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TermDefinition
Axillary nerve spinal cord segment C5, C6
Axillary nerve mm innervation deltoid, teres minor
Axillary nerve sensory distribution lateral arm over lower portion of deltiod
Axillary nerve clinical motor features of paralysis loss of shd abd, weakened shd lat rotation
musculocutaneous nerve spinal cord segment C5, C6
musculocutaneous nerve mm innervation coracobrachialis, biceps, brachialis
musculocutaneous nerve sensory distribution ant lat surface of forearm
musculocutaneous nerve clinical motor features of paralysis loss of elbow flex, weak supination
radial nerve spinal cord segment C6, C7, C8, T1
radial nerve mm innervation triceps, anconeus, brachioradialis, supinator, wrist, finger & thumb extensors
radial nerve sensory distribution post arm, post forearm & rad side of post hand
radial nerve clinical motor features of paralysis loss of elbow, wrist, finger & thumb ext (commonly called "wrist drop"
median nerve spinal cord segment C6, C7, C8, T1
median nerve mm innervation pronators, wrist & finger flexors on radial side, most thumb mm
median nerve sensory distribution palmar aspect of thumb, 2nd, 3rd, 4th (radial half) fingers
median nerve clinical motor features of paralysis loss of forearm pronation, loss of thumb opposition, flex & abd (ape hand), weakened wrist flexors (radial side), weakened wrist radial dev, weakened 2nd, 3rd finger flex (popes blessing or hand of benediction)
ulnar nerve spinal cord segment C8, T1
ulnar nerve mm innervation flexor carpi ulnaris, flexor digitorum profundus (medial half), interossei, 4th & 5th lumbricales
ulnar nerve sensory distribution 4th finger (medial portion), 5th finger
ulnar nerve clinical motor features of paralysis loss of wrist ulnar deviation, weak wrist, finger flex, loss of thumb add, loss of most intrinsics (claw hand)
femoral nerve spinal cord segment L2, L3, L4
femoral nerve mm innervation Iliopsoas (iliacus & psoas major), sartorius, pectineus, quadricep femoris
femoral nerve sensory distribution ant & med thigh, med leg & foot
femoral nerve clinical motor features of paralysis weak hip flex, loss of knee ext
obturator nerve spinal cord segment L2, L3, L4
obturator nerve mm innervation hip add, obturator externus
obturator nerve sensory distribution middle part of medial thigh
obturator nerve clinical motor features of paralysis loss of hip add, weak hip lat rotation
sciatic nerve spinal cord segment L4, L5, S1, S2, S3
sciatic nerve mm innervation hamstring
sciatic nerve sensory distribution none
sciatic nerve clinical motor features of paralysis weak hip ext, loss of knee flex
tibial nerve spinal cord segment L4, L5, S1, S2, S3
tibial nerve mm innervation popliteus, ankle plantar flexors, tibialis post, foot intrinsics (medial & lateral plantar)
tibial nerve sensory distribution post lateral leg, lateral foot
tibial nerve clinical motor features of paralysis loss of ankle plantar flex, weak ankle inversion, loss of toe flex
common peroneal nerve spinal cord segment L4, L5, S1, S2
common peroneal nerve mm innervation peroneals (mostly superficial peroneal), tibialis ant (deep peroneal), toe ext (deep peroneal)
common peroneal nerve sensory distribution ant lateral aspect of leg & foot
common peroneal nerve clinical motor features of paralysis loss of ankle dorsiflex (foot drop), loss of toe ext, loss of ankle eversion
Ant pelvic tilt force couple Back extensors pulling up, hip flexors pulling down
Post pelvic tilt force couple Trunk flexors pulling up, hip extensors pulling down
Level pelvis Trunk lat benders pulling up on side with foot off ground, hip abd pull down on side with foot on ground
