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musculo I > Quiz 4 > Flashcards

Quiz 4 Flashcards

1
Q

what do we want to see within the elbow outcome measures?

A

10 point change

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2
Q

what are some questions we would ask within the examination part specifically the history section?

A
  • age
  • occupational demands
  • MOI
  • aggravating or easing positions
  • impaired motion and function
  • neurological symptoms
  • past medical history
  • general health
  • medications
  • personal goals
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3
Q

if a patient has pain over the lateral elbow during gripping activities what could this possibly be?

A

lateral epicondylitis

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4
Q

if a patient has pain over the medial elbow with wrist flexion and pronation, what could this possibly be?

A

medial epicondylyits

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5
Q

if a patient has numbness and tingling along the ulnar nerve distribution distal to the elbow, what could this possibly be?

A

cubital tunnel syndrome

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6
Q

if a patient has pain with elbow movement with sensation of catching or instability, what could this possibly be?

A

UCL instability

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7
Q

if a patient has posterior elbow pain with elbow hyperextension, what could this possibly be?

A

extension overload

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8
Q

what is the normal carrying angle for males and females?

A

males= 5 to 10 degrees
females= 10 to 15 degrees

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9
Q

what is the one objective examination we shouldn’t see?

A

a cubitus varus look= which is when the arm is completely straight and there is no carrying angle

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10
Q

what does the triangle sign detect?

A

a screen for a fracture
- limited extension

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11
Q

describe the objective examination for someone who has olecranon bursitis?

A

presence of edema, effusion and ecchymosis
- check the tissue temperature!!

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12
Q

what must we rule out within the elbow examination?

A
  1. C spine
  2. shoulder
  3. upper t spine (specifically T7 and up)
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13
Q

what is the inclusion criteria for the elbow extension test?

A
  • acute elbow injury
  • adults > 15 yrs
  • children 3-15 years old
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14
Q

what is the exclusions criteria for the elbow extension test?

A
  • previous limited extension
  • no history of trauma
  • occurred 72 hours after
  • neuromuscular disease
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15
Q

what is the flexion degrees for the elbow?

A

150

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16
Q

what is the extension degrees for the elbow?

A

10

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17
Q

what is the functional ROM for AROM flexion and extension?

A

30 to 130 degrees

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18
Q

what is elbows flexion end feel?

A

soft

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19
Q

what is the elbows extension end feel?

A

hard

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20
Q

what is the difference between the flexion limitation and extension limitation?

A

5% difference

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21
Q

can we see the presence of a capsular pattern?

A

after an injury

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22
Q

what is the AAOS value for elbow pronation?

A

80 degrees

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23
Q

what is the AAOS value for elbow supination?

A

80 degrees

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24
Q

what is the PROM end feel for pronation at the elbow?

A

firm

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25
Q

what is the PROM end feel for supination at the elbow?

A

firm

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26
Q

what is the most limited joint in the elbow?

A

the radiohumeral

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27
Q

what is the least limited joint in the elbow?

A

the distalradioulnar

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28
Q

name the common direction preferences for elbow extension repeated movements:

A
  1. open chain
  2. open chain with flick
  3. loaded (closed chain)
  4. loaded with pt generated overpressure
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29
Q

what special test is associated with the PLRI?

A

pivot shift test

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30
Q

what special test is paired with PLRI?

A

pivot shift test

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31
Q

what special test goes with a RCL sprain/tear?

A

varus stress test

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32
Q

what special test goes with an UCL sprain/tear?

A

1- valgus stress test
2- moving valgus stress test

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33
Q

what are the special tests for the radial nerve?

A

ULTT2b and TTP

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34
Q

the median nerve is associated with what syndrome and special test?

A

pronator teres syndrome and the pronator teres test

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35
Q

the ulnar nerve is associated with what syndrome and special tests?

A

cubital tunnel syndrome and the elbow flexion test and the tinel’s test

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36
Q

the radial nerve is associated with what syndrome and special tests?

A

PIN and the ULTT palpation

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37
Q

what is the diagnostic cluster for lateral epicondylitis?

A
  1. cozens test
  2. mills test
  3. maudsley test
  4. pain palpation
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38
Q

what is the diagnostic cluster for medial epicondylitis?

A
  1. pain with resisted wrist flexion
  2. Pain with stretch of wrist flexors
  3. golfers elbow test
  4. pain with palpation of medial epicondyle
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39
Q

describe the grip strength within muscle performance testing:

A
  • we assess this bilaterally
  • with lateral elbow pain we assess this in elbow extension
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40
Q

what order does muscle performance occur in for the elbow?

A
  1. resisted break testing
  2. elbow flexion
  3. elbow extension
  4. pronation
  5. supination
  6. grip strength
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41
Q

what structures resist varus in the elbow?

