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PTRS 745 Exam 1 > Clinical Syndromes > Flashcards

Clinical Syndromes Flashcards

1
Q

Defn: Rupture of biceps brachii long head

A

Complete tear of the tendon of the biceps brachii long head

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2
Q

Q: What are the 2 most common sites of a biceps brachii long head tear?

A
  1. Supraglenoid tubercle
  2. Proximal intertubercular groove
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3
Q

Content: 4 MOI for biceps brachii long head tear

A
  1. Wear and tear
  2. Sudden, forceful contraction
  3. Repetition, overhead movements
  4. Preexisting shoulder problems
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4
Q

Q: For biceps brachii long head tear’s MOI, what falls under “preexisitng shoulder problems?” (4)

A
  1. Chronic impingement
  2. Tendinitis
  3. SLAP tears
  4. Rotator cuff tears
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5
Q

Content: Signs & Symptoms for biceps brachii long head tear (4)

A
  1. “Popping”
  2. Tenderness w/palpation over anterior shoulder
  3. Popeye sign
  4. Positive Speed’s Test
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6
Q

Q: What is the typical treatment plan for young/athletic pts. (who need max supination strength) after a biceps brachii long head tear?

A

Surgery

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7
Q

Q: What is the typical treatment plan for older pts. after a biceps brachii long head tear?

A

Avoid operation

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8
Q

Q: Describe debridment (sx option for rupture of biceps brachii - long head)

A

Treatment for fraying of small amounts of the tendon

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9
Q

Q: Who typically undergoes debridment with tenodesis?

A

Young pt./athlete who has 50% or greater fraying of the tendon

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10
Q

Q: Describe debridment with subacromial decompression (sx option for rupture of biceps brachii - long head)

A

Treatment for fraying of the tendon along with associated rotator cuff and biceps tendon impingement

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11
Q

Content: Modalities for biceps brachii long head rupture (2)

A
  1. Ice
  2. E-stim
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12
Q

Content: Immobilization (1-2 wks) > gentle PROM/AROM > RC resistive strengthening (2-4 wks) > throwing program (after 6-8 wks) > Return to all overhead motions (3-4 mo)

A

TherEx progression for biceps brachii long head rupture

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13
Q

Defn: Snapping scapula

A

Abnormal articulation of the scapulothoracic joint causing a grinding or snapping sensation of the scapula

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14
Q

Content: 3 MOI for snapping scapula

A
  1. Repetitive overhead use
  2. Muscular imbalance
  3. Bony abnormalities
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15
Q

Q: What muscular imbalances can cause snapping scapula?

A

Serratus anterior or subscapularis

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16
Q

Content: Signs & symptoms of snapping scapula (3)

A
  1. Crepitus of the scapula
  2. Reproduction of symptoms with shoulder abduction
  3. Alleviation of symptoms with adduction (HAC)
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17
Q

Content: TherEx for Snapping Scapula (2)

A
  1. Muscle Training (strength/endurance/stretch)
  2. Postural training (min kyphosis)
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18
Q

Q: What muscles should you focus on stretching for postural training of snapping scapula?

A
  1. Upper trap
  2. Pectoralis
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19
Q

Content: Modalities for snapping scapula (3)

A
  1. Ice
  2. Heat
  3. Ultrasound
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20
Q

Defn: AC joint separation

A

An injury that occurs to the ligaments involved in the AC joint that causes separation of the acromion and clavicle

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21
Q

Q: How many types of AC joint separation classifications are there?

