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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
Name the convexity/ concavity, loose packed position, closed packed position, and capsular pattern of the following: Subtalar Joint (talocalcaneal Joint)
Concave inferior talus, convex calcaneus LPP: midway between extremes of motion CPP: supination Capsular Pattern: limitation of varus
26
Name the convexity/ concavity, loose packed position, closed packed position, and capsular pattern of the following: Midtarsal Joint
LPP: midway between extremes of motion CPP: supination Capsular Pattern: dorsiflexion, plantarflexion, ADD, IR
27
Name the convexity/ concavity, loose packed position, closed packed position, and capsular pattern of the following: Toe Joints
Concave on convex LPP: slight flexion CPP: maximal extension Capsular Pattern: restricted in all directions, slightly more limited extension
28
Name the convexity/ concavity, loose packed position, closed packed position, and capsular pattern of the following: Metatarsal Phalangeal Joints
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
29
Musculocutaneous Nerve innervates which muscle with its associated cord segment?
Biceps Brachii (C5-C6) Coracobrachialis (C6-C7) Brachialis (C5-C6)
30
Axillary Nerve innervates which muscle with its associated cord segment?
Deltoid (C5-C6) Teres Minor (C4-C5)
31
Spinal Accessory Nerve innervates which muscle with its associated cord segment?
Traps (C1-C4)
32
Which nerve innervates Pec minor?
Medial pectoral (C8-T1)
33
Which nerve innervates Pec major?
Medial and lateral pectoral (C5-C8, T1)
34
Which nerve innervates Serratus Anterior and its associated cord segment?
Long Thoracic Nerve (C5-C7)
35
Dorsal Scapular Nerve innervates which muscle?
Levator Scapula (C5) Rhomboids (C4-C5)
36
Suprascapular Nerve innervates which muscle with its associated cord segment?
Infraspinatus (C4-C6) Supraspinatus (C4-C6)
37
Subscapular Nerve innervates which muscle with its associated cord segment?
Lower Subscapular (C5-C6)= Teres Major Thoracodorsal C5-C8 (Middle Subscap)= Latissimus dorsi Subscapularis
38
Ulnar Nerve innervates which muscle with its associated cord segment?
``` 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) ```
39
Median Nerve innervates which muscle?
``` 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
The Radial Nerve innervates which muscle?
``` 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
Femoral Nerve innervates which muscle with cord segment?
Iliopsoas (L1-L3) Sartorius (L2-L3) Quad femoris (L2-L4) Pectineus (sometimes Obturator nerve) Iliacus
42
Superior gluteal nerve innervates which muscle?
Glute Med (L4-S1) Glute Min (L4-S1) TFL (L4-L5)
43
Inferior gluteal nerve innervates which muscle?
Glute Max (L4-S2)
44
Differentiate between muscle spindles and golgi tendon organs
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
What is the difference between isotonic and isokinetic exercise?
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
Differentiate between DeLorme and Oxford exercise programs
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
Resistive Testing and Innervation Level of the Upper Quadrant ... (aka Myotomes)
``` 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
Resistive Testing and Innervation Level of the LowerQuadrant ... (aka Myotomes)
``` 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
Reflex Testing (Common sites throughout entire body)
``` C5 - Biceps C6 - Brachioradialis C7 - Triceps L4 - Patella S1 - Achilles ```
50
Upper Quadrant Dermatomes
``` 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
Lower Quadrant Dermatomes
``` 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
Pudendeal nerve innervates which muscles?
Thats right! S2-S4
53
Name the convexity/ concavity, loose packed position, closed packed position, and capsular pattern of the following: Cervical Spine
Superior segment on inferior segment LPP: between flexion and extension CPP: extension Capsular Pattern: lateral flexion and rotation equally limited, extension
54
Name the convexity/ concavity, loose packed position, closed packed position, and capsular pattern of the following: Thoracolumbar Spine
Superior segment on inferior segment LPP: between flexion and extension CPP: extension Capsular Pattern: lateral flexion and rotation equally limited, extension
55
Differentiate between Type I and Type II muscle fibers
Type I: aerobic, red, tonic, slow twitch, and slow-oxidative | Type II: anaerobic, white, phasic, fast twitch, fast glycolytic
56
Differentiate between muscle spindles and golgi tendon organs
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
What is the difference between isotonic and isokinetic exercise?
