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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
common causes of CC
``` injuries (fx, contusions, tendon/lig tears, overuse) muscular disorders (muscular dystrophy, rabdomyolysis) bone and joint disorders (arthritis-OA or RA) ```
26
PE of Shoulder
``` bones: scapular, humerus, clavicle joints: AC, GH rotator cuff mm ```
27
acromioclavicular joint is?
synovial condylar
28
glenohumeral joint
synovial spheroidal type labrum rotator cuff
29
rotator cuff muscles
supraspinatus infraspinatus subscapularis teres minor
30
inspection and palpation of shoulder
AC jt GH jt: arm ext exposes subacromial structures Scapula: winging Humerus
31
winging of scapular etiology
long thoracic n injury weakens serratus anterior m
32
shoulder ROM
abd: 180 add: 75 flexion: 180 ext: 60 ext rot: 90 int rot: 100
33
trapezius movement
sup: elevates middle: retracts inf: depresses
34
levator scapula action
elevation
35
rhomboids action
retraction
36
pectoralis action
depression
37
biceps action
flezes humerus
38
coracobrachialis action
flexes and ADDucts humerus
39
lat dorsi action
extends and med rotates humerus
40
deltoid action
anterior: flexes middle: abducts after 90 posterior: extends
41
supraspinatus action
abducts 90
42
infraspinatus action
ext rotates
43
subscapularis action
int rotates
44
teres minor action
ext rotates
45
teres major
int rotates
46
strength testing
isolate joint compare b/l grade strength out of 5
47
strength scale
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
empty can test technique
abd arms, flex to 45, pour out soda | dr. puts pressure down and patient resists
49
empty can test tests for
supraspinatus injury | pain/weakness indicates injury
50
lift off test technique
arms internal rotated behind back | pt lifts off while dr resists
51
lift off test tests for
subscapularis injury
52
crossover test technique
ADD arm across chest compressing AC jt
53
crossover test tests for
AC jt disruption, arthiritis
54
rotator cuff injuries
common acute or chronic cause: lifting heavy obj, overuse path: acromial spurring, subacromial impingement/bursitis, microtears of supraspinatus, complete tear
55
rotator cuff injuries sxx
pain inferior to anterior acromion | referred pain to ant deltoid where it inserts on humerus
56
drop arm test technique
dr abd pt arm | asks pt to slowly lower to side
57
drop arm test tests for
rotator cuff problem | usually: supraspinatus
58
apley scratch test technique
upper arm: ext rot/abd | lower arm: int rot/add
59
apley scratch test tests for
adhesive capsulitis (frozen shoulder)
60
apprehension test technique
abd arm to 90 and ext rot with one hand | other hand should push back of shoulder forward
61
apprehension test tests for
pain on pt face loose jt capsule subluxation/dislocation
62
O'brien's test technique
flex arm to 90, add across chest | int rot with thumb down and push down on arm
63
O'brien's test tests for
labral tear-SLAP
64
Speed's test technique
flex straight arm to 90 palm facing up pt resists dr pushing down
65
Speed's test tests for
biceps tendonitis
66
hawkin's impingement sign
dr grasps pt elbow and distal forearm dr passively ext rot shoulder dr passively int rot shoulder
67
hawkin's tests for
ext rot: subscapularis | int rot: supraspinatus, teres minor, infraspinatus
68
subacromial bursa
stabilize shoulder, ext humerus. | pain=subacromial bursitis or rotator cuff
69
elbow ROM
ext: 0 flexion: 150 pronation: 70 supination: 90
70
elbow conditions
``` 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
radial head Sd
posterior with pronation anterior with supination SAPP=normal motion Sd of one means can't do other motion
72
radial head subluxation
