745 Flashcards
1
Q
reversing impairments
A
remediation
2
Q
changes in the environments and tasks
A
compensation or adaptation
3
Q
management of anticipated problem
A
prevention
4
Q
SINSS
A
severity irritability nature stage staility
5
Q
patient profile
A
age occupation current daily activity leve recreation/hobbies psychosocial factors
6
Q
body chart
A
location description clear other areas number each complaint establish relationship btw complaints
7
Q
intensity of the symptoms and the effect on functional ability
A
severity
8
Q
amount of activity to produce an exacerbation of symptoms and the time to subside or ease
A
irritability
9
Q
treatment plan should include
A
education modalities ther ex manual therapy assistive device HEP
10
Q
contraindications to mob/manip
A
malignancy neurological vascular bone diseases inflammatory conditions infection acute symptomatic disc herniation undiagnosed pain
11
Q
distraction grading system
A
grade 1: unloading and decompressing the joint surfaces
grade 2: separation of joint surfaces
grade 3: joint capsule and ligament stretch
12
Q
distraction time for pain
A
10-20 sec
13
Q
distraction time for stretching joint capsule
A
30-60 sec
14
Q
maitland grade I
A
first 25% small amplitude
15
Q
maitland grade II
A
large amplitude middle 50%
16
Q
maitland grade III
A
last 50%
17
Q
maitland grade IV
A
last 25%
18
Q
maitland grade V
A
high velocity small amplitude
manipulation
19
Q
manual technique for treating pain
A
grade I and II
20
Q
manual technique for resistance
A
III and IV
21
Q
hip inferior glide facilitates
A
joint mobility
pain relief
22
Q
hip posterior glide facilitates
A
flexion
IR
23
Q
hip anterior glide facilitates
A
extension
ER
24
Q
hip lateral distraction facilitates
A
joint mobility
pain relief
25
knee distraction facilitates
joint mobility
| pain relief
26
knee anterior glide facilitates
extension
27
knee posterior glide facilitates
flexion
28
ankle talocural distraction facilitates
joint mobility
| pain relief
29
ankle talocural posterior (dorsal) glide facilitates
dorsiflexion
30
ankle talocural anterior (ventral) glide facilitates
plantarflexion
31
ankle subtalar distraction facilitates
joint mobility
| pain control
32
ankle subtalar medial glide facilitates
inversion
33
ankle subtalar lateral glide facilitates
eversion
34
glenohumeral anterior glide facilitates
ER
extension
horizontal abduction
35
glenohumeral posterior glide facilitates
IR
flexion
horizontal adduction
36
glenohumeral inferior glide facilitates
elevation
37
glenohumeral lateral glide facilitates
general hypomobility
38
scapular superior glide facilitates
elevation
39
scapular inferior glide facilitates
depression
40
scapular lateral glide facilitates
abduction/protraction
41
scapular medial glide facilitates
adduction/retraction
42
humeroulnar distraction facilitates
joint mobility
43
humeroulnar medial glide facilitates
elbow extention
44
humeroulnar lateral glide facilitates
elbow flexion
45
humeroradial distraction facilitates
joint mobility
46
distal radioulnar volar glide facilitates
pronation
47
distal radioulnar dorsal glide facilitates
supination
48
wrist volar glide facilitates
wrist extension
49
wrist dorsal glide facilitates
wrist flexion
50
wrist ulnar glide facilitates
radial deviation
51
wrist radial glide facilitates
ulnar deviation
52
MCP volar glide facilitates
flexion
53
MCP dorsal glide facilitates
extension
54
MCP radial glide facilitates
abduction
55
MCP ulnar glide facilitates
adduction
56
MCP traction facilitates
joint mobility
57
ther ex components for bone
biomechanical energy int he line of stress
| avoid sheer forces
58
ther ex components for cartilage
intermittent compression and decompression with gliding
| avoid excessive overload
59
ther ex components for collagen
modified tension in the line of stress
60
ther ex goals in the acute phase
rest
relieve pain
protect
61
ther ex goals in the sub-acute phase
optimal stimulus for regeneration
protect
gain motion
62
ther ex goals in the chronic phase
increase tissue stress
full motion
strengthen
return to pain free function
63
when you are doing 4 reps for strength you should be at ____% rep max
90%
64
when you are doing 16 reps for strength/endurance you should be at ____% rep max
