Exam 1 Lab Content Flashcards
1
Q
T/F: With distraction, you want to mobilize out of the pts. pain range.
A
True, don’t want to cause pain
2
Q
Q: In what direction is distraction performed?
A
Towards the motion barrier
3
Q
Defn: Grade 1 Distraction
A
Not enough force to separate the joint surfaces
4
Q
Defn: Grade 2 Distraction
A
Enough force to separate the joint surfaces and eliminate the joint play
5
Q
Defn: Grade 3 Distraction
A
A distraction force strong enough to stretch the joint capsule
6
Q
Q: What are the 4 c-spine screens?
A
- Flexion AROM, OP 2. Extension AROM, OP 3. Rotation AROM bilateral, OP 4. Quadrant AROM, No OP
7
Q
Q: Describe the quadrant AROM c-spine screen.
A
Combination of side bend, rotation, and extension - have pt. follow your finger
8
Q
T/F: If there is no change in symptoms with the c-spine screen you do not need to apply OP.
A
False; apply OP to check is symptoms are reproduced
9
Q
Q: How do you apply OP to the c-spine?
A
A couple of bounces at end range
10
Q
T/F: You should always help someone out of an OP position.
A
True
11
Q
Q: What are the 3 lumbar spine screen?
A
- Flexion ROM, OP 2. Extension ROM, OP 3. Quadrant ROM
12
Q
Content: Shoulder Exam - Standing Observations (4)
A
- Step Sign - AC separation 2. Scapular location 3. Scapular position/alignment 4. General - swelling, guarding, compensation, skin changes
13
Q
T/F: With shoulder impingement there is equal movement at the GH joint and the scapula.
A
False: less at GH, more at scapula
14
Q
Content: Shoulder Exam - AROM (5)
A
- Elevation/Flexion 2. ABD (Painful Arc) 3. HBB (Ext/ADD/IR) 4. HAC (ADD) 5. HBH (Scap/ER)
15
Q
Special Test: Cross Over Impingement - Assessment
A
Impingement
16
Q
Special Test: Cross Over Impingement - Position
A
Standing
17
Q
Special Test: Cross Over Impingement - Method
A
Apply OP in ADD
18
Q
Special Test: Cross Over Impingement - Positive Test of Anterior Pain (3)
A
- Subscapularis 2. Supraspinatus 3. Long head of biceps
19
Q
Special Test: Cross Over Impingement - Positive Test of Superior Pain
A
AC joint
20
Q
Special Test: Cross Over Impingement - Positive Test of Posterior Pain (3)
A
- Infraspinats 2. Teres Minor 3. Posterior Capsule
21
Q
T/F: The cross over impingement test is an AROM test.
A
False: PROM
22
Q
Special Test: Hawkins-Kennedy - Assessment
A
Impingement of supraspinatus tendon
23
Q
Special Test: Hawkins-Kennedy - position
A
Sitting
24
Q
Special Test: Hawkins-Kennedy - Method
A
Move pt. into 90 shld flexion and 90 elbow flexion, then IR
25
Special Test: Hawkins-Kennedy - Positive Test
Reproduction of symptoms/Pain
26
T/F: The Hawkins-Kennedy test is a PROM test.
True
27
Special Test: Neer's - Assessment
Impingement of supraspinatus tendon
28
Special Test: Neer's - Position
Sitting
29
Special Test: Neer's - Method
Elevate the pt.'s arm overhead in the scapular plane with arm IR, stabilize behind scapula and press into end range
30
Special Test: Neer's - Positive Test
Pain
31
T/F: Neer's test is a PROM test.
True
32
T/F: With a Neer's test the pt.'s elbow should be bent.
False: Straight
33
Special Test: Speed's - Assessment
Biceps Tendinitis
34
Special Test: Speed's - Position
Sitting with elbow in extension and forearm supinated
35
Special Test: Speed's - Method
Apply resistance to a shoulder in 90 degrees of flexion while palpating the biceps tendon
36
Special Test: Speed's - Positive Test
Increased tenderness in the bicipital groove
37
T/F: The Speed's test is a PROM test.
