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Board Studying - NPTE > Musculoskeletal System Review Session 1 (via Scorebuilders) > Flashcards

Musculoskeletal System Review Session 1 (via Scorebuilders) Flashcards

1
Q

What are the 3 energy systems in the human body?

A
  1. ATP-PC/ Phosphagen Energy System
  2. Anaerobic Glycolysis/ Lactic Acid System
  3. Aerobic/ Oxygen System
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2
Q

This type of energy system is utilized during high intensity, short duration bursts (i.e. 100 m sprint). This system provides energy for muscle contraction up to 15s. It does not depend on transporting oxygen for energy.

A

ATP-PC/ Phosphagen Energy System

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3
Q

This system only uses carbohydrates and is utilized during high intensity, short duration activities (i.e. 400m or 800m sprint). This process allows 30 to 40s of a muscular contraction. It does not require the presence of oxygen.

A

Anaerobic Glycolysis/ Lactic Acid System

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4
Q

This type of energy system is used in low intensity, long duration exercise such as running a marathon. This system yields the most ATP, but requires a complex series of chemical reactions. This system provides energy through the oxidation of food.

A

Aerobic/ Oxygen System

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5
Q

Describe the classes of levers (fulcrum [axis of rotation], load [resistance], and effort [force]) and provide an anatomical example for each.

A
  1. Class 1: Fulcrum is between the load and the effort. Ex: Triceps brachii and Atlanto-occipital joint
  2. Class 2: Load is between the fulcrum and the effort (think wheelbarrow) Ex: Plantarflexion, push-up
  3. Class 3: Effort is between the load and the fulcrum. Ex: biceps brachii, biceps femoris
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6
Q

What are the types of joint classifications? Be able to provide examples for each.

A
  1. Fibrous Joints (Synarthroses). 3 types: Sutures (skull), Syndesmosis (interosseous membrane of tib-fib), and gomphoses (tooth in socket). No movement.
  2. Cartilaginous Joints (Amphiarthroses). 2 types: Synchondrosis (sternum) and Symphysis (pubic symphysis). Slight movement.
  3. Synovial Joints (Diarthroses). 3 types: Uniaxial (hinge [elbow], pivot [AA]), Biaxial (condyloid [MCP], saddle [CMC], and Multiaxial (plane [carpal joints], ball and socket [hip])
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7
Q

Name the common Joint Receptors and briefly describe their functions.

A
  1. Free Nerve Endings - mechanical stress and noxious stimuli
  2. Pacinian Corpuscles - vibration, acceleration, and high velocity changes
  3. Golgi Ligament Endings - tension or stretch on ligaments
  4. Ruffini Endings - stretching of joint capsule; amplitude and velocity of joint position
  5. Golgi - Mazzoni Corpuscles - compression of joint capsule
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8
Q

Name the convexity/ concavity, loose packed position, closed packed position, and capsular pattern of the following:

Glenohumeral Joint

A

Convex humeral head on concave glenoid fossa.

LPP: 55° ABD, 30° horizontal ADD

CPP: ABD and ER

Capsular Pattern: ER, ABD, and IR

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9
Q

Name the convexity/ concavity, loose packed position, closed packed position, and capsular pattern of the following:

Sternoclavicular Joint

A

Saddle Joint (with the articular disc)

LPP: Arm resting at side

CPP: Maximum shoulder elevation

Capsular Pattern: pain at extremes of range of motion

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10
Q

Name the convexity/ concavity, loose packed position, closed packed position, and capsular pattern of the following:

Acromioclavicular Joint

A

Planar Joint (Kaltenborne), but anatomically concave acromion on convex clavicle

LPP: Arm resting at side

CPP: 90° ABD

Capsular Pattern: pain at extremes of range of motion

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11
Q

Name the convexity/ concavity, loose packed position, closed packed position, and capsular pattern of the following:

Radiohumeral Joint

A

Concave radial head on convex capitulum

LPP: Full extension and supination

CPP: 90° flexion. 5° supination

Capsular Pattern: flexion, extension, supination, pronation

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12
Q

Name the convexity/ concavity, loose packed position, closed packed position, and capsular pattern of the following:

Ulnohumeral Joint

A

Saddle (Concave trochlear notch moves on trochlea of humerus only though)

