BE - Lecture 1 Flashcards
class notes ended at S: 49 cards to S:42
active ROM
- ____
- ___ is moving parts
- ____ than passive ROM
voluntary
patient
smaller
passive ROM
- ___ barrier
- ____
- ___ is not moving parts
- ___ than active ROM
physiologic
involuntary
patient
larger
joint play
- ____ barrier
- ____ barrier
- _____ and ____
- after ____ and ___ range
- ___ are made here
paraphysiologic structural involuntary and passive active and inactive adjustment
3 true joints of the shoulder complex
GHJ
SCJ
ACJ
1 false joint
STJ
3 bones of the shoulder complex
humerous
clavicle
scapula
GHJ has the ___ mobility
greatest
SCJ is the only real link to ____ skeleton
axial
shoulder complex involves “____ stabilization”
dynamic
if the SCJ moves, so does the ___ and ___
ACJ
STJ
SCJ has a ___ capsule
synovial
the SCJ has a SC ___
disk
the SC disk has inferior part to the ____ and superior part to the ____
clavicle
manubrium
SC disk maintains ___ and ___
strength
stability
SC disk will sublux ___ and ____
ant and sup
dislocation happens __% to the SCJ
1
ACJ has a ___ capsule
synovial
the AC disk with upper extremity usage will go from fibrocartilage —> ____
meniscoid
shoulder separation happens at the ___ J
AC
shoulder separation involves the ____ cap, ___ lig and ___ lig
anterior
AC
CC
with shoulder separation there will be ___ of the ACJ
gapping
T2 landmark seated
seated
superior/medial angle of the scap
T3 landmark seated
spine of the scap
T7 seated
inferior angle of the scap
2” should be the average distance between what?
SPs
vertebral border
primary movements of the STJ
elevation
depression
secondary movements of the STJ
protract retract upward rotation downward rotaion (rotation in reference to the inf angle)
STJ is a ___-joint
pseudo
adhesive capsulitis leads to a loss of the __;___ ratio
2:1
becomes 1:1
adhesive capsulitis you have pain on ___
abd
adhesive capsulitis can be caused by ___ (____/____) or ____ ____
trauma (direct or indirect)
over use
Codman’s exercise
stretch capsule w/o load
hang down in front and make little circles –> big circles
scapular winging
serr ant. subscap, rhomboids keep the scapula gliding and sliding over rib cage and it isn’t
scaps wing out
GHJ has a ___ articular surface of humerus and ____ articular surface of scapula
large
small
angle of inclination for the GHJ
130-150
angle of inclination of the GHJ made by what 2 bones
Btw the midline shaft of the humerus and midline shaft of the scapula
angle of torsion of the GHJ
30
how it hangs in resting position
humerus should hang and should face a little ___ and ___
medial
post
glenoid labrum is an extension from the glenoid ___
fossa
glenoidal labrum ___ and gives ___ articulation to the humerus
deepens
more
glenoid labrum allows ______to attach
long head of the biceps
glenoid labrum is ___ on top and ___ on bottom
loose
tight
(opp of the glenohumeral capsule)
glenohumeral capsule is ___ on top and ___ on bottom
tight
loose
(opp of the glenoid labrum)
glenohumeral capsule is supported by the ___
subscapularis
glenohumeral capsule forms the ___ with the SITS muscles
cuff
coracoacromial arch involves 3 things
coracoid process
acromion
coracoacromial lig
coracoacromial arch protects 3 things
subacromial bursa
rotator cuff tendons
long head of BB
coracoacromial arch keeps the GHJ from dislocating ___
superiorly
2 bursa in the shoulder
subacromial
subdeltoid
bursa decreases ___
friction
dislocation of the GHJ is usually in ___ and ___ ___ position
hyperextention
external rotation
during dislocation of the GHJ the humerus will move ___ and ___
ant
inf
during dislocation of the GHJT there is __ or ___ use
little
no
4 tests for GHJT diagnoses
ant drawer
apprehension
dugas
Feagin
dislocation of the GHJT usually caused by ___
trauma
during dislocation you have to ___ to rule out ___
x ray
fracture
___ maneuver is used to fix a dislocation of the GHJ
Kocher
Reason why the glenoidal labrum is loose on the top?
for mobility
Reason why the glenoid labrum is tight on the bottom
for stability
SX of bursitis
Cardinal signs: swelling pain reddness heat
positions that a pt will feel pain when they have bursitis
Flex, abd, ER
during c.c. _______ will cause pain during PROM and AROM
bursitis
2 causes of bursitis
trauma , overuse
two special test for bursitis
push-button, dawbarns
flexion of GHJ is ____ degrees
160
____ degrees: extension of GHJ
60
____ degrees: adduction of GHJ
75
____ degrees: abduction of GJH
180
____ degrees: protraction of GHJ
20
____ degrees: retraction of GHJ
30
____ degrees: : ER of the GHJ
100
____ degrees: IR of the GHJ
70
M. that preform Flexion of the GHJ
ant. delt
long bicep brachii
pec. Major
M that preform Extension of GHJ
Post. delt teres maj teres minor lat. dorsi triceps
M that preform adduction of GHJ
pect maj
lat dorsi
teres major
M that preform abduction of GHJ
supraspinatus
mid delt
During abduction of the GHJ there is ____ sliding of the humeral head
inferior
the humerus has to _____ for abduction to finish
ER
The first 15 degrees of abduction of the GHJ is preformed by the ______M.
