6 - Upper Quadrant Scan

Question 1

Who are the four “fathers” of physiotherapy?

Answer 1

Cyriax, Kaltenborn, Maitland, McKenzie

Question 2

What is James Cyriax known for?

Answer 2

Selective Tissue Testing and the Upper Quadrant Scan

Question 3

What are selective tissue tension tests?

Answer 3

A systematic examination testing the injured part with active, passive and resisted.

Question 4

What are contractile structures?

Answer 4

Muscle, tendon, tendon-periosteal junction

Question 5

What are inert structures?

Answer 5

Ligaments, bursae, fascia, nerve roots, capsules, dura mater

Question 6

What did Freddy Kaltenborn bring to PT?

Answer 6

Isotonic muscle testing

Graded 0-5 (oxford system). This was compared to Cyriax who did isometric movements

Question 7

What is the concave/convex rule?

Answer 7

Convex - male surface
Concave - female surface

This is used to explain the arthrokinematics of a joint

Concave joint surface glides in the same direction as the long bone (all bones distal to the joint)

Convex joint surfaces glide in the opposite direction of the long bone

Question 8

What did Geoffrey Maitland bring to PT?

Answer 8

Treat signs and symptoms rather than the diagnosis

Focuses on joints that lie below the painful area
Joints that refer pain to the painful area
Muscles that lie below the painful area

Question 9

Characteristics of oscillatory movements

Answer 9

Graded 1-5
No stabilization required
Assess through available range with repetition
Treat - oscillate

Question 10

Characteristics of sustained movements

Answer 10

Not graded
Treat pain or stiffness
Assessment once through available range
Treatment - hold several seconds

Question 11

What did Robin McKenzie bring to PT?

Answer 11

Necks and Backs
Structured approach to assess using repeated movements
If pain moves toward the center thats a good sign (even if it gets more intense it’s still better than being at the periphery)

Question 12

What is the upper quadrant scan?

Answer 12

A screening tool used in orthopaedic assessment
Quick (5-10 min)
Originally developed by Cyriax

Question 13

When would you NOT use the upper quadrant scan?

Answer 13

If irritability is 10/10
Post surgery
or Acute injury

Question 14

What are the 5 D’s?

Answer 14

Diplopia
Dysphagia
Dysarthria
Drop Attacks
Dizziness

Question 15

In what order of positions do you do the upper quad scan?

Answer 15

Sitting/standing
Supine
Prone

Question 16

What are Key Muscles/Myotomes?

Answer 16

Muscles that are supplied by a single segmental level

Question 17

How do you test key muscles?

Answer 17

Mid-range isometric hold for 5 or 6 seconds

Test one muscle per myotome and use alternate if weakness is detected

Question 18

What is the C1-C3 Myotome/Key Muscle and alternate?

Answer 18

Key muscle - neck flexion

Alternate - neck extension and side bending

Question 19

What is the C4 Myotome/Key Muscle and alternate?

Answer 19

Shoulder girdle elevation, no alternate muscle

Question 20

What is the C5 Myotome/Key Muscle and alternate?

Answer 20

Key muscle - shoulder abduction

Alternate - shoulder lateral rotation

Question 21

What is the C6 Myotome/Key Muscle and alternate?

Answer 21

Key muscle - Elbow supination

Alternate - Elbow flexion or wrist extension

Question 22

What is the C7 Myotome/Key Muscle and alternate?

Answer 22

Key muscle - Elbow extension

Alternate - wrist flexion

Question 23

What is the C8 Myotome/Key Muscle and alternate?

Answer 23

Key muscle - Thumb interphalangeal extension

Alternate - Wrist ulnar deviation

Question 24

What is the T1 Myotome/Key Muscle and alternate?

Answer 24

Key muscle - 4th and 5th finger adduction

Alternate - 4th and 5th finger abduction