-
In adults, what type of bone produces RBCs?
flat bones
-
What are 2 examples of minerals taht can be stored in bones and joints?
calcium and iron
-
What are nonmobile joints called?
nonsynovial
-
What are moveable joints called?
Synovial
-
What do synovial joints have in them?
Cartilage, Ligaments, bursa, muscles attached, tendons and fasiculi
-
What does cartilage do?
covers the surface of bone
-
What do ligaments do?
- Connects bone to bone
- provides joint stability
-
What is bursa?
sac of viscous synovial fluid for friction free movement of joint
-
What is bursitis?
- inflammation of bursa
- may be caused by overuse or infection
-
What are fasculi?
bundles of muscle fibers
-
what are tendons?
attach muscle to bone
-
what is tendonitis?
inflammation of tendon
-
What is flexion?
forward or lateral bending
-
What is abduction?
away from midline
-
what is pronation?
palm down
-
what is inversion?
sole in
-
what is protraction?
body part forward
-
where can you internally rotate?
shoulder and hip
-
what is radial deviation?
move hand inward
-
what is rotation?
moving head around central point
-
what is extension?
straightening
-
what is adduction?
towards midline
-
what is supination?
palm up
-
what is eversion?
sole out
-
what is retraction?
body part backward
-
what part of the body can you externally rotate?
shoulder/hip
-
what is ulnar deviation?
move hand outward
-
What is RA? What are the symptoms?
Rheumatoid arthritis. It is inflammation of synovium (lining of the joint)
- symmetric joint involvement
- worse in the am
- movement decreases pain
-
What is DJD? What are th charicteristics of it?
Osteoarthritis, Degenerative Joint Disease. The cartilage wears away.
- may affect unilateral joint
- worse in pm (wear and tear disease)
-
What is MOI?
Method of Injury
-
What is HNP? What are the sensory and motor changes that come with it?
Herniated Nucleus Pulposus ("herniated intervetebral disc")
- Sensory changes: numbness of LE (lower extremities), tingling
- motor changes: weakness
-
what may preclude independent living?
decreased functional ability
-
What are the 4 things you will do to examine each joint?
- inspect
- palpate
- test ROM
- test muscle strength
-
What techniques will you use while examining?
- cephlocaudal (head to toe)
- proximal to distal
- support each joint
- compare corresponding joint (examine unaffected joint first)
-
What are the signs of inflammation or infection of a joint?
redness, heat, swelling, pain
-
What are the 2 causes of joint swelling?
- effusion (excess joint fluid)
- inflammation of surrounding soft tissue (bursa tendon)
-
What is a dislocation?
bone out of joint position
-
what is a subluxation
parital dislocation, bone moves in and out of position
-
what is a contracture?
shortening of muscle leading to limited ROM
associated with BR and immobility
-
What is crepitation? (in conjunction with ROM?)
noise adn palpable crunching with motion
-
What are the 5 grades on the ROM scale?
- 5- FROM against full resistance- normal
- 4- FROM against some resistance- slight weakness
- 3- FROM without resistance- moderate weakness (can move against gravity- over head, but not resistance)
- 2- Full passive ROM- severe weakness, can only roll extremity- cant raise arms over head
- 1- slight muscle contraction- can not move extremity
- 0- no muscle contraction
-
How wide should one be able to open their TMJ?
3-6 cm
-
How far should one be able to move their TMJ side to side?
1-2 cm
-
What nerve are you assessing when palpating the masseter muscle?
CN5
-
What bones are considered art of the shoulder?
scapula, humerus and clavicle
-
What is the subacromial bursa?
- cushioning pad
- allows humerus to move under the acromion process of the scapula during abduction of the arm.
-
What four muscles are part of the rotator cuff?
- supraspinatus
- infraspinatus
- teres minor
- subscapularis
(and tendons that stabilize the joint)
-
What are the palpable landmarks of the shoulder?
- acromian process of the scapula
- greater tublercle of the humerus
- coracoid process of the scapula
-
What is the arm drop test for? What are the components of the test?
tests for rotator cuff tears
- abduct arms past 90 degrees adn ask to lower slowly
- at about 90 degrees, if the arm suddenly drops, there is a supraspinatus muscle weakness, may see the deltoid attempting to compensate
-
What are the bone of the elbow?
articulation of teh humerus, radius and ulna
-
Where is the olecranon bursa?
between olecranon process and skin
-
What is the "funny bone" nerve?
- ulnar nerve, olecranon nerve
- between medial epicondyle and olecranon process.
-
What is epicondylitis
tendonitis
- occurs with repetitive movement
- assess for pain with flexion and extension
-
What would pain over the medial epicondyle suggest?
medial epicondylitis or golfer's elbow
-
What would pain over the lateral epicondyle suggest?
lateral epicondylitis or tennis elbow (from backhand swing movement)
-
Whar are characteristics of Osteoarthritis or DJD?
hard tender nodules on fingers:
- Heberden's nodes: DIP joint
- Bouchards nodes: PIP joint
-
What is common with RA?
