Clinical Syndromes Flashcards
1
Q
Q: What type of elbow instabiltiy is most common?
A
Posterior-lateral
2
Q
Term:
- AC ligament disrupted
- Sprained coracoclavicular
A
AC separation type 2
2
Q
Q: What should you look for with Dupuytren’s Contracture?
A
Nodules, bands of tissue, curled fingers
3
Q
Q: What are the signs and symptoms for DeQuervain’s Syndrome?
A
Radial wrist pain with thumb movements, tenderness over dorsal compartment
4
Q
Q: What is the 3rd most common fracture in the elderly?
A
Humeral head fracture (1 = hip; 2 = distal radius)
4
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)
4
Q
Term: Dislocation and radial head fracture
A
Type 4 radial head fracture
4
Q
Q: What is the MOI for DeQuervain’s Syndrome? (3)
A
- Over use
- Shear force on APL/EPB
- Forceful gripping with UD
5
Q
Q: What does the treatment plan consist of for triceps tendinosis? (3)
A
- Rest
- Stretch
- Strengthen
6
Q
Term: Sprain of AC ligaments
A
AC separation type 1
6
Q
Q: What are the stages in Raynaud’s?
A
Digital pallor > cyanosis > rubor
7
Q
Defn: Rupture of biceps brachii long head
A
Complete tear of the tendon of the biceps brachii long head
7
Q
Term: Small crack in the radial head, bone pieces remain fitted together
A
Type 1 radial head fracture
7
Q
Q: What is olecranon bursitis?
A
Inflammatin of the flat bursa located posterior to the olecranon
7
Q
Q: What are other names for DeQuervain’s Syndrome?
A
Trigger thumb, Gamers thumb, texting thumb
8
Q
Content: What are the signs and symptoms of a type 1 AC joint separation? (3)
A
- Tenderness with mild pain at joint
- Pain with resisted adduction
- Normal x-ray
8
Q
Q: Who is pulled elbow most common in?
A
Children
8
Q
Q: What test will be positive for DeQuervain’s Syndrome?
A
Finkelstein’s test
9
Q
Defn: Triceps tendinosis (2)
A
- Chronic inflammation of the triceps tendon OR
- Degeneration of tricpes tendon insertion
9
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
11
Q
Q: What are the signs and symptoms of olecranon bursitis? (3)
A
- Swelling and pain
- Restricted motion (flexion)
- Infection
12
Q
Q: What is the MOI for a humeral head fracture in older individuals?
A
Low energy trauma - FOOSH
14
Q
Content: Modalities for snapping scapula (3)
A
- Ice
- Heat
- Ultrasound
14
Q
Content: Modalities for AC joint separation in 1) acute 2) subacute and 3) chronic phases
A
- Ice, NSAIDs, analgesics
- Ice and ultrasound
- Ice and/or head as needed
17
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)
TherEx progression for biceps brachii long head rupture
18
Defn: Elbow instability
General laxity with in the elbow joint capsule that makes the joint susceptible to subluxation and dislocation
19
Q: What muscular imbalances can cause snapping scapula?
Serratus anterior or subscapularis
20
Q: \_\_\_% of humeral head fractures are treated conservatively while \_\_\_% of humeral head fractures are treated non-conservatively/surgically.
80, 20
21
Content: Signs & Symptoms for biceps brachii long head tear (4)
1. "Popping"
2. Tenderness w/palpation over anterior shoulder
3. Popeye sign
4. Positive Speed's Test
23
Q: What is the typical treatment plan for young/athletic pts. (who need max supination strength) after a biceps brachii long head tear?
Surgery
24
Q: What are the 2 most common sites of a biceps brachii long head tear?
1. Supraglenoid tubercle
2. Proximal intertubercular groove
25
Content: Qualification for non-conservative treatment of humeral head fractures in young and old (2)
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
25
T/F: Radial head fractures are more common in men than women
False: flip it
26
Defn: Scapulocostal syndrome
Adhesive myocapsulitis (formation of adhesions) that restrict motion and cause pain
28
Q: What is the typical treatment plan for older pts. after a biceps brachii long head tear?
Avoid operation
29
Q: What muscles should you focus on stretching for postural training of snapping scapula?