75%
65
when you are doing 25 reps for endurance you should be at ____% rep max
65%
66
pain in the anterosuperior part of the shoulder: weakness and stiffness
impingement syndrome
67
rotator cuff weakness
overuse of the shoulder
degenerative tendinopathy
intrinsic impingement syndrome
68
instability (classic)
shape of the acromion
degeneration of the AC joint
impingement by the coracoacromial ligament or coracoid process
extrinsic impingement syndrome
69
```
age
position of the arm during activities
repetitive overhead
muscles imbalances
capsular tightness
postural imbalance
structural asymmetry
impaired scapular kinematics
```
MOI of impingement syndrome
70
more than 40 years+ overuse + painful arc
primary impingement
71
young + repetitive overhead/athletic activity + painful arc
secondary impingement
72
education for impingement syndrome
avoid overhead activities and positions of shoulder impingement
73
ther ex for impingement syndrome
postural corrections
ROM
stretching and strengthening
74
manual therapy for impingement syndrome
inferior and posterior glides
75
recurrent shoulder dislocation (chronic phase)
| apprehension test positive
traumatic shoulder instability
76
tendinitis, sensation of instability and laxity
| apprehension test negative
atraumatic shoulder instability
77
education for shoulder instability
avoid MOI and overhead activities
78
ther ex for shoulder instability
scapular stabilization exercises and rotator cuff strengthening
79
sudden eccentric biceps contraction as in trying to grab an object while falling from a height or a fall onto the outstretched hand
repetitive overhead activity, specially in baseball players (they show sig GH IR deficits with the shoulder in 90 degrees abduction, which predispose excessive ER)
MOI SLAP lesion
| Superior labral tear form anterior to posterior
80
pain is the most common long term complaint along with a feeling of instability or lack of control of the are in the overhead as well as abducted ER positions
SLAP lesion
81
education for SLAP
avoid MOI and overhead activities
82
ther ex for SLAP
scapular stabilization exercises and posterior capsular stretching
83
education for frozen shoulder
explain the nature of the disease and prepare them for extended recovery
84
ther ex for frozen shoulder
stretching - progressive in the amount of stress and time (according to the stage)
hold relax stretching and low load prolonged stress is indicated
85
Manual therapy for frozen shoulder
ER with inferior glide (rotator cuff interval RIC)
| posterior glide and maneuvers for general mobility
86
```
location of symptoms
ant capsular strain
biceps rupture
elbow dislocation
pronator syndrome
```
anterior
87
```
location of symptoms
med epicondylitis
MCL injury
ulnar neuritis
fracture
```
medial
88
location of symptoms
olecranon bursitis
olecranon process
stress frcture, triceps tendinitis
posterior
89
```
lat epicondylitis
LCL injury
capitelum fracture
osteocondral degenerative
osteocondritis dissecans
radial head fracture
```
lateral
90
inflammation of one of the epicondyles, which includes both the periosteum and the tendons
epicondylitis
91
tennis elbow
lateral epicondylitis
92
golfers elbow or throwers elbow
medial epicondylitis
93
inflammation in the insertion of the extensor carpi radialis brevis and extensor carpi radialis longus
lateral epicondylitis
94
lateral elbow pain with insidious onset, pain with wrist extension and weakened grip strength
lateral epicondylitis
95
overuse: repetitive grasping with wrist in extension
| trauma
MOI for lateral epicondylitis
96
radicular pain into the elbow
neck pain
symptoms with spine compression/extension
cervical spondylosis
97
insidious onset of lateral elbow pain
| pain 2-4 cm distal to epicondyle
radial tunnel syndrome
98
insidious onset of lateral elbow pain and weakness
| weakness of wrist and finger extensors
PIN compression
99
trauma
weight lifting
clicking or limitation of ROM
intra-articular loose bodies
100
sickle cell anemia, alcohol abuse, HIV, corticosteroids
| joint effusion, mechanical symptoms
avascular necrosis
101
adolescent, gymnasts, throwers
| joint effusion, mechanical symptoms
osteochondritis dessicans
102
