Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PTA Ortho > Shoulder, Elbow, Wrist, Hand > Flashcards

Shoulder, Elbow, Wrist, Hand Flashcards

1
Q

Acromioclavicular Joint-AC Joint

A
  • Convex lateral end of clavicle on Concave acromion

- Acromioclavicular and Coracolavicular Ligaments attach acromion to lateral end of clavicle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Sternoclavicular Joint - SC Joint

A

-Medial end of clavicle is both convex: Superior/INF
—> Concave ant/post
-

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Motion of Clavical

A

moves as a result of scapular elevation, depression, protraction and retraction
-rotates posteriorly when scap is upwardly rotated
Only bone attachment to axial skeleton

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Scapulothoracic Joint

A

scap along thorax

1. Stability: achieved through the balanced forces of upper trap, levator scap, pec minor, rhomboids and serratus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is Scaption?

A

30 degrees anterior to frontal plane
-functional position with less tension on the glenohumeral joint capsule

** Always look at spine of scap to decide if its an upward or downward rotation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

glenohumeral joint

A
  • convex head of humerus with concave glenoid fossa of scapular
  • glenoid labrum increases joint congruence –> increase contact of head of humerus and glenoid
  • labrum serves as an attachment for the joint capsule of the shoulder
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Open pack position of Glenohumeral Joint

A

55 abduction

30 horizontal adduction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Closed pack of Glenohumeral Joint

A

full abduction and external rotation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Arthrokinematic motion of shoulder

A

CONVEX humeral head moving on CONCAVE glenoid fossa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what direction is the glide with the shoulder joint?

A

glide is in the opposite direction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Glide motions for Shoulder:

  1. extension
  2. flexion
  3. abduction
  4. ER
  5. IR
A

ext-ant glide

flex-post glide

abd-inf glide

ER- ant glide

IR- post. glide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

2 glenohumeral ligaments

A

coracohumeral- coracoid process to greater tubercle

glenohumeral- covers ant. capsule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

scapulohumeral rhythm

A

scap rotates 1 degree upward for every 2 degrees of total humeral movement

Starts at :

30 degrees of shoulder abd
60 degrees of shoulder flex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Neer’s impingement sign

A

GOAL: identify inflammation in subacromial space
POS: if there is pain
HOW:
pt. arm is passively forcibly flexed above head which decreases space btw. head of humerus and acromion process

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Hawkins-Kennedy Impingement Test

A

GOAL: identify supraspinatus tendonitis
+ with pain
How:
pt. arm passively abducted 90 degrees and then forced into IR by therapist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Painful Arc

A

G: inflammation in subacromial space
+ pt has pain btw. 60-120 degrees of abd
H: pt. actively abducts against gravity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Speeds Test

A

G: bicep tendonitis
+ pain at bicipital groove
H: pt. forearm is supinated with elbow fully extended

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Yergason’s Test

A

G: tendonitis of long head of bicep
+pain in bicipital groove
H: pt supinates forearm and ER shoulder against therapists resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Apprehension for Anterior Dislocation test

A

G: anterior glenohumeral joint instability
+ pt. demonstrates apprehension and prevents further movement of UE
H: pt. supine-> therapist passively abducts and ER shoulder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

apprehension for posterior dislocation test

A

G: posterior glenohumeral joint instability
+ pt. demonstrates apprehension and prevents further movement of UE
How: pt. in supine and therapist passively flexes UE to 90 degrees and elbow to 90 degrees
-therapist passively IR UE and applies a posterior force to pt. elbow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Drop Arm Test

A

G: identify torn rotator cuff
+ unable to slowly lower arm or experiences pain
H: therapist passively abducts UE to 90 degrees and asks pt. to slowly lower arm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Empty Can Test

A

G: identifies supraspintatus tendon tear
+ patient has pain or weakness
H: pt. UE positioned horizontally @ 30 degrees ant. to the frontal plane with IR .
-therapist applies downward pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is rotator cuff impingement

A

tendons compressed or pinched under coracoacromial arch

  • mechanical compression=primary
  • secondary= glenohumeral instability, weak muscles
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

clinical signs of rotator cuff impingement

A

+ hawkins-kennedy, painful Arc and Neers test

  • pain& tenderness at supraspinatus tendon
  • pain and weakness with abduction, flexion and ER
  • traction to GH joint may decrease pain

pt. c/o:
- pain at night
- pain with overhead activities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Non-surgical Rotator Cuff Phase 1

