Elbow, Wrist, Hand Just how we planned. 12 Flashcards
1
Q
Elbow:
Carrying angle-normal?
A
5-15
2
Q
Elbow:
Carrying angle-normal?
A
5-15
3
Q
Elbow:
Carrying angle-small?
A
4
Q
Elbow:
Carrying Angle-Large
A
> 15 = Cubitus Valgus
5
Q
Elbow:
Where is the ulnar N?
A
Between medial epicondyle and Olecranon
6
Q
Elbow ROM:
Flexion
A
140-150
7
Q
Elbow ROM:
Extension
A
0 to -5
8
Q
Elbow Radial head glide:
Anterior glide with?
A
Supination of the forearm
9
Q
Elbow Radial head glide:
Post glide with?
A
Pronation
The P’s stay together!
10
Q
MFR-Interosseous release:
Pt position?
A
Seated or Supine
11
Q
MFR-Interosseous release:
Doc does?
A
- Palpate affected arm above interosseous membrane
- Note texture, pain and asymmetry with thumbs on pt’s anterior forearm and fingers encircling forearm.
- Palpate R/L, Clock/Cclock, cephalad/caudad
- MFR techniques.
12
Q
ME Post Radial Head-Pronation dysfunction:
Pt position?
A
- Seated
2. Doc flexes elbow into full supination (restrictve barrier)
13
Q
ME Ant. Radial Head-Supination dysfunction:
Doc setup?
A
Doc takes flexed elbow into full pronation (restrictive barrier)
14
Q
ME Ant. Radial Head-Supination dysfunction:
Doc setup?
A
Doc takes flexed elbow into full pronation (restrictive barrier)
15
Q
Elbow:
Carrying angle-small?
A
less than 5 =Cubitus Varus
-GUNSTOCK deformity
16
Q
Elbow:
Carrying Angle-Large
A
> 15 = Cubitus Valgus
17
Q
Elbow:
Where is the ulnar N?
A
Between medial epicondyle and Olecranon
18
Q
Elbow ROM:
Flexion
A
140-150
19
Q
HVLA AB/ADduction Ulnar dysfunctions:
Where is landmark for AB/ADduction?
A
at the wrist
20
Q
Elbow Radial head glide:
Anterior glide with?
A
Supination of the forearm
21
Q
Elbow Radial head glide:
Post glide with?
A
Pronation
The P’s stay together!
22
Q
MFR-Interosseous release:
Pt position?
A
Seated or Supine
23
Q
MFR-Interosseous release:
Doc does?
A
- Palpate affected arm above interosseous membrane
- Note texture, pain and asymmetry with thumbs on pt’s anterior forearm and fingers encircling forearm.
- Palpate R/L, Clock/Cclock, cephalad/caudad
- MFR techniques.
24
Q
ME Post Radial Head-Pronation dysfunction:
Pt position?
A
- Seated
2. Doc flexes elbow into full supination (restrictve barrier)
25
ME Post Radial Head-Pronation dysfunction:
| Where is patient's force?
Pt attempts to pronate isometrically against doc
-ME principles followed
26
ME Ant. Radial Head-Supination dysfunction:
| Doc setup?
Doc takes flexed elbow into full pronation (restrictive barrier)
27
ME Ant. Radial Head-Supination dysfunction:
| Pt force?
Pt attempts to supinate isometrically.
Radial head can't move post. (remember P's go together)
28
HVLA AB/ADduction Ulnar dysfunctions:
| Patient position?
Supinate and fully extend elbow
29
HVLA AB/ADduction Ulnar dysfunctions:
| Doc setup?
1. Grasp elbow on either side of olecranon w/one hand
2. Other hand grasps radius/ulnar
3. Asses dysfunction barriers and apply corrective thrust into barrier.
30
Wrist and Hand:
| Wrist extension with?