inflammation in the insertion of the flexor carpi radiales and pronator teres
medial epicondylitis
103
medial elbow pain, pain with wrist flexion and pronation
medial epicondylitis
104
pain in the medial aspect of the elbow, edema can also be seen
MOI: excessive valgus stress and hyperextension and overuse
little leaguers elbow
105
elbow flexion
ulna slides
radial head
anteriorly, distally and laterally
| anteriorly
106
elbow extension
ulna slides
radial head
posteriorly, proximally and medially
| posteriorly
107
arm is held in extension and pronated: pian moving the elbow, the child stops using the arm and can not flex or supinate the forearm. minimal swelling could be seen
lack of accuracy locallizing the injury. can often lead to thinking that the injury is elsewhere
subluxation of the radial head
108
a sudden pull on the extended pronated arm
pulling and uncooperative child
swinging the child by the arms
subluxation of the radial head
109
a joint condition in which a piece of cartilage, along with a thin layer of the bone beneath it, comes loose from the end of a bone
pain/swelling lat/ant
limited ROM
clicking, locking
osteochondritis dissecans
110
MOI for osteochondritis dissecans
repetitive trauma
| radiohumeral lateral compression forces
111
FOOSH wrist extended
radius fx
112
FOOSH wrist extended >80 degrees
carpal fx
113
FOOSH wrist ext with radial deviation
scaphoid fx
114
FOOSH wrist flexion
radius or ulnar fx
115
fracture of distal radius with dorsal displacement
colles fx (dinner fork deformity)
116
MOI for colles fx
extension and compression
117
fx of distal radius with volar displcement
smiths fx
118
MOI for smiths fx
flexion and compression
119
MOI scaphoid fx
fall with ext and RD
120
pain in anatomical snuffbox
painful/limited wrist movement
painful compression/load
scaphoid fx
121
fx of neck of 5th MC
boxers fx
122
MOI for boxers fx
boxing or punching
123
avulsion of extensor tendon from DIP
mallet finger
124
MOI for mallet finger
direct force causing forced flexion
125
fall or trauma
localized pain, swelling, clicking
pain with extension
positive watsons
scaphoid lunate disassociation
126
pt seated, elbow 90 degrees flexed
forearm pronated
passively move from UD to RD while stabilizing scaphoid
+ if increased movement: pain or clunk into dorsal dir.
watson's test
| scaphoid shift
127
osteonecrosis/AVN of lunate following a fx
History: FOOSH, compression fx
local tenderness, swelling, limited wrist motion, pain with gripping
kienbocks disease
128
median nerve compression in forearm
carpal tunnel syndrome
129
```
trauma
overused of flexor muscles, posture of hands
pain and paresthesia
numbness
nocturnal pain
hand falling asleep
thenar atrophy
```
carpal tunnel syndrome
130
norm step length
72 cm/23 in
131
norm stride length
144
132
norm cadence
90-120 steps/min
133
norm gait speed
1.4 m/sec
134
greatest hip ext and when during giat
20 degrees
| terminal stance
135
greatest knee flex during gait
60 degrees
| initial swing
136
greatest ankle DF
10 degrees
| terminal stance
137
defined as the ability of the structures or segments of the body to move or be moved to allow the presence of range of motion for functional activities
mobility
138
the ability to move a single joint or a series of joints smoothly and easily through an unrestricted pain free ROM
flexibility
139
decreased mobility or restricted motion. one cause is contractures
hypomobility
140
an adaptive shortening of the muscle tendon unit and other soft tissues that cross or surround the joint that results in significant resistance to passive or active stretch and limitation of ROM
contracture
141
adaptive muscle shortening with reduction in the number of sarcomeres units in series, individual sarcomere length is also shortened
myostatic contracture
142
loss of mobility in the connective tissues that cross or attach to a joint or joint capsule
periarticular contracture
143
results from intra-articular pathology (adhesions, synovial proliferation, joint effusion, irregularities in the articular cartilage or osteophyte formation
arthrogenic contracture
144
limited ROM due to hypertonicity associated with central nervous system
pseudomyostatic contracture
145