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
Differentiate between DeLorme and Oxford exercise programs
DeLorme
59
Resistive Testing and Innervation Level of the Upper Quadrant ... (aka Myotomes)
``` 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
How is the Apprehension test for anterior shoulder dislocation Performed, identify a positive Result, and what a positive test is Indicative of?
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
How is the Apprehension test for posterior shoulder dislocation Performed, identify a positive Result, and what a positive test is Indicative of?
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
How is Adson's maneuver Performed, identify a positive Result, and what a positive test is Indicative of?
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
How is Speed's Test Performed, identify a positive Result, and what a positive test is Indicative of?
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
How Is Yergason's Test Performed, identify a positive Result, and what a positive test is Indicative of?
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
How is the Drop Arm Test Performed, identify a positive Result, and what a positive test is Indicative of?
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
How is Hawkins-Kennedy Impingement Test Performed, identify a positive Result, and what a positive test is Indicative of?
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
How is Neer impingement test Performed, identify a positive Result, and what a positive test is Indicative of?
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
How is the Supraspinatus Test Performed, identify a positive Result, and what a positive test is Indicative of?
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
How is Adson maneuver Performed, identify a positive Result, and what a positive test is Indicative of?
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
Resistive Testing and Innervation Level of the Upper Quadrant ... (aka Myotomes)
``` 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
Reflex Testing (Common sites throughout entire body)
``` C5 - Biceps C6 - Brachioradialis C7 - Triceps L4 - Patella S1 - Achilles ```
72
Upper Quadrant Dermatomes
``` 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
How is Allen's Test Performed, identify a positive Result, and what a positive test is Indicative of?
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
How is Costoclavicular Syndrome Test (military brace) Performed, identify a positive Result, and what a positive test is Indicative of?
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
How is Roos test Performed, identify a positive Result, and what a positive test is Indicative of?
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
Lower Quadrant Dermatomes
``` 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
How is Wright test (Hyperabduction test) Performed, identify a positive Result, and what a positive test is Indicative of?
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
How is the Glenoid labrum Test Performed, identify a positive Result, and what a positive test is Indicative of?
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
How is ULTT1 Performed, identify a positive Result, and what a positive test is Indicative of?
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
How is ULTT2 Performed, identify a positive Result, and what a positive test is Indicative of?
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
How is ULTT3 Performed, identify a positive Result, and what a positive test is Indicative of?
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
How is ULTT4 Performed, identify a positive Result, and what a positive test is Indicative of?
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
How is the Elbow Varus Stress test Performed, identify a positive Result, and what a positive test is Indicative of?
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
How is the Elbow Valgus stress test Performed, identify a positive Result, and what a positive test is Indicative of?
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
How is Cozen's Test Performed, identify a positive Result, and what a positive test is Indicative of?
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
How is Lateral epicondylitis test Performed, identify a positive Result, and what a positive test is Indicative of?
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
How is Medial epicondylitis test Performed, identify a positive Result, and what a positive test is Indicative of?
P: Pt seated > PT palpates medial epicondyle > supinates pt's forearm > Ext wrist > Ext elbow. R: + = pain in medial epicondyle. I: Medial epicondylitis
88
How is Mill's Test Performed, identify a positive Result, and what a positive test is Indicative of?
P: Pt seated > PT palpates lateral epicondyle > passively pronates forearm, wrist flex, elbow ext. R: + = Pain in latearl epi I: Lateral epicondylitis
89
How is Tinel's sign Performed, identify a positive Result, and what a positive test is Indicative of?
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
How is the Ulnar Collateral ligament instability test Performed, identify a positive Result, and what a positive test is Indicative of?
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
How is Allen Test (Vascular insufficiency) Performed, identify a positive Result, and what a positive test is Indicative of?
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
How is the Bunnel-Littler Test Performed, identify a positive Result, and what a positive test is Indicative of?
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
How is Froments sign Performed, identify a positive Result, and what a positive test is Indicative of?
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
How is Phalens Test Performed, identify a positive Result, and what a positive test is Indicative of?
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
How is Finkelstein's Test Performed, identify a positive Result, and what a positive test is Indicative of?
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
How is the Grind Test Performed, identify a positive Result, and what a positive test is Indicative of?
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
How is Murphy's sign Performed, identify a positive Result, and what a positive test is Indicative of?
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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