Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
78 Cards in this Set
- Front
- Back
|
Knee joint
|
tibio-femoral joint
patello-femoral joint Synovium excludes cruciate ligaments = extracapsular ligaments |
|
|
Loose Packed position
|
Resting
-ROM where joint is under the least amount of stress -joint capsule has greatest capacity -minimal congruence -ligaments lax -passive separation of joint surface is greatest |
|
|
Closed Packed Position
|
-Maximum tension
-fully congruent joint surfaces -tightly compressed -ligaments are maximally tight -position of maximal joint stability |
|
|
Capsular Pattern
|
pattern of limitation or restriction by a joint with capsule pathology
ONLY JOINTS THAT ARE CONTROLLED BY MUSCLES HAVE A CAPSULAR PATTERN!! |
|
|
Knee menisci movement
|
move with the tibia during flexion and extension, and with the femur during rotation
|
|
|
Medial meniscus
|
-more C-shaped
-loosely attached by coronary ligament -attached to the medial collateral ligament (MCL) |
|
|
Lateral meniscus
|
-more O-shaped
-more mobile because it doesn't attach to LCL or the capsule -arcuate ligament and lateral meniscus are both attached to the popliteus muscle |
|
|
ACL
|
Anterior cruciate ligament
-posterio-lateral part of femur to anterio-medial part of tibia -resist anterior translation of the tibia -most common injured knee ligament -torn by dislocation, torsion, or hyperextension |
|
|
PCL
|
posterior cruciate ligament
-connects posterior intercondylar area of tibia to medial condyle of femur -resist posterior translation of the tibia -common injury: "dashboard injury" |
|
|
Patella position
|
normal: squarely against the anterior femur
Lower posture: patella baja Higher posture: patella alta (less efficient in exerting concentric contractions |
|
|
Screw home mechanism
|
knee glides more in the medial side because the medial meniscus is larger than the lateral side. This produces external tibial rotation or (internal rotation of the femur)
|
|
|
Popliteus
|
prevents tibial external rotation with increasing knee flexion
-active in screw-home mechanism in terminal knee extension: initiates knee flexion by unscrewing the locked knee |
|
|
Male and female alignment (LE)
|
Male: narrower pelvis, genu varum
Female: wider pelvis, femoral anteversion, genu valgum, lateral femoral torsion |
|
|
Q-angle
|
angle between quadriceps muscles and patellar tendon (ASIS to patellar midpoint and tibial tubercle to patellar midpoint)
|
|
|
Knee pathology
|
Malalignment
-genu varum -genu valgum -genu recurvatum -lateral tibial torsion -medial tibial torsion Osgood Schlatter Sprains, strains Meniscal tear |
|
|
Genu Valgum
|
-pes planus
-excessive subtalar pronation -lateral tibial torsion -lateral patellar subluxation -excessive hip adduction -ipsilateral hip excessive medial rotation -lumbar spine contralateral rotation |
|
|
Genu varum
|
-excessive lateral angulation of the tibia in the frontal plane (tibial varum)
-medial tibial torsion -ipsilateral hip lateral rotation -excessive hip abduction |
|
|
Genu recurvatum
|
knee extension greater than 5 degrees
-knee pain -extension gait pattern -consequence have for femur is ROTATION |
|
|
Tibial Torsion
|
13-18 degrees is normal
greater than 18: toe-out from lateral tibial torsion less than 13: toe-in possibly from medial tibial torsion or excessive femoral anteversion |
|
|
squinting patellae
|
femoral anteversion and tibial external rotation
|
|
|
Genu recurvatum (poss. motions or postures)
|
ankle plantar flexion
excessive anterior pelvic tilt |
|
|
Lateral tibial torsion
|
Out toeing
excessive subtalar supination with related rotation along the lower quarter |
|
|
medial tibial torsion
|
in-toeing
metatarsus adductus excessive subtalar pronation with related rotation along the lower quarter |
|
|
"miserable malalignment syndrome"
|
increased femoral anteversion, genu valgum, VMO dysplasia, lateral tibial torsion, foot pronation
|
|
|
Coxa valga/vara
|
femoral neck angles
-coxa valga: 170 degrees -normal: 125 degrees -coxa vara: 100 degrees |
|
|
femoral anteversion
|
normal angle: 15 degrees
excessive anteversion in the hip: toeing in retroverted hip: toeing out |
|
|
Excessive anteversion
|
toeing-in
subtalar pronation lateral patellar subluxation medial tibial torsion medial femoral torsion |
|
|
Excessive retroversion
|
toeing out
