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41 Cards in this Set
- Front
- Back
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Discuss the MSK Imaging modalities, which first & what each is used for. |
X-Ray always first CT - bone or cortical bone MRI - Soft tissue Bone Scan - scan for increased metabolic activity via tagged glucose. |
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Describe the two types of MRIs |
Type 1 - fat is bright, fluid is dull/gray
Type 2 - fluid is bright |
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Describe Bone scan process |
Tracer accumulates in osteoblasts which are increased in fracture, tumor, & infection.
Highly sensitive but not specific. |
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Describe the placement & treatment for Fat Pads. |
1. Patient is suspected of trauma to the XRAY location (or they wouldn't be having an xray)
2. Darkened area next to the bone where it is normally consistently opaque/diffuse white.
3. indicative of a fracture, treat as a fracture. |
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List the types of fractures |
transverse, oblique, spiral, comminuted, segmental, avulsed, impacted, torus, greenstick |
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Describe when an ankle fracture is stable vs. unstable. |
Unstable = proximal to joint space
Stable = distal to joint space |
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Describe the 5 types of Salter-Harris |
1 . fracture through physis 2. fracture through physis & metaphysis 3. fracture through the physis & epiphysis 4. fracture through epiphysis, metaphysis, physis 5. compression/cruss of physeal plate |
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Describe the contents of the Carpal tunnel |
8 Carpal bones. Flexor Retinaculum. 4 flexor digitorum superficialis tendons. 4 flexor digitorum profundus tendons. Flexor pollicis longus tendon. Median nerve. |
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List the 8 Carpal bones |
Scaphoid, Lunate, Triquetrum, pisiform, trapezium, trapezoid, capitate, hamate |
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Discuss the various mechanisms of neck pain |
Trauma via hyperflexion/extension, strain. Tension via isometric contraction, emotional factors, or facilitated segments Degenerative or arthritic. Referred pain. |
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Describe cervical disc disiease |
Degenerative disc disease - involving annular tears, loss of disc height & nuclear degradation
Herneated nucleus pulposus implies extension of disc material beyond posterior margin of the vertebral body. Disc degeneration/herniation can impede spinal cord & nerve roots resulting in stenosis or myofascial pain. |
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Describe myofascial pain syndrome |
1. presence of trigger points (referred pain) 2. muscles usually trapezius, levator scapulae, rhomboids, supraspinatus, infraspinatus. 3. Normal neurologic exam. 4. Neck pain & stiffness worse with stress. 5. limited cervical spine RoM 6. Pain radiation mimics cervical radiculopathy with pain radiating down the arm |
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Describe Thoracic Outlet Syndrome |
1. More common in females possibly due to differences in thoracic weight bearing aspects. 2. r/t occupations/activities involving prolonged posturing of the neck. 3. Neural compression s/sx more common than vascular compression s/sx. 4.Sensory s/sx 90% vs. Motor s/sx 10% 5. usually involves the lower brachial plexus |
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Describe Double Crush syndrome. |
Combination of thoracic outlet syndrome & carpal tunnel syndrome. Compression of axon at one point renders it more susceptible to damage at another site. Altered function is greater than sum of individual impairments (1+1=3). |
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What tests would be used to detect Thoracic outlet syndrome |
Adson's manuever.
Costoclavicular compression test.
Pectoralis minor compression test |
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What signs or tests are used to detect Carpal Tunnel Syndrome. |
Flick Sign Phalen's maneuver Tinel's sign Manual compression |
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Describe the OMT technique used for CTS treatment. |
1. Wrist & digits simultaneously hyperextended 2. Thumb hyperextended, hyperabducted & laterally rotated. 3. Hold for 5-10 seconds. 4. 10-15 repetitions QID or PRN |
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What are the three levels of motor control in modifying motor output. |
Cerebrum
Brainstem
Spinal Cord |
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Describe the Cerebrum with regards to modifying motor output. |
The cerebrum is composed of the basal ganglia and the cerebellum. Function includes planning & initiation of movements & integration of input from the other brain regions. |
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Describe the Basal Ganglia. |
Movement gait, enforcement of desired movement & suppression of undesired movements (e.g. Parkinson's disease) |
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Describe the Cerebellum |
Coordination & planning, timing & precision of fine movements, adjusting ongoing movements, motor learning of skilled tasks. |
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Describe the Brainstem with regards to modifying motor output. |
Control of balance & posture, coordination of head, eyes, & neck movement. |
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Describe the Spinal Cord with regards to modifying motor output. |
Spontaneous reflexes, rhythmic movements, motor outflow to the body. |
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Describe the function of the lateral descending tract & list the 2 parts. |
Modifying extremities & distal musculature, responsible for most voluntary movements of the arms & legs.
Parts: Lateral Corticospinal & Rubrospinal |
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Describe the Lateral Corticospinal |
affects distal limb musculature especially hand precision movements, possibly flexors over extensors. Origin: motor cortex (primary, premotor, supplementary motor) Decussation: Caudal medulla (contralateral) Target: lateral ventral horn, motor neurons & interneurons at all levels of the spinal cord. |
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Describe the Rubrospinal |
excitation of flexor muscles & inhibition of extensor muscles. Origin: Red nucleus in the midbrain Decussation: immediate in midbrain Target: lateral ventral horn, motor neurons & interneurons at all levels of the spinal cord. |
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List the function of the Medial Descending Tracts & the 4 major parts. |
Modify the trunk & proximal muscles, posture/balance. Both Ipsolateral & bilateral
Parts: Anterior corticospinal, Tectospinal, Vestibulospinal (medial & lateral), Reticulosponal (pontine & medullary) |
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What is the most important motor tract in medical neuroscience & what does it affect. |
Lateral Corticospinal: affects distal limb musculature especially hand precision movements, possibly flexors over extensors. 85% of fibers from the motor cortex cross in the medulla & descend to contralateral motorneurons (motor cortex controls opposite side of the body) |
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Define decorticate rigidity |
abnormal flexion (rubrospinal intact)
Think flex towards core |
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Define decerebrate rigidity |
extension posturing (rubrospinal NOT intact)
Celebrating = arms away from the body |
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Which tract plays a role in movement velocity |
Rubrospinal tract |
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What tract plays a role in transmitting learned motor commands? |
Rubrospinal tract |
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Controls proximal & girdle musculature involved in postural tone, balance & orienting movements of the head & neck & automatic gait-related movements. |
Medial tract |
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Describe Jacksonian principle |
Higher Motor centers tonically inhibit lower motor centers resulting in sophistication of motor movements. |
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Describe Lower motor neuron syndrome |
Peripheral nerves: flaccid weakness, decrease or absent muscle tone & tendon reflexes, fasciculations, atrophy, decreased or absent resistance to passive RoM |
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Describe fasciculations |
muscle twitches to ACh still present in the cleft immediately after damage. |
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Describe Upper motor neuron syndrome |
Spastic weakness, increased muscle tone & tendon reflexes, velocity-dependent resistance to passive RoM, Babinski's sign. |
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Describe hypertonia |
increased muscle tone |
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Describe hyperreflexia |
increased tendon reflexes |
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Describe spastic weakness |
Reflexes exist but are uncontrolled |
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Describe Babinski's sign |
abnormal extensor plantar response |
