UE CPR's

Question 1

Cervical Radiculopathy CPR?

Answer 1

If 3 or 4 positive findings (+LR 30.3/6.1)

• (+) ULTT-A
• (+) Spurlings test
• (+) Distraction test
• Cervical rotation less than 60° to ipsilateral side

Question 2

Test item cluster for presence of full-thickness rotator cuff tear?

Answer 2

If 3 positive findings +LR is 15.6
If 2 positive findings AND pt is > 60yrs old +LR is 28.0
- the drop arm sign (pain or sudden arm drop)
- the painful arch sign (60 - 120°)
- infraspinatus muscle test (if painful/weak or if pt arm falls into IR when passive placed into ER and let go)

Question 3

Test item cluster for lateral epicondylalgia?

Answer 3

• pain during palpation of lateral epicondyle
• pain with resisted wrist extension
• pain with resisted middle finger extension

Question 4

Test item cluster: Carpal Tunnel Syndrome?

Answer 4

If 4 or 5 positive findings fairly good at indicating carpal tunnel

1. age >45
2. shaking of hand relieves symptoms
3. wrist ratio index > 0.67
4. reduced median nerve sensory field of first digit
5. symptom severity scale score > 1.9

Question 5

What types of patients would you want to use the Canadian C-Spine Rule (2)?

Answer 5

• alert and stable patients

- suffered cervical spine injury

Question 6

The Canadian C-Spine Rule are has 3 “high-risk factors” that mandate the need for radiographs, what are they?

Answer 6

• 65 years or older
• dangerous mechanism of injury
• paresthesias (pins and needles) in extremities
• just need one of the three

Question 7

If your patients clears the “high-risk factors” from the Canadian C-Spine Rule what are the 5 “low-risk factors” that allow for safe assessment of ROM that indicate the need to check for 45° of rotation left and right?

Answer 7

• simple rear-end motor vehicle collision
• sitting position in the emergency department
• ambulatory at any time
• delayed (not immediate) onset of neck pain
• absence of midline cervical-spine tenderness
• just need one of the five