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THY 422 Eval and Assess > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

In the shoulder, you have ______ over ______.

A

mobility over stability

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2
Q

The shoulder lacks _______ bony structure like a large socket and has ________ contact with the ______ skeleton.

A

intrinsic
minimal
axial

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3
Q

What does the shoulder rely on for stability?

A

ligaments and muscles

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4
Q

What do most shoulder injuries result from?

A

lack of stability

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5
Q

What is the bony anatomy of the shoulder?

A
  • humerus
  • scapula (glenoid, acromion, coracoid, scapular body)
  • clavicle
  • sternum
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6
Q

What are the joints of the shoulder?

A
  • glenohumeral
  • acromioclavicular
  • sternoclavicular
  • scapulothoracic articulation
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7
Q

What are the SITS muscles?

A
  • suprascapularis
  • infraspinatus
  • teres minor
  • subscapularis
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8
Q

What are the movements of the SITS muscles?

A
  • suprascapularis = abduction/external rot
  • infraspinatus = external rot
  • teres minor = external rot
  • subscapularis = internal rot
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9
Q

True or False:
Rotator cuff muscles help to center the head of the humerus on the glenoid fossa (arthrokinematics).

A

True

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10
Q

True or False:
In arthrokinematics, for shoulder flexion, the head of the humerus glides posteriorly up to 90 degrees then glides inferiorly after 90 degrees.

A

True

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11
Q

True or False:
In arthrokinematics, for abduction, the head of the humerus glides inferiorly

A

True

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12
Q

True or False:
In arthrokinematics, for external rotation, the head of the humerus glides anteriorly as it rolls posteriorly.

A

True

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13
Q

True or False:
In arthrokinematics, for internal rotation, the head of the humerus glides posteriorly as it rolls anteirorly

A

True

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14
Q

True or False:
In arthrokinematics, for extension, the head of the humerus glides anteriorly and medially

A

True

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15
Q

For scapulohumoral rhythm, what two joints must function together?

A

GH and scapulothoracic articulation

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16
Q

What is the ratio between GH elevation and scapular rotation?

A

2:1

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17
Q

To accomplish 180 degrees of GH elevation….

A

120 degrees from GH mvmt and 60 degrees from scapular rotation

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18
Q

Where is the subacromial bursa located?

A

above the supraspinatus tendon

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19
Q

What does the subacromial bursa do?

A

buffers tendons contact with acromion process

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20
Q

What can an inflamed subacromial bursa lead to?

A

RTC impingement

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21
Q

What is the past medical history of shoulder injuries?

A
  • AC or GH injury can alter biomechanics
  • cervical spine pathologies (can radiate pain to upper extremity)
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22
Q

What is the history of present condition for shoulder injuries?

A
  • location of pain
  • MOI
  • onset
  • symptoms
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23
Q

What does inspection of the anterior shoulder consist of?

A
  • level of shoulders
  • position of the head
  • position of the arm
  • contour of the clavicles
  • symmetry of the deltoid group
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24
Q

What does inspection of the posterior shoulder consist of?

A
  • alignmet of the vertebral column
  • position of the scapular (winged)
  • muscle development
  • position of the humerus
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25
Q

What can you palpate in the anterior shoulder? (10)

A
  1. sternoclavicular joint
  2. clavicular shaft
  3. acromion process
  4. AC joint
  5. coracoid process
  6. humeral head
  7. greater tuberosity
  8. lesser tuberosity
  9. humeral shaft
  10. shoulder musculature
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26
Q

What can you palpate in the posterior shoulder? (5)

A
  1. spine of scapula
  2. superior angle
  3. inferior angle
  4. medial border
  5. posterior muscles
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27
Q

For joint and muscle assessment, what are the motion for AROM in the shoulder?

A
  • flex/ext
  • ab/add
  • int/ext rot
  • horizontal ab/add
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28
Q

For pathologies of the shoulder and related special tests, what other instabilities do you look at for GH instability?