angle of inclination angle between the shaft and the neck of the femur in the frontal plane-noramlly 15 degrees
coxa valga characterized by a neck-shaft angle greater than 125 degrees
coxa vara neck-shaft angle is less than normal 125 degrees
angle of torsion angle between the shaft & neck of the femur in the transverse plane- normally has the head & neck rotated outward from the shaft abt 15-25 degrees
anteversion increase in the angle of torsion, forces hip jt into a more medially rotated position, toed in
retroversion decrease in angle of torsion, toed out
Q angle patellofemoral angle, angle between quads & patellar tendon (line from ASIS to midpoint of patella & from tibial tuberosity to midpoint of patella. angle formed by intersection of these lines)
genu valgum larger Q angle, knock knees
genu varum smaller Q angle, bowlegs
genu recurvatum back knees
stride length distance traveled during gait cycle
step one half of a stride, distance between heel strike of one foot & heel strike of the other foot
cadence # of steps taken per minute
heel strike initial contact
foot flat loading response
midstance midstance
heel-off terminal stance
toe-off preswing
acceleration initial swing
midswing midswing
deceleration terminal swing
mm working to minimize lat pelvic tilt hip abductors, erector spinae mm
glute max gait trunk shifts posteriorly at heel strike, rocking horse gait because of extreme backward forward movement of the trunk
glute med gait trunk shifts over affected side during stance phase, trendelenburg gait
no ankle dorsiflex toes strike first, equinus gait
weak ankle dorsiflexors may not be able to support body wt after heel strike & move toward foot flat, foot slap
TMJ depression lateral ptergoid, suprahyoid, infrahyoid
TMJ elevate temporalis, masseter, medial pterygoid
TMJ protrusion masseter, lateral pterygoid, medial pterygoid
TMJ retrusion temporalis, masseter, digastric
TMJ side to side medial pterygoid, lateral pterygoid, masseter, temporalis
Cv intervertebral jts flex sternocleidomastoid, longus colli, scalenus mm
Cv intervertebral jts ext splenius cervicis, semispinalis cervicis, iliocostalis cervicis, longissimus cervicis, multifidus, trapezius
Cv intervertebral jts rotation & lat bending sternocleidomastoid, scalenus mm, splenius cervicis, longissimus cervicis, iliocostalis cervicis, levator scapulae, multifidus
thoracic & lumbar intervertebral jts flex rectus abdominis, internal oblique, external oblique
thoracic & lumbar intervertebral jts ext erector spinae, quadratus lumborum, multifidus
thoracic & lumbar intervertebral jts rotation & lat bending psoas major, quadratus lumborum, ext oblique, int oblique, multifidus, longissimus thoracis, iliocostalis thoracis, rotatores
Scapula elevation upper trap, levator scap
Scapula depression lat dorsi, pec major, pec minor, lower trap
Scapula protraction serratus ant, pec minor
Scapula retraction trapezius, rhomboids
Scapula upward rotation trapezius, serratus ant
Scapula downward rotation rhomboids, levator scap, pec minor
shoulder jt flex ant delt, coracobrachialis, pec major, biceps brachii
shoulder jt abd delt, supraspinatus
shoulder jt lat rot teres minor, infraspinatus, post delt
shoulder jt ext lat dorsi, post delt, teres major
shoulder jt add pec major, lat dorsi, teres major
shoulder jt med rot subscapularis, teres major, pec major, latissimus dorsi, ant delt
elbow jt flex biceps brachii, brachialis, brachioradialis
elbow jt ext triceps brachii, anconeus
radioulnar jt supination biceps brachii, supinator
radioulnar jt pronation pronator teres, pronator quadratus
wrist jt flex flexor carpi radialis, flexor carpi ulnaris, palmaris longus