subtalar supination lateral tibial torsion lateral femoral torsion |
|
|
Coxa vara
|
pronated subtalar join
medial rotation of leg short ipsilateral leg anterior pelvic rotation |
|
|
Coxa valga
|
supinated subtalar joint
lateral rotation of leg long ipsilateral leg posterior pelvic tilt |
|
|
functional leg length discrepancy
|
-foot supination (lengthening)
-foot pronation (shortening) -hip extension and external rotation (lengthening) -SI anterior rotation (lengthening) -SI posterior rotation (shortening) |
|
|
sub-talar pronation can be caused by: (4)
|
-medial tibial torsion
-genu valgum -coxa vara -excessive hip anteversion |
|
|
manual muscle testing
|
Normal: 5 (whole hand resistance)
Good: 4 full active ROM against 2 finger resistance Fair: 3 complete full active ROM against gravity Poor: 3 partially complete active available ROM Trace: 1 slight contraction of muscle with no movement |
|
|
Limited ROM causes
|
muscle weakness
nerve damage spine damage arthritis |
|
|
Painful arc
|
subacromial bursitis
tendonitis of rotator cuff |
|
|
supraspinatus impingement
|
Neer (supraspinatus): greater tuberosity jams against acromion
Hawkins-Kennedy: supraspinatus tendon pushed against anterior surface of coracoacromial ligment and coracoid process |
|
|
labral tearing
|
common in throwing athletes
|
|
|
multidirectional instability
|
arm straight and relaxed to side, the elbow is pulled inferiorly.
-a depression occurs below the acromion INSTABILITY |
|
|
scapular stability
|
wall push up, scapular retraction
WINGING IS SERRATUS ANTERIOUS WEAKNESS OF LONG THORACIC NERVE INJURY push up position and touch hands |
|
|
Muscle/tendon pathology
|
empty can: SUPRASPINATUS
lift off: SUBSCAPULARIS |
|
|
Lateral epicondylitis
|
passively pronate arm, flex wrist fully and extend elbow
resist 3rd finger extension wrist extensors |
|
|
Osteoartritis
|
Heberdens and bouchard's nodes
degenerative (breakdown and loss of cartilage) |
|
|
Rheumatoid Arthritis
|
Boutonniere and swan-neck deformity
autoimmune disease that causes chronic inflammation of joints Treatment: reduce joint inflammation and pain, maximize joint function, and prevent joint destruction and deformity |
|
|
Murphy's sign
|
lunate dislocation if the 3rd nuckle is level with the others
|
|
|
Finkelstein test
|
pain over abductor pollicis longus and extensor pollicis brevis at wrist is indicative of tendonitis
|
|
|
Tinel's sign
|
carpal tunnel syndrome
causes tingling and paraesthesia into first 3 fingers |
|
|
Phalen's sign
|
flex wrists maximally and hold for 1 min
|
|
|
facial profiles
|
orthognathic profile "straight jaw"
Retrognathis profile: "receding chin" Prognathic profile: "protruded" or "strong" chin |
|
|
Shoulder girdle movements (primary and accessory)
|
Primary:
-elevation -depression -abduction (protraction) -adduction (retraction) -upward rotation downward rotation Accessory movements -anterior and posterior rotation of clavicle -anterior and posterior tilt of the scapula -scapular winging |
|
|
Humeral head angles
|
head is angled 130-150 degrees to the shaft
transverse plane is angled posteriorly (retroversion) |
|
|
Force couples
|
Shoulder complex muscles can be classified by anatomic and functional groupings
-axioscapular muscles (stabilize and rotate the scapula) trapezius, rhomboids, levator scapulae, serratus anterior -extrinsic shoulder girdle muscles: pedctoralis major and minor, deltoid, subclavious, biceps, triceps, and lats -rotator cuff muscles: supraspinatus, infraspinatus, subscapularis, and teres minor agonists and antagonists working together as force couples |
|
|
Shoulder ROM glenohumeral
|
Resting position: 40 - 55 abduction, 30 horizontal adduction (scapular plane)
Close packed position: full abduction, ER Capsular pattern: ER, abduction, IR |
|
|
thoracic outlet syndrome
|
compressed blood vessels and nerves by structures in the thoracic outlet region
stretching and moving clavicle can reduce pain... |
|
|
speed's
|
biceps
|
|
|
yergason's
|
biceps tendon stability in bicipital groove
|
|
|
Elbow (radiohumeral joint)
|
Resting position: elbow flexed to 90˚, supination 5˚
Close packed position: full extension, full supination Capsular pattern: flexion, extension, supination, pronation |
|
|
Elbow (ulnohumeral joint)
|
Resting position: 70˚ elbow flexion, 10˚ supination
Close packed position: extension with supination Capsular pattern: flexion, extension |