LPP: 70° flexion. 10° supination

CPP: extension

Capsular Pattern: flexion, extension

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13
Q

Name the convexity/ concavity, loose packed position, closed packed position, and capsular pattern of the following:

Proximal Radioulnar Joint

A

Convex radial head of radius moves on concave radial notch of ulna

LPP: 70° flexion. 35° supination

CPP: 5° supination

Capsular Pattern: supination, pronation

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14
Q

Name the convexity/ concavity, loose packed position, closed packed position, and capsular pattern of the following:

Distal Radioulnar Joint

A

Concave radius moves on convex ulna

LPP: 10° supination

CPP: maximum pronation or supination (Kaltenborne)

Capsular Pattern: supination, pronation (equal)

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15
Q

Name the convexity/ concavity, loose packed position, closed packed position, and capsular pattern of the following:

Radiocarpal Joint

A

Convex carpus on concave radius and articular disc

LPP: neutral with slight ulnar deviation

CPP: extension and radial deviation

Capsular Pattern: flexion and extension equally limited

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16
Q

Name the convexity/ concavity, loose packed position, closed packed position, and capsular pattern of the following:

Iliofemoral Joint

A

Ball and Socket (Convex femoral head on concave acetabulum)

LPP: 30° flexion, 30° ABD, slight ER

CPP: Full extenxion and IR

Capsular Pattern: flexion, ABD, and IR (sometimes IR is most limited)

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17
Q

Name the convexity/ concavity, loose packed position, closed packed position, and capsular pattern of the following:

Tibiofemoral Joint

A

Concave medial and lateral tibial plateus on convex medial and lateral condyles of femur

LPP: 25° flexion

CPP: Full extenxion and ER of tibia

Capsular Pattern: flexion, extension

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18
Q

Name the convexity/ concavity, loose packed position, closed packed position, and capsular pattern of the following:

Patellofemoral

A

Convex patella on concave trochlear groove (Kaltenborne actually has contradicting information … choose wisely)

LPP: 25° flexion

CPP: Full extenxion and ER of tibia

Capsular Pattern: flexion, extension

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19
Q

Name the convexity/ concavity, loose packed position, closed packed position, and capsular pattern of the following:

Proximal AND Distal Tibiofibular Joints

A

Concave fibular head on convex tibial condyle

LPP: 10° plantarflexion

CPP: maximum dorsiflexion

Capsular Pattern: (not mentioned in either Scorebuilders or Kaltenborne)

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20
Q

Name the convexity/ concavity, loose packed position, closed packed position, and capsular pattern of the following:

Carpometacarpal Joints II-V

A

Concave metacarapal on convex carpus

LPP & CPP: unknown

Capsular Pattern: equal in all directions

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21
Q

Name the convexity/ concavity, loose packed position, closed packed position, and capsular pattern of the following:

Carpometacarpal Joint I

A

Saddle (flexion/ extension = concave on convex; ABD/ ADD = convex on concave)

LPP: midway between flexion, extension, ABD, and ADD (Kaltenborne)

CPP: maximum opposition

Capsular Pattern: ABD and extension

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22
Q

Name the convexity/ concavity, loose packed position, closed packed position, and capsular pattern of the following:

Finger Joints

A

Concave on Convex rule for DIPs and PIPs

LPP: slight flexion

CPP: maximum extension

Capsular Pattern: restriction in all directions with slightly more limitation in flexion

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23
Q

Name the convexity/ concavity, loose packed position, closed packed position, and capsular pattern of the following:

Metacarpophalangeal

A

Only difference is LPP and CPP:

LPP: slight flexion and ulnar flexion

CPP: Maximal flexion

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24
Q

Name the convexity/ concavity, loose packed position, closed packed position, and capsular pattern of the following:

Talocrural Joint

A

Convex talus on concave mortis

LPP: 10° plantarflexion, midway between inversion and eversion

CPP: maximum dorsiflexion

Capsular Pattern: plantarflexion, dorsiflexion

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25
Q

Name the convexity/ concavity, loose packed position, closed packed position, and capsular pattern of the following:

Subtalar Joint (talocalcaneal Joint)

A

Concave inferior talus, convex calcaneus

LPP: midway between extremes of motion

CPP: supination

Capsular Pattern: limitation of varus

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26
Q

Name the convexity/ concavity, loose packed position, closed packed position, and capsular pattern of the following:

