MSI (part 1)

Question 1

what is your carpel tunnel?

Answer 1

a passageway in the wrist through which nerves (median) and the flexor muscles of the hand pass through

Question 2

what is carpel tunnel syndrome?

Answer 2

impingement of the median nerve caused by irritation and swelling of the tendons in the carpel tunnel (inflammation of the tendons that irritates the median nerve)
- the nerve can become impaired from the pressure

Question 3

3 symptoms of carpel tunnel syndrome

Answer 3

1. pain in first 3 fingers and the thumb
2. numbness in these areas
3. tingling in these areas

Question 4

4 risk factors for carpel tunnel syndrome

Answer 4

1. job tasks that require a combo of repetitive, forceful and awkward or stressed motions of the hands and wrists
2. awkward joint position, direct pressure to the ligaments and bones, high force, vibration
3. could be born with smaller carpal tunnels
4. repetitive movements during assembly line work, wrist injury or swelling due to certain diseases, such as rheumatoid arthritis

Question 5

Wrist extension of ___ degrees and wrist flexion of _____ can be a risk factor of carpel tunnel. Radial deviation of __ degrees and ulnar deviation of ___ degrees is a risk factor for carpel tunnel
–> comfortable zone is __ to __ degrees

Answer 5

• 46, 51
• 15, 25
• 5 to 10

Question 6

10 strategies for carpel tunnel rehab

Answer 6

1. wrist ROM
2. wrist stretch (extension)
3. Mid-trap exercise (superman with arms to side)
4. pec stretch
5. scalene stretch
6. thoracic extension
7. scapular squeeze
8. wrist extension
9. grip strengthening
10. massage

Question 7

what is the cubital tunnel?

Answer 7

a channel which allows the ulnar nerve (commonly known as the ‘funny bone’) to travel over the elbow

Question 8

what is cubital tunnel syndrome?

Answer 8

the ulnar nerve, which feeds the the ring and little finger, can become impaired from pressure near the elbows

Question 9

2 symptoms of cubital tunnel syndrome

Answer 9

1. numbness and paresthesia along the ulnar nerve distribution (ring and little finger) and elbow pain
2. weakness of the intrinsic muscles of the hand and the flexors of the ring and little fingers (interferes with pinch between the thumb and index finger and with hand grip)

Question 10

3 risk factors for cubital tunnel syndrome

Answer 10

1. jobs that involve resting the elbows on the hard surface such as unpadded tables or armrests
2. repetitive bending and straightening of the arm
3. awkward joint posture, direct pressure to the ligaments and bones, high force, vibration

Question 11

what do you do for cubital tunnel syndrome rehab?

Answer 11

• nerve gliding exercises
• help the nerve glide through cubital tunnel at elbow and guyons canal at wrist and prevent stiffness
• -> extend and flex your wrist and elbow

Question 12

CPS due to awkward wrist posture

problem: wrist dorsiflexion
solution: ?

Answer 12

negative tray tilt

Question 13

CPS due to awkward wrist posture

problem: wrist palmar flexion
solution: ?

Answer 13

adjustable height tray table

Question 14

CPS due to awkward wrist posture

problem: wrist ulnar deviation
solution: ?

Answer 14

split keyboard

Question 15

CPS due to awkward wrist posture

problem: excessive use
solution: ?

Answer 15

frequent breaks, wrist exercises

Question 16

cubital tunnel syndrome due to repetitive and sustained elbow flexion

problem: key board or mouse too high
solution: ?

Answer 16

drop - down tray , higher seat

Question 17

cubital tunnel syndrome due to repetitive and sustained elbow flexion

problem: handheld telephone
solution: ?

Answer 17

speakerphone, headset

Question 18

cubital tunnel syndrome due to repetitive and sustained elbow flexion

problem: handheld dictation microphone
solution: ?

Answer 18

headset with voice recognition software

Question 19

cubital tunnel syndrome due to repetitive and sustained elbow flexion

problem: ulnar nerve direct truama
solution: ?

Answer 19

adjustable - height armrests, padded armrests

Question 20

what is the thoracic outlet

Answer 20

  the superior thoracic aperture refers to the superior opening of the thoracic cavity between first rib and collarbone through which brachial plexus (nerve bundle) and subclavian vein and arteries pass.

Question 21

what is thoracic outlet syndrome

Answer 21

Thoracic outlet syndrome is a group of disorders that occur when the blood vessels or nerves in the thoracic outlet — the space between your collarbone (clavicle) and your first rib — become compressed

Question 22

when is thoracic outlet syndrome most likely to happen

Answer 22

when flexion of arm at shoulder, scapula upward rotated, and ribs elevated

• also horizontal abduction and internal rotation
• causes irritation of the brachial plexus

Question 23

what 2 movements of the arm are ‘safe’ for working postures

Answer 23

• 75 degrees across abdomen to 180 degrees above head in frontal plane
• 60 degrees of extension to 180 degrees of flexion in the sagittal plane

Question 24

what are the 2 types of thoracic outlet syndrome

Answer 24

1. neurological thoracic outlet syndrome

2. vascular thoracic outlet syndrome

Question 25

This form is characterized by compression of the brachial plexus (a network of nerves that come from your spinal cord and control muscle movements and sensation in your shoulder, arm and hand

Answer 25

neurological thoracic outlet syndrome

Question 26

This type occurs when one or more of the arteries and veins under the clavicle (subclavian vessels) are compressed.

