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PCM II Exam 1 > Neck and UE (king-10) > Flashcards

Neck and UE (king-10) Flashcards

1
Q

common cervical complaints

A

hoarseness
enlarged LN
enlarged thyroid

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2
Q

cause of hoarseness

A

smoking
tumors
thyroid enlargement
dmg to rec laryngeal n

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3
Q

cause of enlarged LN

A

metastatic cancer
lymphoma
infection

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4
Q

cause of enlarged thyroid

A

goiter

thyroid cancer

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5
Q

structure of vertebrae

A 
body
cartilaginous disc
synovial facets
spinous processes (C7)
transverse processes
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6
Q

anterior triangle borders

A
  1. sup: mandible
  2. med: midline of neck
  3. lat: SCM m.
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7
Q

posterior triangle borders

A
  1. inf: clavicle
  2. post: trap m
  3. ant: SCM m
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8
Q

cervical lymph drainage

A

to deep system

deep LN are deep to SCM and not palpable except supraclavicular LN

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9
Q

Virchow’s node

A

supraclavicular node of deep chain that is palpable in thoracic or abdominal malignancies

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10
Q

thyroglossal duct cyst

A

failure of thyroglossal duct to close before birth

(emobryonic dev: thyroid tissue migrates from base of tongue through duct into neck)`

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11
Q

inspection of neck

A

examine posture: position of head and trunk in 2 positions
should be:
nose midline
lat: ear in line w/ shoulder, greater troch, fib head, lat malleolus
spinal curves: front to back, side to side

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12
Q

palpation of neck

A

ROM

TART: spinous processes, paraspinal mm, transverse processes, upper ribs and clavicle

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13
Q

ROM of Neck

A

Flexion=45
extention=85
rotation=90
side bending=40

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14
Q

ROM of Neck with MM

A

flexion: ant neck mm
ext: post neck mm
rot: trap, scalene, SCM, splenius, longissimus, semispinalis, obliqus capitis
SB: trap, scalene, SCM, splenius, semispinalis, obliqus capitis, LONGUS CAPITIS, RECTUS CAPITIS

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15
Q

Spurling’s manuever

A

side bend to affected side
compress
produces radicular sx

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16
Q

Maximum cervical compression test

A

w/ SB and compression…

add ext and rotation to same side

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17
Q

distraction test

A

alleviates radicular sx

supports dx of radiculopathy

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18
Q

thoracic outlet syndrome

A

when vessels and nerves in clavicular area are compressed (extra rib or tight fibrous band)
sxx:
pain in neck/shoulder
numbness in last 3 fingers and forearm

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19
Q

tx of thoracic outlet

A

physical therapy to strengthen and straighten shoulders

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20
Q

Roo’s test technique

A

arms out and flexed at elbow

pt opens and closes hands for 3 minutes

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21
Q

Roo’s test tests for

A

weakness, numbness, tingling of hand/arm

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22
Q

Adson’s test technique

A

palpate radial pulse with arm out, elbow extended

move arm out and monitor pulse

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23
Q

Adson’s test tests for

A

thoracic outlet syndrome

pulse diminishes

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24
Q

common UE complaints

A 
pain
swelling
stiffness
weakness
redness
noises (grinding, popping, snapping)
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25
Q

common causes of CC

A 
injuries (fx, contusions, tendon/lig tears, overuse)
muscular disorders (muscular dystrophy, rabdomyolysis)
bone and joint disorders (arthritis-OA or RA)
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26
Q

PE of Shoulder

A 
bones:
scapular, humerus, clavicle
joints:
AC, GH
rotator cuff mm
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27
Q

acromioclavicular joint is?

