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NPTE Prep
Musculoskeletal
| Question | Answer |
|---|---|
| Elevation of the Scapula | the upper trap and levator scapulae elevate the scapula |
| Depression of the Scapula | the latissimus dorsi, pec major, pec minor, and lower trap depress the scapula |
| Protraction of the Scapula | the serratus anterior and pec minor protract the scapula |
| Retraction of the Scapula | the middle trapezius and rhomboids retract the scapula |
| Upward Rotation of the Scapula | SALUTe: the serratus anterior, lower trap, and upper trap upwardly rotate the scapula |
| Downward Rotation of the Scapula | Love Rhomin: the levator scapulae, rhomboids, and pec minor downwardly rotate the scapula |
| Flexion of the Glenohumeral Joint | the anterior deltoid, coracobrachialis, pec minor, and biceps perform flexion of the shoulder |
| Extension of the Glenohumeral Joint | the latissimus dorsi is the main extensor, posterior deltoid, teres major, and triceps all perform extension of the shoulder |
| Abduction of the Glenohumeral Joint | the middle deltoid and supraspinatus perform abduction of the shoulder joint |
| Adduction of the Glenohumeral Joint | the pec major, latissimus dorsi, and teres major perform adduction of the shoulder joint |
| Horizontal Abduction of the Glenohumeral Joint | the posterior deltoid, infraspinatus, and teres minor perform horizontal abduction of the shoulder joint |
| Horizontal Adduction of the Glenohumeral Joint | the anterior deltoid and pec major perform horizontal adduction of the shoulder joint |
| External Rotation of the Glenohumeral Joint | the teres minor, infraspinatus and posterior deltoid perform lateral rotation of the shoulder joint |
| Internal Rotation of the Glenohumeral Joint | the subscapularis, teres major, pec major, latissimus dorsi, and anterior deltoid perform internal rotation of the shoulder joint |
| Flexion of the Elbow | the biceps brachii, brachialis, and brachioradialis perform flexion of the elbow |
| Extension of the Elbow | the triceps and anconeus perform extension of the elbow |
| Supination of the Radioulnar joint | the biceps brachii and supinator perform supination of the radioulnar joint |
| Flexion of the Thumb | the flexor pollicis longus and brevis and the opponens pollicis perform flexion of the thumb |
| Extension of the Thumb | the extensor pollicis longus and brevis and the abductor pollicis longus extend the thumb |
| Opposition of the Thumb | the opponens pollicis, flexor pollicis brevis, abductor pollicis brevis, and opponens digiti minimi perform opposition of the thumb |
| Flexion of the Hip | the iliopsoas, sartorius, rectus femoris, and pectineus perform hip flexion |
| Extension of the Hip | the gluteus maximus, gluteus medius, and hamstrings perform extension of the hip |
| Abduction of the Hip | the gluteus medius, gluteus minimus, obturator internus, and TFL perform hip abduction |
| Adduction of the Hip | the muscles that say adductor and the gracilis perform adduction of the hip |
| Internal Rotation of the Hip | the TFL, gluteus medius, gluteus minimus, pectineus, and adductor longus perform internal rotation of the hip |
| External Rotation of the Hip | the gluteus maximus, obturator externus and internus, piriformis, gemelli, and sartorius perform lateral rotation of the hip |
| Flexion of the Knee | the hamstrings and sartorius perform knee flexion |
| Extension of the Knee | the quadriceps are responsible for knee extension |
| Plantar Flexion of the Ankle Joint | the tibialis posterior, triceps surae, fibularis longus and brevis, plantaris, and flexor hallucis longus all perform plantarflexion at the talocrural joint. |
| Dorsiflexion of the Ankle Joint | the tibialis anterior, extensor hallucis longus, extensor digitorum longus, and fibularis tertius perform dorsiflexion at the talocrural joint |
| Inversion of the Ankle Joint | the tibialis posterior, tibialis anterior, and flexor digitorum longus perform inversion at the subtalar joint |
| Eversion of the Ankle Joint | every fibularis muscle performs eversion at the subtalar joint |
| Spinal Accessory Nerve/Cranial Nerve 11 Innervation | the trapezius and sternocleidomastoid |
| Dorsal Scapular Nerve Innervation | the levator scapulae and rhomboids |
| Long Thoracic Nerve Innervation | the serratus anterior |
| Suprascapular Nerve Innervation | the supraspinatus and infraspinatus |
| Subclavian Nerve Innervation | the subclavian |
| Anterior Thoracic Nerve Innervation | the pectoralis major and pectoralis minor |
| Median Nerve Innervation | 1/2 LOAF: lubricals 1 and 2, opponens pollicis, abductor pollicis brevis, flexor muscles on the radial side, palmaris longus, and pronators |
| Musculocutaneous Nerve Innervation | the coracobrachialis, brachialis, and biceps brachii |
| Ulnar Nerve Innervation | lumbricals 3 and 4, abductor, flexor, and opponens minimi, both interossei, adductor pollicis, flexor digitorum profundus, and flexor carpi ulnaris |
| Axillary Nerve Innervation | the deltoids and teres minor |
| Radial Nerve Innervation | A BEAST: anconeus, brachioradialis, wrist extensors, supinator, and triceps |