A
  • decrease pain
  • decrease inflammation
  • pt. education to avoid overhead movements-80 degrees or more
  • restore normal arthokinematics-mobs and sleeper stretch
  • scapular muscle strengthening
  • closed chain-low load
  • wall push-ups
  • progress to open chain only as symptoms allow
  • initiate rotator cuff resistance exercises
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Phase 2 Non surgical Rotator Cuff

A

advanced stabilization and strengthening

  • simple motions to more complex
  • re-education to avoid re-injury
  • exercises mimic desired activity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Sub acromial decompression/ acromioplasty

A

reshaping the acromion with detachment of the coracoacromial ligament and possible distal clavicle resection
-rotator cuff not torn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

clinical signs of rotator cuff torn

A

+Drop Arm Test
+Empty can Test

  • pain/weakness with abduction,flexion,ER
  • may be unable to abduct arm

pt. C/O:
- pain in shoulder which can radiate to deltoid
- sometimes pt. has no pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Phase 1 of Surgical repair of RTC

A
  • 3-4 weeks*
  • modalities
  • shoulder support as supraspinatus heals-sling w/abduction support
  • pain free ROM
  • pendulums
  • PROM w/o gravity
  • active exercises of tri/bi, elbow, wrist & hand
  • slowly progress to AA exercises
  • gentle strengthening MD
  • multiangle isometrics
  • support UE to decrease tension on repair
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Phase 2 of Surgical Repair of RTC

A
  • avoid repeated abduction or motions near 90 degress of shoulder ABD,FLEX
  • *5-12 weeks **
  • short arc exercises between 60-120 degrees
  • ROM & Flexibility of shoulder girdle
  • shoulder girdle and shoulder muscle stability, endurance & function
  • incorporate short-arc ex
  • rotator cuff strengthening MD
  • proceed very cautiously with ER if supraspinatus and infraspinatus was repaired
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Biciptal Tendonitis

A

overuse, glenohumeral instability and impingement

-RTC weakness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Biciptal Tendonitis S&S

A

+speed tests
+ Yergason’s test

c/o:

  • pain at tendon of long head of biceps
  • resistance of shoulder flexion
  • w/ overhead activities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

bicep tendonitis treatment

A

*CONTROL INFLAMMATION & PROMOTE HEALING
-modification of tasks to prevent overuse
-strengthen RTC muscles
-strengthen scapular muscles
may include:
* surgical intervention-scraping of tendon to eliminate adhesion’s/scar tissue or widening of subacromial space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

shoulder instability/subluxation/dislocation

A

cause:

  • can be chronic from hypermobility
  • often result of trauma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

anterior dislocation

A

force/position:
-arm abducted. extended and ER
* Most common
anterior aprrehension test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

anterior dislocation signs

A

humeral head sits anterior in glenoid fossa
pt. c/o pain or catching with movement
pain sleeping on affected side

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

posterior dislocation

A

force/position
-ARM ABDUCTED, FLEX, IR

+posterior apprehension test

immediate need for closed reduction of dislocation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

phase 1 treatment for anterior shoulder instability

A

4-6 WEEKS

  • manage pain and swelling
  • AROM
  • strenghten of elbow, forearm, wrist in pronation that protect shoulder
  • NO SHOULDER ABDUCTION, ER OR EXT
  • submax isometric exercises to RTC, deltoid in positions that protect shoulder
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Recovery phase of anterior instability

A
  • provide continued protection
  • increase shoulder mobility
  • mobs except anterior
  • increase RTC and scap muscle strength
  • isometrics
  • partial WB and stabilization
  • *external rotators need to regain strength to stabilize the humeral head against atn. translating forces
  • *IR&ADD need to regain strength to support ant. capsule
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

adhesive capsulitis/frozen shoulder

A

-capsule inflammation, fibrosis and adhesions with resultant pain and ROM loss

primary cause-most common, occurs spontaneously, from unknown cause

secondary cause-after trauma or immobilization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

clinical signs of frozen shoulder

A

capsular patter ROM loss
muscle weakness
guarded shoulder motions with scapular subsititutions
severe decrease in functional use of arm
pt c/o pain with motion, rest and sleeping

