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USA PTMMD 1 > Arthrokinematics and Extra Info from Kinser and Colby > Flashcards

Arthrokinematics and Extra Info from Kinser and Colby Flashcards

1
Q

What is Hyperalgesia?

A

Increased pain response to a stimulus that normally causes pain

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2
Q

What is Allogynia?

A

Pain caused by a stimulus that does not usually causes pain

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3
Q

What is the Arthrokinematics of the OA?

A
  • Convex occipital condyles move on concave atlas

With Flexion:
- Condyles roll forward and glide backward

With Extension:
- Condyles roll backwards and glide forward

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4
Q

What is the Arthrokinematics of the AA?

A

This is responsible for 50% of cervical rotation
- Sliding motion of the atlas of the dens

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5
Q

What is the Arthrokinematics of Mid-Cervical Spine (C3-C7)?

Flexion, Extension, Sidebending/Rotation

A
  • Flexion: The inferior facets of the superior vertebra slide up and forward on the superior facets of the inferior vertebral
  • Extension: Inferior facets slide down and backward
  • Side-Bending/Rotation: Ipsilateral inferior facet slides down and back ; Contralateral inferior facet slides up and forward
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6
Q

What is the Arthrokinematics in Forward Head Posture?

What are the Compensatory Effects of FHP?

A
  • OA: In Extension
  • Mid Cervical Spine (AA-Everything else): Increased flexion (anterior compression)

Increased strain on posterior muscles (levator scapulae, suboccipital) and anterior structures like disc and ligamets

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7
Q

What are the S/S of DVT?

A

For the early stages
- dull ache or severe pain
- swelling
- changes of skin temperature and color
- Heat and redness

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8
Q

What is a common symptom of Deep Vein Thrombosis (DVT)?

A

Dull ache or pain usually in the calf

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9
Q

What are the signs of DVT upon palpation?

A

Tenderness, warmth, and swelling

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10
Q

List the first goal of the plan of care for DVT.

A

Relieve pain during the acute inflammatory period

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11
Q

When should mobility begin in the management of DVT?

A

When therapeutic levels of anticoagulant medication have been administered

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12
Q

What is the goal as acute symptoms of DVT subside?

A

Regain functional mobility

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13
Q

What is a key preventative goal in the management of DVT?

A

Prevent recurrence of the acute disorder

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14
Q

What is a recommended intervention for managing DVT?

A

Bedrest, pharmacological management, elevation of the affected lower extremity

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15
Q

What should patients wear while progressively increasing ambulation?

A

Graded compression stockings

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16
Q

What are the contraindications in the management of DVT?

A

Passive or active motion, application of moist heat, use of a sequential pneumatic compression pump

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17
Q

What precautions should be taken after discharge while on anticoagulant medication?

A

Avoid contact sports and activities with a high risk of falling or trauma

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18
Q

What is the optimal position for shoulder arthrodesis?

A

15°-30° of abduction and flexion and 45° of internal rotation

This position allows the hand to reach the mouth.

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19
Q

What is the recommended flexion angle for dominant upper extremity elbow arthrodesis?

A

70°-90° of flexion

This position is combined with midposition of forearm pronation/supination.

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20
Q

What is the optimal position for nondominant limb elbow arthrodesis?

A

Greater elbow extension than the dominant extremity

This position differs from that of the dominant limb.

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21
Q

What is the recommended wrist position for arthrodesis?

A

Slight extension

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22
Q

What is the optimal flexion angle for the MCP of the thumb in arthrodesis?

A

20° of flexion

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23
Q

What region does the brachial plexus course through?

A

The thoracic outlet

This region is significant for neurovascular structures.

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24
Q

Name the three primary sites for compression or entrapment of neurovascular structures in the thoracic outlet.