False; AROM
38
Special Test: Empty Can - Assessment
Supraspinatus tendonitis
39
Special Test: Empty Can - Position
Sitting, shoulders elevated to 90 in the scapular plane and IR (thumbs pointed down)
40
Special Test: Empty Can - Method
Apply resistance downward
41
Special Test: Empty Can - Positive Test
Weakness or pain - indicates partial tear
42
Special Test: Drop Arm - Assessment
RC rupture
43
Special Test: Drop Arm - Position
Sitting
44
Special Test: Drop Arm - Method
Passively move arm to 90 ABD, ask pt. to hold arm up, remove support
45
Special Test: Drop Arm - Positive Test
Inability to hold the arm in test position - indicated complete tear
46
Special Test: O'Brien's - Assessment
AC adhesion and Labral tears
47
Special Test: O'Brien's - Position
Sitting, 90 Shld flexion, 10-15 H-ADD IR
48
Special Test: O'Brien's - Method
Apply doward pressure at wrist, to confirm repeat test with ER
49
Special Test: O'Brien's - Positive Test
Pain with IR and no Pain with ER - indicates labral tear (SLAP)
50
Special Test: GH Instability Test - Position
Sitting, arm relaxed at side
51
Special Test: GH Instability Test - Method
Stabilize scapula, gram humeral head/distal humerus, move humerus anterior/posterior
52
Q: How do you grade anterior/posterior GH Instability?
1 cm = G1 laxity 1.5 cm = G2 laxity \> 1.5 cm = G3 laxity
53
Special Test: Sulcus Sign - Assessment
GH instability - particularly inferiorly
54
Special Test: Sulcus Sign - Position
Sitting, arm relaxed at side
55
Special Test: Sulcus Sign - Method
Stabilize scapula, grasp humerus near elbow and distract inferiorly
56
Q: How do you grade the inferior GH instability?
1 cm = G1 laxity 1-2 cm = G2 laxity \> 2 cm = G3 laxity
57
Q: What directions must be lax to be termed multidirection GH instability?
anterior, posterior, and inferior
58
Defn: Primary impingement
Painful arc is positive
59
Defn: Secondary impingement
Painful arc and laxity are positive
60
T/F: When you test ligaments/instability you do not need to compare sides.
False.
61
T/F: With a Neer's or Hawkin's-Kennedy test you need to test both sides.
False
62
Special Test: Clunk - Assessment
Torn glenoid labrum
63
Special Test: Clunk - Position
Supine, arm overhead in full ABD
64
Special Test: Clunk - Method
Support under humeral head and apply anterior force while simultaneously applying compression and rotation to the humerus
65
Special Test: Clunk - Positive Test
Pain, clunk, grinding, pseudolocking
66
Special Test: Apprehension and Relocation - Assessment
Anterior GH stability
67
Special Test: Apprehension and Relocation - Position
supine, with glenoid at edge of table
68
Special Test: Apprehension and Relocation - Method
Bring arm into 90 ABD, ER shld slowly, if pain is elicited, apply posterior force to reduce the humeral head into place (relocate)
69
Special Test: Apprehension - Positive Test
Pain or apprehension
70
Special Test: Relocation - Positive Test
Relief of pain or apprehension
71
Q: A GH joint posterior glide facilitates?
IR, flexion, and horz ADD
72
Q: A GH joint inferior glide facilitates?
Elevation
73
Q: A GH joint lateral glide factilitates?
General pain relief
74
Q: A GH joint anterior glide factilitates?
ER, extension, horz ABD
75
THRUST Manipulation: GH inferior glide - Position
Sitting, 90 shld flexion, neutral rotation
76
THRUST Manipulation: GH inferior glide - PT position
Support weight of arm with one hand and other hand distal to acromion (elbow pointing up)
77
THRUST Manipulation: GH inferior glide - Method
Ask pt. to lean away slightly, apply pressure to end feel, if no pain then apply HVLA thrust inferiorly
78
THRUST Manipulation: GH posterior glide - Position
Supine, arm relaxed at 60 ABD and neutral rotation
79
THRUST Manipulation: GH posterior glide - PT position
Stand with back to pt. with thigh in pt. axilla. One hand supports arm while the other is just anterior to the humerus
80
THRUST Manipulation: GH posterior glide - Method
Apply distraction force with distal hand, apply pressure through end feel, if no pain then apply HVLA thrust inferiorly
81
Q: What is RCI?
Contracture of the rotator cuff interval
82
Special test: Inferior glide with ER - Assessment
Frozen shoulder or RCI
83
Special test: Inferior glide with ER - Position
Supine with arm ABD slightly and elbow bent to 90
84
Special test: Inferior glide with ER - Method
On hand cups elbow other stabilizes hand, apply pressure towards feet
85
T/F: The inferior glide with ER stretches the joint capsule inferiorly for RCI.
False, superiorly
86
Q: What is the technique for the humeroulnar distraction?
scoop and distract
87
Q: What does humeroulnar distraction facilitate?
