Musculoskeletal Flashcards
type of amputation that occurs across a joint
disarticulation; Symes amputation
PAMS used to promote wound healing for an amputation
whirlpool and massage
how to promote desensitization of a residual limb
weight bearing, massage, tapping, and rubbing
WC characteristics required for a LE amputation
large rear wheels further back and anti-tippers
a realistic nonfunctional hand worn for cosmetic purposes
passive terminal device
body-powered, externally powered, or hybrid-powered hook or realistic-looking hand that assists with functional activities
active terminal device
a ________ is more functional than a _________ because of it’s greater precision, greater visibility of objects being grasped, lesser weight, lower cost, greater reliability, and ability to fit into close quarters
hook; hand
to use a ___________ device, a patient must have 2 superficial muscle sites that can fit within the prosthesis socket with sufficient EMG signals to power the hand
myoelectric device
wearing schedule for a prosthesis should start at _________ minutes then increase in ___________ increments a day if no redness is reported after 20 minutes, until the prosthesis is worn for a full day
15-30
15-30
training on the operation of each component of an upper limb prosthesis
prosthesis control training
training in the integration of prosthesis components for efficient assist during functional use
prosthesis use training
training in the identification of optimal position of each positioning unit to perform an activity or grasp an object
prepositioning training
training in terminal device control during grasp activities
prehension training
training in control and use of the prosthesis during functional activities; incorporates the terminal device and focuses on problem solving
functional training
goal of functional treatment for LE amputations
transfers, bed mobility, WC mobility
3 steps in the treatment of contractures
(1) superficial and deep heat to increase tissue extensibility (2) slow stretch (3) static splinting
splint commonly used for clients with rheumatoid arthritis or cerebral alsy to increase functional use of the hand
soft neoprene splint
diagnosis for fibromyalgia
tenderness in at least 11 of 18 trigger points on the body
evaluation method for fibromyalgia
daily activity log
cognitive aspect of fibromyalgia and treatment method
inability to think clearly; memory aids
a _________ is most commonly used to restore hip joint motion and pain, after other forms of treatment such as _________ have proved ineffective
hip replacement/arthroplasty
cortisone injections
precautions associated with a posterolateral approach to hip replacement
no hip flexion greater than 90°
no internal rotation
no adduction
precautions associated with an anterolateral approach to hip replacement
no external rotation
no extension
to adduction
out of bed activity should occur ___________ post operation for a hip replacement
1-3 days
low back pain where the nerve is trapped by a herniated disk
sciatic pain
low back pain where there is a narrowing of the intervertebral foramen
spinal stenosis
low back pain where there is inflammation or changes of the spinal joints
facet joint pain
low back pain where there is a stress fracture of the dorsal to the transverse process
spondylosis
low back pain where there is a slippage of a vertebra out of position
spondyloisthesis
low back pain where there is stress tearing of the fibers of a disc, causing an outward bulge pressing on spinal nerves
herniated nucleus pulposus
standards of body mechanics (9)
maintain a straight back bend from the hip avoid twisting maintain good posture carry loads close to the body lift with the legs lift with a wide base of support lift in sagittal plane lift slowly
type of lift that is safest for the back and ideal for heavy loads
semisquat
type of lift used when space is limited and often preferred by people with low back pain
squat
type of lift used only for light loads (<20 lbs)
stoop lift
type of lift recommended for an individual with low back pain to get clothing out of the washer
golfers lift; lifting the leg opposite the arm used in reach
precautions for chemotherapy (5)
use of mask due to compromised immunity restricted diet due to yeast infection in mouth screen anxiety/depression/fatigue extra care to avoid dropping things monitor for excess bleeding