| Subscapular Nerve Innervation | the subscapularis and teres major |
| Thoracodorsal Nerve Innervation | the latissimus dorsi |
| Femoral Nerve Innervation | the iliopsoas, sartorius, pectineus, and quadriceps |
| Obturator Nerve | the adductor muscles and the gracilis |
| Inferior Gluteal Nerve Innervation | the gluteus maximus |
| Superior Gluteal Nerve Innervation | the gluteus medius, gluteus minimus, and TFL |
| Sciatic Nerve Innervation | the biceps femoris, semitendinosus, and semimembranosus |
| Tibial Nerve Innervation | the triceps surae, popliteus, plantaris, tibialis posterior, flexor hallucis longus, and flexor digitorum longus |
| Deep Peroneal Nerve Innervation | tibialis anterior, extensor hallucis longus, extensor digitorum longus, and peroneus tertius |
| Pes Anserine | located on the anteromedial tibial surface. the sartorius, gracillis, and semitendinosus attach to it. |
| Arthrokinematics of the Glenohumeral Joint | convex rule |
| Arthrokinematics of the Humeroulnar Joint | concave rule |
| Arthrokinematics of the Proximal Radioulnar Joint | convex rule |
| Arthrokinematics of the Distal Radioulnar Joint | concave rule |
| Arthrokinematics of the Radiocarpal Joint | convex rule |
| Arthrokinematics of the Carpometacarpal Joint | concave rule |
| Arthrokinematics of the MCP, DIP, and PIP Joints | concave rule |
| Arthrokinematics of the Hip Joint | convex rule |
| Arthrokinematics of the Tibiofemoral Joint | concave rule |
| Arthrokinematics of the Patellofemoral Joint | convex rule |
| Arthrokinematics of the Proximal Tibiofibular Joint | concave rule |
| Arthrokinematics of the Distal Tibiofibular Joint | convex rule |
| Arthrokinematics of the Talocrural Joint | convex rule |
| Arthrokinematics of the Subtalar Joint | convex rule |
| Arthrokinematics of the Intermetatarsal Joint | concave rule |
| Arthrokinematics of the Metatarsophalangeal and Interphalangeal Joint | concave rule |
| Initial Contact to Loading Response | Ankle: eccentric DF decelerating ankle into PF Knee: Eccentric quads to control amount of knee flexion during loading Hip: isometric hip extensors and abductors |
| Loading Response to Midstance | Ankle: Eccentric PF controlling DF as body moves over stance leg Knee: Concentric quads until neutral knee ext. minimal activity in midstance Hip: Concentric hip extensors to become more erect, with abductors for stabilization |
| Midstance to Terminal Stance and Preswing | Ankle: concentric PF control propulsion Knee: Minimal activity until hamstrings produce knee flexion at toe off Hip: Eccentric hip flexors to control or slow rate of extension |
| Preswing to Initial Swing | Ankle: Concentric DF to clear foot from ground during swing |
| Initial Swing to Midswing | Knee: Concentric hamstrings to bend the knee for foot clearance in early swing Hip: Concentric hip flexors to advance the swing limb forward |
| Midswing to Terminal Swing | Ankle: Concentric then isometric DF to maintain DF during swing Knee: Eccentric hamstrings to slow the rate of knee extension during terminal swing Hip: Eccentric hip extensors to slow rate of hip flexion |
| General rule for eccentric vs. concentric during gait | If it is accelerating or overcoming gravity, it is concentric. If gravity or momentum to control rate of movement, it is eccentric. |
| C2 Myotome | neck flexion/extension |
| C3 Myotome | head side bending |
| C4 Myotome | shoulder elevation |
| C5 Myotome | shoulder abduction/elbow flexion |
| C6 Myotome | elbow flexion/wrist extension |
| C7 Myotome | elbow extension/wrist flexion |
| C8 Myotome | finger flexion/ulnar deviation |
| T1 Myotome | finger abduction |
| L2 Myotome | hip flexion |
| L3 Myotome | knee extension/hip adduction |
| L4 Myotome | ankle dorsiflexion |
| L5 Myotome | big toe extension |
| S1 Myotome | ankle plantarflexion |
| S2 Myotome | knee flexion |
| Q-angle | the average Q-angle is 13-18. if the angle is above 18, this may increase the risk of knee problems due to abnormal patellar tracking or misalignment |
| Patellar Movement | During "normal" knee flexion, the patella moves distally and slightly medially. During "normal" knee extension, the patella moves proximally and slightly laterally. |
| Special Test for Shoulder Dislocation | Apprehension test for anterior shoulder dislocation Apprehension test for posterior shoulder dislocation |
| Special Test for Biceps Tendon Pathology | Speed's test and Yergason's test |
| Special Test for Rotator Cuff Pathology/Impingement | Drop Arm Test, Hawkins-Kennedy Test, Infraspinatus Test, Neer Test, and Supraspinatus Test |
| Special Test for Thoracic Outlet Syndrome | Adson maneuver, Allen Test, Roos test |
| Special Test for Elbow Ligamentous Instability | Valgus Stress Test and Varus Stress Test |
| Special Test for Elbow Epicondylitis | Cozen's test, lateral epicondylitis test, and medial epicondylitis test |
| Special Test for Tinel's Sign of the Ulnar Nerve | tapping the cubital tunnel to see if tingling occurs distally. this is indicative of cubital tunnel syndrome/ulnar nerve entrapment |
| Special Test for Wrist/Hand Ligamentous Instability | Ulnar collateral ligament instability test |