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

capsular patter of shoulder

A

ER
ABDUCTION
FLEXION

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

frozen shoulder treatment goals

A 
control pain, edema and muscle guarding
modalities
-mobs 1-2
pain free ROM
progressively increase joint and soft tissue mobility
-mob grades 3-4
correct faulty glenohumeral and scapulothoracic rhythm
-strengthen scap and RTC muscles
correct faulty posture and movement
-closed kinetic chain exercises
-progress to functional activities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

reflex sympathetic dystrophy

A

an excessive, abnormal response of the sympathetic nerve system in response to trauma

underlying mechanism unclear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

clinical signs of RSD

A

burning pain and hypersensitivity
edema in arm
discoloration of arm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

3 stages of RSD

A
  1. edem, ROM loss
  2. 2-6 months: shiny/tough skin changes, joint stiffness
  3. 6 months and beyond-muscle atrophy, bone loss and joint ankylosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

treatment for RSD

A

respect pain that accompanies RSD

work within pt. levels while attempting to maintain ROM, strengthen& increase function, desensitize painful area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

sprengel’s deformity

A

smaller scap
rotated medially
scap did not descend during last trimester of gestation
limitation of scap movement limits and glenohumeral movement
scap muscles may be poorly developed & replaced by fibrous bands

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

therapy goals for sprengels deformity

A

strengthen scap muscles
improve mobility
improve functional movement of shoulder girdle and shoulder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

what does the bicep do for the RTC

A

pulls the head of the humerus into correct alignment with the glenoid fossa
-depresses head of humerus as arm elevates, keeping head of humerus from impinging on subacromial space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

open pack position of shoulder

A

55 ABDUCTION

30 HORZ ADDUCTION

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

long axis traction

A

sustained glide or oscillaton
purpose: pain relief, general mobility

stabilize: scap in supine, scap stabilized by pts. BW on table
mobilize: humerus from glenoid fossa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

distraction

A

P: pain relief, general mobility
s-scapula
m-proximal humerus in an inferior direction

**use web grip

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

inferior/caudal glide

A

p-increase abduction
s-scapula
m-proximal humerus in an inferior direction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

posterior glide

A

p-increase IR and flex
s-scapula
m-proximal humerus in posterior direction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

anterior glide

A

p-increase ER and ext
s-scapula
m-proximal humerus in an anterior direction

**if elbow comes up-> humerus is shifting forward =need to stop

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Humeroulnar Joint

A

movement-elbow flex/ext
concave ulna on convex distal humerus

  1. elbow flexion-ulna glides ant
  2. elbow ext - ulna glides post
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

open pack of elbow

A

70 DEGREES FLEX

10 DEGREES SUPINATION

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

humeroradial joint

A

movement- elbow flex/ext
supination and pronation

  • Concave radial head on convex distal humerus
    elbow flex-radius glides ant

elbow ext-radius glides post

pronation/sup-radial head spins on humerus capitulum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

proximal radioulnar joint

A

forearm pronation and supination
open pack:
70 flexion
35 supination

  • forearm pron/sup= radial head rolls within ulnar’s radial notch
  • pronation= radial head glides dorsally(post)
  • supination=radial head glides volarly(ant)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

elbow carrying angle

A

full elbow ext-valgus

full elbow flex-varus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Ulnar Medial collateral ligament

A

very thick
**ulnar side considered medial side*
thick triangular ligament that connects distal humerus to the proximal ulna

*tommy john surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Valgus Stress Test

A

assesses integrity of medial collateral ligament
elbow bent to 20-30 degrees
therapist applies a valgus stress
+if pain or increased laxity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

radial lateral collateral ligament

A

connects the distal humerus to the proximal ulna near the radial notch

it is also connected to the annular ligament

provides support against varus stress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Varus Stress Test

A

assesses integrity of lateral collateral ligament

therpist applies a varus stress

+ if pain or increased laxity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

annular ligament

A

surrounds the proximal radius and keeps the radius within the radial notch of ulna

