L4 Flashcards
What is the M/c dislocated joint in the human body
shoulder
What are four common conditions of the shoulder
frozen shoulder
rotator cuff pathology
instability
impingement
with any shoulder complaint, what (4) must be performed for the cervical spine eval to rule out the neck?
ROM
compression
distraction
C5-T1 MRS
What are 9 common shoulder evaluation tests?
appleys
supraspinatus press
codmans drop
impingement
dawbarns pushbutton
abbot saunders
speeds
yergasens
muscle testing shoulder
What were two NEW exams that were presented to diagnose shoulder disorders?
obriens (labrum)
gerbers lift off (subscap)
diagnostic ultrasound is good for visualizing ___ of the shoulder (3 things)
bursa
tendons
ligaments
MRI of the shoulder is used to visualize the following 2 things:
soft tissue
edema
reduced capacity for dye in the GH joint on an MRI is diagnostic of what two conditions?
frozen shoulder
2/3ml compared to 20-30 normal
What are five main medical management of the shoulder?
NSAIS
corticosteroids
surgery
referral to PT or chiro
percutaneous needle tenotomy
What are some common elbow conditions?
medial and lateral epicondylitis
ulnar neuropathy at cubital tunnel (repetitive compression)
medial epicondylitis may cause:
ulnar neuropathy from inflammation and irritation
What are 7 tests for elbow evaluation?
cozens
mills
golfers
varus/valgus
tinel tap at cubital tunnel
rule out referred pain
palpate area for TP/reproduce pain
What are three common wrist/hand complaints?
TFCC tear
carpal tunnel syndrome
DJD
Explain how you obtain a TFCC tear mechanism:
ulnar deviation with compression
forced ulnar deviation
What is a carpal tunnel syndrome DDx?
pronator teres syndrome
(sensation over the flexor retinaculum is maintained in pronator teres syndrome)
Where are the four common median nerve entrapment sites?
ligament of struthers
thickened bicep aponeurosis
pronator teres
carpal tunnel
pronator teres entrapement ddx:
Ok sign is normal in true carpal tunnel and is weak in pronator teres
Anterior interosseous nerve muscles
ulnar nerve entrapment sites:
cubital tunnel (dorsal and palmar sides)
tunnel of guyon (palmar side only)
DDx with TOS (mc C8/T1)
ulnar entrapment mc due to:
repetitive compression/trauma
elbows on table
wrist gripping handlebars
radial nerve entrapment commonly occurs at:
spiral groove
Posterior interosseous nerve is commonly entrapped at:
along radial neck before piercing supinator muscle
terminal branches of radial nerve are often compressed at:
-fibrous bands around radial head
-recurrent radial vessels
-arcade of frohse
-tendinous margin of extensor carpi radialis brevis
-usually due to overuse injuries
EMG/nerve conduction studies shoulder only be considered if:
surgery is a possibility
nerve conduction velocity only evaluates what?
evaluates peripheral nerves only
EMG evaluates what?
peripheral and nerve roots
EMG/NCV must have nerve damage to see what findings at what time frame?
EMG: 7 days spine, 21 days in extremity
EMG differentiates between
acute:
giant:
acute: sharp waves and fibrillation potentials
giant motor waves: chronic
chiropractic management of the shoulder consists of:
shockwave
laser
acupuncture
soft tissue/compression band
mobilization (not unstable)
taping
rehab exercises
elbow conditions and chiropractic management consists of:
education/advice
soft tissue (aggressive)
compression band
shockwave
laser
taping/bracing
nerve flossing
mobilization
(annular lig in relation to extensor carpi radialis)
exercise
what are some medical management of wrist/hand conditions?
rest
pt referral
corticosteroids
surgery:
TFCC
carpal tunnel release
what would be some chiropractic management of wrist/hand complaints?
soft tissue
compression band
laser/EMG therapy
mobilization
taping
median nerve flossing
strengthen/stretch
what are some nerve entrapment treatment?
soft tissue
cupping
acupuncture
rockfloss/voodoo
mobilization
nerve flossing
50-70% successfully treated conservatively
