OAT UE and LE Pain

Question 1

GH joint ROM

Answer 1

Flexion 180

Extension 60

Abduction 180

Horizontal adduction 40-50 or 130-140

Horizontal abduction 130-145 or 40-55

ER 90

IR 90

Question 2

GH SD BLT (indications include subdeltoid bursitis or frozen shoulder)

Answer 2

Pt lateral recumbent

Grasp olecranon of dysfunctional arm and flex elbow; use other hand to stabilize shoulder, monitoring with thumb and index finger

Using elbow as lever, but GH joint in its indirect position. Hold until release is felt

Question 3

Scapular elevation leads to _____ movement at SC joint

Shoulder depression leads to _____ motion of SC

Answer 3

Inferior; superior

Question 4

Protraction of shoulders leads to ____ glide of clavicle at SC joint

Retraction leads to ____ glide

Answer 4

Posterior; anterior

Question 5

SC elevated/adducted SD Still technique

Answer 5

Pt seated with physician behind, monitoring SC with one hand and grasping elbow with other

Start with elbow ADDUCTED and slightly EXTENDED, add compression toward SC joint

Move shoulder into superior glide and abduction, engaging posterior circumduction motion. Remove compression and return to neutral

Question 6

SC depressed/abducted SD Still technique

Answer 6

Pt seated with doc behind, monitoring SC joint with one hand and grasping elbow with other

Start with elbow abducted and slightly flexed. Add compression toward SC joint

Move shoulder into adduction with anterior circumduction motion, returning to an adduction position

Remove compression and return to neutral

Question 7

SC SD HVLA

Answer 7

Pt supine with doc at head of table

Place thenar eminence of monitoring hand over restriction

Apply cephalad traction on arm, apply thrust at SC joint while simultaneously inducing rapid traction through pts arm

[adduction SE (elevated SC) = inferior thrust; extension SD (anterior SC) = posterior thrust]

Question 8

AC joint separated SD Still technique

Answer 8

Pt seated, doc in front of pt

Affected side is abducted with slight extension to open AC joint

Traction applied

Arm is moved into adduction/flexion

Traction removed and arm returned to neutral

Question 9

Ulnar adduction (varus testing) is coupled with wrist ______

Answer 9

Abduction (radial deviation)

[while ulnar abduction is coupled with wrist adduction/ulnar dev]

Question 10

Ulnar abduction SD HVLA

Answer 10

Supinate and fully extend elbow

Move elbow into ulnar adduction. Apply medial to lateral thrust over medial olecranon

Question 11

Ulnar adduction SD HVLA

Answer 11

Supinate and fully extend elbow

Move elbow into ulnar abduction. Apply lateral to medial thrust over lateral olecranon

Question 12

Radial head anterior glide is coupled with ______

Radial head posterior glide is coupled with ______

Answer 12

Supination; pronation

Question 13

Anterior radial head HVLA

Answer 13

Contact anterior radial head

Flex elbow and pronate forearm

Exert rapid hyperflexion force while simultaneously thrusting the radial head posteriorly

Question 14

Posterior radial head SD HVLA

Answer 14

Extend and supinate elbow; place thumb over posterior aspect of radial head

Exert rapid hyperextension force while simultaneously thrusting radial head anteriorly

Question 15

Wrist extension/ventral carpal SD HVLA

Answer 15

Pronate elbow… grasp pts hand, thumbs contacting dorsally at proximal carpal bones (radiocarpal joint)
deliver whip-like force moving from extension to flexion through dysfunction

Question 16

Wrist flexion//dorsal carpal SD HVLA

Answer 16

Pronate elbow. Grasp patient’s hand

Question 17

Severe shoulder pain, limited AROM and PROM, typically unilateral - More common in patients with diabetes mellitus, post-shoulder injury or surgery Shoulder (Adhesive Capsulitis) - Severe shoulder pain, limited AROM and PROM, typically unilateral - More common in patients with diabetes mellitus, post-shoulder injury or surgery

Answer 17

Frozen shoulder (adhesive capsulitis)

Question 18

ymptomatic degeneration of the tendon, characterized histologically by vascular disruption
and an inflammatory repair response.
o Begins insidiously, with onset of pain at the insertion that worsens. May find spurring or erosion
at the insertion on radiographic study although not diagnostic.

Answer 18

Tendonitis

Question 19

Chronic intratendinous degeneration and alteration of tendon architecture, with histologic
findings of non-inflammatory collagen degeneration, fiber disorientation, hypo-cellularity, scattered
vascular ingrowth, and occasionally local necrosis or calcification.

Answer 19

Tendinosus

Question 20

SSRI used in depression, anxiety, diabetic neuropathy, fibromyalgia, generalized
anxiety disorder, chronic musculoskeletal pain, stress urinary incontinence (females)

Answer 20

Duloxetine

Question 21

Hip ROM

Answer 21

Flex 90 (knee extended) 120–135 knee flexed

Extension 15-30

IR 30-40

ER 40-60

Abd 45-50

Add 20-30

Question 22

Posterior glide is the minor motion with ankle _______

Answer 22

Dorsiflexion

Question 23

Most common dysfunction of the navicular is _________ SD

Answer 23

Plantar

[lateral navicular drops plantar]

Question 24

The most common cuboid dysfunction is plantar cuboid SD in which the ______ cuboid drops plantar. This is commonly associated with a ______ fibular head dysfunction

Answer 24

Medial; posterior

Question 25

Grading ankle sprains

Answer 25

Grade 1 = mild — slight stretching and microscopic tearing of ligament fibers, mild tenderness and swelling around ankle

Grade 2 = moderate — partial tearing of ligament, moderate tenderness and swelling around the ankle. If the doc moves the ankle in certain ways, there is an abnormal looseness of ankle joint

Grade 3 = complete tear of ligament; significant tenderness and swelling around the ankle. If the doc pulls or pushes on joint, substantial instability occurs

Question 26

Ottawa ankle rules for traumatic ankle pain

Answer 26

Qualifies for radiograph if:

Point tenderness at posterior edge or tip of lateral malleolus

Point tenderness at posterior edge or tip of medial malleolus

Inability to bear weight x4 steps in ED

Question 27

Ottawa ankle rules for traumatic foot pain

Answer 27

Point tenderness at base of fifth metatarsal

Point tenderness at navicular

Inability to bear weight x4 steps in ED

Question 28

Joint pain while going down a set of stairs is more likely _______, while ascending motion (repetitive knee flexion) is more likely ________ or ______

Answer 28

OA; pes anserine bursitis; patellofemoral pain syndrome

Question 29

With patellar tendonitis, pain _____ during activity

Answer 29

Decreases