Midtarsal Joint

A

LPP: midway between extremes of motion

CPP: supination

Capsular Pattern: dorsiflexion, plantarflexion, ADD, IR

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27
Q

Name the convexity/ concavity, loose packed position, closed packed position, and capsular pattern of the following:

Toe Joints

A

Concave on convex

LPP: slight flexion

CPP: maximal extension

Capsular Pattern: restricted in all directions, slightly more limited extension

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28
Q

Name the convexity/ concavity, loose packed position, closed packed position, and capsular pattern of the following:

Metatarsal Phalangeal Joints

A

Concave on convex

LPP: 10° extension

CPP: MTP I: maximal extension; MTP II-V: maximal flexion

Capsular Pattern: restricted in all directions, slightly more limited flexion

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29
Q

Musculocutaneous Nerve innervates which muscle with its associated cord segment?

A

Biceps Brachii (C5-C6)

Coracobrachialis (C6-C7)

Brachialis (C5-C6)

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30
Q

Axillary Nerve innervates which muscle with its associated cord segment?

A

Deltoid (C5-C6)

Teres Minor (C4-C5)

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31
Q

Spinal Accessory Nerve innervates which muscle with its associated cord segment?

A

Traps (C1-C4)

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32
Q

Which nerve innervates Pec minor?

A

Medial pectoral (C8-T1)

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33
Q

Which nerve innervates Pec major?

A

Medial and lateral pectoral (C5-C8, T1)

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34
Q

Which nerve innervates Serratus Anterior and its associated cord segment?

A

Long Thoracic Nerve (C5-C7)

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35
Q

Dorsal Scapular Nerve innervates which muscle?

A

Levator Scapula (C5)

Rhomboids (C4-C5)

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36
Q

Suprascapular Nerve innervates which muscle with its associated cord segment?

A

Infraspinatus (C4-C6)

Supraspinatus (C4-C6)

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37
Q

Subscapular Nerve innervates which muscle with its associated cord segment?

A

Lower Subscapular (C5-C6)= Teres Major

Thoracodorsal C5-C8 (Middle Subscap)= Latissimus dorsi

Subscapularis

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38
Q

Ulnar Nerve innervates which muscle with its associated cord segment?

A 
Flexar carpi ulnaris (C7-T1)
Flexor Digiti quinti (C8-T1)
Flexor Digitorium Prof. III & IV (C7-C8)
Adductor Pollicis C8-T1
Abductor digiti C8-T1
Opponens digiti C8-T1
interossei C8-T1
Lumbracals III & IV (C8-T1)
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39
Q

Median Nerve innervates which muscle?

A 
Pronator Teres
Pronator Quad
Flex Carpi rad
Palm longus
Flex digit superfic
Flex pollicis longus
Flex digitorum
Abd pollicis brevis
flex pollicis brevis
Opponens pollicis
lumbracals
40
Q

The Radial Nerve innervates which muscle?

A 
Brachioradialis (C5-C6)
Triceps (C6-C8)
Ext Carpi radialis
Ext digitorum
Ext carpi ulnaris
Supinator
Abd pollicis longus
Ext pollicis long/brev
Extensor indicis proprius
41
Q

Femoral Nerve innervates which muscle with cord segment?

A

Iliopsoas (L1-L3)

Sartorius (L2-L3)

Quad femoris (L2-L4)

Pectineus (sometimes Obturator nerve)

Iliacus

42
Q

Superior gluteal nerve innervates which muscle?

A

Glute Med (L4-S1)

Glute Min (L4-S1)

TFL (L4-L5)

43
Q

Inferior gluteal nerve innervates which muscle?

A

Glute Max (L4-S2)

44
Q

Differentiate between muscle spindles and golgi tendon organs

A

Muscle Spindles - located in belly of the muscle; detects muscle length and/ or rate of change in its length. It is important for postural control and involuntary movements

GTO - located near tendons, GTOs are very sensitive to tension changes/ rate of tension changes in muscles.

45
Q

What is the difference between isotonic and isokinetic exercise?