the connective tissues are replaced by great amount of non-extensible tissue: fibrotic adhesions, scar tissue, and heterotopic bone
fibrotic and irreversible contracture
146
parameters for static stretching
30-60 sec 1-3 times
147
parameters for cyclic stretching
low velocity/low intensity held between 5-10 sec several times
148
involved in the stabilization of joints by opposing the effects of gravity. become tight and then weak
antigravity muscles
149
locomotion susceptible to atrophy and then weakness
muscles assisted by gravity
150
posterior muscular chain
erector spinae
deep plevic trochanter muscles
hamstrings
triceps surae
151
anterior muscular chain
```
sternocleidomastoid and scalenes
anterior fascial tissues of the thoracic spine
diaphragm
psoas
adductors
soleus muscles
```
152
hip ER muscles
```
piriformis
superior gemellus
inferior gemellus
obturator internus
obturator externus
quadratus femoris
gluteus maximus
gluteus medius and minimus
```
153
hip IR muscles
```
piriformis
semitendinosus
semimembranosus
adductors
pectineus
tensor fascia latae
glut med and min
```
154
increase joint reaction force
muscles in mechanical disadvantage
modify angle at knee joint
coxa valga
155
decrease joint reaction force
increase the shear forces on the femoral head and neck
damage at the epiphyseal plate
coxa vara
156
normal axis of femoral head
8-15 degrees of anteversion
157
most likely diagnosis for hip in older population
hip osteoarthritis
158
most likely diagnosis for hip in women
slap lesion
| trochanter bursitis
159
most likely diagnosis for hip in children
legg-calve-perthes
160
most likely diagnosis for hip in middle age
avascular necrosis
161
most likely diagnosis for hip in athletes
labral tear
162
gradual onset anterior thigh/groin pain worsening with weight bearing
limited ROM with pain, especially IR
abnormal FABER test
osteoarthritis
163
anteiror hip pain
history of overuse or sports injury
pain with resisted muscle testing
tenderness over specific muscle or tendon
Hip flexor muscle strain/tendonitis
164
anterior pain and associated snapping sensation
tenderness with deep palpation over femoral triangle
positive snapping hip manuever
etiology from overused, acute trauma, or rheumatoid arthritis
iliopsoas bursitis
165
anterior hip pain
fall or trauma followed by inability to walk
limb externally rotated, abducted and shortened
pain with any movement
hip fx (proximal femur)
166
anterior hip pain
history of overuse or osteoporosis
pain with weight bearing activity; antalgic gait
limited ROM
stress fx
167
anterior hip pain
morning stiffness or associated systemic symptoms
previous history of inflammatory arthritis
limited ROM and pain with passive motion
inflammatory arthritis
168
anterior hip pain
activity related sharp groin/anterior thigh pain, esp upon hip extension
deep clicking felt
positive thomas flexion-extension test
acetabular labral tear
169
anterior hip pain
dull ache in groin, thigh, and buttock usually with risk factors (corticosteroid exposure, alcohol abuse)
limited ROM with pain
avascular necrosis of femoral head
170
Lateral hip pain
F:M ratio 4:1 fourth to sixth decade
spontaneous, insidious onset lateral hip pain
point tenderness over greater trochanter
greater trochanteric bursitis
171
Lateral hip pain
pain with resisted hip abduction
tender over gluteus medius
trendelenburg test
gluteus medius muscle dysfunction
172
Lateral hip pain
lateral hip pain or snapping associated with walking, jogging or cycling
positive obers
iliotibial band syndrome
173
posterior hip pain
history of low back pain
pain reproduced with isolated lumbar flexion or extension
radicular symptoms or history consistent with spinal stenosis
Referred pain from lumbar spine
174
Lateral hip pain
controversial diagnosis
posterior hip or buttocks pain usually in runners
pelvic asymmetry found on exam
SI joint dysfunction
175
Lateral hip pain
history of overuse or acute injury
pain with resisted muscle testing
tender over gluteal muscles
hip extensor or rotator muscle strain
176
a slowly progressive joint disease typically seen in middle aged to elderly people. the degenerative changes of this include articular cartilage break down and loss, capsular fibrosis, and osteophyte formation on the joints margins