1. Upper trap
2. Pectoralis
29
Q: What is the MOI for radial head fracture (3)
1. FOOSH
2. Elbow dislocation
3. Direct blow to radial head
30
Content: TherEx for type 1 and 2 AC joint separation in the 1) acute 2) subacute and 3) Chronic
1. Rest, gentle ROM
2. Isometric, CC exercises
3. Isotonic, OC exercises, task specific
31
Q: What activities can increase your risk for scapulocostal syndrome? (3)
1. Desk jobs
2. Prolonged sitting
3. Overhead activities
32
Q: What modalities would you use for TFCC? (3)
1. Ultrasound
2. E-stim
3. Ice
33
Content: 3 MOI for snapping scapula
1. Repetitive overhead use
2. Muscular imbalance
3. Bony abnormalities
34
Q: What modalities can be used for Dupuytren's Contracture? (2)
1. Heat
2. Paraffin bath
35
Q: What is the MOI for varus elbow instability?
1. Chronic instability due to LCL instability
36
Term: Involve larger piece of bone, all slightly displaced
Type 2 radial head fracture
36
Q: What is the MOI for pulled elbow?
Sudden pull of an extended and pronated arm
37
Q: Who typically undergoes debridment with tenodesis?
Young pt./athlete who has 50% or greater fraying of the tendon
37
Q: How many types of AC joint separation classifications are there?
6
38
Q: Describe debridment with subacromial decompression (sx option for rupture of biceps brachii - long head)
Treatment for fraying of the tendon along with associated rotator cuff and biceps tendon impingement
39
Defn: Osteochondritis dissecans
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
40
Q: What manual therapy would you perform for a pulled elbow?
reduction maneuver
41
T/F: Raynaud's increases blood flow to the fingers and toes.
False, reduces
42
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
AC separation type 5
43
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
AC separation type 3
44
Q: What is the triple triad of elbow instability?
1. Elbow dislocation
2. Radial head fracture
3. Cornoid fracture
45
Q: What is the MOI for posterior elbow instability?
excess stretching or rupture of ligaments
46
Q: How is Raynaud's treated? (4)
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
48
Q: What factors are considered when determining the treatment of a humeral head fracture? (4)
1. Age
2. Type and location of fracture
3. # of fragments displaced
4. Amount of displacement
49
Defn: AC joint separation
An injury that occurs to the ligaments involved in the AC joint that causes separation of the acromion and clavicle
51
Q: Describe debridment (sx option for rupture of biceps brachii - long head)
Treatment for fraying of small amounts of the tendon
53
Q: What TherEx plan would you follow if you are going the conservative route for a Type 3 AC joint separation?
Follow the Type 1 and 2 exercise progression
53
Q: Where is the TFCC located?
Between the medial proximal and distal ulna, also includes fibrocartilage disc
54
Q: What is the MOI for osteochondritis dissecans? (2)
1. Repetitive trauma
2. Radiohumeral lateral compression forces
54
Defn: Bennet's fracture
Oblique intra-articular fractures of the 1st metacarpal
55
Defn: Raynaud's Phenomenon
disorder marked by brief episodes of vasospasm causing narrowing of the blood vessels
55
Q: What are the symptoms of Raynaud's? (3)
1. Throbbing
2. Tingling
3. BF returns in \< 15 min
56
Q: What are the symptoms of osteochondritis dissecans? (3)
1. Pain/swelling lateral and anterior
2. Limited ROM
3. Clicking and locking
57
Q: What is the MOI for Bennett's fracture? (2)
1. Axial force down a partial flexed metacarpal
2. Forced ABD of thumb
59
Content: TherEx for type 4 and 5 AC joint separation in the 1) acute 2) subacute and 3) Chronic
1. Immobilization; no shld exercise
2. Gain pain free ROM
3. Progress to strength
61
Q: What are the treatment options for olecranon bursitis? (4)
1. Anti-inflammatories
2. Aspiration
3. Steroid injection
4. Surgery
62
Q: What is the MOI for a humeral head fractures in young individuals?
High energy trauma i.e. MVA or sports injuries
63
Content: Signs & symptoms of snapping scapula (3)
1. Crepitus of the scapula
2. Reproduction of symptoms with shoulder abduction
3. Alleviation of symptoms with adduction (HAC)
64
Content: Modalities for biceps brachii long head rupture (2)
1. Ice
2. E-stim
65
Q: What are the symptoms of Bennett's fracture?(3)
1. Defect - radial dorsal bulge
2. Unable to grab/pinch
3. Numbness and tingling in thumb/wrist
66
Q: What is the funciton of the TFCC? (3)
1. Enhance joint congruity
2. Cushion against compressive forces
3. Ligaments attachment
67
Q: What population is commonly affected by Dupuytren's Contracture?
