Management of Upper Limb Conditions Flashcards
What observations may be made of TOS?
posture (closure of TO)
Any discolouration or evidence of cyanosis, paleness or atrophy of upper limb
What is TOS usually present with?
Pain and heaviness in cx, shoulder, arm and hand that is broad and non-specific
What findings can be made with TOS?
Reproduction of familiar pain/neuro ssx at the scalenes, pec maj/min, supraclavicular fossa, rib 1
UL neuro exam shows possible neuro changes in a non-dermatomal pattern
What are the ortho tests for TOS?
EAST/Roos
ULNTT
What is the management of TOS?
Education and reassurance
Load/activity management and ergonomic advice/education
Manual therapy
Exercise rehabilitation
Surgical intervention
What are the aims of manual therapy for TOS?
Aim to decrease patient symptoms - offload structures surrounding that may place increase stress on upper limb neurovascular structures
How can you deload the brachial plexus?
Humeral head positioning
Cx posture
Scapulothoracic movement
Pec hypertonicity
SCM, scalenes, upper traps, ct junction
What is the suggested exercise rehab for TOS?
Pain reduction and encouraging movement - consider Cx, Tx and GH
Scapulothoracic muscular strengthening and neuro sliders and gliders
Deep Cx flexor retraining
Serratus anterior endurance and motor control
Ergonomic advice
What imaging is usually first in acute pain?
X-ray
Why is x-ray useful for shoulder imaging?
Adequate, fast
What is an MRI used for in shoulder injuries?
Adequate evaluation evaluation of extra articular soft tissue trauma
What is a grade 1 ac joint sprain?
Sprain on capsule
Localised tenderness and pain on movement especially horizontal
