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Interventions 2 > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

Hypomobility pathologies of elbow and forearm

A 
Rheumatoid arthritis 
Juvenile rheumatoid arthritis 
Degenerate joint disease 
Acute joint reactions after trauma
Post-immobilization
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2
Q

Definition of Myositis ossificans

A

formation of bone in muscle tendon unit, capsule, or ligamentous structure

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3
Q

Most common site for myositis ossificans

A

Thigh and elbow

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4
Q

Cause of myositis ossificans

A

trauma (fracture or tear of brachialis tendon)

Aggressive stretching of the elbow flexors after injury and immobilization

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5
Q

Differences between myositis ossificans and arthritis

A

Passive extension more limited than flexion
Resisted elbow flexion causes pain
Resisted flexion in mid-range causes pain in brachialis
Palpation of distal brachialis muscle is tender

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6
Q

Contraindications of myositis ossificans

A

Massage
Passive stretching
Resistive exercises

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7
Q

Symptoms of tennis elbow

A

pain in common wrist extensors along with lateral epicondyle and HR joint with gripping activities

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8
Q

Tendons affected in tennis elbow

A

ECRB and extensor communis

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9
Q

Positive tests for tennis elbow

A

Palpation tenderness on lateral epicondyle
Pain with resisted wrist extension
Pain with resisted middle finger extension
Pain with passive wrist flexion with elbow extended and forearm pronated

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10
Q

Pathology of golfer’s elbow

A

Involvement of flexor/pronator tendon near medial epicondyle

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11
Q

Symptoms of golfer’s elbow

A

Pain with palpation of medial epicondyle
Pain with resisted wrist flexion
Pain with wrist extension and forearm supinated

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12
Q

Etiology of golfer’s elbow

A

Repetitive movement into wrist flexion

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13
Q

Pathologies that can lead to wrist and hand hypomobility

A

Rheumatoid arthritis
Degenerative joint disease
Immobilization

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14
Q

Structural and functional impairments post immobilization of hand

A

Decreased ROM and decreased joint play with firm end feel
Tendon adhesions
Decreased muscle performance and weakness

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15
Q

Causes of tendonoapthies of the wrist and hand

A

Continued or repetitive use of involved muscles beyond its ability to adapt
Effects of RA
Stress overload to contracting muscle
Roughening of the surface of the tendon or its sheath

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16
Q

Common reasons for restricted mobility of GH joint

A

Pathology (OA or RA)
Immobilization
Idiopathic frozen shoulder

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17
Q

Acute signs of GH arthritis

A

Pain and muscle guarding
Pain radiating below elbow and may disturb sleep
Tenderness immediately below the edge of the acromion process

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18
Q

Subacute signs of GH arthritis

A

Capsular tightness
Limited motion consistent with capsular pattern
Pain at the end of limited range
Limited joint play

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19
Q

Chronic signs of GH arthritis

A

Progressive limited motion in a capsular pattern and decreased joint play
Loss of function with an inability to reach overhead
Aching to deltoid region

20
Q

Stage 1 of frozen shoulder

A

Gradual onset of pain that increases with movement and is present at night
Loss of ER with intact rotator cuff strength
Less than 3 months

21
Q

Stage 2 of frozen shoulder

A

Freezing stage
Persistent and more intense pain even at rest
Motion limited in all directions
Typically between 3-9 months

22
Q

Stage 3 of frozen shoulder

A

Frozen stage
Pain only with movement, significant adhesions, and limited GH motions
Atrophy of deltoid, rotator cuff, biceps, and triceps
9-15 months

23
Q

Stage 4 of frozen shoulder

A 
Thawing stage 
Minimal pain an no synovitis
Significant capsular restrictions 
Motion may gradually improve 
15-24 months
24
Q

Pathologies associated with OA

A

Overuse syndromes - stressful movements with arm at waist
Subluxation/disloction - common with falls
Hypomobility

25
Q

Common impairments associated with AC

A 
Pain localized to involved joint or ligaments 
Painful arc toward the end range 
Pain with shoulder HAdd & HAbd 
Hypermobility 
Hypomobility
26
Q

Intrinsic impingement

A

Compromise integrity of musculotendinous structure by vascular changes, tissue tendon overload, and collagen disorientation and degeneration

27
Q

Extrinsic impingement

A

Mechanical wear of RC against acromion in the suprahumeral space during elevation activities of the humerus

28
Q

Primary impingement

A

Can be anatomical or biomechanical factors

29
Q

Anatomical factors

A

Structural variations in acromion, humeral head, hypertrophic changes of AC or humeral head which decrease suprahumeral space

30
Q

Biomechanical factors

A

Altered orientation of the clavicle or scapula during movement or increase anterosuperior humeral head associated with tight posterior GH capsule

31
Q

Secondary impingement

A

Compression of suprahumeral tissues due to hypermobility or instability of GH joint and increased translation of humeral head

32
Q

Internal impingement

A

Occurs in the position of elevation, horizontal abduction, and maximum ER
Entrapment of posterior supraspinatus tendon between humeral head and labrum

33
Q

Stage I impingement

A

Hemorrhage and edema (less than 25 yo)

34
Q

Stage II impingement

A

Tendonitis/bursitis (25-40 yo)

35
Q

Stage III impingement

A

Bone spurs and tendon rupture (greater than 40 yo)

36
Q

Tissues that are impaired with impingement

A 
Supraspinatus
Infraspinatus
Biceps tendon
Superior labrum 
Subacromial bursa
37
Q

Criteria to progress to final stage of rehab in impingement patients

A

Negative impingement test
Full, pain-free AROM of shoulder without substitution
75% or more strength of shoulder compared to other shoulder

38
Q

Cause of anterior instability of shoulder

A

Occurs with forces against arm in an abducted and ER position

39
Q

Cause of posterior instability of shoulder

A

Repetitive forces against a forward flexed humerus

40
Q

Cause of inferior instability of shoulder

A

RC weakness; in patients with hemiplegia and repetitive reaching overhead

41
Q

Causes of multidirectional instability

A

Increased extensibility of CT

Frequently overhead athletes

42
Q

Cause of anterior shoulder dislocation

A

Posteriorly directed forced to arm while humerus is in a position of elevation, ER, HAbd

43
Q

Stability provided by what in elevation, HAbd, ER

A

Subscapularis, GH ligaments, long head of biceps

44
Q

Common complications with anterior dislocation

A

Rupture of RC
fracture of posterolateral humeral head (hill-saks lesion)
Vascular or nerve damage (axillary nerve)

45
Q

Causes of posterior shoulder dislocation

A

Force applied to humerus in position of flexion, adduction, and IR (FOOSH)

46
Q

Rate of recurrence following first time traumatic dislocation

A

Highest in younger populations (less than 30) because they are more active and place greater demands on shoulder

47
Q

Immobilization times following traumatic dislocation

A

6-8 weeks in young patients

2 weeks for older patients

Interventions 2 (6 decks)

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