Supraspinatus
M that preform IR of the GHJ
subscapularis
pec major
M that preform ER of the GHJ
infraspinatus , teres minor
Look at Slide 22 for TOS sx of the GHJ
there are a lot
GHJ Stabilization at rest is provided by the following 3 structures
Joint capsule
superior GH lig.
CH lig
______ joint pressure stabilizes the GHJ at rest
negative joint pressure
The GHJ has _____ at rest (shoulder is rotated)
glenoid inclination
two muscles that stabilizes the GHJ during weight bearing
Suprascapular
long head of the bicep
elbow preforms ____ degrees of flexion
140
M that preform elbow flexion
brachialis
Bicep brachii
brachioradialis
Avulsed bicep brachii usually occurs at the ____ head of the bicep
long head
2 causes of bicep avulsion
lifting trauma
degeneration
elbow can do _____degrees of extension
0.3
2 muscles that assist in elbow extension
tricep brachii
anconeus
students elbow is _______
olecranon bursitis
two causes of olecranon bursitis
trauma, infection
the elbow can preform _____degrees of supination
80 degrees
3 M. that preform supination of the elbow
supinator
bicep brachii
brachioradialis
more axial force load is on _____ bone during supination
ulna
SNP “saturday night palsy” is a condition in the elbow caused by ______
compression of the radial N. from over tension for an extended period of time
Compression on a nerve will cause a decrease of axoplasmic flow with will impede: (3 things)
decrese blood flow
decrease venous return
decrease reduction
the elbow has ____ degrees of pronation
75
M. of pronation of the elbow
pronator teres
pronator quadratus
brachioradialis
There is more axial force on the _____ bone during elbow pronation
radius
ulnar neuropathy can because by entrapment btw which two M
pronator teres
flex. carpi ulnaris
3 special tests for ulnar neuropathy
wartenberg
froment
tinels
wartenberg test tests for _____
ulnar neuropathy
froment test will test for ______
ulnar neuropathy
carrying angle of the humero-ulnar joint is _____ degrees
15 degrees
What causes the 15 degrees of the carrying angle of the humero-ulnar joint
the trochlea
carrying angle _____ with a larger valgus position of the forarm
increases
The carrying angle _____ when the arm is in a more varus position
decreases
The elbow joint capsule blends with the ___, __, & ___ lig of the elbow
annular lig
MCL
LCL
Name the 3 parts of the MCL of the elbow
anterior
medial
transverse
The MCL of the elbow stabilizes _____ stress
valgus
Which lig stabilizes valgus stress of the elbow
MCL
The MCL of the elbow limits end-range ___
extension
MCL of the elbow resists _____ loads
traction
3 condition names that affect the medial lig of the elbow
little league elbow
golfer’s elbow
medial epicondylitis
little league elbow is ___
medial epicondylitis
golfer’s elbow is ______
medial epicondylitis
2 tests for medial epicondylitis
tinels
mills
Pt will experience weakness in the _____ M. when they have medial epicondylitis
weakness in the wrist flexors
the origin of most wrist flexors
Name the 3 parts of the LCL lig of the elbow
radial, ulnar and annular
_____ lig stabilizes varus & supination stress of the elbow
LCL
The LCL lig of the elbow stabilizes about ___ & ___ stresses
varus
supination
The LCL lig of the elbow resists _____ loads
traction
The MCL and LCL of the elbow resist ____ loads
traction
Two conditions that are caused by inflammation of the LCL
tennis elbow , lateral epicondylitis
Tennis elbow is ____
lateral epicondylitis
2 tests for lateral epicondylitis
Cozen
mills
_____ C.c. can be caused by over pronation/ wrist extension
tennis elbow
lateral epicondylitis can cause muscle weakness in the wrist _____ M
wrist extensors
2 causes of lateral epicondylitis
repetitive wrist extension
supination
_____ lig. forms a ring around the radius
annular lig
nursemaids elbow is trauma to the ____ lig
annular
Nursemaids elbow is caused by putting the annular lig in ____,_____, and ____
pronation, extension and distraction
nursemaids elbow is usually on the Right or Left elbow ?