| Special Test for Wrist/Hand Vascular Insufficiency | Allen test and Capillary refill test |
| Capillary Refill Test Times and Implications | Normal: full color returns in < 2 seconds Abnmormal: refill time is > 2 seconds, indicating capillary refill is compromised (arterial occlusion, hypovolemic shock, hypothermia) |
| Special Test for Wrist/Hand Neurological Dysfunction | Froment's sign, phalen's test, and Tinel's sign |
| Special Test for Dequervain's Tenosynovitis | Finklestein Test: APL EPB is affected |
| Special Test for Hip Contracture/Tightness | Ely's test, Ober's test, piriformis test, thomas test, tripod sign, and 90-90 SLR test |
| Ely's Test | pt. is in prone while the therapist passively flexes the knee. a positive test is indicated by spontaneous hip flexion occuring simultaneously and may be indicative of a rectus femoris contracture. |
| Ober's Test | Pt. is in a side lying hook lying position. a positive test is indicative of an ITB or a TFL contracture. |
| Thomas Test | the pt. is in prone doing a SKTC. if contralateral straight leg rises from the table is may be indicative of a hip flexor contracture. |
| Tripod Sign | Pt is sitting with knee flexed to 90 over the edge of table. the therapist passively extends one knee. positive test is indicated by tightness in the hamstrings or extension of the trunk. |
| 90-90 SLR Test | pt. is in supine and is asked to stabilize the hips in 90 degrees of flexion with the knees relaxed. the pt. alternately extends the knee. positive test is indicated by the knee remaining in 20 degrees or more of flexion and indicates hamstring tightness |
| Craig Test | measures the degrees of femoral anteversion. normal anteversion for an adult is 8-15 degrees. |
| FABER Test | a positive test is indicated by failure of the test leg to abduct below the level of the opposite leg and may be indicative of iliopsoas, sacroiliac, or hip joint abnormalities |
| Trendelenburg Test | a positive test is indicated by a drop of the pelvis on the unsupported side and may be indicative of weakness of the gluteus medius on the supported side |
| Special Test for ACL Injury | Anterior Drawer Test and Lachman Test |
| Special Test for PCL Injury | Posterior Drawer Test and Posterior Sag Sign |
| Special Test for MCL Injury | Valgus stress test |
| Special Test for Meniscal Pathology | Apley's compression test and McMurray Test |
| Special Test for Swelling in the Knee | a positive Brush Test or Patellar Tap Test is indicative of joint effusion |
| Anterior Drawer Test in the Ankle | a positive test is indicated by excessive anterior translation of the talus away from the ankle mortise and may be indicative of an ATFL sprain |
| Talar Tilt Test | the therapist tilts the talus into inversion and eversion. a positive test is indicated by excessive inversion and may be indicative of a calcaneofibular ligament sprain |
| Thompson Test at the Calf | the therapist squeezes the calf of a pt who is in prone. if there is an absence of plantar flexion this may be indicative of an Achilles tendon rupture |
| Patellar Grind Test | The purpose of this test is to detect the presence of patellofemoral joint disorder (patellofemoral pain syndrome, chondromalacia patellae, patellofemoral DJD). This test is also known as Clarke's Test. |
| Cause of Foot Slap | weak dorsiflexors and dorsiflexor paralysis |
| Cause of Toe down instead of heel strike | plantar flexor spasticity, plantar flexor contracture, weak dorsiflexors, dorsiflexor paralysis, leg length discrepancy, hindfoot pain |
| Cause of Clawing of Toes | toe flexor spasticity and positive support reflex |
| Cause of Heel Life during Midstance | insufficient dorsiflexion range and plantar flexor spasticity |
| Cause of No Toe Off | forefoot/toe pain, weak plantar flexors, weak toe flexors, insufficient plantar flexor ROM |
| Cause of Exaggerated Knee Flexion at Contact | weak quadriceps, quadriceps paralysis, hamstrings spasticity, insufficient extension ROM |
| Cause of Knee Hyperextension in Stance | compensation for weak quadriceps, plantar flexor contracture |
| Cause of Exaggerated Knee Flexion at Terminal Stance | hip and knee flexion contracture |
| Cause of Insufficient Knee Flexion with Swing | knee effusion, quadriceps extension spasticity, plantar flexor spasticity, insufficient flexion ROM |
| Cause of Excessive Knee Flexion with Swing | flexor withdrawal reflex, lower extremity flexor synergy |
| Cause of Insufficient Hip Flexion at Initial Contact | weak hip flexors, hip flexor paralysis, hip extensor spasticity, and insufficient hip flexion ROM |
| Cause of Insufficient Hip Extension at Stance | insufficient hip extension ROM, hip flexion contracture, lower extremity flexor synergy |
| Cause of Circumduction during Swing | compensation for weak hip flexors, dorsiflexors, and hamstrings |
| Cause of Hip Hiking during Swing | compensation for weak dorsiflexors, knee flexors, and compensation for extensor synergy pattern |
| Cause of Exaggerated Hip Flexion during Swing | lower extremity flexor synergy and compensation for insufficient ankle dorsiflexion |
