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tests/measurements > Quiz #1: Intro & Shoulder > Flashcards

Quiz #1: Intro & Shoulder Flashcards

0
Q

What are the 11 Principles of Examination?

A
  • test the uninvolved side first
  • active mm first , then passive, then resisted iso.
  • painful mm are last
  • apply pressure with care
  • repeat or sustain mm if history indicates
  • do resisted isometric mm in resting position
  • with passive and ligamentous testing, both the degree and quality (end feel) of opening are important
  • with ligamentous testing, repeat with increasing stress
  • with myotome (groups of muscles supplied by the single nerve root) contractions must be held for 5 seconds
  • warn of possible exacerbations
  • refer if necessary
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1
Q

What are the 5 elements of patient/client management?

A
  • Examination
  • Evaluation
  • Diagnosis
  • Prognosis
  • Intervention
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2
Q

Define contractile, nervous and inert tissues

A

Contractile: includes muscles, their tendons, and their attachments into bone

Nervous: nerves and their associated sheaths

Inert: include all structures not considered contractile or neurological such as, joint capsules, ligaments, bursae, blood vessels, cartilage and dura mater.

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3
Q

What are the 3 classic normal end feels? Explain.

A

Bone-to-bone or hard: unyielding sensation that is painless

Soft tissue approximation or soft: yielding compression that stops further mm due to compression of soft tissue

Tissue stretch or firm: springy or firm type of mm with a slight give.

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4
Q

What are the 5 classic abnormal end feels?

A
  • Muscle spasm: painful mm and end feel is sudden and hard.
  • Capsular: hard capsular has thick quality to it and a soft capsular has a boggy feel to it.
  • Bony block: restriction occurs before the end of the ROM
  • Empty: the ROM is stopped by the patient due to pain
  • Springy block: occurs when you wouldn’t expect it to, usually in joints with Menisci
  • Laxity: hyper mobility
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5
Q

What is the grading scale?

A

5: normal: max resistance applied by the examiner
4: good: mod resistance
3: fair: against gravity-no resistance
2: poor: gravity minimal
1: trace: evidence of muscle contraction
0: zero: no contraction

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6
Q

What are the 4 joints of the shoulder?

A

Glenohumeral
Sternoclavicular
Acromioclavicular
Scapularthoracic - functional joint

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7
Q

What type of joint is the Glenohumeral? And what is the capsular pattern?

A

Synovial ball and socket

Lateral rotation, abduction, medial rotation

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8
Q

What type of joint is the sternoclavicular?

A

Synovial joint, saddle shaped joint surface

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9
Q

What type of joint is the acromioclavicular joint?

A

Synovial

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10
Q

What type of joint is the Scapulothoracic?

A

Considered a functional rather than an anatomical joint.

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11
Q

What muscles are being tested during MMT of shoulder flexion? What nerve?

A

Anterior Deltoid- Axillary nerve (C5,C6)

Coracobrachialis- Musculocutaneous (C5,C6,C7)

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12
Q

What muscles are being tested during MMT of shoulder extension? What nerve?

A

Latissimus Dorsi- Thoracodorsal (Long Subscapular
Posterior Deltoid- Axillary
Teres Major- Subscapular

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13
Q

What muscles are being tested during MMT of shoulder scaption? What nerve?

A

Anterior Deltoid- Axillary
Middle Deltoid- Axillary
Supraspinatus- Suprascapular

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14
Q

What muscles are being tested during MMT of shoulder abduction? What nerve?

A

Middle Deltoid- Axillary

Supraspinatus- Suprascapular

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15
Q

What muscles are being tested during MMT of shoulder horizontal abduction? What nerve?

A

Posterior Deltoid- Axillary

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16
Q

What muscles are being tested during MMT of shoulder horizontal adduction? What nerve?

A

Pectoralis Major- Lateral Pectoral and Medial Pectoral (C5, C6)

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17
Q

What muscles are being tested during MMT of shoulder external rotation? What nerve?

A

Infraspinatus- Suprascapular

Teres Minor- Axillary

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18
Q

What muscles are being tested during MMT of shoulder internal rotation? What nerve?

A

Subscapularis- Subscapular

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19
Q

What muscles are being tested during MMT of scapular ABD and upward rotation? What nerve?

A

Serratus Anterior- Long thoracic

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20
Q

What muscles are being tested during MMT of scapular elevation? What nerve?

A

Upper trapezius- Accessory, Cervical Spinal (C3, C4)

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21
Q

What muscles are being tested during MMT of scapular adduction? What nerve?

A

Middle Trapezius- Accessory

Rhomboid Major- Dorsal Scapular

22
Q

What muscles are being tested during MMT of scapular depression and ADD? What nerve?

A

Lower Trapezius- Accessory

23
Q

What muscles are being tested during MMT of scapular ADD and downward rotation? What nerve?

A

Rhomboid Major- Dorsal Scapular

Rhomboid Minor- Dorsal Scapular

24
Q

What muscles are being tested during MMT of scapular depression? What nerve?