A
  • RCL
  • anterior capsule
  • bony articulation (mainly) 75%
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42
Q

what structures resist valgus in the elbow?

A
  • UCL (mainly) 54%
  • anterior capsule
  • bony articulation
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43
Q

the humeroulnar joint Play P-A Is what type of glide?

A

anterior glide

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44
Q

the humeroradial joint play P-A is what type of glide?

A

anterior glide

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45
Q

the humeroulnar A-P is what type of glide?

A

posterior glide

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46
Q

the humeroradial A-P is what type of glide?

A

posterior glide

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47
Q

the radioulnar A-P is what type of glide?

A

medial glide of the radial head

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48
Q

the radioulnar A-P is what type of glide?

A

lateral glide of the radial head

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49
Q

the ULTT2a is associated with what nerve?

A

median nerve

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50
Q

the ULTT2b is associated with what nerve?

A

radial nerve

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51
Q

the ULTT3 is associated with what nerve?

A

ulnar nerve

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52
Q

what are we specifically testing during the Cozen’s test?

A

extensor carpi radialis brevis muscle

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53
Q

what are we specifically doing during the Mills test?

A

stretching the wrist extensors

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54
Q

what are we specifically doing during the Maudsley test?

A

lifting the 3rd digit aka the extensor digitorum

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55
Q

what are we specifically doing during the golfers elbow test?

A

passively supinating the patients forearm, extending the patients wrist and elbow

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56
Q

what are interventions for epicondylitis?

A
  • rest from aggravating activities
  • mobility
  • strength and conditioning
  • bracing or taping
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57
Q

what are the interventions for a UCL elbow sprain?

A
  • rest/ immobilization
  • modalities for pain/swelling- NSAIDS
  • gain pain free ROM
  • general conditioning with shoulder and scapular mobility
  • core stability, balance, strength
  • throwing progression
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58
Q

what are the interventions for someone who has cubital tunnel syndrome?

A
  • splinting at 45 degree flexion and full supination for 4-6 weeks
  • elbow pad over medial epicondyle
  • mobilization
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59
Q

List the common causes of radial sided wrist pain?

A

De quervains tenosynovitis
Thumb UCL
Ganglion cyst
Radial neuritis
C6 Radial
CTS/ Median Nerve
Scapulonate instability

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60
Q

what are some interventions for someone who has PIN syndrome/radial tunnel syndrome?

A
  • immobilization
  • relative rest
  • modalities
  • neural glides
61
Q

what are some interventions for someone who has pronator syndrome that involved the median nerve?

A
  • splinting at 90 degrees flexion and gentle ROM for 2 weeks
  • modalities
  • treat the underlying cause of irritation to nerve
  • soft tissue mobilization TATSM
  • neural glides
62
Q

List the common causes of ulnar side?

A

Instability
TFCC tear
FCU tendonitis
Arthritis
Fracture
hypothenar hammer syndrome
Cervical redic (C8)
Ulnar tunnel/ Guyon’s canal

63
Q

what are some interventions for someone who has a distal biceps tendon rupture following a surgical repair?

A
  • posterior splint at 90 degrees for 1-2 weeks
  • gentle ROM following splint
  • full AROM at week 4
  • strengthening begins at week 6
  • unrestricted activity at week 8
64
Q

what are some interventions for someone who has osteoarthritis in the elbow?

A
  • modalities for pain
  • maximize flexibility of surrounding tissues
  • distraction mobilization
  • muscle performance specifically proximal strength/stability
65
Q

Types of fractures in the wrist and hand?

A

Colles fracture
Smiths Fracture
Scaphoid fracture

66
Q

Signs of infection?

A

Temperature >100
BP> 160/95
Resting pulse >100 bpm
Resting respiration> 25 bpm
Fatigue
inflammation

67
Q

what are some interventions for someone who has elbow instability?

A
  • reduction and placement in a padded splint
  • can begin rehab with no restrictions if stable
68
Q

what is ascending lymphangitis?

A

Inflammation of lymphatic channels
Medical emergency can lead to sepsis and death
Will present with rash on dorsum of hand and arm

69
Q

what are some interventions for someone who had a fracture and is looking for post operative management?

A
  • limb is elevated 24 hours and in a resting splint for 1 week
  • modalities that can reduce swelling/pain
  • early controlled motion and AAROM
  • isotonics at week 8
70
Q

4 signs of flexor shealth infection?

A

Finger/hand held in flexion
swelling
Tenderness over tendon sheath
Pain on passive extension

71
Q

Earliest sign of flexor sheath infectIion?