precautions for radiation (2)
maintain joint ROM avoiding burned skin
water based ointments
surgery precautions for cancer (2)
no bathing until staples/sutures removed
prevent dependent edema
side effects and precautions of hormone therapy for cancer
side effects: menopause symptoms, hot flashes, mood swings
precautions: monitor room temperature and client mood
side effects and precautions of immunotherapy
side effects: heightened/blocked immune system and skin welts
precautions: avoid scratching skin
occupational assessments useful for cancer
COPM
Occupational Performance History Interview
assessment to describe activities that cause fatigue after a cancer diagnosis
brief fatigue inventory
assessment to determine multisymptom client reported outcomes
M.S. Anderson Symptom Inventory
general quality of life assessment for cancer patients
functional assessment of cancer therapy-general (FACIT)
most common joint disorder; non inflammatory condition that causes a breakdown in articular cartilage as a result of mechanical and chemical factors resulting in reduced joint space and eventually painful bone on bone contact
osteoarthritis
osteophytes or bone spur that develops on the edge of the PIP joint with osteoarthritis
bouchard’s node
osteophytes or bone spur that develops on the edge of the DIP joint with osteoarthritis
Herberden’s node
patients with osteoarthritis should be screened for
cognitive and psychosocial deficits
total knee replacement precautions (4)
no pillows under the knee in bed
rest feet on floor when sitting (increase ROM)
wear immobilizer as instructed
avoid kneeling, squatting, twisting knee
PAM used to reduce pain and increase ROM for osteoarthritis
superficial heat modalities
ROM exercises encouraged for osteoarthritis
AROM
PROM only if AROM precluded
which exercises may be contraindicated for CMC osteoarthritis
pinch exercises
type of spline prescribed to provide stability to the CMC joint during pinching for osteoarthritis
spice splint
progressive condition characterized by low bone mass or density and deterioration leading to bone fragility and pathological fracture particularly on weight bearing bones
osteoporosis
reversible weakening of the bone and is a precursor to osteoporosis
osteopenia
back deformity associated with osteoporosis
kyphosis
secondary complications of kyphosis
difficulty breathing and problems with swallowing
chronic systemic inflammatory condition that is a progressive synovitis of the diarthrodial joints
rheumatoid arthritis
juvenile rheumatoid arthritis can develop between the ages of ______ and _______
1 and 6
where do secondary extra-articular complications occur in rheumatoid arthritis (6)
cardiovascular ocular respiratory gastrointestinal renal neurological systems
presentation of rheumatoid arthritis where the most commonly affected joints are the PIP joints, MCP joints, all thumb joints, wrist, elbow, ankle, MTP joints, temporomandibular, hip, knee, shoulder, and cervical spine
symmetric polyarticular presentation
deformity characterized by very floppy joints with shortened bones and redundant skin; caused by reabsorption of bone ends; most common in MCP, PIP, radiocarpal, or radioulnar joints
mutilans deformity
describe ulnar drift or zig zag deformity
radial deviation of wrist and ulnar deviation of MCP joints
hyperextension of the MTP and flexion of the PIP and DIP
claw toe
hyperextension of the MRP and flexion of the PIP and hyperextension of the DIP
hammer toe
subluxation of the metatarsal heads
cock up toe
fibular deviation of the first toe
hallux valgus or bunion
stage of RA characterized by pain and tenderness at rest that increased with movement; there is limited ROM, overall stiffness, gel phenomenon, weakness, tingling/numbness, hot/red joints, cold/sweaty hands, low endurance, weight loss, decreased appetite, fever
acute stage
stage of RA characterized by reduced pain and tenderness, morning stiffness, limited movement, tingling/numbness, pink/warm joints, low endurance, weakness, gel phenomenon, weight loss, decreased appetite, mild fever
subacute stage
stage of RA characterized by low-grade inflammation, decreased ROM, less tingling, pain and tenderness primarily with movement, and low endurance
chronic-active stage
stage of RA characterized by no signs of inflammation, low endurance, pain from stiff/weak joints, morning stiffness as a result of disuse, limited ROM, weaness/muscle atrophy, contractures