A

6

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22
Q

Term: Sprain of AC ligaments

A

AC separation type 1

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23
Q

Term:

  1. AC ligament disrupted
  2. Sprained coracoclavicular
A

AC separation type 2

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24
Q

Term:

  1. AC ligament disrupted
  2. Dislocated w/shoulder complex displaced inferiorly,
  3. Coracoclavicular ligament disrupted with increased interspace
  4. Deltoid and trapezoid usually detached from distal end of clavicle
A

AC separation type 3

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25
Q

Term:

  1. AC and coracoclavicular ligaments completely disrupted
  2. AC joint dislocated
  3. Clavicle displaced posteriorly into or through the trap
  4. Deltoid and trap detached
A

AC separation type 4

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26
Q

Term:

  1. AC and coracoclavicular ligaments completely disrupted
  2. AC joint dislocated w/gross disparity between the clavicle and scapula
  3. Deltoid and trap detached
A

AC separation type 5

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27
Q

Term:

  1. AC and coracoclavicular ligaments completely disrupted
  2. AC joint dislocated
  3. Clavicle displaced inferiorly to the coracoid process
A

AC separation type 6

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28
Q

Content: What are the signs and symptoms of a type 1 AC joint separation? (3)

A
  1. Tenderness with mild pain at joint
  2. Pain with resisted adduction
  3. Normal x-ray
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29
Q

Q: What is the MOI for AC separation?

A

Fall on shoulder with arm ADD is most common

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30
Q

Content: TherEx for type 1 and 2 AC joint separation in the 1) acute 2) subacute and 3) Chronic

A
  1. Rest, gentle ROM
  2. Isometric, CC exercises
  3. Isotonic, OC exercises, task specific
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31
Q

Q: What TherEx plan would you follow if you are going the conservative route for a Type 3 AC joint separation?

A

Follow the Type 1 and 2 exercise progression

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32
Q

Q: What TherEx plan would you follow if you are going the surgical route for a Type 3 AC joint separation?

A

Follow the Type 4 and 5 exercise progression

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33
Q

Content: TherEx for type 4 and 5 AC joint separation in the 1) acute 2) subacute and 3) Chronic

A
  1. Immobilization; no shld exercise
  2. Gain pain free ROM
  3. Progress to strength
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34
Q

Content: Modalities for AC joint separation in 1) acute 2) subacute and 3) chronic phases

A
  1. Ice, NSAIDs, analgesics
  2. Ice and ultrasound
  3. Ice and/or head as needed
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35
Q

Defn: Scapulocostal syndrome

A

Adhesive myocapsulitis (formation of adhesions) that restrict motion and cause pain

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36
Q

Q: What is the MOI for scpaulocostal syndrome? (4)

A
  1. Trauma
  2. Poor posture
  3. Prolonged immobilization
  4. Repetitive Activites
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37
Q

Q: What activities can increase your risk for scapulocostal syndrome? (3)

A
  1. Desk jobs
  2. Prolonged sitting
  3. Overhead activities
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38
Q

Q: What muscles are most commonly involved in scapulocostal syndrome? (3)

A
  1. Levator scapula
  2. Serratus anterior and posterior
  3. Rhomboids
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39
Q

Content: Signs and symptoms of scapulocostal syndrome (3)

A
  1. Pain of medial border of scap and underliying rib cage
  2. Radiating pain
  3. Scapula and thoracic cage move together
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40
Q

Q: What is the 3rd most common fracture in the elderly?

A

Humeral head fracture (1 = hip; 2 = distal radius)

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41
Q

Q: How are humeral head fractures classified according to Neer?

A

There are 4 types based on how many pieces the humerus is broken into (1, 2, 3, and 4 part)

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42
Q

Q: What is the MOI for a humeral head fractures in young individuals?

A

High energy trauma i.e. MVA or sports injuries

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43
Q

Q: What is the MOI for a humeral head fracture in older individuals?

A

Low energy trauma - FOOSH

44
Q

Q: What factors are considered when determining the treatment of a humeral head fracture? (4)

A
  1. Age
  2. Type and location of fracture
  3. # of fragments displaced
  4. Amount of displacement
45
Q

Q: ___% of humeral head fractures are treated conservatively while ___% of humeral head fractures are treated non-conservatively/surgically.

A

80, 20

46
Q

Content: Qualification for non-conservative treatment of humeral head fractures in young and old (2)

A
  1. Used in young pts. with > 0.5 cm or 20 degrees of fracture displacement
  2. Used in older pts. with > 1 cm or 45 degrees of fracture displacement
47
Q

Q: What is the key education point for humeral head fractures?