wrist jt ext ext carpi radialis longus, ext carpi radialis brevis, ext carpi ulnaris
wrist jt radial dev ext carpi radialis, flexor carpi radialis, ext pollicis longus and brevis
wrist jt ulnar dev ext carpi ulnaris, flex carpi ulnaris
hip jt flex iliopsoas, sartorius, rectus femoris, pectineus
hip jt abd glute med, glute min, piriformis, obturator internus, tensor fasciae latae
hip jt med rot tensor fasciae latae, glute med, glute min, pectineus, add longus
hip jt ext glute max & med, semitendinosus, semimembranosus, biceps femoris
hip jt add add magnus, add longus, add brevis, gracilis
hip jt lat rot glute max, obturator ext & int, piriformis, gemelli, sartorius
knee jt flex biceps femoris, semitendinosus, semimembranosus, sartorius
knee jt ext rectus femoris, vastus lateralis, vastus intermedius, vastus medialis
ankle jt plantar flex tibialis post, gastroc, soleus, peroneus longus & brevis, plantaris, flexor hallucis
ankle jt dorsiflex tibialis ant, ex hallucis longus, extensor digitorum longus, peroneus tertius
ankle jt inversion tibialis post, tibialis ant, flexor digitorum longus
ankle jt eversion peroneus longus, brevis & tertius
type 1 mm fiber classification aerobic, red, tonic, slow twitch, slow-oxidative
type 2 mm fiber classification anaerobic, white, phasic, fast twitch, fast-glycolytic
type 1 mm fiber functional characteristics low fatigability, high capillary density, high myoglobin content, smaller fibers, ext blood supply, lots of mitochondria, ex marathon, swimming
type 2 mm fiber functional characteristics high fatigability, low capillary density, low myoglobin content, large fibers, less blood supply, fewer mitochondria, ex high jump, sprint
mmt grade 0/zero no contraction
mmt grade 1/trace slight mm contraction, but no mvmt
mmt grade 2-/poor minus does not complete range of motion in gravity eliminated position
mmt grade 2/poor completes ROM in gravity eliminated position
mmt grade 2+/poor plus mvmt thru complete test range in gravity-eliminated position & thru up to one half of test range against gravity
mmt grade 3/fair completes ROM against gravity w/o manual resistance
mmt grade 3+/fair plus completes ROM against gravity w/min resistance
mmt grade 4/good completes ROM against gravity w/mod resistance
mmt grade 5/normal completes ROM against gravity w/max resistance
grade 1 jt mob SMALL amplitude mvmt performed @ BEGINNING of range
grade 2 jt mob LARGE amplitude mvmt performed WITHIN the range, but not reaching the limit of the range and not returning to the beginning of range
grade 3 jt mob LARGE amplitude mvmt performed UP TO THE LIMIT of range
grade 4 jt mob SMALL amplitude mvmt performed AT THE END OF RANGE
grade 1 sprain mild pn & swelling, little to no tear of ligament
grade 2 sprain mod pn & swelling, min instability of the jt, min to mod tearing of ligament, decreased ROM
grade 3 sprain severe pn & swelling, substantial jt instability, total tear of ligament, substantial decrease in ROM
grade 1 strain localized pn, min swelling & tenderness
grade 2 strain localized pn, mod swelling, tenderness, & impaired motor function
grade 3 strain palpable defect of mm, severe pn & poor motor function
Trendelenburg position head lower than feet-used to facilitate drainage from lower lobes of lungs & increase BP
reverse Trendelenburg position head elevated in relation to feet-reduce hypertension & facilitate mvmt of diaphragm
Trendelenburg gait pattern pattern that denotes glute med wkness; excessive lat trunk flex & wt shifting over the stance leg
Trendelenburg sign The Trendelenburg sign is said to be positive if, when standing on one leg, the pelvis drops on the side opposite to the stance leg to reduce the load by decreasing the lever arm.
