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UE Extremity part 1 > Orthopedic Conditions of UE part 1 > Flashcards

Orthopedic Conditions of UE part 1 Flashcards

1
Q

Patient was found to have an inferior trunk brachial plexopathy.
Which of the following motions would most likely show weakness?

A. Elbow flexion
B. Shoulder Adduction
C. Scapular Upward Rotation
D. Scapular Adduction

A

B. Shoulder Adduction

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2
Q

THORACIC OUTLET SYNDROME

A: _________ P: _________
M: _________ L: _________

Passage of: _________

Causes: _________

S/Sx: _________

Nn affected: _________

Sensory: _________

Motor: _________

Impaired circulation: _________

Tx:_________

A

THORACIC OUTLET SYNDROME
Boundaries:

A: Clavicle P: 1st rib
M: sternum L: coracoid process

Passage of: subclavian vessels & inf trunk BP (C8-T1)

Causes: trauma, congenital anomaly, hypertrophied neck ms

S/Sx: Pain at: neck & shoulder/arm pain

Nn affected: ulnar & med pectoral nn

Sensory: medial arm, FA & hand

Motor: ↓ power grip (4th & 5th finger) & Claw hand

Impaired circulation: pallor, cyanosis, pulselessness

Tx:nn mob, 1strib mob, postural reeduc, surgery for cervical
rib & fibrotic scalenes

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3
Q

HR jt mob: _________
To increase flexion: _________
To increase extension: _________

A

HR jt mob: Same
To increase flexion: volar glide
To increase extension: dorsal glide

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4
Q

PRU jt mob: _________
To increase supination = _________
To increase pronation = _________

A

PRU jt mob: opposite
To increase supination = anterior glide
To increase pronation = posterior glide

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5
Q

TOS: COMMON AREAS OFCOMPRESSION

1.
2.
3.
4.

A
  1. CERVICAL RIB SYNDROME
  2. SCALENUS ANTICUS SYNDROME
  3. COSTOCLAVICULAR SPACESYNDROME
  4. Hyperabduction Syndrome
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6
Q
  1. CERVICAL RIB SYNDROME
    - _________
    - Extra ___ or ___ rib
    - May cause _________
    - Tx: _________
A
  1. CERVICAL RIB SYNDROME
    - Congenital anomaly
    - Extra C6 or C7 rib
    - May cause dangerous clots
    - Tx: Cervical ribs surgery
    removal
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7
Q
  1. SCALENUS ANTICUS SYNDROME

Aka: _________

  • _________and _________ hypertrophy

Stretch: _________
R SCM: action? _________
R SCM: _________
R Scalene: _________

A
  1. SCALENUS ANTICUS SYNDROME

Aka: Scalene Triangle

  • middle and ant scalenes hypertrophy

Stretch: same SCM
R SCM: A: R LF LRot
R SCM: stretch L LF, R Rot
R Scalene: stretch L LF, R Rot

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8
Q
  1. COSTOCLAVICULAR SPACESYNDROME

In between: _________ & _________

Causes: _________

A
  1. COSTOCLAVICULAR SPACESYNDROME

In between: 1st rib & clavicle

Causes:postural, tumor, callus s/p Fx,
**heavy backpack (Military position)

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9
Q
  1. Hyperabduction Syndrome

Passes under: _________
Compression in: _________

PT goals: _________

A
  1. Hyperabduction Syndrome

Passes under: Pecs Minor
Compression in: sub coracoid region

PT goals: Postural Reeducation

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10
Q

Identify the 3 TOS locations

1.
2.
3.

A
  1. Scalenus
  2. Costoclavicular
    3.hyperabduction
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11
Q

Shoulder Girdle Passive Elevation (Relief Test)
“RELEASE PHENOMENON”

Arterial: ___________________________
Venous: ___________________________
Neurological: ___________________________

A

Shoulder Girdle Passive Elevation (Relief Test)
“RELEASE PHENOMENON”
Arterial: stronger pulse, skin color changes (pinker) and increased hand temperature

Venous: decreased cyanosis and venous engorgement

Neurological: numbness to pins and needles

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12
Q

Phases of Pitching (Muscle Activity)
Wind Up: ____________
Cocking: ____________
Acc: ____________
Dec/F-T: ____________

A

Phases of Pitching (Muscle Activity)
Wind Up: Conc – ER ms
Cocking: Ecc – IR ms
Acc: Conc – IR ms
Dec/F-T: Ecc – ER ms

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13
Q

SPECIALTESTS FOR TOS

(+): ___________________________
Indicative: ____________

A

(+): diminished pulse + reproduction of sx

Indicative: TOS

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14
Q

Adson Maneuver

❑ Palpate ____________
❑ Px rotates head to ____________
❑ PT ____________
❑ Ask the px to ____________
❑ (+):
❑ Muscle tested?

