Muscle Gait Lecture Exam 1

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dcmommy13
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66302
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Muscle Gait Lecture Exam 1
Updated:
2011-02-15 16:43:19
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Life University
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*Taught by Dr. Roche this quarter due to Krothe breaking her leg*
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  1. Fair game for exam:
    • Synergist, antagonist.
    • Planes, axis, translation.
    • 40% from lab:
    • -inclinometry.
    • -goniomentry: axis of rotation.
    • -muscle testing: action, innervation, testing.
  2. Which mover is primarily responsible for generating a specific movement?
    • Agonist.
    • (primary mover).
  3. Which mover performs, or assitst in performing the same set of joint motion as the agonist?
    • Synergist.
    • (Secondary mover).
  4. Which mover is responsible for returning a limb to its initial position?
    • Antagonist.
    • (Tertiary mover).
  5. Rotator Cuff Muscles:
    • Supraspinatus: abduction (suprascapular N).
    • Infraspinatus: external rotation (suprascapular N).
    • Teres minor: external rotation (axillary N).
    • Subscapularis: internal rotation (upper/lower subscapularis N's).

    • Action cheer: AB-EX-EX-IN
    • Nerve cheer: Supra-Supra-Ax-Up/Lo.
  6. Which two movers take a joint through it's full ROM?
    Primary & secondary.
  7. Example: Shoulder ABduction.
    Primary: ?
    Secondary: ?
    Tertiary: ?
    • Primary: supraspinatus (abducts).
    • Secondary: middle deltoid (abducts).
    • Tertiary: latissimus dorsi (adducts).
  8. Example: Ankle Dorsiflexion.
    Primary: ?
    Secondary: ?
    Tertiary: ?
    • Primary: TA (dorsiflexes).
    • Secondary: EHL (dorsiflexes).
    • Tertiary: Gastroc (plantar flexes).
  9. Contraindications for muscle testing:
    • 1. Fracture.
    • 2. Dislocation.
    • 3. Severe joint instability (chronic ankle sprain/strain).
    • 4. Patient <5 yo.
    • 5. Resistance to motion would be over a wound (surgical suture).
  10. Cautions for muscle testing:
    • 1. Patient has osteoporosis.
    • 2. Patient has metastatic disease.
  11. True or false: muscle testing is always done at the beginning of the ROM.
    • False: always test 1/2 way through ROM.
    • -Never stabilize on a muscle belly.
    • -Never stabilize on a joint.
    • -Always test bilaterally.
    • -Hold the test for 3-5 seconds.
  12. True or false: when testing a muscle you should contact the muscle tendon proximal to it's insertion.
    False: contact distal to insertion.
  13. Which muscle grade exhibits sufficient contraction to move the joint through the full ROM against gravity, but NOT against resistance?
    • Grade 3.
    • Grade 4: sufficient contraction to move the joint through the full ROM against full gravity & slight resistance.
    • Grade 5: (normal) sufficient contraction to move the joint through full ROM against gravity & full resistance.
  14. Which muscle grade exhibits sufficient contraction to move the joint through the full ROM, but not against gravity?
    • Grade 2.
    • Grade 1: slight muscle contraction but no movement.
    • Grade 0: no detectable muscle contraction or joint movement.
  15. What is the a/k/a for the Sagittal plane? How does it divide the body?
    • Sagittal plane: median plane.
    • Divides the body into right & left.
  16. What is the a/k/a for the coronal plane? How does it divide the body?
    • Coronal plane: frontal plane.
    • Divides the body into anterior & posterior.
  17. What is the a/k/a for the horizontal plane? How does it divide the body?
    • Horizontal plane: transverse plane.
    • Divides the body into superior & inferior (cephalic & caudal respectively).
  18. Planes --> axis:
    axis: how the rotation occurs.
    • Sagittal (median) plane --> coronal (bilateral) axis.
    • Coronal (frontal) plane --> sagittal (A-P) axis.
    • Horizontal (transverse) plane --> VLP (Vertical Longitudinal Polar).
  19. Where is the center of gravity located within the body?
    • Where all three cardinal planes intersect, slightly anterior to the 1st or 2nd sacral tubercle.
    • Pt1NB Bonus: eyes are OPEN in anatomical position.
  20. True or false: goniometers are combination move instruments because it's triaxial.
    FALSE! Goniometers are pure motion instruments because they are uniaxial.
  21. What is the term used to describe the end of passive ROM?
    • End Feel.
    • Hard: bone contacting bone (elbow extension).
    • Firm: muscle, capsule, or ligamentous stretch (finger extension, hip flexion with the knee straight).
    • Soft: soft tissue approximation (flexion of the knee).
  22. What does abnormal soft end feel indicate?
    • Soft tissue edema (it feels boggy).
    • End occurs sooner or later in the ROM than is normal, or in a joint where you would expect firm or hard end feel.