| Antalgic Gait | a protective gait pattern associated with a rapid and shorter swing phase of the uninvolved limb. causes include disease (bone or joint), joint inflammation, or injuries to muscles, tendons, and/or ligaments |
| Ataxic Gait | gait characterized by staggering and unsteadiness. there is usually a wide BOS and movements are exaggerated. |
| Cerebellar Gait | a staggering gait pattern seen in cerebellar disease |
| Circumduction Gait | lower extremity advances with a circular motion during swing phase. usually to compensate for insufficient hip flexion, knee flexion, or dorsiflexion |
| Double Step Gait | a gait pattern in which alternate steps are of a different length or rate |
| Equine Gait | a gait pattern characterized by high steps. there is excess activation of the gastrocnemius |
| Festinating Gait | a gait pattern characterized by a pt. walking on toes as though pushed. it starts slowly, increases, and may continue until the pt. grasps an object in order to stop |
| Hemiplegic Gait | the patient abducts the paralyzed limb, swing it around, and bring it forward so the foot comes to the ground in front of them |
| Parkinsonian Gait | a gait pattern marked by increased forward flexion of the trunk and knees. gait is shuffling with quick and small steps. festinating may occur |
| Scissor Gait | a gait pattern in which the legs cross the midline upon advancement |
| Spastic Gait | a gait pattern with stiff movement, toes seeming to catch and drag, legs held together, and hip and knee joints slightly flexed. commonly seen in spastic paraplegia |
| Steppage Gait | a gait pattern in which the feet and toes are lifted through hip and knee flexion to excessive heights, usually secondary to to dorsiflexor weakness. foot slap will occur at initial contact |
| Tabetic Gait | a high stepping ataxic gait pattern in which the feet slap the ground |
| Vaulting Gait | a gait pattern where the swing leg advances by compensating through the combination of elevation of the pelvis and plantar flexion of the stance leg |
| Achilles Tendonitis | a repetitive overuse disorder resulting in microscopic tearing of collagen fibers characterized by aching or burning in the posterior heel, tenderness, pain with increased activity, and morning stiffness |
| Adhesive Capsulitis | loss of ROM in a capsular pattern of the shoulder that is ER>ABD>IR>FLEX. there is also night pain and localized pain extending down the arm. perform posterior mobilizations. |
| ACL Sprain | a non-contact testing injury associated with hyperextension, varus, or valgus stress to the knee. pt c/o a loud pop or feeling the knee "give away" or "buckling". anterior drawer test, lachman test, and lateral pivot shift test are used to identify |
| Congenital Hip Dysplasia | characterized by malalignment of the femoral head within the acetabulum in the last trimester. identified by ortoloni's and barlows test and ultrasound. "B comes before the O" |
| Transverse vs Longitudinal Limb Deficiencies | transverse deficiency refers to improper growth of a limb in girth longitudinal deficiency refers improper groth of a limb in length treatment focuses on symmetrical movements |
| Congenital Torticollis | unilateral contracture of the SCM muscle. presentation includes lateral cervical flexion to the same side and rotation toward the opposite side. manual stretching 3 times a day for 3-6 months. |
| Glenohumeral Instability | anterior dislocations are most common and happen when in a position that combines ABD, ER, and EXT. commonly associated with a bankart lesion. initially do isometrics and progress to strenghten shoulder stabilizers. |
| Impingement Syndrome | individuals in throwing activities, swimming, and racquet sports are most susecptible. pt. has a painful arc of motion (70-120 degrees of ABD), pain with overhead activities, and positive impingement sign. (HK, Neer, Hornblower Tests) |
| Juvenile Rheumatoid Arthritis | Oligoarticular (pauciarticular) is most common and affects less than 5 joints with asymmetrical involvement. Polyarticular is 2 second most common and presents with high female incidence, significant rhematoid factor and arthritis in 4+ joints |
| Lateral Epicondylitis | caused by repeated overuse of the wrist extensors, particularly extensor carpi radialis brevis. clinical symptoms include difficulty holding or gripping objects and insufficient forearm functional strength |
| Legg-Calve-Perthes Disease | degeneration of the femoral head due to a disturbance in the blood supply characterized by pain, decreased ROM, antalgic gait, and a positive trendelenburg sign. positioning, pain relief, and improving ROM is the primary focus. |
| MCL Sprain | usually injured d/t a blow to the outside of the knee causing a valgus stress. return to previous level of function in 4-8 weeks if no other involved structures. heels slides, quad closed chain and isometric exercises should be done. |
| Osgood-Schlatter Disease | refers to traction apophysitis causing inflammation at the tibial tuberosity. it is associated with times of rapid growth with boys being more susceptible. may use an infrapatellar strap. |
| Osteoarthritis | degneration of articular cartilage that most commonly affects the hands and weight bearing joints such as hips and knees. pt. has increased pain with activity and weather changes as well as nodes in hands, crepitus, edema, and limited ROM |