chronic-inactive stage
RA progression with no destructive changes on X ray with possible presence of osteoporosis
stage I, early
RA progression with radiographic evidence of osteoporosis, possible subchondral bone destruction and presence of cartilage destruction, no joint deformity (may be limited ROM), adjacent muscle atrophy, possible presence of extra-articular soft tissue lesions
stage II, moderate
RA progression with radiographic evidence of osteoporosis, cartilage and bone destruction, joint deformity, extensive muscle atrophy, possible presence of extra-articular soft-tissue lesions
stage III, severe
RA progression with fibrous or bone ankylosis in addition to severe signs
stage IV, terminal
ROM exercises appropriate during acute flare up of RA to prevent stress on inflamed joints
PROM
strengthening exercises appropriate during acute flare ups of RA
isometric exercises with pain free exertion
bone of the hand and wrist from distal to proximal and ulnar to radial side
distal: hamate, capitate, trapezoid, trapezium
proximal: pisiform, lunate, triquetrum, scaphoid
large muscles that originate from the lateral epicondyle
aconeous
brachioradialis
supinator
large muscle that originates from the medial epicondyle
pronator teres
main arteries supplying blood to the hand and wrist
radial and ulnar arteries
main arteries supplying the forearm and upper arm
brachial and brachiocephalic arteries
large muscles of the forearm and upper arm (7)
deltoid triceps aconeus biceps brachii brachialis brachioradialis
sensory receptor in the hand responsible for vibration
pacinian corpuscles
sensory receptor in the hand responsible for tension
ruffini end organs
sensory receptor in the hand responsible for pressure
Merkel cells
Allen’s test is used to assess
vascular function
Semmes-Weinstein monofilament testing is typically use for
nerve compression
two-point discrimination is typically used for
nerve laceration
outcome measure for UE dysfunction
quick disabilities of the arm, shoulder, and hand questionnaire (Quick DASH)
the most common carpal fracture seen and missed in injuries to the wrist can lead to poor blood supply and become necrotic
scaphoid fracture
fractures of the _______ are assosciated with Keinbocks disease (no blood suppply)
lunate fracture
injury that occurs when the tendon separates from the bone and its insertion and removes bone material with the tendon
avulsion injury
avulsion of the terminal tendon and treatment
mallet finger
splint in full extension for 6 weeks
disruption of the central slip of extensor tendon characterized by PIP flexion and DIP hyperextension and treatment
boutonniere deformity
PIP splinted in extension with isolated DIP flexion exercises
injury to the MCP, PIP, or DIP joint characterized by PIP hyperextension and DIP flexion and treatment
swan neck deformity
PIP splinted in slight flexioin
3 common phases of fracture healing
inflammation
repair (callus/stabilization)
remodeling (deposits bone)
PAMS for pain relief and tissue healing
heat ultrasound cryotherapy parrafin TENS
when does controlled AROM being after a hand fracture if the fixation is stable
3-6 weeks
complete fracture of the distal radius with dorsal displacement; most common type of wrist fracture
colles fracture
complete fracture of the distal radius with palmar displacement
smith’s fracture
fracture of the first metacarpal base
Bennet’s fracture
primary treatment for CRPS
stress loading
how can a type I non displaced radial head fracture be treated
long arm splint
how can a type II single fragment displacement of a radial head fracture be treated
nonoperative with immobilization for 2-3 weeks
early motion with medical clearance
how can a type III comminuted radial head fracture be treated
operatively with immobilization and early motion within first postoperative week as medically prescribed (cast)
what kind of orthotic can be used for a non displace proximal humeral fracture
humeral fracture brace
when can ROM begin for a non operative proximal humeral fracture as medically prescribed
2 weeks
an aggressive stretching ROM protocol can being how long after the fracture as prescribed by the physician
4-6 weeks
how long is a sling used for comfort and sleeping as needed at home for a proximal humeral fracture
6 weeks
CRPS developed after a noxious event