- Flexion contracture of MCP
- called Swan's neck or boutonniere deformity
-
When do we commonly see carpel tunnel syndrome?
during pregnancy
-
What are the median nerve distribution tests for Carpel tunnel syndrome? and the results?
- Phalen's- positive (paresthesia of fingers with median nerve distribution
- Tinel's sign- positive (numbness and tingling over median nerve distribution)
- Thenar eminence atrophy
-
What are the Ulnar nerve distribution tests for carpel tunnel syndrome?
- Phalen's- positive (paraesthesia of fingers with ulnar nerve distribution)
- Hypothenar atrophy
-
What is Phalen's?
(a test for CTS)
90 degree flexion of wrist x 60 sec
will cause paraesthesia of fingers if t has CTS
-
What is tinel's sign?
(a test for CTS)
percuss median nerve
will cause numbness and tingling if pt has CTS
seen in median nerve distribution
-
What is Hypothenar atrophy?
(a test for CTS)
palmar area distal to wrist on ulnar side
seen in ulnar nerve distribution
-
What is thenar emience atrophy?
(a test for CTS)
- round mound proximal to thumb
- seen in median nerve distribution
-
What comprises the hip?
acetabulum and head of femur.
-
Do you inspect the hip while standing or sitting?s
standing!
-
What are palpable landmarks of the hip?
- anterior superior ilian crests
- ischial tuberosity (what you sit on)
- greater trochanter
-
What are the 3 bones that comprise teh knee?
femur, tibia and patella
-
What is the largest joint in the body?
KNEE
-
What does the medial and lateral menisci do?
cushions tibia and femur (it is cartilage)
-
What are the ligaments of the knee?
medial and lateral collateral (med and lat stability)
anterior adn posterior cruciate (post and ant cushions)
-
Palpate the knee while the pt is.........
supine
-
What are things that we will inspect for in the knee?
- shape and contour (note hollows on either side of patella)
- note inflammation and deformities
- assess quads for atrophy
-
What comprises the tibiotalor joint?
articulation of tibia, fibula nad talus
-
What are the landmarks of the ankle?
- medial malleolus
- lateral malleolus
- most feet have a longitudinal arch
-
What should you have the pt do while you are inspecting the ankle- sit, stand, or walk?
all three
-
Findings with the toes:
- Toes should lie flat
- hammer toes are more common with a high arch (hyerextension od MTP and flexion of PIP)
- claw toes
- hallux valgus (bunion)- lateral deviation of toes
-
Where should weight bear on the foot?
Weight should fall in the middle of the foot
-
What are the characteristics of a supinated foot?
strike of heel on ground is concentrated on outsid eof foot; ankles appear to turn outward
-
What are the characteristics of a pronated foot?
strike of heel on ground is concentrated on inside of foot; ankles appear to turn inward
-
What is the technical name for a foot drop?
plantar flexion
-
Wherer are the 4 major landmarks of the spine?
- C7- at vetebral prominens
- T7- inferior angle of scapula
- L4- crosses the highest point on each iliac crest
- S2- crosses two symmetric dimples over posterior superior iliac spines
-
What are the 4 curves of the spine?
- cervical
- thoracic
- lumbar
- sacral
-
What is scoliosis?
lateral curvature of thoracic adn lumbar spine- note asymmetry of shoulders, scapular, and iliac crests when bending forward.
-
What is kyphosis?
enhanced thoracic curve
-
what is lordosis?
enhanced lumbar curve
-
How do we measure leg length?
anterior iliac spine to medial malleolus
-
What are the 4 landmarks that we inspect for the back?
symmetry of shoulders, scapulae, iliac crests, and gluteal folds with knees and feet together.
-
What indicates a herniated nucleus pulposus?
pain shoots down buttocks and leg past knee
-
When does long bone growth end?
until about age 20
-
Where do children grow? (place on bone, name for growth plate)
epiphyses
-
What are common sightings in preschool aged children?
- lordosis is common
- normally may apear flat footed (fat pad along arch until age 3)
- walks with broad stance until age 3
- toeing in common until age 3
- Not so normal things::
- oberve for bow legs or knock knees
- check for trendelenburg sign
-
What is genu varum?
bow legs
-
what is genu valgum?
knock knees
-
What age should you start scoliosis screening?
age 12
-
What does pregnancy do to the spine?
- progressive lordosis
- anterior cervical flexion, kyphosis, adn slumping of the shoulder girdle by 3rd trimester (may cause median and ulnar nerve impingement in upper extremities)
-
What are common findings in older adults?
- osteoporosis
- height decreses (up to 2 inches)
- loss of sq fat from bony prominences
- loss of muscle mass
-
What are the characteristics of the height decreses in older adults?
- discs thing and collapse (6th adn 7th decade)
- kyphosis of spine occurs with backward head tilt
- hips and knees flex
- up to 2 in of loss
-
What is osteoporosis?
- loss of bone matrix
- more in females than males
- more in whites than blacks
-
What are the advantages of blacks in consideration of their bones?
longer and denser long bones (less osteoporosis)
-
Asians and Eskimos have a lower _______ thank whites and blacks
bone density
|
|