Ventral carpal glide
31
HVLA AB/ADduction Ulnar dysfunctions:
| Restriction to ABduction
ADduction dysfunction
Requires Valgus force for Tx
32
HVLA AB/ADduction Ulnar dysfunctions:
| Where is landmark for AB/ADduction?
at the wrist
33
HVLA Anterior Radial Head Dysfunction?
| Associated with?
supination disfunction
34
HVLA Anterior Radial Head Dysfunction?
| Doc setup?
1. 2nd and 3rd fingers of one hand into crease of elbow. -Contacting directly over radial head
2. Other hand flexes elbow and pronates forearm
35
HVLA Anterior Radial Head Dysfunction?
| Force?
Take elbow to hyperflexion while simultaneously thrusting dorsally on radial head.
36
HVLA Posterior Radial Head Dysfunction?
| More or less common than Ant.?
More common
37
HVLA Posterior Radial Head Dysfunction?
| Associated with?
Pronation disfunction
38
HVLA Posterior Radial Head Dysfunction?
| Doc Setup?
1. Engage barrier with one hands thumb over post radial head.
2. Other hand grasps pt'd distal radius/ulna bringing elbow into extension and supination
39
HVLA Posterior Radial Head Dysfunction?
| Force?
HVLA thrust simultaneous w/ventral force on radial head and elbow hyperextension
40
Wrist and Hand:
| Observations?
1. Masses-ganglion syst
2. Bouchard's PIP or Heberden's DIP nodes
3. Ulnar drift of fingers
4. Usual stuff
41
ME Ulnar deviation/Addiction wrist dysfunction:
| Patient force?
Pt ulnar deviates against resistance
42
Wrist and Hand:
| Wrist flexion with?
Dorsal carpal glide
43
Wrist and Hand:
| Wrist extension with?
Ventral carpal glide
44
Wrist and Hand:
| Ulnar deviation?
Towards pinky
45
Wrist and Hand:
| Radial Deviation?
Towards thumb
46
Wrist and Hand:
| Finger apposition?
OK sign etc.
| -Tests for anterior interosseous N.
47
MFR Wrist flexor retinaculum dysfunction:
| Dx?
1. Palpate TART and tenderness deep in wrist between thenar/hypothenar eminence
48
MFR Wrist flexor retinaculum dysfunction:
| Tx-Patient position?
1. Seated
| 2. Palm up with wrist in extension
49
MFR Wrist flexor retinaculum dysfunction:
| Tx-Doctor position?
Facing patient
50
MFR Wrist flexor retinaculum dysfunction:
| Tx-Doctor setup
1. Dr's thumbs over anterior aspect, one on each retinaculum
| 2. Fingers wrap around dorsal aspect
51
MFR Wrist flexor retinaculum dysfunction:
| Tx-Force?
1. Thumbs press posteriorly and apart.
| 2. Maintain for tissue creep 60 sec.
52
MFR Wrist flexor retinaculum dysfunction:
| Tx-Stop?
1. Pain/Paresthesias in median nerve
53
HVLA Radial Deviation/ABduction wrist dysfunction:
| Doctor setup
1. Elbow flexed
2. doc facing patient on side of dysfunction
3. Contact hand w/one hand and distal radius with other
54
ME Ulnar deviation/Addiction wrist dysfunction:
| Patient force?
Pt ulnar deviates against resistance
55
ME Ulnar deviation/Addiction wrist dysfunction:
| Doc force?
Brings to radial deviation barrier
56
ME Radial deviation/ABdiction wrist dysfunction:
| ROM
20-30
57
HVLA Ulnar Deviation/ADduction wrist dysfunction:
| Tx
Move into radial/ABduction barrier and provide HVLA thrust
58
ME Radial deviation/ABdiction wrist dysfunction: Doc force?
Ulnar deviation
59
ME Extesion wrist/Ventral Carpal Dysfunction:
| ROM
70
60
ME Extension wrist/Ventral Carpal Dysfunction:
| What happens?