A

❑ Palpate radial pulse
❑ Px rotates head to tested Sh c head ext
❑ PT ext & ER the Sh
❑ Ask the px to take a breath & hold
❑ (+): Diminished pulse
❑ Muscle tested: Scalene

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15
Q

Costoclavicular Syndrome
(Military Brace) Test

❑ Palpate ____________
❑ Head in ____________
❑ Draw the ____________
❑ **very particularly effective in px who
complains symptoms while they ____________

A

❑ Palpate radial pulse
❑ Head in neutral
❑ Draw the px Sh down & back
❑ **very particularly effective in px who
complains symptoms while they carry
a heavy coat or backpack

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16
Q

Halstead Maneuver

❑ Palpate ____________
❑ Px ____________
❑ PT applies ____________

A

❑ Palpate radial pulse
❑ Px hypertext head & rotate towards
opp side
❑ PT applies downward traction

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17
Q

Wright Test or Hyperabd Test

❑ Palpate ____________
❑ PT ____________

A

❑ Palpate radial pulse
❑ PT hyperabd the ER Sh
(palms facing backward)

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18
Q

Allen Maneuver (modified wright test)

❑ Aka: ____________
❑ Palpate ____________
❑ PT ___________________________

A

❑ Aka: Modified Wright Test
❑ Palpate radial pulse
❑ PT places elbow to 90 flex. Sh ext
& ER c head rotated away

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19
Q

Roo’s Test/EAST/Positive AER Test/
Hands Up Test

❑ Most accurate clinical test
(84% sensitivity)
❑ ____________
❑ ____________

❑ (+): ___________________________
❑ (-): ___________________________

A

❑ Most accurate clinical test
(84% sensitivity)
❑ Sh abd 90, ER, & flex elbow 90
❑ Open & close hands slowly for 3 mins

❑ (+): unstable to maintain position,
ischemic pain, heaviness or profound
weakness, numbness/tingling sensation
❑ (-): minor fatigue – Normal

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20
Q

Shoulder Girdle Passive Elevation
(Relief Test)

❑ ____________
❑ Px ____________
❑ ____________
❑ (+): ____________

A

❑ Perform to px who presents
c symptoms
❑ Px sitting c PT grasping
from behind, passively elevate
Sh girdle up & forward into full
elevation (passive B Sh shrug)
❑ Hold 30 secs
❑ (+): relief of sx = “Release
Phenomenon”

(Dapat my pain ang patient)

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21
Q

TRAUMATIC VS. ATRAUMATIC Shoulder Instabilities

TRAUMATIC
T - ____________
U - ____________
B - ____________
S - ____________

ATRAUMATIC
A - ____________
M - ____________
B - ____________
R - ____________
I – ____________

A

TRAUMATIC
T - Traumatic
U - Unidirectional (ant)
B - Bankart lesion (AI labrum detachment)
S - Surgery is required (Bankart repair)

ATRAUMATIC
A - Atraumatic
M - Multidirectional
B - Bilateral
R - Rehab is required but if conservative Tx fails…
I – Inf capsular shift – best alternative for surgical therapy

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22
Q

Anterior Shoulder Dislocation
Aka: Dead Arm Syndrome
**MC Sh dislocation
Anatomical fault: ___________________________
___________________________

MOI: ____________ (common in baseball
____________ in late ____________)
Tx: ___________________________

A

Anterior Shoulder Dislocation
Aka: Dead Arm Syndrome
**MC Sh dislocation
Anatomical fault: assoc c Bankart, weakness
of ant Sh capsule, absent MGH ligament

MOI: Abd + ER (common in baseball
player/pitcher in late cocking & acceleration)
Tx: strengthening of Add IR
If unreduced for >6 wks: surgery