A

pain with passive extension

72
Q

What is a colles fracture? MOI

A

Distal radius fracture with posterior displacement
FOOSH

73
Q

Common findings with a colles fracture?

A

dinner fork deformity
distal + dorsal wrist pain
swelling
increased distal radius angulation
inability to grasp

74
Q

What is a smiths fracture? MOI

A

Distal radius fracture with anterior displacement
Garden spade deformity
Fall on flexed hand

75
Q

Treatment options for a distal radius fracture?

A

reduction of the fracture
Casting

76
Q

What motion is usually limited after distal radius fracture?

A

rotation of the forearm

77
Q

What is the most commonly fractured carpal bone/

A

scaphoid

78
Q

Common findings of a scaphoid fracture?

A

Ache in snuff box
pain made worse with pinching/gripping
Swelling/ bruising

79
Q

Who is at risk for scaphoid fracture?

A

males
sports flayers
pain with thumb-index finger pinching

80
Q

Criteria for moderate suspicion of scaphoid fracture?

A

Snuff box tenderness
painful resisted supination
painful compression of thumb
ST tenderness

81
Q

Treatment options for scaphoid fracture?

A

non-displaced: splint
AROM/PROM
Joint mobs

82
Q

MOI for a metacarpal fracture?

A

Boxers fracture
from punching

83
Q

Clinical presentation for metacarpal fracture?

A

pain
swelling, bruising
limited AROM/PROM
Deformity/assymetry
Compression of finger–> reproduces pain

84
Q

treatment for metacarpal fracture?

A

casting for 2-4 weeks

85
Q

MOI for a lunate dislocation?

A

wrist hyperextension
Spilled t-cup

86
Q

Common findings for lunate dislocation?

A

swelling
deformity
Decreased ROM
Spilled t-cup xray
murphys sign

87
Q

Treatment for lunate dislocation?

A

surgical repair
casting
Gentle stretch-> gentle strengthening

88
Q

MOI for a scapholunate dislocation?

A

FOOSH
Terry thomas sign

89
Q

What nerve is involved for carpal tunnel syndrome?

A

median neuropathy

90
Q

Risk factors for developing Carpal tunnel syndrome?

A

Obesity, >50, female
DM
OA
Estrogen therapy
hypothyroid
family history
Wrist ratio> .70

91
Q

Symptoms of carpal tunnel syndrome?

A

Pain in palmar aspect of 1,2,3,4 digits
pain at wrist
Weakness of thenar muscles
thenar waisting (ape-hand)

92
Q

What reflexes are affected in someone with carpal tunnel syndrome?

A

Reflex normal

93
Q

What do you use to do sensation testing for carpal tunnel syndrome?

A

Semmes weinstein monofilament

94
Q

What test helps differentiate between AIN and Cubital tunnel syndrome?

A

okay sign/tear drop sign

95
Q

Clinical prediction rule for carpal tunnel syndrome?

A

positive flick signs
wrist ration>.67
Symptom severity> 1.9
Reduced median sensation to D1
Age> 45 y/o

96
Q

What is a positive sign for tinels test?

A

tingiling in median nerve distrubtion

97
Q

what is phalens test

A

hold wrists flexed together for 1minute
positive if median nerve distribution tingles

98
Q

What is reverse phalens test?

A

hold wrist extended together for 1 minute
positive is median nerve distribution tingles

99
Q

What is carpal compression test?

A

PT applies pressure at transverse carpal lig for 30 seconds
positive is median nerve distribution tingles

100
Q

What is a positive sign for ULNTT-A?

A

reproduction of symptoms
difference in elbow extension>10 degrees

101
Q

Treatment options for carpal tunnel syndrome?

A

Surgery (CTR)
Very effective
Splinting, mobilization, nerve gliding, exercise

102
Q

Night splints have what kind of impact on CTS?

A

Strong if used in early CTD
Prevent symptoms

103
Q

How does nerve gliding treat CTS?

A

improve healing of nerve tissue, reduce pain

104
Q

how does carpal bone mobilization treat CTS?

A

Improves blood flow, gate pain, increases mobility

105
Q

How does activity modification treat CTS?

A

prevents symptoms and reduces risk factors

106
Q

What is wartenberg syndrome?

A

entrapment of the superfiical radial nerve
wrist watch/handcuff neuropathy

107
Q

MOI for wartenberg syndrome?

A

trauma
prolonged compression
operative complication during fracture reduction

108
Q

Is wartenbergs syndrome common or rare?

A

rare

109
Q

Symptoms associated with wartenbergs syndrome?

A

paraesthesia along anatomical snuff box, thumb, dorsum 2-3
may be worse with gripping
no motor issues
sensation decreased in radial n. distrubtion in hand

110
Q

What special tests can you use for wartenbergs syndrome?