hip osteoarthritis
177
MOI for hip OA
```
aging process
joint trauma
repetitive abnormal stress
obesity
systemic diseases
```
178
inclusion criteria for hip OA
hip pain AND hip IR _ 15 degrees AND pain on hip IR AND morning stiffness _ 50
179
insidious onset of pain in anterolateral hip and groin region; decreased ROM
AG factors:
standing, walking or sitting for too long
squatting
active hip flexion causing lateral hip pain
scour test with adduction causing lateral hip or groin pain
active hip extension causing pain
possible gait alterations
Hip OA
180
doubtful narrowing of joint space and possible osteopytic lipping
grade 1 OA
181
definite osteophytes, definite narrowing of the joint space
grade 2 OA
182
moderate multiple osteophytes, definite narrowing of joint space, some sclerosis and possible deformity of contour
grade 3 OA
183
large osteophytes, markes narrowing of joint space, severe sclerosis and definite deformity of bone contour
grade 4 OA
184
education for OA
lose weight
185
a tear of the acetabular labrum resulted from excessive forces at the hip joint
labral tear
186
pain is usually anterior/groin and can also have clicking, catching, giving way and stiffness
patients are often seen by multiple health care providers before obtaining a definitive diagnosis
labral tear
187
MOI for labral tear
```
MVA
sporting activities
forced movements: torsional or twisting, hyperabdution/extention and hyperextension with lateral rotation
repetitive microtrauma
hip dysplasia
```
188
tests for OA
FABER
scour
resisted SLR
Flex-Add-IR
189
education for OA
limited weight bearing, avoid pivoting motions under load and excessive extension, be careful walking on treadmil
190
chronic, intermittent pain accompanied by tenderness to palpation overlying the lateral aspect of the hip
may be associated to tendinitis, muscle tears, trigger points, IT band disorders
Greater trochanteric pain syndrome
191
MOI for Greater trochanteric pain syndrome
```
chronic microtrauma
regional muscle dysfunction
overuse
acute injury
obesity
muscle fatigue
```
192
```
persistent pain in the lateral hip and or buttock
AGG factors:
lying on affected side
prolonged standing
transitioning to standing position
sitting with the affected leg crossed
climbing stairs
running or other high impact activities
```
Greater trochanteric pain syndrome
193
education for Greater trochanteric pain syndrome
ice, avoid MOI, avoid laying on hard surfaces, lose weight
194
most common knee diagnosis for adolescents
epiphysitis
195
most common knee diagnosis for young adults
femoral condyle defects
meniscus
lig injuries
196
most common knee diagnosis for middle aged population
tendinopathies
articular surface damage
osteoarthritis
197
most common knee diagnosis for older population
osteoarthritis
198
most common knee diagnosis for women
PF symdrome
199
most common knee diagnosis for athletes
meniscus
| lig injuries
200
locking in the tib fem
loose body or meniscus
| difficulty with extension
201
locking in the tib fem
loose body
| difficulty with flexion
202
giving way of buckling in the tib fem
ligament
| meniscal injury
203
giving way or buckling in the pat fem
patellar tracking problem
204
```
sports trauma, cause unknown
pain, swelling, catching
focal tenderness
joint effusion
limited ROM
pain with weight bearing
```
femoral condyle injury
205
MOI for meniscus injury
trauma: compression and rotation
flex+rotation or ext+ rotation during WB
sudden acceleration or deceleration combined with a change in direction
Degenerative
206
knee pain and limited motion
locking, giving out
limited extension, hard end feel
joint line palpation
meniscus injury
207
ACL prevents
ant translation of tibia in NWB and guides tibial rotation
208
ACL MOI
hyperextension with ant translation
209
PCL MOI
hyperflexion with posterior translation
210
MCL MOI
valgus stress
211
LCL MOI
varus stress
212
ACL +med meniscus MOI
hyperextension with rot
213
ACL+med meniscus+ MCL MOI
ext, valgus with rotation
214
```
knee giving out
pain, edema, joint stiffness
immediate dysfunction
inability to walk unassisted
lack of quad control
```
ACL injury
215
should OKC ext exercises be performed for ACL rehab?
initially NO!!