General mobility
88
PAM: Medial humeroulnar glide - Facilitates
Elbow extension
89
PAM: Lateral humeroulnar glide - facilitate
Elbow flexion
90
Q: What does humeroradial distraction facilitate?
Joint mobility
91
PAM: Humeroradial distraction - Method
Pull radius along long axis while stabilizing the humerus, may apply a slight rotation force
92
Q: What does a volar humeroradial glide facilitate?
flexion
93
Q: What does a dorsal humeroradial glide facilitate?
extension
94
PAM - Humeroradial volar glide - position
supine with elbow extended and supinated
95
PAM - Humeroradial volar glide - method
grasp the medial aspect to stabilize, move radial head volarly with fingers
96
PAM - Humeroradial dorsal glide - position
supine with elbow extended and supinated
97
PAM - Humeroradial dorsal glide - method
grasp the medial aspect to stabilize, move radial head dorsally with thenar eminence
98
Q: What does a anterior or volar proximal radioulnar glide facilitate?
supination
99
Q: What does a posterior or dorsal proximal radioulnar glide facilitate?
pronation
100
Q: What does a volar distal radioulnar glide facilitate?
pronation
101
Q: What does a dorsal distal radioulnar glide facilitate?
supination
102
Special Test: Medial collateral stress test - position
sitting with arm relaxed and 20 elbow flexion
103
Special Test: Medial collateral stress test - method
Hold elbow laterally and apply valgus force at wrist
104
Special Test: Medial collateral stress test - Positive Test
abnormal gapping of joint
105
Special Test: Tindel's Sign - Assessment
involvement of ulnar nerve
106
Special Test: Tindel's Sign - Method
tap along the ulnar nerve in groove between olecranon and medial epicondyle
107
Special Test: Tindel's Sign - Positive Test
Tingling sensation that reproduces the pts. symptoms
108
Special Test: Median nerve test - Assessment
Pronator teres syndrome, median nerve entrapment
109
Special Test: Median nerve test - Method
Grasp pts. hand as if for a hand shake, apply a supination force and have them resist with the elbow flexed. Then straighten the elbow while the resistance is applied
110
Special Test: Median nerve test - Positive Test
Pain, tingling, reproduction of symtpoms
111
Special Test: Medial epicondylitis muscle resisted test - Method
Resist wrist flexion with the elbow straight
112
Special Test: Medial epicondylitis muscle resisted test - Positive Test
Pain, reproduction of symptoms
113
Special Test: Medial epicondylitis passive stretch test - Method
passively supinate the pts. forearm with the elbow and wrist in extension while palpating the medial epicondyle
114
Special Test: Medial epicondylitis passive stretch test - Positive Test
Pain
115
Special Test: Lateral collateral stress test - position
sitting with arm supinated and flexed 5-30
116
Special Test: Lateral collateral stress test - Method
Apply varus force
117
Special Test: Lateral collateral stress test - Positive Test
ABnormally gapping of the joint when stress is applied
118
Special Test: Posterolateral instability test - Method
Apply valgus force while moving elbow through extension and flexion
119
Specail Test: Posterolateral instability test - Positive Test
Elbow subluxes with extension and relocated with flexion
120
Q: What two muscle resisted tests can be performed for lateral epicondylitis?
1. Middle finger (ECRB) extension 2. Wrist extension
121
Special Test: Mill's Test - Assessment
Lateral epicondylitis
122
Special Test: Mill's Test - Method
Passively flex the wrist and pronate the forearm
123
Special Test: Mill's Test - Positive Test
Pain at lateral epicondyle
124
Manipulation: Pulled elbow reduction - Child Position
Sitting or standing on the caregiver's lap
125
Manipulation: Pulled elbow reduction - Method
Grasp the child's wrist while thumb is placed on radial head, apply elbow flexion + supination high velocity low amplitude thrust
126
Manipulation: Pulled elbow reduction - Variation
Pt in supine, elbow 90 flexion, wrist extended, locking thumbs, compress the long axis of the radius while supinating the forearm
127
Manipulation: Mill's test maneuver - Pt. position
Sitting, shld abd 60
128
Manipulation: Mill's test maneuver - Method
One hand on elbow, thumb on radial head other holding forearm in pronation and wrist flexion; apply thrust increasing shld IR/extension and elbow extension
129
Q: What is the position for transvermassage of the triceps tendon?
elbow 90, forearm neutral
130
Q: What is the position for transvermassage of the extensor tendons?
elbow 90, forearm neutral
131
Q: What is the position for transvermassage of the flexor tendons?
elbow 15-30, forearm supinated
132
Q: What does a radiocarpal volar glide facilitate?
