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Patient Management II > Exam II Study Guide > Flashcards

Exam II Study Guide Flashcards

1
Q

Localized pain without radiation

A

Muscle pain
Facet pain
Facet impingement

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2
Q

Radiating pain

A

Nerve root irritation

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3
Q

History suggesting Cervical Spondylosis (arthritis)

A

Age >45
Most commonly affected levels C5-6, C6-7
Slow, gradual onset
Unilateral pain
Pain radiates into specific dermatomes
Pain increases with extension and decreases with flexion

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4
Q

History Suggesting cervical Disc Involvement

A

Age < 60 years
Most commonly effects C5-6
Sudden onset
Unilateral
Symptoms radiate into a dermatome
Tingling present
Pain increases with flexion

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5
Q

History suggesting cervical Instability

A

Traumatic mechanism of injury
Complaint of nonspecific symptoms that are worse in vertical and better with head support

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6
Q

Vertebral Artery Insufficiency symptoms

A

Dizziness/Vertigo
Nausea/Vomiting
Inability to stand
Blurred vision/ diplopia
Headache
Facial paresthesia/ facial palsy/ difficulty swallowing

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7
Q

Pain with compression

A

Disc
Vertebral body fracture
Nerve root irritation (radiating)

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8
Q

Decreased pain with distraction

A

Disc
Spinal Facet
Nerve root (centralizing)

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9
Q

Spurling’s A

A

Patient seated
Cervical extension with SB
PT applies compression gently
Positive= radiating symptoms

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10
Q

Test Item Cluster- Radiculopathy

A

ULTT-A
Spurling’s
Distraction
Cervical rotation < 60 degrees to ipsilateral side

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11
Q

Mobility exam findings

A

Recent onset
Absence of referred symptoms
Restricted ROM in rotation and/or SB
Restricted cervical and thoracic segmental mobility

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12
Q

Mobility intervention focus

A

Spinal mobilization/manipulation
Active range of motion exercises

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13
Q

Centralization exam findings

A

-Radicular/referred symptoms in the upper quarter
-Peripheralization and/or centralization of symptoms with range of motion
-Signs of nerve root compression present
-May have medical diagnosis of cervical
-radiculopathy (see TIC)

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14
Q

centralization intervention focus

A

Mechanical/manual cervical traction
Repeated movements to centralize symptoms
Manual Therapy

HEP of cervical spine retraction and deep
cervical flexor training

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15
Q

Test item cluster for Improvement with 3 weeks Mechanical Traction

A

Age greater than 55 years
Positive shoulder ABDuction test
Positive ULTT-A
Symptom peripheralization with central PA testing lower CS (C4-C7)
Positive neck distraction test

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16
Q

Conditioning exam finding

A

Lower pain and disability scores
Longer duration of symptoms
No signs of nerve root compression
No peripheralization/centralization during range of motion

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17
Q

Conditioning intervention focus

A

Strengthening and endurance exercises for the muscles of the neck and upper quarter

Aerobic conditioning exercises

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18
Q

Headache exam finding

A

Unilateral HA with onset preceded by or associated with neck pain
Cervical AROM
Cervical/Thoracic segmental mobility
Cranial Cervical Flexion test

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19
Q

Headache intervention strategy

A

Spinal manipulation/mobilization
Deep cervical flexor training
Soft Tissue/Muscle trigger point treatment
Postural education and training

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20
Q

Pain Control exam finding

A

High pain and disability scores
Recent onset of symptoms
Traumatic onset
May have referred pain
Poor tolerance to exam and/or interventions

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21
Q

pain control intervention focus

A

Gentle AROM as tolerated
ROM for adjacent regions
Modalities prn
Activity modification

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22
Q

Levator Scapulae stretch

A

-Lie on your back with your knees bent
-Place one hand under your hip
-Rotate your head to the opposite side of the hand that is under your hip
-Place your other hand on back of your head and pull your head and nose toward your armpit

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23
Q

Scalene Stretch Supine

A

-Lie on your back with your knees bent
-Place one hand under your hip
-Keep your head from rotating by keeping your nose pointed toward the ceiling at all times
-Place your other hand on the side of

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24
Q

Thoracic Spine Mobilization: Towel roll stretch

A

Roll up a large bath towel
Lay on it crossways, placing it on a stiff spot on your spine
Rest in this position

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25
Q

Thoracic Spine Mobilization: Foam Roller Stretch

A

Use a 6 inch foam roller for this exercise
Lay on it crossways, placing it on a stiff spot on your spine
Place your hands behind your head for support
Perform the following option if directed by your therapist
□ Perform a small sit up over
the foam roll
□ Lean side to side while
maintaining pressure on
the foam roll

26
Q

McKenzie Derangement Syndrome

A

Reducible Derangement
-One direction of repeated movement centralizes symptoms (preferred direction/ directional preference)
-Opposite direction of repeated movement peripheralizes symptoms

27
Q

ANTERIOR IMPINGMENT SYNDROME RISK FACTORS

A

History of overhead movements
Progressive
-Stage 1 <25 y/o overhead movements
-Stage II 25-45 y/o overhead movements, decreased inferior glide humerus
-Stage III >40 y/o Overhead movements, arthritis of acromion, loss of biomechanics

28
Q

ANTERIOR IMPINGMENT SYNDROME CLINICAL MANIFESTATIONS

A
  • Pain with overhead movements from acromion to lateral shoulder into deltoid region
    -Difficulty reaching up back
    -Stage I: intermittent, mild pain with overhead movements
    Stage II: Intermittent mild to moderate pain with overhead movements
    Stage III: Pain with rest and activities, night pain, weakness
29
Q

