1/10 Flashcards
What is the pathology?
- History of trauma
- Heaviness of head, lump in throat
- Nausea, headache, dizziness
- often occurs with atlantoaxial subluxation or an atlas fracture
transverse ligament tear
What is the pathology?
Signs and symptoms limited to local findings for level of spinal cord involvement eg. C5 nerve root
- dermatome - anterolateral shoulder, arm
- myotome - deltoid, biceps
- deep tendon reflex - biceps
cervical disc herniation
What is the pathology? Non-traumatic neck and shoulder pain Decreased hand dexterity Paresthesia in right upper extremity Hyperreflexia Urinary retention with overflow incontinence
cervical myelopathy
what brain artery lesion?
- unilateral or bilateral weakness of extremities
- loss of vibratory sense, two-point discrimination, and position sense
- Diplopia, homonymous hemianopsia, dysphagia, dysarthria, nausea, and confusion may also occur.
Vertebral (basilar) arteries
supply the brainstem and cerebellum
what brain artery lesion?
- personality changes
- hemiparesis or hemiplegia legs
anterior cerebral artery
superior surfaces of frontal
parietal lobes and the medial surfaces of the cerebral hemispheres
- look for personality changes, motor and somesthetic cortex serving the legs
what brain artery lesion?
- Alterations in communication, cognition, mobility, and sensation
- Contralateral hemianopsia
- Contralateral hemiplegia (greater in the face and arm rather than leg)
- Hemiparesis or hemiplegia
middle cerebral artery
frontal lobe, parietal lobe, and cortical surfaces of the temporal lobe
- look for affects higher cerebral processes of communication, language interpretation, and interpretation of space, sensation, form, and voluntary movement.
what is hemiparesis?
Muscle weakness or partial paralysis on one side of the body that can affect the arms, legs, and facial muscles.
what brain artery lesion?
- Contralateral hemiplegia (greater in the face and arm than in the leg)
- Ataxia/tremor
- Homonymous hemianopsia, cortical blindness
- Receptive aphasia
- Memory deficits
posterior cerebral artery
medial and inferior temporal lobes, medial occipital lobe, thalamus, posterior hypothalamus, and visual receptive area.
- look for ataxia and tremors
interventions for severs disease?
Sever disease is a calcaneal apophysitis, heel pain
- stretch to improve flexibility of the gastrocnemius and soleus
- use heel wedge to decrease the stress and traction of the Achilles insertion
patient pop for severs disease?
adolescents during growth spurt
- girls 8 to 13 years of age
- boys 10 to 15 years of age
what nerve glide intervention?
Cubital tunnel syndrome
ulnar nerve glides
due to entrapment of the ulnar nerve at the elbow
what nerve glide intervention?
- symptoms related to shoulder girdle depression
- tennis elbow (lateral epicondylalgia)
- de Quervain syndrome
- nerve distribution lateral arm to thumb
radial nerve glide
what tendons inflamed in De Quervain tenosynovitis?
abductor pollicis longus (APL)
extensor pollicis brevis (EPB)
jaw reflex test for what cranial nerve? how is it performed?
trigeminal nerve (CN V)
masseter reflex is a stretch reflex
The mandible is tapped at a downward angle just below the lips at the chin while the mouth is held slightly open.
+ masseter muscles will jerk the mandible upwards. upper motor neuron lesions the jaw jerk reflex can be quite pronounced.
Normally this reflex is absent or very slight.
how to mobilize scapula out of UE flexion synergy?
synergy pattern - scapular retraction/elevation or hyperextension.
- PROM to lateral (external) rotation and distraction of the humerus, especially as ranges approach 90° of flexion or more.
- scapula should be mobilized on the thoracic wall with an emphasis on upward rotation and protraction to prevent soft tissue impingement in the subacromial space during overhead movements of the arm.
what location has dysfunction?
pain in response to palpation of the anteromedial knee below the joint line.
- pain with active knee flexion, passive knee extension, and valgus stress.
pes anserine
medial and just distal to knee joint line.
- semitendinosus and sartorius insert here, would be stretched with extension and valgus, and are involved in knee flexion.
what kind of incontinence screening?
- Do you have frequent, strong or sudden urge to urinate and cannot get to the bathroom in time? When arriving home and getting out the car? When using a key to open the door? When you hear water running or when you run water over your hands? When you go out into cold weather or put your hands in the freezer?
- Do you urinate more than eight times a day?
- Do you get up to go more than twice a night?
urge incontinence (overactive)
Interventions for muscle strain?
Soft tissue mobilization in direction of muscle fibers
modalities
How to perform scar mobilization?
Cross friction massage
What is the patient population for slipped capital femoral epiphysis?
Adolescent 10-16 years old
teens like to eat Skippy peanut butter
What are symptoms of slipped capital femoral epiphysis?
leg shortness - effected side shorter Goin, Hip, or Knee pain Foot/leg turned outward Pain when hip is IR Antalgic gait Groin pain triggered with anterior impingement test (hip flex 80-90, 20-30deg adduction, max IR)
What is FABER test/Patricks test for?
