NPTE MSK

for Adhesive capsulitis is the best glide. it has to say adhesive capsulitis to use the exemption, it cannot just say capsular pattern.

posterior-inferior best evidence is stretching

what creates more force eccentric or concentric?

eccentric

inability to shortened simultaneously at two joints. (too much shortening)... think of function of the muscle

active insufficiency

inability to lengthen simultaneously at two joints. (too much lengthening).... Think of stretching of muscle

passive insufficiency

_____ active insufficient muscles

strengthen

____ passive insufficient muscles

stretch

Coxa Vara

decreased angle of inclination

<120

coxa valga

increased angle of inclination >135

Supine to sit : leg is short in supine then long

pelvis is Posteriorly rotated

supine to sit : leg is long in supine then short

anterior rotated

Supine to sit test: long to short =

anterior rotated

supine to sit: short to long

posterior rotated

femoral anteversion causes ____tibal torsion and ___ toeing

internal tibial torsion

in-toeing

fact joints bear ____ % of compressive load

30

facet and intervertebral discs bear _____% of shear and torsional load

80

Spondylolisthesis must avoid what?

hyperextension of the spine

vertebrae sit on top of each other so if we hyperextend we will make it worse.

-even though flexion will cause mild symptoms is always better than doing hyperextension, so always avoid hyperextension compared to hyperflexion.

degeneration of spine and or intervertebral disc

spondylosis

defect in the pars interarticularis of the arch of the vertebra

*here there is a fracture but it is not displaced

spondylolysis

B fracture of pars with forward displacement of one vertebra over another

spondylolisthesis

backward displacement of one vertebrae on another

RETROLISTHESIS

usually called gymnast spine or juvenile kyphosis, it is going to be typical finding of crowding of these vertebrae's, wedging of T7-T9. they are also called Schorml nodes.

Scheunemanns disease

Stenosis diagnostic test

MRI

patients with stenosis will feel comfortable going up or down the ramp?

up

*flexion exercises

Stenosis pain increased with what?

extension

stenosis pain is decreased with what?

flexion

*walking up a hill

Vascular claudication pain is increased with what

walking uphill

*physical exertion

Cervical spine: ____ and ____ are in the same direction

side bending

rotation

Lumbar spine: ___ and _____ are in the opposite direction

side bend

rotation

Leg that is short _____ more

PF

leg that is long ____ more

DF

tight hip flexors will cause a ______ pelvic tilt

anterior

Upper crossed syndrome

A postural distortion syndrome characterized by a forward head and rounded shoulders.

Lower crossed syndrome

a postural distortion syndrome characterized by an anterior tilt to the pelvis (arched lower back)

screw home mechanism

A phenomenon that increases knee joint stability by locking the femur on the tibia (or vice-versa) when the knee is fully extended.

causes tibia to rotated laterally on femur at full extension

Scoliosis is named for the _____

convexity

_____ scoliosis has a rotation component

structural

*functional does not

is an avulsion/tear of the ant/inf capsule & inferior labrum tear (inf glenohumeral lig)

Bankart

compression fracture of a posterior humeral head due to dislocation

hill Sachs

superior labrum tearing or pulling away by the biceps insertion which is under the subacrominal arch

SLAP

whats stronger knee extensors or flexors?

extensors

ideal ratio is 2:1

ALWAYS REMEMBER: whats stronger hamstrings or quads?

quads

is static and occurs when a muscle contracts without a length change. Strengthening of muscles is developed at a point in the ROM, not over the entire length of muscle.

isometric

is dynamic and can have constant or variable load as the muscle lengthens or shortens through the available ROM. Speed can be variable for this type of exercise

isotonic

is dynamic and has a speed control for muscle shorting and lengthening. Resistance is accommodating and variable. Peak torque, the maximum force generated through the ROM, is inversely related to angular velocity, the speed, the body segment moves through its ROM.

isokinetic

cane goes on what side?

opposite side of weakness

o A cane (or any other AD) is never given in order to facilitate or strengthen a muscle.

true

hips & knees flexed 90˚, post force through knee à positive if hip dislocates

Barlow

abd the hip with ant force to relocate the hip

ortalani

§ Age of onset 2-10 years

§ Flattening of femoral head

§ Prognosis: better if the patient is young

leg perthes

Age of onset leg perthes

2-13

age of onset SCFE

10-17

ROM limitation with congenital hip dislocation

abduction

legg calve perthes disease treatment

contain the femoral head in the acetabulum using a brace

_____ rotation of the scalp causes scalar winging

upward

gold standard mobilization for adhesive capsulitis

posterior glide

then posterior-inferior

whats better for adhesive capsulitis ? resistive exercises or anterior glide?

