PTHY 6401 Kinesiology I
Unit Objectives & Study Guide for Exam 4 - Spring 2015
Content to be tested: Hand-Fingers (Neumann Ch 8; lecture & lab), UQ-LQ Peripheral Neuro & Screening Exam
(handouts and lab experiences), Radiology content (reading; lecture & lab)
Exam will be ~ 60 questions (120 points)
Hand-Fingers:
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15.
Explain the landmarks used for goniometric measurement procedures for each joint measured.
Explain the grading system for MMT from Reese (word & number scale).
Describe normal/average ROM for the goniometric measures done at the hand, thumb & fingers. (not 1st CMC)
Describe osteology of the hand, thumb, & fingers; including name & location of bones of the hand.
Describe Joint structure/anatomy of the hand, thumb, & fingers including

planes in which 1st CMC abd, add, flex, & ext occur
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function of the collateral ligaments at the MCPs, PIPs, & DIPs.
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specific movements available at each joint.
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location and function of the volar plate.
Explain the concentric action and innervation of musculature acting on the hand and fingers.
Explain the arthrokinematics / convex-concave rules as they apply to the 1st CMC, and all MCP & IP joints;
compare and contrast similarities and differences.
Describe which extrinsic muscles acting on the hand, thumb, & fingers are in the Superficial and Deep muscle
groups in the anterior and posterior regions of the forearm; know the concentric action and innervation.
Describe the contents and borders of the Carpal Tunnel and Anatomical Snuffbox.
Describe what causes the tenodesis grasp. Know how it might be useful for grasping objects in the absence of
normal muscle function in the finger flexors (ie. the spinal cord injury scenario discussed in the notes).
What does L.O.A.F. mean?
Know detailed anatomy of the extensor tendon expansion in the fingers that allows it to act at the PIP and DIP.
Specifically, what/where is the central tendon? What/where are the lateral bands?. If either of these
structures/tendons avulse or detach from the bone (distally), what is the name of the resulting deformity? (ie.
mallet vs boutonniere)
Prehension: Describe the various forms/types of power grip and precision handling.
Synthesize the main ideas in Neumann Special Focus: study only SF 8-1, 8-2, 8-3, 8-5, 8-6
Synthesize the main ideas in Neumann Clinical Connection: study CC1 (pg 289 only), and CC8-3 (pg 293-294
only)
UQ/LQ Screening Exam:
1. Explain the purpose & use of a Screening Exam, it’s place in the comprehensive physical therapy examination,
the data & information collected, and key concepts of performing the exam.
2. Describe (list the steps in) the Upper and Lower Quarter Screening Exams.
3.
4.
5.
6.
Relate spinal nerves to the location where they exit the spinal column (ie. between which two vertebrae?)
Contrast the meaning of "dermatome" and "peripheral nerve sensory innervation".
Contrast the meaning of "myotome" and "peripheral nerve motor innervation".
Describe the myotome tests for C1-T1, L1-S2 nerve roots, dermatome tests for C4-T2, L1-S2 nerve roots, &
reflex tests for C5, C6, C7, L3-4, S1-2 nerve roots.
7. How should you grade/record the results of the 1) gross muscle testing, 2) light touch sensation testing, and 3)
reflex testing that is done in the screening exam?
8. List the various synonyms for the deep tendon reflex.
Radiology:
From the notes/lecture AND reading “Basics of Radiology & Medical Imaging”.
1. Which form of medical imaging makes up the majority of all medical imaging exams? About how
much/percentage? Speculate on why this is so.
2. Describe the following radiology terms; compare and contrast them; apply them in the context of body tissues
and plain film radiographs: radiolucency, radiodensity, radiopaque, sclerosis, magnification, foreshortening,
elongation.
3. Explain the expected appearance of air, fat, muscle/connective tissue, bone, contrast media, and metal on a
plain film radiograph.
4. Why is contrast media used in combination with a plain film radiological (x-ray) exam?
5. Name and differentiate the 4 different examples of contrast enhanced radiographs mentioned in the notes and
reading.
6. Explain some basics about the technology used in plain film x-ray - vs - CT scan - vs - MRI.
7. How do you tell the difference between a CT film and a MRI film in terms of tissue appearance? How do you
differentiate T1 from T2 MRI signal images?
8. List the common plain film views (orthopedic) ordered and taken throughout the UE, LE, and Spine/pelvis.
9. What guidelines should be followed for correctly placing an AP radiograph in a view box? What is different
about placing a radiograph of the hand or foot in a view box?
10. What is the ABCS system? What do the letters stand for?
From the required reading, “Musculoskeletal Imaging in Physical Therapist Practice” JOSPT 2005;35:708-721
11. What evidence was presented in section 1 (after the Intro) of the article regarding the clinical diagnostic
accuracy of PTs in comparison to orthopedic MDs and non-orthopedic MDs on patients with musculoskeletal
injuries who were referred for MRI?
12. According to the author, even if PTs cannot order musculoskeletal imaging studies in their practice setting . . .
what minimum knowledge/understanding should PTs have regarding musculoskeletal imaging? (section 2 &
7).
13. “Imaging studies are normally indicated when ________________ will influence ________________.”
14. What is the problem with ordering advanced & expensive imaging, such as MRI, for a patient to determine if
he/she is in need of surgery yet he/she is unwilling or is unable to undergo the surgical intervention?
15. What sublte and/or early-stage pathologies have a high chance of being missed (eg. false negative) on a plain
film radiograph? (section 3)
16. The potential for false negative and false positive imaging results (as well as true positive & true negative
results) are expressed by psychometric properties called ______________ & ________________ (section 3).
17. Given that numerous musculoskeletal pathologies are often identified (by a radiologist) on imaging studies of
asymptomatic individuals, the findings from imaging studies must be interpreted in the context of
____________________________________________? (section 4)
18. Describe potential sources of error in musculoskeletal imaging (section 5).
19. True/False: Overuse of plain film radiologic imaging occurs because of a lack of clinical prediction or decision
rules that help providers determine when there is a need for a radiographic imaging study.
20. Compare & contrast plain film, CT, and MRI regarding cost, radiation dose, and ability to differentiate between
different types of soft tissue.
21. Is firmly implanted orthopedic hardware considered a contraindication for MRI? To what extent are metal
implants a contraindication for MRI? (section 11)
22. What are the most common uses of ultrasound imaging by physical therapists? (section 13)
23. Even if diagnostic ultrasound is used for its intended purpose, what is the most limiting factor in the usefulness
of diagnostic ultrasound imaging by physical therapists?