Term
| Identify the primary muscles of mastication and the movements they produce at the TMJ. |
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Definition
Temporalis - elevate and retract mandible
Masseter - elevate and protract mandible (close mouth)
Medial Pterygoid - laterally deviate, elevate and protract the mandible
Lateral Pterygoid - laterally deviate and protract the mandible |
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Term
| Identify the nerve that innervates these muscles and how you would test its function. |
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Definition
| You would test by activating and resisting the motions the muscles of mastication. You may also test this nerve by testing sensation of the face and the corneal reflex. |
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Term
| Identify the muscles of the rotator cuff and describe an exercise to improve the performance of each of them. |
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Definition
Supraspinatus, Infraspinatus, Teres minor, Subscapularis
Concentric strengthening would involve shortening of the muscle against gravity or some other resistance. |
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Term
| Identify the triangular space and its contents. Describe a mechanism of injury where you might be concerned about these structures. |
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Definition
Boundaries: Long head triceps, Humerus, Teres minor
Contents: Radial nerve, Brachii artery
MOI: Saturday Night Palsy, Humeral fractures |
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Term
| Identify all muscles that upwardly or downwardly rotate the scapula. |
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Definition
Upward rotation: Upper Trapezius, Lower Trapezius, Serratus Anterior
Downward rotation: Levator Scapula, Rhomboid Major/Minor |
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Term
| Describe positions to test the strength of scapula upward/downward movers. |
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Definition
| The manual test position for each muscle will be in its shortened position against gravity |
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Term
| Identify the muscles and their innervations of all of the elbow flexors. |
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Definition
Biceps Brachii(Musculocutaneous)
Brachialis (Musculocutaneous, little radial)
Brachioradialis (Radial) |
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Term
| How might one flex the elbow after a loss of the musculocutaneous nerve? |
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Definition
| Brachioradialis - Radial nerve |
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Term
| Identify all intrinsic muscles of the hand and differentiate them by their innervation. |
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Definition
Median – abductor pollicis brevis, flexor pollicis brevis (superficial head), opponens pollicis, 2-3rd lumbricals
Ulnar – flexor pollicis brevis (deep head), adductor pollicis, 4-5th lumbricals, interossei, palmaris brevis, abductor digiti minimi, flexor digiti minimi, oponens digiti minimi |
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Term
| Describe some common clinical features of the hand with loss of the median, ulnar, and radial nerves respectively. |
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Definition
Median n. – Ape hand
Ulnar n. – Claw hand
Radial n. – Loss of extension, sometimes the waiters tip position, but this can involve more |
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Term
| Describe the difference in actions of the Upper Trapezius and Levator Scapulae and defend this based on the origin and insertion of each muscle |
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Definition
| The difference here is in rotation. This is due to the attachment of the Upper Trapezius to the spinous process and the Levator Scapulae to the transverse process. |
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Term
| Identify a facet (zygapophyseal) joint in the cervical, thoracic, and lumbar regions and describe the primary motion that occurs at each. |
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Definition
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Term
| Describe the motion that occurs at the segment with posterior to anterior pressure on one or both facets. |
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Definition
| Central posterior to anterior pressure will increase extension. Unilateral posterior to anterior pressure on the facet or transverse process will cause rotation to the opposite side. |
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Term
| Describe the attachments of the thoracolumbar fascia and the muscles that attach to it. |
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Definition
Attachments: sacrum, posterior iliac crest, lower thoracic vertebrae
Muscles that attach to it:
Erector Spinae ( Iliocostalis, Longissimus, Spinalis)
Internal Oblique
Transverse Abdominis
Latissimus Dorsi |
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Term
| Describe the motions that can be produced through the attachments of the thoracolumbar fascia. |
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Definition
| Depending on the muscles you have identified actions can be to compress and stabilize the lumbar region or produce lumbar extension, rotation, or side bending. |
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Term
| Identify the abdominal muscles and the fiber direction of each. Describe the action of each. Identify the innervation of each and describe the segmental innervation as is relates to the lumbosacral plexus. |
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Definition
Rectus abdominis - vertical fiber direction, flexion
External oblique - hands in pockets
fiber direction, rotation to opposite side
Internal oblique - hands on boobs fiber direction, rotation to same side
Transverse abdominis - horizontal fiber direction, stability |
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Term
| Identify the Erector Spinae and describe its actions in the different regions of the spine. |
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Definition
Iliocostalis, Longissimus, Spinalis
Actions - laterally flex to the same side and extend the vertebral column |
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Term
| Identify the Multifidus and describe their actions based on their origin and insertion. |
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Definition
Origin - sacrum and transverse processes of lumbar through vervical vertebrae
Insertion - spinous processes of lumbar vertebrae through second spinal cervical - spanning 2-4 vertebrae
Action - rotate to opposite side, side bend to same side and extend the vertebral column |
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Term
| Identify the inguinal ligament. Describe the difference between a direct and indirect hernia. |
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Definition
Direct: bowel is pushed through the wall of the inguinal canal secondary to the conjoin tendon weakening.
