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PTRS 745 Exam 1 > Exam 1 Lab Content > Flashcards

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

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2
Q

Q: In what direction is distraction performed?

A

Towards the motion barrier

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3
Q

Defn: Grade 1 Distraction

A

Not enough force to separate the joint surfaces

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4
Q

Defn: Grade 2 Distraction

A

Enough force to separate the joint surfaces and eliminate the joint play

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5
Q

Defn: Grade 3 Distraction

A

A distraction force strong enough to stretch the joint capsule

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6
Q

Q: What are the 4 c-spine screens?

A
  1. Flexion AROM, OP 2. Extension AROM, OP 3. Rotation AROM bilateral, OP 4. Quadrant AROM, No OP
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7
Q

Q: Describe the quadrant AROM c-spine screen.

A

Combination of side bend, rotation, and extension - have pt. follow your finger

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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

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9
Q

Q: How do you apply OP to the c-spine?

A

A couple of bounces at end range

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10
Q

T/F: You should always help someone out of an OP position.

A

True

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11
Q

Q: What are the 3 lumbar spine screen?

A
  1. Flexion ROM, OP 2. Extension ROM, OP 3. Quadrant ROM
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12
Q

Content: Shoulder Exam - Standing Observations (4)

A
  1. Step Sign - AC separation 2. Scapular location 3. Scapular position/alignment 4. General - swelling, guarding, compensation, skin changes
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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

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14
Q

Content: Shoulder Exam - AROM (5)

A
  1. Elevation/Flexion 2. ABD (Painful Arc) 3. HBB (Ext/ADD/IR) 4. HAC (ADD) 5. HBH (Scap/ER)
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15
Q

Special Test: Cross Over Impingement - Assessment

A

Impingement

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16
Q

Special Test: Cross Over Impingement - Position

A

Standing

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17
Q

Special Test: Cross Over Impingement - Method

A

Apply OP in ADD

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18
Q

Special Test: Cross Over Impingement - Positive Test of Anterior Pain (3)

A
  1. Subscapularis 2. Supraspinatus 3. Long head of biceps
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19
Q

Special Test: Cross Over Impingement - Positive Test of Superior Pain

A

AC joint

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20
Q

Special Test: Cross Over Impingement - Positive Test of Posterior Pain (3)

A
  1. Infraspinats 2. Teres Minor 3. Posterior Capsule
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21
Q

T/F: The cross over impingement test is an AROM test.

A

False: PROM

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22
Q

Special Test: Hawkins-Kennedy - Assessment

A

Impingement of supraspinatus tendon

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23
Q

Special Test: Hawkins-Kennedy - position

A

Sitting

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24
Q

Special Test: Hawkins-Kennedy - Method

A

Move pt. into 90 shld flexion and 90 elbow flexion, then IR

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25
Q

Special Test: Hawkins-Kennedy - Positive Test

A

Reproduction of symptoms/Pain

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26
Q

T/F: The Hawkins-Kennedy test is a PROM test.

A

True

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27
Q

Special Test: Neer’s - Assessment

A

Impingement of supraspinatus tendon

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28
Q

Special Test: Neer’s - Position

A

Sitting

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29
Q

Special Test: Neer’s - Method

A

Elevate the pt.’s arm overhead in the scapular plane with arm IR, stabilize behind scapula and press into end range

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30
Q

Special Test: Neer’s - Positive Test

A

Pain

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31
Q

T/F: Neer’s test is a PROM test.

A

True

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32
Q

T/F: With a Neer’s test the pt.’s elbow should be bent.

A

False: Straight

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33
Q

Special Test: Speed’s - Assessment

A

Biceps Tendinitis

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34
Q

Special Test: Speed’s - Position

A

Sitting with elbow in extension and forearm supinated

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35
Q

Special Test: Speed’s - Method

A

Apply resistance to a shoulder in 90 degrees of flexion while palpating the biceps tendon

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36
Q

Special Test: Speed’s - Positive Test

A

Increased tenderness in the bicipital groove

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37
Q

T/F: The Speed’s test is a PROM test.

A

False; AROM

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38
Q

Special Test: Empty Can - Assessment

A

Supraspinatus tendonitis

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39
Q

Special Test: Empty Can - Position

A

Sitting, shoulders elevated to 90 in the scapular plane and IR (thumbs pointed down)

