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65 Cards in this Set
- Front
- Back
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What are the 4 general functions of ligaments?
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• Ligaments are designed to limit abnormal or excessive movements at a joint
• Ligaments do permit normal motion • Ligaments are slightly elastic • Ligaments are part of a reflex response to excessive movement. |
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What type of joint is the pubic symphysis?
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secondary cartilaginous joint (that has an interpubic disc)
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What are the MAJOR hip flexors? Lesser?
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illacus and psoas; lesser: rectus femoris and sartorius
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What are the hip extensors?
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Three hamstrings (semimembranosus, semitendinosus, biceps femoris) and gluteus maximus
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What are the hip adductors?
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adductor magnus, brevis, and longus
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Common origin of hip adductors?
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All attach to the pubic ramus and the medial and/or posterior femur
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What are the abductors of the hip?
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gluteus medius and minimus (and tensor fascia lata)
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What are the lateral/external rotators of the hip?
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piriformis, obturator internus and externus, gemellus superior and inferior, and quadratus femoris
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What is the only rotator that connects directly to the sacrum?
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piriformis
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If you have an anterior innominate rotation dysfunction, where are the ASIS, PSIS, and malleolus?
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inferior ASIS, superior PSIS, and long or inferior malleolus ALL on the AFFECTED SIDE
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If you have a right side superior ASIS, inferior PSIS, and short malleolus, what is the somatic dysfunction?
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Right posterior innominate rotation dysfunction
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How do you decide which side is dysfunctional when testing the innominate?
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Side of the POSITIVE test for standing flexion test and/or pelvic compression test is the AFFECTED side
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What is a positive standing flexion test?
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When bending over, if one innominate locks early, its PSIS will elevate sooner (and probably farther) than the PSIS on the other side. This would be a positive test for the iliosacral somatic dysfunction of the ipsilateral side
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A medial malleolus that is more cephalad on the side of a positive standing flexion test may indicate what?
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It may indicate a shorter leg, a superior innominate shear, or a posteriorly rorate ilium on that side
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A medial malleolus that is more pedad on the side of a positive standing flexion test may indicate what?
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It may indicate a longer leg, an inferior innominate shear, or an anteriorly rotated ilium on that side
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Where does the abdominal diaphragm anchor?
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L1-L2
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What three muscle (groups) attach to the lumbar spine?
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diaphragm, erector spinae, L. dorsi (and, through fascia, the oblique abdominals and lower extremity muscles: gluteals, hamstrings, IT band)
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What sympathetic innervation is associated w/ the lumbar spine?
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What parasympathetic innervation is associated w/ the lumbar spine?
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Describe the shape and/or orientation of the spinous processes and superior/inf. facets of the lumbar vertebrae.
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What happens if the lamina fail to fuse and form the spinous process?
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spina bifida
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What is the average degree of curve of the lumbar spine?
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43 degrees
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Does the lumbar spine achieve extension or flexion better?
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extension
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In what plane does the facet joint space lie for the lumbar vertebrae?
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coronal plane
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Where does spina bifida most commonly occur? It is associated w/ increased incidence of what vertebral dysfunction?
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L5-S1
associated w/ spondylolisthesis |
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What is the difference b/w spina bifida occulta, menigocele, and myelomeningocele?
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occulta: spinal defect, no herniation of structures
meningocele: herniation of meninges myelomeningocele: meninges + spinal cord herniation |
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Where does the spinal cord terminate?
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L1-2
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T of F. The spinal canal decreases in diameter w/ age.
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True
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What are some causes of spinal canal compromise?
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Pt. presents w/ progressive weakness and paralysis of the lower extremities and "saddle numbness", and bladder/bowel incontinence. What could be a lumbar-region cause?
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Cauda equina syndrome (edema of the spinal cord). A surgical emergency
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The iliolumbar ligament connects what to what?
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Connects the transverse process of L4 and 5 to the iliac crest and the SI joint
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What is the first ligament to become tender in lumbosacral postural decompensation?
Where will you find the tender point? |
Iliolumbar ligament
Tender point: 1 in. lateral and 1 in. superior to PSIS |
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What is the second most common reason pts. go to see the doctor?
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low back pain
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How is spondylolisthesis graded?
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degree of anterior slippage:
Grade 1: 0-25% 2: 25-50 3: 50-75 4: 75-100 |
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What are 3 non-mechanical causes of low back pain?
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renal colic, endometriosis, and abdominal aortic aneurysm
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If you translate a cervical (typical) segment to the R, which way does it SB?
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to the L (opposite)
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Pt comes in after MVA and says "i'm not sore!". What do you say?
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Warn them that they will be more sore tomorrow
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What are 2 important of predictors of chronic neck pain at 1 yr after MVA?
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1. pain at time of collision
2. presence of lawsuit compensation |
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Major motions of OA joint?
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flex/extend
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What are contraindications of HVLA of cervical spine?
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RA, downs, PVD, osteoporosis, pt.s on anticoags
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Right rotation occludes which vertebral artery?
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Left
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Speeds as low as what in an MVA can cause tissue damage?
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7 mph
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What is the first muscle to be injured in a hyperext/hyperflex accident?
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sternocleidomastoid
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Key nerve in the post neck/head that can cause much of the pain associated w/ whiplash?
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greater occipital (also lesser and suboccipital)
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Spasm of the SCM muscle causing a rotational tilting of the neck. Dx?
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torticollis
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spasm of the trapezius muscle causing a lateral tilt of the neck. Dx?
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laterocollis
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spasm of one or all of the ant. neck muscles causing flex of the neck. Dx?
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anterocollis
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spasm of one ore more of the post neck muscles causing a "backward flexion" of the neck. Dx?
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retrocollis
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Describe the stretching treatment for congenital torticollis.
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Stabilize chest and shoulders. Tilt head away from contracted muscle and rotate chin TOWARDS contracted side. hold 10 sec. do 15 reps
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What is the sympathetic innervation to the heart?
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T1-T6
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What is the symp. innervation to the SA node and what does hyperactivity predispose to?
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Right side fibers pass to right deep cardiac plexus
predisposes to SVTs |
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What is the symp. innervation to the AV node and what does hyperactivity predispose to?
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Left-side fibers pass through left deep cardiac plexus and innervate AV node
predisposes to ectopic foci and VF |
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Post-MI, increased symp. tone is associated w/ what vascular problems?
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coronary vasospasm and inhibition of collateral circulation development
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What is the parasymp. innervation to the SA node and what does hyperactivity predispose to?
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Right vagus
hyper: sinus bradyarrhythmias |
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What is the parasymp. innervation to the AV node and what does hyperactivity predispose to?
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Left vagus
hyper: AV block |
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Primary vagal connections to heart are associated w/ what vertebrae?
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OA, AA, C2 areas.
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What provides most of the lymphatic drainage from the heart and lungs?
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right lymphatic duct
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Thoracic duct is under what autonomic control?
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sympathetic
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Where are cardiac and coronary (MI) palpatory findings located?
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T2-T4 on the left
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Palpatory findings w/ ant. MI?
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T1-4 on the left
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Palpatory findings w/ post. and inf. MI?
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C2
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What chapman's points are associated w/ essential HTN?
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T11-12
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Common CXR heart finding in HF?
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cardiomegaly
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Categories of HF?
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A: high risk for development
B: structural disorder of heart, no Sx C: Sx + structural disorder D: end stage |
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What is the order of the History and Physical?
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CC, HPI, PMH, PSH, meds, allergies, Soc, Fam, ROS, PE, Imp/A, Plan
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