A

Isotonic - muscle length changes through contract and relax and the resistance stays the same

Isokinetic - the muscle length still changes, but the resistance adjusts so the speed of the contraction and relaxation remains constant

46
Q

Differentiate between DeLorme and Oxford exercise programs

A

DeLorme
- 1st set: (10 reps) x (50% of 10 rep max)
- 2nd set: (10 reps) x (75% of 10 rep max)
- 3rd set: (10 reps) x (100% of 10 rep max)
Oxford
- Reverse (100%, 75%, 50%)

47
Q

Resistive Testing and Innervation Level of the Upper Quadrant … (aka Myotomes)

A 
C1 - cervical flexion
C2 - cervical extension/ rotation
C3 - cervical lateral flexion
C4 - shoulder elevation
C5 - shoulder ABD/ ER
C6 - elbow flexion/ wrist extension
C7 - elbox extension/ wrist flexion
C8 - thumb extension/ ulnar deviation
T1 - finger ABD/ ADD
48
Q

Resistive Testing and Innervation Level of the LowerQuadrant … (aka Myotomes)

A 
L1 - hip flexion
L2 - hip flexion (ADD and IR)
L3 - knee extension
L4 - dorsiflexion, ankle inversion
L5 - great toe extension
S1 - ankle plantarflexion, knee flexion, ankle eversion
S2 - ankle plantarflexion, knee flexion
S3 -S5 - perianal area ;)
49
Q

Reflex Testing (Common sites throughout entire body)

A 
C5 - Biceps
C6 - Brachioradialis
C7 - Triceps
L4 - Patella
S1 - Achilles
50
Q

Upper Quadrant Dermatomes

A 
C2 - Posterior Head
C3 - Lateral Neck
C4 - Acromioclavicular Joint
C5 - Lateral Arm
C6 - Lateral forearm and thumb
C7 - Middle  finger
C8 - ular border of hand and little finger
T1 - medial forearm
51
Q

Lower Quadrant Dermatomes

A 
L2 - Anterior Thigh
L3 - Middle third of Anterior thigh
L4 - Patella and medial malleolus
L5 - Fibular Head and Dorsum of Foot
S1 - Lateral aspect and plantar aspect of foot
S2 - Medial aspect of posterior thigh
S3 -S5 - perianal area ;)
52
Q

Pudendeal nerve innervates which muscles?

A

Thats right! S2-S4

53
Q

Name the convexity/ concavity, loose packed position, closed packed position, and capsular pattern of the following:

Cervical Spine

A

Superior segment on inferior segment

LPP: between flexion and extension

CPP: extension

Capsular Pattern: lateral flexion and rotation equally limited, extension

54
Q

Name the convexity/ concavity, loose packed position, closed packed position, and capsular pattern of the following:

Thoracolumbar Spine

A

Superior segment on inferior segment

LPP: between flexion and extension

CPP: extension

Capsular Pattern: lateral flexion and rotation equally limited, extension

55
Q

Differentiate between Type I and Type II muscle fibers

A

Type I: aerobic, red, tonic, slow twitch, and slow-oxidative

Type II: anaerobic, white, phasic, fast twitch, fast glycolytic

56
Q

Differentiate between muscle spindles and golgi tendon organs

A

Muscle Spindles - located in belly of the muscle; detects muscle length and/ or rate of change in its length. It is important for postural control and involuntary movements

GTO - located near tendons, GTOs are very sensitive to tension changes/ rate of tension changes in muscles.

57
Q

What is the difference between isotonic and isokinetic exercise?

A

Isotonic - muscle length changes through contract and relax and the resistance stays the same

Isokinetic - the muscle length still changes, but the resistance adjusts so the speed of the contraction and relaxation remains constant

58
Q

Differentiate between DeLorme and Oxford exercise programs

A

DeLorme

59
Q

Resistive Testing and Innervation Level of the Upper Quadrant … (aka Myotomes)

A 
C1 - cervical flexion
C2 - cervical extension/ rotation
C3 - cervical lateral flexion
C4 - shoulder elevation
C5 - shoulder ABD/ ER
C6 - elbow flexion/ wrist extension
C7 - elbox extension/ wrist flexion
C8 - thumb extension/ ulnar deviation
T1 - finger ABD/ ADD
60
Q

How is the Apprehension test for anterior shoulder dislocation Performed, identify a positive Result, and what a positive test is Indicative of?

A

P: Pt supine > UE 90 degrees ABD > PT Lat. rot shoulder.

R: + = Look of apprehension/facial grimace before end point

I: Ant Shoulder Disloc.