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40
Q

Special Test: Empty Can - Method

A

Apply resistance downward

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41
Q

Special Test: Empty Can - Positive Test

A

Weakness or pain - indicates partial tear

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42
Q

Special Test: Drop Arm - Assessment

A

RC rupture

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43
Q

Special Test: Drop Arm - Position

A

Sitting

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44
Q

Special Test: Drop Arm - Method

A

Passively move arm to 90 ABD, ask pt. to hold arm up, remove support

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45
Q

Special Test: Drop Arm - Positive Test

A

Inability to hold the arm in test position - indicated complete tear

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46
Q

Special Test: O’Brien’s - Assessment

A

AC adhesion and Labral tears

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47
Q

Special Test: O’Brien’s - Position

A

Sitting, 90 Shld flexion, 10-15 H-ADD IR

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48
Q

Special Test: O’Brien’s - Method

A

Apply doward pressure at wrist, to confirm repeat test with ER

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49
Q

Special Test: O’Brien’s - Positive Test

A

Pain with IR and no Pain with ER - indicates labral tear (SLAP)

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50
Q

Special Test: GH Instability Test - Position

A

Sitting, arm relaxed at side

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51
Q

Special Test: GH Instability Test - Method

A

Stabilize scapula, gram humeral head/distal humerus, move humerus anterior/posterior

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52
Q

Q: How do you grade anterior/posterior GH Instability?

A

1 cm = G1 laxity 1.5 cm = G2 laxity > 1.5 cm = G3 laxity

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53
Q

Special Test: Sulcus Sign - Assessment

A

GH instability - particularly inferiorly

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54
Q

Special Test: Sulcus Sign - Position

A

Sitting, arm relaxed at side

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55
Q

Special Test: Sulcus Sign - Method

A

Stabilize scapula, grasp humerus near elbow and distract inferiorly

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56
Q

Q: How do you grade the inferior GH instability?

A

1 cm = G1 laxity 1-2 cm = G2 laxity > 2 cm = G3 laxity

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57
Q

Q: What directions must be lax to be termed multidirection GH instability?

A

anterior, posterior, and inferior

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58
Q

Defn: Primary impingement

A

Painful arc is positive

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59
Q

Defn: Secondary impingement

A

Painful arc and laxity are positive

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60
Q

T/F: When you test ligaments/instability you do not need to compare sides.

A

False.

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61
Q

T/F: With a Neer’s or Hawkin’s-Kennedy test you need to test both sides.

A

False

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62
Q

Special Test: Clunk - Assessment

A

Torn glenoid labrum

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63
Q

Special Test: Clunk - Position

A

Supine, arm overhead in full ABD

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64
Q

Special Test: Clunk - Method

A

Support under humeral head and apply anterior force while simultaneously applying compression and rotation to the humerus

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65
Q

Special Test: Clunk - Positive Test

A

Pain, clunk, grinding, pseudolocking

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66
Q

Special Test: Apprehension and Relocation - Assessment

A

Anterior GH stability

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67
Q

Special Test: Apprehension and Relocation - Position

A

supine, with glenoid at edge of table

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68
Q

Special Test: Apprehension and Relocation - Method

A

Bring arm into 90 ABD, ER shld slowly, if pain is elicited, apply posterior force to reduce the humeral head into place (relocate)

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69
Q

Special Test: Apprehension - Positive Test

A

Pain or apprehension

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70
Q

Special Test: Relocation - Positive Test

A

Relief of pain or apprehension

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71
Q

Q: A GH joint posterior glide facilitates?

A

IR, flexion, and horz ADD

72
Q

Q: A GH joint inferior glide facilitates?

73
Q

Q: A GH joint lateral glide factilitates?

A

General pain relief

74
Q

Q: A GH joint anterior glide factilitates?

A

ER, extension, horz ABD

75
Q

THRUST Manipulation: GH inferior glide - Position

A

Sitting, 90 shld flexion, neutral rotation

76
Q

THRUST Manipulation: GH inferior glide - PT position

A

Support weight of arm with one hand and other hand distal to acromion (elbow pointing up)

77
Q

THRUST Manipulation: GH inferior glide - Method

A

Ask pt. to lean away slightly, apply pressure to end feel, if no pain then apply HVLA thrust inferiorly

78
Q

THRUST Manipulation: GH posterior glide - Position

A

Supine, arm relaxed at 60 ABD and neutral rotation

79
Q

THRUST Manipulation: GH posterior glide - PT position

A

Stand with back to pt. with thigh in pt. axilla. One hand supports arm while the other is just anterior to the humerus

80
Q

THRUST Manipulation: GH posterior glide - Method

A

Apply distraction force with distal hand, apply pressure through end feel, if no pain then apply HVLA thrust inferiorly

81
Q

Q: What is RCI?

A

Contracture of the rotator cuff interval

82
Q

Special test: Inferior glide with ER - Assessment

A

Frozen shoulder or RCI

83
Q

Special test: Inferior glide with ER - Position

A

Supine with arm ABD slightly and elbow bent to 90

84
Q

Special test: Inferior glide with ER - Method

A

On hand cups elbow other stabilizes hand, apply pressure towards feet

85
Q

T/F: The inferior glide with ER stretches the joint capsule inferiorly for RCI.

A

False, superiorly

86
Q

Q: What is the technique for the humeroulnar distraction?