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23
Q

Phases of Pitching (Muscle Activity)
Wind Up: ____________
Cocking: ____________
Acc: ____________
Dec/F-T: ____________

A

Wind Up: Conc – ER ms
Cocking: Ecc – IR ms
Acc: Conc – IR ms
Dec/F-T: Ecc – ER ms

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24
Q

Anterior Shoulder Dislocation
COMPLICATIONS:
1.Hill-Sach’s Lesion – ___________________________ **Reverse Hill-Sach – ___________________________ ___________________________

  1. Bankart lesion – ___________________________
    **If (+) Fx = Bony Bankart
  2. SLAP – ___________________________
  3. Axillary nn injury d/t ___________________________
    **mm involved:
A

COMPLICATIONS:
1.Hill-Sach’s Lesion – compression Fx of PL aspect of HHead
**Reverse Hill-Sach – compression Fx of AM aspect of HHead 2°
posterior dislocation

  1. Bankart lesion – detachment of anteroinferior glenoid labrum
    **If (+) Fx = Bony Bankart
  2. SLAP – Superior Labrum from Anterior to Posterior
  3. Axillary nn injury d/t traction/compression ff ant dislocation
    **mm involved:
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25
Q

Anterior Apprehension (Crank) Test

❑ ____________
❑ **PT fist under HHead
= ____________
❑ (+): ____________
❑ Indic: ____________

❑ (+): ____________
❑ Indic: ____________

A

❑ Abd + ER slowly
❑ **PT fist under HHead
= FULCRUM TEST
❑ (+): apprehension>pain
❑ Indic: Ant Sh dislocation

❑ (+): pain @ post HHead
❑ Indic: Post internal
impingement

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26
Q

*Crank Test –Test for GH ligaments

SGHL -

MGHL -

IGHL -

A

SGHL - Arms by the side

MGHL - 45-60 abd

IGHL - >90abd

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27
Q

Active Compression Test of O’BRIEN

A. ___________________________
B. ___________________________

(+): ___________________________
Indic: ___________________________

A

A. Px shoulder F flex, add,
and IR c elbow ext then PT
apply downward force
B. Px same position but c
shoulder ER then PT apply
downward force

(+): pain in A, ↓ or eliminated
in B
Indic: SLAP

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28
Q

Inferior Shoulder Dislocation

❑ Can be ____________ or d/t
____________ (____________ & ____________)
❑ Use ____________ sign
❑ FES: ____________ & ____________

A

❑ Can be congenital or d/t
ms weakness (post
deltoids & supraspinatus)
❑ Use Sulcus sign
❑ FES: Supraspinatus &
post deltoids

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29
Q

Sulcus Sign

❑ ____________: best to test for
inf instability
❑ ____________
❑ (+): ____________

+1 = ____________
+2 = ____________
+3 = ____________

❑ Indic: ____________

A

❑ 20-50 Abd: best to test for
inf instability
❑ PT grasp distal arm, pull
hand inferiorly
❑ (+): sulcus

+1 = <1cm
+2 = 1-2cm
+3 = >2cm

❑ Indic: Inf GH instability

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30
Q

Feagin Test

❑ Sh ____________ degrees
❑ PT holds hands over ____________
❑ (+): ____________
❑ Indic: ____________

A

❑ Sh 90 degrees
❑ PT holds hands over humerus
& pushes down
❑ (+): sulcus @ coracoid process
❑ Indic: Multidirectional instab

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31
Q

Posterior Shoulder Dislocation

❑ MOI: ___________________________
❑ ___________________________
❑ Assoc ____________

A

❑ MOI: axial loading of arm
in FADIR or direct blow
❑ Rare & occurs c
multidirectional laxity of
GH jt
❑ Assoc congenitally

32
Q

Load & Shift Test

❑ ___________________________
❑ 1st = ___________________________
❑ 2nd = ___________________________

❑ Compare to the N side
❑ If Bilat affectation, use grading system
N:
I:
II & III:

A

❑ Grasp HHead & stabilize Sh
❑ 1st = seat the humerus on the G. fossa
❑ 2nd = push the humerus ant & post

❑ Compare to the N side
❑ If Bilat affectation, use grading system
N: <25% - c in fossa
I: 25-50% - at the rim
II & III: >50% - over the rim

33
Q

Grades of Anterior glenohumeral translations

  3. 4.
A

0-25% - Mild amount of translation
25-50% - Feeling of humeral head riding up to the glenoid rim
>50% - Feeling of humeral head riding up to the glenoid rim, but spontaneously reduces.
50% - Feeling of humeral head riding up to the glenoid rim, but remains dislocated.

