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OS3 EX1 > Compression Neuropathy lab & HYHO > Flashcards

Compression Neuropathy lab & HYHO Flashcards

1
Q

What would a (+) spurling test indicate?

A

radiculopathy

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2
Q

What tests can be used for plexopathy?

A

East/Roo
Adson
Military Brace
Wright

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3
Q

What does a (+) Adson test indicate?

A

scalene muscles or 1st rib/cervical rib causing compression neuropathy.

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4
Q

What is the difference between radiculopathy vs plexopathy vs mononeuropathy?

A 
radiculopathy = localized region of one unilat limb experiencing symptoms due to nerve root impingement (disc herniation, etc)
plexopathy = intermittent symptoms inconsistent with one nerve root due to brachial plexus (or other plexus) impingement
mononeuropathy = compression at one nerve usually within the extremity (ie carpal tunnel syndrome)
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5
Q

lumbosacral radiculopathy most common effected segment and most common etiology?

A

L5-S1

herniated disc

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6
Q

lumbosacral radiculopathy pain distribution?

A

frequently lead to pain down one leg from the butt to the foot.
WATCH FOR RED FLAGS: weight loss, fever, chills, loss of bowel or bladder control

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7
Q

What is piriformis syndrome? classic presentation?

A

sitting on a wallet for a long time.
mononeuropathy where the sciatic nerve is pinched by the piriformis muscle.
pain with sitting/standing longer than 15-20min, pain radiating from sacrum through butt and down posterior thigh (will stop above the knee). may have foot drop/weird gait, numbness in 1 foot, ipsilateral LE weakness

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8
Q

Spurling’s maneuver

A

seated or supine. Dr ex/rot pt head to one side and pushes down for 1 min. do bilat
(+) = reproduction of pain, paresthesia
COMPRESSED CERVICAL NERVE ROOT IPSILAT

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9
Q

Straight leg raise

A

one leg passively flexed with knee extended. do bilat.
(+) = pain/repro symps bw 35-70deg
COMPRESSED LUMBOSACRAL NERVE RT

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10
Q

Apprehension test

A

shoulder abd to 90 elbow flexed to 90 force into external rotation.
(+) = pt apprehension
GLENOHUMERAL INSTABILITY

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11
Q

sulcus sign

A

pull arm down
(+) = indentation
glenohumeral instability

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12
Q

Yergason Test

A

palpate bicipital groove, supinate and ex rotate against dr resistance.
(+) = pain/subluxation out of groove
UNSTABLE BICIPITAL TENDON/SUBLUX

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13
Q

Adson Test

A

monitor pt radial pulse, extend arms, ext rot, abd at affected shoulder, apply cervical traction and rot toward affected side and INHALE = lots P.
(+) = repro symps or dec radial pulse
THORACIC OUTLET SYNDROME

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14
Q

Military Test

A

monitor pt radial pulse, extend arms, ext rot, abd at affected shoulder, pt sit or stand to “military attention” (retract scapula)
(+) = repro symps or dec radial pulse
THORACIC OUTLET SYNDROME

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15
Q

East/Roos Test

A

bilat shoulder and flex and ext rot all to 90. open and close repeated open and close
(+) = repro of symps/weakness/discolored hands
THORACIC OUTLET SYNDROME

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16
Q

Wright hyperabduction test

A

Start at roos positioning and then hyperflex while monitoring radial pulse
(+) = repro symps/ dec radial pulse
THORACIC OUTLET SYN DUE TO PECT MINOR

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17
Q

Tinel’s Sign at wrist

A

tap over transverse carpal L (bw thenar and hypothenar eminences)
(+) = parasthesias radiating to thumb/index/middle
MEDIAN NERVE ENTRAP. OR CARPAL TUNNEL SYN.

18
Q

Phalen’s sign

A

put dorsal parts of pt hands together and force into wrist flex for 60s
(+) = parasthesis in median n
MEDIAN N TRAPPED. CARPAL TUNNEL SYN

19
Q

OK test

A

have pt make ok sign
(+) = one had makes pinched circle instead of actual circle
ANTERIOR INTEROSSEOUS N PALSY

20
Q

Froments Sign

A

pt pinch paper between thumb and index and pull paper.
(+) = thumb joint flex
ULNAR N PALSY, ADDUCTOR POLLICIS

21
Q

How would treat a radiculopathy of the neck?

A

1) evaluate OA, AA, C2-C7 and diagnose
2) tx options:
contralateral traction cervical
suboccipital release
unilat forearm fulcrum forward bending
bilate forearm fulcrum forward bending

22
Q

How can you diagnose and treat a first rib caused plexopathy?

A

dx: Adson test
tx: supine inhalation dysfxn MET
exhalation dysfxn MET
J-stroke HVLA

23
Q

How can you diagnose and treat a clavicular caused plexopathy?

A

dx: miliary brace test
tx: SC horizontal extension SD MET
SC elevated/ADDucted SD MET
AC internal rot SD MET
AC external rot SD MET

24
Q

How can you diagnose and treat a pectoralis minor caused plexopathy?

A

dx: wright hyperabduction test
tx: f-F ADD TP

25
Q

What SD could a pronator teres mononeuropathy present as and how would you treat?

A

radial head pronated (posterior) SD
radial head supinated (anterior) SD
tx: F PRO Add TP

26
Q

What tests would be positive for carpal tunnel syndrome?

A

Phalens, Prayer tests, OK test, Tinel test

27
Q

What tests would be positive for pronator teres syndrome?

A

phalens, resisted pronation test, ok test

28
Q

What SD could someone with carpal tunnel syndrome have?

A

wrist extension or flexed SD

wrist Add or Abd SD

29
Q

How can you treat carpal tunnel with OMT?

A 
figure 8 wrist articulation
wirst isonotic MET (thumbs in x over thenar)
wrist flexor retinaculum MFR
wrist extensino/ventral carpal SD HVLA
Wrist Flex/dorsal carpal SD HVLA
30
Q

What tests would be positive for cubital tunnel syndrome?

A

tinel posterior/superior to elbow
froment’s test
decreased sensation/numbness medial forearm into the 4th and 5th digits

31
Q

What SD could someone with cubital tunnel syndrome present with?

A

elbow extension/flex SD

elbow add/abd SD

32
Q

where is the UPL5 located?

A

superior medial surface of PSIS

33
Q

where is the LPL5 located?

A

on the ileum just inferior to PSIS press superior

34
Q

where is the PL3 gluteus located?

A

2/3 lateral from PSIS to tensor fasciae latae

35
Q

PL4 gluteus is located where?

A

posterior margin of tensor fasciae latae

36
Q

How can you treat piriformis syndrome with OMT?

A

counterstrain F abd ER
Supine piriformis self-stretch
Piriformis MET

37
Q

What OMT can you provide for pts with meralgia paresthetica?

A

Psaos, sacrum, innominate, anterior thigh SD
MFR to abdomen
L2-L3 focused treatments

38
Q

what’s the most worrisome symptom to a patient with common fibular nerve syndrome?

A

foot drop

39
Q

How can you treat common fibular nerve syndrome?

A

posterior fibular head MET
post fibular head HVLA
post fibular head BLT

40
Q

how can you treat tarsal tunnel syndrome with OMT?

A

calcaneal HVLA
Talar tug HVLA
gastrocnemius CS plantarflex
ankle figure 8

OS3 EX1 (11 decks)

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