| Osteogenesis Imperfecta | a collagen disorder that effects all connective tissue in the body. type 1 and 3 have blue sclera and a triangle face. type 4 has shorter stature, bowing of long bones, a barrel shape chest, brittle teeth w/ near normal sclera |
| Patellofemoral Syndrome | caused by an abnormal tracking of the patella and occurs with excess lateral tracking in ext. pain is often behind the patella and is exacerbated with compression activities like ascending stairs. VMO is weak. clarke's sign and increased Q-angle. |
| Normal Patellar Tracking with Flexion or Extension | the patella slides superior with extension and inferiorly with knee flexion |
| Plantar Fasciitis | caused by excess pronation during gait, obesity, possessing a high arch, there will be severe pain when first standing up in the morning and can radiate up the leg or to the toes. point tenderness over the calcaneal insertion with bony growths present. |
| PCL Sprain | caused by posteriorly directed force such as when the knee hits the dishboard in a MVA or hyperflexion of the knee w/o a traumatic blow. test like posterior drawer test, posterior sag sign, and quadriceps active drawer test. |
| Which ligament can heal without surgical intervention? | The medial collateral ligaments will heal without surgical interventions secondary to its good vascular supply and anatomical position that prevents undue stress during the healing process. |
| Rheumatoid Arthritis | patients have prolonged morning stiffness, positive rheumatoid factor, bilateral involvement, swan neck deformity and women being more susceptible. during acute stages, avoid resistance, heat, and stretching. |
| Rotator Cuff Tear | may occur as a result of an acute traumatic event or due to a chronic degenerative pathology such as chronic tendonitis. drop arm test and empty can test can confirm supraspinatus involvement. pt. c/o of night pain or discomfort laying on involved arm. |
| PT Post Rotator Cuff Surgery | first 6 weeks, isometrics/gentle PROM like pendulums and positioning. 6-12 wks, add in progressive resistive exercises and AROM. 12+ wks, improve ROM, strength, and endurance. |
| Scoliosis | non-structural is reversible and can change with repositioning. it is non-progressive and is usually caused by poor posture or leg length discrepency. strengthen convex side, and stretch concave side. |
| Naming Scoliosis | the side where you see the hump. if the convex side is on the right it is right sided scoliosis. |
| Hip compared to Shoulder with Scoliosis | the side with the rib hump will have a contralateral hip hike. |
| Talipes Equinovarus | also known as clubfoot, is a deformity where there is adduction of the forefoot, varus positioning of the hindfoot, and equinus at the ankle. splinting and serial casting begins shortly after birth. |
| Hip Precautions for the Anterolateral Approach of a THA | avoid extension, external rotation, and adduction of the hip |
| Hip Precautions for the Direct Lateral Approach of a THA | avoid flexion of the hip beyond 90 degrees, extension, lateral rotation, and adduction of the hip. if gluteus medius was repaired, active or resisted activation may need to be avoided for 6-8 weeks |
| Hip Precautions for the Posterolateral Approach of a THA | avoid flexion of the hip beyond 90 degrees, adduction, and internal rotation. use of an abduction pillow |
| PT Intervention post THA | initiate hip protocols (ankle pumps, quad sets, glute sets, heel slides, and isometric abduction). encourages early ambulation with pt. adhereing to precautions. Outpatient to assist with progression to a cane. precautions for up to 3 months |
| Discharge requirements following a THA | the patient should be able extend the hip to neutral and flex the hip up to 90 degrees |
| PT Intervention post TKA | emphasize ankle pumps, quad sets and hamstring sets, as well as ROM and stretching. a goal of 90 degrees of knee flexion and 0 degrees of knee extension is often established prior to discharge from hospital or rehab facility |
| Precautions following a TKA | avoid squatting, quick pivoting, do not use pillows under the knee while in bed, and avoid low seating for several months after surgery. closed chain exercises and functional activities only when pt. reaches WBAT |
| Disease-Modifying Antirheumatic Agents (DMARDs) | Examples: Rheumatrax, Arava Indication: rheumatic disease |
| Glucocorticoid Agents (Corticosteroids) | Examples: Dermacort, Cordrol Indication: therapy for endocrine dysfunction; anti-inflammatory and immunosuppressive effects |
| Nonopioid Agents | Examples: Tylenol, Aspirin Indication: mild to moderate pain, fever, headache, muscle ache, inflammation (except acetaminophen) |
| Opioid Agents (Narcotics) | Examples: Demerol, OxyContin Indication: moderate to severe pain, management of opioid dependence, relief of severe and persistent cough |
| Corset Orthotic | utilized to provide pressure and relieve pain associated with mid and low back pathologies |