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

distal radioulnar joint

A

movement: forearm pronation and supination

concave radius within convex ulna

pronation: radius moves ant
supination: radius moves post

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

elbow flexion

A

biceps bradhii, brachialis and brachioradialis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

elbow extension

A

triceps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

forearm supination

A

supinator and biceps brachii

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

forearm pronation

A

pronator teres and pronator quadratus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

causes of elbow hypomobility

A

trauma

fractures
degenerative joint disease
subluxations
dislocations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

capsular pattern of the elbow

A

flexion>ext

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

pushed elbow

A

proximal subluxation of ulna

occurs form FOOSH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

clinical signs of pushed elbow

A

decrease:
-elbow flex or ext
-forearm pronation
wrist flex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

pulled elbow or nursemaids elbow

A

radial head is pulled out of annular ligament

forceful pull on hand - pick up heavy object or jerking motion

common in young children

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

clinical signs of pulled elbow

A

supination is restricted

person holds forearm in pronation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

treatment of pulled elbow

A

restore alignment of radial head within annular ligament performed by appropriate medical provider

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

phase 1 for elbow hypomobility

A

minimize adverse impacts on immobilization

reduce inflammation

maintain joint and soft tissue mobility

maintain intergrity and function of related areas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

goals of phase 2 elbow hypomobility

A

increase soft tissue and joint mobility

  • joint mob 3+4
  • manual stretching
  • self-stretching and hep
  • self mobilization with movment

improve muscle performance and strength
-open and then closed chain

initiate functional activities

81
Q

phase 3 goals for elbow hypo-mobility

A

increase muscle performance/ strength

  • isokinetic ex
  • plyometric ex if appropriate

restore full functional mobility of joints and soft tissue

promote joint protection

progress to independence

JOINT MOB 3-4

82
Q

criteria for phase 2 of elbow hypomobility

A

no swelling, minimal pain and tolerates ROM activities

83
Q

criteria for phase 3 of elbow hypomobility

A

no pain, almost full AROM, strength 4/5

84
Q

total elbow arthroplasty

A

significant pan and decrease of function

follow MD protocol

85
Q

over-use/repetitive stress injuries

A

excessive use causes micro-trauma and parital tearing of muscle tissue
inflammation can become chronic with continue irritation

new scar tissue if repeatedly over stressed before it is mature

86
Q

lateral epicondylitis

A

tennis elbow
inflammation at wrist extensor tendons
can become chronic with fibrosis-epicondylosis
more common

repeated wrist extensor activities

87
Q

signs of lateral epicondylitis

A

general increase pain at lateral epicondyle
pain with palpitation on lat epicondyle
pain w. resisted wrist ext w/ elbow ext
pain with passive wrist flexion and elbow extended and forearm pronated —-stretches the wrist extenors

88
Q

medial epicondylitis

A

inflammation at wrist flexor tendons and pronator teres

can become chronic with fibrosis of area

GOLFERS ELBOW

89
Q

signs of medial epicondylitis

A

general increased pain at medical epicondyle
pain with palpation on medial epicondyle
pain with resisted wrist flexion with elbow ext
pain with passive wrist ext w/ elbow extended and forearm supinated —-stretches wrist flexors

90
Q

medial ulnar collateral ligament-valgus stress overload

A

acceleration phase and deceleration forces apply high valgus stress loads on ulnar collateral ligament

91
Q

clinical signs of medial valgus stress overload

A

pain along medial aspect of elbow joint
+valgus stress test-pain and laxity of ulnar collateral ligament
–if sprain is significant may require tommy john’s surgery =grade 3

92
Q

medial collateral ligament rehab with no surgery

A

rehabilitation is similar to overuse injuries

  • stretch/strength-no valgus stress
  • monitory full extension
93
Q

exercises for medial collateral ligament with no surgery

A 
emphasize eccentric control of bicep
ROM 
Low load stretching 
HEP
controls speed of movement 
PNF patterns 
try to prevent elbow flexion contractures
94
Q

Tommy John Surgery Rehab

A

limited ROM 3-4 weeks: 110 ROM elbow flex, submax isometric
full ROM 406 weeks:0-130 elbow flexion= con,ecc contraction
Functional training 2-4 months-> begin throwing, 2 hands then 1 hand
resume sports 10-12 months
immobilization is important