resistive exercises

*never choose anterior glide

Upward rotator of the scapula

upper trap

serratus

lower trap

Downward rotators of scapulas

rhomboids

levator

pec minor

For chronic LBP what is the first exercise we teach?

begin with awareness of safe spinal motions

what is this disease? back pain, morning stiffness, better with movement

ankylosing spondylitis

Tibofem joint convex concave

context femoral condyles articulate with the concave tidal plateus

Saddle on bike: higher seat height equals

_______ knee extension

_______ work on the hamstrings muscles

_______ less lateral displacement of the knee

greater knee extension

greater work on the hamstrings muscle

less lateral displacement of the knee

Bike saddle: lower seat height=

______ flexion of knee

______ performance

_____ stress on the knee

greater flexion of the knee

decrease in performance

greater stress on the knee

backward positioning of the bike saddle =

______ work on the hamstrings

_______ stress on the knee

greater work on the hamstrings

less stress on the knee

forward position on the bike saddle =

______ work on the rectus

_____ stress on the patella

greater work on the rectus

more stress on the patella

_______ glide of the calcaneus will improve pronation (EV)

medial

_______ glide of the calcaneus will improve supination (IV)

lateral

For Achilles tendon repairà after they take out the cam boot we can use a ________ to provide some support to the tendon essentially, we don't want to stretch too much.

1-1.5cm heel lift

beginning of a walking event by one limb and continuing until the event is repeated again with the SAME limb

Time from heel strike to the next ipsilateral heel strike

gait cycle

one complete Gait cycle

stride

beginning of an event by one limb until the beginning of the same event with contralateral limb

step

causes of lateral lean in gait

o Weak hip abductors

o Adductor contracture

o Short limb

o Impaired body image (hemiplegic)

tibialis anterior, EDL, EHL activity prior to and during heel strike

eccentric contraction, lowers foot to ground

tibialis anterior, EDL, EHL activity prior to and during pre swing

concentric contraction (DF foot and clears foot)

calf muscles during loading response (foot flat)

eccentric contraction, control of the tibia over the foot

step length deviations have to do with what?

ROM deficits

if the hip flexors are tight it will cause a step length deficit on what side?

opposite side

if the hip extensors are tight it will cause a step length deficit on what side?

same side

tightness of hip flexors (anterior pelvic tilt) will have deficits in what phase of gait?

terminal stance

*hip flexor contracture causes the leg to not go into full terminal stance so secondarily it creates an early toe off.

tightness of hip extensors will affect _______ phase of gait

swing

Deviation: lateral bend

Anatomic cause

Prosthetic cause

weak abductors, short amputation

Short prosthesis, inadequate lateral wall

deviation: abduction

anatomic cause

prosthetic cause

abduction contracture, Knee instability

long prosthesis, abducted hip joint

deviation: lodosis

anatomic cause

prosthetic cause

hip flexion contracture, weak extensors

anterior socket wall discomfort

deviation: forward flexion

anatomic cause

prosthetic cause

weak quads

unstable knee joint, short walker

above knee prosthesis: low walls are similar to what?

weak muscles

low anterior wall=weak ___

quad

low lateral wall = weak

glut med

low posterior wall = weak

glut max

above knee prosthesis:

high walls are similar to what?

tight muscles

high anterior wall = tight

hip flexor

high lateral wall = tight

glut med

high posterior wall = tight

hip extensors

So, patients with PF contracture they will have hyperextension of the knee- to improve this you can place the prosthetic foot into more _____ to improve knee flexion.

DF

lateral calcanea whip is due to excessive _____ rotation

medial

medial calcanea whip is due to excessive ____ rotation

lateral

Parkinson's disease TRAP

T: tremos (pill rolling)

R: rigidity (lead pipe throughout/ cogwheel on/off)

A: akinesia, bradykinesia

P: postural instability

Parkinson's disease appears when in life?

55 and later

gait parkinsons

festinating

freezing

this type of gait is a progressive increase in speed with shortening of stride

festinating

this type of gait is a sudden abrupt inability to initiate any movement

freezing