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Extremities Technique > midterm > Flashcards

midterm Flashcards

1
Q

what syndrome(s) might cause a positive allen’s test?

A

TOS
Cervical subluxation
Raynaud’s syndrome

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2
Q

How long do you palpate the radial artery with adson’s?

A

10-20 seconds, enough to decide if the pulse volume has changed

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3
Q

what does a positive adson’s indicate?

A

scalenus anticus syndrome

-pressure on the subclavian artery and brachial plexus

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4
Q

what diagnosis is suspected with a positive adson’s turning away from the side being tested?

A

maybe a cervical rib or scalenus medius syndrome

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5
Q

is a cervical rib that causes loss of patency acute or chronic?

A

usually an acute exacerbation, because bone will normally grow away from the artery

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6
Q

what is a positive eden’s test?

A

decreased pulse volume

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7
Q

a positive eden’s test indicates?

A

Costoclavicular syndrome

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8
Q

what constitutes a positive wright’s test?

A

10-15 degree difference in left vs. right arm abduction. You’re comparing where you lose the palpable pulse from one arm to the other arm

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9
Q

a positive wright’s test indicates?

A

hyperabduction syndrome

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10
Q

what constitutes a positive yergason’s?

A
  • Positive: Tendon pops out of groove
  • Indicates: Bicepital instability
  • Differential Diagnosis; pain w/o slipping may be an inferior humerus
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11
Q

what constitutes a positive Dawburn’s?

A
  • Positive: pain disappears on abduction
  • indicates: subacromial bursitis
  • Negative: pain remaining throughout abduction may be an inferior humerus
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12
Q

what constitutes a positive Dugas?

A

positive: patient cannot touch chest with affected arm/elbow while grasping the opposite shoulder
Indicates: shoulder dislocation/separation

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13
Q

what constitutes a positive shoulder apprehension?

A

positive: look of alarm on face or patient pulling away from doctor’s pressure
Indicates: Glenohumeral instability/ Propensity to dislocate

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14
Q

visualization of St-Cl S would be?

A

Proximal end of clavicle sits higher than the opposite side

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15
Q

Visualization of A-C PS would be?

A

Distal end of the clavicle sits higher causing a visual prominence

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16
Q

visualization of G-H I?

A

Dimpling or indent of soft tissue over the joint space

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17
Q

visualization of lateral scapula?

A

Vertebral border of scapula has flared lateral in relation to the spine

18
Q

Fluid motion of St-Cl?

A

place fingers at St-Cl joints and ask patient to shrug and roll their shoulders

19
Q

fluid motion of A-C PS

A

Compress humeral head into the glenoid fossa then apply S to I pressure over distal end of clavicle

20
Q

fluid motion of G-H?

A

Block A-C and scapular spine with one hand, apply I-S pressure at elbow

21
Q

fluid motion of S-T?

A

Dr. places thumbs at medial inferior angle, applying M-L pressure; then Dr. places thumbs at lateral inferior angle applying L-M pressure

22
Q

what are 5 indicators of an inferior humerus?

A

1) shoulder visualizes as being low with soft tissue dimpling/ sulcus sign (DUH)…
2) Point tenderness at the anterior aspect of G-H Joint
3) Loss of fluid motion
4) loss of apley’s external rotation
5) anterior deltoid weakness

23
Q

what are 5 indicators of a posterior Humerus?

A

1) visualizes normally, no apparent visual change (malingering!!!) J/K
2) loss of fluid motion
3) point tenderness at posterior aspect of G-H joint
4) loss of internal rotation
5) Teres major muscle weakness

24
Q

with any shoulder complaint the Dr. should routinely examine? (6 things)

A

1) St-Cl
2) A-C
3) G-H
4) Sc-Th
5) St-Co
6) The fucking Spine

25
Q

On scapulo-Thoracic Lateral (S-T L) what position do we replace the patient’s arm?

A

Behind the Patients back (side lying) with doctor reaching through the Patients axillary arm opening

26
Q

where is #11 of the stabilization hand for S-T L?
where are the fingers?
In what direction does the stabilization hand push to bring the joint to tension?

A 
#11 over the A-C joint
Fingers- Over the G-H joint
tension- S to I
27
Q

what is the pain point for S-T L?

A

deep to or under the scapula, in the subscapularis muscle

28
Q

what 4 ways can you differentiate S-T L from S-T M?

A

1) fluid Motion
2) visualization of distance from spine
3) S-T L appleys scratch is limited internal rotation
4) S-T M appleys scratch is limited External rotation

29
Q

what part of the scapulo-humeral ration would be decreased with a G-H P?

A

the glenohumeral portion

30
Q

for scapulothoracic medial, prone where shoudl the patients shoulder be? what side should the doctor be on? and what contact hand should be used?

A
  • shoulder off the table
  • opposite side of contact
  • inferior hand contact
31
Q

LOC for G-H posterior prone?

A

P-A be careful not to get any S-I

32
Q

where is the patients hsoulder for G-H P?

A

supported on the table

33
Q

why is the patients shoulder on the table for G-H P

A

for stabilization; we dont want to dislocate it.. do we?

34
Q

Indication of a positive Yergason’s?

A
  • bicepital tendon instability, usually caused by a shallow groove
  • or a tear or sprain of transverse humeral ligament
35
Q

what is the first part of drop arm test and what does it indicate? Least invasive

A

patient lowers arm to side against gravity; if it drops fast, its often a severe tear of rotator cuff, grade 3. supraspinatus muscle

36
Q

what is the second part of drop arm test? middle invasive

A

apply a little pressure while they lower it; some resistance, moderate tear of rotator cuff, Grade 2

37
Q

what is the third part of drop arm test? most invasive

A

put an impulse in the abducted arm; fair resistance, mild tear or strain of rotator cuff, grade 1

38
Q

with G-H P seated what is the most important about LOC?

A

Straight P-A, Drop elbow so it’s level or below the wrist

39
Q

what ROM do you use to bring a G-H P to Tension?

A

Abduction and extension

40
Q

where is the pain point for G-H P?

A

over the posterior glenohumeral joint

41
Q

How to differentially diagnose a G-H P, from a G-H Inf?

A

pain point is posterior; visualizes as normal, not inferior

  • G-H P is decreased ROM on internal rotation, not external rotation
  • X-Ray shows humeral head is posterior and superior, not inferior
  • Teres major muscle test is weak on G-H P, not anterior deltoid as G-H I
42
Q

what is the move of choice for the G-H joint?

A

Supine traction because you can feel the joint space

Extremities Technique (1 decks)

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