61
Q

How is the Apprehension test for posterior shoulder dislocation Performed, identify a positive Result, and what a positive test is Indicative of?

A

P: Pt supine > UE 90 deg flex & med rot > PT applies POST force through long axis of humerus

R: + = Look of apprehension/facial grimace before end point

I: Post. Shoulder Disloc

62
Q

How is Adson’s maneuver Performed, identify a positive Result, and what a positive test is Indicative of?

A

P: Pt seated/standing > PT takes radial pulse > pt ROTATES head Ipsilaterally > active cervical EXT with PT laterally rotating and extending pt’s shoulder.

R: + = Absent/Diminished radial pulse

I: TOS

63
Q

How is Speed’s Test Performed, identify a positive Result, and what a positive test is Indicative of?

A

P: Pt seated/standing > UE @ 90 deg, Elbow Ext, Forearm Sup > PT palpate bicipital groove other on volar surface pt forearm > PT resists active shoulder flex.

R: + = Pain/tenderness in bicipital groove.

I: BICIPITAL TENDONITIS

64
Q

How Is Yergason’s Test Performed, identify a positive Result, and what a positive test is Indicative of?

A

P: Pt seated > 90 deg Elbow flex, forearm pronated > humerus stabilized against patients thorax > PT 1 hand on pt’s forearm, 1 on bicipital groove > pt actively supinates and lat rotate against resistance.

R: + = Pain/tenderness in bicipital groove

I: Bicipital tenonitis

65
Q

How is the Drop Arm Test Performed, identify a positive Result, and what a positive test is Indicative of?

A

P: Pt seated/standing > UE 90 deg ABD > Pt slowly lowers arm to side.

R: + = Can’t lower slow OR severe pain.

I: Rotator Cuff Tear

66
Q

How is Hawkins-Kennedy Impingement Test Performed, identify a positive Result, and what a positive test is Indicative of?

A

P: Pt sitting/standing > PT flex’s pt’s shoulder to 90 deg with medial rot.

R: + = Pain

I: Shoulder impingement of Supraspinatus tendon

67
Q

How is Neer impingement test Performed, identify a positive Result, and what a positive test is Indicative of?

A

P: Pt seated/standing > PT 1 hand on post aspect of scapula, other stabilize elbow > PT elevates pt’s UE through Flex.

R: + = Facial grimace/ pain

I: Shoulder impingement of Supraspinatus tendon

68
Q

How is the Supraspinatus Test Performed, identify a positive Result, and what a positive test is Indicative of?

A

P: Pt standing > UE 90 deg ABD > 30 deg horizontal ADD with thumb pointing down > PT resists pt attempt to ABD.

R: += Weakness or pain

I: Tear supraspin. impingement or suprascapular nerve involvement

69
Q

How is Adson maneuver Performed, identify a positive Result, and what a positive test is Indicative of?

A

P: Pt seated/standing > PT takes radial pulse > pt ROTATES head Ipsilaterally > active cervical EXT with PT laterally rotating and extending pt’s shoulder.

R: + = Absent/Diminished radial pulse

I: TOS

70
Q

Resistive Testing and Innervation Level of the Upper Quadrant … (aka Myotomes)

A 
L1 - hip flexion
L2 - hip flexion (ADD and IR)
L3 - knee extension
L4 - dorsiflexion
L5 - great toe extension
S1 - ankle plantarflexion, knee flexion, ankle eversion
S2 - ankle plantarflexion, knee flexion
S3 -S5 - perianal area
71
Q

Reflex Testing (Common sites throughout entire body)

A 
C5 - Biceps
C6 - Brachioradialis
C7 - Triceps
L4 - Patella
S1 - Achilles
72
Q

Upper Quadrant Dermatomes

A 
C2 - Posterior Head
C3 - Lateral Neck
C4 - Acromioclavicular Joint
C5 - Lateral Arm
C6 - Lateral forearm and thumb
C7 - Middle  finger
C8 - ular border of hand and little finger
T1 - medial forearm
73
Q

How is Allen’s Test Performed, identify a positive Result, and what a positive test is Indicative of?

A

P: Pt seated/standing > UE 90 deg ABD, ER, and elbow FLEX > Pt rotate contralaterally while PT takes radial pulse

R: + = Absent or diminished pulse

I: TOS

74
Q

How is Costoclavicular Syndrome Test (military brace) Performed, identify a positive Result, and what a positive test is Indicative of?