A

synovial condylar

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28
Q

glenohumeral joint

A

synovial spheroidal type
labrum
rotator cuff

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29
Q

rotator cuff muscles

A

supraspinatus
infraspinatus
subscapularis
teres minor

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30
Q

inspection and palpation of shoulder

A

AC jt
GH jt: arm ext exposes subacromial structures
Scapula: winging
Humerus

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31
Q

winging of scapular etiology

A

long thoracic n injury weakens serratus anterior m

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32
Q

shoulder ROM

A

abd: 180
add: 75
flexion: 180
ext: 60
ext rot: 90
int rot: 100

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33
Q

trapezius movement

A

sup: elevates
middle: retracts
inf: depresses

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34
Q

levator scapula action

A

elevation

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35
Q

rhomboids action

A

retraction

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36
Q

pectoralis action

A

depression

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37
Q

biceps action

A

flezes humerus

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38
Q

coracobrachialis action

A

flexes and ADDucts humerus

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39
Q

lat dorsi action

A

extends and med rotates humerus

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40
Q

deltoid action

A

anterior: flexes
middle: abducts after 90
posterior: extends

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41
Q

supraspinatus action

A

abducts 90

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42
Q

infraspinatus action

A

ext rotates

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43
Q

subscapularis action

A

int rotates

44
Q

teres minor action

A

ext rotates

45
Q

teres major

A

int rotates

46
Q

strength testing

A

isolate joint
compare b/l
grade strength out of 5

47
Q

strength scale

A

0-no active mvmt
1-m contracts, no mvmt
2-full active ROM w/o gravity
3-full active ROM against gravity
4-full active ROM against some resistance
5-full active ROM overcomes full resistance

48
Q

empty can test technique

A

abd arms, flex to 45, pour out soda

dr. puts pressure down and patient resists

49
Q

empty can test tests for

A

supraspinatus injury

pain/weakness indicates injury

50
Q

lift off test technique

A

arms internal rotated behind back

pt lifts off while dr resists

51
Q

lift off test tests for

A

subscapularis injury

52
Q

crossover test technique

A

ADD arm across chest compressing AC jt

53
Q

crossover test tests for

A

AC jt disruption, arthiritis

54
Q

rotator cuff injuries

A

common
acute or chronic
cause: lifting heavy obj, overuse
path: acromial spurring, subacromial impingement/bursitis, microtears of supraspinatus, complete tear

55
Q

rotator cuff injuries sxx

A

pain inferior to anterior acromion

referred pain to ant deltoid where it inserts on humerus

56
Q

drop arm test technique

A

dr abd pt arm

asks pt to slowly lower to side

57
Q

drop arm test tests for

A

rotator cuff problem

usually: supraspinatus

58
Q

apley scratch test technique

A

upper arm: ext rot/abd

lower arm: int rot/add

59
Q

apley scratch test tests for

A

adhesive capsulitis (frozen shoulder)

60
Q

apprehension test technique

A

abd arm to 90 and ext rot with one hand

other hand should push back of shoulder forward

61
Q

apprehension test tests for

A

pain on pt face
loose jt capsule
subluxation/dislocation

62
Q

O’brien’s test technique

A

flex arm to 90, add across chest

int rot with thumb down and push down on arm

63
Q

O’brien’s test tests for

A

labral tear-SLAP

64
Q

Speed’s test technique

A

flex straight arm to 90
palm facing up
pt resists dr pushing down

65
Q

Speed’s test tests for

A

biceps tendonitis

66
Q

hawkin’s impingement sign

A

dr grasps pt elbow and distal forearm
dr passively ext rot shoulder
dr passively int rot shoulder

67
Q

hawkin’s tests for

A

ext rot: subscapularis

int rot: supraspinatus, teres minor, infraspinatus

68
Q

subacromial bursa

A

stabilize shoulder, ext humerus.

pain=subacromial bursitis or rotator cuff

69
Q

elbow ROM

A

ext: 0
flexion: 150
pronation: 70
supination: 90

70
Q

elbow conditions

A 
sprains
olecranon bursitis
epicondylitis (lat and med)
nursemaid's elbow (radial head d/l)
posterior elbow (ulnar d/l)
SD (radial head ant/post)
OA or RA
Fx
Peripheral neuropathies (ex: cubital tunnel syndrome-ulnar n compression behind medial epicondyle)
71
Q

radial head Sd

A

posterior with pronation
anterior with supination
SAPP=normal motion
Sd of one means can’t do other motion

72
Q

radial head subluxation

A

“nursemaid’s elbow”
-grip radial head and fell motion during pronation and supination
glide it anteriorly and posteriorly

73
Q

lateral epicondylitis

A

tennis elbow
chronic
sxx: pain in lat elbow and dorsal region of forearm
worst w/ wrist extension, gripping, lifting
cause: overuse

74
Q

medial epicondylitis

A

golfer’s elbow
chronic
sxx: pain in med elbow and volar region of forearm
worse w/ wrist flexion, gripping, lifting
cause: overuse

