MSI (part 1) Flashcards
what is your carpel tunnel?
a passageway in the wrist through which nerves (median) and the flexor muscles of the hand pass through
what is carpel tunnel syndrome?
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
3 symptoms of carpel tunnel syndrome
- pain in first 3 fingers and the thumb
- numbness in these areas
- tingling in these areas
4 risk factors for carpel tunnel syndrome
- job tasks that require a combo of repetitive, forceful and awkward or stressed motions of the hands and wrists
- awkward joint position, direct pressure to the ligaments and bones, high force, vibration
- could be born with smaller carpal tunnels
- repetitive movements during assembly line work, wrist injury or swelling due to certain diseases, such as rheumatoid arthritis
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
- 46, 51
- 15, 25
- 5 to 10
10 strategies for carpel tunnel rehab
- wrist ROM
- wrist stretch (extension)
- Mid-trap exercise (superman with arms to side)
- pec stretch
- scalene stretch
- thoracic extension
- scapular squeeze
- wrist extension
- grip strengthening
- massage
what is the cubital tunnel?
a channel which allows the ulnar nerve (commonly known as the ‘funny bone’) to travel over the elbow
what is cubital tunnel syndrome?
the ulnar nerve, which feeds the the ring and little finger, can become impaired from pressure near the elbows
2 symptoms of cubital tunnel syndrome
- numbness and paresthesia along the ulnar nerve distribution (ring and little finger) and elbow pain
- 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)
3 risk factors for cubital tunnel syndrome
- jobs that involve resting the elbows on the hard surface such as unpadded tables or armrests
- repetitive bending and straightening of the arm
- awkward joint posture, direct pressure to the ligaments and bones, high force, vibration
what do you do for cubital tunnel syndrome rehab?
- 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
CPS due to awkward wrist posture
problem: wrist dorsiflexion
solution: ?
negative tray tilt
CPS due to awkward wrist posture
problem: wrist palmar flexion
solution: ?
adjustable height tray table
CPS due to awkward wrist posture
problem: wrist ulnar deviation
solution: ?
split keyboard
CPS due to awkward wrist posture
problem: excessive use
solution: ?
frequent breaks, wrist exercises
cubital tunnel syndrome due to repetitive and sustained elbow flexion
problem: key board or mouse too high
solution: ?
drop - down tray , higher seat
cubital tunnel syndrome due to repetitive and sustained elbow flexion
problem: handheld telephone
solution: ?
speakerphone, headset
cubital tunnel syndrome due to repetitive and sustained elbow flexion
problem: handheld dictation microphone
solution: ?
headset with voice recognition software
cubital tunnel syndrome due to repetitive and sustained elbow flexion
problem: ulnar nerve direct truama
solution: ?
adjustable - height armrests, padded armrests
what is the thoracic outlet
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.
what is thoracic outlet syndrome
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
when is thoracic outlet syndrome most likely to happen
when flexion of arm at shoulder, scapula upward rotated, and ribs elevated
- also horizontal abduction and internal rotation
- causes irritation of the brachial plexus
what 2 movements of the arm are ‘safe’ for working postures
- 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
what are the 2 types of thoracic outlet syndrome
- neurological thoracic outlet syndrome
2. vascular thoracic outlet syndrome
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
neurological thoracic outlet syndrome
This type occurs when one or more of the arteries and veins under the clavicle (subclavian vessels) are compressed.
vascular thoracic outlet syndrome
what are the neurological signs of thoracic outlet syndrome
- numbness or tingling in fingers
- pain in shoulder or neck
- ache in arm or hand
- weakening grip
what are the vascular signs of thoracic outlet syndrome
- Discoloration of your hand (bluish color)
- Subclavian vein thrombosis 3. Arm pain and swelling
- Throbbing lump near your collarbone
- Lack of color (pallor) in one or more of your fingers or your entire hand
- Tiny black spots (infarcts) on your fingers
thrombosis is caused from a ___, it causing pain and swelling and is typically in a ____
clot, vein
what are 2 thoracic outlet syndrome risk factors
- Repetitive and forceful Reaching above shoulder level with or without heavy objects (arms above head, decrease blood flow, decrease stroke volume, numbness and weakness)
- Prolonged incorrect seated posture
what a can we do to decrease risk of thoracic out syndrome
strengthening, change position, reduce work load, stretch to create space
7 thoracic outlet syndrome rehab exercises
- scalene stretch
- pectoralis stretch
- scapular squeeze
- arm and side on wall
- thoracic extension
- rowing exercise
- mid trap exercise
what is raynaud’s syndrome
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.
in raynauds syndrome what is the color change in part related to?
initial blood-vessel narrowing due to spasm of the tiny muscles in the wall of the vessels, followed by sudden opening (dilation)
2 symptoms of raynauds
- Numbness and tingling in the fingers
2. Blanching (whitening) of one or more fingertips because of a temporary constriction of blood flow
treatment of raynauds
is none
- increasing blood flow to areas does not help too much
- some ppl respond to vasodilators
raynauds occupational risk factors
vibrating tools, such as hair clippers and jack hammers
hedge trimmers, chainsaw, hammering
6 upper extremity tendon disorders
- rotator cuff syndrome
- tendinitis - irritation of the tendon
- ganglion cyst - accumulation of fluid within the tendon sheath
- tenosynovitis- irritation of the synovial sheath
- dequervains disease - combo of tendinitis and tenosynovitis
- trigger finger or thumb- tendon movement problems
what is rotator cuff syndrome
is a disorder involving swelling and pain of tendons comprising the rotator cuff muscle group: subscapularis, supraspinatus, infraspinatus, & teres minor
symptoms of rotator cuff syndrome
- Pain when you bend the arm and rotate it outwards against resistance
- Pain on the outside of the shoulder possibly radiating down into the arm
- Pain in the shoulder, which is worse at night
- Stiffness in the shoulder joint.
injury to nay muscles of the rotator cuff is considered?
rotator cuff syndrome
what is the most common cause of tear of rotator cuff
external rotation
what is normal for external rotation strength
10-15lbs (a little more for internal rotation)
rehab for rotator cuff syndrome
do exercises that strengthen rotator cuff muscles
tendinitis=
tendinosis=
both = tendinopathy
- acute response to an injury
- accumulated injuries that don’t want to heal
inflammation of a tendon which is caused by the straining, or tearing of the tendon fibers
tendonitis
chronic injury caused by an accumulation of small tears in the tendon that have failed to heal properly overtime
tendinosis
tennis elbow =
golfers elbow =
- lateral epicondylitis
- medial epicondylitis
4 symptoms of tendinitis
- point tenderness
- swelling
- tennis elbow, pain radiates down back oh hand
- golfers elbow, pain radiates down back of hand
a condition that results in deterioration of the tendon fibers that attach to the bone at the outside of the elbow.
lateral epicondylitis
signs and symptoms of lateral epicondylitis
pain occurring where the tendons of the forearm muscle attach to the elbow bone at the lateral epicondyle
2 risk factors of lateral epicondilitis
- repeated use of forearm muscles
- 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.
