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Orthopedics

Quiz yourself by thinking what should be in each of the black spaces below before clicking on it to display the answer.
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Question
Answer
Fascicles combine into:   muscle body  
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Slow twitch (type I) muscle   Oxidative; Aerobic; Endurance  
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Fast twitch (type II) muscle   Glycolytic (ATP system); Anaerobic; Speed/ Strength  
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Muscle Action: stimulus in neuron:   carried down axon to neuromuscular junction  
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At NMJ:   ACTH released from pre-synaptic vesicles & diffuses across synapse to receptor on muscle  
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Muscle Action: binding at receptor triggers:   depolarization, releasing Ca  
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Muscle Action: Calcium binds:   troponin  
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Muscle Action: troponin is bound; then:   Actin-myosin cross bridges form; muscle contracts  
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Tendon:   Attaches mx to bone; transfers mx action to bone; enclosed within a tendon sheath  
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Ligament:   Attaches bone to bone; provides stability to the joint  
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Dorsal Wrist Compartment I   APL & EPB  
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Dorsal Wrist Compartment II   ECRL, ECRB  
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Dorsal Wrist Compartment III   EPL  
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Dorsal Wrist Compartment IV   extensor digitorum comunis (four tendons) & extensor indicis (EDC, EI)  
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Dorsal Wrist Compartment V   extensor digiti minimi (EDM)  
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Dorsal Wrist Compartment VI   extensor carpi ulnaris (ECU)  
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Median nerve: Motor   Wrist flexors, thumb opposition  
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Median nerve: Sensory   Volar thumb, radial 2 ½ digits  
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Ulna nerve: Motor   Intrinsics, Adductor Pollicis  
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Ulna nerve: Sensory   Ulnar 1 ½ digits volar & dorsal  
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Radial nerve: Motor   Wrist extensors, APL, EPB  
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Radial nerve: Sensory   Dorsal thumb & radial half of hand  
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Vertebral Disk contains:   central nucleus pulposus; peripheral annulus fibrosis  
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Anterior Mxs:   Abdominal & Psoas  
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Posterior Mxs: Superficial:   Erector Spinae, Iliocostal, longissimus & spinalis  
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Posterior Mxs: Middle:   Multifida  
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Posterior Mxs: Deep:   Intersegmental  
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Anterior & posterior muscles alternate to:   control trunk movement  
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Sensory Dermatomes: Lumbar & sacral n. innervate:   lower extremities  
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LS Spine Exam: motor: L1:   Hip flexion  
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LS Spine Exam: motor: L2:   Hip adductors  
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LS Spine Exam: motor: L3:   Knee extension  
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LS Spine Exam: motor: L4:   Ankle dorsiflexion  
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LS Spine Exam: motor: L5:   Hallicus Longus extension  
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LS Spine Exam: motor: S1:   Hallicus Longus flexion  
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LS Spine Exam: sensory: L1:   Upper outer thigh  
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LS Spine Exam: sensory: L2:   Mid anterior thigh  
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LS Spine Exam: sensory: L3:   Below patella  
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LS Spine Exam: sensory: L4:   Medial ankle  
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LS Spine Exam: sensory: L5:   First web space  
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LS Spine Exam: sensory: S1:   Lateral ankle  
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LS Spine Exam: DTRs: Knee:   L2,3,4  
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LS Spine Exam: DTRs: Ankle:   S1  
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Cartilage is nourished and maintained by:   hydrostatic transfer of joint fluid (no vascular network); need ROM with joint loading  
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Mx decrease w/age   strength dec 15% / decade (50-70 yo); mass dec 40% by 80 yo  
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MS H&P: AMPLE =   Allergies, meds, Past Hx , Last meal, Events of trauma; PE  
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Strength 0/5   No movement  
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Strength 1/5   Trace movement, fasciculations  
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Strength 2/5   FROM without gravity  
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Strength 3/5   FROM against gravity but no resistance  
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Strength 4/5   FROM against gravity and mild resistance  
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Strength 5/5   FROM: Full Resist; Normal ROM  
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Resisted ROM: Neck Flex/Extend: level:   C1-2  
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Resisted ROM: Neck Lateral Flexion: level:   C3  
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Resisted ROM: Shoulder Shrug: level:   C4, CN XI  
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Resisted ROM: Shoulder Abduction: level:   C5  
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Resisted ROM: Elbow Flex-Wrist Extend: level:   C6  
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Resisted ROM: Elbow Extend: level:   C7  
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Resisted ROM: Hand Grip: level:   C8  
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Resisted ROM: Abduction of Fingers: level:   T1  
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Resisted ROM: Opposition of Fingers/Pincer: level/mx:   Interosseous muscles  
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Resisted ROM: Hip flexion: level:   L1-L3  
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Resisted ROM: Knee extension / Ankle dorsiflexion: level:   L4  
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Resisted ROM: Great toe extension: level:   L5  
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Resisted ROM: Ankle plantar flexion: level:   S1  
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Pulses : normal =   2+  
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Gait categories   Normal, Unsteady, Cautious, Antalgic, Use of assisted devices  
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Open chain exercise:   Distal end of limb is free, isolates mx (i.e., seated leg extension, biceps curl)  
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Closed chain exercise:   Distal end is fixed, recruits accessory muscles (e.g., push-ups, squats)  
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ROM: Hand   CMC flex: 0-15; CMC ext: 0-30; MCP: 0-90; PIP: 0-100; DIP: 0-70  
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ROM: Elbow   Flexion: 0-150; Pronation/supination: 0-80  
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ROM: Wrist   Extension: 0-60; Flexion: 0-70; Ulnar deviation: 0-30; Radial deviation: 0-20  
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ROM: Hip   Flexion: 0-100; Ext: 0-30; Abd: 0-40; Add: 0-20; IR: 0-40; ER: 0-70  
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ROM: Knee   Flex: 0-140  
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ROM: Ankle   Dorsiflexion: 0-20; Plantar flexion: 0-40; Inversion: 0-30; Eversion: 0-20  
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ROM: Cervical Spine   Flexion: 0-45; Extension: 0-45; Lateral flexion: 0-45; Rotation: 0-80  
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ROM: Thoracolumbar Spine   Flexion: 0-90; Extension: 0-30; Lateral flexion: 0-30; Rotation: 0-30  
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Axillary nerve innervates:   C5-C6. Motor: deltoid, teres minor, triceps). Sensory: shoulder joint, inferior deltoid  
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Musculocutaneous nerve innervates:   C5-C7. Motor: coracobrachialis, biceps, bracialis. Sensory: radial side of forearm-  
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Radial nerve innervates:   C5-T1. Motor: triceps, hand extensors. Sensory: dorsal hand  
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