A

No movement above 90 degrees

48
Q

T/F: Radial head fractures are more common in men than women

A

False: flip it

49
Q

Q: What is the age range of most radial head fractures?

A

30-40 yo

50
Q

Q: What is the MOI for radial head fracture (3)

A
  1. FOOSH
  2. Elbow dislocation
  3. Direct blow to radial head
51
Q

Term: Small crack in the radial head, bone pieces remain fitted together

A

Type 1 radial head fracture

52
Q

Term: Involve larger piece of bone, all slightly displaced

A

Type 2 radial head fracture

53
Q

Term: Comminuted and siplaced, requires surgery to be reduced

A

Type 3 radial head fracture

54
Q

Term: Dislocation and radial head fracture

A

Type 4 radial head fracture

55
Q

Defn: Triceps tendinosis (2)

A
  1. Chronic inflammation of the triceps tendon OR
  2. Degeneration of tricpes tendon insertion
56
Q

Q: What is the MOI for triceps tendinosis?

A

Overuse/strain or repetitive sudden elbow extension

57
Q

Q: What does the treatment plan consist of for triceps tendinosis? (3)

A
  1. Rest
  2. Stretch
  3. Strengthen
58
Q

Content: TherEx for triceps tendinosis

A

Stretch and strengthen

59
Q

Q: What is olecranon bursitis?

A

Inflammatin of the flat bursa located posterior to the olecranon

60
Q

Q: What is the MOI of olecranon bursitis? (4)

A
  1. Traumatic event
  2. Pressure/Occupational
  3. Infection
  4. Other medical history
61
Q

Q: What are the signs and symptoms of olecranon bursitis? (3)

A
  1. Swelling and pain
  2. Restricted motion (flexion)
  3. Infection
62
Q

Q: What are the treatment options for olecranon bursitis? (4)

A
  1. Anti-inflammatories
  2. Aspiration
  3. Steroid injection
  4. Surgery
63
Q

Content: Modalities for olecranon bursitis (3)

A
  1. Ice
  2. Phonophoresis
  3. E-stim
64
Q

Defn: Pulled elbow

A

subluxation of the radial head

65
Q

Q: What are the symptoms of pulled elbow? (3)

A
  1. Arm stuck in extension and pronation
  2. Pain with moving elbow
  3. Unableto flex and supinate arm`
66
Q

Q: What is the MOI for pulled elbow?

A

Sudden pull of an extended and pronated arm

67
Q

Q: Who is pulled elbow most common in?

A

Children

68
Q

Q: What manual therapy would you perform for a pulled elbow?

A

reduction maneuver

69
Q

Defn: Osteochondritis dissecans

A

A joint condition in which a piece of cartilage along with a thing layer of the bone beneath it comes loose from the end of a bone

70
Q

Q: What are the symptoms of osteochondritis dissecans? (3)

A
  1. Pain/swelling lateral and anterior
  2. Limited ROM
  3. Clicking and locking
71
Q

Q: What is the MOI for osteochondritis dissecans? (2)

A
  1. Repetitive trauma
  2. Radiohumeral lateral compression forces
72
Q

Defn: Elbow instability

A

General laxity with in the elbow joint capsule that makes the joint susceptible to subluxation and dislocation

73
Q

Q: What is the MOI for valgus elbow instability?

A
  1. FOOSH
  2. Repetitive overhead movements
74
Q

Q: What is the MOI for varus elbow instability?

A
  1. Chronic instability due to LCL instability
75
Q

T/F: Elbow instability can be due to trauma but not congenital.

A

False: can also be congenital

76
Q

Q: What is the MOI for anterior elbow instability?

A

blow to flexed elbow

77
Q

Q: What is the MOI for posterior elbow instability?

A

excess stretching or rupture of ligaments

78
Q

Q: What type of elbow instabiltiy is most common?

A

Posterior-lateral

79
Q

Q: What are the signs and symtpoms of elbow dislocation? (4)

A
  1. Valgus - flexion limited
  2. Varus - no symptoms except when WB
  3. Anterior - arm held in extension
  4. Posterior - arm held in flexion
80
Q

Q: What is the triple triad of elbow instability?

