Term | Definition |
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 |