75
Q

lat epi test

A

palpate lat epicondyle
resist pt wrist extension
pain=(+)

76
Q

med epi test

A

palpate med epicondyle

resist pt wrist flexion

77
Q

varus/valgus testing

A

stabilize humerus

move arm out and in

78
Q

radiohumeral/ulnohumeral jt tests

A

position elbow where discomfort is
ulnar/radial deviate
compress radial/ulnar head into humerus
test for pain

79
Q

inspection of hand and wrist

A

hand: RA (ulnar dev, boutonniere deformity0
OA (Heberden’s nodes at DIP and Bouchard’s nodes at PIP)
wrist: ganglion cyst

80
Q

palpation of hand and wrist

A

radius, ulnar styloid, radiocarpal/ulnar jts
anatomic snuffbox
carpometacarpal jts
lateral and medial aspects: MCP, PIP, DIP

81
Q

wrist ROM

A

ext: 70
flex: 90
radial dev: 20
ulnar dev: 55

82
Q

hand ROM

A 
MCP hyperext: 30
MCP flex: 90
PIP and DIP ext: 0
PIP and DIP flex: 90
opposition: thumb to 5th MCP
83
Q

Tinel’s sign technique

A

tap over median n in carpal tunnel on palmar surface of wrist w/ index finger/hammer

84
Q

tinel’s sign tests for

A

shooting pain/paresthesia of median n

dx for compression neuropathy (not specific for carpal tunnel)

85
Q

phalen’s manuever technique

A

pt flexeds both wrist to 90 and combines dorsal aspects together

86
Q

wrist/hand problems

A 
tenosynovitis (DeQuervain's)
ganglion cysts
OA
RA
psoariatic arthritis
gout
carpal tunnel syndrome
87
Q

Colle’s fx

A

distral radius fx w/ distal fx fragment displaced dorsally

cause: fall on outstretched hand

88
Q

Boxer’s fracture

A

distal 5th MC fx w/ volar/palmar angulation

cause: punching wall

89
Q

scapohid fx

A

snuffbox tenderness
missed on XR
heals poorly b/c of poor vasc

90
Q

dupuytren’s contracture

A

ifm, thickening, contracture of palmar fascia

common in 4th and 5th digits

91
Q

trigger finger

A

ifm of flexor dig tendon sheath becoming trapped prox to MCP jts during flexion so ext of finger is harder and usually snaps

92
Q

grind test

A

tests carpo-metacarpal OA
common at 1st jt
technique: abd thumb, grasp base, rotate back and forth

93
Q

finkelstein’s test

A

put pt thumb in fist, gently ulnar deviate wrist

if painful=(+) for tenosynovitis of ext pol brevis and abd pol longus (deQuervain)

94
Q

what tests for deQuervain/gamers tumb?

A

finkelstein’s test

95
Q

varus/valgus hand tests

A

for ligament stress/instability

thumb/ulnar collateral ligament stress: stress upper thumb jt, push thumb away from hand

96
Q

cervical tests (2)

A

spurlings

distraction

97
Q

thoracic outlet tests (2)

A

roo’s

adson’s

98
Q

shoulder tests (8)

A 
empty can
lift off
crossover
apprehension
o'briens
speed's
drop arm
hawkin's impingement
(neer impingement ?)
99
Q

elbow tests (4)

A

lat epi
med epi
varus/valgus
radiohumeral/ulnohumeral

100
Q

wrist/hand tests (4)

A

finkelstein’s
tinel’s/phalen’s
finger varus/valgus
thumb/ulnar coll lig stress

101
Q

common neck conditions

A 
Sd
muscle sprain/spasm
disc herniation
spondylolisthesis
OA
ankylosing spondyilitis
vertebral fx
102
Q

muscle sprain/spasm

A

torticollis: SCM spasm causing ipsilat SB, contralat rot

thoracic outlet syndrom

103
Q

disc herniatio

A

nerve root impingement

104
Q

spondylolithesis

A

forward displacement of vertebra compresses SC

105
Q

OA

A

chronic degen arthritis

106
Q

ankylosing spondylitis

A

spinal ifm degen arthritis causes vertebral fusion

107
Q

vertebral fx

A

trauma
osteoporosis
malignancy

PCM II Exam 1 (7 decks)

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