frontal lobe personality
occipital lobe vision
parietal lobe touch & pressure
temporal lobe behavior, hearing, language reception & understanding
midbrain center for visual reflexes
pons located between midbrain & medulla
medulla oblongata center for automatic control of respiration and heart rate
type I collagen thick fibers, most abundant
type II collagen thinner, less tensile strength
type III collagen found in organs, wound repair
DeLorme progressive resistance exercise (PRE) 3 sets of 10, arbitrary increase in resistance each week- find 1 rep max- 70%-80% is what you'll use in workout
Oxford program establishes the individuals 10 Rep max for the 1st set, moving to 75% of the 10 RM for the 2nd, and ending w/50% of the 10 RM for the 3rd set (10 reps each)
Knight (DAPRE) four sets with variable reps & wts
rule of tens 10 sec contraction, 10 reps, 10 sec rest in between
increased arterial pressure with exercise... greater increase in systolic pressure (top #)
AMRI-anteromedial rotary instability MCL, ACL, medial capsule
ALRI-anterolateral rotary instability lateral capsule, ITB & sometimes ACL
PLRI-posterior lateral rotary instability post arcuate ligaments, popliteus & part of lat collateral
ALL-ant longitudinal lig limits ext
PLL (post longitudinal lig) connects vertebral bodies, limits flex
ISL interspinous lig spans only 1 vertebral section, can be easily palpated, limits flex
ligamentum flavum yellow ligament, very strong stabilizer, connects lamina
SSL supraspinous lig limits flex
ITL intertransverse lig between TPs-limit lat bending
(K0) MFLC-0 doesnt have ability or potential to amb or trsf safely with or w/o assist and a prosthesis does not enhance quality of life or mobility
(K1) MFLC-1 has ability or potential to use a prosthesis for transfers or amb on level surfaces at fixed cadence. typical of the limited & unlimited household ambulator
(K2) MFLC-2 has the ability or potential for amb with the ability to transverse low-level environmental barriers such as curbs, stairs or uneven surfaces. Typical of the limited community ambulator
(K3) MFLC-3 has the ability or potential for amb with variable cadence. typical of the communtiy ambulator who has the ability to tranverse most environmental barriers and may have activity that demands prosthetic utilization beyond simple locomotion
(K4) MFLC-4 has the ability or potential for prosthetic amb that exceeds the basic amb skills, exhibiting high impact, stress or energy levels, typical of the prosthetic demands of the child, active adult or athlete
bicipital tendinitis pn in ant inner shd w/resisted sup
drop arm test pt unable to lower arm from 90 abd, complete tear of supraspinatus
apprehension test slowly abd & ext rot- test for ant glenohumeral dislocation
adsons test TOS
impingement test flex, int rot, add humerus so that cuff impinges under acromion-pn indicates impingement
apleys scratch test opp shd, behind back, behind head
speeds-resist GH flex w/elbow ext & palpate bicipital groove for bicipital tendinitis
lachmans drawer in 25-30 degree flex hold leg in air, stabilize femur, check end feel. checking for lig inj
pivot shift test ALR instability indicates torn ACL and middle third of lateral capsule. from 90 degrees, ext knee w/valgus stress and tibia internally rot. you can feel tibial condyle lat sublux off of femur, then reduce
McMurrays knee taken into full flex & ER applying slight valgus stress look for click or lock while knee ext
ant/post drawer done @ 90 degrees, ant force to test ACL, posterior for PCL
Patrick's test (FABER) flex, abd, ER. normal is leg being tested dropping to at least the height of the other leg. not normal (or Positive) would be the leg not dropping to a ht even with the other leg-applying overpressure may cause pn in the hip or SI on the testing side
True leg length supine legs equally abducted ~ 7-10 in apart-measure from ASIS to medial malleolous/lat malleolus & compare right and left
Weber-Barstow maneuver supine w/knees & hips flexed-examiner stands at the pt ft and places his thumbs on the med malleoli0the pt lifts his pelvis from the table (bridge) and returns- the examiner passively ext the legs and compares the position of the med malleoli using thumbs