A

P: Pt seated > PT find radial pulse> move shoulder down and back.

R: + = Absent/Diminished radial pulse

I: TOS, , via compression of subclavian artery between first rib and clavicle

75
Q

How is Roos test Performed, identify a positive Result, and what a positive test is Indicative of?

A

P: Seated/standing > B UE @ 90 deg abd, ER, elbow Flex > Pt open and close hands for 3 minutes.

R: Cant hold position, weakness, sensory loss, ischemic pain

I: TOS

76
Q

Lower Quadrant Dermatomes

A 
L2 - Anterior Thigh
L3 - Middle third of Anterior thigh
L4 - Patella and medial malleolus
L5 - Fibular Head and Dorsum of Foot
S1 - Lateral aspect and plantar aspect of foot
S2 - Medial aspect of posterior thigh
S3 -S5 - perianal area
77
Q

How is Wright test (Hyperabduction test) Performed, identify a positive Result, and what a positive test is Indicative of?

A

P: Pt seated/stand > PT takes radial pulse > UE passively into max ABD and ER > Pt takes deep breath and cervical rot to contralateral side

R: + = Absent/Diminished pulse

I: TOS

78
Q

How is the Glenoid labrum Test Performed, identify a positive Result, and what a positive test is Indicative of?

A

P: Pt supine > PT 1 hand post. aspect of humerus, other stabilize humerus proximal to elbow > PT passively ABD + ER UE over pt’s head > PT apply ANT directed force to humerus.

R: + = Clunk or grinding sound

I: Glenoid labrum tear

79
Q

How is ULTT1 Performed, identify a positive Result, and what a positive test is Indicative of?

A

P: Shoulder Depressed > Shoulder ABD 110 deg > Elbow ext > Forearm Supination > Wrist Ext > FInger/Thumb ext > Cervical contralateral lat flexion

R: + = Reproduction of symptoms

I: Median Nerve + Anterior interosseous nerve

80
Q

How is ULTT2 Performed, identify a positive Result, and what a positive test is Indicative of?

A

P: Shoulder Depressed > Shoulder ABD 10 deg > Elbow ext > Forearm Supination > Wrist Ext > FInger/Thumb ext > SHOULDER ER > Cervical contralateral lat flexion

R: + = Reproduction of symptoms

I: Median, Axillary, and Musculocutaneous Nerve

81
Q

How is ULTT3 Performed, identify a positive Result, and what a positive test is Indicative of?

A

P: Shoulder Depressed > Shoulder ABD 10 deg > Elbow EXT > Forearm PRONATION > Wrist FLEX+ ULNAR DEV > FInger/Thumb FLEX > SHOULDER IR > Cervical contralateral lat flexion

R: + = Reproduction of symptoms

I: Radial Nerve

82
Q

How is ULTT4 Performed, identify a positive Result, and what a positive test is Indicative of?

A

P: Shoulder Depressed > Shoulder ABD 10-90 deg with hand to ear > Elbow FLEX > Forearm Supination > Wrist EXT AND RADIAL DEV > FInger/Thumb EXT > Shoulder ER > Cervical contralateral lat flexion

R: + = Reproduction of symptoms

I: Ulnar Nerve

83
Q

How is the Elbow Varus Stress test Performed, identify a positive Result, and what a positive test is Indicative of?

A

P: Pt seated > Elbow 20-30 deg Flex > PT 1 hand on elbow, other prox to pt’s wrist > PT applies varus force while palpating lateral joint line

R: + = Inc. laxity in lateral collateral lig, apprehension or pain

I: Lateral collateral lig sprain

84
Q

How is the Elbow Valgus stress test Performed, identify a positive Result, and what a positive test is Indicative of?

A

P: Pt seated > Elbow 20-30 deg Flex > PT 1 hand on elbow, other prox to pt’s wrist > PT applies valgus force while palpating medial joint line.

R: + = Inc. laxity in medial collateral lig, apprehension or pain

I: Medial collateral lig sprain

85
Q

How is Cozen’s Test Performed, identify a positive Result, and what a positive test is Indicative of?

A

P: Pt seated > Elbow slight Flex > PT thumb on Lateral epicondyle with stabilization of elbow joint > Pt makes fist, pronates forearm, radially deviates, and extends wrist against resistance.