A
  1. Elbow dislocation
  2. Radial head fracture
  3. Cornoid fracture
81
Q

Defn: Raynaud’s Phenomenon

A

disorder marked by brief episodes of vasospasm causing narrowing of the blood vessels

82
Q

T/F: Raynaud’s increases blood flow to the fingers and toes.

A

False, reduces

83
Q

Q: What triggers Raynaud’s?

A

Cold temperatures and emotional stress

84
Q

Q: What are the symptoms of Raynaud’s? (3)

A
  1. Throbbing
  2. Tingling
  3. BF returns in < 15 min
85
Q

Q: What are the stages in Raynaud’s?

A

Digital pallor > cyanosis > rubor

86
Q

Q: How is Raynaud’s treated? (4)

A
  1. Drugs (Ca blockers, Angiotensin converting enzyme inhibitors)
  2. Lifestyle changes (exercise, diet, clothing, stop smoking)
  3. Modalities: biofeedback, heat pack, paraffin
  4. Manual therapy: massage
87
Q

Q: What is the most frequent of all thumb fractures?

A

Bennett’s fracture

88
Q

Defn: Bennet’s fracture

A

Oblique intra-articular fractures of the 1st metacarpal

89
Q

Q: What is the MOI for Bennett’s fracture? (2)

A
  1. Axial force down a partial flexed metacarpal
  2. Forced ABD of thumb
90
Q

Q: What are the symptoms of Bennett’s fracture?(3)

A
  1. Defect - radial dorsal bulge
  2. Unable to grab/pinch
  3. Numbness and tingling in thumb/wrist
91
Q

Q: What is the treatment plan for Bennett’s fracture?

A

Immobilization

92
Q

Defn: Dupuytren’s Contracture

A

Knots in the fascia of the palm that force your fingers to stay flexed

93
Q

Q: What digits are most commonly affected by Dupuytren’s Contracture?

A

4th and 5th

94
Q

Q: What population is commonly affected by Dupuytren’s Contracture?

A

Older men

95
Q

Q: What should you look for with Dupuytren’s Contracture?

A

Nodules, bands of tissue, curled fingers

96
Q

Q: What modalities can be used for Dupuytren’s Contracture? (2)

A
  1. Heat
  2. Paraffin bath
97
Q

Q: What is the TherEx approach to Dupuytren’s Contracture? (2)

A
  1. Intensive stretching program (for maintenance not prevention)
  2. Exercises (finger lifts, spreads, grip strength, pronation/supination)
98
Q

Defn: Triangular fibrocartilage disc (TFCC)

A

Stabilizes the distal radoulnar joint and helps improve ROM allowing the wrist to move in 6 different directions

99
Q

Q: Where is the TFCC located?

A

Between the medial proximal and distal ulna, also includes fibrocartilage disc

100
Q

Q: What is the funciton of the TFCC? (3)

A
  1. Enhance joint congruity
  2. Cushion against compressive forces
  3. Ligaments attachment
101
Q

Q: What is the MOI for a TFCC injury? (4)

A
  1. Trauma
  2. FOOSH
  3. Power drill injuries (wrist moves instead of drill)
  4. Degenerative changes
102
Q

Q: What modalities would you use for TFCC? (3)

A
  1. Ultrasound
  2. E-stim
  3. Ice
103
Q

Defn: DeQuervain’s Syndrome

A

painful stenosing tenosynovitis of the first dorsal compartment of the hand

104
Q

Q: What are other names for DeQuervain’s Syndrome?

A

Trigger thumb, Gamers thumb, texting thumb

105
Q

Q: What is the MOI for DeQuervain’s Syndrome? (3)

A
  1. Over use
  2. Shear force on APL/EPB
  3. Forceful gripping with UD
106
Q

Q: What are the signs and symptoms for DeQuervain’s Syndrome?

A

Radial wrist pain with thumb movements, tenderness over dorsal compartment

107
Q

Q: What test will be positive for DeQuervain’s Syndrome?

A

Finkelstein’s test

PTRS 745 Exam 1 (9 decks)

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