A

scoop and distract

87
Q

Q: What does humeroulnar distraction facilitate?

A

General mobility

88
Q

PAM: Medial humeroulnar glide - Facilitates

A

Elbow extension

89
Q

PAM: Lateral humeroulnar glide - facilitate

A

Elbow flexion

90
Q

Q: What does humeroradial distraction facilitate?

A

Joint mobility

91
Q

PAM: Humeroradial distraction - Method

A

Pull radius along long axis while stabilizing the humerus, may apply a slight rotation force

92
Q

Q: What does a volar humeroradial glide facilitate?

93
Q

Q: What does a dorsal humeroradial glide facilitate?

94
Q

PAM - Humeroradial volar glide - position

A

supine with elbow extended and supinated

95
Q

PAM - Humeroradial volar glide - method

A

grasp the medial aspect to stabilize, move radial head volarly with fingers

96
Q

PAM - Humeroradial dorsal glide - position

A

supine with elbow extended and supinated

97
Q

PAM - Humeroradial dorsal glide - method

A

grasp the medial aspect to stabilize, move radial head dorsally with thenar eminence

98
Q

Q: What does a anterior or volar proximal radioulnar glide facilitate?

A

supination

99
Q

Q: What does a posterior or dorsal proximal radioulnar glide facilitate?

100
Q

Q: What does a volar distal radioulnar glide facilitate?

101
Q

Q: What does a dorsal distal radioulnar glide facilitate?

A

supination

102
Q

Special Test: Medial collateral stress test - position

A

sitting with arm relaxed and 20 elbow flexion

103
Q

Special Test: Medial collateral stress test - method

A

Hold elbow laterally and apply valgus force at wrist

104
Q

Special Test: Medial collateral stress test - Positive Test

A

abnormal gapping of joint

105
Q

Special Test: Tindel’s Sign - Assessment

A

involvement of ulnar nerve

106
Q

Special Test: Tindel’s Sign - Method

A

tap along the ulnar nerve in groove between olecranon and medial epicondyle

107
Q

Special Test: Tindel’s Sign - Positive Test

A

Tingling sensation that reproduces the pts. symptoms

108
Q

Special Test: Median nerve test - Assessment

A

Pronator teres syndrome, median nerve entrapment

109
Q

Special Test: Median nerve test - Method

A

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
Q

Special Test: Median nerve test - Positive Test

A

Pain, tingling, reproduction of symtpoms

111
Q

Special Test: Medial epicondylitis muscle resisted test - Method

A

Resist wrist flexion with the elbow straight

112
Q

Special Test: Medial epicondylitis muscle resisted test - Positive Test

A

Pain, reproduction of symptoms

113
Q

Special Test: Medial epicondylitis passive stretch test - Method

A

passively supinate the pts. forearm with the elbow and wrist in extension while palpating the medial epicondyle

114
Q

Special Test: Medial epicondylitis passive stretch test - Positive Test

115
Q

Special Test: Lateral collateral stress test - position

A

sitting with arm supinated and flexed 5-30

116
Q

Special Test: Lateral collateral stress test - Method

A

Apply varus force

117
Q

Special Test: Lateral collateral stress test - Positive Test

A

ABnormally gapping of the joint when stress is applied

118
Q

Special Test: Posterolateral instability test - Method

A

Apply valgus force while moving elbow through extension and flexion

119
Q

Specail Test: Posterolateral instability test - Positive Test

A

Elbow subluxes with extension and relocated with flexion

120
Q

Q: What two muscle resisted tests can be performed for lateral epicondylitis?

A
  1. Middle finger (ECRB) extension 2. Wrist extension
121
Q

Special Test: Mill’s Test - Assessment

A

Lateral epicondylitis

122
Q

Special Test: Mill’s Test - Method

A

Passively flex the wrist and pronate the forearm

123
Q

Special Test: Mill’s Test - Positive Test

A

Pain at lateral epicondyle

124
Q

Manipulation: Pulled elbow reduction - Child Position

A

Sitting or standing on the caregiver’s lap

125
Q

Manipulation: Pulled elbow reduction - Method

A

Grasp the child’s wrist while thumb is placed on radial head, apply elbow flexion + supination high velocity low amplitude thrust

126
Q

Manipulation: Pulled elbow reduction - Variation

A

Pt in supine, elbow 90 flexion, wrist extended, locking thumbs, compress the long axis of the radius while supinating the forearm

127
Q

Manipulation: Mill’s test maneuver - Pt. position

A

Sitting, shld abd 60

128
Q

Manipulation: Mill’s test maneuver - Method

A

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

Q: What is the position for transvermassage of the triceps tendon?

A

elbow 90, forearm neutral

130
Q

Q: What is the position for transvermassage of the extensor tendons?

A

elbow 90, forearm neutral

131
Q

Q: What is the position for transvermassage of the flexor tendons?