95
Q

olecranon fractures

A

usually fall on the point of the elbow
forceful contraction of triceps
-no active tricep contraction until fully healed

96
Q

supracondylar fractures

A

can be due to FOOSH =distal humerus goes posteriorly

direct trauma to posterior elbow=distal humerus displaces anteriorly

97
Q

intercondylar fractures

A

-T or Y fracture to distal humerus which goes through the condyles

-can be due to fall on elbow
direct trauma to posterior elbow

98
Q

Radial Head and/or proximal ulna fractures

A

usually due to FOOSH

99
Q

possible fracture complications

A

nondisplaced
displaced
comminuted

100
Q

Volkmann ischemic contracture

A

severe swelling at elbow due to fracture creates pressure on blood vessels and nerves

  • brachial artery
  • median nerve
101
Q

increased varus or valgus deformity

A

gunstock deformity=cubitus varus-radial head and neck fracture
valgus deformity=cubitus valgus- prox. radius and ulnar fracture—> very tight joint and wont fully extend

102
Q

what do you stretch for the lateral epicondyle?

A

wrist extensors

103
Q

what do you stretch for the medial epicondyle

A

wrist flexors

104
Q

joint distraction of humeroulnar joint

A

p-pain control, general mobility to increase elbow flex/ext
s-humerus using a belt
m-ulna
**mobilize ulna at 45 degree angle to the shaft using both hands

105
Q

open pack position of humeroulnar joint

A

70 degrees of elbow flexion

10 degrees supination

106
Q

distal glide of elbow

A

p: increase elbow flexion
S:humerus
m: ulna

**Perform scooping motion toward your body

107
Q

joint distraction of humeroradial joint

A

p: pain control, general joint mobility
s: distal humers
M: distal radius
*pull radius distally

108
Q

Dorsal Radial Glide

A

p: increase elbow extension
S: distal humerus
M: proximal radius in a dorsal direction–posterior

*radial head toward floor with palm

109
Q

Volar Radial Glide

A

p: increase elbow flexion
S: distal humerus
M: proximal radius in a volar direction-anterior
* radial head towards ceiling with fingers underneath

110
Q

open pack of proximal radioulnar joint

A

70 degrees of elbow flexion

35 degrees of supination

111
Q

dorsal glide of proximal radioulnar joint

A

p: increase pronation
s:proximal ulna
M: proximal radius in dorsal direction
**Posterior direction

112
Q

Volar Glide of proximal radioulnar joint

A

P: to increase supination
S: proximal ulna
M:proximal radius in a volar or anterior direction
**grasp underneath and mobilize toward palm

113
Q

Distal Radioulnar Joint Dorsal Glide

A

P: increase supination
S: distal Ulna
M: distal radius in a dorsal direction
**pt. is seated-> elbow flexed 70 degrees and supinated 10 degrees

114
Q

Olecranon bursitis - students elbow

A

Edema in bursa along posterior elbow
causes: repeated leaning or crawling using elbows
or repeated throwing overhead
arthritis

115
Q

treatment considerations

A

elbow pad with resting activities

anti-inflam supportive techniques

116
Q

elbow overuse/repetitive phase 1 treatment

A

ICE-superficial injury

supportive techniques and taping

alter activities-give pt. other things to do to avoid doing activity that caused injury

soft tissue/joint mobs

pt. education

deep friction massage

stretching-be careful at beginning of treatment to not damage origin of muscles

muscle setting-elbow initially flexed, pain free ROM

117
Q

phase 2 of elbow overuse treatment

A

criteria: no signs of inflammation

restore full ROM

strengthen muscles

initiate functional activities

start w/ eccentric -> less stress and helps w/ collagen realignment

supportive straps -> cause muscle to think the origin is where the strap is and takes load off muscle

118
Q

elbow overuse phase 3

A

criteria: full pain-free ROM

activity modification
-help retrain muscle into proper alignment

functional training
* if they start to have pain-> they will begin to substitute —need to stop exercise so they do not do compensate

119
Q

distal radial ulnar joint

A

forearm prontation/supintation

concave ulnar notch of radius on distal convex ulna

120
Q

radiocarpal joint

A

radius connects to: scaphoid, lunate, triquetrum
-only the radius is part of the joint
MOVEMENT: wrist radial and ulnar deviation & wrist flex/ext

prox. row of carpal bones are convex and move on concave distal radius

121
Q

what does that annular disc provide at the radiocarpal joint?