A
  • anterior instability
  • posterior instability
  • inferior instability
  • multidirectional instability
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29
Q

For pathologies of the shoulder and related special tests, what do you look at for rotator cuff pathology?

A
  • impingement syndrome
  • rotator cuff tendinopathy
  • subacromial bursitis
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30
Q

What does a SLAP lesion stand for?

A

supeiror labrum anterior to posterior lesion

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31
Q

For pathologies of the shoulder and related special tests, what should you know about biceps tendon pathology?

A
  • bicipital tendinopathy
  • causes: RTC dysfunction & impingement
  • SLAP lesions
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32
Q

What is a SLAP lesion?

A

tears of the superior aspect of the glenoid labrum that extend anteriorly and posteriorly to the biceps insertion

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33
Q

What does a winged scapula result from?

A

weak serratus anterior

34
Q

The cubital fossa is a triangular area demarcated by the _________ muscle laterally and the _________ ____ medially.

A

Lateral = brachioradialis
Medial = pronator teres

35
Q

In the cubital fossa, the _________ artery and its two subdivisions (radial and ulnar arteries), the _________ nerve, and the ________________ nerve pass through this fossa

A
  1. brachial artery
  2. median nerve
  3. musculocutaneous
36
Q

What is the past medical history for the elbow?

A
  • seasonal pain
  • cervical injury
  • general medical health
  • vascular, neurological, or systemic conditions
37
Q

What is the history of present condition for the elbow?

A
  • location of symptoms
  • onset
  • MOI
  • technique
  • associated sounds and sensations
38
Q

What does inspection of the elbow consist of?

A
  • functional observation
  • anterior structures (carrying angles cubitus val/var)
  • cubital fossa
  • medial structures (medial epicondyle, flexor muscle mass)
39
Q

What does inspection of the elbow consist of for the lateral side?

A
  • alignment of wrist and forearm
  • cubital recurvatum
  • extensor muscle mass
40
Q

What does inspection of the elbow consist of for the posterior side?

A
  • bony alignment
  • olecranon process and bursa
41
Q

What are the 3 types of bursitis in the elbow?

A
  • student’s elbow (elbows on table)
  • miner’s elbow
  • draftsman’s elbow
42
Q

What are the palpation sites for the elbow?

A
  • medial and lateral epicondyles
  • olecranon process
  • ulnar
  • radius
43
Q

What are the movements of the elbow?

A
  • flex/ext
  • pro/sup
44
Q

What are the joint stability tests for elbow?

A
  • medial and lateral ligament laxity
45
Q

What is the MOI of elbow dislocations?

A

axial force through the forearm with the elbow flexed
- extremely painful
- obvious deformity

46
Q

What does the terrible triad consist of?

A
  • dislocation
  • fracture of radial head
  • fracture of coronoid process
47
Q

What does FOOSH stand for?

A

fall on outstretched hand

48
Q

What sides of the elbow can you obtain epicondylitis on?

A

medial and lateral

49
Q

What does lateral epicondylitis consist of?

A

“tennis elbow”
- inflammation or repetitive stress at the lateral epicondyle
- swelling
- tender to palpation
- pain with active wrist extension

50
Q

What does medial epicondylitis consist of?

A

“little leaguer’s elbow”
- tender to palpation
- neuropathy of the ulnar nerve

51
Q

In what age group is a distal biceps tendon rupture most common in and what gender?

A

males over 40 years old

52
Q

What is the MOI of a distal biceps tendon rupture?

A

eccentric loading of the biceps brachii when the elbow is flexed to 90 degrees

53
Q

True or False:
A distal biceps tendon rupture can be complete or partial.

A

True

54
Q

What are the signs and symptoms of a distal biceps tendon rupture?

A
  • pain
  • “pop” within elbow
  • palpable defect
55
Q

What is the usual treatment option of a distal biceps tendon rupture?

