PTA NPTE (Musculoskeletal) Advance Exam with Complete Solutions

Hip illiofemoral ligament - ANSWER-Extends from anterior inferior iliac spine to intertrochanteric line of femur. LIMITS excessive hip extension Y fan shape Hip Pubofemoral ligament - ANSWER-Extends from Pubic portion of the rim of acetabulum to the neck of the femur. LIMITS excessive abduction and extension Ischiofemoral ligament - ANSWER-extends from the iscial wall of the acetabulum to the neck of the femur Limits EXT and IR and reinforces the articular capsule Acetabular labrum - ANSWER-Fibrocatilaginous rim attatched to the margin of the acetabulum ATP-PC system - ANSWER-High intensity short duration exercise such as sprinting 100 meters. Phosphocreatine decomposes and releases a large amount of energy. Provides energy up to 15 seconds Anaerobic glycolysis - ANSWER-High intensity short duration activities such as sprinting 400-800 meters. Stored glycogen is split into glucose and through glycolysis split agian into pyruvic acid to form ATP 30-40 seconds of muscle contraction Aerobic Metabolism - ANSWER-Low intensity long duration exercise such as running a marathon. Oxygen yield the most ATP but requires complex chemical reactions through oxidation of food. Synarthroses joint (fibrous) joint classification - ANSWER-Fibrous joints composed of bones united by fibrous tissue and are non synovial. movement is minimal Sutre (synarthroses) - ANSWER-Union of 2 bones by a ligament or membrane (ex sagittal sutre of skull) Gomphosis (synarthroses) - ANSWER-2 bony surfaces connect such as a peg in the whole ex (tooth in a socket) Syndesmosis (joint classification) - ANSWER-Bone connected to bone by a dense fibrous membrane or cord Amphiarthrosis (cartiliginous joint) - ANSWER-Cartiliginous joints have cartilage or fibrocartilage that connects one bone to another. slightly moveable joints Shoulder flexion - ANSWER-Anterior delt, Coracobrachialis, pec major, biceps brachii Shoulder extension - ANSWER-lattisimus dorsi, posterior delt, teres major Shoulder abduction - ANSWER-Middle deltoid, supraspinatus Shoulder external rotation - ANSWER-Teres minor, infraspinatus, posterior deltoid Shoulder internal rotation - ANSWER-Subscapularis, teres major, pectoralis major, lattisimus dorsi, anterior deltoid Scapula elevation - ANSWER-upper traps, levator scapulae Scapula depression - ANSWER-lattisimus dorsi, pec major, pec minor, lower traps Scapula protraction - ANSWER-serratus anterior, pec minor scapula retraction - ANSWER-traps, rhomboids scapula upward rotation - ANSWER-traps, serratus anterior, scapula downward rotation - ANSWER-rhomboids, levator scapula, pec minor Synchondrosis (amphiarthroses) - ANSWER-Hyaline cartilage with cartilage adjoining 2 ossifying centers of bone ex. Sternum and true rib articulation Symphysis (ampiarthroses) - ANSWER-located in the midline of the body, 2 bones with hyaline cartilage Diarthroses (synovial joints) - ANSWER-Provide free movement between bones and have 5 distinguising characteristics, Joint cavity, articular cartilage, synovial membrane, synovial fluid, and fibrous capsule most complex and vulnerable Uniaxial-one plane ( hinge/Pivot) Biaxial - 2 planes (condyloid, saddle) Multiaxial- 3 planes (plane, ball and socket) Shoulder Glenoid labrum - ANSWER-firocartiliginous structure that deepends the glenoid fossa and increases the size of the articular surface Shoulder joint capsule - ANSWER-Arises from the glenoid fossa and the glenoid labrum to blend with the muscles of the rotator cuff Shoulder Subacromial bursa - ANSWER-Extends over the supraspinatus tendon and distal muscle elly to facilitate movement of the deltoid muscle over the fibrous capsule of the shoulder joint (often involved with impingement) Shoulder subscapular bursa - ANSWER-overlies the anterior joint capsule beneath the subscapularis muscle Elbow flexion - ANSWER-Biceps Brachii, brachialis, brachioradialis elbow extension - ANSWER-triceps brachii, anconeus forearm supination - ANSWER-biceps brachii, supinator forearm pronation - ANSWER-pronator teres, pronator quadratus Radial (lateral) collateral ligament elbow - ANSWER-Extends from the lateral