| Halo Vest Orthosis | invasive cervical thoracic orthosis that is commonly used with cervical spine injuries to prevent further damage or dislocation during the recovery period. pt. will wear until the spine becomes stable |
| Milwaukee Orthosis | designed to promote realignment of a scoliotic curve with corrective padding applied to the areas of the severity of the curve |
| Taylor Brace | a TLSO that limits trunk flexion and extension |
| Thoracolumbosacral Orthosis (TLSO) | a TLSO that limits all trunk motions and is commonly utilized as a means of post-surgical stabilization |
| Foot Orthosis | an insert that is worn inside a shoe aht corrects foot alignment and improves function. may also be used to relieve pain. they are custom molded. |
| Solid AFO | controls dorsiflexion/plantarflexion as well as inversion/eversion with a trim line anterior to the medial malleoli |
| Posterior Leaf Spring Orthosis | plastic AFO with a trim line posterior top the medial malleoli. its primary purpose is to assist with dorsiflexion and prevent foot drop. |
| Floor Reaction AFO | assists with knee extension during stance through positioning of a calf band and/or positioning at the ankle |
| Plastic AFO | the use of a plastic AFO is more cosmetic, lighter, and requires that if a patient presents with edema, it does not significantly fluctuate. |
| Metal AFO | the ankle joint may the ability to lock in to place and not allow any motion, or set to have limited anterior/posterior capability depending on the patient's needs |
| KAFO | both plastic and metal types allow for a lock mechanism at the knee that provides stability. the ankle is also held in proper alignment. |
| Craig-Scott KAFO | the KAFO is designed specifically for persons with paraplegia. it allows for a person to stand with a posterior lean of the trunk |
| HKAFO | indicated for patients with weakness in each of those joints. it can control rotation of the hip and abduction/adduction. restricts pts. to a swing to or swing-through gait. |
| Reciprocating Gait Orthosis (RGO) | a derivative of the HKAF. when the pt shifts weight onto a selected lower extremity, the cable system advances the opposite lower extremity. primarily used with paraplegia |
| Parapodium | standing frame designed to allow a pt. to sit when needed. primarily used in the pediatric population. |
| Cock-Up Splint | positions wrist and hand in functional position wrist in neutral or 12-20 degrees wrist ext fingers supported, all slightly flexed with thumb in partial opposition and abd used for pts with RA, fx of carpal bones, Colles' fx, CTS, stroke with paralysis |
| Jewett Orthosis | limits flexion, but encourages hyperextension used for compression fractures of spine |
| Medial Heel Wedge | used to prevent excessive hindfoot eversion |
| Lateral Heel Wedge | used to prevent excessive hindfoot inversion |
| Heel Wedges | can be used to treat symptoms associated with pes planus or pes cavus |
| Heel Lift | rigid insert that adds extra height to the heel. commonly used to take pressure off of achilles tendon for pts. with achilles tendonitis. can also limit the effects of a leg length discrepency |
| Heel Cushion | a soft pad that is placed on heel of the inner sole to help cushion the heel and thus derease pain in that region. may be used for a patient with a calcaneal spur or plantar fasciitis |
| Heel Cup | a rigid insert that that covers the plantar surface on all three sides. it helps stabilize the calcaneus in a neutral position and provide some shock absorption. may be used for a patient with a calcaneal spur or plantar fasciitis |
| Metatarsal Bar/Pad | a flat piece of padding that is placed just posterior to the metatarsal heads either on the outer sole (bar) or inner sole (pad). helps relive pain for patients with metatarsalgia |
| Rocker Bar | similar to a metatarsal bar except it is a convex strip. it assists pts. who have difficulty with the terminal stance phase of gait secondary to limited mobility in the foot, especially the great toe. can also relieve pain from metatarsal heads |
| Pressure Sensitive Areas for the Transtibial Residual Limb | fibular head, lateral tibial flare, tibial crest, distal end of fibular and tibia, patella, anterior tibial tubercle, peroneal nerve, and adductor tubercle |
| Pressure Sensitive Areas for the Transfemoral Residual Limb | greater trochanter, pubic tubercle, pubic ramus, pubic symphysis, distal end of femur, and perineum. |
| Prosthetic Cause of Lateral Bending | prosthesis too short, improperly shaped lateral wall, high medial wall, prosthesis aligned in abduction |
| Prosthetic Cause of Abducted Gait | prosthesis too long, high medial wall, poorly shaped lateral wall, prosthesis positioned in abduction, inadequate suspension, excessive knee friction |
| Prosthetic Cause of Circumducted Gait | prosthesis too long, excessive knee friction, socket too small, excessive plantar flexion |
| Prosthetic Cause of Excessive Knee Flexion during Stance | socket set forward in relation to foot, excessive dorsiflexion, stiff heel, prosthesis too long |
| Prosthetic Cause of Vaulting | prosthesis too long, inadequate socket suspension, excessive alignment stability, excessive plantar flexion |
