3rd Written Sim Flashcards
What are the 3 initial hypothesis’s based on the following symptoms:
–Lateral/anterior shoulder pain w/ overhead activities or exhibiting a painful arc
- -Subacromial impingement
- -Tendinitis
- -Bursitis
What are the 2 initial hypothesis’s based on the following symptoms:
–Instability, apprehension, and pain w/ action, especially w/ shoulder abducted and externally rotated
- -Shoulder instability
- -Possible Labral tear if clicking
What is the initial hypothesis based on the following symptoms:
–Patient falls on shoulder followed by AC joint pain
AC joint sprain
What is the initial hypothesis based on the following symptoms:
–Decreased ROM w/ pain during resistance
Rotator cuff or bicep tendon involvement
What is the initial hypothesis based on the following symptoms:
–Pain and weakness w/ muscle loading, night pain age > 60
Rotator cuff
What is the initial hypothesis based on the following symptoms:
–Poorly located shoulder pain, occasionally extending into elbow, pain aggravated by movement, loss of movement age > 45, females more affected
Adhesive capsule this
If you suspect a SLAP Lesion, what are 3 tests you should utilize?
- -Bicep Load Test
- -O’Briens Test
- -Active Compression Test
If you suspect a Rotator Cuff Tear, what are 5 tests you could use?
- -Full Can
- -Empty Can
- -External Rotation Lag Sign
- -Hornblower’s Sign
- -Belly Press Test
What is the procedure for External Rotation Lag Sign?
- -Elbow flexed to 90*
- -Passively externally rotate the arm
- -Arm should remain in external rotation
What is a positive External Rotation Lag Sign and what does it mean?
Arm lags back
–Infraspinatus tear
What is the procedure for Hornblower’s Sign?
Patient put hand to mouth and extend elbow above mouth
What is a positive Hornblower’s Sign and what does it indicate?
Patient is unable to raise elbow above mouth
–Teres Minor tear
What is the procedure for Belly Press?
Patient pushes arm against bell while DR tries to pull arm away
What is a positive Belly Press and what does it indicate?
Patient doesn’t provide resistance to DR
–Subscapularis problem
What type of SLAP lesion is this:
–Fraying of and degeneration of superior labrum
Type 1
What type of SLAP lesion is this:
- -Fraying of and degeneration of superior labrum
- -Biceps anchor detachment
Type 2 (Most common)
What type of SLAP lesion is this:
–More of a bucket handle tear of labrum, intact bicep tendon
Type 3
What type of SLAP lesion is this:
–Bucket handle tear of labrum w/ extension of tear into biceps tendon
Type 4
What is the best test for diagnosing Shoulder Instability?
Apprehension test w/ relocation
What are the 2 initial hypothesis’s based on the following symptoms:
–Pain over lateral elbow during gripping
- -Lateral epicondylitis
- -Radial Tunnel Syndrome
What is the initial hypothesis based on the following symptoms:
–Pain over medial elbow during wrist flexion and pronation
Medial epicondylitis
What is the initial hypothesis based on the following symptoms:
–Numbness and tingling in ulnar nerve distribution distal to elbow
Cubical tunnel syndrome
What is the initial hypothesis based on the following symptoms:
–Pain in anterior aspect of elbow and forearm that is exacerbated by wrist flexion combined w/ elbow flexion and forearm pronation
Pronator syndrome
What is the initial hypothesis based on the following symptoms:
–Pain during movement w/ sensation of catching or instability
Rotary instability
What is the initial hypothesis based on the following symptoms:
–Posterior elbow pain during hyperextension
Valgus extension during hyperextension
What are the following Elbow ROM’s?
- -Flexion
- -Extension
- -Supination
- -Pronation
Flexion = 140* Extension = 0* Supination = 80* Pronation = 80*
What is the procedure for Elbow Flexion Test?
Patient will hold a flexed position at the elbow for up to 5 minutes
What is a positive Elbow Flexion Test and what does it mean?
Tingling/parasthesia along ULNAR N in forearm and hand
–Cubital Tunnel Syndrome
What is the procedure for Tinel’s Test at the Elbow?
Doc taps the groove b/w
- -1.) Olecranon and lateral epicondyle
- -2.) Olecranon and medial epicondyle
What is a positive Tinel’s Test at the Elbow and what does it mean?
Hypersensitivity is indicative of nerve damage/irritation
What is the procedure for Cozen’s Test?
Patient extends the wrist while the Doc sustains pressure
What is a positive Cozen’s Test and what does it mean?
Pain at lateral epicondyle
–lateral epicondylitis
What is the procedure for Caplans Test?
Grip strength test one time then again w/ a brace
What is a positive Caplans test and what does it mean?
Grip strength increases the second time
–Epicondylitis
What is the Golfer’s Elbow Test procedure?
Patient flexes wrist while the doctor sustains pressure
What is a positive Golfer’s Test and what does it mean?
Pain at medial epicondyle
–Medial epicondylitis
What is the procedure for Lift Test?
Patient takes weight and flexes wrist, then pronates and extends wrist
What is a positive Lift Test and what does it mean?
Pain at epicondyle
–Epicondylitis
What is the procedure for Ligamentous Instability Test?
Patient flex elbow 20-30* and doc applies valgus and varus stress
What is a positive Ligamentous Instability Test and what does it mean?
Laxity and pain
–MCL, LCL sprain/strain
What is the procedure for Mill’s Test?
- -Patients forearm, fingers and wrist are passively flexed
- -Forearm is then pronated and extended
What is a positive Mill’s Test and what does it mean?
Pain and Lateral epicondylitis
What are the normal Elbow ROM’s?
- -Flex
- -Ext
- -Ulnar Dev
- -Radial Dev
- -Flex = 60*
- -Ext = 60*
- -Ulnar Dev = 30*
- -Radial Dev = 20*
What is the initial hypothesis based on the following symptoms:
–Pain over radial styloid process w/ gripping
Possible de Quervain’s syndrome
What is the initial hypothesis based on the following symptoms:
–Insidious onset of numbness and tingling in 1st 3 fingers; may be worse at night
Carpal tunnel syndrome
What is the initial hypothesis based on the following symptoms:
–Paresthesia over dorsal aspect of Ulnar border of hand and fingers 4,5
Ulnar nerve compression at canal of Guyon
What are 2 of the initial hypothesis’s based on the following symptoms:
–Inability to extend metacarpophalangeal of IP joints
- -Dupuytren’s contracture
- -trigger finger
What are the 2 initial hypothesis’s based on the following symptoms:
–Falling on hand w/ wrist hyperextended, complains of pain w/ loading the wrist
- -Scaphoid fracture
- -Carpal instability
What is the procedure for Tinel’s sign at the wrist?
Doc taps over the carpal tunnel w/ reflex hammer
What is a positive Tinel’s sign at the wrist and what does it mean?
Hypersensitivity
–Carpal tunnel syndrome
What is the procedure for Phalen’s Test?
Patient puts dorsal aspect of hands together and pushes them in contact
What is a positive Phalen’s Test and what does it mean?
Increase pressure on median nerve
–Carpal tunnel symptoms
What is the procedure for Froment’s Test?
Patient attempts to grab a piece of paper b/w thumb and index finger Doc then tries to pull it out of the grip
What is a positive Froment’s Test and what does it mean?
Can’t hold paper
–Ulnar nerve paralysis