Slides Flashcards
Lateral/anterior shoulder pain with overhead activities or exhibiting a painful arc? 3
- Subacromial impingement
- Tendinitis
- Bursitis
Instability, apprehension, and pain with action, especially with shoulder abducted and externally rotated? 2
- Shoulder instability
- Possible labral tear if clicking
Patient falls on shoulder followed by AC joint pain?
AC joint Sprain
Decreased ROM with pain during resistance? 2
- Rotator cuff
- Bicep tendon involvement
Pain and weakness with muscle loading, night pain age>60?
Rotator Cuff (active range is restricted)
Poorly located shoulder pain, occasionally extending into elbow, pain aggravated by movement, loss of movement age>45, females more affected. Passive and Active ROM will be restricted?
- Adhesive Capsulitis
What would the most harmful diagnosis be?
SLAP?
Rotator cuff tear?
Bicep tendonitis?
40%
20%
40%
External Rotation Lag Sign, tests what muscle?
Infraspinatus
Hornblower’s Sign tests what muscle?
Teres minor
Belly press test, tests what muscle?
subscapularis
Positive External rotation lag sign?
arm moves back (infraspinatus tear)
Positive Hornblower’s sign?
the patient is unable to externally rotate the arm from this position (teres minor tear)
Positive Belly Press test?
Examiner should not be able to pull arm away (subscapularis)
Type I slap lesion?
11% of SLAP lesions, fraying of and degeneration of superior labrum. Usually occurs in middle aged adults.
Type II slap lesion?
41%, most common-same findings as type I with biceps anchor detachment (fraying of and degeneration of superior labrum)
Type III slap lesion?
33% more of a bucket handle tear of labrum, intact bicep tendon
Type IV slap lesion?
15% involve same features as type III with extension of tear into the biceps tendon (a bucket handle tear of labrum, intact bicep tendon)
Pain over lateral elbow during gripping?
– Possible lateral epicondylitis
- possible radial tunnel
Pain over medial elbow during wrist flexion and pronation?
– Possible medial epicondylitis
Numbness and tingling in ulnar nerve distribution distal to elbow?
– Possible cubital tunnel syndrome
Pain in anterior aspect of elbow and forearm that is exacerbated by wrist flexion combined with elbow flexion and forearm pronation?
– Possible pronator syndrome
Pain during movement with sensations of catching or instability?
– Possible rotary instability
Posterior elbow pain during hyperextension?
– Possible valgus extension overload syndrome (clicking during pronation and supination)
Positive Elbow flexion test?
Tingling or parasthesia along ulnar nerve distribution in the forearm and hand will suggest cubital tunnel syndrome
Elbow flexion test stresses what nerve?
Ulnar nerve
How can the ulnar nerve become stresses? 3
- hypertrophy of MCL
- MCL tear causing swelling leading to numbness
- medial epicondylitis
What devices can you use when testing lateral/medial epicondylitis?
- Kaplans test grip strength machine
- Put strap on and reduced pain and increased strength
Pain over radial styloid process with gripping?
– Possible de Quervain’s syndrome
Insidious onset of numbness and tingling in 1st 3 fingers; may be worse at night?
– Possible carpal tunnel syndrome
Paresthesias over dorsal aspect of ulnar border of hand and fingers 4,5?
Ulnar nerve compression at canal of Guyon
Inability to extend metacarpophalangeal of IP joints?
– Possible Dupuytren’s contracture, possible trigger finger
Falling on hand with wrist hyperextended, complains of pain with loading the wrist?
– Possible scaphoid fracture, possible carpal instability
Froment’s Test:
With ulnar nerve palsy, the patient will experience difficulty maintaining a hold and will compensate by flexing which muscle?
flexor pollicis longus
Pinch Grip Test:
With anterior interroseous nerve palsy, the patient will experience difficulty maintaining a pinch and will compensate by pressing the pads of the fingers to maintain grip pressure using what muscle innervated by the ulnar nerve?
adductor pollicis
With Finkelstein’s test, pain indicates tenosynovitis (inflammation b/t the shealth and tendon) of what 2 muscle tendons?
- extensor pollicis brevis
- abductor pollicis longus
Tensynovitis of extensor pollicis brevis, and abductor pollicis longus has what other 4 names?
– de Quervain’s
- hoffman’s disease
- gamer’s thumb
- washerwomans sprain.
Thickening of the sheath of the flexor tendons at the A1 pulley?
Trigger Finger
Extension of MCP and DIP, flexion of the PIP?
Boutonniere deformity
Flexion of the MCP and DIP, hyperextension of the PIP?
Swan Neck Deformity
Rupture of extensor digitorum tendon at the insertion on distal phalanx?
Mallet Finger
Avulsion of flexor profundus, forced hyperextension, loss of DIP flexion?
Jersey Finger
Autonomic nervous system preparing for fight-or-flight with this test?
Mannkopf’s test - press on area of pain and pulse rate should increase
