PTFE MSK Flashcards
goniometry steps
- determine joints
- organize by body position
- educate pt
- stabilize proximal segment
- move joint through ROM and determine end feel
- make clinical estimate
- align goniometer, record starting position
- record end position
empty end feels are d/t
pain
boggy end feels are d/t
hemoarthrosis - blood in joint
passive insufficiency
- inability of 2 joint muscle to passively extend across full ROM of both joints
- stretch - hamstrings w/ hip flexed and knee extended
active insufficiency
- inability of 2 joint muscle to actively contract across full ROM of both joints
- can’t flex wrist AND flex fingers
open-packed positions - arm
- GH: abd 55-70, abd 30, neutral rotation
- humeroulnar: 70 flexion, 10 supination
- humeroradial: full ext and supination
- prox radioulnar: 70 flexion, 35 supination
- distal radioulnar: 10 degrees supination
- radiocarpal: neutral
vertebral open pack
midway between flexion and extension
LE open-pack positions
- hip: 30 flexion, 30 abd, sligh ER
- knee: 25 flexion
- ankle: 10 PF
hip closed pack
- ligamentous: full ext, abd, IR
- bony: 90 flex, slight abd, ER
phases of healing
- hemostasis: day 1-3
- inflammation: day 3-20 - new BV growth
- proliferation/granulation: week 1-6 - scar tissue formation
- remodeling/maturation: week 6-2 years
6/6/6 rule
- first 6 weeks: max protection - limit ROM, activation, & stretching
- second 6 weeks: mod protection - control loading
- 6 month: return to sport, ACL, RTC for hi-load and hi-velocity
pancoast tumor
- tumor in apical segment
- like TOS but w/ lung symptoms
osteosarcoma
- cancer in end of bone, metaphysis, M > F
- painful bump, sunburst X-ray
ewing’s sarcoma
- in shaft, diaphysis
- painful lumps, sunburst patterns on x-ray
convex on concave rules
- opposite direction
- shoulder, ankle, hip
- improve IR - post mob, ER - ant mob, flexion - post/inf, abd - inf
concave on convex
- same direction
- fingers
shoulder upward rotators
- SA: serratus anterior
- LT: lower trap
- UT: upper trap
shoulder downward rotators
- Love: levator
- Rha: rhomboids
- Min: pec minor
scapular dyskinesia
- needs coordination
- pt ABD alone, then w/ PT
- (+) is pt feel better
TOS testing
- Adson: head toward PT
- ROOS: 3 minutes
- Allen: head away from PT
- Halstead: reverse adson
shoulder impingement and testing
- primary: bony
- secondary: RTC
- Hawkin’s kennedy: arm 90, PT moves into IR
- Neer: arm near ear
- painful arc: abd 60-120
RTC tear tests
- drop arm: supraspinatus
- lag: ER - supra or infra, IR - subscap
- empty can: supraspinatus
- hornblower/Patte: teres minor
SLAP tests
- o’briens: “oh that’s better”
- speeds: speedily bring arm forward
- biceps load/kim: pt supine, activates bicep
- yergasons: turn palm over - strong supination, “why am i doing this”
- clunk test: pt supine
bankart lesion
- inferior labrum
apprehension test
- posterior or anterior
adhesive capsulitis
- lose ER -> ABD -> IR - AROM and PROM
- F > M
- after immobilization, hypothyroidism
- protection - freezing, pendulum
- controlled - subacute, progress ROM, function, self-mob
- return to function - stretch and strengthen as tolerated
midshaft humerus fracture results in damage to
radial nerve
distal humerus fracture (supracondylar) results in damage to
- lateral side: radial nerve
- medial side: median nerve
lateral epicondylitis
- tennis elbow
- wrist extensors
- cozen’s test: resisted extension and radial deviation
- treatment: night immobilization, counter force brace, cross-friction, eccentric
medial epicondylitis
- golfer’s elbow
- wrist flexors
- test w/ passive supination, elbow extension, wrist extension
- treatment: night immob, counterforce brace, cross-friction, eccentric
de quervain’s tenosynovitis
- abductor pollicis longus and extensor pollicis brevis
- overuse w/ gripping and lifting
- finklestein’s: passive thumb flexion w/ ulnar deviation
- eichoff’s: thumb in clenched fist, active/passive ulnar dev
bunnell-littler test
- test tightness of MCP intrinsics - MCP tight capsule vs tight intrinsics
- PT move finger to MCP ext to stretch lumbrical and flex PIP to further to further stretch
- then MCP flexion for slack
- if tight in both -> capsular
- if different -> muscle tightness
normally, lumbricals flex MCP and extend PIP
elbow moves
- concave on convex
- distraction improves flexion and extension
- distal/hook improves flexion
radioulnar joint
- PPP - at Proximal joint, to improve Pronation, do a Posterior/dorsal glide
- at distal, to improve pronation, do an anterior glide (opposite of proximal)
radiocarpal joint
- convex on concave
- improve ext - volar/ant glide
- improve flex - dorsal/post glide
fingers and toes move
- concave on convex
- improve extension - volar/ant glide
- improve flexion - dorsal/post glide
thumb movement
- out/in is flexion/extension - concave on convex
- forward is abd/add - convex on concave
bc thumb is a saddle joint
nutation
- anterior sacral tilt w/ posterior pelvic tilt
- apex at bottom of sacrum posterior and superior
counter nutation
- post sacral tilt w/ anterior pelvic tilt
- apex anterior and inferior
achilles tendonitis
- burning/aching in heel
- TTP
- pain w/ activity
- swelling
- thickening
- morning stiffness
- weakness d/t pain
plantar fasciitis
- TTP at insertion
- heel spur
- pain worse in AM or after prolonged inactivity
- difficulty w/ prolonged standing
- pain w/ walking barefoot
patellofemoral syndrome chondomalacia patella
- ant knee pain
- pain w/ prolonged sitting
- swelling
- crepitus
- pain w/ stairs