A

it helps evenly transfer force along the radius

122
Q

midcarpal joint

A

joint btw. 2 rows of carpals

movement: wrist radial/ulna deviation
wrist flex/ext

midcarpal joint is a plane joint

glide on each other

123
Q

what is the arrangement of carpal bones?

A

trapezium, trapezoid, capitate, hamate = convex(distal)

scaphoid, lunate, triquetrum, pisiform=concave(prox)

124
Q

carpometacarpal joint CMC 2-5

A

2nd metacarpals w/ trapezoid
3rd with capitate
4th w/ hamate

  • allows cupping of hand
  • allows extension which improves release objects

CONCAVE=METACARPAL
CONVEX=CARPAL

125
Q

carpometacarpal joint CMC 1

A

1st metal carpal w/ trapezium=saddle joint

movement:
flex/ext
abd/add
opposition

1st MTC concave on convex trapezium=flex/ext
1st MTC convex on concave trapezium=abd/add

126
Q

metacarpophalangeal MCP 2-5

A

condyloid joints

MCP flex/ext
MCP abd/add

concave prox phalanx w/ convex metacarpal

127
Q

interphalangeal: IP, PIP, DIP

A

movement:
IP flex/ext
PIP flex/ext
DIP flex/ext

128
Q

wrist extension muscles

A

extensor carpi radialis brevis and longus
extensor carpi ulnaris

**lateral epicondyle

129
Q

wrist flexion muscles

A

flexor carpi radialis
flexor carpi ulnaris

**medial epicondyle

130
Q

finger extension

A

extensor digitorum
*extensor hood ligament= wraps around distal MTC/ prox phalanx and continues distally

extensor indices
extensor digiti minimi

131
Q

finger flexion

A

flexor digitorum profundus
flexor digitorum superficialis
lumbricals

132
Q

finger abduction

A

dorsal interossi- ulnar

133
Q

finger adduction

A

palmer interossi-ulnar

134
Q

radial nerve

A
  • posterior hand*
    sensation: dorsal hand 1- medial side of 4th finger, medial thumb
  • *fingers 1-3 on dorsal side but not finger tips

motor: wrist & finger extension, thumb extension

nerve compression/injury:

  • drop wrist deformity
  • extensor muscles are paralyzed
135
Q

median nerve

A

sensation:
fingers 1-3-on voral side or palm side and finger tips
medial side of 4th finger

motor:
finger flexion
thumb opposition
flexion

nerve compression:
thenar eminence atrophy-starts to flatten
can be due to carpal tunnel syndrome

136
Q

ulnar nerve

A

sensation:
dorsal and palmer of 5th and lateral side of the 4th finger

motor:
PIP and DIP of 4/5 finger ext.
flexion of little finger 
MCP finger abduction
thumb adduction
DIP/ PIP adduction

nerve compression:
hypothenar eminence atrophy
hand of benediction
narrowing of gunyon’s canal can compress ulnar nerve

137
Q

Tinel’s Sign test

A

therapist taps over carpal tunnel of wrist
+pt. reports parathesia distal to wrist

identifies carpal tunnel syndrome

138
Q

Phalen’s Test

A

pt. maximally flexes wrists and holds the back of the hands together for 1 minute
+ pt. reports paresthesia, tingling, numbness in median nerve distribution

identifies carpal tunnel syndrome

139
Q

Reverse Phalen Test

A

pt. maximally extends wrists and holds the palms together for 1 minute
- prayer stretch

+ pt. reports parathesia, tingling, numbness in median nerve

identifies carpal tunnel

140
Q

Finkelstein’s Test

A

pt. makes a fist while holding thumb inside fingers
therapist performs ulnar deviation to wrist

