Eval & Diagnosis Flashcards
Forearm Extensor muscles (posterolateral)
- Extensor carpi radialis longus
- Extensor carpi radialis brevis
- Extensor carpi ulnaris
- Brachioradialis
- Extensor pollicis longus
- Extensor pollicis brevis
- Adductor pollicis longus
- Extensor indicus supinator
Forearm Flexor Muscles
- Flexor carpi radialis
- Flexor carpi ulnaris
- Palmaris longus
- Flexor digitorum superficialis
- Flexor digitorum profundus
- Flexor pollicis longus
- Pronator quadratus
- Pronator teres
Colles’ fracture
- Lower end of radius or ulna
- FOOSA -hyperextention
- Out for 1-2 months
Silver Fork Deformity
Fwd displacement of the radius that causes a visible deformity to the wrist
Bishop’s or Benediction deformity
- Results from injury to ulnar nerve
* Flexion of pinky and ring finger
Claw Hand
- Results from compression of he median and ulnar nerve
* Flexion of all fingers and thumb
Drop Wrist
- Results from palsy of the radial nerve
* Wrist flexion
Ape Hand
Results from palsy of the median nerve
*Thumb is pulled into extension and fingers 2-5 into flexion
What runs through the carpal tunnel?
- Flexor digitorum profundus (4 tendons)
- Flexor digitorum superficialis (4 tendons)
- Flexor pollicis longus (1 tendon)
- Median nerve
De Quervain’s Disease (Hoffman’s Disease)
- Stenosing tenosynovitis in the thumb
* Effects the extensor pollicis brevis & abductor pollicis longus
Bowler’s Thumb
Perineural fibrosis of the subcutaneous ulnar digital nerve of the thumb
Trigger Finger/Thumb
Stenosing tenosynovitis commonly occurring in a flexor tendon
Mallet Finger
- Avulsion of an extensor tendon in the finger from the insertion.
- PIP into 30° of flexion
- splinted in extensio for 6-8 weeks
Boutonniere (Buttonhole) Deformity
- Rupture of the extensor tendon dorsal to the middle phalanx
- DIP joint into extension and PIP into flexion
- Splinting for 5-8 weeks
Jersey Finger
- Rupture of the flexor digitorum profundus tendon from the insertion of the distal phalanx
- DIP cannot be flexed
Dupuytren’s Contracture
- Nodules develop in the palmar aponeruosis
* Limit extension and eventually cause felxion deformity
Gamekeepers Thumb
*Sprain of the UCL of the MCP in the thumb
*Forceful abduction and possible hyperextension of the thumb
*
Swan Neck (Pseudoboutonniere) Deformity
- Injury to the proximal volar plate of the PIP
* Hyperextenstion of the PIP and flexion of the DIP
Bennett’s Fracture
- Fx in at the CMC of the thumb
* From axial and abduction forces
Degrees of ROM in the Shoulder
- Flexion: 180°
- Extension: 50°
- Abduction: 180°
- Adduction: 40°
- Internal Rotation: 90°
- External Rotation: 90°
Scapulohumeral Rhythm
Scapular/Humeral
0°-30°: 0°/30°
30°-60°: 1°/2°
60°-90°: 1°/1°
Tests for GH instability (8)
- Load Shift
- Anterior Drawer
- Posterior Drawer
- Sulcus
- Clunk
- O’Brian
- Apprehension
- Relocation
Tests for Shoulder Impingement
- Neers
2. Hawkins-Kennedy
Tests for Supraspinatus Weakness
- Drop Arm
2. Empty Can
Test for Serratus Anterior Weakness
Wall push-ups (winging scapula)
Tests for Biceps Tendonitis
- Yegerson’s
- Speed’s
- Ludington’s
Tests for Thoracic Outlet Syndrome
- Adson’s (Anterior scalene syndrome test)
- Roo’s (Costoclavicular syndrome test)
- Military Brace Position
- Allen’s (Hyperabduction syndrome test)
Adson’s Test
- Indicated compression of the subclavian artery at the point between the heads of the anterior & middle scalenes
- Arm extended -> add head
Roo’s Test
- Indicates compression of the subclavian artery between the first rib and clavicle
- flashing field goal
Military Brace Test
- Indicates compression of the subclavian artery between the first rib and clavicle
- Athlete standing -> shoulders retracted ->arm abducted to 30° and extended
Allen Test
- Subclavian, axillary vessels &brachial plexus are compressed behind the pec. minor and beneath the coracoid process
- Pules is taken with arm full extended over head
AC Sprain Grades
1: No disruption
2: Tear/rupture of AC ligaments and coracoclavicular ligaments
3: Complete rupture of AC and CC ligaments
4: Post. dislocation of clacicle
5: Rupture AC and CC with tearing of trap and deltiod attachments
6: Clavivle is displaced inferior to the coracoid behind the coracobrachialis
Muscles to Strengthen for TOCS
- Traps
- Rhomboids
- Serratus anterior
- Errector spinae muscles
Muscles to Stretch for TOCS
- Pec. minor
2. Scalenes
Bicipital bursae
- Anterior aspect of the bicipital tuberosity
* Cushions the tendons in forearm pronation
Olecranon Bursea
*Between the olecranon process and skin
Elbow Flexors
- Biceps brachii
- Brachialis
- Brachioradialis
Elbow Extensors
- Triceps brachii
2. Anconeous
Elbow Pronators
- Brachioradialis
- Pronator teres
- Pronator quadratus
Elbow Supinators
- Biceps brachii
- Brachioradialis (semisupination)
- Supinator
Normal Carrying Angle
- Females: 10°-15°
* Males: 5°-10°
Elbow ROM
- Flexion: 145°
* Supination/Pronation: 90°
Cubitus Valgus
*Abnormally increased carrying angle of the elbow
Cubitus Varus
*Abnormally decreased carrying angle of the elbow
Cubitus Recurvatus
*Abnormally increased extension of the elbow (hyperextension)
Medial/Lateral Epicondylitis Tests
- Resisted extention: pain on lateral epicondyle
* Resisten felxion: pain on medial epicondyle
Tennis Elbow
- Lateral Epicondylitis
- Involves: carpi radialis brevis, extensor digitorum communus, (Sometimes: pronator teres, flexor carip radialis, & triceps)
Golfer’s Elbow
- Medial Epicondylitis
* Involves: pronator teres, flexor carpi radialis, ulnaris & palmaris tongus
Tendinosis
Degeneration of the tendon without inflammation
Osteochondritis Dissecans
- Impairment of blood supply to the ant. surfaces lead to fragmentation and separation of a portion of articular cartilage and bone- creates loose bodies in the joint
- Most common in knee, also occurs in the elbow
Panner’s Disease
OCD in children younger than 10
Gunstock Deformity
- From an elbow fx
* When arm is extended there is a varus angle to the elbow