R: + Pain in lateral epicondyle or muscle weakness

I: Lateral epicondylitis

86
Q

How is Lateral epicondylitis test Performed, identify a positive Result, and what a positive test is Indicative of?

A

P: Pt seated> PT stabilize elbow, other hand on dorsal surface of 3rd PIP > Pt actively EXT 3rd PIP against resistance.

R: + Pain in lateral epi. or muscle weakness

I: Lateral epicondylitis

87
Q

How is Medial epicondylitis test Performed, identify a positive Result, and what a positive test is Indicative of?

A

P: Pt seated > PT palpates medial epicondyle > supinates pt’s forearm > Ext wrist > Ext elbow.

R: + = pain in medial epicondyle.

I: Medial epicondylitis

88
Q

How is Mill’s Test Performed, identify a positive Result, and what a positive test is Indicative of?

A

P: Pt seated > PT palpates lateral epicondyle > passively pronates forearm, wrist flex, elbow ext.

R: + = Pain in latearl epi

I: Lateral epicondylitis

89
Q

How is Tinel’s sign Performed, identify a positive Result, and what a positive test is Indicative of?

A

P: Pt seated slight elbow flex > PT taps between olecranon process & medial epi.

R: + = Tingling sensation in ulnar nerve distribution

I: Ulnar nerve compression

90
Q

How is the Ulnar Collateral ligament instability test Performed, identify a positive Result, and what a positive test is Indicative of?

A

P: Pt seated > PT holds pt’s thumb in Ext > applies valgus force to MCP joint of thumb

R: + = Excessive valgus movement

I: Gamekeeper’s or skiers Thumb. Tear of ulnar collateral and accessory collateral ligaments.

91
Q

How is Allen Test (Vascular insufficiency) Performed, identify a positive Result, and what a positive test is Indicative of?

A

P: Pt seated > pt asked to open and close hand several times and then maintain hand in closed position > PT compresses radial and ulnar arteries > pt asked to relax hand > PT releases pressure on one artery & observes color of hand and fingers.

R: + = Delayed or absent flushing of radial or ulnar half of hand

I: Occlusion of radial or ulnar artery.

92
Q

How is the Bunnel-Littler Test Performed, identify a positive Result, and what a positive test is Indicative of?

A

P: Pt seated > MCP held in slight Ext > PT attempts to move PIP into Flex.

R:
PIP does not Flex with MCP joint extended = tight intrinsic muscle or capsular restriction

PIP fully Flex with MCP in slight flex = intrinsic muscle tightness NO capsular restriction

93
Q

How is Froments sign Performed, identify a positive Result, and what a positive test is Indicative of?

A

P: Pt seated/standing > Hold piece of paper between thumb and index > PT attempts to pull paper away from pt.

R:

Pt flexing distal phalanx of thumb = adductor pollicis paralysis. If at the same time, pt hyperextends MCP joint of thumb = Jeanne’s sign

I: Ulnar nerve involvement

https://www.youtube.com/watch?v=1_I_djZaX9M

94
Q

How is Phalens Test Performed, identify a positive Result, and what a positive test is Indicative of?

A

P: Pt seated/standing > PT flexes pt’s wrist maximally > pt hold position for 60 sec.

R: + = Parasthesia in thumb, index, middle, and lateral half or ring finger

I: Carpal tunnel syndrom (Median Nerve involvement)

95
Q

How is Finkelstein’s Test Performed, identify a positive Result, and what a positive test is Indicative of?

A

P: Pt seated/standing > Pt makes fist with thumb tucked inside fingers > PT stabilizes pt’s forearm and ulnarly deviates wrist.

R: + = pain over ABD pollicis longus and Ext pollicis brevis.

I: DeQuervain’s Disease

96
Q

How is the Grind Test Performed, identify a positive Result, and what a positive test is Indicative of?

A

P: Pt seated/standing > PT stabilizes pt’s hand and grasps pt’s thumb on the metacarpal > PT applies compression & rotation through metacarpal

R: + = Pain

I: Degenerative joint disease in the CMC joint.

97
Q

How is Murphy’s sign Performed, identify a positive Result, and what a positive test is Indicative of?

A

P: Pt seated/standing > Pt asked to make fist

R : + = pt’s 3rd metacarpal remaining level with 2nd and 4th metacarpal.

I: Dislocated lunate

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