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PD Block III > Exam of the Upper Extremities > Flashcards

Exam of the Upper Extremities Flashcards

1
Q

name the four joints of the shoulder girdle

A
  1. sternoclavicular joint (joins sternum to clavicle)
  2. glenohumeral joint (shoulder joint)
  3. acromioclavicular joint (joins the claficle to the acromion of the scapula)
  4. thoracoscapular articulation (junction between ribs and medial aspect of scapula)
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2
Q

what features should you look for during skin and soft tissue inspection of the shoulder?

A
  1. scars/abrasions
  2. discolorations/bruising
  3. muscle wasting
  4. swelling (intra vs. extra-articular)
  5. asymmetry
  6. deformities/atrophy/abnormal contours
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3
Q

what body landmarks should you palpate during examination of the shoulder?

A
  1. clavicle
  2. scapula
  3. humerus
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4
Q

bicipital groove

A

anterior groove running vertically along the humerus, should be palpated during exam of the shoulder

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5
Q

greater tuberosity of the humerus

A

swelling on the superior aspect of the humerus, should be palpated during exam of the shoulder

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6
Q

discuss the soft tissue that should be included in exam of the shoulder

A
  1. rotator cuff
  2. subacromia and subdeltoid bursa
  3. axilla
  4. prominent muscles of the shoulder girdle (deltoid)
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7
Q

what is the correct ROM for shoulder flexion?

A

150-180

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8
Q

describe the movement of shoulder flexion and extension

A

flexion: arm raises up and forward (like a Nazi salute)
extension: arm moves down and back (hyperextended) backward, like you are swinging your arms back

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9
Q

what is the correct ROM for shoulder extension?

A

40

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10
Q

what is the correct ROM for shoulder internal rotation?

A

70

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11
Q

coracoid process

A

lateral, superior, anterior portion of the scapula that can be palpated anteriorly during the shoulder exam. it lies inferior to the lateral edge of the calvicle

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12
Q

what is the correct ROM for external shoulder rotation?

A

80

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13
Q

lesser tuberosity of the humerus

A

swelling on the anterior aspect of the humerus. separated from the greater tuberosity (lateral) by the biceps tendon that attaches there.

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14
Q

describe the process necessary to palpate the lesser tuberosity of the humerus

A

w/ the patient’s arm relaxed, hold their forearm out at 90 degrees so that it lies parallel to the floor. externally rotate the shoulder and feel anterolaterally for the greater tuberosity of the shoulder.

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15
Q

describe the movement of shoulder internal and external rotation

A

w/ pt. arm at side, forearm parallel to ground (maybe resting on table), shoulder rotates inward so forearm moves in toward chest for internal rotation, opposite for external rotation

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16
Q

what is the correct ROM for shoulder abduction?

A

150-180

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17
Q

what is the correct ROM for should adduction?

A

30-45

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18
Q

describe the movement of shoulder abduction and adduction

A

abduction: if looking at the pt. straight on, arm raises up laterally (like the arms of a clock)
adduction: patient moves arm to cross midline, arm looks like the arm of a clock.

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19
Q

what are the nine motions involved in muscle testing of the shoulder exam?

A
  1. flexion
  2. extension
  3. abduction
  4. adduction
  5. internal rotation
  6. external rotation
  7. scapular retraction (standing at attention)
  8. scapular elevation (shoulder shrug)
    9 shoulder protraction (reaching)
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20
Q

what nerves provide sensation of the shoulder?

A

supraclavicular nerve (C3-C4)

axillary nerve (C5-C6)

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21
Q

what reflexes are being tested in the shoulder exam? what nerves do they correspond to?

A

biceps (C5-C6)

triceps (C6-C7)

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22
Q

what 3 joints are involved in the elbow?

A
  1. humeroulnar joint
  2. humeroradial joint
  3. radioulnar joint
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23
Q

what are you inspecting during examination of the elbow?

A
  1. skin and soft tissue
  2. swelling
  3. bony anatomy
  4. carrying angle
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24
Q

what is a normal carrying angle for males?