Doc Flexes
Patient extends
61
ME Flexion wrist/Dorsal Carpal Dysfunction:
| ROM
80-90
62
ME Flexion wrist/Dorsal Carpal Dysfunction:
| What happens?
Doc extends
Patient tries to flex
63
HVLA Extension wrist/Ventral Carpal Dysfunction:
| Doc Setup?
1. Grasp Patient's hand, thumbs contact dorsally at proximal carpal bones (radiocarpal joint)
2. Deliver whip-like thrust moving from extension to flexion and dorsal glide through dysfunction
64
HVLA Flexion wrist/Dorsal Carpal Dysfunction:
1. Grasp Patient's hand, thumbs contact dorsally at proximal carpal bones (radiocarpal joint)
2. Deliver whip-like thrust flexion to extension with ventral glide into dysfunction
65
HVLA Radial Deviation/Abduction wrist dysfunction:
| ROM
20-30
66
HVLA Radial Deviation/Abduction wrist dysfunction:
| Doctor setup
1. Elbow flexed
2. doc facing patient on side of dysfunction
3. Contact hand w/one hand and distal radius with other
67
HVLA Radial Deviation/ABduction wrist dysfunction:
| Tx
Move into Ulnar/ADduction barrier and provide HVLA thrust
68
Articulatory Squeeze technique:
| Doc setup?
1. Pt sits and doc stands in front of pt.
| 2. Dr's thumbs on oneside of dysfunction articulations-fingers on other side of hand
69
HVLA Ulnar Deviation/ADduction wrist dysfunction:
| Doc Setup
1. Elbow flexed
2. doc facing patient on side of dysfunction
3. Contact hand w/one hand and distal radius with other
70
HVLA Ulnar Deviation/ADduction wrist dysfunction:
| Tx
Move into radial/ABduction barrier and provide HVLA thrust
71
HVLA Phalangeal Dysfunction:
| ROM assesment
1. F/E
2. ABD/ADD
3. Int/ext rotation
72
HVLA Phalangeal Dysfunction:
| Doc setup and Tx?
1. Isolate dysfunctional joint
2. Provide traction
3. Deliver hyperflexion thrust
73
Articulatory wrist/Carpal dysfunctions (flexion and extension with glide and ABD/ADD dysfunctions):
Dx?
1. Assess ROM for these movements
74
Articulatory wrist/Carpal dysfunctions (flexion and extension with glide and ABD/ADD dysfunctions):
Tx- Positions?
1. Pt. Seated
| 2. Doc in front of pt
75
Articulatory wrist/Carpal dysfunctions (flexion and extension with glide and ABD/ADD dysfunctions):
Tx-Doc setup?
1. Dr. palms placed over dysfunctional carpal bone articulations and interlaces fingers
2. applies squeeze btw hands w/TRACTION between joints
76
Articulatory wrist/Carpal dysfunctions (flexion and extension with glide and ABD/ADD dysfunctions):
Tx-Articulatory force
Applied via circumduction of pt's wrist (clockwise than CC) Figure 8 motion!
-Carries restrictions through barriers
77
Articulatory Phalangeal dysfunction:
| Dx?
Look at ranges of motion
78
Articulatory Phalangeal dysfunction:
| Doc Setup?
1. Isolate MCP joint by blocking metacarpal bone
| 2. other hand, take phalanx through range of motion while applying TRACTION
79
Articulatory Intersegmental bonus technique:
| How do it?
1. Isolate metacarpal bone by blocking out those around it
| 2. Articulate in A/P glide and rotation
80
Articulatory Squeeze technique:
| What is it?
Alternative to Wrist/carpal dysfunction technique
81
Articulatory Squeeze technique:
| Doc setup?
1. Pt sits and doc stands in front of pt.
82
Articulatory Squeeze technique:
| Force?
1. Doc squeeze btw thumbs and fingers and adds traction at joints
2. Applies articulatory force as circumduction of patients's wrist. figure 8 stuff through barriers.
