Musculoskeletal Part Ten Flashcards
Active Compression
- what’s it for
- position
- positive result
- labral tear (GH)/AC lesion
- active 90 flexion and 10 ADD.. arm actively IR so thumb is pointing down.. PT applies inferior directed force first with thumb pointing down and a second force with thumb pointing up
- AC - pain with thumb pointing down, decrease pain with thumb pointing up
Labral - clicking in joint with thumb pointed down, no pain with thumb up
osteoporosis predisposes the individual to
fracture
Roos Test
- what’s it for
- position
- positive result
- TOS
- patient stands, shoulders fully ER, 90 ABD, elbows flexed 90, patient opens/closes hand for 3 minutes
- disappearance of pulse
Drop Arm Test
- what’s it for
- position
- positive result
- tear/full rupture of rotator cuff
- shoulder passively ABD to 120, patient instructed to bring arm down to side slowly
- patient unable to lower arm back down to side
best diagnostic test for gout
lab tests to identify monosodium urate crystals in synovial fluid/CT samples
Posterior Internal Impingement Test
- what’s it for
- position
- positive result
- impingement between rotator cuff and greater tuberosity OR posterior glenoid and labrum
- patient supine, move shoulder into 90 ABD, max ER, 15-20 hor ADD
- reproduces pain in posterior shoulder during test
Adson’s Test
- what’s it for
- position
- positive result
- TOS
- patient sits.. find radial pulse of test side, rotate head toward test side, then extend and ER shoulder while extending head
- pulse disappears
Empty Can Test:
- what’s it for
- position
- positive result
- tear/impingement of supraspinatus tendon (suprascapular nerve neuropathy)
- shoulder at 90 and they resist ABD (while in empty can position)
- pain in supraspinatus/weakness
best diagnostic test for osteoporosis and why
CT for bone density
what is gout
genetic disorder of purine metabolism
what is hypertrophied with DJD
subchondral bone
joint capsule of WB joints
Biceps Load 2
- what’s it for
- position
- positive result
- SLAP lesion (GH labral tear)
- passive 120 ABD, max ER, 90 elbow flexion, forearm supination.. PT holds patients wrist with one hand and stabilizes elbow with second hand.. perform elbow flexion against PT resistance
- symptoms increase during resisted biceps contraction
Neer’s Test:
- what’s it for
- position
- positive result
- impingement of soft tissue structures of shoulder (long head biceps and supraspinatus)
- shoulder passively IR and ABD
- pain in shoulder
initial symptoms of ankylosing spondylitis
mid/LBP
morning stiffness
sacroiliitis
Rent Sign
- what’s it for
- position
- positive result
- torn rotator cuff/rotator cuff impingement
- PT standing to rear of patient.. palpates anterior to anterior edge of acromion with one hand while holding patient’s flexed elbow with the other.. PT passively extends shoulder while slowly IR and ER
- greater tuberosity will be prominent and depression of about 1 finger width will be felt if RC tear is present
what is worn down in degenerative joint disease (DJD)
articular cartilage
Crank Test
- what’s it for
- position
- positive result
- anterior shoulder instability/different GH ligaments/labral tear
- PT places hand on subject’s elbow and another one on proximal humerus and then passively elevates subject’s shoulder to 160 scaption.. apply load along the long axis of the humerus while the proximal hand ER and IR
- pain with or without a click in the shoulder
what is osteoporosis
metabolic disease that depletes bone mineral density/mass
Hawkins-Kennedy
- what’s it for
- position
- positive result
- subacromial impingement
- 90 shoulder flexion, elbow flexed to 90.. PT passively IRs arm
- pain with IR
Speed’s Test:
- what’s it for
- position
- positive result
- biceps tendonitis
- arm in full extension and forearm supinated.. resist shoulder flexion (can also place shoulder in 90 flexion and push UE into extension causing eccentric contraction of biceps)
- pain in biceps tendon
ULTT 2
- what’s it for
- position
- positive result
- median, axillary, and musculocutaneous nerve
2. shoulder depression/ABD, elbow extension, forearm sup, wrist/fingers ext, shoulder ER
what is rheumatoid arthritis
chronic systemic disorder of unknown etiology, usually involving a symmetrical pattern of dysfunction in synovial tissues and articular cartilage of joints of hands, wrists, elbows, shoulders, knees, ankles, and feet