A

5 degrees of valgus

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25
Q

what is a normal carrying angle for females?

A

10-15 degrees of valgus

26
Q

what are you palpating in the shoulder exam?

A
  1. soft tissue (anterior, posterior, lateral, medial)

2. bones (humerus, olecranon, head of radius)

27
Q

what is the normal ROM for flexion of the elbow?

A

150

28
Q

what is the normal ROM for extension of the elbow?

A

0-5

29
Q

what is the normal ROM for pronation of the elbow?

A

80

30
Q

what is the normal ROM for supination of the elbow?

A

80

31
Q

what nerve controls biceps muscle strength?

A

C6

32
Q

what nerve controls triceps muscle strength?

A

C7

33
Q

what nerve controls wrist flexors muscle strength?

A

C7

34
Q

what nerve controls wrist extensors muscle strength?

A

C6

35
Q

what nerves controls biceps reflex?

A

C5-C6

36
Q

what nerves control the triceps reflex?

A

C6-C7

37
Q

what nerves control the brachioradialis reflex?

A

C5-C6

38
Q

scapular winging

A

pt. to place arms on wall in front of them and push, indicative of serratus anterior muscle weakness.

39
Q

drop arm test

A

abduct pt/ arm and have them slowly lower arm. if unable to drop slowly, indicates rotator cuff tear.

40
Q

Yergason test

A

tests stability of biceps tendon. flex pt’s arm hold wrist while externally rotating shoulder, biceps tendon will pop out of bicipital groove and pt. will be in pain if tendon is unstable.

41
Q

apprehension test

A

tests for chronic shoulder dislocations, abduct arm externally rotate, pt/ will resist and look apprehensive

42
Q

tennis elbow test (lateral epicondylitis)

A

tests for pain on lateral epicondyle, pt. flex wrist while pressing on lateral aspect of their arm, just distal to elbow, if pain, test it positive.

43
Q

Tinel test

A

detects irritated nerves. tap on groove between olecranon and medial condyle, will send tingling sensation down to pinky and ring finger on that hand if positive. indicates carpal tunnel syndrome

44
Q

Allen test

A

tests for radial ulnar artery patencies. occlude blood flow to each artery separately and test if hand re-profuses with each artery occluded separately.

45
Q

Finkelstein test

A

test for tenosynovitis (De Quervian’s disease), pt tucks thumb into palm and ulnar deviate, pain is positive test.

46
Q

Phalen test

A

tests for carpal tunnel. push dorsal side of hands together and hold for 1 min, assess for pain/ tingling (affects median nerve)

47
Q

tenosynovitis/De Quervain’s disease

A

inflammation of the synovial lining along thumb side of hand/wrist

48
Q

what might you suggest if someone has pain in the anatomical snuff-box?

A

scaphoid fracture/injury

49
Q

name the bones in the hand from thumb to pinky, distal to proximal.

A

trapezium, trapezoid, capitate, hamate

scaphoid, lunate, pisiform

50
Q

what fits into the olecranon fossa of the humerus?

A

olecranon process of the ulna

51
Q

what is the most distal part of the humerus called?

A

capitulum

52
Q

gunstock deformity

A

varus angulation of the arm

53
Q

what is the normal ROM for flexion of the wrist?

A

80

54
Q

what is the normal ROM for extension of the wrist?

A

70-80

55
Q

what is the normal ROM for radial deviation?

A

20

56
Q

hat is the normal ROM for ulnar deviation?

A

30-35

57
Q

what is normal ROM for flexion of MCP joints?

A

90

58
Q

what is normal ROM for hyperextension of MCP joints?

A

30

59
Q

what nerves are you assessing during neuro exam of the wrist?

A
  1. musculocutaneous nerve (C6)
  2. radial nerve (C6-C7)
  3. median nerve (C5-C8)
  4. median antebrachial cutaneous (C8-T1)
60
Q

what nerves are you assessing during neuro exam of the hand?

A
  1. radial nerve (C6-C7)
  2. ulnar nerve (C8-T1)
  3. medial nerve (C5-C8)

PD Block III (11 decks)

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