Type I CRPS
CRPS developed after a nerve injury
Type II CRPS
sensation misinterpreted as pain
allodynia
increased response to painful stimuli
hyperalgia
pain that continues after the stimuli is removed
hyperpathia
PAMS indicated for CRPS
TENS (pain), contrast baths (edema), fluidotherapy (desensitization)
description of cumulative trauma disorder characterized by pain after activity that resolves quickly
grade I
description of cumulative trauma disorder characterized by pain during activity that resolves when the activity is stopped
grade II
description of cumulative trauma disorder characterized by pain that persists after activity, affects work productivity, and includes objective weakness and sensory loss
grade III
description of cumulative trauma disorder characterized by use of extremity resulting in pain up to 75% of the time with work being limited
grade IV
description of cumulative trauma disorder characterized by unrelenting pain and inability to work
grade V
goal of acute intervention for cumulative trauma disorders
reduce pain and inflammation
center the extensor tendons over the MCP joint
sagittal bands
when can modalities be used for extensor tendon repair
once cleared by the prescribing physician
when is strengthening typically initiated after a tendon repair
8-12 weeks after surgery
describe flexor zone I
fingertip to center of middle phalanx
describe flexor zone II
middle phalanx to distal palmar crease
no mans land
why is flexor zone II referred to as no mans land
difficulty of tendon gliding without scarring surrounding tissues
describe flexor zone III
distal palmar crease to transverse carpal ligament
describe flexor zone IV
lies over the transverse carpal ligament
describe flexor zone V
extends beyond the wrist
protocol for flexor injuries that calls for an early passive ROM program
Duran protocol
protocol for flexor injuries that calls for active extension of digits with passive flexion via traction (rubber band)
Kleinert protocol
when does an early active motion protocol begin for flexor tendon injuries to prevent adhesion and promote tendon gliding and excursion
within days of surgery
protocol used for patients who are unable to care for themselves and do not have the cognitive capacity to ensure safety postoperatively for a flexor tendon injury; sometimes used with children; length
immobilization protocol; 6 weeks
what kind of splint is used for a flexor tendon repair to prevent rupture
dorsal blocking splint with wrist flexed 30° and MCPs flexed 60°
when is a repaired tendon at its weakest
10 to 12 days
what modality is used to promote tendon excursion and activation after a tendon injury
neuromuscular electrical stimulation (NMES)
describe the sequence of tendon glides used to promote full tendon excursion, full ROM, and prevent adhesion
finger straight
MCPs flexed
hook fist
flat fist
protocol for operative treatment of a radial nerve injury
static wrist extension splint (30°) 4 weeks
after 4 weeks, adjust splint to 10-20°
non operative treatment of radial tunnel syndrome
long arm splint: elbow flexion, supination, neutral wrist (2 weeks) wrist cock up, A/P pronation/supination (2 more weeks) hand strengthening (3 weeks) resistive exercises (6 weeks)
syndrome resulting in motor loss of flexor digitorum longus, flexor profundus to the index finger, and pronator quadratus
anterior interosseous syndrome
non operative treatment of pronator syndrome
elbow splinted in 90-100° flexion with neutral forearm
gentle prolonged stretching
operative treatment of pronator syndrome
half cast with AROM of UE joints with cast
muscle strengthening after 1 week
full AROM in 8 weeks
non operative median nerve treatment
static thenar web spacer splint
operative median nerve treatment
dorsal wrist blocking splint (4-6 weeks)
AROM/PROM for digits, tendon glides, scar massage
d/c splint after 6 weeks and start strengthening
occurs when a peripheral nerve is entrapped in more than one location
double crush syndrome
how long should the phalens test be administered to assess for carpal tunnel syndrome while looking for changes in sensation
1 minute
timed test involving picking up, holding, manipulation, and identifying small objects; used with children and cognitively impaired adults to test median nerve function
Moberg PickupTest
when should AROM of the wrist, thumb, and fingers be initiated after carpal tunnel surgery