| Prosthetic Cause of Rotation of Forefoot at Heel Strike | excessive toe-out built in, loose fitting socket, inadequate suspension, rigid SACH heel cushion |
| Prosthetic Cause of Forward Trunk Flexion | socket too big, poor suspension, knee instability |
| Prosthetic Cause of Medial or Lateral Whip | excessive rotation of the knee, tight socket fit, valgus in the prosthetic knee, improper alignment of toe break |
| Lateral Ankle Sprain | occurs due to excessive ankle inversion and involves the lateral ligament complex, mostly affecting the ATFL, but also involves the CFL and PTFL. pain elicited by passive inversion and end range PF. anterior drawer test assesses ATFL integrity. |
| Bicipital Tendonitis | repeated full abduction and ER of the humeral head can lead to irritation. usually repetitive overhead activities. pts. report deep ache directly in front and on top of shoulder. positive Yergason's test or Speed's test. |
| Rehab for Bicipital Tendonitis | acute rehab consists of education, guidelines for restrictions, pendulum exercises, and the use of TENS. |
| Osteosarcoma | usually affects bones with an active grows phase such as the femur or tibia usually in the growth plate. can metastasize early in the disease process. affects young children (more often boys). lie prone to prevent hip flexion contracture with a amputation |
| Arteriosclerosis Obliterans | also knows as PAD. results in ischemia with the affected areas presenting with necrosis, gangrene, and may require amputation. pt. usually smokes and has intermittent claudication in triceps surae as well as decreased pulse, skin temp, and pallor skin. |
| Positioning Following a Transtibial Amputation | keep the knee in extension as well as the hip in neutral as knee flexion and hip flexion contracture are common in a transtibial amputation. do not put a pillow under the knees while in bed |
| Positioning Following a Transtibial Amputation | patients should lie prone for a period of time each day with the knee adducted as patients with a transfemoral amputation are susceptible to hip flexion and abduction contractures. |
| Disk Herniation | often caused by twisting and bending, usually with the addition of some external load (like bending over to lift a heavy object) in conjunction with gradual age-related changes that cause disk degeneration. |
| Symptoms and PT for Disk Herniation | low back pain with unilateral radicular leg pain. symptoms are exaggerated by sitting, walking, standing, and any increase in abdominal pain. acute rehab consists of education and pain management. once tolerated, pt will progress to extension exercises. |
| Anterior GH Dislocation | commonly occurs when upper extremity is in a position of ABD, ER, and EXT. the limb will be positioned in slight ABD and ER with the pt. unable to touch opposite shoulder. "square" contour of the shoulder. possible nerve involvement except for ulnar nerve |
| Medial Epicondylitis | aka golfer's elbow. commonly occurs with repetitive wrist or elbow motions or gripping, and is often seen in racket sports. affects the pronators, wrist flexors, and finger flexors. |
| Splinting for Medial Epicondylitis | counterforce brace just distal to the elbow, to limit muscular strain. cock-up splint to limit repetitive movements of the wrist |
| TMJ | occurs due to change joint structure. the meniscus will be torn and cause bone on bone grinding. pt. will c/o of clicking or popping sound. splinting, pain management and education are main goals of PT. decrease grinding at night and stopping nail biting |
| Total Shoulder Arthroplasty | candidate if conservative treatment has failed, with irreparable damage to GH joint; or with bone tumor, paget's disease, or recurrent dislocations. AROM is contraindicated during 1st 6wks. first 3 wks immobilized with protocols set by PA. then isometrics |
| Anterior Compartment Syndrome | acute traumatic injuries are considered a medical emergency. the increase in pressure causes occlusion of BF which may cause necrosis or ischemia. pt. will have effusion of the tibialis anterior and pain with P/AROM. deep fibular nerve will be affected |
| Colles' Fx | occurs with reaching forward to break a fall (FOOSH). it is a transverse fx of the distal radius. pt. will present with a "dinner fork" or "bayonet" deformity. subjective report is very important for diagnosis. |
| De Quervain's Tenosynovitis | an inflammatory process of the APL and EPB. caused by repetitive use of thumb abduction and extension. diagnosis can be confirmed with a finkelstein's test. |
| Myositis Ossificans | calcification of muscle caused by neglecting to treat a muscle strain or contusion (failing to apply cold after injury, applying heat or having massage too soon after injury). quadriceps are common area. |
| Symptoms of Myositis Ossificans | pt. will have pain with functional activities, and stiffness and pain after prolonged rest. there will be a hard lump in muscle belly. bone will grow 2-4 wks after injury and mature in 3-6 months |
| Osteochondritis Dissecans | a condition where subchondral bone and its associated cartilage crack and separate from the end of the bone and freely float inside the joint. usually affects the knee, elbow, and ankle. symptoms are similar to myositis ossificans |