Extension
133
Q: What does a radiocarpal dorsal glide factilitate?
Flexion
134
Q: What does a radiocarpal distraction assess?
Joint mobility of the wrist
135
Q: What does a radiocarpal ulnar glide facilitate?
RD
136
Q: What does a radiocarpal radial glide facilitate?
UD
137
Q: What does a CMC volar/ulnar glide facilitate?
flexion
138
Q: What does a CMC dorsal/radial glide facilitate?
extension
139
Q: What does a CMC volar glide facilitate?
ADD
140
Q: What does a CMC dorsal glide facilitate?
ABD
141
Q: What do MCP and IP anterior glides facilitate?
flexion
142
Q: What do MCP and IP posterior glides facilitate?
extension
143
Special Test: Allen Test - Assesment
Patency of the radial and ulnar a.
144
Special Test: Allen Test - Pt position
Sitting with forearm free to move, elbow bent, fingers toward ceiling
145
Special Test: Allen Test - Method
Compress the radial and ulnar a., have pt. open and close fist rapidly 3-5x, release one artery and observe, repeat with other artery
146
Special Test: Allen Test - Positive Sign
Blanching remains, normal filling \< 5 sec
147
Special Test: Finkelstien's Test - Assesment
Tenosynovitis of the thumb (APL, EPB)
148
Special Test: Finkelstien's Test - Pt position
Sitting
149
Special Test: Finkelstien's Test - Method
Pt makes fist with thumb inside, clinician stabilizes forearm and UD wrist
150
Special Test: Finkelstien's Test - Positive Test
Pain over the APL and EPB (compare both sides)
151
Special Test: Phalen's Test/Reverse Phalen's Test - Assesment
Median n. compression, carpal tunnel syndrome
152
Special Test: Phalen's Test/Reverse Phalen's Test - Pt. Position
Sitting Phalen's: Dorsum of hands together, fingers down ReversE: Palms together, fingers up
153
Special Test: Phalen's Test/Reverse Phalen's Test - Method
Maintain the position for 60 sec, note the time of onset of symptoms and end the test
154
Special Test: Phalen's Test/Reverse Phalen's Test - Positive Test
Increase in symptoms in median n. distribution
155
Special Test: Median Nerve Tinel's Sign - Assessment
Median n.
156
Special Test: Median Nerve Tinel's Sign - Pt. Position
Sitting, arm supinated
157
Special Test: Median Nerve Tinel's Sign - Method
tap over median nerve at wrist ~20 sec
158
Special Test: Median Nerve Tinel's Sign - Positive Test
Pain or paresthesia distal to the wrist
159
Special Test: Froment's Sign - Assesment
Adductor pollicis weakness from ulnar n. injury
160
Special Test: Froment's Sign - Pt. position
sitting
161
Special Test: Froment's Sign - Method
Place a piece of paper between the thumb and index finger, attempt to remove the paper
162
Special Test: Froment's Sign - Positive Test
Unable to grasp paper or substitutes with thumb flexors
163
Special Test: Watson's Sign - Assessment
Volar scaphoid lunate ligament
164
Special Test: Watson's Sign - Pt. Position
Seated with elbow flexed 90, forearm pronated
165
Special Test: Watson's Sign - Method
Stabilize scaphoid and passively move the wrist through UD/RD
166
Special Test: Watson's Sign - Positive Test
Scaphoid shifts dorsally
167
Capitate THRUST (volar glide) - Indication
Restricted wrist mobility
168
Capitate THRUST (volar glide) - Pt. Position
Sittingat EOB with forearm pronated
169
Capitate THRUST (volar glide) - PT position
Face pt., hold pt. hand with both hands, thumbs overlapped on capitate
170
Capitate THRUST (volar glide) - Method
Apply slight traction to wrist with slight wrist flexion, apply quick thrust while maintain posterior to anterior pressure on the capitate
171
Capitate THRUST (volar glide) - Alternative method
Can be modified to other carpal bones
172
MCP THRUST - Indications
Restricted MCP joint mobility
173
MCP THRUST - Pt. Position
Sitting with upper arm supported on table or thigh
174
MCP THRUST - PT position
stabilize distal MC with thumb and index finger with one hand and grasp proximal phalanx with the other thumb and index finger
175
MCP THRUST - Method
Bunch up skin at then, distract, then apply thrust in volar direction