left
What bones of the wrist are considered to be the “big 3”
scaphoid, lunate, triquetrum
proximal row
___degrees of flexion in the wrist
75
M. that preform wrist flexion
flexor carpi ulnaris
flexor carpi radialis
_____ degrees of wrist extension
74
M that preform wrist extension
extensor carpi radialis longus/ brevis
extensor carpi ulnaris
There is no muscular force on the ____ row of the carpals
proximal
Intercalated - there is no lig insertions
under compression the scaphoid ____ & the lunate ___
scaphoid flexes
lunate extends
The capitate bone is the “_____” or pivot
keystone
In neutral the ____ and ___ bones of the wrist pack together
capitate and scaphoid
In full extension the ____ and _____ bones of the wrist pack together
scaphoid and lunate
compressive forces can cause the scaphoid to _____ which can cause a fracture
drop
compressive forces allows toe lunate to ____ which can cause subluxation
move up
What is a SLAC injury
when the capitate drops btw the lunate and scaphoid
Why are the tunnel of guyon and carpel tunnel to most suseptable to injury?
because they are under the retinaculum
boundaries of the carpel tunnel
pisiform/ hook of hamate
navicular / trapezium
boundaries of the tunnel of guyon
hamate/ pisiform
what passes through the tunel of guyon
ulnar nerve
def____: hand goes numb
anstisia
def_: no feeling
dis-astisia
def____: tingling
parastesia
What bones of the wrist are considered to be the “big 3”
scaphoid, lunate, triquetrum
proximal row
___degrees of flexion in the wrist
75
M. that preform wrist flexion
flexor carpi ulnaris
flexor carpi radialis
_____ degrees of wrist extension
74
M that preform wrist extension
extensor carpi radialis longus/ brevis
extensor carpi ulnaris
There is no muscular force on the ____ row of the carpals
proximal
Intercalated - there is no lig insertions
under compression the scaphoid ____ & the lunate ___
scaphoid flexes
lunate extends
The capitate bone is the “_____” or pivot
keystone
In neutral the ____ and ___ bones of the wrist pack together
capitate and scaphoid
In full extension the ____ and _____ bones of the wrist pack together
scaphoid and lunate
compressive forces can cause the scaphoid to _____ which can cause a fracture
drop
compressive forces allows toe lunate to ____ which can cause subluxation
move up
What is a SLAC injury
when the capitate drops btw the lunate and scaphoid
Why are the tunnel of guyon and carpel tunnel to most suseptable to injury?
because they are under the retinaculum
boundaries of the carpel tunnel
pisiform/ hook of hamate
navicular / trapezium
boundaries of the tunnel of guyon
hamate/ pisiform
what passes through the tunel of guyon
ulnar nerve
def____: hand goes numb
anstisia
def_: no feeling
dis-astisia
def____: tingling
parastesia
name the 4 tests that can be used to assess carpel tunnel sx
tinels
phalens
reverse-phalens
carpel compression
Ulnar triad will be seen where there is trauma to _____ tunnel
pisiform/ hamate tunnel
Describe 3 sx of the ulnar triad that is caused in the pisiform/hamate tunnel
tenderness
clawing
hypothenar atrophy
_____ degree of ulnar deviation
35
ulnar deviation is _____ movement
adduction
____ degrees of radial deviation
21
radial deviation is ____ movement
abduction
M that contribute to ulnar deviation
flexor carpi ulnaris
extensor carpi ulnaris
M that contribute to radial deviation
extensor carpi radialis brevis & longus
abductor pollicis longus
extensor pollicis brevis
What joint has recipical motion?
intercarpels - when one row goes one way the other moves the opposite
To get very little to no recipical motion deviation in the wrist: closed pack position in _______
full extension
or splay
To get very little to no recipical motion deviation in the wrist: ______ position
splay
(of closed pack full extension
What is splaying position ?
having the fingers fully spread out
What is two importances to distal and proximal carpel row shift
decrease friction on the wrist
increase ROM
Closed back position keeps which two bone tight
schapoid & lunate
What are the two tendons constricted during de quervains disease
abductor pollicis longus
extensor pollicis brevis
_______ disease is caused by stenosiing tenosynovitis
de quervains disease
____: c.c. where there is inflammation of the tenson sheath over the radial styloid process
stenosing tenosynovitis
de quervains disease
What are two causes of tensosing tenosynovitis
overuse trauma of thumb and wrist
direct trauma
c.c._________ disease : symptoms show increase pain on thumb/wrist extension
increase pain on general wrist flexion
palp. tenderness over radial styloid process
de quervains disease
stenosing tenosynovitis
c.c.________: nodule formation on hand flexor tensons or aponeurosis
dupuytrens contracture
What digits are usually affected by dupuytrens contracture
4 & 5th
makes them look claw like
c.c._________: presentation is flexion deformity of hand
fingers drawn into palm
pain may/may not be present
duputrens contracture
c.c. duputrens contracture : _______
nodule formation on hand flexor tensons or aponeurons
usually 4th and 5th digit
