shannons theory review Flashcards
what mm would you strengthen to support the anterior talofibular ligament and reduce re-injury?
peroniels & tib an
what mm would you strengthen to support the medial collateral ligament and reduce re-injury?
semitendinosus and semimembranosus
what mm would you strengthen to support the ulnar collateral ligament of the elbow and reduce re-injury?
what mm would you strengthen to support the radial collateral ligament of the elbow and reduce re-injury?
what health history questions would you be sure to include when assessing a cx with suspected tendinitis?
tendons have a rich vascular supply and therefore able to heal quickly
false. they have a limited blood supply, making them more difficult to heal
tendinitis is categorized into 3 grades based on presenting sx and sx
false. categorized into 4 grades based on severity
adhesions can form between tendon and bone if inflammation is not treated properly
true
the ACL is the most commonly sprained ligament in the knee
false. MCL
in order to perform frictions on the supraspinatus tendon you must place cx arm in extension, abduction and external rotation
internal rotation
list the OA tests appropriate for detecting rotator cuff tendinitis
length tests
hawkins kennedy (supra)
neer impingement (supra)
empty can (supra & suprascap nerve)
drop arm (RC tear)
tendinitis differentiation
list the OA tests appropriate for testing bicipital tendinitis
yearagons
speeds
list the OA tests appropriate for detecting instability of the shoulder
load & shift (ant/pos instability)
posterior apprehension (pos instability)
apprehension crank test (ant instability)
push-pull (pos instability)
sulcus sign (inf instability)
which one of the RC mms are most commonly affected with tendinitis? why?
supraspinatus
what hydro is best prescribed for a cx with acute bursitis
cold (not heavy, padded donut for olecranon/trochanteric bursa)
appropriate OA tests for determining tennis elbow (lateral epicondylitis/common extensor)
cozens
mills
method 3
appropriate OA tests for golfers elbow (medial epicondylitis/common flexor)
tinels at the elbow
reverse mills/medial epicondylitis test
between which structures will you find the subacromial bursa
acromion & supraspinatus
portion of bursa between deltoid mm & humerus
between which structures will you find the subscapular bursa
scapula and subscap mm
between which structures will you find the olecranon bursa
olecranon & subcutaneous fascia
between which structures will you find the iliopectineal bursa
iliospoas mm and iliofemoral ligament
between which structures will you find the trochanteric bursa
one between glute max tendon &trochanter
other between glute med tendon & trochanter
between which structures will you find the ischial bursa
glute max mm and ischial tuberosity
between which structures will you find the pes anserine bursa
tendons of sartorius, gracilis & semitendinosis and the medial tibia
describe each grade of tendinitis (4)
1: px only after activity
2: px beginning, not during, px after
3: px beginning, during and after
4: px with ADL, continues to worsen
in which position should the shoulder be in to perform cross fiber frictions on tendon of long head of biceps
extension
describe which movements are happening when the foot is pronating
eversion, DF and ABduction
describe which movements are happening when the foot is supinating
inversion, PF and ADduction
which techniques are performed to break down adhesions
deep techniques like stripping prior to cross fiber frictions
cross fiber frictions
how do adhesions form
untreated inflammation/edema?
in which stage of healing would you treat adhesions
late subacute and chronic
grade 1 - mild or first degree sprain
minor stretch/tear
non instability on PR testing
continue activity with some discomfort
grade 2 - moderate or second degree sprain
tearing of ligament fibers
snapping sounds at injury & joint give away
joint hypermobility yet stable on PR testing
difficulty continuing activity due to px
grade 3 - severe or third degree sprain
- complete rupture/avulsion fracture
- snapping sound at time of injury ad joint gives away
- instability with no end point on PR testing
- person cannot continue due to px and instability
- px in acute
- hypermobile in direction the ligament is meaning to test in chronic
- palpable gap
describe impingement syndrome. when might you see it develop?
- inflammation, pain and edema between the AC and GH joints
- supraspinatus, biceps and subacromial bursa
how is tendinosis different from tendinitis?
tendinitis= inflammation of tendon
tendinosis= degeneration changes with chronic overuse tendon injuries (ie tennis elbow)
what is a bursa
- small, flat sac lined with synovium
- both membrane surfaces in contact, seperated by lubricating fluid
- reduces friction. not palpable unless inflamed
cx comes to you with acute grade 3 sprain, how would you proceed?
- pain free AF ROM
- cold hydro
- decrease edema before doing compensatory work
- decrease SNS, DDB
- trunk and uninjured limb treated with effleurage and slow petrissage
- proximal limb: decrease pain, decrease HT, instead LD & venous return
- distal limb: light stoking & mm squeezing
- midrange PR ROM to prod joints to increase LD and maintain rom
list the ligaments that will be stressed by applying a varus force to each:
elbow, wrist, knee
elbow: radial collateral
wrist: radial collateral
knee: lateral collateral
which structures are affected with a sprain
ligaments
which structures are affected with tendinitis
tendon
which structures are affected with a strain
tendon
which structures are affected with a fracture
bone
MOI for rotator cuff tendinitis
overhead arm positions
swimming, golf, throwing sports
MOI for biceps long head tendinitis
arm in adduction
swimming, throwing sports with adduction
MOI for common extensor tendinitis
repetitive wrist ext
tennis/racquet sports, poor technique, wheelchair athletes, plumping, electrical
MOI for common flexor tendinitis
repetitive wrist flexion
hammering, screwdriver, golf, overhead serve in tennis
MOI for dequarvians tenosynovitis tendinitis
repetitive thumb work
factory work, ML, racquet sports
MOI for patellar tendinitis
running, jumping, track and field
MOI for popliteus tendinitis
downhill running/walking with pronation
MOI for tibialis posterior tendinitis
running, step aerobics, step machine combined with excessive pronation
MOI for achilles tendinitis
running with pronation, poor foot wear, tight gastroc/soleus
what is a bakers cyst?
enlargement of the extracapsular bursa between the gastroc and semimenbranosus muscle or a herniation of the synovium through posterior joint capsule wall
contributing factors for sprains?
congenital ligamentous instability
history of pervious sprains
altered biomechanics that out stress on joint
connective tissue pathologies
define hemarthosis
bleeding into the synovial space
which OA tests would you expect to be positive with subacute ACL sprain?
lachmans
anterior drawer
yeargsons test
purpose: bicipital tendinitis/rupture of transverse numeral ligament
action: cx seated, palpate bicipital groove, flex their elbow to 90, stabilize their arm against their thorax, start with arm pronated. they then resist supination while laterally rotating
positive: tenderness in groove or tendon popping out of groove
speeds test
purpose: bicipital tendinitis, strain if week
action: cx standing. resist GH flexion with arm supinated and then probated
positive: tenderness in the bicipital groove or weakness
empty can test
purpose: tear in supraspinatus tendon/mm or neuropathy of supra scapular nerve
action: arms abducted 90 thumbs up, press up into resistance, bring arms forward a little with thumbs down and press up into resistance
positive: weakness/px
which bursa can you palpate through the deltoid near the acromion and is absent in some?
subcoracoid portion of shoulder bursae
what are the sx and sx of someone suffering with trochanteric bursitis
px local to lateral hip, cx can’t sleep on affected side
px worse climbing stairs/getting out of car
causes altered biomechanics leading to leg length discrepancy
low back pain=antalgic gait
PF AF ROM and submaximal isometrics are indicated in which stage of healing as long as client can handle it
acute bursitis
CI’s for bursitis
no compression of bursa or putting drag on surrounding tissue
no on site techniques
refer to MD if bursa is infected
