Misc. Midterm Notes Flashcards
should pt. go into a composite fist when evaluating PROM?
no - only during AROM
- pt. is seated, stabilize elbow, pt. makes fist, radially deviates and asks to extend wrist under your resistance
- if there is pain, they have tennis elbow/lateral epicondylitis
- active provocative test
cozen’s test
In the subacute stage, if you stress a tendon slightly, it ___ ___.
heals better
if a pt. has more active than passive movement at a joint, what is it?
joint contracture
if a pt. has more passive than active ROM at a joint what is it?
muscle weakness
codman’s exercise - starts motion with the ___ rather than ___.
trunk, arm
muscle strengthening helps to improve what?
AROM
stretching helps to improve what?
PROM
when pitting edema stays a while and it becomes very difficult to move; fluid is so hard it may not even pit.
brawny edema
t/f - a resting hand splint is the same as safe position.
false
subluxation of joint is commonly seen in which types of pts?
RA pts.
what is an example of a non-articular splint?
buddy straps (tape injured finger to uninjured fingers)
- provides a prolonged sustained stretch
- fast, inexpensive method of correcting burn, scars, contractures
serial casting
is the safe position the same for burn pts?
no different for burn pts.
ulnar fracture with radial head dislocation; radial nerve involved
monteggia fracture
heat transfer from 1 solid to another
conduction
mixed with oil at ration of 7:1 and kept at 125 degrees; has a low specific heat, so it is unable to deliver as much heat per gram as water, therefore it feels cooler at a higher temperature
paraffin
heat transfer by fluid to gas
convection
a dry heat in which heat is transferred to the UE by swirling mixture of are and small particles at temperature of 118 degrees
fluidotherapy
what is NMES used for?
getting muscle to move
what is TENS used for?
pain
___ ___ never reaches pre-injury status.
tensile strength
name 4 purposes of static splints.
- support
- protection
- rest
- immobilize
name 2 purposes of dynamic splints.
-increase PROM and AROM
what is the purpose of serial static splints?
making adjustments to orthosis to increase range
what is the purpose of static progressive splints?
uses a static adjustment part (such as hinge, turn buckle or strap) to increase motion.
a group of rare diseases that involve the hardening and tightening of the skin and connective tissues; makes skin tight and shiny - often breaks (systemic disease)
scleroderma
the study of mechanical laws relating to the movement or structures of living bodies
biomechanics
name the 3 components of the capacity for motion.
- joint ROM (potential for movement at a joint)
- muscle strength
- endurance
hyperhidrosis
sweating
finger pulp
can become atrophied with PNI
gold standard pain assessment; check off symptoms and mark on blank body where the pain is on front and back
McGill Pain Questionnaire
gold standard pain assessment; check off symptoms and mark on blank body where the pain is on front and back
McGill Pain Questionnaire
complete loss of sensation
anesthesia
dont have to know
dont have to know
abnormal sensation
paresthesia
newer philosophy that you can get scarring if the edema doesn’t leave
mother of scar
“Can you raise you arms above your hand?”
shoulder flexion
“Can you touch your hands behind your back?”
shoulder abduction/extension
“Can you touch your hand to the small of your back?”
shoulder internal rotation
can you place your hands behind your head
shoulder abduction/external rotation
can you touch your mouth
elbow flexion
can you hold your hands and arms straight out in front of you
shoulder flexion and elbow extension
can you turn your palms up and down?
forearm pronation/supination
can you wave your hands up and down?
wrist flexion/extension
can you touch your fingers to your thumb?
thumb opposition
the dominant hand is usually how much stronger than non-dominant hand?
10-15%
against gravity, full ROM, max resistance
normal (5)
against gravity, full ROM, moderate resistance
good (4)
against gravity, full ROM, no resistance
fair (3)
gravity eliminated, full ROM, no resistance
poor (2)
tension is palpated in the muscle or tendon but no motion occurs at the joint
trace (1)
no tension is palpated in the muscle or tendon, and no motion occurs.
zero (0)
name 3 examples of objective sensibility tests.
- nerve conduction studies
- ninhydrin sweat test
- wrinkle test
name 3 examples of threshold sensibility tests.
- tuning fork
- eraser end of pencil
- semmes-weinstein monofilaments
name 4 examples of functional sensibility tests.
- moving 2 pt discrimination
- static 2 pt discrimination
- seddon coin test
- moberg pick up test
name 4 examples of functional sensibility tests.
- moving 2 pt discrimination
- static 2 pt discrimination
- seddon coin test
- moberg pick up test
have the pt. pinch a piece of paper btwn the thumb and the radial aspect of the forefinger; if you can pull out the paper, it is positive
froment’s sign
what is the clinical interpretation of a positive froment’s sign?
ulnar nerve weakness
grasp the pts. thumb and gently grind it like a peppermill
grind test
what is the clinical interpretation of pain during the grind test?
OA of thumb
have pt. make an OK sign by opposing the thumb and forefinger to make a ring; check the strength of the O by trying to open it with your fingers.