ANTERIOR IMPINGMENT SYNDROME SPECIAL TESTS

A

-Hawkins and Kennedy
-Painful arc sign
-Infraspinatus test
-Neer test

30
Q

RCT (SUPRASPINATUS TEAR) RISK FACTORS

A

Age >40 y
History of overhead sports or occupations

31
Q

RCT (SUPRASPINATUS TEAR) CLINICAL MANIFESTATIONS

A

-Deep ache in shoulder and along deltoid region
-Night pain
-Pain reaching up back
-, weakness in ABD and ER, Loss of AROM

32
Q

RCT (SUPRASPINATUS TEAR) SPECIAL TESTS

A

-Drop arm
-Painful arc
-Infraspinatus muscle test
-Dropsign
-Empty and full can
-Scapular retraction test
-ER lag sign
-Subacromial grind test

33
Q

GH INSTABILITY RISK FACTORS

A

-Congenital laxity of capsule
-Progressive laxity of capsule with overhead athletes

34
Q

GH INSTABILITY CLINICAL MANIFESTATIONS

A

-Popping and/or feeling of instability with movements of shoulder into elevation
-Can usually self reduce

35
Q

GH INSTABILITY SPECIAL TESTS

A

-Sulcus sign
-Load and shift
-Apprehension/ relocation/release

36
Q

GH DISLOCATION RISK FACTORS

A

Traumatic dislocation,
Can be associated with Bankart lesion (see labral tear) and Hills Sachs lesions (compression impaction fracture)

37
Q

GH DISLOCATION CLINICAL MANIFESTATIONS

A

Apprehension with shoulder ABD and ER

38
Q

GH DISLOCATION SPECIAL TESTS

A

-Sulcus sign
-Load and shift
-Apprehension/ relocation/release

39
Q

LABRAL TEAR RISK FACTORS

A

-trauma FOOSH
-degeneration with age-overhead activities or heavy lifting

40
Q

LABRAL TEAR CLINICAL MANIFESTATIONS

A

-Aching pain, vague location
-Clunking with overhead movements
-Feeling of weakness in shoulder

41
Q

LABRAL TEAR SPECIAL TESTS

A
  • Anterior slide test
    -Crank test
    -Compression Rotation test
    -Active Compression test
    -Bicep load test
    -Kim test
42
Q

ADHESIVE CAPULITIS (FROZEN SHOULDER) RISK FACTORS

A

-Gradual onset of loss of ROM in a capsular pattern (ER>ABD>IR)
-May be accompanied with a history of shoulder pain however generally idiopathic

43
Q

ADHESIVE CAPULITIS (FROZEN SHOULDER) CLINICAL MANIFESTATIONS

A

-Pain with all movement
-Pain when sleeping on involved side
-Difficulty with ADLs

44
Q

ADHESIVE CAPULITIS (FROZEN SHOULDER) SPECIAL TESTS

A

-Loss of AROM and PROM (ER>ABD>IR)
-Decreased capsular mobility

45
Q

AC JOINT SPRAIN RISK FACTORS

A

-Result from a fall on the acromion (direct force) or FOOSH
-First-degree, grade I A-C joint sprain: minimal loss of function
-Second-degree, grade II A-C sprain: moderate pain, some dysfunction
-Third-degree, grade III A-C ligament injury, may have significant dysfunction

46
Q

AC JOINT SPRAIN CLINICAL MANIFESTATIONS

A

-Localized pain, swelling over AC joint
-Cradling arm decreases pain

47
Q

AC JOINT SPRAIN SPECIAL TESTS

A

-Horizontal ADD painful
-Positive active compression test

48
Q

C1/ C2 Rotation testing

A

Patient is seated
C2 is stabilized and C1 is rotated

49
Q

C2/C3 Lateral flexion testing

A

Patient seated or supine
Passive SB to C2/3

50
Q

Cervical Spine: Foramina Degeneration symptoms

A

Dermatomal pattern
Can just be sensory without
motor component
Reproduced with closure of foramina

51
Q

Cervical Spine: Disc symptoms

A

Dermatomal pattern – usually limited to 1
Usually a pattern across neurological tests (sensory, motor and reflexes)
Foraminal closure can reproduce symptoms but repetitive opening may increase symptoms

52
Q

Thoracic Outlet Syndrome

A

Anatomical structures compressing the brachial plexus

Thoracic outlet: brachial plexus, ant and med scalene, clavicle

53
Q

Sternocostovertebral Space impingement

A

Roots have just left the spine and trunks have not formed.
Pancoast tumor

54
Q

Costoclavicular syndrome symptoms

A

Posterior, lateral and medial cord sensory and motor patterns

55
Q

Pathology in Costoclavicular space

A

Soldiers with heavy backpacks
Test exaggerated military posture with inspiration

56
Q

Posterior cord branches

A

STAR – subscapular, thoracodorsal, axillary, radial

57
Q

Lateral Cord Branches

A

LLM “Lucy Loves Me” –lateral Pectoral, lateral root of the median nerve, musculocutaneous

58
Q

Medial Cord Branches

A

MMMUM “Most Medical Men Use Morphine” –medial pectoral, medial cutaneous nerve of the arm, medial cutaneous nerve of the forearm, ulnar, medial root of the median nerve

59
Q

Cords: Lateral, Posterior, Medial

A

Lateral= C5-C7 (LLM)
Medial= C8-T1 (MMMUM)
Posterior= C5-T1 (STAR)

60
Q

Causative pathology within pectoralis minor space

A

Increased tension in pect minor
Overuse as accessory respiratory muscle
Postural kyphosis
Direct trauma to muscle
Upper thoracic spinal dysfunction
Costal lesions
Facilitated segment of CT segment

Patient Management II (8 decks)

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