Indirect: (more common) bowel herniates through the canal from the deep to superficial ring and possibly into the scrotum |
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Term
| Identify the deep hip lateral rotators and describe the complete action of each muscle. |
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Definition
Piriformis - lateral rotate and abduct hip
Quadratus femoris - lateral rotate
Obturator internus - lateral rotate
Obturator externus - lateral rotate
Gemellus superior - lateral rotate
Gemellus inferior - lateral rotate |
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Term
| Identify all muscles that abduct the hip and describe how you might differentiate between them for strength testing. |
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Definition
Glute max, glute med, glute min, TFL, sartorius
Find which motions are unique to each muscle that abducts the hip. Abduction with the other motion will be the test position for each muscle. |
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Term
| Identify the origin and insertion of the Iliopsoas and describe its actions (hint: can the action changed based of the position of the hip and spine?). |
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Definition
origin: transverse processes of lumbar vertebrae and iliac fossa
insertion: lessser trochanter
Iliopsoas is a hip and trunk flexor. However, in supine with the lumbar spine in extension if an individual has poor performing abdominals, activation of the Iliopsoas can cause anterior shearing and extension of the lumbar spine. |
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Term
| Identify the muscles of the pelvic floor and describe all of the muscles individual functions and the combined function of the floor. |
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Definition
Piriformis and Obturator Internus
both laterally rotate hip - piriformis also abducts flexed hip |
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Term
| How would you instruct an individual to improve the performance of the muscles of the pelvic floor? |
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Definition
| Pelvic floor exercise is performed with the “keagle” maneuver. Tensing the pelvic floor musculature and holding is a typical cue for this exercise. |
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Term
| Describe the actions of the hamstring musculature. |
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Definition
Biceps Femoris - flex knee, laterally rotate flexed knee, extend hip (long head), posterior pelvis tilt
Semitendinosus- flex knee, medially rotate flexed knee, extend hip, posterior pelvis tilt
Semimembranosus - flex knee, medially rotate flexed knee, extend hip, posterior pelvis tilt |
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Term
| What is the difference between the prone leg curl and the seated leg curl to strengthen the hamstrings? |
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Definition
| The prone leg curl maximally shortens the hamstrings and never fully lengthens them due to the hip not moving into flexion. In a seated position the hip is flexed to 90 degrees allowing for strengthening in a more lengthened position. Clinically, this has significance because a person needs to strengthen the muscle in the range that they will be using it in. For example, sprinters that have decreased strength with the hamstrings in a lengthened position may be at an increased risk of injury. |
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Term
| Identify the muscles of the quadriceps. |
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Definition
| Rectus femoris, vastus medialis, vastus lateralis, vastus intermedius |
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Term
| What is the action of the VMO (lets debate)? |
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Definition
| The function of the VMO and even whether or not it should be considered any different from the rest of the Vastus Medialis has been debated for quite some time. The VMO has oblique fibers that some say help to prevent lateral movement of the patella. Others say that the contribution of the VMO is minimal for this and that patella lateral movement is more related to relative medial rotation of the femur and weakness in the hip. You saw it in the lab. What do you think? |
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Term
| Identify the menisci of the knee. Where does the blood supply come from? Do you expect tears in the meniscus to heal, why or why not? |
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Definition
| Genicular a’s supply. The blood supply decreases as we age to where the outer third has the greatest vascularity and the inner has the least. The amount of blood supply along with many other factors will be considered when deciding between the type of surgery and physical therapy to follow. |
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Term
| Identify the borders of the popliteal fossa and the contents within. |
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Definition
Top: hamstrings
Bottom: gastrocnemius
Contents: tibial nerve, popliteal artery and vein |
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Term
| What is the action of the Popliteus in a closed chain position? |
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Definition
| Lateral rotation of the femur on a fixed tibia to unlock the knee. |
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Term
| Identify the muscle(s), artery(s), and nerve(s) in the anterior compartment of the lower leg. |
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Definition
muscles:peroneus tertius,tibialis anterior, extensor hallicus longus, extensor digitorum longus
arteries:anterior tibial artery
nerves: common peroneal, deep peroneal
The structures of anterior compartment can be remembered using the mnemonic, "TEA DEPt" for Tibialis anterior, Extensor hallucis longus, Anterior tibial artery, Deep peroneal nerve, Extensor digitorum longus and Peroneus tertius |
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Term
| What syndromes are possible in the anterior compartement of the lower leg and why? |
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Definition
| Keep it simple and think of Anterior Compartment Syndrome. It is common in this area because of the small amount of space and many structures. |
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Term
| Identify the muscles in each of the four layers of the foot. |
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Definition
1 - abductor digiti minimi, flexor digitorum brevis, abductor hallucis
2 - flexor hallucis longus, flexor digitorium longus, flexor digitorium, lumbricals
3 - adductor hallucis, flexor hallucis brevis, flexor digiti minimi brevis
4 - plantar interossei, tibialis posterior, peroneus longus, peroneus brevis |
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Term
| What types of foot alignment may lead to plantar fasciitis syndrome and why? |
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Definition
| Plantar fasciitis is simply inflammation of the fascia. Any foot alignment away from neutral can place excessive stress on the fascia and lead to an overuse type of injury. Your job will be to determine what movement is impaired and why and correct it. |
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