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Patient Management II > Midterm Practical Prep > Flashcards

Midterm Practical Prep Flashcards

1
Q

Open pack of shoulder

A

55 degrees flexion with 30 degrees horizontal ABD and slight external rotation (scaption plane)

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2
Q

Closed pack of shoulder

A

maximal ABDuction and ER

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3
Q

capsular pattern of shoulder

A

ER> ABD>IR

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4
Q

Glenohumeral lateral distraction

A

for all motions

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5
Q

Glenohumeral inferior glide

A

For abduction

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6
Q

Glenohumeral Posterior glide

A

Flexion, horizontal ADDuction

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7
Q

shoulder instability history

A

History
-Multiple recurrent subluxations
-Injury to the shoulder
-Dislocation

Sensation of something slipping/ unstable or anxiety in certain positions

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8
Q

Sulcus sign

A

for shoulder instability

Patient sitting. Inferior glide of humerus. Measured in centimeters inferior acromion to humeral head

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9
Q

Load and shift (inferior, posterior, anterior)

A

sitting- must stabilize scapula. Starting position: passively position humerus within glenoid. 0-3 scale. 0=no laxity, 3= complete loss of humeral position on glenoid

NORMAL=anterior is half distance of humeral head

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10
Q

Apprehension/ relocation/ release RULE IN

A

Apprehension
Patient is supine. Arm positioned in 90 degrees abduction and moved towards full ER. Positive= Apprehension (spec .99, sens .53, +LR 53)

Relocation
From above position of apprehension, apply posterior glide of humerus. Positive= decreased apprehension (sens .46, spec .54, +LR 1.0, -LR 1.0)

Release (surprise test)
From above position, release posterior force. Positive= return of apprehension (sens .64, spec .99, +LR 64, -LR .36)

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11
Q

Labral tear history

A

Fall on outstretched arm or shoulder
Brace one self with an outstretched arm in a MVA
Lifting heavy objects repeatedly
Overhead activities

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12
Q

labral tear symptoms

A

Popping, clicking, or catching in the shoulder.

Pain when you move your arm over your head or throw a ball

A feeling of weakness or instability in the shoulder

Aching pain of vague location

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13
Q

labral tear anterior slide test

A

Patient standing or sitting. Hand on hip. Examiner stabilizes scapula with one hand and with other hand on elbow, applies an anterior/superior force. Patient instructed “don’t let me move you.” Positive= click in anterior shoulder

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14
Q

crank test

A

for labral tear

Patient supine. Examiner passively elevate arm to 160 degrees scaption. Axial load applied to humerus and shoulder is IR and ER. Positive=Pain(+LR 1.05, -LR .96)

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15
Q

Active compression test

A

for labral tear

Patient standing. Active flexion to 90 degrees with 10 degrees ADDuction and full IR. Examiner provides a downward force versus resistance. Patient then ER shoulder and test is repeated. Positive= pain with first maneuver and decreased pain with second maneuver

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16
Q

Bicep load test

A

for labral tear,

Patient supine. Arm is passive ABDucted 90 degrees with elbow in 90 degrees flexion and supinated. Examiner ER arm until patient reports apprehension. Resisted elbow flexion performed. Positive= Pain

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17
Q

sub-acrominal impingement history

A

overhead activities

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18
Q

Subacromial Impingement symptoms

A

Difficulty reaching up behind the back
Pain with overhead use of the arm
Weakness of shoulder muscles

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19
Q

Test Item Cluster for Identification of Subacromial Impingement Syndrome

A

Hawkins and Kennedy Impingement sign
Painful arc sign
Infraspinatus muscle test

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20
Q

Hawkins and Kennedy Test

A

for subacromial impingement

Patient standing. Passive elevation of shoulder to 90 degrees scaption, elbow in 90 degrees flexion. Passive IR to pain or end range. Positive= pain

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21
Q

Painful arc sign

A

for subacromial impingement

Patient instructed to fully flex arm in scapular plane and then slowly lower. The test is positive if the patient has pain between 60 and 120 degrees.

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22
Q

Infraspinatus Muscle Test

A

for subacromial impingement

Arm in neutral and elbow flexed to 90 degrees. The patient resists internal rotation force. A positive test is pain and weakness when pressure applied.

23
Q

Neer Test (+LR 1.5, -LR 0.68)

A

for subacromial impingement

Patient sitting or standing. Examiner stabilizes scapula with one hand.
Passive shoulder elevation with full IR. Positive=pain.

24
Q

Rotator cuff history

A

Age (>40)
Overhead sports
Overhead occupations

25
Q

rotator cuff symptoms

A

dull ache deep in the shoulder
Disturb sleep, particularly if you lie on the affected shoulder
Painful to reach behind back
weakness

26
Q

Test item cluster for the identification of a full-thickness rotator cuff tear

A

Drop arm sign
Painful arc sign
Infraspinatus muscle test

27
Q

Drop arm test

A

for supraspinatus tear

The patient is asked to elevate arm in scaption plan and slowly lower. The test is positive if the arm drops suddenly.