“OK sign”
what is the clinical interpretation of the “OK” sign?
weakness indicates median nerve abnormality
pt. puts palm on surface, examiner checks for adduction of the 5th finger.
wartenburg’s finger sign
what is the clinical interpretation of warternburg’s finger sign?
suggest ulnar nerve palsy
pt makes a fist, pronates his or her forearm as well as radially deviate and extend wrist while examiner gives resistance over the radial aspect of the pts. hand.
cozen’s test
what is the clinical interpretation of a positive cozen’s test?
lateral epicondylitis (ECRB could be affected)
lightly stroked the pts. unaffected area first to see if pt feels sensation. repeated on unaffected and affected sides simultaneously using the same amt of pressure
10 test
fluid can no longer be displaced (indented) and there is no pitting; becomes first and hard.
brawny edema
which type of scar causes less stiffness than a straight scar?
z-plasty scar
exerted by elastic when it is put on stretch; exerts pressure whether a pt is moving or immobile.
resting pressure (Co-ban compression wrap - edema)
produced by active muscles pushing against an inelastic bandage and is only produced when the pt. is moving and contracting the muscles.
working pressure (Co-ban compression wrap - edema)
- monophasic current used to promote tissue healing and manage acute edema
- direct current can produce mechanical and chemical changes
- used to produce analgesia, muscle contractions and to facilitate wound healing
high volt pulsed galvanic stim (HVPG)
inflatable garment that is intermittently inflated and deflated with the intention of forcing lymph out of the extremity/affected body part and into the central compartments of the body.
pneumatic compression pump
name 2 examples of static progressive splints.
- proglide
- JAS
name 2 examples of static progressive splints.
- proglide
- JAS
name 2 examples of static progressive splints.
- proglide
- JAS
which conditions respond well to serial casting?
flexion contractures greater than 30 degrees
paraffin dip 2x, then cast
tim technique
when are high profile outriggers used?
- when mobilizing stiff joints (allows for easier adjustment)
- provides greater joint stability
when are low-profile outriggers used?
when joints are supple and purpose is to substitute for absent motion
all 3 arches of the hand create what?
dual obliquity
modify joints positions according to diagnosis
resting splint
modify wrist position according to diagnosis
cock-up splint
if AROM is > than PROM what is the indication?
joint contracture
if PROM > AROM what is indicated?
muscle weakness
what does PROM measure?
the extensibility of the connective tissue surrounding a joint
Maitland Joint Mobilization Grading Scale - Grade 1 involves a ___ amplitude rhythmic oscillating movement at the ___ of ROM.
small, beginning
Maitland Joint Mobilization Grading Scale - Grade 2 involves a ___ amplitude rhythmic oscillating movement within ____ of ROM.
large, midrange
what is the concave-convex rule?
- if concave surface is moving on a stationary convex surface, gliding will occur in the same direction as rocking motion.
- if convex surface is moving on a stationary concave surface, gliding will occur in the opposite direction to the rolling motion.
exists when there is loss of joint AROM in the direction of the agonist, but there is full PROM
lag
digits are passively placed in the position that the client cannot achieve actively, then the client tries to hold the digits in that position while the support is released.
place and hold
what should you do to improve AROM?
improve muscle strength
what should you do to improve PROM?
stretch
name the 3 components of the stress-strain curve.
- neutral zone
- elastic zone
- plastic zone
represents the unfolding of the collagen fibers as stress is applied
neutral zone
represents where tissue resistance is first felt when a therapist performs PROM on a joint
elastic zone
areas where application of increased stress after the end of joint PROM can result in tissue microfailure; if more stress is applied, failure point is reached, and gross rupture of tissue occurs.
plastic zone
how do you treat tendon adhesions?
- elongate the adhesion so that is no longer restricts tendon excursion
- heat before exercise can improve extensibility of the tissue
what is the easiest type of muscle contraction?
isometric
how should frequency of exercise progress?
-first start with short period of frequent exercise, then move to longer periods of less frequent exercise
no motion, force and load are equivalent
isometric contraction
force of muscle is sufficient to lift the load, the muscle shortens
concentric contraction
force of muscle is not sufficient to retain load, muscle extends and slows down load
eccentric contraction
necrosis is common in which types of fractures?
scaphoid fx
a radial fx and ulnar sided pain could indicate what?
potential TFCC damage
no thermal modalities during the ____ phase of healing.
inflammatory
NMES is indicated if MMT is less than what?
3/5
what is boxer’s fracture?
fracture of the 5th MC, end of the 5th MC takes the force of the impact and breaks at its neck; creates a dorsal bump.
describe a boxer’s fracture splint.
splint with ulnar gutter: MP flexion, IP extension, wrist in neutral
fracture of the ulnar shaft with concomitant dislocation of the radial head
monteggia fracture
are RA joints hyper or hypo mobile?
hypermobile from loss of elastic properties of joints
abnormal growth of tissue that develops in the joints from synovial lining of cells that builds up
pannus
how can you combat ulnar drift with an orthosis?
to combat this from occurring, use ulnar drift static progressive splint
is OA an inflammatory disease?
onset in non-inflammatory but secondary inflammation is common
idiopathic, affects joints of one site with no known cause
primary OA
affects a joint of one site and is due to some external or internal injury or disease
secondary OA
what is the most prominent feature of the 7 presenting pt complaints of OA?
pain
generally, OA pts. have pain with ____.
movement
OA usually comes with what comorbidity?
trigger finger
what do the grind and finklestein tests tell the difference btwn?
OA or an inflammation of the 1st dorsal compartment
prefab splint designed to support the CMC joint
colditz metagrip
presents with deep thenar eminence and thumb basilar pain, often coexistent with CMC arthritis of the thumb.
STT arthritis
with OA, work ___ pain, no ___ pain.
TO, THROUGH
describe intrinsic tightness
lumbricals; if you extend the MP and the PIP extends
describe extrinsic tightness
communis; if you extend the MP and the PIP flexes
a common and painful condition that affects the tendons on the thumb side of the wrist; hurts when person turns wrist, grasps anything or makes a fist.
dequervain’s synovitis
what is the finklestein test used to diagnose?
dequervain’s synovitis
what is froment’s test used to diagnose?
ulnar nerve palsy
describe tenodesis.
passive opening of the fingers when the wrist is flexed and closing of the fingers when the wrist is extended.
