Quiz 3

Question 1

Pronator Teres Syndrome

Answer 1

proximal forearm pain volarly, numbness/tingling volar index, long, ring
thumb, index, and long finger weakness
symptoms reproduced with palpation pronator

Question 2

Anterior Interosseous nerve compression

Answer 2

proximal forearm pain volarly
sensory disturbances absent
thumb IP weakness and FDP weakness index
no symptoms with palpation of pronator
** unable to make an “O” due to paralysis of FPL and FDP to digit #2

Question 3

Hand of Benediction

Answer 3

prolonged compression of high median nerve - unable to flex MCP of index due to profundus and superficialis loss of innervation

(shooter hand)

Question 4

Ape hand

Answer 4

low lesion - prolonged low median nerve injury, loss of thumb opposition

Question 5

motor return for median nerve injury

Answer 5

elbow: pronator teres

wrist/below elbow: opponent pollicis

Question 6

exercises for median nerve injury

Answer 6

hold hand so thumb is in a palmar opposition position and try to maintain this. try to mimic the perimeter of a jar lid

Question 7

motor return for ulnar nerve injury

Answer 7

elbow: flexor carpi ulnaris
wrist: abductor digiti minimi

Question 8

exercises for ulnar nerve injury

Answer 8

finger abduction and adduction. hand palm down on a flat surface and do this with fingers. use powder on a board to reduce friction.

Question 9

motor return for radial nerve injury

Answer 9

upper arm: brachioradialis

elbow: supinator
forearm: extensor carpi ulnaris

Question 10

exercises for radial nerve injury

Answer 10

extension of wrist, fingers, and thumb, when restraining, finger intrinsic substitution can be a problem. use cabana to isolate extensor digitorum

Question 11

risk factors for carpal tunnel

Answer 11

pregnancy, women, work related factors, obesity, thyroid disease, RA

Question 12

identify which muscles would have motor deficits with posterior interossei compression and anterior interossei compression

Answer 12

posterior interossei: weakness and/or paralysis to EXTENSORS
ECRB, supinator, ECU, EDC, EDM, APL, EPL, EPB, EI

anterior interossei: paralysis of FLEXORS
FPL and FDP to digit #2

Question 13

appropriate interventions for radial nerve compressions

Answer 13

orthosis/splinting, edema, progress AROM as each mx returns, radial nerve glides

Question 14

neurogenic TOS day/night

Answer 14

paresthesia am & pm
compressors day pain > night pain
confirmation with neurophysiological tests

Question 15

disputed neurogenic TOS day/night

Answer 15

paresthesias awaken often pm
releasers pm pain> day pain
no confirmation with neurophysiological test

Question 16

characteristic (epidemiology) of individuals that acquire TOS

Answer 16

20-30 years old
women 3-4x more likely to develop neurogenic TOS
neurogenic is >90%, vascular 2-5%, arterial 1%

Question 17

3 spaces of TOS

Answer 17

• interscalene triangle (anterior and middle scalenes)
• costoclavicular space (between clavicle and 1st rib)
• thoraco-coracopectoral space (pec minor)

Question 18

causes of TOS

Answer 18

congenital anomaly related to extra 1st rib
post traumatic structure
post traumatic posture structures

Question 19

clinical test for neurogenic TOS

Answer 19

clinical index for diagnosis of TOS (3 of 4 symptoms)
history of possible pain patterns
palpation: supra and infra clavicular fossa, distal nerve palpation to rule out peripheral nerve involvement, coracoid process
tests: elevated arm stress, supraclavicular pressure, costoclavicular maneuver, wright’s, cyriax release test (sleep), upper limb tension test (elvey test)

Question 20

rehab phases for TOS

Answer 20

1. symptom control
2. specific postural control exercises
3. general maintenance exercises

Question 21

interventions for TOS

Answer 21

• breathing, stretching scalenes, neck pillows, thoracic extension, chin side flexion

Question 22

theoretical concept for elastic tape application

Answer 22

Taping to promote upward rotation
• Patient is standing supporting arms on the wall in the teardrop position. Apply two to three pieces of tape from the inferior lateral border of the scapula towards axilla. Tape stretch at 50%