34
Q

Jerk Test

❑ ___________________________
❑ ___________________________
❑ ___________________________
❑ Indic: ____________

❑ Can be (+) c ____________

A

❑ Sh flex 90 & IR
❑ PT grasps elbow & apply axial load &
then H. Add → (+) sudden jerk/clunk
❑ Return to orig position → (+) 2nd jerk
❑ Indic: Post Sh dislocation

❑ Can be (+) c PosteroInf labral tear

35
Q

SURGICAL MANAGEMENT

  1. Bankart Repair: ___________________________ : ___________________________
  2. Putti-Platt: ___________________________
    : ___________________________
  3. Capsular Shift: ___________________________
  4. Capsulorraphy: ___________________________
A
  1. Bankart Repair: Operation of choice for Throwing athletes (ER is not
    compromised)
    : tightens the labrum & capsule anteriorly
  2. Putti-Platt: subscapularis tendon transfer
    : not ideal for athletes bec ER is compromised (for sedentary)
  3. Capsular Shift: tightening of capsule
  4. Capsulorraphy: altering size/features of ant capsule
36
Q

POST-SURGICAL Rehabilitation

AVOID:
1.
2.
3.

A

AVOID:
1. Flexion and horizontal abduction to 90 degrees or greater
2. External rotation to 80 degrees
3. Activities/sports that will induced shoulder dislocations.

37
Q

AC & SC Joint Disorders

AC Jt
❑ MOI: ___________________________
❑ (+) ___________________________
❑ Tx: Acute phase: ___________________________

SC Jt
❑ MOI: ___________________________
❑ Tx: ___________________________

A

AC Jt
❑ MOI: direct blow to Sh (Rugby)
❑ (+) Fountain sign = swelling of AC jt
❑ Tx: Acute phase: UE should be in
neutral c the use of sling & avoid sh
elevation

SC Jt
❑ MOI: fall on lat aspect of Sh c UE Add
❑ Tx: No need = little disability

38
Q

Shear Test

❑ Landmark: ___________________________
❑ ___________________________
❑ (+) ___________________________
❑ Indic: ___________________________

A

❑ Landmark: Clavicle & spine of scapula
❑ Squeeze c both hands
❑ (+) AbN movement of AC
❑ Indic: AC jt pathology

39
Q

Paxinos Sign

❑ ___________________________
❑ Thumb ____________
❑ Thumb ____________
❑ (+): ____________

A

❑ 2nd & 3rd finger @ clavicle
❑ Thumb @ PL acromion
❑ Thumb applies AS force @
acromion while 2nd & 3rd finger
apply post force @ clavicle
❑ (+): pain at AC jt

40
Q

Total Shoulder Arthroplasty VS.
Reverse Total ShoulderArthroplasty

INDICATION: persistent or incapacitating pain; loss of shoulder
mobility or stability and/or upper extremity strength leading to
inability to perform functional tasks

A
41
Q

Study exercise guidelines IN UR GDRIVE

A
42
Q

Supraspinatus tendinitis

Most common cause of shoulder pain 2° to ___________________________
Patient Profile: ___________________________

: ____________
: ____________ (if young = baseball pitchers

or ____________)

: ____________, ____________, ____________

S/sx: ____________
Can lead to supraspinatus tear – less pain, nocturnal pain that can be altered c sleeping position, & full PROM

A

Most common cause of shoulder pain 2° to degenerative changes
Patient Profile: Overhead activities

: F>M
: 35-50 y/o (if young = baseball pitchers

or swimmers)

: Sedentary, overuse, degenerative

S/sx: weakness & painful arc (60-120 Abd)
Can lead to supraspinatus tear – less pain, nocturnal pain that can be altered c sleeping position, & full PROM

43
Q

NEER’s CLASSIFICATION of RC PATHOLOGY

I – ____________
*____________

II - ____________
*____________

III – ____________

IV – ____________

A

I – HE (hemorrhage and edema)
*reversible & resolves c rest (<25 y/o)

