Final Exam Study Guide: Gait, Scapulohumeral Movement, and MMT

Flashcards covering gait analysis, weight-bearing statuses, scapulohumeral rhythm, muscle synergists/antagonists, elbow anatomy, MMT grading, and pinch patterns based on lecture notes.

What is the minimum MMT grade required for efficient ambulation?

At least $3+/5$

How is 'Gait' defined in the context of ambulation?

Gait is the manner in which one ambulates (walks).

What are the two divisions of the gait cycle and their approximate durations?

Stance phase (over half of gait cycle, or approximately $62\%$) and Swing phase ($38\%$).

Name the three rockers of gait.

Heel rocker, Ankle rocker, and Toe rocker.

List the eight phases of gait in the correct order.

Initial contact, Loading response, Midstance, Terminal stance, Pre-swing, Initial swing, Mid-swing, and Terminal swing.

What mechanical events occur during the 'Loading response' phase of gait?

Forefoot contacts floor, first period of double limb stance, heel rocker, controlled ankle plantarflexion, controlled knee flexion, and hip stability.

What occurs during the 'Pre-swing' phase of gait?

The foot is on the ground while the knee flexes (passive knee flexion).

Define the weight-bearing statuses WBAT and TTWB.

WBAT (Weight bearing as tolerated): as much weight as the patient can tolerate on the LE; TTWB (Toe tap weight bearing): can put toe down to assist with ambulation, weighting determined by physician.

Describe the scapulohumeral rhythm/ratio after the initial $30$ degrees of abduction.

After the first $30$ degrees of abduction (which occurs at the glenohumeral joint), every $2$ degrees of abduction must be supplemented by $1$ degree of upward rotation ($2:1$ ratio).

Which muscle is the prime mover for Scapular Elevation and what are its synergists?

Prime mover: Upper trapezius; Synergists: Levator scapulae and rhomboids.

Which muscle is the prime mover for Scapular Protraction and which muscle prevents winging of the scapula?

The prime mover is the Serratus anterior, which also helps prevent winging of the scapula.

What are the antagonists to Scapular Retraction?

Serratus anterior and pectoralis minor.

According to the transcript, what is the origin, insertion, and innervation of the Serratus anterior?

Origin: Lateral surface of the $1st$ through $8th$ ribs; Insertion: Anterior surface of the vertebral border of the scapula; Innervation: Long thoracic nerve ($C5$, $C6$, $C7$).

Identify the muscles responsible for elbow flexion.

Brachialis, Biceps Brachii, Brachioradialis, and Pronator Teres.

What is the normal range of motion (ROM) for elbow flexion/extension and forearm supination/pronation?

Elbow Flexion/Extension: $0$ to $115$ degrees; Forearm Supination and Pronation: $0-80$ degrees.

On the MMT grading scale, what does Grade $3$ (Fair) represent?

Full Range of Motion (ROM) against gravity with no added resistance.

How does MMT Grade $2+$ (Poor Plus) differ from other grades?

It can represent two scenarios: less than half ROM against gravity with no resistance, or full ROM in a gravity-eliminated plane.

Define Grade $1$ (Trace) and Grade $0$ (Zero) in Manual Muscle Testing.

Grade $1$: No joint movement, but a contraction is palpable; Grade $0$: No contraction felt or seen.

What is the difference between Power Grasp and Precision Grasp?

Power Grasp focuses on the strength of the grip (e.g., opening a jar), while Precision Grasp focuses on accuracy and coordination of the fingertips (e.g., holding a pencil).

Define Lateral Prehension (Key Grip) and identify an adaptive tool for it.

It is used for turning a key; $3D$-printed large key holders can be used to increase surface area for patients with limited dexterity.

What are the characteristics of the Lumbrical Grasp?

It is often described as "holding a plate" or making a puppet shape with the hand.

What are the common types of nerve injuries affecting muscle strength?

Common types include compression, laceration, and traction injuries, which can lead to weakness or paralysis of muscles.

What is the common presentation of wrist drop?

Wrist drop is characterized by the inability to extend the wrist and fingers, often caused by radial nerve injury.

What muscles are primarily involved in wrist flexion?

The primary muscles are the flexor carpi radialis, flexor carpi ulnaris, and palmaris longus.

What are the primary muscle groups of the hand responsible for fine motor movements?

The intrinsic muscles of the hand, including the lumbricals, interossei, and thenar/hypothenar muscles.

What is the function of the Flexor Pollicis Longus?

It aids in flexing the thumb at the interphalangeal joint.

What are common signs of a median nerve injury in the hand?

Signs include loss of thumb opposition, weakness in grip, and sensory loss in the thumb, index, and middle fingers.

What is the clinical significance of the Froment's sign?

Froment's sign tests for ulnar nerve dysfunction by assessing the ability to grasp paper between the thumb and index finger.

Which muscles are primarily responsible for wrist extension?

The primary wrist extensors include the extensor carpi radialis longus, extensor carpi radialis brevis, and extensor carpi ulnaris.

What is the role of the hypothenar muscles?

The hypothenar muscles control movements of the little finger and facilitate grip.

What are the effects of a ulnar nerve injury on hand function?

It leads to loss of function in the intrinsic muscles, causing claw hand deformity and impaired fine motor skills.

Define FWB (Full Weight Bearing).

Full Weight Bearing: the patient can place full weight on the lower extremity during ambulation.

Define PWB (Partial Weight Bearing).

Partial Weight Bearing: the patient can put a specified amount of weight on the lower extremity, as determined by the physician.

What does WBAT stand for and mean?

WBAT (Weight Bearing As Tolerated): the patient can bear as much weight on the lower extremity as they can tolerate.

Define TTWB (Toe Tap Weight Bearing).

TTWB (Toe Tap Weight Bearing): the patient may place their toe down to assist with balance but is not allowed to bear weight on the lower extremity.

What are the implications of FWB for rehabilitation?

FWB allows for normal ambulation and weight-bearing activities, promoting faster recovery and muscle strengthening.

What is the significance of the various weight-bearing statuses in rehabilitation?

These statuses help guide rehabilitation protocols, ensuring safe progression of activities based on the patient's condition and healing.