1-2 days
when can strengthening begin after carpal tunnel surgery
3-6 weeks
nerve disorder characterized by decreased grip and pinch due to weak interossei, adductor pollicus, and flexor carpi ulnaris
cubital tunnel syndrome
flexion of the IP of the thumb when a lateral pinch is attempted
Froment’s sign
5th finger held abducted from the 4th finger
wartenberg’s sign
the elbow flexion test where the elbow is flexed for 5 minutes with the wrist in neutral is used to elicit symptoms to test for what type of nerve injury
cuibtal tunnel syndrome
non operative treatment of cubital tunnel syndrome
elbow splint in 30-60° flexion for 3 weeks
operative treatment of cubital tunnel syndrome
protection phase (1 day-3 weeks): elbow flexion splint 70-90° active phase (3 weeks): d/c splint, elbow AROM
progression of elbow AROM for operative cubital tunnel syndrome
pronation
supination
wrist ROM with elbow flexed
wrist ROM with elbow extended
non operative treatment of de Quervain syndrome
forearm based thumb spica: wrist neutral thumb radially abducted (3 weeks)
after 3 weeks: soft splint and isometric exercise
operative treatment of de Quervain syndrome
forearm based thumb spice: wrist 20° extended thumb radially abducted (3 weeks)
grip/pinch strengthening: 2 weeks
result of distal ulnar nerve compression
claw deformity
if sensory loss is present on the dorsal side of the hand injury with a claw deformity, the injury is ______to the Guyon’s canal
proximal
hyperextension of the thumb MCP
Jeanne’s sign
non operative treatment of claw deformity
ulnar nerve palsy/anticlaw splint with dynamic PIP extension
padded antivibration glove
operative treatment of claw deformity
bulky dressing: 3-10 days
dorsal blocking splint: 20-30° wrist flexion and MCP block to 45° extension (adjust at 3-6 weeks to bring wrist to neutral)
d/c splint after 6 weeks
AROM at 6 weeks
sensory reeducation at 10-12 weeks (once protective sensation returned)
non operative treatment of digital stenosing tenosynovitis (trigger finger)
splint MCP at 0° for 3-6 weeks
gentle PIP ROM x 20 every 2 hours
operative treatment of digital stenosing tenosynovitis (trigger finger)
surgical release of A1 pully
educating a client to visually compensate for sensory loss to and to avoid working with machinery at temperatures below 60°
protective reeducation
educating a client to use motivation and repetition in a vision-tactile matching process in which clients identify objects with and without vision
discriminative reeducation
applying different textures and tactile stimulation to reeducation the nervous system so clients can tolerate sensations during functional use of the UE
desensitization
describe the process of sensory recovery
pain perception
vibration of 30 cycles per second
moving touch
constant touch
cryotherapy (cold therapy) contraindications
impaired circulation peripheral vascular disease hypersensitivity to col open wounds infections
thermotherapy (warm therapy) contraindications
acute inflammation edema sensory impairment cancer blood clots infection cardiac problems impaired cognition
use of ultrasound to promote absorption of topically applied medication to accelerate tissue repair and decrease inflammation
phonophoresis
contraindications for ultrasound
pregnancy over eyes pacemaker bleeding infections cance over blod clots over growth plate of bones in children
precautions for ultrasound
inflammation
fractures
breast implants
clients with cognitive/language/sensory impairments
electrical stimulation that promote wound healing, muscle mass maintenance, ROM, decreased edema, voluntary motor control, decreased spasms and spasticity and as an orthotic substitute
NMES
electrical stimulation that primarily controls pain through 3 possible mechanisms: gate control, endorphin release, and acupuncture
TENS
electrical stimulation that decreases inflammation and controls pain
iontophoresis
contraindications for electrical stimulation
do not use over pacemarkers, carotid sinus, pregnant uterus, eyes
clients with epilepsy, cancer, infection, decrease sensation, cardiac disease, stroke
precaution for iontophoresis
be aware of drug allergies
contraindications for laser/light therapy
protective eye wear
do not use over vagus nerve, pregnant uterus, eyes, infection, endocrine glands, cancer
describe the position of a resting hand splint