28
Q

Full and empty can

A

for supraspinatus tear,

Positive= pain and or mus weakness.

29
Q

ER lag sign Rule IN

A

for supraspinatus tear

Patient seated. Shoulder scaption 20 degrees with elbow flexed 90 degrees. Examiner passively ER shoulder to within 5 degrees of full motion. Patient told to hold in position when examiner releases. Positive= patient unable to maintain ER

30
Q

Dropping sign

A

infraspinatus tear

Patient seated. Examiner passively places shoulder in 90 degrees ABDuction with 45 degrees ER and elbow flexed 90 degrees. Patient instructed to hold position when released. Positive= patient unable to maintain position.

31
Q

Horn blower’s sign

A

for teres minor tear

Patient seated. Examiner passively places shoulder in 90 degrees scaption and asks patient to ER against resistance. Positive= unable to ER shoulder

32
Q

IR lag sign

A

for subscapularis tear

Patient seated. Examiner passively IR shoulder by placing hand behind back. With elbow in 90 degrees flexion, examiner passively extends shoulder. Patient instructed to hold position when released. Positive= patient unable to maintain position.

33
Q

AC joint separation history

A

FOOSH (fall on outstretched hand), direct blow to shoulder
Cradling arm decreases pain
Pain directly over AC joint

34
Q

AC joint separation symptoms

A

Horizontal ADDuction painful
Positive active compression test

35
Q

AC Joint Separation type I

A

AC ligament disruption but coracoclavicular ligaments intact

36
Q

AC Joint Separation type II

A

AC joint ligaments torn and coracoclavicular ligaments disrupted

37
Q

AC Joint Separation type III

A

All ligaments torn and complete AC joint separation.

38
Q

Active compression test Rule IN and OUT

A

AC joint lesion

Patient standing. Active flexion to 90 degrees with 10 degrees ADDuction and full IR. Examiner provides a downward force versus resistance. Positive = pain localized to AC joint

39
Q

ULTT- A

A

Patient is supine. Upper extremity is passively moved into the following position IN ORDER
-Scapular depression
-Forearm supination
-Wrist and finger extension
-Shoulder ER
-Elbow extension
-Shoulder ABDuction
No symptoms: ask patient to SB away and towards UE

40
Q

Pain with cervical compression

A

Disc
Vertebral body fracture
Nerve root irritation (radiating)

41
Q

Decreased pain with cervical distraction

A

Disc
Spinal Facet
Nerve root (centralizing)

42
Q

Spurling’s

A

Patient seated
Cervical extension with SB
PT applies compression gently

Positive= radiating symptoms

43
Q

Test Item Cluster- Radiculopathy

A

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

44
Q

Test for upper cervical instability

A

sharp purser, tests transverse ligament

45
Q

Vertebral artery tests

A

Hautant
Cervical quadrant test
Pre manipulative position test

46
Q

Hautant test

A

Patient is seated

Shoulders are flexed to 90 degrees
Patient closes eyes 10 sec

If arms move, proprioceptive loss has a NON vascular cause

If negative, have patient open eyes and extend and rotate neck to one side. Hold 10-30 sec

If arms move or nystagmus or dizziness, vascular cause suspected

47
Q

cervical quadrant test

A

Patient supine, eyes open
Passive movement of head into extension, and ipsilateral SB and ROT
Hold 30 sec

48
Q

neck flexor muscle endurance test

A

Patient positioned in supine/ hooklying

Chin is maximally retracted and maintained isometrically as the head and neck is lifted 1 inch above the table

PT places fingers in space to ensure height is maintained

Test is terminated with patient loses retraction or head falls

Normal: 38 sec

49
Q

shoulder abduction test

A

Patient is seated and asked to place symptomatic extremity on head. Positive if symptoms reduce

50
Q

Strength parameters for novice

A

Load: 60-80% of 1RM
Volume: 1-4x7-12 reps
Rest: 2-3 min for multijoint, 1-2 min for assistive exercises
Frequency: 2-3x/week

51
Q

Hypertrophy parameters for novice

A

Load: 70-85% of 1RM
Volume: 1-3x6-10 reps
Rest: 1-2 min for assistive exercises
Frequency: 2-3x/week

52
Q

Power parameters for novice

A

Load: 30-80% of 1RM
Volume: 1-3x7-30 reps
Rest: 1-2 min for assistive exercises, 2-3 min for multi-joint exercises
Frequency: 2-3x/week

53
Q

Endurance parameters for novice

A

Load: 30-60% of 1RM
Volume: 4-7x12-30 reps
Rest: <1 min
Frequency: 2-3x/week

Patient Management II (8 decks)

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