Older men
69
Content: Modalities for olecranon bursitis (3)
1. Ice
2. Phonophoresis
3. E-stim
71
Content: Signs and symptoms of scapulocostal syndrome (3)
1. Pain of medial border of scap and underliying rib cage
2. Radiating pain
3. Scapula and thoracic cage move together
73
Q: What TherEx plan would you follow if you are going the surgical route for a Type 3 AC joint separation?
Follow the Type 4 and 5 exercise progression
73
Q: What is the MOI for anterior elbow instability?
blow to flexed elbow
75
Q: What are the signs and symtpoms of elbow dislocation? (4)
1. Valgus - flexion limited
2. Varus - no symptoms except when WB
3. Anterior - arm held in extension
4. Posterior - arm held in flexion
76
T/F: Elbow instability can be due to trauma but not congenital.
False: can also be congenital
77
Q: What is the MOI of olecranon bursitis? (4)
1. Traumatic event
2. Pressure/Occupational
3. Infection
4. Other medical history
78
Content: TherEx for triceps tendinosis
Stretch and strengthen
79
Defn: Snapping scapula
Abnormal articulation of the scapulothoracic joint causing a grinding or snapping sensation of the scapula
81
Q: For biceps brachii long head tear's MOI, what falls under "preexisitng shoulder problems?" (4)
1. Chronic impingement
2. Tendinitis
3. SLAP tears
4. Rotator cuff tears
82
Q: What triggers Raynaud's?
Cold temperatures and emotional stress
83
Q: What is the MOI for AC separation?
Fall on shoulder with arm ADD is most common
85
Q: What muscles are most commonly involved in scapulocostal syndrome? (3)
1. Levator scapula
2. Serratus anterior and posterior
3. Rhomboids
86
Defn: Dupuytren's Contracture
Knots in the fascia of the palm that force your fingers to stay flexed
87
Q: What digits are most commonly affected by Dupuytren's Contracture?
4th and 5th
88
Q: What are the symptoms of pulled elbow? (3)
1. Arm stuck in extension and pronation
2. Pain with moving elbow
3. Unableto flex and supinate arm`
89
Term:
1. AC and coracoclavicular ligaments completely disrupted
2. AC joint dislocated
3. Clavicle displaced inferiorly to the coracoid process
AC separation type 6
90
Content: TherEx for Snapping Scapula (2)
1. Muscle Training (strength/endurance/stretch)
2. Postural training (min kyphosis)
91
Defn: Pulled elbow
subluxation of the radial head
92
Defn: DeQuervain's Syndrome
painful stenosing tenosynovitis of the first dorsal compartment of the hand
94
Term: Comminuted and siplaced, requires surgery to be reduced
Type 3 radial head fracture
95
Content: 4 MOI for biceps brachii long head tear
1. Wear and tear
2. Sudden, forceful contraction
3. Repetition, overhead movements
4. Preexisting shoulder problems
96
Q: What is the MOI for scpaulocostal syndrome? (4)
1. Trauma
2. Poor posture
3. Prolonged immobilization
4. Repetitive Activites
98
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
AC separation type 4
99
Q: What is the most frequent of all thumb fractures?
Bennett's fracture
101
Q: What is the treatment plan for Bennett's fracture?
Immobilization
102
Q: What is the key education point for humeral head fractures?
No movement above 90 degrees
103
Q: What is the MOI for triceps tendinosis?
Overuse/strain or repetitive sudden elbow extension
104
Q: What is the MOI for a TFCC injury? (4)
1. Trauma
2. FOOSH
3. Power drill injuries (wrist moves instead of drill)
4. Degenerative changes
105
Q: What is the age range of most radial head fractures?
30-40 yo
106
Q: What is the TherEx approach to Dupuytren's Contracture? (2)
1. Intensive stretching program (for maintenance not prevention)
2. Exercises (finger lifts, spreads, grip strength, pronation/supination)
107
Q: What is the MOI for valgus elbow instability?
1. FOOSH
2. Repetitive overhead movements