|
|
radio-ulnar joint
|
functional unit
pivot joint movements: supination and pronation |
|
|
carrying angle
|
10-15 degrees
people with more carrying angle is more likely to pronate forearm when holding objects in the hand to keep load closer to the body |
|
|
carpal tunnel
|
4 tendons to flexor digitorum superficialis
4 tondons to flexor digitorum profundus flexor pollicis longus flexor carpi radialis |
|
|
radiocarpal joint
|
radioulnar disk
scaphoid, lunate, triquetrum |
|
|
Dupuytren's contracture
|
connective tissue under skin of palm contracts and toughens over time
after 40, mostly ring and little finger involved |
|
|
Exercise: three types
|
Flexibility: stretching improve ROM of muscles and joints
Aerobic exercises: cycling, walking, running, hiking--increasing cardiovascular endurance Anaerobic exercises: weight lifting, functional training or sprinting increase short term muscle strength |
|
|
exercise to restore strength and ROM
|
Active exercise
-active assistive, active, active resistive Passive exercise -physiological ROM -passive accessory movement (arthrokinematics) |
|
|
Structural or FUnctional (thoughts of musculoskeletal medicine)
|
Structural: specific static structures is emphasized, diagnosis based on localized evaluation (x-ray, MRI, CT scan)
Functional: recognizes function of all processes and systems within the body rather than on single site of pathology Structural if for acute injury Functional is when addressing chronic musculoskeletal pain |
|
|
Vladimir Janda
|
two groups of muscles based on phylogenetic development
-tonic: flexors, dominant -phasic: extensors, work eccentrically against force of gravity Upper and lower crossed syndrome |
|
|
Upper crossed syndrome
|
Inhibited (weak): deep cervical flexors, Lower trap, serratus ant, lower and middle trap
Facilitated (strong): SCM, pectoralis, upper trap, levator scapula, suboccipitals |
|
|
Lower crossed syndrome
|
inhibited (Weak): Abdominals, gluteus min, med, max
facilitated (tight): thoraco-lumbar extensors, quadratus lumborum, rectus remoris, iliopsoas |
|
|
Muscle (active and passive)
|
Active element: muscle tissue
-bundles fascicles -bundles of muscle fibers -myofibrils -thick and thin filament fibers Passive element: wrappings (epi, peri, endo) which make up the tendon |
|
|
Extrafusal
|
Extrafusal muscle fibers:
-contains myofibrils -intervated by alpha motor neurons, -contract and generate muscle tension |
|
|
Intrafusal
|
Intrafusal fibers (muscle spindles)
-parallel to extrafusal fibers -innervated by gamma motor neurons -stretch receptors are primary proprioceptors in muscle; sensitive to change in muscle length and rate of change in muscle length -fibers are stretched in 2 different ways: muscle stretch and muscle contraction |
|
|
Monosynaptic stretch reflex
|
when muscle is stretched, so is the muscle spindle
-muscle spindle records change in length and sends signals to spine (stronger or faster the stretch, the stronger the message) -stretch reflex is triggered. (myotatic reflex) |
|
|
function of muscle spindle
|
helps to maintain muscle tone and protect body from injury
|
|
|
Monosynaptic stretch reflex example
|
patella tendon
only involves one synapsis..FAST! synapses with alpha motor neurons that innervate the same muscle |
|
|
golgi tendon organ
|
located in the tendon near the end of the muscle fiber
sensitive to change in tension and rate of change of the tension stimulated when muscle contracts sends signal to spinal cord and then sends a reflexive message to the muscle to relax PROTECTIVE MECHANISM THAT STOPS CONTRACTION BEFORE THE TENSION IS GREAT ENOUGH TO RIP ALL OR PART OF THE TENDON FROM THE BONE |
|
|
Myotatic stretch reflex (autogenic inhibition)
|
Polysynaptic reflex
-contains at least one interneuron between sensory and motor neuron lengthening is only possible because the signaling of golgi tendon organ to the spinal cord is powerful enough to overcome the signaling of muscle spindles telling the muscle to contract |
|
|
Active/passive stretch
|
Active: agonist of the to be stretch muscle is contracted "reciprocal inhibition"
-contract DF to stretch PF passive: external force is used to slowly increase available ROM "inverse myotatic reflex" |
|
|
PNF stretch
|
Contract-relax: contract muscle, then relax and stretch more
Contract-relax-antagonist-contract: reciprocal inhibition |