A

surgical repair

56
Q

What happens to the elbow when there is osteochondritis dessicans of the capitulum?

A

increased valgus loading, compressing the radial head and capitulum within overhead throwing
- disrupts blood flow, creating defect over time

57
Q

What are signs and symptoms of osteochondritis dessicans of the capitulum?

A
  • lateral elbow pain (increases with activity)
  • flexion contracture

**loose body warrants surgical removal

58
Q

What are the 4 nerve pathologies of the elbow?

A
  1. ulnar nerve pathology
  2. radial nerve pathology
  3. median nerve pathology
  4. forearm compartment syndrome
59
Q

True or False:
The wrist is very complex due to the numerous joints combined to work as one

A

True

60
Q

What are all 8 bones in the hand?

A

Scaphoid
Lunate
Triquetrum
Pisiform
Trapezium
Trapezoid
Capitate
Hamate

61
Q

What is the midcarpal joint?

A

between the two rows of carpal bones. Plane joints that allow gliding motion, assist with wrist motions

62
Q

In the snuff box, what tendon does the medial border consist of?

A

tendon of the extensor pollicis longus

63
Q

In the snuff box, what tendons does the lateral border consist of?

A

tendons of the extensor pollics brevis and abductor pollicis longus

64
Q

In the snuff box, what does the floor consist of?

A

carpal bones; scaphoid and trapezium

65
Q

What does the radial nerve do?

A

wrist and finger extension (wraps around arm)

66
Q

What does the median nerve do?

A

thenar eminence, opposition, pincer grip

67
Q

What does the ulnar nerve do?

A

hypothenar eminence intrinsic muscles, power grip (pinky and ring fingers don’t work when ulnar nerve is damaged)

68
Q

Where do you take the radial pulse?

A

on the wrist just under the thumb

69
Q

What is the past history of the wrist?

A
  • loss of function from previous injury
  • general medical health
  • RA (ulnar dev of fingers)
  • PVD (peripheral vascular disease)
  • Raynaud’s phenomenon
70
Q

What is the history of present condition of the wrist?

A
  • location
  • MOI
  • relevant sounds or sensations
  • duration of symptoms
  • description of symptoms
  • changes in activity
71
Q

What does inspection consist of for the wrist as a whole?

A
  • functional observation
  • general inspection
  • posturing of the wrist and hand
  • gross deformity
  • lacerations or scars
72
Q

What does inspection consist of for the wrist and hand specifically?

A
  • continutiy of the distal radius and ulna
  • continuity of the carpals and metacarpals
  • alignment of the phalanges
  • posture of wrist and hand
  • ganglion cyst
73
Q

Which two of the carpal bones are most easy to palpate?

A

scaphoid and pisiform

74
Q

What is a scaphoid fracture consist of/how does it happen?

A

FOOSH
- fracture of scaphoid which you can palpate in the snuff box. occurs with fall on hand in extension. most commonly fractured carpal bone

75
Q

What is Colles’s fracture and how does it happen?

A
  • fracture of radius just above the wrist
  • fall with wrist extended
76
Q

What nerve is impinged with carpal tunnel syndrome?

A

median nerve

77
Q

How does carpal tunnel syndrome occur?

A

repetitive activities

78
Q

What is a transverse carpal ligament release?

A

In carpal tunnel release surgery, the surgeon cuts the transverse carpal ligament, a band of tissue on the palm side of the carpal tunnel. This takes pressure off the median nerve and relieves symptoms.

79
Q

What is wrist drop?

A

radial nerve palsy
Saturday night palsy
honeymoon palsy
crutch palsy
- in all cases the radial nerve is entrapped and damaged.
** terminal end of the posterior cord of the brachial plexus, fracture distal humerus. Usually alcohol is involved

80
Q

What are the movements of the wrist?

A
  • flex/ext
  • pro/sup
  • rad/uln deviation

THY 422 Eval and Assess (3 decks)

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