| Myositis Ossificans Vs Osteochondritis Ossificans | myositis ossificans involves the formation of bone inside the muscle belly whereas osteochondritis ossificans involves the associated cartilage inside a joint. |
| Osteomyelitis | an infection that occurs within the bone, most commonly secondary to staphylococcus aureus microbe. fever and chills are are common systemic complaints. localized complaints consist of pain, edema, and erythema. |
| Piriformis Syndrome | a result of compression or irritation of the sciatic nerve and is a common cause of generalized low back pain. symptoms are exacerbated by prolonged sitting and activities that combine IR and adduction of the hip. |
| Tarsal Tunnel Syndrome | occurs as a result of compression of the tibial nerve as it passes through the tarsal tunnel. caused by tumor, scar tissue, crush injury, severe ankle sprain, pes planus, deformity, or hindfoot valgus |
| Trochanteric Bursitis | lateral hip pain that doesnt involve the hip joint. acute causes include falls or impact sports. chronic causes include activities that produce friction between bursa and ITB. pain is at the lateral hip which may radiate to the lateral aspect of the thigh |
| UCL Sprain of the Thumb | the most common ligament injury in the hand caused by valgus force of the MCL joint of the thumb. "gamekeeper's thumb" and "skier's thumb" are associated names. symptoms include ecchymosis, pain, edema, and tenderness on the medial side of the thumb |
| Anterior Pelvic Tilt/Longer Leg Length Fix | Strengthen: abdominals and hip extensors Stretch: hip flexors and low back extensors |
| Posterior Pelvic Tilt/Shorter Leg Length Fix | Strengthen: hip flexors and low back extensors Stretch: abdominals and hip extensors |
| Flexor Digitorum Superficialis | the muscle that controls the finger flexors that attaches at the middle phalanx. they are the primary flexors of the PIP of digits 2-5 |
| Flexor Digitorum Profundus | the muscle that controls finger flexion that attaches at the most distal portion of the fingers. they are the sole flexors of the DIP of digits 2-5. |
| Extension Lag | when a muscle is not able to actively move a joint to its passive limit. PROM is always > AROM. a bony prominence does cause lag because it would interfere with AROM and PROM |
| Sacroiliac Dysfunction | signs include pain with prolonged sitting, standing or walking, stair climbing, rolling in bed, unilateral standing, or torsion activities. avoid going up multiple stairs at once, crossing legs when sitting, and swinging one leg at a time when leaving bed |
| ROM Norm for Shoulder Flexion | pt. is in supine. stabilize thorax to prevent extension of the spine. max range is 180 degrees. |
| ROM Norm for Shoulder Extension | pt. is in prone. stabilize the thorax to prevent flexion of the spine. max range is 60 degrees. |
| ROM Norm for Shoulder Abduction | pt. is in supine. stabilize the thorax to prevent lateral flexion of the spine. max range is 180 degrees. |
| ROM Norm for Shoulder Adduction | pt. is in supine. stabilize the thorax to prevent lateral flexion of the spine. |
| ROM Norm for Shoulder Internal Rotation | pt. is in supine with the shoulder abducted to 90 and the elbow flexed to 90. stabilize the distal end of the humerus to maintain the shoulder in 90 degrees of abduction. max range is 70. |
| ROM Norm for Shoulder External Rotation | pt. is in supine with the shoulder abducted and elbow flexed to 90 degrees. stabilize the distal end of the humerus to maintain the shoulder in 90 degrees of abduction. max range is 90 degrees. |
| ROM Norm for Elbow Flexion | pt. is in supine. stabilize the humerus to prevent flexion of the shoulder. max range is 150 degrees. |
| ROM Norm for Elbow Extension | pt. is in supine. stabilize the humerus to prevent flexion of the shoulder. max range is 0 degrees. |
| ROM Norm for Pronation and Supination of the Forearm | max range is 80 degrees. |
| ROM Norm for Wrist Flexion | max range is 80 degrees |
| ROM Norm for Wrist Extension | max range is 70 degrees |
| ROM Norm for Radial Deviation | max range is 20 degrees |
| ROM Norm for Ulnar Deviation | max range is 30 degrees |
| ROM Norm for Hip Flexion | pt. is in supine. stabilize the pelvis to prevent posterior tilting. max range is 120 degrees |
| ROM Norm for Hip Extension | pt. is in prone. stabilize the pelvis to prevent anterior tilting. max range is 30 degrees |
| ROM Norm for Hip Abduction | pt. is in supine. stabilize the pelvis to prevent lateral tilting and rotation and stabilize the trunk to prevent lateral flexion. max range is 45 degrees |
| ROM Norm for Hip Adduction | pt. is in supine. stabilize the pelvis to prevent lateral tilting. max range is 30 degrees |
| ROM Norm for Hip Internal and External Rotation | pt. is in sitting. stabilize the distal end of the femur. max range is 45 degrees |
| ROM Norm for Knee Flexion | pt. is in supine. stabilize the femur to prevent rotation, abduction, and adduction of the hip. max range is 135 degrees. |
| ROM Norm for Dorsiflexion | max range is 20 degrees |
| ROM Norm for Plantarflexion | max range is 50 degrees |
Created by:
bradenator8