216
dashboard injury causing forceful posterior translation of tibia
PCL injury
217
restrains valgus and lateral rotation of the tivia
MCL
218
restrains varus and medial rotation of tibia
LCL
219
increased Q angle, patella alta, pes planus
muscle weakness: hip abductors, quads
flexibility: tight ITB or lat retinaculum
motor control: poor muscle control during sports or training errors
PF pain syndrome
220
anterior/lateral knee pain/ retro-patellar pain
duss ache
clicking or popping
knee giving out
Agg: walking, stair climbing, kneeling, squatting or sit to stand
PF pain syndrome
221
training for PFJ OCK performed at
90-45 degrees
222
training for PFJ CKC performed at
0-45 degrees
223
pain over the posterior aspect of the patellar tendon
mild stiffness in am or after prolonged sitting
pain worsens with activities
AGG: jumping, landing: severely limits and athletic career
palpation or proximal patellar tendon
tissue thickness with palpation
Patellar tendinopathy
224
subtalar joint anteriorly
convex talus
| concave calcaneus
225
subtalar joint posteriorly
concave talus
| convex calcaneus
226
subtalar joint roll and glide are in the
opposite direction
227
common ankle injuries for adults
```
achilles tendonitis/tendinosis,
plantar fascitis,
ligamentous sprains
rheumatoid arthritis
gout
```
228
common ankle injuries for children and adolescents
osteochondritis dissecans of the talus
juvenile rheumatoid arthritis
epiphyseal fractures
229
excessive load on a supinated ankle. rolling the foot inward
inversion sprains
230
excessive load on a pronated ankle. Rolling the foot outward
eversion sprains
231
grade 1 ankle sprain
232
26-75% tearing, moderate pain and swelling, loss of ROM and slight instability. patient may only manage partial weight bearing with crutches. loss of anywhere from 2-6 weeks of activity
grade 2 ankle sprain
233
total disruption of the ligament, severe pain and swelling, loss of ROM and instability present. patient will typically not be able to weight bear. loss of as few as 4 weeks to as many as 26 weeks from full activity
grade 3 ankle sprain
234
heel strike and weight acceptance with excessive pronation. increased tibial internal rotation/delayed tibial external rotation
rearfoot varus
235
excessive mobility in midstance and propulsion (decreased supination)
forefoot varus
236
compensation of equinus
increase pronation
| knee hyperextension
237
presents itself as a sharp short pain between the toes at or about the met heads
primary symptom is pain at the end of one or more of the metatarsal bones. typically aggravated when walking or running
most often pain comes on over a period of several months rather than suddenly
metatarsalgia
238
pain along the back of your foot and above your heel, especially with stretching your ankle or standing on your toes; with this, pain my be mild and worsen gradually.
tenderness
swelling
stiffness
difficulty flexing your foot or pointing your toes
achilles tendonitis
239
```
D1 UE flexion
scapula
shoulder
forearm
wrist
fingers
```
```
elevation, protraction
flexion, adduction, ER
supination
flexion
flexion
```
240
```
D1 UE extension
scapula
shoulder
forearm
wrist
fingers
```
```
depression, retraction
extension, abduction, IR
pronation
extension
extension
```
241
```
D2 flexion UE
scapula
shoulder
forearm
wrist
fingers
```
```
elevation, retraction
flexion, abduction, ER
supination
extension
extension
```
242
```
D2 extension UE
scapula
shoulder
forearm
wrist
fingers
```
```
depression, protraction
extension, adduction, IR
pronation
flexion
flexion
```
243
```
D1 LE flexion
Hip
Knee
Ankle
Toes
```
Flexion, Adduction, ER
Either
DF, inversion
DF
244
```
D1 LE extension
Hip
Knee
Ankle
Toes
```
Extension, Abduction, IR
Either
PF, eversion
PF
245
```
D2 LE flexion
Hip
Knee
Ankle
Toes
```
Flexion, abduction, IR
Either
DF, Eversion
DF
246
```
D2 LE extension
Hip
Knee
Ankle
Toes
```
Extension, adduction, ER
either
PF, inversion
PF
247
take muscle to point of limitation
end-range isometric contraction into direction of stretch (contraction of antagonist muscles)
relax and passively move limb to new range
useful if tight muscle is painful to contract
Hold relax
248
take muscle to point of limitation
end-range contraction with rotation into opposite direction of stretch (contraction of agonist/tight muscles)
relax and passively move limb to new range
contract relax
249