A

Latissiumus Dorsi- Thoracodorsal (Long Subscapular)

25
Q

What are the “Red Flags” in exam indicating need for medical consultation?

A
  • severe unremitting pain
  • pain unaffected by meds or position
  • severe pain with no history of injury
  • severe spasm
  • psychological overlay
26
Q

What should be noted when patient is performing active movement?

A
  • when/where during each mm the onset of pain occurs
  • whether the mm increases the intensity and quality of pain
  • reaction patient has to pain
  • amount of observable restriction
  • pattern of mm
  • rhythm and quality of mm
  • mm of associated joints
  • willingness of patient to move the part
  • any limitations and it’s nature
27
Q

What should be noted with a patient when they are going through passive movements?

A
  • when/where during each mm the pain begins
  • whether the mm increases the intensity and quality of pain
  • the pattern of limitation of mm
  • the end feel of mm
  • the mm of associated joints
  • the ROM available
28
Q

Define Capsular Pattern

A

When the joint capsule is affected there will be pattern of proportional limitation specific to each joint of the body.

29
Q

Define Noncapsular pattern

A

A limitation that exists but does not follow the classic capsular pattern for that particular joint

30
Q

What are the 4 classic patterns seen in lesions of inert tissue?

A
  • Pain-free, full ROM= no lesion
  • Pain and limited ROM in every direction= entire joint is affected! indicating arthritis or capsulitis
  • Pain and excessive or limited ROM in some directions= lesion of inert tissue such as ligamentous sprain or local capsular pattern lesion
  • Pain-free, limited ROM= often of abnormal bone-on-bone type, usually indicating symptomless arthritis
31
Q

What type of tissue would be affected: restricted and painful, same direction?

A

Non contractile tissue affected (inert or capsular)

32
Q

What type of tissue would be affected: restricted and painful, opposite direction?

A

Contractile tissue affected (muscle tissue)

33
Q

Define Validity

A

The degree to which an instrument measures what it is purported to measure; the extent to which it fulfills it’s purpose.

34
Q

What are the 4 main types of validity?

A

Face validity
Content validity
Criterion-related validity
Construct validity

35
Q

Define Reliability

A

Refers to the amount of consistency btw successive measurements of the same variable on the same subject under the same conditions

36
Q

Define Intrarater reliability

A

The degree to which one person can replicate the measurement he/she obtains

37
Q

Define interater reliability

A

The degree to which multiple testers can obtain measurements that agree

38
Q

What does “gonia” and “metron” stand for?

A

Gonia- angle

Metron- measure

39
Q

Define Arthrokinematics

A

Refers to the mm of joint surfaces such as, slides, spins and rolls

40
Q

Define Osteokinematics

A

Refers to the mm of the shaft of the bone rather than the joint surface

41
Q

What are some factors that affect a persons ROM?

A

Age: in most cases there is some degree of decreased ROM in all joints with age

Gender: in most cases females have more flexibility

Hypermobility vs. Hypomobility

42
Q

Define Active Insufficiency

A

Inability for a muscle to exert enough tension to shorten sufficiently to complete ROM in all joints simultaneously.

43
Q

Define Passive Insufficiency

A

Inability for a muscle to stretch enough to complete full ROM in all joints simultaneously.

Crosses 2 or more joints

44
Q

Define Prime mover/Agonist

A

Muscle primarily responsible for the mm

45
Q

Define Antagonist

A

Muscle or muscle group that opposes the prime mover/agonist

46
Q

Define Synergist

A

Muscle or muscle group that works with the agonist to produce the desired mm.

Ex: knee ext
Agonist: quads
Antagonist: hams
Synergist: TFL

47
Q

What are the 4 possible findings on resisted mm?

A
  1. Strong and Painless= no lesion
  2. Strong and Painfull= minor lesion
  3. Weak and Painless= interruption of nerve supply or complete rupture of tendon or muscle
  4. Weak and Painful: partial tendon/muscle rupture or pain inhibition due to serious pathological condition
48
Q

Convex/Concave Rule: Sternoclavicular Joint

A

Elevation/depression: Convex clavicle moves on concave Manubrium in opposite direction of lateral end of clavicle

Protraction/Retraction: Concave clavicle moves on concave Manubrium in same direction as lateral end of clavicle

49
Q

Osteokinematics of GH joint?

A

3 degrees of freedom

Flex/ext
ABD/add
Med/lat rotation

50
Q

Osteokinematics of the sternoclavicular joint?

A

3 degrees of freedom

Elevation/depression
Protraction/retraction
Ant/post rotation

51
Q

Osteokinematics of acromioclavicular joint?

A

3 degrees of freedom

Up/downward rotation
Tilting (tipping)
Protraction/retraction

52
Q

Osteokinematics of Scapulothoracic joint?

A

Scapular elevation/depression
Up/downward rotation
Ant/post tilting
Pro/retraction

53
Q

What is normal ROM for shoulder flexion, extension, ABD, medial (internal) rotation, and lateral (external) rotation?

A 
Flex: 0-180*
Ext: 0-60*
ABD: 0-180*
IR: 0-70*
ER: 0-90*

tests/measurements (9 decks)

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