    • Abnormal firm: shortening of capsule, ligament or muscle.
    • Abnormal hard: loose bodies in a joint, fracture.
    • Empty: acute joint inflammation, fracture, or abscess.
  23. What is the plane for external & internal rotation of glenohumeral joint? the axis?
    • Glenohumeral internal & external rotation:
    • Transverse (horizontal) plane.
    • VLP axis.

    *The axis is always perpendicular to the plane.*
  24. What is the plane & axis for hip external & internal rotation?
    Sagittal plane, coronal axis.
  25. Where is your reference point for scapular special movements?
    • The inferior border.
    • Upward rotation: inferior angle moves superior & lateral (ex. shoulder abduction).
    • Downward rotation: inferior angle moves inferiorly & medial.
    • Protraction: scapula moves anterior & lateral.
    • Retraction: scapula moves posterior & medial.
  26. Where is the reference point for the figures? And the toes?
    • Fingers: digit 3.
    • -Radiad: deviation towards the radius.
    • -Ulnad: deviation towards the ulna.
    • Toes: digit 2.
  27. Name an example of angular motion:
    • Bicycle wheel in motion.
    • Car tires in motion.
    • Gymnast on high bars.
  28. How many degrees of freedom are possible in a joint?
    6.
  29. What is the plane & axis for pronation/supination of the forearm?
    • Transverse (horizontal) plane.
    • VLP axis.
  30. What is the plane, axis, & coordinate for shoulder abduction & adduction?
    • Plane: coronal (frontal).
    • Axis: sagittal (AP).
    • Coordinate: Z.

    (Axis & coordinate are the same).
  31. NERVE ROOT EVALUATION REVIEW:
    • Yes, neurological pin wheels make great bath toys.
  32. C5 "Strong Man"
    • Disc level: C4.
    • 1. FA Flexion: biceps, MCN.
    • 2. Shoulder ABduction: deltoids, axillary N.
    • Reflex: biceps.
  33. C6 "Biker Chicks"
    • Disc level: C5.
    • 1. Wrist extension: ECRL & B, ECU, radial N.
    • Reflex: brachioradialis.
  34. C7 "Egyptian"
    (or "Elbow extension, wrist flexion, finger extension looks like a 7")
    • Disc level: C6.
    • 1. Elbow extension: triceps, radial N.
    • 2. Wrist flexion: FCR, FCU, median & ulnar N.
    • 3. Finger extension: extensor digitorum communis, extensor indicis profundus, EDM, Radial N.
    • Reflex: triceps.
  35. C8 "Finger Flexion"
    • Disc level: C7.
    • 1. Finger flexion: FDS, FDP, lumbricals, median & ulnar N.
    • Reflex: NONE.
  36. T1 "Finger Fun"
    • Disc level: T1.
    • 1. Finger ABduction: dorsal interossei, ulnar N.
    • 2. Finger adduction: palmar interossei, ulnar N.
    • Reflex: NONE.

    Mneumonic: PAD & DAB to remember which does which!
  37. L4 "Dorsiflex & Invertor makes a 4"
    • Disc: L3.
    • 1. Foot dorsiflexion & inversion (up & in): TA- DPN.
    • Reflex: patella.
  38. L5 "Toe jive, heel jive, abduct the thigh"
    • Disc level: L4.
    • 1. Foot dorsiflexion (up): TA, EHL, EDL- DPN.
    • 2. Big toe dorsiflexion: EHL- DPN.
    • 3. Toe dorsiflexion: EDL & B- DPN.
    • 4. Hip/pelvis ABduction: G max & min, Superior Gluteal N.
    • Reflex: NONE.
  39. S1 (yeah, this one's just weird, sorry!)
    • Disc level: L5.
    • 1. Foot plantar flexion: gastric & soleus, Tibial N.
    • 2. Foot plantar flexion & eversion (down & out): superficial peroneal N.
    • 3. Hip extension: glute max, inf gluteal N.
    • Reflex: achilles.
  40. Which nerve roots do not have an associated reflex?
    C8, T1, & L5.
  41. MISC INFO.
    • Tim Sylvia!
  42. Piriformis:
    Origin, Insertion, Action, Innervation...
    • Origin: sacral pelvic surface.
    • Insertion: greater trochanter.
    • Action: thigh external rotation.
    • Innervation: sacral plexus.
  43. Psoas Major:
    • Origin: Lumbar bodies, discs, TP's.
    • Insertion: Lesser trochanter.
    • Action: thigh flexion.
    • Innervation: Lumbar plexus.

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