a low severity injury that typically leads to complete recovery. the structure of the nerve remains intact but electrical conduction down the axon is interrupted, typically by ischemia or compression injury, additionally secondary injuries can be caused by vascular damage leading to intrafascicular edema
neurapraxia
250
disruption of the neuronal axon takes place but the myelin sheath is still intact. Typically this is caused by a crush based injury, and not a laceration. If the neuronal tubules are maintained in place, regeneration and restoration of sensory or motor ability my return
Axonotmesis
251
characterized by not only loss of nerve conduction, but damage to surrounding nerve trunk connective tissue. in extreme cases of this injury category complete transection occurs. commonly a neuroma forms over the proximal stump of the nerve, preventing normal continued regeneration to occur
Neurotmesis
252
never affected in thoracic outlet syndrome
brachial plexus
253
never affected in cubital tunnel syndrome
ulnar nerve
254
never affected in radial nerve compression
radial nerve
255
never affected in carpal tunnel syndrome
medial nerve
256
never affected in tunnel of guyon
ulnar nerve
257
never affected in piriformis syndrome
sciatic nerve
258
never affected in peroneal nerve compression
peroneal
259
never affected in tarsal tunnel syndrome
tibial nerve
260
shoulder depression and lateral flexion of the neck
loss of shoulder abduction, ER weakness of the arm flexion and forearm supination
waiters tip position
upper plexus injury
| C5,6
261
compression of cervical rib or stretching the arm overhead
| paralysis of the intrinsic muscles of the hand
Lower plexus injury
| C8. T1
262
brachial plexus pain paresthesia, numbness, weakness. nerve tension when the plexus is stretched
TOS
263
MOI for axillary nerve (C5, 6)
acute dislocation
| fractures of the humerus's neck
264
squared shoulder from deltoid muscle atrophy
shoulder abd, ER weakness
sensory lateral deltoid
axillary nerve
| C5,6
265
atrophy along the flexor surface of the upper arm (flatness)
weakness of the elbow flexion with forearm supinated
sensory: radial side of forearm
musculocutaneous N.
| C5-7
266
MOI for median nerve (C6-8, T1)
impingement in hypertrophied pronator teres
| carpal tunnel syndrome
267
burning, tingling, or itching numbness in the palm of the hand and the fingers, especially the thumb and the index and middle fingers
Palsy: ape hand with atrophy in the thenar eminence
no arm pronation, weak grip, no thumb abduction and opposition
sensory: thenar region
median nerve C6-8,T1
268
MOI for ulnar nerve (C8,T1)
cubital tunnel syndrome
| compression in the guyons canal
269
pain, numbness and or tingling int he ring and little fingers
partial claw with atrophy between the metacarpals and hypothenar region
loss of use of 4th and 5th digits for spherical and cylindrical power grip
thumb for adduction finger abduction and adduction are lost
sensory: hypothenar region
Ulnar nerve
| C8, T1
270
MOI for radial nerve
| C5-8, T1
Crutch palsy, saturday night palsy (compression site radial sulcus)
posterior interosseious nerve syndrome PINS
compression sites: radial head, ECRB and supinator
271
pain and tenderness in the proximal forearm, finger extension weakness
numbness should not be present
PINS
272
wrist drop
high lesions affecting the triceps, can not push, weak supination
unable to make fist or grip objects unless wrist is stabilized in extension
sensory: posterior arm, forearm, and hand radial side
radial nerve palsy
| C5-8, T1
273
pain radiating to posterior thigh and leg; atrophy posterior thigh, leg and foot; calf atrophy
weak knee flexion, loss of ankle and foot control affecting all phases of gait
sensory: lateral, posterior leg. lateral, posterior lower leg and plantar part of the foot
sciatic nerve
| L4,5, S1-3
274
MOI for common peroneal nerve deep and superficial
| L4-S2
compression from crossing legs, fracture at head/neck of fibula
275
deep- foot drop
superficial - eversion weakness
gait impairment during the loading response with foot slap, excessive hip flexion to clear the toes
sensory: anterior- lateral of lower leg and dorsal part of the foot
common peroneal nerve (deep and superficial)
| L4-S2
276
MOI for tibial nerve L4-S3
tarsal tunnel syndrom
| compression site: between medial malleolus and flexor retinaculum
277
sensory: tingling, burning, or a sensation similar to an electical shock, numbness, pain, including shooting pain felt on the inside of the ankle and/or on the bottom of the foot
inability to plantar flex ankle or flex the toes
gait impairment during terminal stance
tibial nerve
| L4-S3