+pain in snuffbox

identifies de Quervian’s Syndrome

141
Q

acute phase goal for wrist

A

control pain

maintain joint mobility and muscle flexibility

maintain function of surrounding uninvolved areas

142
Q

therapeutic management in acute phase for wrist

A

well joint motion

splinting/bracing

modalities to control pain and inflammation

pain free ROM

multi-angle isometrics

143
Q

sub acute phase for wrist/hand

A

CRITERIA
-resolving edema
minimal to no pain with ROM and isometrics

GOALS:
progressively restore joint mobility-mobs
progressively restore muscle flexibility -gain full ROM
progressively strengthen involved area
return to functional activities w/ protection

144
Q

wrist/hand return to function phase

A

criteria:
pain free ROM
strength testing

*limitations in functional use of the involved area due to losses of ROM and muscle weakness

145
Q

how to achieve main goals of: return to function phase of wrist/hand

A 
specificity of exercises 
increase complexity 
increase speed of movement
perform close chained ex
increase joint mobility
reduce risk of re-injury
146
Q

Rheumatoid arthritis

A

most common inflammation in MCP, PIP and wrist joints, extrinsic tendon and sheaths

joint capsule weakening, cartilage destruction, bone erosion and tendon rupture

147
Q

clinical signs of RA

A

flexion at wrist joint
radial deviation of wrist
rupture/stretching of collateral ligaments of MCP joint
–ulnar drift of fingers, volar sublux of prox phalanx

swan neck deformity of fingers 2-5

boutonniere of thumb

148
Q

Swan Neck

A

hyper ext. of PIP

flexion of DIP

149
Q

Boutonniere deformitiy

A

PIP flex
DIP ext

*extensor hood mechanism breaks off

150
Q

DJD/OA

A

chronic degenerative disease which affects articular cartilage

can cause bony overgrowths/spurs

151
Q

signs of OA

A

restricted/painful ROM

joint capsule limitations

possible abnormal hard end feels due to bone spurs

muscle weakness
joint enlargement

most common in trapezoiscaphoid articulation
CMC, DIP

152
Q

heberdon nodes

A

DIP enlargement

153
Q

bouchard nodes

A

PIP enlargement

154
Q

RA/OA acute phase

A 
increase rest during flare-ups 
alternate activities to avoid fatigue
use frequent but short episodes ofe x
pain free AROM ex
avoid prolonged static positions during the day
155
Q

what to be aware of with RA

A

ligaments,tendons and capsule will be weakened due to the diseases process and the use of steroids

person experiences low-grade fever and fatigue during acute phase

active ex not tolerated with pain use gentle PROM

grade 1-2 mobs can be used but not recommended

avoid/alter strong grasping activities which further deform wrist and hand

avoid twisting motions

156
Q

subacute and chronic phase treatment of RA/OA

A

use appropriate adaptive equipment to decrease stress on joints

pain free resistance ex within tolerance of joint

very gentle pain-free stretching within tolerance

encourage nonimpact or low impact conditioning ex

HEP of AROM and gentle stretching

157
Q

Colle’s fracture

A

distal radius is fracture

distal radius then displaces in dorsal direction

dinner fork deformity

FOOSH

RADIUS MOVES POSTERIORLY

158
Q

Smith Fracture

A

reverse colles fracture

displaced fracture of radius in palmar direction-anterior

fall on dorsum of hand

159
Q

ulna fracture

A

usually occur together w/ radial fracture

160
Q

scaphoid fracture

A

result of FOOS with hyperextended and ulnar devation

avascular necrosis due to disruption of blood supply possible

management: proximal portion of scaphoid no direct circulation w/ 12-24 weeks of immobilization

161
Q

clinical signs of scaphoid fracture

A

pain and swelling in anatomical snuffbox
pain with wrist extension
decreased grip strength

162
Q

MCP fractures

A
  1. boxers fracture-neck of 4/5 MTC

2. bennett fracture-palmar base of proximal 1st metacarpal

163
Q

phalanx fracture

A

treatment depends on type and displacement

164
Q

TFCC-triangular fibrocartilage complex

A

injury to articular disc and ligaments on the ulnar side of wrist

Cause:
-force applied to pronated hand: FOOSH; drill “catching” arm and rotating

165
Q

Treatment for TFCC

A

nonsurgical -splint

surgical-arthroscopic or open surgical repair

166
Q

SKier’s Thumb

A

acute sprain of collateral ligament of thumb

167
Q

cause of skier’s thumb

A

valgus stress and hyper extension of thumb

168
Q

treatment of skier’s thumb

A

spint or surgery

169
Q

DeQuervains tenosynovitis

A

swelling thickening and narrowing of sheath’s tunnel for abductor pollicis longus and extensor pollicus brevis tendon