A

Tinels test @ snuff box
Radial N. ULTT

111
Q

If you have sensation lose in dorsum of hand what nerve is affected and where?

A

Radial nerve @wrist

112
Q

If you have wrist drop + weakness of wrist and finger extensors + weak triceps what nerve is affected and where?

A

radial nerve above the elbow

113
Q

What reflex is affected with radial n. impingement?

A

brachioradialis

114
Q

Symptoms associated with ulnar n. entrapment at guyons canal?

A

Weakness and atrophy of ulnar intrinsic hand muscles
Numbness in palmar aspect and dorsum digits 4,5
Ulnar claw hand
wattenbergs sign

115
Q

What reflex would be affected with ulnar nerve entrapement?

A

none babe

116
Q

What is wartenbergs sign?

A

difficulty adducting the fifth digit bc of weakness in 3rd palmar interosseoi

117
Q

What is froments test and what nerve does it target?

A

paper test
ulnar n.

118
Q

What is de quervains tenosynovitis?

A

inflammation of synovial fluid tendon of 1st dorsal compartment
pain and edema
EPB, APL

119
Q

MOI for de-quervains tenosynovitis?

A

repitive trauma w/ thumb

120
Q

What test can you use for de-quervains tenosynovitis?

A

finkelstein’s test
Thumb in wrist, ulnarly deviate

121
Q

Treatments for dequervains tenosynovitis?

A

Splinting 2-3 weeks
stretching
joint mobs of thumb and wrist
strengthening grip strength
Resisted thumb extension and abduction

122
Q

What is gamekeepers’ thumb?

A

distrubtion of ulnar collateral ligament
occurs with trauma (valgus force)

123
Q

Clinical presentation of gatekeepers thumb?

A

pain
tenderness, bruising, swelling near MCP of thumb
instability/ trouble grasping

124
Q

Treatment for gatekeepers thumb?

A

surgery
immbolization for 6 weeks

125
Q

what position should the thumb splint be in ?

A

20* of wrist extension
MCP in slight flexion

126
Q

what position should the thumb splint be in ?

A

20* of wrist extension
MCP in slight flexion

127
Q

Symptoms of wrist and hand osteoarthritis?

A

pain
swelling
morning stiffness
weakness griping
Reduced ROM

128
Q

What are heberdens nodes?

A

Osteoarthritic enlargement of DIP

129
Q

what are bouchard’s nodes?

A

osteoarthritic enlargement of PIP

130
Q

What are deformities associates with rheumatoid arthritis at wrist and hand

A

Ulnar drigs at MCP, radial drift at wrist
Bouchards nodes

131
Q

What test can you use for arthritis of MCP?

A

CMC grind test

132
Q

How do you treat a ganglion cyst?

A

nothing
aspiration
surgical excision

133
Q

MOI for TFCC?

A

trauma
degeneration

134
Q

symptoms of TFCC?

A

Ulnar sided wrist pain
TTPL distal to ulnar styloid
Click with ulnar deviation
Ulnar grind test positive

135
Q

Special tests for TFCC?

A

Shear/load
Supination lift test
Fovea sign

136
Q

Treatment for TFCC?

A

Bracing
Therapeutic exercise: wrist circles

137
Q

MOI of wrist sprain?

A

Trauma
dislocation

138
Q

Simple v.s complex sprain?

A

Simple: pain with function
complex: dislocation occurs with activity

139
Q

Treatment for a simple wrist sprain?

A

protect, tape/splint
Keep fingers moving

140
Q

What is the most common static instability in the wrist?

A

scapholunate instability

141
Q

What does the terry thomas sign indicate?

A

Scapholunate instability

142
Q

Symptoms of scapholunate instability?

A

point tenderness over ligament
dorsal wrist swelling
pain
Click/clunck with radial dev
pinch weakness

143
Q

Tests used for scapholunate instability?

A

Scapholunate ballotment test
watson test

144
Q

Treatment for scapholunate instability?

A

> grade 1: surgical canidate
ROM: dart throws
Strengthen ECRL, FCR, ABP (10 s, 10 reps, 3x /day_

145
Q

What is the most commmon dynamic wrist instability?

A

midcarpal

146
Q

Symptoms of a midcarpal instability?

A

TTP @triquetrohamate hunction
lichtman test
x-rays normal

147
Q

Signs and symptoms of ligamentous injury of the wrist/hand?

A

TTP and swelling over joint
MCP joints stress collateral ligs in flexion
IP joints: stress collateral ligs in extension

148
Q

What tests can you use for ligamentous instability?

A

shuck test
Lunotriquetral ballotment test

musculo I (1 decks)

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