wrist: 20-30° extension
thumb: 45° palmar abduction
MCPs: 35-45° flexion
PIP/DIP: slight flexion
describe the position of the antideformity resting hand splint
wrist: 30-40° extension
thumb: 45° palmar abduction
MCPs: 70-90° flexion
PIP/DIP: full extension
ball of cone antispasticity splints involve _______ of the wrist
serial casting
splint position for carpal tunnel syndrome
10° extension or neutral
splint position for ulnar nerve at the wrist
block 4th and 5th MCPs to 30-45° flexion to prevent hyperextension
splint position for anterior interosseous syndrome
forearm neutral, elbow flexed 90°
splint position for radial tunnel syndrome
wrist: 30° extension
forearm supinated
elbow: 90° flexion
dynamic splint conditions for correcting contractures
mechanical stretch of prolonged gentle pull over 8-12 hours
wound is closed with sutures
primary wound closure
wound is left open and allowed to close on its own
secondary wound closure
wound is cleaned, derided, and observed 4-5 days before suturing it closed
delayed primary
progression of wound healing phases
inflammatory
proliferative
remodeling
how long does the acute phase and subacute phase of the inflammation stages of wound healing last
acute: 24/48 hours - 7 days
subacute: 7-14 days
stage of wound healing where lactic and ascorbic acid stimulate fibroblasts to synthesized collagen, and cross linkage of collage increases the tensile strength of repaired skin to 80%; how long does it last
proliferative phase (fibroplastic, granulation, epithelialization) 5 days - 2/3 weeks
resurfaces the wound
epithelialization
forms new collagen and blood vesels
granulation
which wounds heal quickest to slowest
linear
rectangular
circular
how long does the remodeling phase of wound healing last
2 weeks - 1/2 years
when do hypertrophic/keloid scars form
when collagen synthesis exceeds collagen lysis
full ROM against gravity with moderate resistance
4
full ROM against gravity with less than moderate resistance
4-
full ROM against gravity with minimum resistance
3+
full ROM against gravity with no resistance
3
less than full ROM against gravity
3-
full ROM in gravity eliminated with minimal resistance
2+
full ROM in gravity eliminated with no resistance
2
less than full ROM in gravity eliminated
2-
acute edema is considered
pitting
chronic edema is considered
brawny
method for measuring edema of the hands
figure of 8 method
significant change in edema would be
> 10 mm
recognition of touch by common objects
stereognosis
normal 2 point moving discrimination for the hands
2 mm
dermatome location; muscles; function for CN V
anterior facial region
mastication
ingestion
dermatome location; muscles; function for C3
neck region
sternocleidomastoid/upper trapezius
head control
dermatome location; muscles; function for C4
upper shoulder region
trapezius (diaphragm)
head control
dermatome location; muscles; function for C5
lateral aspect of shoulder
deltoid/biceps/ rhomboids
elbow flexion
dermatome location; muscles; function for C6
thumb and radial forearm
extensor carpi radialis/biceps
shoulder abduction/wrist extension
dermatome location; muscles; function for C7
middle finger
triceps and wrist/finger extensors
wrist flexion/finger extension
dermatome location; muscles; function for C8
little finger/ulnar forearm
wrist/finger flexors
C8 finger flexion
dermatome location; muscles; function for T1
axilla and proximal medial forearm
hand intrinsics
finger abduction/adduction
dermatome location; muscles; function for T2-T12
thorax
intercostals
respiration
dermatome location; muscles; function for T4-T6
nipple line
intercostals
respiration
dermatome location; muscles; function for T11
mid chest region/lower rib
abdominal wall/muscles
T5-T7 superficial abdominal reflex
dermatome location; muscles; function for T10
umbilicus
psoas, iliacus
leg flexion
dermatome location; muscles; function for L1-L2
inside of thigh
cremastueric reflex/accessory muscles
scrotum elevation
dermatome location; muscles; function for L2
proximal anterior thigh
iliopsoas, thigh adductors
reflex voiding
dermatome location; muscles; function for L3-L4
anterior knee
quadriceps, tibialis anterior, detrusor urinae
hip flexion, knee extension, thigh abduction
dermatome location; muscles; function for L5
great toe
lateral hamstrings
knee flexion, toe extension
dermatome location; muscles; function for L5-S1