170
Q

causes of DeQuervain’s

A

forceful repeated thumb abduction and extension usually with radial deviation

171
Q

Clinical signs of DeQuervain’s

A

pain on radial side of wrist aggravated by use of thumb

pain increased by ulnar deviation of wrist

+ flinkelstein test

172
Q

Trigger Finger

A

inflammation or thickened tendon/flexor sheath

173
Q

causes of trigger finger

A

idiopathic or repetitive tasks requiring prolonged grasp

174
Q

clinical signs of trigger finger

A

sticking/catching of tendon with finger flexion

175
Q

Boutonniere Deformity

A

rupture or stretched extensor tendon at pip

176
Q

clinical signs of Boutonniere deformity

A

PIP flexion

DIP hyper extension

177
Q

Mallet finger

A

avulsion fracture or tendon rupture at distal phalanx

178
Q

signs of mallet finger

A

DIP flexion cant actively extend DIP

179
Q

Transverse Carpal ligament

A

formed by carpal bones and transverse carpal ligament

contains median nerve and 9 flexor tendons

180
Q

carpal tunnel syndrome

A

median nerve entrapment

181
Q

cause of CTS

A 
arthritis
fracture
cysts
swelling from trauma
aging
pregnancy 
occupational factors
vibration
repeated motion of wrist
182
Q

signs of CTS

A

numbness and tingling of thumb and radial digits

pain worsens at night
atrophy of thenar muscles
swelling in hand and forearm

183
Q

tests for CTS

A

Tinnel’s

Phalen’s

Reverse Phalen’s

184
Q

Possible rehabilitative management options

A 
altering lifestyle
avoid extreme wrist flex/ext
tendon gliding ex
supportive modalities
cock-up splint: 0-20 ext
surgery
185
Q

types of grips 4

A
  1. Hook- holding on to monkey bars ex
  2. cylinder-obj. btw finger and thumb–holding water bottle
  3. holding on to hammer
    spherical-opening a jar w/ finger tips on top
186
Q

full hand extension glide

A

MCP PIP DIP

187
Q

hook/claw glide

A

MCP ext, PIP DIP flex

188
Q

Full fist glide

A

full flexion of MCP PIP DIP

189
Q

lumbricals

A

MCP Flexion

DIP PIP extension

190
Q

Straight Fist

A

MCP Flex
PIP flex
DIP ext

191
Q

how to strengthening lumbricals

A

MCP joint flexion with IP ext

192
Q

interossei and thumb abductor brevis and longus strengthening

A

MCP abduction

ex: rubberband around fingers and have pt. open hands

193
Q

Oppones pollicis strengthening

A

thumb opposition: pinching, tripod and tip to tip

194
Q

3 precautions with stretching fingers

A

fingers should always be stretched individually

lengthen the muscle over one joint while stabilizing the other joints

careful not to cause hypermobility

195
Q

Radiocarpal joint traction

A

p: pain control and general mobility
S: distal radius and ulna
M: proximal row of carpals

position: pt. seated with forearm pronated
grasp: styloid processes and fixate the radius and ulna against table

mobilize the distal direction

196
Q

radiocarpal dorsal glide

A

p: Increase wrist flexion
s: distal radius and ulna
M: proximal row of carpals in a dorsal direction-posterior/back of hand

**have arm pronated and towel under wrist

197
Q

radiocarpal joint volar glide

A

p: increase wrist extension
s: distal radius and ulna
M: proximal row of carpals in a volar direction–towards palm of hand

**pt. hand is pronated

198
Q

radiocarpal joint ulnar glide

A

P:increase radial deviation
s: distal radius and ulna
M: proximal row of carpals in ulnar direction

  • *pt. forearm in neutral with ulna supported on treatment table
  • *move towards ulna–> towards floor
199
Q

radiocarpal joint radial glide

A

p: increase ulnar deviation
s: distal radius and ulna
m: proximal row of carpals in an radial direction

**neutral hand and move towards radius –>towards ceiling

PTA Ortho (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions