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Caroline > EEO: Lecture 7 > Flashcards

EEO: Lecture 7 Flashcards

1
Q

elbow and forearm mobility position hand for _________ tasks

A

elbow and forearm mobility position hand for functional tasks

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2
Q

elbow and forearm stability is for __________ through the upper extremity

A

elbow and forearm stability is for weight bearing through the upper extremity

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3
Q

normal cubitus valgus

A

8-15 degrees

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4
Q

excessive cubitus valgus stretched versus compressed tissues

A

too much carrying angle

stretched: UCL, ulnar n, flexor tendons

compressed: extensor tendons, RCL, radial n

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5
Q

cubitus varus stretched versus compressed structures

A

too little carrying angle

stretched: brachioradialis, extensor tendons, RCL, radial n

compressed: UCL, ulnar n, flexor tendons

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6
Q

Does excessive cubitus valgus or cubitus varus require more shoulder ROM for functional movement?

A

cubitus varus

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7
Q

What is the source of hyperextended elbows with weight bearing?

A

lack of shoulder flexion

tricep weakness

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8
Q

locations of entrapment for the ulnar nerve

A

nerve roots
first rib
pec minor
humeral head
cubital tunnel
guyon’s canal

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9
Q

peripheral nerve cutaneous innervation of the palmar hand

A

ulnar nerve: 5th digit and medial 4th digit

median nerve: 1st, 2nd, 3rd digits and lateral half of 4th digit

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10
Q

peripheral nerve cutaneous innervation of the dorsal hand

A

ulnar nerve: 5th digit and medial 4th digit

median nerve: tips of 1st, 2nd, 3rd digits and tip of lateral 4th digit

radial nerve: dorsum of hand digits 1-3 and lateral 4th digit (not the finger tips!)

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11
Q

what nerve roots comprise ulnar nerve?

A

C8-T1

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12
Q

what is the motion that screens for a compromised ulnar nerve ?

A

claw hand

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13
Q

what population is notorious for having ulnar nerve problems?

A

baseball players (pitchers) tend to have excessive valgus

cyclists

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14
Q

what muscles are atrophied due to ulnar nerve injury

A

hypothenars, intrinsics

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15
Q

how do you screen for ulnar nerve?

A

finger cross

key fob - watch for PIP flexion compensation

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16
Q

locations of median nerve entrapment

A

nerve roots
scalenes
pec minor
humeral head
pronator teres
carpal tunnel

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17
Q

does first rib elevation or depression compress the ulnar nerve?

A

elevation

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18
Q

how can the humeral head compress the ulnar nerve?

A

internal rotation

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19
Q

what nerve roots comprise the median nerve?

A

C5-T1

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20
Q

median nerve entrapment sites

A

nerve roots
between scalenes
pec minor
humeral head
pronator teres
carpal tunnel

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21
Q

median nerve entrapment clinical tests

A

tinels
phalens
reverse phalens

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22
Q

tinels

A

nerve tap

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23
Q

median nerve entrapment hand positions

A

at rest: Ape Hand
make a fist: hand of benediction

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24
Q

how to screen median nerve?

A

OK sign, opposition

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25
what nerve roots comprise radial nerve
C5-T1
26
radial nerve locations of entrapment
nerve roots scalenes triangular space spiral groove lateral epi ECRB arcade of froshe (supinator)
27
what are the borders of the triangular space
superior: teres minor inferior: teres major lateral: long head of triceps
28
clinical tests for radial nerve entrapment
tinels (laterally) resisted supination
29
clinical appearance of radial nerve entrapment
wrist drop
30
radial nerve screen
thumbs up
31
causes of lateral elbow tendinopathy (tennis elbow)
repetitive wrist extension w/ radial deviation
32
pt presentation of LET
**crepitus** pain with eccentric wrist flex pain with gripping profession with repetitive wrist/hand movements (barbers)
33
what is the major functional outcome measure to use for a patient with tennis elbow?
grip strength
34
causes of medial epicondylagia (golfers elbow)
repetitive wrist flexion, gripping/twisting
35
Does lateral epicondylitis or medial epicondylagia heal faster? Why?
Medical epicondylagia heals faster due to its better blood supply
36
What are 2 function outcome measures you can use for a patient with medial epicondylagia?
grip strength key fob: ulnar nerve runs behind medial epicondyle
37
what are the borders of the cubital tunnel?
roof: arcuate ligament floor: UCL medial/anterior: medial epicondyle lateral/posterior: olecranon
38
cubital tunnel syndrome causes
ulnar nerve entrapment repetitive microtrauma in flexion sustained position- **full flexion** in sleeping trauma to posteromedial elbow
39
patient presentation of cubital tunnel syndrome
- numbness/tingling in ulnar nerve distribution - weakness in ulnar sided gripping - weakness with fine motor control - ulnar nerve snapping
40
causes of osteochondritis dessicans
repetitive, forceful valgus (pitchers), repetitive weight bearing
41
is osteochondritis dessicans intra-articular or extra-articular?
intra-articular
42
pt of osteochondritis dessicans are usually...
younger athletes, males more than females
43
patient presentation of osteochondritis dessicans
**catching/locking in joint** loss of elbow extension
44
what is important to assess in patients with OCD?
elbow flexion/extension ENDFEEL
45
what are the 3 bands of the UCL?
anterior cord posterior cord oblique cord
46
what is little leaguers elbow?
ulnar collateral ligament sprain
47
causes of UCL sprain
repetitive VALGUS
48
UCL sprain presentation
may have heard snap with MOI pain with valgus force pain over medial elbow (stretched) may have underlying shoulder issue may see ulnar nerve irritation
49
How can an underlying shoulder issue cause problems with the UCL?
decreased shoulder ER leads to compensation within the elbow
50
lateral collateral ligament sprain causes
trauma with varus force VARUS chronic crutch users
51
patient presentation of LCL sprain
radial head subluxation lateral elbow pain feeling unstable popping clicking, catching
52
is a LCL intra-articular or extra-articular?
intra-articular --> popping, clicking, catching
53
what intrinsic hand muscles does median nerve innervate?
recurrent: thenar muscles - FPB (superficial) - APB - OP Digital: - 1st/2nd lumbricals
54
what intrinsic hand muscles does the ulnar nerve innervate?
deep branch: - hypothenar muscles: flexor digiti minimi abductor digiti minimi opponens digiti minimi - FPB (deep) - **adductor pollicis** - 3rd/4th lumbricals - PADs -DABs
55
what passes through the carpal tunnel?
median nerve FDS FPD FPL *the **palmar cutaneous branch** of the median nerve does NOT pass through the carpal tunnel
56
carpal tunnel syndrome causes
sustained/repeated wrist flexion and extension
57
how do you differentiate between carpal tunnel syndrome and a median nerve injury higher up?
the palmar cutaneous branch of the median nerve does NOT pass through the carpal tunnel, so sensation over the thenar eminence is usually spared in CTS
58
what is an outcome measure you would use for a patient with CTS?
lateral pinch (key fob) - testing opponens pollicis
59
what is the main test/measurement you should use for a patient with CTS?
hand/wrist circumference (swelling) - should be 2:1
60
dequervains tenosynovitis causes
tenosynovitis between EPB and APL, repetitive radial deviation
61
what do you need to rule out with DeQuervain's?
radial nerve! radial nerve innervates the extensors (PIN is only motor)
62
how do you screen for DeQuervain's?
thumb tuck
63
scaphoid fracture causes
TRAUMATIC FOOSH, especially wrist hyperextension
64
patient presentation scaphoid fractures
- pain with compression - pain in snuff box (ext tunnels 1 &3) - pain worsens with extension and radial deviation - weak grip - thenar eminence muscles attach to scaphoid
65
CMC Arthritis causes
NON_TRAUMATIC repetitive loading through thumb, especially CMC hyperextension
66
CMC arthritis is correlated in what populations?
female, older
67
patient presentation CMC arthritis
pain with compression dull pain at base of thumb loss of grip and pinch strength
68
do patients with CMC arthritis present with numbness and tingling?
no, just muscle atrophy
69
mallet finger deformity
DIP flexion extensor digitorum tendon
70
AROM vs. PROM mallet finger
**AROM**: patient cannot actively extend the DIP joint **PROM**: PT can extend the DIP joint because it is a problem with the tendon, not the joint
71
patient presentation with radial head compression factor
lateral elbow pain limited pronation/supination DRUJ or ligament issues
72
post-op elbow patient presentation
-elbow post op brace - limit PROM in all planes - ORIF: AROM only - tendon/ligament: PROM only
73
Causes of Radial head compression fracture
FOOSH- elbow extension, forearm pronation

Caroline (78 decks)

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