foot region
gastrocnemius, soleus, extensor digitorum longus
flexor withdrawal/urinary retention
dermatome location; muscles; function for
narrow band of posterior thigh
small muscles of foot (flexor digitorum/hallucis)
bladder retention
test of hand function including 7 subtests with score based on time (writing, page turning, picking up objects, simulated feeding, stacking, picking up large objects, picking up heavy objects)
Jebsen-Taylor Hand Function Test
assessment of client perception of unilateral and bilateral functional activity; includes pain perception, ability to participate, and appearance
Michigan Hand Outcome Questionnaire
describe differential tendon gliding exercises
straight hook first fist table top straight fist
overstretching can sometimes result in
heteroptrophic ossificans
what kind of strengthening is contraindicated for an individual with hypertension and cardiovascular issues
isometrics
for what condition would you want to avoid extreme elevated positioning above the heart
R sided heart weakness- fluid can empty into heart too fast
contraindications for contrast bath
infections vascular/circulation damage blood clots unstable fractures CHF cardiac edema
what kind of splint should be used for a brachial plexus injury
flail arm splint for positioning
what kind of splint would you use for a combined median and ulnar nerve injury
figure of 8 splint or lumbrical bar
splint for ulnar collateral ligament (UCL)/skiers thumb injury
hand-based thumb splint
continuous ultrasound has _______properties
thermal
pulsed ultrasound has _________properties
non-thermal
which muscles are responsible for finger adduction (and innervation)
palmar interossei; ulnar nn
which muscles are responsible for finger abduction (and innervation)
dorsal interossei; ulnar nn
what are the lumbricals responsible for (and innervation)
MCP flexion and IP extension
D2-D3: median
D4-D5: ulnar
what innervates the flexor digitorum profundus and what is it responsible for
median nerve: DIP flexion D2/D3
ulnar nerve: DIP flexion D4/D5
what nerve is responsible for forearm pronation
median nn
what nerve is responsible for forearm supination
radial nn
what is the difference between the function of the biceps and brachialis (and what innervates them)
biceps: elbow flexion with supinated forearm
brachialis: elbow flexion with pronated forearm
musculocutaneous nn
what innervates the brachioradialis
radial nn
what is the aconeus responsible for
elbow extension
what are the 4 rotator cuff muscles and what are their functions
subscapularis: internal rotation
supraspinatus: abduction/flexion
infraspinaturs: external rotation
teres minor: external rotation
what muscles flex the shoulder
anterior deltoid
coracobrachialis
supraspinatus
what muscles abduct the shoulder
middle deltoid
supraspinatus
what muscles horizontally abduct the shoulder
posterior deltoid
what muscles horizontally adduct the shoulders
pectoralis major
what muscles extend the shoulder
latissimus dorsi
teres major
posterior deltoid
what muscles upwardly rotate the scapula
trapezius (CN XI), serrratus anterior
what muscles downwardly rotate the scapula
levator scapulae (C4-C4), rhomboids, serratus anterior, latissimus dorsi
what muscles adduct the scapula
middle trapezius and rhomboid major
what muscles abduct the scapula
serratus anterior
what muscles elevate the scapula
upper trapezius and levator scapulae
what muscles depress the scapula
lower trapezius
splint for Dupytren’s disease
hand based extension splint worn at all times except for ROM and bathing (ideally full extension)
functional treatment for Dupytren’s disease
occupations that emphasize flexion (grip) and extension (release)
conservative treatment of skier thumb
splint 4-6 weeks
AROM/pinch strength at 6 weeks
post-operative treatment for skiers thumb
thumb splint 6 weeks
AROM
PROM week 8
strengthening week 10
can be seen with a high median nerve injury when asked to make a fist
sign of benediction
partial head replacement of femoral head
Austin Moore
what is the most commonly used medication for iontophoresis due to it’s antiinflammatory properties
dexamethasone
if a tendon injury is proximal to the juncturae tendinum, what fingers need to be included in the splint
forearm based with middle, ring, and index
at what point should iontophoresis be discontinued
after 4-6 visits if 50% relief is not obtained