A

elbow 15-30, forearm supinated

132
Q

Q: What does a radiocarpal volar glide facilitate?

133
Q

Q: What does a radiocarpal dorsal glide factilitate?

134
Q

Q: What does a radiocarpal distraction assess?

A

Joint mobility of the wrist

135
Q

Q: What does a radiocarpal ulnar glide facilitate?

136
Q

Q: What does a radiocarpal radial glide facilitate?

137
Q

Q: What does a CMC volar/ulnar glide facilitate?

138
Q

Q: What does a CMC dorsal/radial glide facilitate?

139
Q

Q: What does a CMC volar glide facilitate?

140
Q

Q: What does a CMC dorsal glide facilitate?

141
Q

Q: What do MCP and IP anterior glides facilitate?

142
Q

Q: What do MCP and IP posterior glides facilitate?

143
Q

Special Test: Allen Test - Assesment

A

Patency of the radial and ulnar a.

144
Q

Special Test: Allen Test - Pt position

A

Sitting with forearm free to move, elbow bent, fingers toward ceiling

145
Q

Special Test: Allen Test - Method

A

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
Q

Special Test: Allen Test - Positive Sign

A

Blanching remains, normal filling < 5 sec

147
Q

Special Test: Finkelstien’s Test - Assesment

A

Tenosynovitis of the thumb (APL, EPB)

148
Q

Special Test: Finkelstien’s Test - Pt position

149
Q

Special Test: Finkelstien’s Test - Method

A

Pt makes fist with thumb inside, clinician stabilizes forearm and UD wrist

150
Q

Special Test: Finkelstien’s Test - Positive Test

A

Pain over the APL and EPB (compare both sides)

151
Q

Special Test: Phalen’s Test/Reverse Phalen’s Test - Assesment

A

Median n. compression, carpal tunnel syndrome

152
Q

Special Test: Phalen’s Test/Reverse Phalen’s Test - Pt. Position

A

Sitting Phalen’s: Dorsum of hands together, fingers down ReversE: Palms together, fingers up

153
Q

Special Test: Phalen’s Test/Reverse Phalen’s Test - Method

A

Maintain the position for 60 sec, note the time of onset of symptoms and end the test

154
Q

Special Test: Phalen’s Test/Reverse Phalen’s Test - Positive Test

A

Increase in symptoms in median n. distribution

155
Q

Special Test: Median Nerve Tinel’s Sign - Assessment

156
Q

Special Test: Median Nerve Tinel’s Sign - Pt. Position

A

Sitting, arm supinated

157
Q

Special Test: Median Nerve Tinel’s Sign - Method

A

tap over median nerve at wrist ~20 sec

158
Q

Special Test: Median Nerve Tinel’s Sign - Positive Test

A

Pain or paresthesia distal to the wrist

159
Q

Special Test: Froment’s Sign - Assesment

A

Adductor pollicis weakness from ulnar n. injury

160
Q

Special Test: Froment’s Sign - Pt. position

161
Q

Special Test: Froment’s Sign - Method

A

Place a piece of paper between the thumb and index finger, attempt to remove the paper

162
Q

Special Test: Froment’s Sign - Positive Test

A

Unable to grasp paper or substitutes with thumb flexors

163
Q

Special Test: Watson’s Sign - Assessment

A

Volar scaphoid lunate ligament

164
Q

Special Test: Watson’s Sign - Pt. Position

A

Seated with elbow flexed 90, forearm pronated

165
Q

Special Test: Watson’s Sign - Method

A

Stabilize scaphoid and passively move the wrist through UD/RD

166
Q

Special Test: Watson’s Sign - Positive Test

A

Scaphoid shifts dorsally

167
Q

Capitate THRUST (volar glide) - Indication

A

Restricted wrist mobility

168
Q

Capitate THRUST (volar glide) - Pt. Position

A

Sittingat EOB with forearm pronated

169
Q

Capitate THRUST (volar glide) - PT position

A

Face pt., hold pt. hand with both hands, thumbs overlapped on capitate

170
Q

Capitate THRUST (volar glide) - Method

A

Apply slight traction to wrist with slight wrist flexion, apply quick thrust while maintain posterior to anterior pressure on the capitate

171
Q

Capitate THRUST (volar glide) - Alternative method

A

Can be modified to other carpal bones

172
Q

MCP THRUST - Indications

A

Restricted MCP joint mobility

173
Q

MCP THRUST - Pt. Position

A

Sitting with upper arm supported on table or thigh

174
Q

MCP THRUST - PT position

A

stabilize distal MC with thumb and index finger with one hand and grasp proximal phalanx with the other thumb and index finger

175
Q

MCP THRUST - Method

A

Bunch up skin at then, distract, then apply thrust in volar direction

PTRS 745 Exam 1 (9 decks)

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