what drugs are used for DJD
corticosteroids (glucocorticoids)
NSAIDs
Wright (Hyperabduction Test)
- what’s it for
- position
- positive result
- TOS
- find radial pulse of test side, move shoulder in maximum ABD and ER.. take deep breath and rotate head opposite side being tested
- disappearance of pulse
Horizontal Adduction
- what’s it for
- position
- positive result
- AC joint dysfunction/subacromial dysfunction
- PT stands behind patient on side being tests.. grasp patients arm just distal to the elbow and passively flex shoulder to 90. maximally horizontal ADD
- pain during ADD motion or localized pain in acromioclavicular
Costoclavicular Syndrome (Military Brace Test)
- what’s it for
- position
- positive result
- TOS
- find radial pulse of test side.. move involved shoulder down and back
- disappearance of pulse
what are Bouchard’s nodes commonly seen with
OA, RA
the NSAID indomethacin is most likely used for
gout
Yergason’s Test:
- what’s it for
- position
- positive result
- transverse humeral ligament integrity (bicipital tendonitis)
- arm against trunk, elbow at 90 degrees, forearm pronated.. they resist supination of forearm and ER of shoulder
- biceps tendon pops out/pain reproduced in long head of biceps tendon
a decrease in _____ can lad to osteoporosis for women
estrogen
for a child with neurogenic bladder going into preschool, what would be most appropriate to assist the kid in maintaining urinary continence
clean intermittent catheterization every four hours
what deformity is present with ankylosing spondylitis
kyphosis of cervical and thoracic
decreased lordosis in lumbar
what is senile osteoporosis
occurs due to a decrease in bone cell activity secondary to genetics or acquired abnormalities
what happens to the excessive uric acid with gout
uric acid changes to crystals and deposits into peripheral joints and other tissues (kidneys)
ULTT3
- what’s it for
- position
- positive result
- radial nerve
2. shoulder depression and ABD 10, elbow ext, forearm pron, wrist flex/UD, fingers flex, shoulder IR
AC Shear Test
- what’s it for
- position
- positive result
- AC dysfunction (arthritis, separation)
- patient sits with arm at side.. PT clasps hands and places heel of one hand on spine of scapula and heel of other hand on clavicle.. squeeze hands together which causes compression of AC joint
- pain in AC joint
most common sites of fracture following osteoporosis
thoracic/lumbar spine
femoral neck
proximal humerus
proximal tibia
pelvis
distal radius
when is ankylosing spondylitis first seen
40 years old
where is gout most frequently observed
knee and great toe
ULTT 4
- what’s it for
- position
- positive result
- shoulder depression/ABD (10-90) with hands to ear, elbow flexion, forearm supination, wrist extension/RD, fingers ext, shoulder ER
where does the erosive degeneration of psoriatic arthritis most commonly seen
joints of digits and axial skeleton
what is psoriatic arthritis
chronic, erosive inflammatory disorder of unknown etiology associated with psoriasis
Belly Compression Test
- what’s it for
- position
- positive result
- subscapularis lesion
- PT hand on belly, pt hand over his.. have pt push as hard as they can onto stomach. have pt bring elbow forward in the scapular plane causing IR.
- patient can’t maintain pressure on PT hand while moving elbow forward
Bear Hug Test
- what’s it for
- position
- positive result
- subscapularis tear
- patient hand on opposite shoulder with elbow anterior to body.. PT applies ER force while patient attempts to maintain hand on shoulder
- can’t hold against the shoulder after ER force
Clunk Test
- what’s it for
- position
- positive result
- glenoid tear
- patient supine with shoulder in full ABD.. push humeral head anterior while rotating humerus externally
- audible clunk heard during test
what joints are usually spared for RA
DIP
ULTT 1:
- what’s it for
- position
- positive result
- median/anterior interossesous nerve
2. shoulder depression/110 ABD, elbow ext, forearm sup, wrist/fingers ext
what are Bouchard’s nodes
excessive bone formation on dorsal PIP
Allen’s Maneuver
- what’s it for
- position
- positive result
- TOS
- 90 ABD, ER, elbow 90 flex.. patient rotates head opposite side while radial pulse palpated
- radial pulse diminished
what type of condition is ankylosing spondylitis
rheumatoid
what is elevated with gout
serum uric acid