Lumbar, SI joint, or posterior hip dysfunction associated w hip capsule
Figure 4 position - Flexion, abduction, ER
Intervention patient with rheumatoid arthritis neck pain
to try? avoid?
rheumatoid arthritis linked to cervical ligament laxity
- cervical stabilization exercises in neutral are appropriate for managing neck pain in patients who have rheumatoid arthritis
Avoid
- mobilizations: high risk for subluxation and significant complications from cervical mobilization
- Cervical traction
- thermal agents: application of heating modalities to an area with potential ligamentous laxity or acute inflammation
what condition?
- chronic neck pain
- marked ulnar drift in both hands at the MCP joints
rheumatoid arthritis
cervical spine ligaments can be affected in this population, ligament laxity
what is spastic (reflex) bowel function
SCI above spinal segments S2–S4, leaving spinal defecation reflexes intact
- neurogenic bowel - loss of normal bowel function, can’t voluntarily relax the anal sphincter
- reflex that triggers a BM still works, may not feel it coming, leads to unplanned BM can happen when the rectum is full
- signal between brain and colon disrupted
what is Flaccid bowel problem
SCI at or below spinal segments S2–S4 result in
flaccid bowel dysfunction with loss of spinal defecation reflexes
- reduced movement in the colon, less peristalsis, and the sphincter is looser than normal.
- lead to constipation with frequent leaking of stool.
what are these movements?
- long history of taking antiparkinsonian medications
- random, rapid, and jerky movements.
chorea- type of dyskinesia
common side effect of antiparkinsonian medication especially after prolonged
what is dysmetria? what part of brain associated with Dysmetria?
cerebellum
- problems in judging the distance or range of movement
what is dystonia? what part of brain associated with dystonia?
basal ganglia
co-contraction of the agonist and antagonist muscles
Segmental dystonia involves two or more adjoining body regions dominated by sustained muscle contractions, causing twisting and repetitive movements and abnormal postures.
what part of brain associated with abnormal synergies?
motor cortex deficits and lesions in the corticospinal centers
result in the emergence of mass movement patterns
order of donning PPE?
- gown
- face mask or respirator (makeup)
- goggles or face shield
- gloves
- the order cinderella would dress for a ball
what muscle is weak?
- trunk leans away from the involved side to avoid potential buckling of the involved knee
- circumduction of the involved leg
quads
what muscle is weak?
excessive lateral trunk lean during gait due to the decreased to stabilize the pelvis while in stance phase on the contralateral leg
gluteus medius
what muscle is weak?
- high steppage to allow clearing of the ankle and foot during gait and to avoid tripping over the foot
- foot drop
tibialis anterior - decrease in ankle dorsiflexion
what muscle is weak?
- posterior thrust of the trunk at heel strike (initial contact) to help obtain hip extension of the stance leg.
- anterior tilt of the pelvis to help maintain posture.
gluteus maximus
what condition?
Pain symptoms anterior shoulder in the area of the biceps tendon.
Pain occurs with full extension of the shoulder and elbow
bicipital tendinitis
what shoulder diagnosis?
“popping out” or “slipping” during overhead activities and is more common in athletic adolescents or young adults
glenohumeral instability
what shoulder diagnosis?
usually occurs as a result of a trauma
pain associated with this condition is more localized to the AC joint
Acromioclavicular joint sprain
how to test for bowler’s thumb? what is bowler’s thumb?
direct pressure to the base of the thumb (1st digit) is digital nerve compression test for bowler’s thumb
- Bowler’s thumb is a rare, traumatic neuropathic condition involving the ulnar digital nerve of the thumb. due to chronic frictional irritation when an avid bowler repeatedly compress the ulnar digital nerve by the thumbhole of a bowling ball.
- symptoms: thumb numbness, pain on the inner part of the thumb and the web that goes between the index finger and the thumb, weak pinch
what test is described
Compressing the cervical spine with ipsilateral rotation and extension - apply downward pressure?
what other tests are it used with?
Spurling, Maximal Cervical Compression, or Foraminal Compression Test
test for cervical radiculopathy cluster:
- Spurling’s Test
- Upper limb tension 1
- Quadrant test
- Distraction test
how to perform distraction test?
for cervical radiculopathy
- Patient lies supine and the neck is comfortably positioned. Examiner securely grasps the patient’s either by placing each hand around the patient’s mastoid processes, while standing at their head, or place one hand on their forehead and the other on the occiput. Slightly flex the patient’s neck and pull the head towards your torso, applying a distraction force
+ positive test is the reduction or elimination of symptoms with traction
how to perform Cervical Flexion-Rotation Test (CFRT)?
assess dysfunction at the C1-C2 motion segment, high sensitivity and specificity to detect the presence or absence of cervical joint dysfunction in neck pain and headache patients
- Patient is relaxed in supine
- Examiner fully flexes the cervical spine with the occiput resting against the examiners abdomen
- The patient’s head is then rotated to the left and the right
If a firm resistance is encountered, pain provoked, and range is limited before the expected end range, then the test is considered positive, with a presumptive diagnosis of limited rotation of C1 on C2
what is Chylous drainage?
milky, white drainage that occurs after abdominal surgeries where there is trauma to the cisterna chyli (sac at the lower end of the thoracic duct where lymph from intestinal trunk and two lumbar lymphatic trunks flow) or adjacent lymphatic trunks.
