from the cerebellum, basal ganglia and all sensory pathways except for olfactory tract

What is practice?

Repeated performance of an activity in order to learn or perfect a skill

What is Osgood-Schlatter disease?

Repetitive traction on the tibial tuberosity apophysis Also know as traction apophysis

What are indications for glucocorticoid agents (corticosteroids)?

Replacement therapy for endocrine dysfunction Anti-inflammatory and immunosuppressive effects Treatment if rheumatic, respiratory and various other disorders

What is intrinsic (inherent) feedback?

Represents all feedback that comes to the person through sensory systems as a result of the movement including visual, vestibular, proprioceptive and somatosensory inputs

What is extrinsic (augmented) feedback?

Represents the information that can be provided while a task or movement is n progress or subsequent to the movement Ex. verbal feedback or manual contacts

What is declarative learning?

Requires attention, awareness, and reflection in order to attain knowledge that can be consciously recalled (mental practice)

What is the etiology of asthma?

Respiratory infections Allergens to pollen, mold, animal dander, feathers, dust, food, cockroaches, exposure to cold air, cigarette smoke

What are blood platelets?

Responsible for clotting blood

What are treatments for bronchitis?

Rest Fluids Warm moist air Medication Life style changes Airway clearance Breathing exercises Endurance training

What are signs and symptoms of Parkinson's?

Resting tremors Balance issues Difficulty rolling over and getting out of bed Impairment with fine manipulative movements seen in writing, bathing and dressing Poor posture Shuffling gait Bradykinesia

What are the 3 groups of tremors?

Resting: Observable at rest and may or may not disappear with movement; may increase with mental stress Postural: Observable during a voluntary contraction to maintain posture Intention (kinetic): Absent at rest but observable with activity and typically increase as the target approaches

What are indications for joint mobilization?

Restricted joint mobility Restricted accessory motion Desired neurophysiological effects

What is the purpose of the Ligament Nuchae?

Restricts flexion in the cervical spine.

What is the purpose of the Supraspinous Ligament?

Restricts flexion in the thoracic and lumbar spine

What is deep vein thrombosis (DVT)?

Results from the formation of a blood clot that becomes dislodged and is termed an embolus.

What are indications for disease- modifying anti-rheumatic agents?

Rheumatic disease

What muscles does the dorsal scapular nerve supply?

Rhomboids Levator Scapulae

What muscles assist with scapular downwards rotation?

Rhomboids Levator Scap Pec Min

What are the gross motor skills for a 2 yr old?

Rides tricycle Walks on tip toes Runs on toes Walks downstairs alternating feet Catches large ball Hops on one foot

What are gyrus>

Ridges of the brain

The sagittal plane divides the body into _________________ and _________________ portions.

Right Left

What are the 2 inferior chambers of the heart?

Right and left ventricles

What is the cerebrum?

Right vs left Joined by white matter called the corpus, which relays information from one side of the brain to another Outer surface of the cerebrum is termed grey matter Inner surface of the cerebrum is termed white matter

How many bronchopulmonary segments are on the right lung? Left lung?

Right- 10 Left- 8

How many lobes are there in the right lung? Left lung?

Right- 3 Left- 2

What are the gross motor skills for a 6-7 month old in prone?

Rolls from supine to prone position Holds weight on one hand to reach for toy

What are the gross motor skills for a 4-5 month old in supine?

Rolls from supine to side position Plays with feet to mouth

What is the etiology of myocardial infarctions?

Ruptured atherosclerotic plaque or blood clot blocks the flow of blood through the coronary artery Uncommon- spasm of the coronary artery

What is the innervation level for dermatome testing of the lateral and plantar aspect of the foot?

What is the innervation level for functional testing of toe walking?

What is the innervation level for reflex testing of the achillies?

What is the innervation level for resistive testing of ankle plantar flexion?

What is the innervation level for dermatome testing of the medial aspect of the posterior thigh?

What is the innervation level for dermatome testing of the perianal area?

S3-S5

What is the pacemaker of the heart?

SA node

What is autonomic dysreflexia?

SCI= occurs with lesions at or above T6 A Noxious stimulus below the level of the lesion triggers the ANS causing sudden elevation of BP

What muscles make up the rotator cuff?

SITS: Subscapularis Infraspinatus Teres minor Supraspinatus

Reflexes affected for S1

SLR limited Achillies reflex weak or absent

Reflexes affected for S2

SLR limited Achillies reflex weak or absent

Reflexes affected for L4

SLR limited Neck flexion pain Weak or absent knee jerk Side flexion limited

Reflexes affect for L5

SLR limited one side Neck flexion painful Ankle decrease Crossed- leg raising pain

What are signs and symptoms of a pulmonary embolism?

SOB Chest pain what is worse with deep breathing, coughing, eating or bending Coughing up bloody or blood streaked sputum Wheezing LE swelling Excessive sweating Rapid or irregular pulse Lightheadedness or fainting

What are signs and symptoms of heart failure?

SOB Fatigue and weakness Swelling of the legs, feet and abdomen Rapid or irregular HR Persistent cough or wheezing Weight gain from fluid retension

What are signs and symptoms of emphysema?

SOB Wheezing Chronic cough Orthopnea BARREL CHEST Increased use of accessory muscles Increased respiration rate Fatigue Reduced exercises capacity

What is a cerebrovascular accident?

STROKE The sudden death of some brain cells due to lack of oxygen when the blood flow to the brain is impaired by blockage or rupture of an artery to the brain

Paresthesia for S4

Saddle area Genitals Anus Impotence Massive posterior herniation

What are signs and symptoms if cystic fibrosis?

Salty tasting skin Persistent and progressive cough Frequent lung infections Wheezing SOB Poor growth/ weight gain in spite of good appetite Frequent greasy and bulky stools

What is the sharpened Romberg test?

Same as Romberg but in tandem stance

What is the synergy pattern for the UE extensors? Scapula Shoulder Elbow Forearm Wrist Fingers Thumb

Scapula: Depression and protraction Shoulder: Adduction and IR Elbow: Extension Forearm: Pronation Wrist: Extension Fingers: Flexion with adduction Thumb: Flexion and adduction

What is UE D2 Extension Scapula Shoulder Elbow Radioulnar Wrist Thumb

Scapula: Depression, ABD, Downwards rotation Shoulder: Extension, ADD, IR Elbow: Flexion or extension Radioulnar: Pronation Wrist: Flexion, Ulnar deviation Thumb: Opposition Tuck the sword away

What is UE D1 Extension Scapula Shoulder Elbow Radioulnar Wrist Thumb

Scapula: Depression, ADD, Downwards rotation Shoulder: Extension, ABD, IR Elbow: Flexion or extension Radioulnar: Pronation Wrist: Extension, Ulnar deviation Thumb: ABD car seatbelt

What is UE D1 Flexion Scapula Shoulder Elbow Radioulnar Wrist Thumb

Scapula: Elevation, ABD, Upwards rotation Shoulder: Flexion, ADD, ER Elbow: Flexion or extension Radioulnar: Supination Wrist: Flexion, Radial deviation Thumb: Adduction Grabbing something off top left shelf with right hand

What is UE D2 Flexion Scapula Shoulder Elbow Radioulnar Wrist Thumb

Scapula: Elevation, ADD, Upwards rotation Shoulder: Flexion, ABD, ER Elbow: Flexion or extension Radioulnar: Supination Wrist: Extension, Radial deviation Thumb: Extension take out sword

What is the synergy pattern for the UE flexors? Scapula Shoulder Elbow Forearm Wrist Fingers Thumb

Scapula: elevation and retraction Shoulder: Abduction and ER Elbow: Flexion Forearm: Supination Wrist: Flexion Fingers: Flexion with adduction Thumb: Flexion and adduction

What are treatment options for pressure ulcers?

Seat cushions Movement Nutrition Hydration Skin care Surgery if necessary

What is the epithalamus?

Secretes melatonin, and is involved in circadian rhythms, the internal clock, selected regulation of motor pathways and emotions

What are side effects of muscle relaxant agents?

Sedation Drowsiness Dizziness Nausea Vomiting Headache Tolerance Dependence

What is diplopia?

Seeing two images of an object, also known as double vision

What are indications of anti-epileptic agents?

Seizure activity

What are signs and symptoms of epilepsy?

Seizure symptoms, loss of awareness, loss of consciousness, disturbance of movement, sensation, mood or mental function

What muscles are supplied by the sciatic nerve?

Semitendinosus Semimembranosus Biceps femoris

Dorsal roots are _____ (sensory/ motor) Dorsal roots contain _____ (afferent/ efferent) fibers

Sensory Afferent

What is "B" considered on the ASIA Impairment Scale?

Sensory Incomplete- Sensory but not motor function is preserved below the neurologic level and extends through sacral segments S4-S5

What are signs and symptoms of carpal tunnel syndrome?

Sensory changes and paresthesia along the median nerve Radiates to upper arm, shoulder and neck Night pain, weakness, muscle atrophy, decreased grip strength, clumsiness and decreased wrist mobility

What is the ascending spinothalamic tract (anterior)?

Sensory tract for light touch and pressure

What is the ascending spinothalamic tracts (lateral)?

Sensory tract for pain and temperature sensation

What is the ascending fasciculus gracilis (posterior or dorsal column) tracts?

Sensory tract for the trunk and lower extremity proprioception, two- point discrimination, vibration and graphesthesia

What is the ascending fasciculus cuneatus (posterior or dorsal column) tracts?

Sensory tract for trunk, neck and upper extremity proprioception, vibration, two point discrimination and graphesthesia

What is the ascending spinotectal tract?

Sensory tract providing afferent information for spinovisual reflexes and assists with movement of eyes and head towards stimulus

What is the ascending spinocerebellar tract (dorsal)?

Sensory tract that ascends to the cerebellum for ipsilateral subconscious proprioception, tension in muscles, joint sense, and posture of the trunk and lower extremities

What is the ascending spinocerebellar tract (ventral)?

Sensory tract that ascends to the cerebellum, some fibers crossing with subsequent recrossing at the level of the pons for ipsilateral subconscious proprioception, tension in muscles, joint sense and posture of the trunk, upper extremities and lower extremities

What muscles does the long thoracic nerve supply?

Serratus Anterior

What muscles assist with scapular protraction?

Serratus Anterior Pec Minor

What is spina bifida myelomeningocele?

Severe form of spina bifida herniation of the meninges, cerebral spinal fluid and the spinal cord extend through the spinal column and a cyst forms

What is a grade III ligament sprain?

Severe pain and swelling, substantial joint instability, total tear of the ligament, substantial decrease in ROM

What are sulci?

Shallow grooves

What are symptoms of anemia?

Shortness of breath, fatigue, weakness, pale

Dermatome for C4

Shoulder area Clavicular area Upper scapular area

What are signs and symptoms of scoliosis?

Shoulder level asymmetrical Rib hump

What is the 6th level "Confused- Appropriate" of the Ranchos Los Amigos Levels of Cognitive Functioning?

Shows goal directed behavior Follows simple direction Appropriate responses

What are examples of dopamine replacement agents?

Sinemet Levodopa

What is the best position for a patient with autonomic dysreflexia?

Sitting

What does the startle reflex interfere with?

Sitting balance Protective responses in sitting Eye- hand coordination, visual tracking Social interaction, attention

What are the gross motor skills for early school age (5-8 yrs)?

Skips on alternate feet Gallops Can play hopscotch, balance on 1 foot, controlled hopping, squatting on one leg Jumps with rhythm, controlled (jump rope) Bounces large ball Kicks ball with greater control Limbs growing faster than trunk allowing greater speed, leverage

What is patellofemoral syndrome?

Slight malalignment of the patella that causes knee pain pain under patella and/or around it Chondromalacia patella- softening of the articular cartilage of the patella Females > men

Where is the location of the MCL?

Slightly above medial femoral epicondyle to the medial aspect of the of the tibial shaft

Where should the plumb line run through for proper posture?

Slightly posterior to the coronal suture Through the external auditory meatus Through the axis of the odontoid process Midway though the tip of the shoulder Through the bodies of the lumbar vertebrae Slightly posterior to the hip Slightly anterior to the axis of the knee joint Slightly anterior to the lateral malleolus Through the calcaneocuboid joint

What are signs and symptoms of post- polio syndrome?

Slow and progressive weakness Fatigue Atrophy Pain Swallowing issues

What is bradykinesia?

Slow movement

What are disease- modifying anti-rheumatic agents?

Slows or halts the progression of rheumatic diseases. They are used in early disease process to slow the progression prior to widespread damage of the affected joints. They act to induce remission by modifying the pathology and inhibiting the immune response responsible for rheumatic disease.

What is dysarthria?

Slurred and impaired speech due to a motor deficit of the tongue or other muscles essential for speech

What is a grade 1 joint mobilization?

Small amplitude of movement performed at the beginning of the range

What is a grade 4 joint mobilization?

Small amplitude of movement performed at the limit of the range

What are characteristics of C Fibers? Size of fibers Myelinated? Unmyelinated? Speed of conduction rate Extra

Small fibers Poorly myelinated or unmyelinated Slowed conduction rate Post- ganglionic fibers of the sympathetic system Exteroceptors for pain, temperature and touch

What should you feel with a soft normal end feel?

Soft tissue approximation ex. elbow flexion knee flexion

What muscles are supplied by the tibial nerve?

Soleus Popliteus Plantaris Tibalis posterior Gastrocnemius Flexor hallucis longus Flexor digitorum longus

What are the 3 components of balance?

Somatosensory information Visual information Vestibular information

What is the 4th stage of recovery?

Spasticity begins to decrease. Movement patterns are not dictated coley by limb synergies

What are key points of control?

Specific handling of designated areas of the body will influence and facilitate posture, alignment and control

What are some special test for a biceps tendon pathology?

Speeds test Yergason's test

Brachioradialis Tendon DTR Testing Spinal level: Procedure: Normal response:

Spinal level: C5-C6 Procedure: 1. Rest the hand on the lab in sitting with the forearm supported and in neutral 2. Strike the radius 1-2 inches superior to the wrist Normal response: 1. Contraction of the brachioradialis muscle 2. Elbow flexion and/ or forearm supination

Biceps Tendon DTR testing Spinal level: Procedure: Normal response:

Spinal level: C5-C6 Procedure: 1. Support the elbow in partial flexion in sitting or supine 2. Place the thumb firmly over the biceps tendon at the elbow 3. Strike the hammer through the thumb Normal response: 1. Contraction of the biceps muscle 2. Flexion of the elbow

Triceps Tendon DTR Testing Spinal level: Procedure: Normal response:

Spinal level: C6-C7 Procedure: 1. Support the UE through the humerus and allow the lower portion to hang with elbow flexion 2. Strike the tendon directly above the elbow Normal response: 1. Contraction of the triceps muscle 2. Elbow extension

Patellar Tendon DTR Testing Spinal level: Procedure: Normal response: Spinal level: Procedure: Normal response:

Spinal level: L3-L4 Procedure: 1. Supported knee flexion with the patient sitting or supine 2. Strike the tendon directly inferior to the patella Normal response: 1. Contraction of the quads 2. Knee extensoin

Achillis Tendon DTR Testing Spinal level: Procedure: Normal response:

Spinal level: S1-S2 Procedure: 1. In sitting, flex the foot at the ankle putting the achillies on stretch 2. Strike the achillies tendon above the foot Normal response: 1. Plantar flexion

What is a posterior cruciate ligament sprain?

Sprain of a PCL Not common Accompanied by ACL, MCL, LCL and/or menisci injuries

What is a Medical Collateral Ligament Sprain?

Sprain to the MCL of the knee

What are the gross motor skills for a 16-24 month old?

Squats in play Walks backwards Walks up and down stairs with one hand held using both feet on step propels ride on toys Kicks ball Throws ball Picks up toy from floor without falling

What are 3 activities that you should avoid doing with osgood- schlatters disease?

Squatting Running Jumping

What is the purpose of the interosseous membrane of the wrist?

Stabilizes against axial forces applied to the wrist

Abnormal Gait: What is cerebellar gait?

Staggering gait pattern seen in children with a cerebellar disease.

Which phase takes up 60% of the gait cycle?

Stance Phase

What does the positive support reflex interfere with?

Standing and walking Balance reactions and weight shifting in standing Can lead to contractures of the ankles into PF

What does the walking (stepping) reflex interfere with?

Standing and walking Balance reactions and weight shifting in standing Development of smooth, coordinated reciprocal movements of LE

What are the gross motor skills for a 8-9 month old in standing?

Stands at furniture Pulls to stand at furniture Lowers to sitting position from supported stand

What are the gross motor skills for a 10-11 month old in standing?

Stands without support briefly Pulls to stand using half kneel intermediate position Picks up object from floor from standing with support

What are the signs and symptoms of Duchenne Muscular Dystrophy?

Start between 2-5yrs old Progressive weakness Disinterest in running Falling Toe walking Excessive lordosis Pseudohypertrophy

What is a thrombus?

Stationary blood clot Symptoms appear in minutes or over several days

What is peripheral arterial disease?

Stenotic, occlusive and aneurysmal diseases of the aorta and peripheral arteries

According to standard terminology, what is heel strike?

Step 1/8: The instant the heel touches the ground to begin stance phase

According to Ranchos Los Amigos, what is initial contact?

Step 1/8: When the foot touches the ground

According to Ranchos Los Amigos, what is loading response?

Step 2/8: The amount of time between initial contact and the beginning of the swing phase for the other leg

According to standard terminology, what is foot flat?

Step 2/8: The point in which the entire foot makes contact with the ground and should occur directly after heel strike

According to standard terminology, what is midstance?

Step 3/8: The point during the stance phase when the entire body weight is directly over the stance limb

According to Ranchos Los Amigos, what is midstance?

Step 3/8: The point in stance phase when the other foot is off the ground until the body is directly over the stance limb

According to standard terminology, what is heel off?

Step 4/8: The point in which the heel of the stance limb leaves the ground

According to Ranchos Los Amigos, what is terminal stance?

Step 4/8: When the heel of the stance limb rises and ends when the other foot touches the ground

According to standard terminology, what is toe off?

Step 5/8: The point in which only the toe of the stance limb remains on the ground

According to Ranchos Los Amigos, what is pre-swing?

Step 5/8: When the other foot touches the ground and ends when the stance foot reaches toe off

According to Ranchos Los Amigos, what is initial swing?

Step 6/8: When the stance foot lifts from the floor and ends with maximal knee flexion during swing

According to standard terminology, what is acceleration?

Step 6/8: When toe off is complete and the reference limb swings until positioned directly under the body

According to Ranchos Los Amigos, what is midswing?

Step 7/8: Begins with maximal knee flexion during swing and ends when the tibia is perpendicular with the ground

According to standard terminology, what is midswing?

Step 7/8: The point when the swing limb is directly under the body

According to standard terminology, what is deceleration?

Step 8/8: When the swing limb begins to extend and ends just prior to heel strike

According to Ranchos Los Amigos, what is terminal swing?

Step 8/8: When the tibia is perpendicular to the floor and ends when the foot touches the ground.

What muscles assist with spine cervical flexion?

Sternocleidomastoid Longus Colli Scalenes muscles

What muscles assist with spine cervical rotation and lateral bending?

Sternocleidomastoid Scalenus muscles Splenius Cervicis Iliocostalis Cervicis Levator Scapulae Multifidus

What is the thorax made up of?

Sternum Spine Ribs Connective cartilage

Abnormal Gait: What is spastic gait?

Stiff movement, toes seeming to catch and drag, legs held together, and hip and knee joints slightly flexed. Commonly seen in spastic paraplegia

What is the response to the positive support reflex?

Stiffening legs and trunk into extension

What are treatment options for scoliosis?

Strengthening Stretching Shoe lifts Bracing Spinal orthosis if curve is 25-40 degrees Surgery if curve is x >40 degrees

What should you feel with a firm normal end feel?

Stretch ex. ankle DF finger extension

Where is the anterior ligament of the elbow located?

Stretches from the radiocarpal joint and attaches above the upper coronoid fossa.

What are treatment options of congenital torticollis?

Stretching AROM Positioning Caregiver education

What can polycythemia lead to?

Stroke Heart Attack

What can thrombocythemia lead to?

Stroke Heart Attack

What muscles does the nerve to the subclavius supply?

Subclavius

What are signs and symptoms of glenohumeral instability?

Subluxation: Feeling the shoulder "popping" in and out Pain Paresthesias Sensations of the arm feeling "dead" Positive apprehension test Capsular tenderness Swelling Dislocation: Sever pain Paresthesia Limited ROM Weakness Visible shoulder fullness Arm supported by contralateral limb

What muscle is supplied by the upper subscapular nerve?

Subscapularis

What muscles assist with shoulder medial rotation (IR)?

Subscapularis Teres Major Pec Major Latissimus Dorsi Anterior Deltoid

What muscle is supplied by the lower subscapular nerve?

Subscapularis Teres Major

What are tics?

Sudden, brief, repetitive coordinated movements that will occur usually at irregular intervals

The Zygapophyseal joints are formed by the right and left ____ ____ ____ of one vertebra and the right and left inferior articular facets of an adjacent superior vertebra.

Superior Articular Facet

What are the most common motions for a PCL injury?

Superior portion of the tibia is struck while the knee is flexed Tibia being struck posteriorly Tibia being driving anteriorly Severe hyper flexion *** CAR ACCIDENTS- when knee hits dashboard

The patella slides ___ in knee extension and ___ in knee flexion.

Superiorly Inferiorly

What is the closed pack position for the midtarsal joint?

Supination

What is the closed pack position of the subtalar joint?

Supination

What is the capsular pattern for the proximal radioulnar joint?

Supination Pronation

What are treatments for Cor Pulmonale?

Supplemental oxygen Diuretics Anticoagulation

What are treatments for pulmonary edema?

Supplemental oxygen Medication

What are treatments for angina pectoris?

Supplemental oxygen Nitroglycerin Rest Beta blockers Calcium cannel blockers Angioplasty surgry Coronary artery bypass surgery

What is the stimulus for the walking (stepping) reflex?

Supported upright position with soles of feet on firm surface

Myotome for C5

Supraspinatus Infraspinatus Deltoids Biceps

What muscles does the suprascapular nerve supply?

Supraspinatus Infraspinatus

What is a myelotomy?

Surgical procedure that severs certain tracts within the spinal cord in order to decrease spasticity and improve function

What is a partial hand amputation?

Surgical removal of a portion of the hand and/or digits at either the transcarpal, transmetacarpal or transphalangeal level

What is a neurectomy?

Surgical removal of a segment of a nerve in order to decrease spasticity and improve function

What is a hemipelvectomy?

Surgical removal of one half of the pelvis and the LE

What is a transtibial amputation?

Surgical removal of the LE below the knee joint

What is a Syme's amputation?

Surgical removal of the foot at the ankle joint with removal of the malleoli

What is a wrist disarticulation?

Surgical removal of the hand through the wrist joint

What is a elbow disarticulation amputation?

Surgical removal of the lower arm and hand through the elbow joint 100% of humerus

What is a transfemoral amputation?

Surgical removal of the lower extremity above the knee joint

What is a hip disarticulation?

Surgical removal of the lower extremity from the pelvis

What is a transmetatarsal amputation?

Surgical removal of the midsection of the metatarsals

What is a transradial amputation?

Surgical removal of the upper extremity distal to the elbow joint

What is a transhumeral amputation?

Surgical removal of the upper extremity proximal to the elbow joint

What is a shoulder disarticulation?

Surgical removal of the upper extremity through the shoulder

What is a knee disarticulation?

Surgical removal through the knee joint

What is a rhizotomy?

Surgical resection of sensory component of a spinal nerve in order to decrease spasticity and improve function

Where is the arachnoid mater located?

Surrounds the brain in a loose manner Impermeable

Where is the location of the annular ligament of the elbow?

Surrounds the head of the humerus.

What is dystonia?

Sustained muscle contractions that frequently causes twisting, abnormal postures and repetitive movements

What are pressure ulcers caused by?

Sustained pressure, friction and/ or shearing to a surface

What are symptoms of a DVT?

Swelling of LE Pain Sensitivity over the area of the clot Warmth in the area

What are signs and symptoms of rheumatoid arthritis?

Symmetrical involvement Pain Tenderness Morning stiffness Warm joints Decreased appetite Malaise Increased fatigue Swan neck deformity Boutonniere deformity Low grade fever

What makes up the ANS?

Sympathetic nervous system Parasympathetic nervous system

Excess fluid within the spinal cord is termed _____.

Syringomyelia

What are the 3 classifications of juvenile rheumatoid arthritis?

Systemic Polyarticular Oligoarticular

What are lymphocytes?

T Lymphocytes AND Natural killer- Both help protect against viral infection and can detect and destroy some cancer cells B Lymphocytes- Develop into cells that produce antibodies

What is the innervation level for dermatome testing of the medial forearm?

What is the innervation level for resistive testing of finger ADD?

The Lumbar Plexus is formed by the nerve root of ___ and ___-___

T12 L1-L4

What muscles assist with Hip medial rotation (IR)?

TFL Gluten Med Gluten Min Pectineus Adductor Longus

What are the 3 joints of the forefoot?

Tarsometatarsal joints Metatarsophalangeal joints Interphalangeal joints

Dermatome for C2

Temple Forehead Occiput

What muscles assist with Head retrusion?

Temporalis Masseter Digastric

What muscles assist with Head elevation?

Temporalis Masseter Medial Pterygoid

What are the 3 options for superficial sensory testing?

Tempurature Light touch Pain

What are signs and symptoms of plantar fasciitis?

Tenderness at the insertion of the plantar fascia Heel spurs Pain worse in the morning and after period of prolonged inactivity Difficulty with prolonged standing Pain when walking on bare feet

What muscles assist with shoulder lateral rotation (ER)?

Teres Minor Infraspinus Posterior Deltoid

How do you classify level of SCI through motor index scoring?

Testing each key muscle using the 0-5 scoring, with total points of 25 per extremity for the total possible score of 100

Bilateral occlusion (blockage) of the posterior cerebral artery will typically produce what?

Thalamic pain syndrome and cortical blindness Thalamic pain syndrome- Abnormal sensations of pain, temperature, touch and proprioception Cortical blindness- The loss of vision due to damage to the visual portion of the occipital lobe. Although the affected eye is physically normal, there is full or partial visual loss

What is the Cognitive stage of motor learning?

The 1st stage of learning where there is a high concentration of conscious processing of information. The person will acquire information regarding the goal of the activity and begin to problem solve as to how to attain the goal

What is the associative stage of motor learning?

The 2nd stage of learning where a person is able to more independently distinguish correct vs incorrect performance

What is the autonomous stage of motor learning?

The 3rd stage of learning where a person improves the efficiency of the activity without a great need for cognitive control The person can also perform the task with interference from a variable environment

What part of the brain controls rapid alternating movements?

The Cerebellum

What is plasticity?

The ability of modify or change at the synapse level either temporarily or permanently in order to perform a particular function

What is skill?

The ability to consistently perform functional tasks and manipulate the environment with normal postural reflex mechanisms and balance reactions. Ex. ADLs, community locomotions

What is mobility?

The ability to initiate movement through a functional range of motion

What is stability?

The ability to maintain a position or posture through cocontraction and tonic holding around a joint. Ex. Unsupported sitting with midline control

What is compensation?

The ability to utilize alternate motor and sensory strategies due to an impairment that limits the normal completion of a task

What is placing?

The act of moving an extremity into a position that the patient must hold against gravity

What is the ascending spinoreticular tract?

The afferent pathway for the reticular formation that influences level of consciousness

What is emphysema?

The alveolar walls are gradually destroyed and the alveoli are turned into large, irregular pockets with gaping holes in the walls The elastic fibers that hold open the bronchioles are destroyed, so that they collapse during exhalation, NOT LETTING AIR EXCAPE FROM THE LUNGS DEAD SPACE INCREASES

What does cholesterol test measure?

The amount of cholesterol and triglycerides on the blood

What is distributed practice?

The amount of rest time between trials is equal to or is greater than the amount of practice time for each trial

What is cadence?

The amount of steps over a period of time

What is degree of toe out?

The angle formed by each foots line of progression and a line intersecting the center of the heel and second toe.

What is the body's largest artery?

The aorta

What is the 2nd stage of recovery?

The appearance of basic limb synergies. The beginning of spasticity

Where is the subarachnoid space located?

The area between the arachnoid and pia mater that contains CSF and the circulatory system for the cerebral cortex

Where is the subdural space located?

The area between the dura and arachnoid meninges

What are Pulmonary Arteries?

The arteries that cary deoxygenated blood from the right ventricle to the left and right lungs

Where does the right and left coronary arteries arise from?

The ascending aorta

What is neurogenic reflexive bladder?

The bladder empties reflexively for a patient with an injury above the level T12. The sacral reflex arc remains intact

What is neurogenic nonreflexive bladder?

The bladder is flaccid as a result of a cauda equina or conus medullaris lesion. The sacral reflex arc is damaged

What is the aorta?

The body's largest artery and the central conduit of blood from the heart to the body

What is the apex of the heart?

The bottom of the heart

What is habituation?

The decrease in response that will occur as a result of consistent exposure to non- painful stimuli

What separates the thoracic cavity from the abdominal cavity?

The diaphragm

What is step length?

The distance between the right heel strike and the left heel strike

What is stride length?

The distance measured between right heel strike and the following right heel strike

Abnormal Gait: What is steppage gait?

The feet and toes are lifted through hip and knee flexion to excessive heights; usually secondary to dorsiflexor weakness. the foot will slap at initial contact with the ground secondary to the decreased control

What is the ankle strategy?

The first strategy to be elicited by a small rand and slow velocity perturbation when the feet are on the ground

What is afterload?

The forces that impede the flow of blood out of the heart, primarily the pressure in the peripheral vasculature, the compliance of the aorta, and the mass and viscosity of blood

What are mass movement patterns?

The hip, knee and ankle move into flexion/ extension simultaneously

What is impingement syndrome?

The humeral head and the associated rotator cuff attachments migrating proximally and becoming impinged on the under surface of the acromion and the coracoacromial ligament

What is aphasia?

The inability to communicate or comprehend due to damage to specific areas of the brain

What is dysmetria?

The inability to control the range of movement and the force of muscular activity

What is anterograde amnesia?

The inability to create new memory Last thing to recover after comatose state

What is ideational apraxia?

The inability to formulate an initial motor plan and sequence tasks where the proprioceptive input necessary for movement is impaired

What is agnosia?

The inability to interpret information

What is unilateral neglect?

The inability to interpret stimuli and events on the contralateral side of a hemispheric lesion. Left side neglect is most common with a lesion to the right inferior parietal or superior temporal lobes

What is dysdiadochokinesia?

The inability to perform rapidly alternating movements

What is dysphagia?

The inability to properly swallow

What is astereognosis?

The inability to recognize objects by sense of touch

What is agraphesthesia?

The inability to recognize symbols, letters or numbers traced on the skin

What is bronchitis?

The inflammation of the bronchi Hypertrophy of the mucus secreting glands, increased mucus secretions and insufficient oxygenation due to mucus blockage

What is Raimiste's phenomenon?

The involved lower extremity will abduct or adduct with applied resistance to the uninvolved LE in the same direction

Abnormal Gait: What is scissor gait?

The legs cross the midline upon advancement

What is homonymous hemianopsia?

The loss of the right or left half of the visual field on both eyes

What is a neurologic level?

The lowest segment (most caudal) of the spinal cord with intact strength and sensation. Muscle groups at this level must receive a grade of fair.

What is peak expiratory flow (PEF)?

The maximal flow of air during the beginning of a forced expiratory rate

What is forced expiratory volume (FEV)?

The maximal volume of air exhaled in a specific period of time

What is expiratory reserve volume (ERV)?

The maximal volume of air that can be exhaled after a normal tidal exhalation

What is inspiratory reserve volume (IRV)?

The maximal volume of air that can be inspired after normal tidal volume inspiration.

What is inspiratory capacity?

The maximum amount of air that can be inhaled after a normal tidal exhalation

How do you classify level of SCI through motor level?

The motor level is determined by the most caudal key muscles that have strength of 3 or greater with the superior segment tested as normal or 5

What is an isotonic contraction?

The muscle shortens or lengthens while resisting a constant load

What is CAD?

The narrowing or blockage of the coronary arteries due to atheromatous plaques resulting in diminished blood flow

What is phantom pain?

The patients perception of some sort of painful stimuli as it relates to the residual limb

What is massed practice?

The practice time in a trial is greater than the amount of rest between trials

What is learning?

The process of acquiring knowledge about the world that leads to a relatively permanent change in a person's capability to perform a skilled action

What is a total hip arthroplasty?

The removal of the proximal and distal joint surfaces of the hip with subsequent replacement by an acetabular component and a femoral implant. Cement fixation- immediate WBAT Cementless fixation- PWB/ NWB Last 15-20 years

What is a total knee arthroplasty?

The removal of the proximal and distal joint surfaces of the knee and replacing them with an implant. Unicompartmental- Only the medial or lateral joint surface was replaced. Bicompartmental- The entire surface of the femur and tibia were replaced. Tricompartmental- Replacement of the femur, tibia and patella. Last 15-20 yrs

What is vertigo?

The sensation of movement and rotation of oneself or the surrounding environment

How do you classify level of SCI through sensory level?

The sensory level is determined by the most caudal dermatome with a normal score if 2/2 for pinprick and light touch

What is the epicardium?

The serous layer of the pericardium Contains the epicardial coronary arteries and veins, autonomic nerves and lymphatics

What is atherosclerosis?

The slow hardening of the arteries by accumulation of fatty deposits which form blood clots

What is an ectopic bone?

The spontaneous formation of bone in the soft tissue

What is balance?

The state of physical equilibrium Maintenance and control of the center of gravity Achieving and maintaining and upright posture

What is perseveration?

The state of repeatedly performing that same segment of a task or repeatedly saying the same word/ phrase without purpose.

What is motor learning?

The study of the acquisition and/or modification of movement Learning vs performance

What is motor control?

The study of the nature of movement; or the ability to regulate or direct essential movement

Abnormal Gait: What is vaulting gait?

The swing leg advances by compensating through the combination of elevation of the pelvis and plantar flexion of the stance leg

What is the 3rd stage of recovery?

The synergies are performed voluntarily; spasticity increases

What is preload?

The tension in the ventricular wall at the end of diastole. It reflects the venous filling pressure that fills the left ventricle during diastole

Where are the most common sites for aneurysms?

The thoracic and abdominal aorta and vessels within the heart

What is the superior vena cava?

The vein that returns venous blood from the head, neck and arms to the right atrium

What is the inferior vena cava?

The vein that returns venous blood from the lower body and viscera to the right atrium

What is chronic venous insufficiency?

The veins and valves in the LE are damaged and cannot keep blood flowing toward the heart.Veins remain filled with blood

What are the pulmonary veins?

The veins that carry blood back to the heart from the lungs to the left atrium

What is vital capacity?

The volume change that occurs between maximal inspiration and maximal expiration

What is forced vital capacity (FVC)?

The volume of air expired during a forced maximal expiration after a forced maximal inspiration

What is minute volume ventilation?

The volume of air expired in one minute

What is total lung capacity (TLC)?

The volume of air in the lungs after maximal inspiration The sum of all lung values TCL=RV+VC TCL=FRC+IC

What is anatomical dead space volume (VD)?

The volume of air that occupies the non-respiratory conducting airways

What is stroke volume?

The volume of blood pumped from the left ventricle per beat

What is Risidual Volume?

The volume of gas remaining in the lungs at the end of a maximal expiration

What are implications for PT for anti-epileptic agents?

Therapist must know protocol for seizures and side eddects

The Lumbar Plexus innervates the anterior and medial muscles of the ___

Thigh

What is the open system model?

This is characterized by a single transfer of information without any feedback loop

What is another name for blood platelets?

Thrombocytes

What are the gross motor skills for preschool age (3-4 yrs)?

Throws ball 10ft Walks on a line 10ft Hops 2-10 times on one foot Jumps distances of up to 2ft Jumps over obstacles up to 12inches Throw and catches small ball Runs fast and avoids obsticles

Paresthesia for C6

Thumb Index finger

What muscles assist with Ankle DF?

Tibialis Anterior Extensor Hallucis Longus Extensor Digitorum Longus Peroneus Tertius

What muscles assist with Ankle PF?

Tibialis Posterior Gastroc Soleus Peroneus Longus Peroneus Brevis Plantaris Flexor Hallucis

What muscles assist with Ankle inversion?

Tibialis Posterior Tibialis Anterior Flexor Digitorum Longus

Peak muscle activity during the gait cycle. Name the muscle group: Peak activity is just after heel strike. Responsible for eccentric lowering of the foot into plantar flexion.

Tibialis anterior

What muscles are supplied by the deep peroneal nerve?

Tibialis anterior Extensor digitorum longus Extensor hallucis longus Peroneus tertius Extensor digitorum brevis

Myotome for L4

Tibialis anterior Extensor hallucis

What are some special test for elbow neurological dysfunction?

Tinel's sign

What is the average range of motion for thumb carpometacarpal opposition?

Tip of the thumb to the base of fifth digit

What is the etiology of an ectopic bone?

Tissue hypoxia Abnormal calcium metabolism

What is the purpose of the heart valves?

To control unidirectional flow

What is the purpose of collecting arterial blood gas?

To evaluate acid- base status (pH), ventilation (PaCO2), and oxygenation of arterial blood (PaO2)

What is the purpose of a hematocrit (HCT) test?

To measure the percentage of red blood cells in total blood volume

Whats the purpose of a complete blood count?

To measure the red blood cell count, total white blood cell count, platelets, hemoglobin and hematocit

What is the response for the planter grasp reflex?

Toe flexion

What is polycythemia?

Too many red blood cells Blood too thick

The transverse plane divides the body into _________________ and _________________ portions.

Top Bottom

What is the base of the heart?

Top of the heart

What is tidal volume?

Total volume inspired and expired with each breath during quiet breathing

What is the stimulus for the rooting reflex?

Touch on cheek

What is the stimulus for the galant reflex?

Touching the skin along spine from shoulder to hip

What is the closed system model?

Transfer of information that incorporates multiple feedback loops and larger distribution control

Myotome for C4

Trapezius Levator scapulae

Myotome for C3

Trapezius Splenius capitus

What muscles assist with scapular retraction?

Traps Rhomboids

What muscles assist with scapular upwards rotation?

Traps Serratus Anterior

What are treatments for heart failure?

Treating underlying cause Medication Lifestyle change Surgery/ medical devices

Reflexes affected for C7

Triceps

Myotome for C7

Triceps Wrist flexors

What muscles assist with elbow extension?

Triceps Brachii Anconeus

True or false: People who have cystic fibrosis inherit two faulty CF genes, one from each parent.

True

What are ribs 1-7 called?

True ribs

What is the response to the rooting reflex?

Turning head to same side with mouth open

What are the fine motor skills for a 2 yr old?

Turns knob opens and closes jar Able to button large buttons Uses child sized scissors with help Does 12-15 piece puzzles Folds paper or clothes

What are some special test for wrist/ hand ligamentous instability?

Ulnar collateral ligament instability test

Myotome for C8

Ulnar deviators Thumb extensors Thumb adductors

What is anosognosia?

Unawareness or denial of illness

What is ataxia?

Uncoordinated or unsteady gait

What is lead pipe rigidity?

Uniform and constant resistance to range of motion

What is the etiology of Alzheimers?

Unknown

What is the etiology of Parkinson's disease?

Unknown Contributing factors: - Genetic defect - Toxicity from carbon monoxide - Encephalitis - Huntington's disease - Alzheimers

What is the etiology of atherosclerosis?

Unknown Damage or injury to the inner wall of the artery from hypertension, high cholesterol, smoking or diabetes

What is the etiology of multiple sclerosis?

Unknown Genetics, viral infections and environment all have a role in the development of MS

What is the etiology of hypertension?

Unknown Secondary hypertension- renal cause

What is the etiology of Guillain-Barre syndrome?

Unknown Theory- an autoimmune response to previous respiratory infection, influenza, immunization or surgery

What is the etiology of Amyotrophic Lateral Sclerosis (ALS)?

Unknown Theory- inheritance, virus, metabolic disturbance and toxicity of lead and aluminum

What is the etiology of carpal tunnel syndrome?

Unknown Theory: repetitive use, rheumatoid arthritis, pregnancy, diabetes, cumulative trauma disorder, tumor, hypothyroidism, and wrist sprain or fracture

What are characteristics of a Brainstem CVA?

Unstable vital signs Decreased consciousness Decreased ability to swallow Weakness on both sides of the body Paralysis on both sides of the body

Anaerobic: How long can the ATP - PC System last?

Up to 15 seconds

Anaerobic: How long can Anaerobic Glycolysis last?

Up to 30-40 seconds

Where is the posterior ligament of the elbow located?

Upper portion of the olecranon fossa to just below the olecranon process.

What nerves are supplied from the posterior cord of the brachial plexus?

Upper subscapular Thoracodorsal Lower subscapular Axillary Radial

Dermatome for T3-T6

Upper thorax

What muscles assist with scapular elevation?

Upper trap Levator Scap

What is a Craig-Scott KAFO?

Used for those with paraplegia shoe attachments with reinforced foot plates. Design allows a person to stand with a posterior lean of the trunk.

What is the suspensory strategy ?

Used to lower the center of gravity during standing or ambulation in order to better control the center of gravity ex. knee flexion, crouching, squatting

What is timing for emphasis (TE)? *Skill

Used to strengthen the weak component of a motor pattern. Isotonic and isometric contractions produce overflow to weak muscles

What is the purpose of two point discrimination sensory testing?

Using a 2 point caliper on the skin, identify one or two points without visual input

What is slow reversal hold (SRH)? *Stability *Controlled mobility *Skill

Using slow reversal with the addition of an isometric contraction that is performed at the end of each movement in order to gain stability

What is unstable angina?

Usually is more intense, last longer, is precipitated by less exertion, occurs spontaneously at rest, is progressive, or any combination of these

What is the equation for vital capacity?

VC=TV+IRV+ERV

What is the equation for minute volume ventilation?

VE = TV x Respiratory rate minute volume ventilation = tidal volume x respiratory rate

What is a vestibulo-ocular reflex (VOR)?

VOR allows for head/ eye movement coordination Supports gaze stabilization through eye movement that counters movements of the head Maintains a stable image on the retina during movement

What is a vestibulospinal reflex (VSR)?

VSR attempt to stabilize the body and control movement Assists with stability while the head is moving as well as coordination of the trunk during upright postures

What are the most common motions for a MCL injury?

Valgus load at the knee without rotation Lateral blows to the knees *Contact activities

What are special tests for a MCL injury?

Valgus stress test

What are examples of muscle relaxant agents?

Valium Flexeril

What is a special test for a LCL injury?

Varus stress

What are some special test for elbow ligamentous instability?

Varus stress test Valgus stress test

What are the most common motions for a LCL injury?

Varus stress without rotation Medial blow to the knee **Contact sports

What is random practice?

Varying practice amongst different tasks

What muscles are supplied by the femoral nerve?

Vastus lateralis Rectus femoris Vastus medialis Vastus intermedius Iliacus Sartorius Pectineus

What is ventricular diastole?

Ventricular relaxation

What is the wall between the left and right ventricle?

Ventricular septum

Dermatome for C1

Vertex of skull

What is the reflex name for a 4+ grade and is it normal?

Very brisk/ hyperactive Always abnormal

What is poliomyelitis?

Viral infection resulting in neuropathy that includes local and asymmetrical motor impairments

What are signs and symptoms of multiple sclerosis?

Visual problems Paresthesia and sensory changes Clumsiness Weakness Ataxia Balance dysfunction Fatigue **Period of exacerbations and remissions

What is functional residual capacity (FRC)?

Volume of air remaining in lungs at end of normal exhalation

What are functions of the frontal lobe of the brain?

Voluntary movement (primary motor cortex/ precentral gyrus), intellect, orientation Brocas area (typically located on the left hemisphere): speech, concentration Personality, temper, judgement, reasoning, behavior, self-awareness, executive functions

What are the gross motor skills for a 10-11 month old in mobility?

Walks with both hands held Walks with one hand held Creeps on hands and feet (bear walk)

What are the gross motor skills for a 12-15 month old?

Walks without support Fast walking Walks sideways Bends over to look between legs Creeps or hitches upstairs Throws ball in sitting

What is the etiology of chronic venous insufficiency?

Weak or damaged valves inside the veins

What are signs and symptoms of diabetic neuropathy?

Weakness and sensory disturbances occur distally in a symmetrical pattern Tingling, numbness, pain, especially in the feet

What are characteristics of a Right Hemisphere CVA?

Weakness, paralysis of the left side Decreased attention span Left hemianopsia Decreased awareness and judgement Memory deficits Left inattention Decreased abstract reasoning Emotional lability Impulsive behaviors Decreased spacial orientation

What are characteristics of a Left Hemisphere CVA?

Weakness, paralysis of the right side Increased frustration Decreased processing Possible aphasia Possible dysphagia Possible motor apraxia Decreased discrimination between left and right Right Hemianopsia

What are treatment options for CAD?

Weight loss Stop Smoking Diet Medication Surgery

What is the stimulus for the positive support reflex?

Weight places on balls of feet when upright

What is a synergy pattern?

What the higher centers of the brain lose control and the uncontrolled or partially controlled stereotyped patterns of the middle and lower centers emerge

What are signs and symptoms of asthma?

Wheezing Chest tightness Slight shortness of breath

What is active insufficiency?

When a 2 joint muscle contracts across both joints simultaneously

What is passive insufficiency?

When a 2 joint muscle lengthens across both joints simultaneously

What is pulmonary edema?

When fluid collects in the alveoli within the lungs, making it difficult to breathe

What is the response of symmetrical tonic neck reflexes (STNR)?

When head is in flexion, arms are in flexion and legs are in extension. When head is in extension, arms are in extension and legs are in flexion

What is the etiology of pulmonary edema

When the left ventricle is unable to pump blood adequately (left side heart failure). As a result, pressure increases inside the left atrium and then in the pulmonary veins and capillaries, causing fluid to be pushed through the capillary walls into the alveoli

Abnormal Gait: What is festinating gait?

Where a patient walks on toes as though pushed. Ot starts slowly, increases, and may continue until the patient grasps an object in order to stop

What is a closed TBI?

Without penetration to the skull

Is Alzheimer's more common in men or women?

Women

Is acute pulmonary edema a medical emergency?

Yes

What is an embolus?

a blood clot (can be a solid, liquid or gas) that has broken loose and is floating freely in the blood stream of the cerebral arteries

What is rheumatoid arthritis?

a chronic progressive autoimmune disease causing inflammation in the synovial tissue of a joint that results in erosion of cartilage Common in small joints 1-2% of american population is affected Woman x3 more than men Onset: 40-60yrs

What is Achilles tendonitis?

a repetitive overuse disorder resulting in microscopic tears of collagen fibers on the surface or in the substance of the Achilles tendon

What is cardiac output?

amount of blood pumped by the left OR right ventricle in one minute

What is Parkinson's disease?

degenerative disorder of the CNS resulting in loss of dopamine neurotransmitters Responsible for voluntary movement

What are the fine motor skills for a 8-9 month old?

develops active supination Radial- digital grasp develops Uses inferior pincer grasp Extends wrist actively Points with index finger Pokes with index finger Release of objects is more refined Takes objects out of containers

What should you feel with a soft abnormal end feel?

ex. edema synovitis ligament instability/ tear

What should you feel with a hard abnormal end feel?

ex. fracture osteoarthritis osteophyte formation

What should you feel with a firm abnormal end feel?

ex. increased tone tightening of a capsule ligament shortening

What are signs and symptoms of down syndrome?

flattened face, small head, short neck, protruding tongue, upward standing eyelids (palpebral fissures), unusually shaped or small ears, poor muscle tone; broad, short hands with a single crease in the palm; relatively short fingers and small hands and feet, Brushfield's spots

The spinal cord runs from the _____ to the _____.

foramen magnum Conus medullaris (L1/L2)

What is adhesive capsulitis?

frozen shoulder- soft tissue contracture More common in women Occurs mostly between 40-60 yrs of age Occurs a lot in diabetics due to decreased blood flow lasts usually 1-2 yrs

What is hypertension?

high blood pressure 140/90 < x >95th percentile for children

What is the etiology of epilepsy?

idiopathic or r/t another condition (causing abnormal brain wiring)

What is the etiology of cerebral palsy?

lack of oxygen, maternal infection, drug or alcohol abuse, placental abnormalities, prolonged labor

What is an isokinetic contraction?

tension developed by the muscle, while shortening or lengthening at a constant speed, is maximal over the full range of motion

What is controlled mobility?

the ability to move within a weight bearing position or rotate around a long axis. Ex. Activities in prone on elbows or weight shifting in quadruped

What is post- traumatic amnesia?

the time between the injury and when the patient is able to recall recent events. Patient does not recall the injury or events up until this point in recovery.

What is a compound fracture?

type of fracture where the bone breaks through the skin

What are signs and symptoms of juvenile rheumatoid arthritis?

~ Systemic 10-20% of the cases, and present with acute onset, high fever, rash, enlargement of the spleen and liver, inflammation of the lungs and heart ~ Polyarticular 30-40% of the cases, and present with high female incidence, significant rheumatoid factor, and arthritis in more than four joints with symmetrical joint involvement ~ Oligoarticular 50-60%, affects less than 5 joints with asymmetric joint involvement

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