Thomas test hip flex contracture-supine w/bottom close to end of table. person passively draws one knee to ches w/LB flat against table. normal if other leg stays on table. positive(not normal)if leg lifts at hip or knee straightens
Ober's test test TFL & IT band tightness-pt sidelying w/ bottom close to EOTable-examiner at back cradling top leg in ABD & EXT, then let it down. if can't go past midline to table there is tightness
extension of the spine is contraindicated... spondylolisthesis, spondylolysis, stenosis, DDD, arthritis
extension of the spine works best for mildly bulging discs
SLR in supine bring straight leg into 90 degrees @ hip. positive test if pn in sciatic distribution. dorsiflexion creates increased tension on nerve. bilateral test also down. indicates herniated nucleus pulposus
compression test apply compression thru lumbar or cx, pt in sitting. pain/radicular signs are positive test:indicates disc pathology
distraction test done in sitting. examiner applies distraction & if pn relieved, positive test. indicates disc pathology
carrying angle because medial surface ext farther distally, in ext the elbow is in valgus position-10-15 degrees
fall on flexed wrist can cause... Smith fx
fall on ext wrist can cause... Colles fx
most common carpal fx scaphoid
boxer's fractures fractures of the neck of the 4th or 5th metacarpal... occur when the pt strikes a hard object with a clenched fist
skiers thumb sprain ulnar collateral
dupuytren dx formation of pits & firm nodules that lie just below the skin of the palm. mostly Caucasian men of N Europe descent, may need sx, rx centered on pt reassurance & edu
CTS carpal tunnel syndrome compression neuropathy, structures constrict MEDIAN nerve & blood supply resulting in impaired nerve conduction. decreased sensation, pn & tingling
CTS carpal tunnel syndrome motor probs including mm loss thenar intrinsic mm (flexor pollicis brevis), abductor pollicis brevis, and opponens pollicis, loss of 1st two lumbrical mm
CTS carpal tunnel syndrome-Tunnel defined by Pisiform-side-ulnar/scaphoid-side-radial/hook of hamate-side-radial/tubercle of trapezium-side-ulnar/transverse carpal lig-roof
structures located w/in carpal tunnel are flexor pollicis longus tendon, 4 tendons of flex digitorum superficialis, 4 tendons of profundus, median nerve
functional loss CTS grip awkward, flex & opp of thumb is lost & thumb pulled dorsally, index & middle finger lost flex of IPs
sensory deficit CTS palmar side of thumb & digits 1,2,3, half of 4, all finger tips
Normal 4/4 Functional Balance Grade Static: can maintain steady balance w/o HH support. Dynamic: accept max challenge & can wt shift easily w/in full LOS
Good 3/4 Functional Balance Grade Static: can maintain steady balance w/o HH support, limited posturaly sway. Dynamic: Accepts mod challenge & can maintain balance while picking object off floor
Fair 2/4 Functional Balance Grade Static:maintain balance w/HH support, may need occasional min A. Dynamic: Accepts min challenge, can maintain balance w/head turn.
Poor 1/4 Functional Balance Grade static: requires HH support, mod to max A. Dynamic: cannot accept any challenge w/o LOS
brown sequard one side-like stabbing or gunshot wound-motor, proprioception & vibration lost on ipsilateral side, on contralateral side pn & temp perception lost
Ant cord syndrome; front- cv flex injury, sudden jerk to head-lose motor, pn & temp bilaterally-proprioception & vibration intact
central cord syndrome caused by hyper ext or compression injury, have more deficit in UE- typically have bowel, bladder & sexual function intact-most common
post cord syndrome (dorsal column syndrome) rare-lose proprioception & vibration bilaterally- tumor or vascular cause
GMFCS (gross motor function classification system) 1st decreased speed, balance & coordination
GMFCS (gross motor function classification system) 2nd limited jumping & running on uneven surfaces
GMFCS (gross motor function classification system) 3rd AD or WC
GMFCS (gross motor function classification system) 4th mostly WC
GMFCS (gross motor function classification system) 5th limited in all motor functions with no independent mobility
Created by: jessigirrl4