Common Presentations (elbow, wrist, hand) Flashcards
what are the non-diagnosis specific outcome measures we discussed in class?
numerical pain rating scale, patient specific functional scale, global rating of change
what are some general UE outcome measures? Hand-specific?
DASH, Quick DASH; Michigan hand outcomes Questionnaire
Unless there is a clear MOI that rules out___, you MUST include ___screening during any UE eval
cervical spine
what components are you looking for in an UQS?
symmetry, quality of movement, willingness to move, pain. end feel, neurological exam
resisted isometrics in neutral anatomical position
what are some posture observations you need to keep in mind re:UE pathologies?
head on neck, neck on trunk, arm and scapula position, carrying angle of elbow
How are elbow dislocations defined? Most common type/ MOI?
position of olecranon on humerus-posterior/posterolateral ; traumatic/FOOSH
What other pathologies are likely to occur in a posterolateral elbow dislocation
tear of LCL,UCL and possible joint capsule, brachialis and wrist flex/ext muscles
what muscles are innervated by the median nerve (but not AIN)?
pronator teres
FCR
palmaris longus
flexor dig superficialis
L.O.A.F.
What median nerve-innervated muscles are represented by “L.O.A.F”
1/2 lumbricals, opp policis, abd poll brevis, flex poll brevis (superficial head)
which muscles are innervated by the AIN branch of the median nerve?
1/2 flex digit profundus
flex pollicis longus
pronator quadratus
what muscles are innervated by the ulnar nerve?
FCU, 1/2 flex digiti prof, opp digiti minimi, abd digiti minimi, flexor digiti minimi
1/2 lumbricals, interossei, add poll, flex poll brevis (deep portion)
what muscles are innervated by the radial nerve (but not PIN)?
triceps
anconeus
brachioradialis
ECRL
ECRB
supinator
what are 5 common observations you might see in an elbow/wrist/hand pt?
prominent distal ulna, ulnar drift, common finger deformities, myelopathy of the hand, postural changes
what 3 characteristics describe myelopathy of the hand.
muscle wasting, loss of power in the fingers, pre-existing cervical spinal cord compression/pathology
what s/s might you expect after an elbow dislocation? interventions?
rapid swelling and deformity, severe pain and positive x-ray
PROM, proprio??
what components contribute to elbow instability? WHat might we find in the pt Hx?
humeroulnar and humeroradial articulation=~50% and the ligaments ad muscle of the area make up to other 50%; MOIs of FOOSH and repetitive use
what special tests do we have for elbow instability?
valgus stress
moving valgus stress
varus stress
what are the ROM and MMT expectations you would have for a pt with ligamentous instability?
MMT- strong but potentially limited by guarding
RMO- pain @ end range due to stress
what are the goals for the acute phase (first 2 weeks) for ligament sprains?
rest and activity mod for 2-4 weeks; ROM, promoting healing/limit atrophy, decreasing pain and inflammation
what are the goals for the subacute phase for ligament sprains?
increasing motion @ 10*/week to 135, strengthening of flexors and extensors in full range starting with isometrics++
what are the criteria for the chronic phase for ligament sprains?
full ROM, pain-free, no increased laxity, >4/5 MMT in flexors and extensors
what are the goals for the chronic phase for ligament sprains?
continue strengthening elbow flex/ext muscles, ,forearm sup/pro, wrist flex/ext
what are the intervention focuses of epicondylitis?
pain management, strength/flexibility/endurance, kinetic chain impairments, cross friction, eccentrics, bracing
what are the special tests for lateral epicondylitis?
Cozen’s, Mill’s ,(passive tennis elbow test) resisted tennis elbow test