II - FT (fibrosis tendinitis)
*recurrent pain c activity (25-40 y/o)

III – BSTR (bone spurr, tendon rupture)
(>40 y/o)

IV – RCTear rotator cuff
(>60 y/o)

44
Q

S/P ROTATOR CUFF REPAIR REHABILITATION

6 – 8 wks: ___________________________
10 – 12 wks: ___________________________
12 – 14 wks: ___________________________
24 – 28 wks: ___________________________
36 – 40 wks: ___________________________

A

6 – 8 wks: passive ROM, endurance, neuromuscular control and maintaining ROM, no CKC
10 – 12 wks: strengthening, no vigorous stretching
12 – 14 wks: task specific strengthening; activities in a controlled environment
24 – 28 wks: return to recreational activities; (80% regained)
36 – 40 wks:90% of strength is regained

45
Q

Acute Calcific Tendinitis

Aka: Peritendinitis Calcarea
* Deposition of ____________ in ____________
* S/Sx: ____________

: pain affecting sleep
: Sh LOM d/t pain
: No Abd & Rot

  • Iontophoresis:Acetic Acid
  • Tx:Immob
    : Aspiration (most effective)
A

Aka: Peritendinitis Calcarea
* Deposition of Ca phosphate in tendon
* S/Sx: severe localized intolerable pain
that radiates to deltoid insertion

: pain affecting sleep
: Sh LOM d/t pain
: No Abd & Rot

  • Iontophoresis:Acetic Acid
  • Tx:Immob
    : Aspiration (most effective)
46
Q

Subacromial Bursitis

❑ Acute phase:
❑ hard to distinguish bet
supraspinatus tendinitis
❑ Both (+) pain c resist

❑ Chronic phase:
❑ (+) pain c resist =
❑ (-) pain c resist =

A

❑ Acute phase:
❑ hard to distinguish bet supraspinatus tendinitis
❑ Both (+) pain c resist

❑ Chronic phase:
❑ (+) pain c resist = supraspinatous tendinitis
❑ (-) pain c resist = subachromial bursitis

47
Q

Bicipital Tendinitis

Caused by: ____________

Pain at: ____________, ____________, ____________

Special Test:
SPEED’S vs YERGASON’S TEST

A

Caused by: inadequate depth of
bicipital groove

Pain at: anteromed Sh, biceps
belly, Delts insertion

Special Test:
SPEED’S vs YERGASON’S TEST

48
Q

Speed’s Test
aka: Biceps or Straight-Arm Test

Procedure
(+):
Indic

❑ Maybe (+) in px c __________

A

❑ Resist F Flex while elbow ext &
FA supinated 1st
❑ then pronated
❑ (+): tenderness in bicipital
groove (esp. supination)
❑ Indic: Bicipital
Paratenonitis/tendinosis

❑ Maybe (+) in px c SLAP Type 2
lesion

LBC - Labral Biceps Complex

most painful during supination

49
Q

Yergason’s

❑ 1° tests the ability of _____ to hold the _______
❑ Palpate: _________
❑ 1st =
❑ 2nd =
❑ (+):

❑ (+): tenderness =

A

❑ 1° tests the ability of THL to hold the biceps tendon
❑ Palpate: bicipital groove
❑ 1st = Elbow flex 90, FA pronated, Sh IR (used to give way to step 2)

❑ 2nd = Px ER & supination c PT resist

❑ (+): popping out of biceps tendon from groove = Torn THL

❑ (+): tenderness = Bicipital paratenonitis

(+) = THL pathology

50
Q

Biceps Tendon Rupture
❑ may progress to ____________ tear:
❑ may be ____________;
❑ MOI: ____________
❑ S/Sx: ____________

Popeye’s sign
Heuter’s sign

❑ Tx:
Young: ____________
Adults: non-op = ____________

❑ Special Test:

A

❑ may progress to biceps tendon tear:
❑ may be avulsed anywhere in the mm;
❑ MOI: sudden indirect violence c a tendon that
has already degen changes
❑ S/Sx: sharp pain c audible snap

Popeye’s sign
Heuter’s sign

❑ Tx:Young: surgery (tendon transfer to coracoid
or bicipital floor)
Adults: non-op = regain ms strength 4-6 mos

❑ Special Test: Ludington’s Test

51
Q

Ludington’s Test

Procedure
(+):
Indic

A

❑ Alternate contxn of biceps
❑ (+): no palpable contxn
❑ Indic: Long head biceps
tendon rupture

52
Q

Impingment Syndrome

Characterized by soft tissue
inflammation of the shoulder
against the acromion with
repetitive overhead AROM.