epicondyle of the humerus to the lateral border of the olecranon process/ Fan shaped ligament that prevents adduction Ulnar collateral ligament (medial) elbow - ANSWER-Runs from the medial epicondyle of the humerus to the proximal portion of the ulna. Prevents excessive abduction of the elbow joint annular ligament (elbow) - ANSWER-band of fibers surrounding the head of radius and wllow the radius to rotate and retain contact with the radial notch of ulna Wrist flexion - ANSWER-flexor carpi radialis, flexor carpi ulnaris, palmaris longus Wrist extension - ANSWER-extensor carpi radialis longus, extensor radialis brevis, extensor carpi ulnaris Radial deviation (wrist) - ANSWER-extensor carpi radialis, flexor carpi radialis, extensor pollicis longus, extensor pollicis brevis ulnar deviation - ANSWER-extensor carpi ulnaris, flexor carpi ulnaris Carpal tunnel - ANSWER-median nerve enters the palm through the capal tunnel, and is located close to the deep surface of the flexor retinaculum Radial collateral ligament (wrist) - ANSWER-Limits ulnar deviation, extension, and flexion. Originates from the stloid process of radius and inserts on the scaphoid and trapezium palmar radiocarpal ligament - ANSWER-limits hyperextension dorsal radiocarpal ligament - ANSWER-limits wrist flexion Hip flexion - ANSWER-Iliopsoas, sartorius, rectus femoris, pectineus, Hip extension - ANSWER-glute max, glute med, semitendinosis, semimembranosus, biceps femoris hip abduction - ANSWER-glute med, glute min, piriformis, obturator internus, TFL Hip adduction - ANSWER-adductor magnus, addutor longus, adductor brevis, gracilis hip internal rotation - ANSWER-TFL, Glute med, Glute min, Adductor longus, Pectinius Hip external rotation - ANSWER-Glute max, obturator externus/internus, piriformis, gemelli, sartorius Ideal plumb Line - ANSWER--Slightly posterior to the coronal sutre -through the external auditory meatus -through the axis of the odontoid process -Through the tip of the shoulder -Through the vertebrae of the Lumbar spine -Posterior to the hip joint -slight anterior to the knee joint -slight anterior to the lateral malleolus -through the calcaneocuboid joint Normal end feel - ANSWER-Firm (stretch) ex. ankle dorsi, finger ext Hard (bone to bone) ex. elbow extension Soft (soft tissue approximation) ex. elbow flexion Abnormal end feel - ANSWER-empty (cannot reach end feel due to pain) ex. joint inflamation, fracture Firm ex. increased tone, tightning of the capsule Hard ex. fracture, osteoarthritis Soft: edema, synovitis 0/5(zero) MMT grade - ANSWER-no palpable muscle contraction 1/5 (trace) MMT grade - ANSWER-muscle contraction is palpated but no joint movement 2-/5 (poor minus) MMT grade - ANSWER-the subject does not complete range of motion in gravity eliminated position 2/5 (poor) MMT grade - ANSWER-The subject completes ROM in gravity eliminated position 2+/5 (poor plus) MMT grade - ANSWER-The subject is able to initiate movement against gravity 3-/5 (fair minus) MMT grade - ANSWER-The subject does not complete the ROM agianst gravity but does complete more than half the range 3/5 (fair) MMT grade - ANSWER-The subject can complete full ROM against gravity 3+/5 (fair plus) MMT grade - ANSWER-The subject can compelte full ROM with minimal resistance 4-/5 Good minus MMT Grade - ANSWER-The subject can complete full ROM with min/mod resistance 4/5 good MMT grade - ANSWER-The subject can complete full ROM with mod resistance 4+/5 good plus MMT grade - ANSWER-The subject can compelte full ROM with mod/max resistance 5/5 normal MMT grade - ANSWER-The subject can complete full ROM with max resistance Active muscle insufficiency - ANSWER-2 joint muscle contracts across both joints simultaneously which is less than optimal muscle contraction Passive Muscle insufficincy - ANSWER-2 joint muscle is lengthened over both joints simultaneously which is less than optimal muscle contraction Standard terminology Gait Phases - ANSWER-Heel Strike Foot Flat Midstance Heel off toe OFF acceleration midswing deceleration Rancho los amigo gait phases - ANSWER-Initial contact Loading response Midstance terminal stance pre-swing initial swing midswing terminal swing