"nursemaid's elbow" -grip radial head and fell motion during pronation and supination glide it anteriorly and posteriorly
73
lateral epicondylitis
tennis elbow chronic sxx: pain in lat elbow and dorsal region of forearm worst w/ wrist extension, gripping, lifting cause: overuse
74
medial epicondylitis
golfer's elbow chronic sxx: pain in med elbow and volar region of forearm worse w/ wrist flexion, gripping, lifting cause: overuse
75
lat epi test
palpate lat epicondyle resist pt wrist extension pain=(+)
76
med epi test
palpate med epicondyle | resist pt wrist flexion
77
varus/valgus testing
stabilize humerus | move arm out and in
78
radiohumeral/ulnohumeral jt tests
position elbow where discomfort is ulnar/radial deviate compress radial/ulnar head into humerus test for pain
79
inspection of hand and wrist
hand: RA (ulnar dev, boutonniere deformity0 OA (Heberden's nodes at DIP and Bouchard's nodes at PIP) wrist: ganglion cyst
80
palpation of hand and wrist
radius, ulnar styloid, radiocarpal/ulnar jts anatomic snuffbox carpometacarpal jts lateral and medial aspects: MCP, PIP, DIP
81
wrist ROM
ext: 70 flex: 90 radial dev: 20 ulnar dev: 55
82
hand ROM
``` MCP hyperext: 30 MCP flex: 90 PIP and DIP ext: 0 PIP and DIP flex: 90 opposition: thumb to 5th MCP ```
83
Tinel's sign technique
tap over median n in carpal tunnel on palmar surface of wrist w/ index finger/hammer
84
tinel's sign tests for
shooting pain/paresthesia of median n | dx for compression neuropathy (not specific for carpal tunnel)
85
phalen's manuever technique
pt flexeds both wrist to 90 and combines dorsal aspects together
86
wrist/hand problems
``` tenosynovitis (DeQuervain's) ganglion cysts OA RA psoariatic arthritis gout carpal tunnel syndrome ```
87
Colle's fx
distral radius fx w/ distal fx fragment displaced dorsally | cause: fall on outstretched hand
88
Boxer's fracture
distal 5th MC fx w/ volar/palmar angulation | cause: punching wall
89
scapohid fx
snuffbox tenderness missed on XR heals poorly b/c of poor vasc
90
dupuytren's contracture
ifm, thickening, contracture of palmar fascia | common in 4th and 5th digits
91
trigger finger
ifm of flexor dig tendon sheath becoming trapped prox to MCP jts during flexion so ext of finger is harder and usually snaps
92
grind test
tests carpo-metacarpal OA common at 1st jt technique: abd thumb, grasp base, rotate back and forth
93
finkelstein's test
put pt thumb in fist, gently ulnar deviate wrist | if painful=(+) for tenosynovitis of ext pol brevis and abd pol longus (deQuervain)
94
what tests for deQuervain/gamers tumb?
finkelstein's test
95
varus/valgus hand tests
for ligament stress/instability | thumb/ulnar collateral ligament stress: stress upper thumb jt, push thumb away from hand
96
cervical tests (2)
spurlings | distraction
97
thoracic outlet tests (2)
roo's | adson's
98
shoulder tests (8)
``` empty can lift off crossover apprehension o'briens speed's drop arm hawkin's impingement (neer impingement ?) ```
99
elbow tests (4)
lat epi med epi varus/valgus radiohumeral/ulnohumeral
100
wrist/hand tests (4)
finkelstein's tinel's/phalen's finger varus/valgus thumb/ulnar coll lig stress
101
common neck conditions
``` Sd muscle sprain/spasm disc herniation spondylolisthesis OA ankylosing spondyilitis vertebral fx ```
102
muscle sprain/spasm
torticollis: SCM spasm causing ipsilat SB, contralat rot | thoracic outlet syndrom
103
disc herniatio
nerve root impingement
104
spondylolithesis
forward displacement of vertebra compresses SC
105
OA
chronic degen arthritis
106
ankylosing spondylitis
spinal ifm degen arthritis causes vertebral fusion
107
vertebral fx
trauma osteoporosis malignancy

PCM II Exam 1 (7 decks)

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