PRIMARY
SECONDARY
POSTERIOR (INTERNAL) IMPINGEMENT

A

A. PRIMARY Impingment Syndrome
* Inflammation at the
subacromial space
* Rotatorcuff tendon degeneration
* Osteophytes under AC joint
* Hooked acromion

B. SECONDARY Impingment Syndrome
* Abnormal glenohumeral/scapul
othoracic arthrokinematics
* Slouched posture
* Poking chin
* Muscle hypomobility
* Capsule tightness
(especially posterior)
* Adhesions
(especially inferiorly)

C. Posterior Internal Impingement

  • MC in: overhead athletes (throwers, swimmers, tennis players)
  • Manifests at: late cocking/early acceleration
  • RC (supraspinatus) impinges against the PS edge of the G. fossa
  • occurs when the arm is in: EXABER
  • Dx Test:Arthrogram or MRI
53
Q

PRIMARY Impingment Syndrome

A

A. PRIMARY Impingment Syndrome
* Inflammation at the
subacromial space
* Rotatorcuff tendon degeneration
* Osteophytes under AC joint
* Hooked acromion

54
Q

SECONDARY Impingment Syndrome

A

B. SECONDARY Impingment Syndrome
* Abnormal glenohumeral/scapul
othoracic arthrokinematics
* Slouched posture
* Poking chin
* Muscle hypomobility
* Capsule tightness
(especially posterior)
* Adhesions
(especially inferiorly)

55
Q

Posterior Internal Impingement

A

C. Posterior Internal Impingement

  • MC in: overhead athletes (throwers, swimmers, tennis players)
  • Manifests at: late cocking/early acceleration
  • RC (supraspinatus) impinges against the PS edge of the G. fossa
  • occurs when the arm is in: EXABER
  • Dx Test:Arthrogram or MRI
56
Q

Neer Impingement Test

Procedure
(+):
Indic

A

❑ Sitting
❑ PT depress scapula while other hand IR
❑ Max forced full arm elevation
❑ (+): apprehension – “when px face
shows pain”

❑ But if (+) pain on ER = AC jt patho

57
Q

Hawkins-Kennedy test

Procedure
(+):
Indic

A

❑ Sitting
❑ F Flex 90
❑ Perform passive IR
❑ (+): pain

58
Q

Yocum’s Test

Procedure
(+):
Indic

A

❑ Px hand is placed on opp Sh
❑ PT elevate elbow – Passive
❑ (+): pain = Sh impingement

59
Q

Dugas Test

Procedure
(+):
Indic

A

❑ Px hand is placed on opp Sh
❑ Px lowers elbow to chest – Active
❑ (+): inability = ant Sh disloc s reduction

60
Q

Posterior Internal Impingement Test

Procedure
(+):
Indic

A

❑ Supine
❑ PT Abd 90-110 c 15-20 Ext & full ER
❑ (+): pain at post aspect of Sh

61
Q

Impingement tests?

1.
2.
3.
4.
5.

A

Neer Impingement Test
Hawkins-Kennedy test
Yocum’s Test
Dugas Test
Posterior Internal Impingement Test

62
Q

Adhesive Capsulitis

Aka: ____________, ____________, ____________

Characterized by a restriction in Sh motion as a result of
____________ usually d/t ____________ or ____________.

Sex affected? ; age affected?
Capsular pattern of limitation:

Trick motions: to ↑ Sh Abd =
: to ↑ Sh Flex =
Reverse Scapulohumeral rhythm
Self-limiting (up to 2 years)

A

Aka: Frozen Sh, Obliterative Arthritis, Diffused
RC tendinitis

Characterized by a restriction in Sh motion as a result of
inflammation and fibrosis of the Sh capsule usually d/t
disuse ff injury or repetitive micro trauma.