Answer 26

vascular thoracic outlet syndrome

Question 27

what are the neurological signs of thoracic outlet syndrome

Answer 27

1. numbness or tingling in fingers 2. pain in shoulder or neck 3. ache in arm or hand 4. weakening grip

Question 28

what are the vascular signs of thoracic outlet syndrome

Answer 28

1. Discoloration of your hand (bluish color) 2. Subclavian vein thrombosis 3. Arm pain and swelling 4. Throbbing lump near your collarbone 5. Lack of color (pallor) in one or more of your fingers or your entire hand 6. Tiny black spots (infarcts) on your fingers

Question 29

thrombosis is caused from a ___, it causing pain and swelling and is typically in a ____

Answer 29

clot, vein

Question 30

what are 2 thoracic outlet syndrome risk factors

Answer 30

1. Repetitive and forceful Reaching above shoulder level with or without heavy objects (arms above head, decrease blood flow, decrease stroke volume, numbness and weakness) 2. Prolonged incorrect seated posture

Question 31

what a can we do to decrease risk of thoracic out syndrome

Answer 31

strengthening, change position, reduce work load, stretch to create space

Question 32

7 thoracic outlet syndrome rehab exercises

Answer 32

1. scalene stretch 2. pectoralis stretch 3. scapular squeeze 4. arm and side on wall 5. thoracic extension 6. rowing exercise 7. mid trap exercise

Question 33

what is raynaud's syndrome

Answer 33

is when blood vessels of the hand are damaged (narrowed). This results in Abnormal nerve control of the blood-vessel diameter and nerve sensitivity to cold exposure.

Question 34

in raynauds syndrome what is the color change in part related to?

Answer 34

initial blood-vessel narrowing due to spasm of the tiny muscles in the wall of the vessels, followed by sudden opening (dilation)

Question 35

2 symptoms of raynauds

Answer 35

1. Numbness and tingling in the fingers | 2. Blanching (whitening) of one or more fingertips because of a temporary constriction of blood flow

Question 36

treatment of raynauds

Answer 36

is none - increasing blood flow to areas does not help too much - some ppl respond to vasodilators

Question 37

raynauds occupational risk factors

Answer 37

vibrating tools, such as hair clippers and jack hammers | hedge trimmers, chainsaw, hammering

Question 38

6 upper extremity tendon disorders

Answer 38

1. rotator cuff syndrome 2. tendinitis - irritation of the tendon 3. ganglion cyst - accumulation of fluid within the tendon sheath 4. tenosynovitis- irritation of the synovial sheath 5. dequervains disease - combo of tendinitis and tenosynovitis 6. trigger finger or thumb- tendon movement problems

Question 39

what is rotator cuff syndrome

Answer 39

is a disorder involving swelling and pain of tendons comprising the rotator cuff muscle group: subscapularis, supraspinatus, infraspinatus, & teres minor

Question 40

symptoms of rotator cuff syndrome

Answer 40

1. Pain when you bend the arm and   rotate it outwards against resistance 2. Pain on the outside of the shoulder possibly radiating down into the arm 3. Pain in the shoulder, which is worse at night 4. Stiffness in the shoulder joint.

Question 41

injury to nay muscles of the rotator cuff is considered?

Answer 41

rotator cuff syndrome

Question 42

what is the most common cause of tear of rotator cuff

Answer 42

external rotation

Question 43

what is normal for external rotation strength

Answer 43

10-15lbs (a little more for internal rotation)

Question 44

rehab for rotator cuff syndrome

Answer 44

do exercises that strengthen rotator cuff muscles

Question 45

tendinitis= tendinosis= both = tendinopathy

Answer 45

- acute response to an injury | - accumulated injuries that don't want to heal

Question 46

inflammation of a tendon which is caused by the straining, or tearing of the tendon fibers

Answer 46

tendonitis

Question 47

chronic injury caused by an accumulation of small tears in the tendon that have failed to heal properly overtime

Answer 47

tendinosis

Question 48

tennis elbow = | golfers elbow =

Answer 48

- lateral epicondylitis | - medial epicondylitis

Question 49

4 symptoms of tendinitis

Answer 49

- point tenderness - swelling - tennis elbow, pain radiates down back oh hand - golfers elbow, pain radiates down back of hand

Question 50

a condition that results in deterioration of the tendon fibers that attach to the bone at the outside of the elbow.

Answer 50

lateral epicondylitis

Question 51

signs and symptoms of lateral epicondylitis

Answer 51

pain occurring where the tendons of the forearm muscle attach to the elbow bone at the lateral epicondyle

Question 52

2 risk factors of lateral epicondilitis

Answer 52

1. repeated use of forearm muscles 2. chronic stress to the forearm muscles, especially the Extensor Carpi Radialis Brevis. Activities such as meat cutting, hammering, screw driving, plumbing, painting, and weight lifting require steady powerful grasping and gripping movements. using a keyboard places the hand in a raised position for a prolonged length of time.