OAT UE and LE Pain Flashcards
GH joint ROM
Flexion 180
Extension 60
Abduction 180
Horizontal adduction 40-50 or 130-140
Horizontal abduction 130-145 or 40-55
ER 90
IR 90
GH SD BLT (indications include subdeltoid bursitis or frozen shoulder)
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
Scapular elevation leads to _____ movement at SC joint
Shoulder depression leads to _____ motion of SC
Inferior; superior
Protraction of shoulders leads to ____ glide of clavicle at SC joint
Retraction leads to ____ glide
Posterior; anterior
SC elevated/adducted SD Still technique
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
SC depressed/abducted SD Still technique
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
SC SD HVLA
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]
AC joint separated SD Still technique
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
Ulnar adduction (varus testing) is coupled with wrist ______
Abduction (radial deviation)
[while ulnar abduction is coupled with wrist adduction/ulnar dev]
Ulnar abduction SD HVLA
Supinate and fully extend elbow
Move elbow into ulnar adduction. Apply medial to lateral thrust over medial olecranon
Ulnar adduction SD HVLA
Supinate and fully extend elbow
Move elbow into ulnar abduction. Apply lateral to medial thrust over lateral olecranon
Radial head anterior glide is coupled with ______
Radial head posterior glide is coupled with ______
Supination; pronation
Anterior radial head HVLA
Contact anterior radial head
Flex elbow and pronate forearm
Exert rapid hyperflexion force while simultaneously thrusting the radial head posteriorly
Posterior radial head SD HVLA
Extend and supinate elbow; place thumb over posterior aspect of radial head
Exert rapid hyperextension force while simultaneously thrusting radial head anteriorly
Wrist extension/ventral carpal SD HVLA
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
Wrist flexion//dorsal carpal SD HVLA
Pronate elbow. Grasp patient’s hand
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
Frozen shoulder (adhesive capsulitis)
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.
Tendonitis
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.
Tendinosus
SSRI used in depression, anxiety, diabetic neuropathy, fibromyalgia, generalized
anxiety disorder, chronic musculoskeletal pain, stress urinary incontinence (females)
Duloxetine
Hip ROM
Flex 90 (knee extended) 120–135 knee flexed
Extension 15-30
IR 30-40
ER 40-60
Abd 45-50
Add 20-30
Posterior glide is the minor motion with ankle _______
Dorsiflexion
Most common dysfunction of the navicular is _________ SD
Plantar
[lateral navicular drops plantar]
The most common cuboid dysfunction is plantar cuboid SD in which the ______ cuboid drops plantar. This is commonly associated with a ______ fibular head dysfunction
Medial; posterior
Grading ankle sprains
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
Ottawa ankle rules for traumatic ankle pain
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
Ottawa ankle rules for traumatic foot pain
Point tenderness at base of fifth metatarsal
Point tenderness at navicular
Inability to bear weight x4 steps in ED
Joint pain while going down a set of stairs is more likely _______, while ascending motion (repetitive knee flexion) is more likely ________ or ______
OA; pes anserine bursitis; patellofemoral pain syndrome
With patellar tendonitis, pain _____ during activity
Decreases