F>M; 40-60 y/o
Capsular pattern of limitation: ER>AB>IR

DM pt.
Dominant: IR = ER > AB > EXT
Non-dominant: Hyperext = ER > ABD > IR
: trick motions: for increase sh abd (lat bend trunk)
increase sh flex (trunk ext)

Trick motions:
: to ↑ Sh Abd =
: to ↑ Sh Flex =
Reverse Scapulohumeral rhythm
Self-limiting (up to 2 years)

63
Q

Stages of Adhesive Capsulitis check on Gdrive

A

Claim RPT!

64
Q

Brachial Plexus Injuries

1.
2.

A
  1. ERB-DUCHENNE PARALYSIS
  2. DEJERINE-KLUMPKE’S PARALYSIS
65
Q

ERB-DUCHENNE PARALYSIS

Nn root: ____________
MOI: ____________

Strong mm: ____________
Weak mm: ____________

Prognosis: ____________ (____________& ____________)

A

Nn root: C5-C6
MOI:Overstretched upper trunk of BP

Strong mm: Mm that asume waiters tip (adducted and IR)
Weak mm: Sh. ER, AD, F, FA SUPINATOR, WRIST EXTENSION

Prognosis: GOOD (hands & fingers
not affected)

66
Q

DEJERINE-KLUMPKE’S PARALYSIS

Nerve root: ____________
Affects: ____________, ____________,
____________

____________ prognosis

A

Nerve root: C8-T1
Affects: FA pronators, Wrist flexors,
Intrinsic ms of the hands

POOR prognosis

67
Q

Long Thoracic Nerve Injury

Can be injured by blows or pressure on the ____________ trunk or during the surgical procedure of ____________.
Aka: ____________
Weakness: ____________
- ____________
- ____________

Occurs on: ____________
Difficulty in: ____________
Tx: Strengthen: ____________

A

Can be injured by blows or pressure on the posterior trunk or during the
surgical procedure of radical mastectomy.
Aka: Open Book Paralysis
Weakness:SA
- Medial winging
- Scapula elevated & moves medially,
Inf angle moves medially

Occurs on: Abd & F Flex ≥90
Difficulty in: combing hair
Tx: Strengthen: Push up c a Plus

Wall Push-ups
❑ 15-20 reps
❑ Winging observed @ 5-10 reps

68
Q

Spinal Accessory Nerve Injury

Causes the scapula to ____________ and move
____________, with the inferior angle rotated
____________.

____________
Aka: ____________

Weakness: CN XI = ____________
Occurs on: ____________

A

Causes the scapula to depress and move
laterally, with the inferior angle rotated
laterally.

Radical neck dissection
Aka: Sliding Door paralysis

Weakness: CN XI = Trapz
Occurs on: Lateral winging <90

69
Q

Punch out Test

Procedure:
(+):
Indication:

A
70
Q

Apley’s Scatch Test

R problematic: ____________

A

R problematic: difficulty in hooking bra

71
Q

Sprengel’s Deformity

____________

MC ____________
Presentation: Scapula is congenitally ____________
& ____________
LOM: ____________

A
72
Q

Scapula & its muscles are poorly developed
Scapula is smaller than normal and is
medially rotated/placed

A

Sprengel’s Deformity

73
Q

MCcongenital deformity in the Shcomplex
Presentation: Scapula is congenitally high
& undescended

A

Sprengel’s Deformity

74
Q

Complex Regional Pain Syndrome

Previously known as ____________
* Usually occurs after ____________ (esp. ____________)
* SEX? at ____________
* laterality?
* S/sx: ____________

CRPSI – ____________
STAGEI STAGEII STAGEIII

CRPSII – Causalgia – develop after trauma c nerve lesion

A

Previously known as Shoulder Hand Syndrome
* Usually occurs after trauma (esp. Fracture)
* F>M at 5th decade
* Bilateral or unilateral at first
* S/sx: pain, tenderness, stiffness, trophic skin changes, non pitting edema (impaired venous & lymphatic return)

CRPSI – RSD (Reflex Sympathetic Dystrophy) – without nerve involvement
STAGEI STAGEII STAGEIII

CRPSII – Causalgia – develop after trauma c nerve lesion

75
Q

Complex Regional Pain Syndrome

STAGES?

A

CRPS I – RSD (Reflex Sympathetic Dystrophy)
Stage 1 – acute/reversible
Stage 2 – dystrophic/vasoconstriction/ischemic
Stage 3 - atrophic

UE Extremity part 1 (6 decks)

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