A
  • Interscalene triangle
  • Costoclavicular space
  • Retropectoralis minor space
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25
What structures are contained within the interscalene triangle?
* Subclavian artery * Upper trunk of the brachial plexus * Middle trunk of the brachial plexus * Lower trunk of the brachial plexus
26
What borders the interscalene triangle?
* Anterior scalene muscle * Middle scalene muscle * First rib
27
What structures are contained within the costoclavicular space?
* Subclavian vessels * Divisions of the brachial plexus
28
What are the boundaries of the costoclavicular space?
* Clavicle * Subclavius muscle * Costocoracoid ligament (anteriorly) * First rib * Anterior scalene muscle * Middle scalene muscle (posteriorly)
29
What structures are contained within the retropectoralis minor space?
* Cords of the brachial plexus * Axillary artery * Axillary vein
30
What are the anatomical boundaries of the retropectoralis minor space?
* Inferior to the coracoid process * Anterior to the second through fourth ribs * Posterior to the pectoralis minor
31
What structural anomalies may compress or entrap the brachial plexus?
* Cervical rib * Elongated C7 transverse process * Malunion of a clavicular fracture
32
What is the primary focus during the Maximum Protection Phase of rehabilitation?
To protect the repaired tendon and prevent adverse effects of immobilization ## Footnote The repaired tendon is at its weakest approximately 3 weeks after repair.
33
How long should the repaired tissue be avoided from loading after surgery?
A minimum of 6 weeks ## Footnote Failure of the repaired tendon through retearing or nonhealing is common.
34
What is the duration of the Maximum Protection Phase after a small or medium tear repair?
3 to 4 weeks ## Footnote This phase can extend to 6 to 8 weeks after repair of large or massive tears.
35
What should be attained by 6 to 8 weeks postoperatively after an arthroscopic repair of a small or medium tear?
Nearly full passive shoulder ROM, particularly elevation and external rotation.
36
What are the goals during the Maximum Protection Phase? List at least three.
* Control pain and inflammation * Prevent loss of mobility of adjacent regions * Prevent shoulder stiffness/restore shoulder mobility.
37
What interventions can be used to control pain and inflammation during the Maximum Protection Phase?
* Periodic cryotherapy * Transcutaneous electrical neuromuscular stimulation (TENS) * Medically prescribed medications.
38
What is the purpose of pendulum exercises in the rehabilitation process?
To prevent shoulder stiffness and restore shoulder mobility ## Footnote Pendulum exercises typically begin the first postoperative day or when the immobilizer is removed.
39
What is the 'balance point position' of the shoulder?
The position where the arm is placed in 90° of shoulder flexion if pain-free ## Footnote In this position, the effect of gravity on the shoulder musculature is minimal.
40
What initial exercises are recommended for passive ROM of the shoulder?
Exercises in the supine position, beginning with arm elevation and external rotation in the plane of the scapula.
41
How soon can self-assisted ROM using the opposite hand or a wand begin for patients with small to medium tears?
1 to 2 weeks ## Footnote For large tears, it begins at 3 to 4 weeks.
42
What are the three categories of cuff repair?
* Arthroscopic * Mini-open (arthroscopically assisted) * Traditional open ## Footnote Each category is defined by the surgical approach and techniques used.
43
Describe the arthroscopic repair technique.
The entire procedure is performed arthroscopically with only a few small skin incisions. ## Footnote This technique minimizes soft tissue disruption and promotes quicker recovery.
44
What are the two variations of the mini-open repair technique?
* Subacromial decompression performed arthroscopically * A portion of the cuff repair performed arthroscopically ## Footnote Both variations involve an anterolateral incision and splitting of the deltoid.
45
What is the purpose of the anterolateral incision in mini-open repair?
To visualize the cuff tear without detaching the deltoid from its proximal insertion. ## Footnote The incision is extended distally between 1.5 to 4 cm along the fiber orientation of the deltoid.
46
What is the traditional open repair technique?
An anterolateral incision that extends obliquely from the middle one-third of the inferior aspect of the clavicle to the anterior aspect of the proximal humerus. ## Footnote This technique requires detaching and reflecting the proximal insertion of the deltoid.
47
What has happened to the use of traditional open repair techniques in recent years?
The use has decreased as arthroscopic and arthroscopically assisted techniques have advanced. ## Footnote This trend reflects improvements in minimally invasive surgical methods.
48
What is Pulled Elbow also known as?
Nurse maid’s elbow
49
What type of injury is Pulled Elbow?
A common minor soft-tissue injury of the radiohumeral joint
50
What age group is primarily affected by Pulled Elbow?
Preschool-age children
51
What causes the radial head to slip in a Pulled Elbow injury?
A sudden longitudinal traction force on the pronated wrist and extended elbow
52
What happens to the annular ligament during a Pulled Elbow injury?
Fibers of the annular ligament become interposed between the radius and the capitellum of the humerus
53
List common causes of Pulled Elbow.
* An adult lifts the child from the ground by their hands * The child's forearm, wrist, or hand is held firmly by a parent as the child attempts to walk away * A mother grabs a child's hand to prevent a fall * The young child is lifted by the hand from a lying or sitting position * The child is swung around by the hands during play
54
What are the clinical findings associated with Pulled Elbow?
Painful and dangling arm, hanging limply with elbow extended and forearm pronated
55
What signs indicate a child has a Pulled Elbow?
Reluctance to use the arm and resistance to attempted supination of the forearm
56
What are the common sites of pain in Pulled Elbow?
* Forearm and wrist * Wrist alone * Elbow alone
57
What is the intervention of choice for Pulled Elbow?
Manipulation
58
What should be done before manipulating a Pulled Elbow?
Explain the procedure to the parents and win the child's confidence
59
Describe the manipulation technique for Pulled Elbow.
Hold the child's wrist with one hand while supporting the elbow and palpating the radial head with the other hand, then forcibly supinate the forearm
60
What indicates a successful reduction during manipulation of a Pulled Elbow?
A click in the region of the radial head
61
What should parents be advised to avoid to prevent Pulled Elbow?
Avoid pulling on the hands or wrists of the child
62
What should be done if a child experiences a delay in using the arm after manipulation?
Use a sling for comfort and to protect the arm from recurrence
63
What are ganglia?
Thin-walled cysts containing mucoid hyaluronic acid that develop spontaneously over a joint capsule or tendon sheath.
64
What is the most common soft-tissue hand tumor?
Ganglia
65
Where are common sites for ganglia?
Anterior (volar) or posterior (dorsal) surfaces of the wrist and fingers.
66
Do ganglia typically cause pain?
They may not cause pain.
67
What symptoms may arise as a ganglion begins to grow?
Aching irritated by flexion and extension of the joint.
68
How can ganglia affect nerves in the wrist?
They can cause ulnar or median nerve compression.
69
What sensory symptoms may develop from nerve compression due to ganglia?
Sensory symptoms in the digits or intrinsic muscle weakness.
70
What is the appearance of a ganglion upon examination?
Smooth, round, or multilobulated and tender with applied pressure.
71
What test can be used to determine the presence of an occult ganglion?
Finger extension test.
72
What indicates the presence of an occult dorsal wrist ganglion during the finger extension test?
Pain in the wrist's third and fourth dorsal compartments.
73
What alternative condition may the finger extension test indicate?
Scapholunate joint pathology.
74
What is an effective method for symptom relief of a ganglion?
Immobilization of the wrist through splinting.
75
Does immobilization usually resolve the ganglion?
It is uncommon for the immobilization to be effective in resolving the ganglion.
76
What procedure can resolve a ganglion?
Needle aspiration.
77
When is surgical excision indicated for ganglia?
For patients with significant pain or cosmetic irritation.

USA PTMMD 1 (40 decks)

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