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Terms in this set (93)
Type of joint that is Nonsynovial immovable (growth plate between distal ends of radius and ulna, root of tooth to mandible)
Type of joint that is Non-synovial slightly movable (vertebrae, symphysis pubis)
The type of joint that is freely movable (shoulder, elbow)
Where can synovial fluid be located?
On sliding bone surfaces
Fibrous capsules that are surrounded by ligaments
What are the categories of synovial joints?
Uniaxial (hinge, pivot)
Biaxial (saddle, condyloid)
Multiaxial (ball and socket, gliding joint)
The uniaxial joint that has angular movement in 1 axis and 1 plane
Elbows, fingers, knees
The uniaxial joint that has rotary movement, a ring rotates around a pivot
Radioulnar, 1st and 2nd cervical vertebrae
The type of biaxial joint that has articulating surfaces where one bone is convex and the surface of the other bone is concave
The type of biaxial joint that has angular motion on 2 places without axial rotation
Wrist between distal radius and carpels
The type of multiaxial joint where there is a round end of bone into cuplike cavity
Shoulder and hip
Ball and socket
The type of multiaxial joint that has gliding motion
Vertebrae, tarsal bones of ankle
Strong connective tissue, outer cover of muscle belly, attaches muscle to bone
The avascular, dense, connective tissue that covers and of opposing bones withstands increased pressure and tension
Strong fibrous connective tissue, connect bones to each other at joint level and encase capsule, support purposeful joint movement and prevent wrong movement
enclosed sac filled with viscous fluid located in joint areas of potential friction
As you get your history from the patient, it is very important with an injury or compliant to find out what?
How the injury occurred (activity, trauma)
If and how the patient has self treated
What type of medication should you ask the patient about history of use in the M/S assessment?
Use of NSAIDS
When looking at a joint, like the knee, and you see lack of nooks and crannies?
Effusion, thickening of synovial lining, inflammation of bursa, tendons, and bony enlargement
Fusion of bones across a joint (stiffness)
What are the types of ROM assessments?
What is isometric ROM?
Patient contracts muscles at injured area without moving bones
Note any visible defects
Movement away from the midline of the body
Movement toward the midline of the body
When palpating a joint and you feel crepitus, seen with what?
Patient has full ability to demonstrate full range of motion/full resistance of the joint with you the examiner applying for pool or force in the opposite direction. What grade would you give on muscle strength?
Patient has full range of motion/some resistance. The examiner uses less opposite pool or force. What grade would you give when assessing muscle strength?
The patient has full range of motion with gravity. There is no resistance supplied by the examiner but the patient is able to have full range of motion against normal Gravity. What grade would you get when assessing muscle strength?
The patient has full range of motion with gravity removed. What grade would you give when assessing muscle strength?
The patient has a slight contraction, 10%. What grade would you get one testing muscle strength?
No contraction noted. What would grade would you give when assessing muscle strength?
What muscle strength grade indicates a disability?
3 or less
Strain vs sprain?
Strain- muscle heals faster
Sprain- ligament heals slower
A patient has pain with passive range of motion?
Joint, ligament, bursa
A patient has pain with active range of motion?
A patient comes in with pain but unknown cause. The pain comes after activity. The pain is vague, she can't point to one spot, no pain with rest. Physical exam shows no ecchymosis, no knot. Nearly full range of motion, nearly full strength, gate without limp or mild. What grade muscle strain would you give this?
A patient comes in complaining of pain after several steps, and muscle spasms. She is able to locate the pain in one small area or spot. Upon physical examination a knot is palpable and Ecomosis/swelling is possible. Patient reports pain between 1/2 to 3/4 with stretch on range of motion. Patient has significantly decreased strength to resisted contraction with pain. A definite limp is noted with gait. Antalgic gait. What grade Strain would you give this patient?
Patient comes in saying that it feels like someone hit me with a rock. Sudden intense pain accompanied by a snap. The pain is at the point of area of tear in tendon or muscle belly. Physical exam shows visible tear defect and muscle belly - a hole. No active range of motion, intense pain in first 1/3 of range. Patient unable to develop tension in muscle unit. Patient unable to use muscle to ambulate. . What grade Strain would you give this patient?
Which muscles are involved in a rotator cuff?
How do you test for a strain in the supraspinatus?
How do you test for a strain in the suprascapularis, pectoralis, latissimus dorsi?
How do you test for a strain in the infraspinatus?
How do you test for a strain in the subscapularis?
How do you test for a strain in the biceps?
How do you test for a strain in the triceps?
How do you test for a bursitis?
How do you test for strain on rotator cuff?
+resisted bicep/tricep pain
Serratus muscle damage
Broken clavicles are often silent in infants but may be noticed later when a _______ forms a few weeks of age.
Big red elbow?
Muscle mass inflamed as it attaches to bone
What is golfers elbow?
What is tennis elbow?
How do you test for epicondylitis?
Nurse maids elbow?
radial head dislocation
Patient fingers are spread outward?
Patients wrist is in extreme flexion?
Patient has a swan neck deformity of the hand?
Seen with RA
palmar aponeurosis undergoes a nodular
thickening . Ring and litle finger( flexion contracture)
flexion of PIP joint and hyperextension of DIP joint
Dupuytren's contracture usually appears between age ___ and ___ years. It occurs more often and is more severe in _____ or persons of _____ origin. Can be associated with ____, epilepsy (due to meds), and or DM, and has genetic _____ in some cases. It occurs most often in the ___ and _____ fingers and is bilateral ___% of the time.
Patient has numbness, tingling, weakness in hands, sleepless nights, and pain up and down arm. +tinnels and +phalens (most specific)
Carpal tunnel syndrome
What causes carpal tunnel syndrome?
Repetitive use, endocrine as with DM, pregnancy, thyroid, anoxia
"pins and needles" sensation felt when an injured nerve (median nerve of wrist) site is tapped
webbed fingers or toes
Where is C7?
Top of scapula, base of neck
Where is T7-8?
Bottom of scapula
Where is L4?
Where is the piriformis muscles located?
Sacrum to greater trochanter
Unable to keep other leg flat on table when bending knee to chest
Indicates hip flexion contracture
What is a significant limb discrepancy?
>3cm may be congenital or fracture or dislocation
How do you preform it?
Degenerative disc disease
Patient supine, position heel of right for on knee of left leg. Lower right leg to table with modified pressure
+ test: unable to lower leg or pain in lower back or inguinal area
Where can bursitis be in the hip?
Ileopectinal (find femoral pulse and go lateral)
How to auscultate for hip fracture?
Auscultate over symphysis pubis when gently tapping on one patella and then the other. If hips/knees have never been replaced, the sounds should be equal. But if there is a decrease in sound the chance of a fracture is sig higher
What infants are at risk for hip dysplasia?
Which hip is more common?
female gender, first born, and babies born in breech position
What does it test for?
What is a positive test?
Dislocated hip that can be reduced
There is a palpable clunk as the hip reduces back into position
What does it test for?
An unstable hip that is in a reduced position that can be passively dislocated
Palpable clunk may be detected as a the femoral head exits the acetabulum
What degree of spine curvature requires an X-ray?
When using a scoliiometer, what degree needs an extra and referral?
Patient comes in with lower back pain. She felt when it occurred, palpable pain, no radiculopathy.
Patient with Huntington disease comes in with pain that starts *********** and radiates down mid posterior thigh, at the knee it separates and does medial/lateral back of leg.
How to test for herniated disc?
Walk on toes/heel (pain or inability)
Straight leg raise (pain into hip and down leg)
DTR- patellar and Achilles
Contralateral pain- worse sign
Absent DTR of MPT?
L2,3,4 herniated disc
Absent DTR at Achilles?
L5,S1 herniated disc
Sensory loss at great toe?
Herniated disc at L5
Sensory loss inside heel?
Herniated disc at L4
Sensory loss at 5th toe?
Herniated disc at S1
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